Fibroblast growth factor 23 (FGF23) is a new endocrine factor, mainly expressed in osteoblasts and osteoblasts. Many studies have found that FGF23 can act on kidney, parathyroid and other tissues after binding with Klotho protein, and participate in bone mineral metabolism. In addition, in recent years, the role of FGF23 in exoskeleton has been gradually discovered, such as FGF23 and thyroid diseases, diabetes and so on. Therefore, understanding the biological characteristics, regulatory mechanism of FGF23 and its relationship with related diseases is of great clinical significance for the diagnosis and treatment of diseases. This article reviews the relationship between FGF23 and metabolic diseases such as phosphorus metabolic disease, parathyroid disease, hyperthyroidism, osteoporosis, diabetes, iron metabolism and so on.

Objective To evaluate the value of two-dimensional strain imaging in assessing right ventricular function of recipient fetus in TTTS pregnancies.Methods Sixteen TTTS pregnancies and 19 normal monochorionic diamniotic pregnancies(controls) were included.Doppler studies of the umbilical artery,umbilical vein,ductus venosus,middle cerebral artery,atrioventricular valve and semilunar value were recorded in both fetus,and myocardial performance index of both ventricles was calculated.Longitudinal peak systolic strain of right ventricular were calculated and compared between recipient fetus and other fetus.Results Cardiothoracic ratio and myocardial performance index of right ventricular showed significant differences between recipient fetus and controls.Right ventricular strain was decreased in recipient fetus compared with controls.Conclusions Two-dimensional strain imaging can be used to evaluate right ventricular myocardial function in the recipient fetus of TTTS.

Objective To investigate the different expressions of adiponectin receptor 2(AdipoR2) mRNA in liver between diet-induced obese rats and controls.Methods The level of AdipoR2 mRNA expression was detected by reverse transcriptase polymerase chain reaction(RT-PCR).Insulin sensitivity was evaluated by insulin sensitivity index(ISI).Results Diet-induced obese rats showed higher expression of AdipoR2 mRNA compare to controls.The ISI of diet-induced obese rats was lower than that of controls.Conclusion High energy diet induceds AdipoR2 expression in liver.

Background Age-related cataract is one of the common causes of blindness.Although the pathophysiology of age-related cataract is far from clearly understood,it is well accepted that DNA damage plays an important role in the disease pathogenesis.Objective The purpose of this study was to quantitatively evaluate the DNA damage in peripheral lymphocytes of age-related cataract.Methods A cross-sectional study was carried out.This study complied Declaration of Helsinki and approved by Ethic Committee of Affiliated Hospital of Nantong University.Written informed consent was obtained from each subject.Two hundred and eleven patients with agerelated cataract and 147 normal subjects were enrolled from a “ Jiangsu Eye Study:Funing 2011 Eye Disease Epidemic Survey”.All the subjects aged from 50 through 80 years with matched age and gender between the two groups.The percentage of tail DNA and Olive tail moment (OTM) were detected by comet assay to assess the extent of DNA damage in peripheral lymphocytes.Statistical analyses were performed with SPSS 17.0 software,and the differences of the percentage of tail DNA and OTM were compared between the age-related cataract group and normal control group by independent sample t test as well as among the 50-59 years group,60-69 years group and ≥70 years group by one-way analysis of variance.Results Comet assay showed a round lymph cell with the clear border in the normal group;while in the age-related cataract group,the cell was bigger with a comet-like tail.The percentage of tail DNA and OTM in peripheral lymphocytes were (21.75 ± 3.51) ％ and 6.54 ± 1.65 in the age-related cataract group,and those in the normal control group were (9.31 ±3.60)％ and 2.18 ± 1.10,respectively,with significant differences between them (t =32.67,P =0.00 ; t =28.02,P =O.00).In the 50-59 years subgroup of the age-related cataract group,the percentage of tail DNA and OTM in peripheral lymphocytes were (20.04±2.86) ％ and 5.92± 1.14,and in the 60-69 years subgroup of the age-related cataract group,the percentage of tail DNA and OTM in peripheral lymphocytes were (20.77 ±2.93) ％ and 6.13 ± 1.14,which were significantly reduced in comparison with (22.79 ± 3.67)％ and 6.95±1.91 of the ≥70years subgroup(TailDNA％:q=2.75,P=0.00; q=2.02,P=0.00;OTM:q=1.03,P =0.02 ; q =0.82,P =0.00).Conclusions The pathogenesis and development of age-related cataract probably is associated with DNA damage.

