Objective To investigate the association of cytotoxic T lymphocyte associated antigen 4(CTLA 4) gene polymorphism with type 1 diabetes in Chinese Han population.Methods The A/G phenotype at position 49 of the CTLA 4 gene exon 1 was determined by polymerase chain reaction restriction fragment length polymorphism(PCR RFLP)method in 33 typical type 1 diabetes patients,57 latent autoimmune diabetes in adults(LADA) patients and 84 healthy control subjects of Chinese Han.Results The frequency of the CTLA 4/G 49 phenotype was significantly higher in type 1 diabetes patients than in control subjects(55.6% vs 36.9%, respectively, P =0.0005),but there was no significant difference between typical type 1 DM and LADA groups. Neither the presence nor the absence of G 49 allele influenced the occurrence of islet autoantibody(ICA) and glutamate decarboxylase antibody(GADAb).Conclusion The polymorphism of CTLA 4 gene exon1 confers susceptibility to type 1 diabetes. This association is independent of ICA and GADAb.

BACKGROUND:Receptor-interacting protein 140-knockout mice are lean and resistant to high fat diet-induced obesity due to an increase in mitochondrial biogenesis, fatty acid oxidation and oxidative phosphorylation.
OBJECTIVE:To study the expression level of receptor-interacting protein 140 mRNA in adipose tissue of high fat diet-induced obese mice and the correlation with insulin resistance.
METHODS:Male C57BL/6J mice were randomly divided into control group and high fat diet group, and fed for 14 weeks separately. The mice of the two groups were weighed. Mice in high fat diet group whose body weight were 20%higher than average weight of control mice were selected as obese mice.
RESULTS AND CONCLUSION:A total of 12 mice in high fat diet group were recruited into the obesity group. The levels of triglycerides, total cholesterol, fast blood glucose and fast insulin in obesity group were significantly higher than those of control group (P<0.05 or P<0.01). The expression of receptor-interacting protein 140 mRNA in adipose was significantly higher in obesity group compared with the controls (P<0.05). Moreover, the expression of receptor-interacting protein 140 mRNA in adipose was positively correlated with triglycerides levels and insulin resistance index (r=0.526, P<0.05;r=0.465, P<0.05), but negatively associated with the levels of total cholesterol, fast blood glucose and fast insulin (P>0.05).

Objective To compare the endocrine and metabolic parameters between patients suffering from polycystic ovary syndrome (PCOS) with or without subclinical hypothyroidism.Methods One hundred and fifty-six PCOS patients and 47 healthy controls were enrolled.Height,weight,waist circumference,and hip circumference were measured and recorded.Fasting blood samples were collected for measuring luteinizing hormone (LH),follicular stimulating hormone (FSH),total testosterone,prolactin,estrogen,sex hormone binding globulin (SHBG),thyroidstimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),blood glucose,serum insulin,triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol (HDL-C).Body mass index,waist-to-hip ratio,LH-to-FSH ratio,and free androgen index (FAI) were calculated.Homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-β) were assessed.All patients underwent ultrasound for diagnosing polycystic ovary.All the patients were subdivided into two groups in terms of TSH value:subclinical hypothyroidism group with TSH level ≥4.2 μIU/ml and non-subclinical hypothyroidism group with TSH level＜4.2 μIU/ml.The differences in endocrine and metabolic parameters were compared between two subgroups.Results Compared with healthy controls,the PCOS patients had significantly higher body mass index,waist-to-hip ratio,LH,LH-to-FSH ratio,total testosterone,FAI,TSH,and lower SHBG (all P＜0.05).The other indexes were not different between two groups (P＞0.05).24.4％ PCOS patients were diagnosed as cases of subclinical hypothyroidism.TSH,prolactin,and triglycerides levels were higher in PCOS patients with subclinical hypothyroidism than those without (P＜0.01).Whereas estrogen,FT3,FT4 were significantly lower(P＜0.01).The differences of other parameters were not significant between two groups(P＞0.05).The results of correlation analysis and TSH quartiles showed no significant linear correlation between TSH and sex hormones,lipids,insulin resistance indices (P＞0.05).Conclusions The incidence of subclinical hypothyroidism in all PCOS patients is 24.4％.Prolactin and triglycerides levels were higher in PCOS patients with subclinical hypothyroidism than those without.Whereas estrogen,FT3,FT4 were significantly lower.

