Objective To evaluate the possibility of slow and rapid liquid nutrient loading test (LNLT) in the proximal gastric function assessment according to the results of gastric barostat testing.Methods From April to August in 2013,20 healthy volunteer were selected.The sensitivity of gastric,basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds were examined by barostat.The average gastric volume after fasting was tested by barostat,which reflected gastric accommodation.And then 200 mL liquild meal was taken in five minutes by the volunteers.The difference value between the maximum gastric volume in 60 minutes after taking the meal minus the average gastric volume after fasting was used to evaluate the proximal gastric adapted diastolic function.In LNLT,volunteers drank 100 mL/min and 15 mL/min (rapid and slow) liquid meal.The threshold value of drinking volume,satiety drinking volume and maximum drinking volume were determined.Pearson correlation analyses were performed in the results of fast and slow LNLT,correlation between LNLT and sensitivity of gastric,gastric adapted diastolic function tested by barostat.Results The basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds,gastric volume after fasting,maximum gastric volume and adapted diastolic volume was (6.8±1.2) mmHg (1 mmHg=0.133 kPa),(2.7±1.9) mmHg,(5.2±2.0) mmHg,(7.3-±-2.1) mmHg,(188.7-±-80.0) mL,(505.2±133.7) mL and (316.5±87.7) mL,respectively.The maximum gastric volume after the meal was at (9.8±3.3) min after meal.In rapid LNLT,the threshold value of drinking volume,satiety drinking volume and maximum drinking volume of volunteers was (209-±-96),(501±148) and (674±199) mL,respectively,and that in slow LNLT was (107 ± 43),(340 ± 134) and (524 ± 213) mL,respectively,there was correlation between rapid and slow LNLT (r=0.768,0.825 and 0.856,all P＜0.01).The maximum drinking volume of rapid and slow LNLT was at (8.6± 1.2) and (34.9±6.4) minutes after meal.Threshold value of drinking volume in the slow drinking test was positively correlated with the gastric sensing threshold (r=0.714,P＜0.01).Satiety drinking volume in the slow drinking test was correlated with gastric sensing threshold,gastric discomfort and pain thresholds (r=0.599,0.650 and 0.622,all P＜0.01).The proximal gastric adapted diastolic volume was related with slow satiety drinking volume,rapid satiety drinking volume,slow maximum drinking volume and rapid drinking volume (r＝0.543,0.636,0.527 and 0.493,all P＜0.05).Conclusions Threshold value of drinking volume and satiety drinking volume in the slow LNLT is more suitable for evaluating the sensitivity of stomach.Satiety drinking volume in the rapid LNLT is more suitable for the evaluating of gastric adapted diastolic function.

Objective To investigate the different distribution and expression of mammalian target of rapamycin complex (mTORC) in the kidney of diabetic nephropathy (DN) mice.Methods Fourteen eight-week-old male C57BL/6 mice were assigned to 2 groups: the control group ( n=7 ) and the streptozotocin ( STZ )-induced DN group ( n=7 ) . Blood and urinary variables including glucose , albumin, creatinine and albumin/creatinine ratio were assessed 2 weeks after STZ injection.Hematoxylin-eosin staining was performed for renal pathological analyses .The distributions of mTOR , phosph-ser2448-mTOR(p-mTOR), mTORC1(Raptor), mTORC2(Rictor) and phosph-ser240/244-S6K1 (p-S6K1) were determined by immunofluorescence.The expression levels of mTOR, p-mTOR, mTORC1(Raptor), mTORC2(Rictor), S6K1 and p-S6K1 were detected by Western blotting .Results Two weeks after STZ injection , the diabetic mice developed albuminuria (P<0.01) and renal hypertrophy (P<0.05).The immunofluorescence positive staining for mTOR , Raptor, and Rictor was distributed in the epithelial cells of proximal tubules , glomerular mesangium and capillary loops as well as the medullary collecting ducts of the control mouse kidney .These positive signals increased in the DN mouse kidney ( P<0.05).However, pS6K1 was not detected in the inner medulla of control mouse and p-mTOR was not found in the glomeruli of both control and DN mice .Conclusion mTORC is widely expessed in the mouse kidney and participates in the development of DN , whereas the 2448 serine phosphorylation of mTOR may be not implicated in the hyperglycemia mediated glomerular injury .

