AIM:To investigate the relationship between the fluctuation of blood glucose and the macrovascular complication of atherosclerosis (AS) in diabetic patients.METHODS:The individuals with different glucose tolerance were observed by continuous glucose monitoring for 3 days including the mean blood glucose (MBG) and its standard deviation (SD),mean amplitude of glycemic excursions (MAGE) and absolute means of daily differences (MODD).In addition,the intima-media thickness (IMT),intima smoothness as well as AS scores were measured respectively in bilateral common carotid arteries by means of high resolution B mode ultrasonography.RESULTS:The incidence of macrovascular complications in the subjects with impaired glucose tolerance (IGT) and newly diagnosed type 2 diabetes (T2DM) was significantly higher than those in the subjects with normal glucose tolerance (NGT),and a significantly difference between group IGT and T2DM was observed.The indexes detected by B mode ultrasonography were all increased gradually from NGT to IGT,then to newly diagnosed T2DM.The values of glycemic excursion were higher in IGT and T2DM group,especially in the subjects with diabetes than those in NGT group.In addition,multiple regression analysis showed that MAGE was significantly correlated with mean IMT and AS scores.CONCLUSION:Blood glucose fluctuation is associated with atherosclerosis.The patients with a larger range of blood glucose excursion have higher risks for developing atherosclerotic complications.The impaired glucose stability is a possible risk factor for atherosclerotic macroangiopathy in diabetes.

AIM To study the chemical constituents from twigs of Trigonostemon lutescens Y.T.Chang et J.Y.Liang.METHODS The ethyl acetate fraction of 95％ ethanol extract from T.lutescens twigs was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and elucidated as 3-O-acetyloleanolic acid (1),methyl 3-acetoxy-12-enly-oleanen-28-oate (2),taraxerone (3),spiciflorin (4),simiarenol (5),β-sitosterol palmitate (6),3,3',4-tri-O-methylellagic acid (7),β-sitosterol (8),stigamasterol (9),palmitic acid (10).CONCLUSION Compounds 1-6 are isolated from genus Trigonostemon for the first time,compounds 7 and 9 are first obtained from this plant.

Objective To observe the effect of T-2 toxin on growth and development of rat epiphyseal plate of left knee and metaphyseal bone of femur and tibia in normal and low nutritional status, to find out possible pathogenic factors of Kashin-Beck disease and provide experimental basis for early intervention. Methods Ninety 3-week-old Wistar rats, weighing 60 - 70 g, were randomly divided into three groups: control group(general feed), T-2 toxin + general feed group, T-2 toxin + low nutrition feed group, thirty rats in each group with equally sex ratio. T-2 toxin (1.0 mg/kg) was administered orally 5 times a week via a gavage needle for 4 weeks. The change of hair, activity and body weight was observed. After 1, 2, 4 weeks, the epiphyseal plate of left knee and metaphyseal bone of femur and tibia (including distal femur and proximal tibia) were collected. Specimens were processed with HE and Masson staining. The morphology of chondrocytes and matrix collagen content in epiphyseal plate was observed. Trabecular bone volume fraction in tibial metaphyseal bone was analyzed by Image-Pro Plus 6.0 software. Results In the control group, rats were in good movement and hair with light, but in T-2 toxin + general feed group and T-2 toxin + low nutrition feed group, rats were found with reduced activities and hair with dark color. Body weights(g) of the control group, the T-2 toxin + general feed group and the T-2 toxin + low nutrition feed group were 81.0 ± 6.2, 79.0 ±5.1, 77.0 ± 7.5, respectively, by the end of first week; 101.8 ± 6.7, 97.0 ± 6.8, 93.0 ± 5.3, respectively, by the end of second week; 151.1 ± 15.7, 126.5 ± 11.9, 106.5 ± 11.5, respectively, by the end of fourth week. There was significant difference in groups by second week and the fourth week (F = 9.72, 41.65, all P ＜ 0.05 ). There was significant difference among multi-groups by the fourth week(all P ＜ 0.01 ). Under light microscope, at the second weeks, coagulative necrosis of chondrocytes was found in hypertrophic zone in the two groups with T-2 toxin; at the fourth weeks, cell necrosis increased. Masson staining showed collagen staining in the two groups with T-2 toxin significantly turned to clear pale coloration, indicating that the collagen matrix was significantly reduced. Image analysis showed there was significant difference in groups at the second and fourth week(F= 9.72, 41.65, all P＜ 0.05)in tibial metaphyseal trabecular bone volume fraction. There was significant difference between T-2 toxin + low nutrition feed group[(0.55 ± 0.12)％, (0.21 ± 0.0)％] and control group[(0.67 ± 0.09)％, (0.51 ± 0.14)％] by the second and fourth week(all P ＜ 0.01 ). Conclusions Under normal nutritional status, T-2 toxin can induce hypertrophic epiphyseal cartilage necrosis, collagen content decreased in epiphyseal plate, metaphyseal trabecular bone formation disorders; in the low nutritional status, T-2 toxin can lead to rat epiphyseal necrosis and significant metaphyseal bone disorder, but whether the performance is related to Kaschin-Beck disease needs to be studied further.