Objective To observe the protective and anti-apoptosis effects of Rannasangpei (RNSP) on brain ischemia and reperfusion injury in rats. Methods Middle cerebral artery occlusion (MCAO) model was established and the groups were divided as sham group, MCAO group, vehicle + MCAO group and RNSP + MCAO group. Neuronal deficient signs, brain infarct area, the ratio of Bcl-2/Bax and the expression of caspase-3 were evaluated by neuronal deficient score, TTC (2,3,5-Triphenyltetrazolium chloride) staining and Western blot respectively. Results Compared with those parameters in sham group, the neuronal deficient signs, infarct area and caspase-3 expression increased evidently while the ratio of Bcl-2/Bax decreased markedly in MCAO group. But in RNSP+MCAO group, the neuronal deficient signs, infarct area and cas?pase-3 expression decreased greatly while the ratio of Bcl-2/Bax increased markedly compared with those parameters in MCAO group. Conclusion RNSP may have protective effects on brain ischemia and reperfusion, which is related to its an?ti-apoptosis role indicated by upregulation of Bcl-2/Bax ratios and downregulation of caspase-3.

To study the pharmacokinetics of ~(131)I-Metuximab injection (Licartin) combined with transarterial chemoembolization (TACE) for treatment of hepatocellular carcinoma (HCC). MethodsLicartin (27.75 MBq/kg) and the mixture of anticancer drug and Lipiodol were sequentially administered with interval of 20 minutes to 15 patients with HCC via a transfemoral catheter.After the Licartin was administrated, the pharmacokinetic and biodistribution data were evaluated through venous blood samples,urine collections,and 4 γ-scintigraphies (SPECT) over 7 days. The pharmacokinetic parameters were determined from integration of the blood radioactivity-time curves using the SPSS 12.0 software. The tumor-no-tumor ratio (T/NT) was calculated by ROI. Absorbed doses in organ were estimated according to the medical internal radiation dose formalism. The biodistribution of licartin within patient's body at different time points was compared for various organs using analysis of variance for repeated measures, as well as the T/NT ratio. ResultsThe blood radioactivity-time curves followed the dynamics two-compartment model, with the major pharmacokinetic parameters including t_(1/2)α(1.96±1.65) h, and t_(1/2)α(19.07±5.91) h,and t_(1/2)β (57.09±10.92) h, and C_(max) 2.113×10~9min~(-1)·L~(-1), and AUC_(0-∞) 1.302×10~(11) h·min~(-1)·L~(-1), respectively. The accumulated urine radioactivity was 52.2% of administrated dosage during 144 h after administration. There were statistical significant difference of biodistribution of licartin and T/NT ratio between organs at different time points (F=6.583, P<0.01 and F=3.546, P<0.01). SPECT scans showed the significant accumulation of the radioconjugate in liver tumor and faint uptake in other organs for 14 days. Tumor-to-liver ratio decreased from 2.88±1.02 at 3 h to 1.64±0.40 at 168 h (n=7). Organ absorbed dose was (3.19±1.01) Gy in liver (n=12) and (0.55±0.09) Gy in red marrow (n=7). ConclusionLicartin combined with TACE for treatment of HCC is helpful to significantly accrete the radioconjugate in liver tumor, and protect normal organs from radiotoxictiy.

Objective To investigate vascular endothelial growth factor receptor-2(VEGFR-2)and its phosphorylated state in cancerous and peri-cancerous tissues of hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE).Methods Forty-three cases of second-stage surgery of HCC after TACE(TACE & surgery group)and twenty cases of surgery without TACE(direct surgery group)were performed.Surgical specimens were made into paraffin-embedded slices.VEGFR-2,phosphorylated VEGFR-2,hypoxia induced factor-1α(HIF-1α)and microvessel density(MVD,labeled by CD31)were detected using immunohistochemical method.All data was statistically processed with SPSS for Windows.Results The absorption factor(A factor)of phosphorylated VEGFR-2 and HIF-1α in the cancerous tissue of HCC were(0.034±0.016)and(0.047±0.021)in TACE & surgery group,and(0.024±0.009)and(0.035±0.016)in direct-surgery group,which showed statistically significant difference(F=6.75,4.77,P＜0.05).The A factors of VEGFR-2,phosphorylated VEGFR-2 and HIF-1α in the peri-cancerous tissue were(0.040±0.017),(0.031±0.011)and(0.037±0.015)respectively in TACE & surgery group,and(0.030±0.015),(0.020±0.008)and(0.024±0.014)respectively in direct-surgery group,all of which showed statistically significant difference(F=4.60,13.72,11.65,P＜0.05).MVD of the peri-cancerous tissue was(58.3±15.2)/HP in TACE & surgery group and(44.4±10.5)/HP in direct-surgery group,which showed statistically significant difference(χ2=13.64,P＜0.05).Conclusion The cancerous and peri-cancerous tissues in HCC after TACE showed more hypoxic changes.Both expression and function of VEGFR-2 were enhanced following TACE.