Objective To explore the risk factors of vascular cognitive impairment (VCI)among Chinese population, and to clarify the scientific evidences for further prevention and treatment.Methods PubMed,CNKI,CBM,VIP and Wangfang databases (from 2002.1 to 2013.1)were searched to collect case-control studies or cohort studies studying risk factors of VCI among Chinese population. Meta-analysis was performed to calculate combined odds ratio (OR)or mean difference (MD)and its 95% confidence interval (95%CI).Results A total of 42 proper papers involving 3 282 cases and 7 815 controls were included in the review.For categorical variables,pooled OR and its 95% CI were as follows:hypertension 2.56 (2.03 - 3.21 ), hyperlipidemia1.79 (1.39 - 2.30 ), hyperglycemia 2.46 (1.90-3.19),Leukoaraiosis 5.46 (2.60-11.46),cerebral infraction multiple foci 4.39 (2.61-7.38),stroke history3.79(2.35-6.11),left hemisphere lesions 2.13(1.42-3.20),smoking 1.51 (1.08-2.11),drinking 0.99(0.73-1.36),basal ganglia lesions 2.15(1.55-2.99),thalamus lesions 2.34(1.57-3.47);for continuous variables,MD and its 95%CI were as follows:level of TG 0.35(0.15-0.55),level of TC 0.44(-0.16-1.04),level of folic acid -4.10(-5.50- -2.69),vitamin B12 -130.44(-225.46--35.41).Conclusion Except for drinking and level of TC, hypertension, hyperlipidemia, hyperglycemia, leukoaraiosis,cerebral infraction multiple foci,stroke history,left hemisphere lesions,smoking,basal ganglia lesions,thalamus lesions,high level of TG,low level of folic acid and vitamin B12 might be the risk factors of VCI among Chinese population.

Objective To explore the pathological changes of lung, expression of the relevant inflammatory factors and oxidative stress markers of Sprague-Dawley (SD) rats undergoing autologous orthotopic liver transplantation (AOLT). Methods Thirty SD rats were randomized into sham group and AOLT group. The pathological changes of lung, expression of the relevant inflammatory mediators and oxidative stress markers were detected . Results ( 1 ) Compared with the sham group , the pathological scores of lung tissue in AOLT group increased significantly and reached its peak at 8 h after surgery. Then the pathological scores decreased to the level of sham within 24 h to 48 h after surgery; (2)The relative expression of inflammatory mediators including TNF-α, IL-1β, IL-6 and IL-8 increased significantly and reached its peak at 8 h after surgery in AOLT group. Then decreased to the level of sham group within 24 h to 48 h after surgery; (3)The change trends of MDA and H2O2 were similar to inflammatory mediators.The relative SOD expression decreased significantly and touched the nadir at 8h after surgery and then increased. Conclusion The pathological changes of lung expression, the relevant inflammatory mediators and oxidative stress markers of rats underwent AOLT were consistent.