The aim of this research is to evaluate the effect of tetramethylpyrazine (TMP) and connective tissue growth factor (CTGF) miRNA plasmids on the expressive levels of CTGF, transforming growth factor-beta (TGFbeta) and type I collagen of rat hepatic stellate cells (HSC) which are stimulated by high glucose. The rat HSCs which were successfully transfected rat CTGF miRNA plasmids and the rat HSCs which were successfully transfected negative plasmids were cultured in vitro. After stimulus of the TMP and the high glucose, the protein levels and gene expressive levels of CTGF, TGF-beta and type I collagen were tested. The results indicated that high glucose increased the expression of CTGF mRNA, CTGF protein, TGF-beta mRNA,TGF-beta protein and type I collagen (P < 0.05). The expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in TMP group were lower than those in high glucose group and showed statistically significant differences (P < 0.05). Compared with high glucose group, the expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in rat CTGF miRNA plasmid interference group were significantly lower (P < 0.05). However, no statistically significant difference was found in CTGF mRNA and CTGF protein levels between TMP group and CTGF miRNA group (P > 0.05), while type I collagen levels showed statistically significant differences (P < 0.05). It is concluded that high glucose could promote the expressions of CTGF, TGF-beta and type I collagen, and TMP and rat CTGF miRNA plasmids could reduce the expressions of CTGF, TGF-beta, type I collagen.
Animals ; Cells, Cultured ; Collagen Type I ; metabolism ; Connective Tissue Growth Factor ; genetics ; Culture Media ; pharmacology ; Glucose ; pharmacology ; Hepatic Stellate Cells ; drug effects ; metabolism ; MicroRNAs ; genetics ; Plasmids ; Pyrazines ; pharmacology ; RNA, Messenger ; Rats ; Transfection ; Transforming Growth Factor beta ; metabolism

Objective To evaluate the possibilities of using circulating miR-155-5p, miR-21-5p, miR-29a and miR-142-5p as biomarkers for the diagnosis of active pulmonary tuberculosis (TB).Methods Plasma samples were collected from 60 healthy subjects, 40 patients with active pulmonary TB and 20 sub-jects with latent tuberculosis infection ( LTBI) to extract miRNAs.The levels of miR-155-5p, miR-21-5p, miR-29a and miR-142-5p in plasma samples were detected by using reverse transcription-quantitative PCR. Results The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were re-spectively 10.13, 7.34 and 2.74 times as much as those in healthy subjects(P<0.05).No significant differences with the level of miR-142-5p were observed between the two groups.The receiver operating char-acteristic (ROC) curve analysis of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB and healthy subjects showed that the areas under the curve (AUC) were respectively 0.905, 0.830 and 0.687.The level of miR-155-5p in patients with LTBI was 3.1 times than that in healthy subjects ( P<0. 05).No differences with miR-21-5p, miR-29a and miR-142-5p were found between patients with LTBI and healthy subjects.The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were respectively 3.26, 6.69 and 1.98 times than those in patients with LTBI (P<0.05).The rate of LTBI was 40.58%in people who were in close contact with patients with active pulmonary TB.Conclusion Sig-nificant differences with the levels of miR-155-5p, miR-21-5p and miR-29a were observed among healthy subjects, patients with active pulmonary TB and patients with LTBI, but no difference with the level of miR-142-5p was observed among them.miR-155-5p, miR-21-5p and miR-29a could be used as the potential bio-markers for the diagnosis of active pulmonary tuberculosis and latent tuberculosis infection.People who were in close contact with patients with active pulmonary TB could have a higher LTBI rate.

Objective To evaluate mid-term(5-6 years)clinical and radiographic outcomes of cementless acetabular prosthesis in total hip arthroplasty(THA)and discuss the factors affecting postop- erative effect.Methods THA with cementless acetabular was used to treat 139 cases(148 hips)from January 1998 to May 1999.A retrospective study was done to analyze clinical effect and X-ray manifesta- tion of 109 cases(116 hips)that were followed up.Clinical evaluation was based on Harris hip score. The radiographical evaluation was performed according to orthotropia and lateral images of hip joint to ob- serve acetabular migration and bone changes around the hip and measure the polyethylene wear rate and direction of the acetabular polyethylene wear.Results The mean Harris score before operation was 44 points(10-70 points)but that after operation increased to 92.4 points(80-100 points)at latest follow up.Radiographical evaluation showed one hip with focal osteolysis,mean linear wear rate of 0.15 mm/ year and mean 10.4?for angle with vertical line.Abduction angel of the acetabula was mean 46?,with 10.5 mm for vertical distance and 8.7 mm for level distance.There was no revision of a fixed acetabulum component because of pelvic osteolysis secondary to polyethylene wear.No acetabular component was re- vised because of aseptic loosening or acetabular component migration at the latest follow up.Conclu- sions Cementless acetabular prosthesis in THA can successfully have good fixation.A long term follow up for cementless acetabular prosthesis is necessary because of potential factors like polyethylene wear and osteolysis.

