BACKGROUND: Epidemiologic studies have shown an association between higher insulin levels and coronary artery disease, and metabolic studies have associated insulin resistance and compensatory hyperinsulinemia with non-insulin-dependent diabetes mellitus, hypertension, obesity,and lipid disorders.OBJECTIVE: To investigate the relationship between insulin resistance (IR) and erythrocyte insulin receptors (EIRs) in the patients with cerebral infarction (CI).DESIGN: Case-control trial.SETTING: Department of Neurology, China-Japan Union Hospital of Jilin University.PARTICIPANTS: From January 2004 to October 2004, 40 patients with CI, who were in-patients in China-Japan Union Hospital of Jilin University,were selected for the study. Meanwhile, 30 healthy doctors or nurses were recruited as normal controls.METHODS: The levels of blood glucose and serum insulin under fasting and 2-hour after oral glucose tolerance test (OGTT) were detected in the 40 patients with CI and 30 healthy doctors or nurses. Fasting blood glucose multiplied by fasting serum insulin was insulin resistance index (IRI). The number of insulin receptors and their binding affinity on every erythrocyte were determined using modified Gambhir's method. The correlation between the number of EIRs and IRI was analyzed.MAIN OUTCOME MEASURES: Comparison of CI group with controlRESULTS: Data of 40 patients with CI and 30 controls were analyzed, and under fasting and 2-hour after OGTT: The level of serum insulin under fasting and blood glucose, serum insulin at 2-hour after OGTT in CI group were higher than those in normal group [(13.30±5.15), (9.85±4.36) mU/L,(8.27±1.65), (6.32±1.37) mmol/L, (75.21±21.12), (28.26±6.31)mU/L,P ＜ 0.01,EIRs: The number of insulin receptors with high and low affinity and maximum specific binding rate in the patients with CI were significantly less than those in normal group [20.30±4.50, 23.80±4.10; 2 223.80±509.30,2 610.10±435.10; (10.62±3.55)%, (13.21±2.94)%, P ＜ 0.01]. Multiple linear regression analysis and correlation analysis showed the numbers of two types of EIRs in the patients with CI were negatively correlated with IRI (r=-0.458, -0.439, P ＜ 0.01, both).CONCLUSION: Insulin resistance can lead to cerebral infarction. Decrease in insulin receptors may play an importance role in cerebral infarction induced by insulin resistance.

Objective To explore the quadriceps muscles function in patients with unilateral knee injury.Methods 23 unilateral knee injured patients with joint dysfuntion were assessed with isometric EMG activity of vastus lateralis (VL), vastus medialis obliques (VMO) and rectus femoris(RF) of both thighs during three 5-s maximal isometric voluntary contractions at a knee joint angle of 30° (0° - full knee extension), and the torque were recorded at same time. Results The average amplitude (AEMG), mean power frequency (MPF), and median frequency (MF) of VL, VMO and RF in affected knees were significantly lower than those in unaffected knees（P＜0.01）, as well as the torque（P＜0.01）. In the unaffected side, the AEMG, MPF of VL were higher than VMO and RF（P＜0.05）, and RF than VMO（P＜0.05）. In the affected side, the AEMG, MPF of RF are higher than VMO and VL（P＜0.05）, and VL than VMO（P＜0.05）. Conclusion sEMG can provide quantitative measurements of muscle function. The isometric strength and neuromuscular activation lever are lower in affected limb, RF may be affected less than VL and VMO in knee injured patients with knee dysfunction.

AlM:To compare the clinical results of different surgical methods for diabetic antipathy.
METHODS: Eighty cases ( 102 eyes ) with diabetic antipathy were selected in our hospital from January 2012 to December 2013. Thirty-eight cases (48 eyes) in group A received joint surgical treatment, 42 cases (54 eyes) in group B took staging of surgical treatment. The clinical effect was observed in both groups.
RESULTS: The vision after surgery was improved than that of before surgery in two groups, there were no significant differences ( P > 0. 05 ). A postoperative complication rate was 16. 7% in group A and 22. 2% in group B, showed no significant difference (P>0. 05).
CONCLUSlON: Surgery and staging joint surgery are both feasible for diabetic retinopathy patients, can, improve the visionr. Both of them are worthy of clinical application.

AIM: To identify an unknown peak in Guanxinning Injection(Radix et Rhizome Salviae Miltiorrhizae,Rhizoma Chuanxiong) chromatographic fingerprint. METHODS: The elution(44-46 min) separated and collected by HPLC was analyzed by GC-MS and HPLC-PDA-MS-MS. RESULTS: The unknown peak was corresponding to senkyunolidel I. CONCLUSION: It is quick method to identify the reported chemical in herbal medicine based on a small quantity of sample by GC-MS and HPLC-PDA-MS-MS.

Objective To investigate clinical features and prognostic factors in acquired immune deficiency syndrome (AIDS) patients with opportunistic infections.Methods Forty-two cases of AIDS patients with opportunistic infections were enrolled in this study.Clinical data and major factors affecting the prognosis were analyzed using Logistic regression.Results Bacterial infection was the first etiological factor(57.1%) of opportunistic infections in AIDS patients.Eighty-three point three percent of patients infected with more than two kind of etiological agents.Fifty-seven point one per- cent of cases were infected in multiple sites.CD4~+ T cells count was associated with the opportunistic infections.Conclusions The CD4~- T lymphocytes count is the key factor affecting the prognosis of AIDS patients with opportunistic infections.The average of CD4~+ T lymphocytes count is significant- ly related with the major opportunistic infections in AIDS paitents.