Objective To study the FDG SUVmax cutoff values in detection of metastases in mediastinal lymph nodes (MLN) and hilar/intralobar lymph nodes (HILN) in pre-operative patients with N0-2 stage NSCLC.Methods A total of 69 patients with stage N0-2 NSCLC (40 males,29 females,age 36-87 years) were included in this retrospective study.18F-FDG PET/CT was performed and followed by lung cancer resection with lymph node dissection in 1 month.The excised lymph nodes were compared one by one between their SUVmax and histopathology.The SUVmax cutoff value in detection of lymph node metastases was determined by the ROC curve.Mann-Whitney u test,x2 test,and Fisher exact test were used for data analysis.Results Metastatic MLN and (or) HILN were found in 21 of 69 NSCLC patients.The histopathologic results demonstrated metastases in 61 of 339 lymph nodes.The SUVmax of metastatic lymph nodes (4.95(3.46,7.19)) was significantly higher than that of benign lymph nodes (2.10(1.59,3.22);z=-7.576,P＜0.05).The SUVmax of metastatic HILN (6.32 (4.28,8.27)) was significantly higher than that of metastatic MLN (3.90(2.12,6.41);z=-2.921,P＜0.05).With cutoff of SUVmax ≥2.5,the sensitivity,specificity and accuracy in detection of all metastatic lymph nodes were 83.6％ (51/61),61.9％ (172/278)and 65.8％ (223/339) respectively,and the parameters were 74.2％ (23/31),79.6％ (160/201) and 78.9％ (183/232) for metastatic MLN,and 93.3％ (28/30),15.6％ (12/77) and 37.4％ (40/107) for metastatic HILN.The diagnostic sensitivities for metastatic MLN and for metastatic HILN were not significantly different (Fisher exact test,P＞0.05),while the specificities and accuracies between the two groups were significantly different (x2 values:96.7 and 56.1,both P＜0.05).According to ROC curves,cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN were 2.78 and 4.93.With the specific cutoff value,the sensitivity,specificity and accuracy in detection of metastatic MLN were 71.0％ (22/31),87.1％ (175/201)and 84.9％(197/232),respectively.The corresponding data in detection of metastatic HILN were 73.3％ (22/30),77.9％(60/77) and 76.6％(82/107).Conclusion Different cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN should be considered for more accurate lymph nodes staging in patients with NSCLC.

In this study, the effects of hyperosmolality on the expression of urea transporter A2 (UTA2) and aquaporin 2 (AQP2) were investigated in transfected immortalized mouse medullary collecting duct (mIMCD3) cell line. AQP2-GFP-pCMV6 and UTA2-GFP-pCMV6 plasmids were stably transfected into mIMCD3 cells respectively. Transfected mIMCD3 and control cells were cultured in different hypertonic media, which were made by NaCl alone, urea alone, or an equiosmolar mixture of NaCl and urea. The mRNA and protein expression of AQP2 was elevated by the stimulation of NaCl alone, urea alone and NaCl plus urea in AQP2-mIMCD3 cells; whereas NaCl alone and NaCl plus urea rather than urea alone increased the mRNA and protein expression of UTA2 in UTA2-mIMCD3 cells, and all the expression presented an osmolality-dependent manner. Moreover, the mRNA and protein expression of UTA2 rather than AQP2 was found to be synergistically up-regulated by a combination of NaCl and urea in mIMCD3 cells. It is concluded that NaCl and urea synergistically induce the expression of UTA2 rather than AQP2 in mIMCD3 cells, and hyperosmolality probably mediates the expression of AQP2 and UTA2 through different mechanisms.