Objective To evaluate application of recombinant human luteinizing hormone (r-hLH)used in ovarian stimulation of assisted reproductive technique and impact on outcome of pregnancy. Methods From Apr. To Jul. 2009, 123 patients with low LH level ( < 1 U/L) at day 3 of menstruation and downregulation of pituitary function undergoing in vitro fertilization-embryo transfer (IVF-ET) in Reproductive Medical Center, Provincial Hospital Affiliated to Shandong University were enrolled in this study, whom were classified into 66 cases treated by r-hLH in r-hLH group and 57 cases without r-hLH treatment in non-r-hLH group. In the mean time, 145 patients with normal level of serum LH ( 1-2 U/L) not given by r-hLH treatment and undergoing IVF-ET were matched as control group. Total amount of gonadotropin, estradiol levels and LH levels on the administration of human chorionic gonadotropin ( hCG), number of oocytes retrieved, number of 2PN zygotes, rate of high quality embryos, the rates of implantation and clinical pregnancy were compared among these three groups. Results The level of serum LH on the day of hCG administration were ( 1.59 ± 0.77 ) U/L in r-hLH group, (0.54 ± 0.25 ) U/L in non-r-hLH group and (2.39 ± 1.01 ) U/L in control group, which reached tatistical difference between every two groups (P < 0.05). The rates of high quality embryo were 59.36％ in r-hLH group, 57.79％ in non-r-hLH group,which were significantly lower than 65.94％ in control group, respectively (P < 0. 05 ). The rates of 2PN were 67.62％ in r-hLH group and 68. 32％ in control group, which were significantly higher than 62. 84％ in non-r-hLH group, respectively ( P < 0.05 ). The rates of implantation of 29.77％ in r-hLH group were significantly higher than 18.26％ in non-r-hLH group ( P < 0.05 ). The total amount of gonadotropin,estradiol level on the day of hCG administration, the number of oocytes retrieved, and clinical pregnancy rate were not significantly different among those three groups ( P > 0.05 ). Conclusion The administration of recombinant human uteinizing hormone in patients who are profoundly suppressed after down-regulation with long protocol can get more quality embryos, the higher rates of 2PN and implantation.

Objective To evaluate the short-term and long-term efficacy of interventional therapy for acute hepatic artery thrombosis.Methods We analyzed retrospectively the interventional treatment and long-term follow-up data of 34 patients with acute hepatic artery thrombosis in Zhongshan hospital of Fudan University from March 2003 to October 2015.Results Thirty-four patients with acute hepatic artery thrombosis were performed with urokinase thrombolytic therapy.Twenty-one patients were implanted stents in the thrombolytic therapy.Splenic artery embolization were performed in 3 patient with splenic artery steal syndrome.Technical and clinical success rates were 91％ (31/34).The complication associated with interventional procedures were observed in 2 patients.The patency rates of hepatic artery in 1,2,3 and 5 years were 82％,73％,57％ and 57％ respectively.The median obstruction free time was 94 months.Conclusions Good short-term and long-term effect have been obtained in interventional treatment for acute hepatic artery thrombosis,which can be used as the first treatment for acute hepatic artery thrombosis after liver transplantation.

OBJECTIVETo synthesize venlafaxine with an improved novel method.

METHODSp-methoxypheny lethyl-acid was reacted with SOCl(2) to produce acyl chloride which was reacted with N,N-dimethylamine solution to get amide; then through Ivanov reaction and reduction by KBH(4)/BF(3).Et(2)O to yield venlafaxine.

RESULTVenlafaxine was successfully synthesized by using this method with an yield rate of 50.3%.

CONCLUSIONThe improved method is suitable for industrial production of venlafaxine.