Objective To investigate the characteristic of type 2 diabetes (T2DM) patients with coronary heart disease (CHD),and provide methods for prevention and treatment for patients who suffered from CHD.Methods The hospitalized patients were divided into three groups.The treatment group contains 46 cases who were T2D with CHD;The control group Ⅰ contains 30 cases who were T2DM without CHD;The control group Ⅱ contains 50 cases who were CHD without T2DM.Their ordinary circumstances were compared;the blood sugar,BP,TC,TG,HDL,LDL,HbA1c,C-P,Ins were measured.Insulin sensitive index(ISI) was calculated.Results Three groups had obvious statistical differences in BP,TC,LDL-C,ISI,HbA1 c.Diabetic patients with CHD have more common with three lesions.Conclusion In the clinical job,the composite observation should be strengthened and treatment because the factors of atherosclerosis in T2DM patients were numerous and complex.

Third-generation aromatase inhibitors (AIs) have been considered as standard adjuvant endocrine therapy for hor-mone-responsive breast cancer in postmenopausal women. Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are prevalent among patients undergoing AI therapy;these symptoms result in reduced quality of life and poor dependence to AI treatment. The mechanisms mediating AIMSS and the effective management of AIMSS have not been extensively investigated. This article re-views the incidence, clinical characteristics, possible mechanisms, and treatment of AIMSS.

In order to examine the feasibility of cytokine fusion gene transfer into tumor cells, a retroviral vector (pLXSN) for human interleukin 6/interleukin 2 (IL6/IL2) fusion gene was constructed by using PCR and ligating the 2 genes with a synthesized flexible linker. The IL6/IL2 fused gene was introduced into B16 melanoma cell line mediated by retrovirus and the changes of adhesive and metastatic ability of fused gene-modified cells were detected. The B16-IL6/ IL2 cells showed efficient expression of both cytokines and decreased binding affinity with extracellular matrix (Laminin and Matrigel), accompanying with decreased experimental metastatic potentials. These data suggest that the mechanism involving the decreased metastases may relate with the changes of biological characteristics and immune stimulating activity of gene-modified cells.

Objective To assess the diagnostic performance of CT for detecting anastomotic leak after esophagectomy.Methods A total of 50 patients who underwent both CT and fluoroscopy after esophagectomy in our hospital from September 2013 to December 2015 were enrolled in this study.The fluoroscopy features and CT findings were analyzed retrospectively.Results The sensitivity,specificity,positive and negative predictive values were 100%,86.67%,83.33%,100%,respectively,for CT,and 85%,100%,100%,90.91%,respectively,for fluoroscopy.The differences in CT features,including leak of contrast,wall discontinuity and air-fluid collection in the mediastinum were statistically significant between leak and no leak(P=0.000,P=0.000,P=0.005,retrospectively),while no statistically significant in air collection in the mediastinum,hydropneumothorax,pleural effusion and pneumatosis.The maximum diameter of air collection in leak was(1.54±0.97)cm,while the maximum diameter of air collection in no leak was (0.56±0.20)cm,the difference in the maximum diameter of air collection between leak and no leak was statistically significant(P=0.007).Conclusion CT is more sensitive but less specific than fluoroscopy for detecting anastomotic leak.CT can be a better choice for the patients who can not tolerate the fluoroscopy or the fluoroscopy results is negative but anastomotic leak is still suspected.

Objective To investigate the value of MRI combined with serum CA125 test in the diagnose of ovarian tumor.Methods To investigate the MRI and serum CA125 level of healthy control group (40 cases),benign tumor group (52 cases),and the malignant tumor group (43 cases).Results Of 95 patients with ovarian masses,CA125 was detected in the malignant patients with the sensitivity of 79.3 ％,specificity of 72.6 ％ and accuracy of 75.1％.MRI was 73.8 ％,81.2 ％,and 82.6 ％ respectively.Combined with CA125 and MRI was 69.4 ％,97.3 ％,and 88.6 ％.Youden' s index of combined detection was significantly higher than single detection (MRI combined with CA125 and single MRI u =1.97,P =0.012 5,and CA125 u =1.96,P =0.012 0).Conclusion MRI combined with CA125 could improve the accuracy of diagnosis ovarian neoplasm in clinic.