Objective To investigate the regional cerebral stimulation after central analgesics nasal spray and its mechanism with pharmacological functional magnetic resonance imaging (phfMRI). Methods Eighteen healthy right-handed volunteers participated. Butorphanol tartrate nasal spray was used as the experiment agent. Ethological experiment was carried out to record the participants' subjective feeling and the onset time of the analgesics, followed by the functional MRI (fMRI) scan two weeks later. Block design was adopted. Two phases of fMRI scan were performed at 7 min and 25 min after the nasal spray, respectively. Participants were also given pain stimulation in the dorsum of hand during the fMRI scanning. The data were post-processed with Matlab 6.5 and SPM 2. Results ①Onset time of butorphanol tartrate was 15-35 min after nasal spray administration, which was consistent with its concentration-time curve. ②After nasal spray, activations were observed in the cerebral cortex, including frontal lobe (orbitofrontal gyrus, medial frontal gyrus, superior frontal gyrus), temporal lobe (insula, middle temporal gyrus, inferior temporal gyrus), parietal lobe (precuneal gyrus), limbic system (anterior cingulate gyrus, middle cingulate gyrus, hippocampus, parahippocampal gyrus);subcortical region (globus pallidus) and cerebellum (6-9 of cerebellar cortex, cerebellar peduncle, vermis). ③The number and activation intensity of the second phase were more obvious than those of the first phase (P<0.01). Conclusion The feasibility of phfMRI study on cerebral stimulation and the mechanism of nasal spray is demonstrated. The study of butorphanol tartrate further validates the main distribution of opioid receptors in the central nervous system and the possible mechanism of central analgesia.

The goal of the present study was to explore high-frequency rotation sensation function damage of the crista of the horizontal semicircular canal induced by gentamicin and its morphological basis. The guinea pigs were randomly divided into four groups (group 1, 2, 3 and control group, n=20). The animals of treated groups received gentamicin subcutaneously (50 mg/kg per day) for 1 week (group 1), 2 weeks (group 2) and 3 weeks (group 3), respectively. The animals of control group were administered with equal volume of saline subcutaneously. Videonystagmography (VNG) evoked by ice water or high-frequency rotations, and vestibular evoked potential (VsEP) evoked by low- and high-frequency rotations were recorded after the administration. After VNG and VsEP were examined, the cristae of the horizontal semicircular canals were prepared for scanning and transmission electron microscopy. The results are as follows: (1) In VNG examination, after ice water stimulation, no obvious nystagmus was observed in the animals of group 3, and there was no significant difference in nystagmus frequency and duration among group 1, 2 and control group (P>0.05). After high- frequency rotations, no obvious nystagmus was yet observed in the animals of group 3. There were significant differences in the nystagmus frequency and duration of the VNG waves between the experimental group 2 and control group (P<0.01), and no difference was found between group 1 and control group (P>0.05). (2) In VsEP examination, there was no significant difference in the parameters of VsEP among group 1, 2 and control group (P>0.05), and VsEP was not observed in group 3 after low-frequency rotations. After high- frequency rotations, compared with control group, the latencies and amplitudes of P1 and P2 in group 2 significantly decreased (P<0.01), while no changes were found in group 1 (P>0.05). Group 3 had no response of VsEP to high-frequency rotations. (3) Electron microscopy was used to observe the crista hair cells of the four groups. In control group, the hair cells were normal. In group 1, almost normal appearance with slight edema of the hair cells was shown. In group 2, some hair cells in the central top of the crista necrosed, but other hair cells in the peripheral area showed normal appearance. In group 3, vestibular hair cells were entirely impaired or necrosis. These results show gentamicin selectively induces high-frequency rotation sensation function damage of the crista of the horizontal semicircular canal. The damage is concentrated on the central top area and then subsequently extended to the peripheral area of vestibular crista. It can be inferred that the hair cells in the central top area of the crista are involved in high-frequency rotation vestibular perception.
Animals ; Gentamicins ; adverse effects ; Guinea Pigs ; Nystagmus, Physiologic ; Rotation ; Semicircular Canals ; physiopathology ; Vestibular Evoked Myogenic Potentials

Objective To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis. Methods Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged atⅢ-Ⅳ, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC). Results (1) The study group had a much higher incidence of 30%(13/44) on de novo SUI than that of control group (4%, 2/49;P<0.01). (2) Vaginal delivery (OR=5.327, 95%CI:1.120-25.347), constipation (OR=5.789, 95%CI:1.492-22.459), preoperative OSUI (OR=13.695, 95%CI:2.980-62.944), anterior vaginal wall prolapse (OR=6.115, 95%CI:1.231-30.379) were identified as dependent risk factors for de novo SUI by logistic regression analysis. (3) For POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P<0.05), the sensitivity reached 88.9%and specificity was 73.9%. According to ROC curve of Ba point, a cutoff value of+2.5 cm was chosen as the threshold to predicting incidence of de novo SUI post-operation, it had a sensitivity of 66.7% and specificity of 82.6%, AUC was 0.766 (P<0.05). Conclusions Pre-operative OSUI is a dependent risk factor of de novo SUI for advanced POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be considered as a risk predictor on forecasting the incidence of de novo SUI post pelvic reconstruction surgery.

Apoptosis ; drug effects ; Cell Division ; drug effects ; Esophageal Neoplasms ; pathology ; Humans ; Selenomethionine ; pharmacology ; Tumor Cells, Cultured