Objective　To investigate the association of gene polymorphism of cytotoxic T lymphocyte-associated antigen 4（CTLA-4） with autoimmune thyroid diseases. Methods　The A／G transition polymorphism at position 49（exon 1，codon 17） of the CTLA-4 gene was determined by polymerase chain reaction restriction fragment length polymorphism （PCR-RFLP）method in 122 autoimmune thyroid diseases patients which included 87 Graves’ disease （GD） patients and 35 Hashimoto's thyroiditis（HT） patients， as well as 84 control subjects. We detected their thyroid function by ELISA technique， and the thyroid autoimmune antibodies （TGAb，TPOAb） by indirect immunofluorescent technique. Results　The strong association of the CTLA-4／G49 allele with AITDs was seen in our study（66.4％ vs 36.9％ P＜0.0001）. The G allele in GD patients was significantly increased compared with control subjects（69.5％ vs 36.9％， P＜0.0001）. In HT patients， the frequency of G allele was also higher than control subjects（58.6％ vs 36.9％，P＜0.01）， and there was no significant difference between HT and GD groups. When GD and HT subjects were stratified with respect to sex， neither female nor male patients demonstrated evident association of G49 allele with gender.Conclusions　The polymorphism of CTLA-4 gene （exon 1 condon 17 position 49）confers susceptibility to AITDs. This association is independent of sex.

BACKGROUND:Pretreatment is a dominant way to increase the histocompatibility of biomaterials,but many pretreatments are not satisfactory due to some reactions,such as calcification,cytotoxic reaction and reducing the tension resistance.OBJECTIVE:To investigate the effect of immunogenicity,scaffold tension and cell growth factor on the non-pretreated scaffold biomaterials,and to prepare the homograft decellularized scaffolds.DESIGN:Contrast observation for the histomorphology.SETTING:The experiments were carried out in the Department of General Surgery,Affiliated Hospital of Nantong University from June 2006 to March 2007.MATERIALS:Wistar rats of SPF grade were adopted in this study.Sodium dodecyl sulfate from BioteehGrade Company(U.S.A.);basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) from Peprotech Company(UK);dynamometer from Suzhou Electrical Element First Factory (China).METHODS:The vena cava inferior from rats were selected as experimental materials,we decellularized the epithelial cells from vein according to the improved Booth's methods with low osmotic Tris buffer containing sodium dodecyl sulplate,and then reserved the extracellular matrix.After fixing,the decellularized scaffold was stained by hematoxylin and eosin,the collagen fibers were observed and photographed by light microscope and scanning electron microscope.Changes of the intensity of the scaffolds were measured before and after decellularization.The deceilularized scaffolds were transplanted subcutaneously at homogeneity rats to observe whether the scaffolds had induced immunological rejection.In combination with bFGF and/or VEGF,the scaffolds were transplanted subcutaneously at homogeneity rats and took out two weeks later,in order to exam the new vessels in the scaffolds by immunohistochemistry.Dynamometer was applied to compare the change of the intensity of the scaffolds before and after transplantation.MAIN OUTCOME MEASURES:Change of the intensity of the scaffolds after decellularization and transplantation.Formation of new vessels in scaffolds.Local rejection of the scaffold subcutaneously transplanted into rats.RESULTS:The endothelial cells of the vein were completely removed when incubated with Tris buffer containing 0.03% sodium dodecyl sulfate for 48 hours.Results of hematoxylin and eosin staining,light microscope and scanning electron microscope showed that,the main components of extracellular matrix (collagen fiber) were reserved.There was no significant difference in the morphological structure and the intensity of collagenous scaffolds before and after decellalarization (P＞0.05).There was no apparent reject reaction at the embedded site,local incisions healed well.New vessels could be observed in the scaffolds two weeks later.There was no significant difference in the intensity of collagenons scaffolds before and after inoculation (P＞0.05).CONCLUSION:The low osmotic Tris buffer containing 0.03% sodium dodecyl sulfate is suitable for decellularizing the vein.The homograft collagenous scaffolds exhibit no rejection after transplantation,and the intensity of the scaffolds does not descend.VEGF and bFGF can improve the growth of new vessels in the decellularized scaffolds,and have a synergistic effect.