Objective To evaluate the role of silent information regulator fac tor 2-related enzyme 1 (SIRT1)/Forkhead Box O3 (FoxO3a) signaling pathway in berberine pretreatment-induced reduction of hypoxia/reoxygenation (H/R)-caused injury to hepatic parenchymnal cells.Methods Hepatic parenchymal cells obtained from AML12 mice were cultured and seeded in 6-well plates (2 ml/well) and in 96-well plates (200 μl/well) at the density of l×l06 cells/ml.The cells were divided into 4 groups (n=36 each)using a randomn number table:control group (group C),group H/R,berberine pretreatment group (group BP) and SIRT1-siRNA group (group SS).The cells were cultured in normal culture atmosphere (5％ CO2-21％ O2-74％ N2) in group C.In H/R,BP and SS groups,the cells were exposed to hypoxic air (5％ CO2-1％ O2-94％ N2) for 12 h,followed by 6 h reoxygenation in normal culture atmosphere (5％ CO2-21％ O2-74％ N2).In group SS,small interference RNA targeting SIRT1 (SIRT1-siRNA) was added to the culture medium at 24 h prior to hypoxia.Berberine (final concentration 5 μmol/L) was added at 2 h prior to hypoxia in BP and SS groups.At the end of reoxygenation,the cell viability was measured by methyl thiazolyl tetrazolium assay,the malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were determined using enzyme-linked immunosorbent assay,cell apoptosis was detected by flow cytometry,the expression of SIRT1 and FoxO3α was detected by Western blot,and the acetylation of FoxO3α was measnred by using immunoprecipitation.Apoptotic rate was calculated.Results Compared with group C,the cell viability was significantly decreased,the MDA content was increased,the SOD activity was decreased,apoptotic rate was increased,the expression of SIRT1 and ratio of FoxO3α expression in nucleus/in cytoplasma were increased,and the acetylation of FoxO3α in the nucleus was increased in H/ R,BP and SS groups (P＜ 0.05).Compared with group H/R,the cell viability was significantly increased,the MDA content was decreased,the SOD activity was increased,apoptotic rate was decreased,the expression of SIRT1 and ratio of FoxO3α expression in nucleus/in cytoplasma were increased,and the acetylation of FoxO3α in the nucleus was increased in group BP (P＜0.05).Compared with group BP,the cell viability was significantly decreased,the MDA content was increased,the SOD activity was decreased,apoptotic rate was increased,the expression of SIRT1 and ratio of FoxO3α expression in nucleus/in cytoplasma were decreased,and the acetylation of FoxO3α in the nucleus was decreased in group SS (P＜O.05).Conclusion The mechanism by which berberine pretreatment attenuates H/R-caused injury to hepatic parenchymal cells is related to promotion of SIRT1 expression in cells and inhibition of FoxO3α acetylation in the nucleus.

T he finite element method (FE m) is a mathematical technique using modern computer tech-nology for stress analysis, and has been gradually used in simulating human body structures in the biomechanical field, especially more widely used in the research of thoracolumbar spine traumatology. T his paper reviews the establishment of the thoracolumbar spine FE m, the verification of the FE m, and the thoracolumbar spine FE mresearch status in different fields, and discusses its prospects and values in forensic thoracolumbar traumatology.