Objective To evaluate the biocompatibility of vessel extracellular matrix (VECM) with bladder smooth muscle cells of rabbits,and to discuss the feasibility of vessel extracellular matrix as a matrix for urinary tract reconstruction.Methods Primary cuhured bladder smooth muscle cells (RBSMCs) iso- lated from New Zealand rabbits were implanted on VECM (1?10~6 cells/ml).The effect of VECM on meta- bolic activity,attachment,proliferation of RBSMCs were monitored in vitro by inverted light microscopy and scanning electron microscopy.The extracts of VECM and emulsion were prepared as experimental group and positive controls separately.The culture medium was used as negative control,and simple culture medium without cells was used as blank control.The cell viability was monitored by MTT method after 1-,3-,5-d see- ding.The in vivo tissue response to VECM was investigated by implanting into the subcutaneous sites of the rabbits.Results VECM exhibited nontoxic and bioactive effect on RBSMCs.RBSMCs could be attached to and proliferated on VECM and remained their morphologies.The cell proliferation rates of experimental group were 95.61%、98.34%、102.91%,respectively,after 1,3,5 d;those of negative control group were 100.00% ,respectively;and those of positive control group were 35.14%、38.95%、32.66%,respectively. There was significant difference in the rate between experimental group and positive control (P＜0.01),and no significant difference in the rate between experimental group and negative control (P＞0.05).In vivo, VECM demonstrated favorable tissue compatibility without tissue necrosis and fibrosis.Conclusions VECM exhibits nontoxic and bioactive effects on primary cultured bladder smooth muscle cells.It is a suit- able material for urinary tract reconstruction.

Objective To study treatment of Vancouver type-B periprosthetie femoral fractures after total hip arthroplasty.Methods There were 10 cases with Vancouver type-B periprosthetic femo- ral fractures after total hip arthroplasty being treatment,including three cases with type-B1 undergone open reduction and allografi strut to fix the fracture,two with type-B2 undergone open reduction and revi- sion with a long stem and five with type-B3 undergone open reduction,revision with a long stem and al- lograft strut to restore bone.The mean duration of follow-up was 27 months(8-36 months).The Harris Hip Score and radiographs were used to evaluate the outcome.Failure of the procedure.was defined as the need for revision surgery because nonunion of fracture,implant loosening,and infection.Results All cases obtained successful fracture healing,with no stem loosening or infection.Of all,nine cases were a- ble to walk by themselves but one needed aid in walking.The Harris Hip Score was 83 at the time of the final follow-up.Osseous union of the allograft to the host femur occurred in eight hips and mild graft re- sorption in two.The cotex thickness of host femur was increased more than 3-5 mm.Conclusions Stem stability and bone quality are important factors determining the outcome of treatment for periprosthet- ic femoral fracture after hip arthroplasty.Good outcome can be achieved by adopting different treatments according to sub-classification of Vancouver type-B fractures.The allograft strut for the treatment of a Vancouver type-B periprosthetic femoral fracture can not only provide fixation,but also make fracture heal fast and augment bone mass and strength.

Objective: To explore the application of18F-lfuorodeoxyglucose (FDG) micro- positron emission tomography (PET) myocardial metabolism imaging for evaluating dilated cardiomyopathy model (DCM) in experimental rats. Methods: A total of 12 male SD rats were randomly divided into 2 groups: DCM group, the rats received intraperitoneal injection of adriamycin at 1.0 mg/kg twice per week and Control group, the rats received intraperitoneal injection of normal saline, all animals were treated for 6 weeks followed by 2 weeks observation.n=6 in each group. Echocardiography was performed at pre- and post-modeling,18F-FDG micro-PET myocardial metabolism imaging was conducted after modeling and plasma level of BNP was examined as well. Finally, the rats were scariifed to observe the pathological changes of myocardial tissue. Results: 1 rat died in DCM group and the rest were with successful modeling conifrmed by echocardiography and pathology. Compared with Control group, DCM group showed decreased standard uptake value of18F-FDG (1.23 ± 0.55) vs (6.65 ± 0.41),P<0.01; the standard uptake value of18F-FDG was negatively related to left ventricular end diastolic diameter (LVEDD) (R=-0.709,P=0.015), LVESD (R=-0.924, P=0.000) and plasma level of BNP (R=-0.948,P=0.000), while positively related to LVEF (R=0.968,P=0.000) and fractional shortening (R=0.863,P=0.001). Conclusion:18F-FDG micro-PET myocardial metabolism imaging combining echocardiography, biochemical and pathological examinations may evaluate DCM modeling in rats, which provide a non-invasive and intravital tool for small animal experiment.

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.