Pain is one of the common symptoms of cancer which seriously affects the quality of life of the patients. Cancer pain is mainly treated with the three-step method, biological therapy or nerve block therapy based on antitumor therapy. However, up to 50 percent of patients with cancer-related pain do not receive adequate pain relief, affecting their physical and psychological well-being, and leading to a lower quality of life for the patient after conventional treatment. Clinical observation suggests that traditional Chinese medicine may alleviate cancer-related pain either by oral administration, topical administration, acupuncture or other means with continuing non-addictive and non-drug-resistant qualities. However, scientific evaluation of the efficacy of herbs in the treatment of pain is insufficient; the underlying mechanisms are unclear and, safety and toxicity remain a concern.

Objective To explore a kind of comfortable medical for ervical plexus anesthesia auxiliary anesthesia .Methods 80 thyroidectomy female patients were randomly divided into normal saline group (group A) ,droperidol-fentanyl group (group B) ,bu-torphanol group (group C) ,dex group (group D) ,20 cases in each group .The change of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,heart rate (HR) ,blood oxygen saturation (SpO2 ) ,narcotrend index (NTI) were monitored .The above pa-rameters were recorded at 10 min before cervical plexus(T0 ) ,cervical plexus operation(T1 ) ,skin incision(T2 ) ,separation of thyroid upper extreme(T3 )and suture(T4 ) .Results There was no significant difference between the groups A and B at the same time point (P>0 .05) .In group C ,the SBP、DBP、HR at T3 and T4 were significant higher than at T0 ,and at the same point the A and B group decreased statistically significant (P<0 .05) .In group D ,the SBP、DBP、HR at T2 、T3 、T4 were significant lower than at T1 ,espe-cially at T4 compared to at T0 (P<0 .05) .Compared to group A ,B ,C ,the SBP、DBP、HR in group D were lower at T3 and T4(P<0 .05) .NTI in group D at T1 、T2 had significant difference compared with group A and B (P<0 .05) ,especially at T3 、T4 were sta-tistically significant than the other three groups(P<0 .05) ,sedation was better than the other groups .Conclusion Cervical plexus block supplemented by dex can reduce the patient′s stress response and reach moderate sedation analgesia to comfortable medical purposes .

Objective To investigate the significance of the expression of serum LDH and β2-MG in predicting survival of NHL patients and there correlations with clinical parameters. Methods The serum levels of LDH and β2-MG of 429 patients with NHL were measured by rate method and immunoturbidimetry.Besides,the clinical reference of the patients such as gender,age,B symptoms,clinical stages,extranodal sites and Karnofsky evaluation were summarized and grouped.All patients' survival status were achieved via phone and letter. All statistical analyses were performed using the SPSS program for Windows (version 16.0).Results The levels of LDH and β2-MG in age,B symptom,the advanced stage,extranodal sites≥2,Karnofsky evaluation were obviously higher than their counterpart and the difference was significant (P＜0.001). The median of LDH and β2-MG lever in age group was 229 U/L,190 U/L, 2.4 mg/L,1.7 mg/L. In B symptom was 260 U/L,192 U/L,2.3 mg/L, 1.7 mg/L. In clinical stage was 252 U/L, 175 U/L, 2.5 mg/L, 1.6 mg/L. In extranodal sites group was 278 U/L,195 U/L,2.4 mg/L,1.8 mg/L.In Karnofsky evaluation group was 250 mg/L,195 mg/L,2.2 mg/L,1.8 mg/L.LDH level of invasive lymphoma was significantly higher than that of indolent ones (median 211U/L,175 U/L,P=0.002),but there were no difference in the 32-MG level (P=0.937). There were no statistical significance about LDH and β2-MG levels in gender and cell type (P＞0.05).Overall survival rates were different between the abnormal LDH group and the normal LDH group (χ2=119.029, P＜0.001).Overall survival rates were different between the elevated β2-MG group and the normal β2-MG group (χ2 =104.733,P＜0.001).Overall survival rates of the abnormal LDH/β2-MG group was significantly lower than that of normal group (x2=192.326,P＜0.001).Multivariate analysis in Cox regression showed that LDH,β2-MG,age,clinical stages, extranodal sites, Karnmofsky evaluation and aggressive were independent prognostic factors.Conclusion The level of serum LDH and β2-MG can be taken as an auxiliary clinical index to evaluate the prognosis of the NHL patients.