Objective The paper is an attentative effort to evaluate the reaction and mechanism of estrogen on pregnant rabbits with acute lung injury caused by hemorrhagic shock. Methods Sixty pregnant New Zealand white rabbits were randomly divided into 6 groups, with 10 rabbits in each group, namely normal control group (NG group, with anesthesia only), estrogen group (E2G group, with additional estrogen injection at 60 min) and the other four hemorrhagic shock groups underwent hemorrhagic shock (i.e. E2SG, FSG, SBSG, E2SBSG group;mean blood pressure-40 mmHg(1 mmHg=0.133 kPa)by phlebotomy for 15 min. After maintenance of the pressure for 45 min, the rabbits were treated with E2(0.37 mg/kg), fructose injection(5%,2 ml/kg), the p38 mitogen-activated protein kinases(p38MAPK) inhibitor SB-203580 (2 mg/kg) or E2 plus SB-203580. Tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) were measured at different time points(0 min, 60 min, 80 min and 260 min), lung tissue methane dicarboxylic aldehyde(MDA) level, lung tissue myeloperoxidase(MOP), superoxide dismutase(SOD) activity, lung tissue dry weight/wet weight (DW/WW) value were measured after the experiment was finished, pulmonary pathology of the rabbits was observed. Result (1) Serum TNF-α level of NG group and E2SG group were not significantly different compared with the other four groups at the 0 min and 60 min. At 80 min and 260 min of experiment, serum TNF-αlevel of all the four shock groups were increased, E2SG group [(172.4±16.0) and (216.7±18.6) ng/L], FSG group [(171.6 ± 9.1) and (263.9 ± 7.8) ng/L], SBSG group [(172.8 ± 7.2) and (300.6 ± 4.8) ng/L], E2SBSG group [(167.9±4.8 )and (261.8±9.6) ng/L], and significantly higher than NG group and E2G group, separately (P<0.05). (2) Serum IL-6 level of NG group and E2SG group were not significantly different compared with the other four groups at the 0 min, 60 min and 80 min. At 260 min, the serum IL-6 level[(98.3 ± 0.9) and (110.4 ± 1.8) ng/L;(120.9 ± 2.3)and (109.8 ± 2.6) ng/L] of the four shock groups (E2SG, FSG, SBSG, E2SBSG group) were significantly higher than NG group and E2G group (P<0.05). (3) Lung tissue MDA level [(2.20± 0.12),(2.57±0.11),(3.17±0.08), (2.75±1.09) nmol/mg] and MPO activity [(4.45±0.25),(6.65±0.56),(9.55±0.30), (6.78 ± 0.11) U/mg] of the four shock groups (E2SG, FSG, SBSG, E2SBSG group) were higher than NG group and E2G group (P<0.05). (4) Lung tissue SOD activity [(51.8 ± 1.8),(40.2 ± 1.5), (30.0 ± 1.7),(41.2 ± 2.0) U/mg] was significantly higher in the four shock groups(E2SG, FSG, SBSG, E2SBSG group) compared with NG group and E2G group (P<0.05). (5) Lung tissue DW/WW value(0.143 ± 0.008, 0.127 ± 0.008, 0.109 ± 0.006, 0.125 ± 0.008) was significantly lower in the four shock groups(E2SG, FSG, SBSG, E2SBSG group) compared with NG group and E2G group (P<0.05). (6) Lung tissue of the rabbits in NG group and E2G group is basically normal without obvious pathology changes. Lung tissue pathological damage of rabbits was observed in the four shock groups, and the pathological damage of rabbits in SBSG group was most serious. Conclusion Estrogen can reduce acute lung injury of pregnant rabbits with hemorrhagic shock, the p38MAPK pathway plays a critical role in mediating the salutary effects of E2 on shock-induced acute lung injury.

Objective To study the predictive value for adverse cardiac events (ACE) of left ventricular diastolic function measured by G-MPI. Methods Patients assessed by 2 days rest-stressed G-MPI during March 2012 to May 2013 in Beijing Hospital were collected and observed for the cumulative survival rate without ACE after G-MPI. ACE included cardiac death, non-fatal MI and late revascularization (60 d after the examination). Using quantitative gated SPECT (QGS) to get the LVEF and left ventricular peak filling rate (PFR). Using 17 segments, 5-point scoring system to get the summed stress score (SSS). Cox regression analysis was used to identify the independent predictors for ACE, and Kaplan-Meier method was used to investigate the cumulative survival rate without ACE.χ2 test was also used. Results A total of 11 patients who underwent early revascularization (within 60 d after G-MPI) were excluded and 139 patients (76 males, 63 females; average age 68.73 years) were assigned to different groups for outcome analysis, and 9 (6.5%, 9/139) patients had ACE in the whole group. Cox regression analysis showed that SSS, LVEF, PFR were the independent predictors for ACE (all P<0.05). Patients with PFR<2.1 EDV/s had a higher incidence of ACE than those with PFR≥2.1 EDV/s (14.3%(7/49) vs 2.2%(2/90), χ2=7.63, P<0.05). Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE was lower in patients with PFR<2.1 EDV/s than that in patients with PFR≥2.1 EDV/s (67.7% vs 95.0%), and lower in patients with LVEF<50% than that in patients with LVEF≥50%(32.0% vs 90.8%), and also lower in patients with SSS≥8 than those with SSS<8(62.0% vs 94.7%; χ2 values: 11.92,11.27, 10.40, all P<0.01).Combining PFR with SSS and LVEF respectively, Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE in patients with LVEF≥50% was higher than that in patients with LVEF<50% when PFR<2.1 EDV/s (76.7% vs 30.8%), and also higher in patients with SSS<8 than that in patients with SSS≥8 when PFR≥2.1 EDV/s (100% vs 72.2%; χ2 values: 7.14, 13.09, both P<0.01). Conclusion PFR of left ventricular diastolic function measured by G-MPI is one of the independent predictors for ACE, and it could effectively improve the predictive value for ACE if combined with LVEF and SSS.