Objective To evaluate the effect of dexmedetomidine on myocardial injury in pediatric patients undergoing living-related liver transplantation. Methods Fifty-eight pediatric patients of both sexes,aged 5-20 months,weighing 4.5-15.0kg,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,scheduled for elective living-related liver transplantation,were divided into 2 groups(n=29 each)using a random number table:control group(group C)and dexmedetomidine group(group D).In group D,dexmedetomidine was intravenously infused at a dose of 0.5 μg/kg over 10min starting from the time point immediately before skin incision,followed by an infusion of 0.8 μg·kg-1·h-1 until the end of surgery. The equal volume of normal saline was given instead in group C. Immediately before skin incision(baseline,T0),at 10min of anhepatic phase(T1),at 30min of neohepatic phase(T2)and at the end of surgery(T3),blood samples were obtained from the central vein for determination of serum cardiac troponin I(cTnI),lactate dehydrogenase(LDH),alpha-hydroxybutyrate dehydrogenase(α-HBDH),interleukin-6(IL-6)and IL-10 concentrations. The changing rate of serum cTnI concentrations were calculated at T2. The occurrence of myocardial ischemia and ventricular premature beat and requirement for dopamine were recorded during surgery. Results Compared with the baseline at T0,the serum concentrations of cTnI,LDH and α-HBDH were significantly increased at T2,3,and the serum concentrations of IL-6 and IL-10 were increased at T1-3 in both groups(P<0.05).Compared with group C,the serum concentrations of cTnI,LDH,α-HBDH and IL-6 were significantly decreased at T2,3,the serum concentration of IL-10 was increased at T1-3,the changing rate of serum cTnI concentrations was decreased(P<0.05),and no significant change was found in the incidence of myocardial ischemia and ventricular premature beat and requirement for dopamine in group D(P>0.05).Conclusion Dexmedetomidine can attenuate the myocardial injury to some extent in pediatric patients undergoing living-related liver transplantation.

Clinical data were retrospectively analyzed in 20 cases with Hashimoto's thyroiditis complicated with subacute thyroiditis from February 2009 to April 2013.85％ of the patients showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).Thyroid peroxidase antibody (TPOAb) was found in 95 ％ of the patients,while thyroid globulin antibody (TgAb) in 100％.Uptakes of radioactive iodine were lowered.Symptoms such as fever or pain were ameliorated quickly after treatment with glucocorticoids or non-steroidal anti-inflammatory drugs.

Objective To confirm the protective effect of berberine (BBR) on cold ischemia reperfusion (I/R)-induced liver injury and to show whether the hepatic protection conferred by BBR involves the activation of phosphatidylinositol 3 kinase (PI3K) / protein kinase B (Akt)/mammalian target of rapamycin(mTOR) signal pathway.Method Adult male Sprague-Dawley rats were assigned randomly to four groups:BBR group (BBR was intragastrically administered at a dose of 100 mg·kg-1 · d-1 2 weeks before hepatic cold I/R treatment),dimethyl sulfoxide (DMSO) group (BBR was replaced by DMSO,and others were the same as BBR group),I/R group (BBR was replaced by normal saline,and others were the same as BBR group) and sham group (normal saline was administered 2 weeks before opening and closing abdomen treatment).Then the rats were sacrificed at 3,6,and 24 h after reperfusion.The liver function,oxidative stress level,apoptosis rate,and the expression of PI3K/Akt/mTOR related pathway proteins were assayed.Result As compared with sham group,the I/R-induced liver tissue displayed severe lobular distortion with widespread necrosis,high level of oxidative stress and apoptosis rate.As compared with I/R group,BBR dramatically attenuated the histopathologic damage,restored the liver function and decreased the oxidative stress level.Simultaneously,BBR significantly ameliorated the apoptosis by decreasing the apoptosis rate,increasing the Bcl-2/Bax ratio and inhibiting caspase-3 activity in rats subjected to hepatic I/R.The expression of p-Akt was effectively upregulated with the inhibited expression of p-mTOR.Conclusion Our result provides robust in vivo evidence that BBR can prevent I/R-induced oxidative stress and apoptosis.The mechanisms involved can be attributed to the activation of P]3K/Akt/mTOR signal pathway.