BACKGROUND: An important development orientation of osteomyelitis treating is to prepare a drug delivery system which has the characteristics of excellent biocompatibility, degradable, lengthen drug-released time, source sufficient, as well as use security. Alginate and chitosan can be used as drug delivery system due to the superordlnary biological properties. OBJECTIVE: To explore the feasibility and safety of alginate/chitosan incorporated vancomycin (VCM/ACA) as release carrier, in addition, to compare the difference from systematic injection. DESIGN, TIME AND SETTING: An in vivo drug concentration determination, matching grouping experiment. The experiment was performed at the animal and orthopedics laboratories, Affiliated Zhongshan Hospital of Dalian University from August 2008 to March 2009. MATERIALS: The alginate solution and vancocin solution was uniform mixed followed by adding CaCO_3 and citrate sodium solution, then the mixed liquor was prepared for vancocin-calcium alginate gel beads with microcapsule preparation instrument. After that, the vancocin-calcium alginate gel beads were reacted with chitosan/vancocin mixed liquor and cellulose acetate to prepare for VCM/ACA release carrier. METHODS: Forty rabbits were prepared for middle of left femur bone defect models, and then randomized divided into 2 groups, with 20 animals in each group. In the local medication group, VCM/ACA release carrier was inlaid to the defects. In the systemic administration group, rabbits were intravenous injected 10% vancocin (10 mg/kg). MAIN OUTCOME MEASURES: The drug concentrations in the serum and bone tissues of the local medication group was detected by high performance liquid chromatograph at hours 0.5, 1, 6, 24, 72 and weeks 1, 2 after operation. In the systemic administration group, the drug concentrations in the serum, bone and muscle tissues were measured at minute 10 and hours 0.5, 1, 6, 24, and 72 after operation. In addition, histological sections of body tissues were prepared to look for signs of systemic toxicity of the implants. RESULTS: The serum drug concentrations of the systemic administration group were obvious greater than the local medication group at each time points prior to 24 hours, which less than the local medication group at hour 24. The drug concentration in bone and muscle tissues of local medication group were significant greater than the systemic administration group at different time points, which sustained for at least 2 weeks, while serum concentration in the systemic administration group was much lower than minimum inhibitory concentration after 24 hours. However, no multiple tissues revealed histological evidence of toxicity. CONCLUSION: There has feasibility and safety in vivo in course of ALM/VCM release carrier, which has superior effect to systemic administration.

Objective To provide an anatomic evidence for the double-bundle posterior cruciate ligament (PCL) reconstruction, the sizes and locations of the attachments of the PCL to the tibia and the femur were measured. Methods We studied 30 cadaveric knees. PCLs were divided into anterolateral and posteromedial bundles to the insertion footprint, and those locations were measured and described. Results The distances from the center of the femoral insertions of the anterolateral and posteromedial bundles to the anterior margin of the medial femoral condyle were (8.52±1.81)mm and (11.63±1.81)mm. The vertical distances from the center of the femoral insertions of the double-bundle to the intercondylar roof were (4.67±0.55)mm and (10.32±1.23) mm. The vertical distances from the tibial insertion of the center of the double-bundle to the plane of the tibial articular surface were (8.43±1.21)mm and (14.52±2.31)mm. The distances from the medial margin of the articular cartilage of the tibial plateau to the center of the tibial insertions of double-bundle were (47.44±6.23)mm and (45.95±6.32)mm. The areas of the insertions of the anterolateral and posteromedial bundles on the femur were (107.12±15.25)mm~2 and (65.35±10.27)mm~2. The areas of the insertions of the double-bundle on the tibia were (50.07±11.33)mm~2and (51.08±10.22)mm~2. Conclusion The anatomic characteristic of the attachment of the anterolateral and posteromedial bundles was revealed, providing anatomical bases for surgery.