Objective:To investigate the awareness of diabetic retinopathy (DR) prevention and treatment knowledge of diabetic patients in the community of Shenzhen, and analyze its influencing factors.Methods:A cluster random sampling method was used to select 904 patients with diabetes diagnosed in 6 community health service centers in 2 administrative districts of Shenzhen and included in this study. Questionnaire survey of patients were performed to understand their knowledge of DR prevention and treatment. The multi-factor logistic regression analysis method was used to analyze the related influencing factors of DR prevention knowledge awareness.Results:Among 904 patients, 144 patients (15.93%, 144/904) knew about DR prevention and treatment knowledge. The highest awareness rate were about "Diabetes can affect vision and even cause blindness" (88.60%, 801/904). The lowest awareness rate (6.20%, 56/904) were about "DR treatment methods". About "diabetes requires regular fundus examinations" and "diabetics", the awareness rate of fundus examination interval were less than 50.00%. The results of multivariate logistic regression analysis showed that gender [odds ratio ( OR)=1.595], education level ( OR=2.963, 3.937), monthly income level ( OR=3.871, 4.675), diabetes course ≥15 years ( OR=1.829), treatment measures ( OR=3.318, 4.512). Whether people had DR ( OR=1.605) were important factors that affected the awareness of DR prevention and treatment knowledge ( P<0.05). Conclusions:The overall awareness of DR prevention and treatment knowledge among diabetic patients in the community of Shenzhen is relatively low. Males, low education and income levels are the main influencing factors.

Objective:To introduce recent progress on diagnosis and treatment of benign symmetric lipomatosis(BSL).Method:Detailed clinical data of 6 patients with BSL were reviewed and analyzed.We present a summary of the clinical symptoms,physical sign,diagnosis and therapeutic methods of BSL. And related literatures were discussed together.Result:All of 6 patients have excessive subcutaneous fat deposit predominantly around neck.One patients had upper extremity localizations. Six patients had the complication of left ventricular diastolic function changes,glucose intolerance or diabetes mellitus, chronic hepatopathy, hyperuricemia and sleep apnea syndrome in one or more. One patients with several symptoms occur simultaneously, another one female patient was accompanied by all symptoms but chronic hepatopathy. Five male patient were alcohol abusers. Tatal neck lipentomy and abstinence from alcohol were performed on 5 patients. One patient refused treatment.During a follow-up of 3 months to 4 years, one patients was relapsed again,and no recurrence was seen in another 4 patients. All pathological results were nonencapsulated fat. Conclusion:BSL is a lipodystrophy caused by diffuse fatty tissue, symmetry deposition in the neck and shoulder subcutaneous fascia space or deep fascial space .The highest incidence favors to middle-aged man who is alcoholist. Chronic alcohol addiction and typical clinical symptoms help to diagnosis BSL. Lipectomy represents a successful procedure in treating BSL.