AIM　To study the glucose and lipids metabolis m and insulin sensitivity of MSG rats during their growing period, and to evalua te the effects of insulin sensitizer pioglitazone on the model rats. MET HODS　Body weights were measured regularly, and glucose and insulin tole rance tests were taken. In their 3 and 10 months old, rats were given insulin se nsitizer pioglitazone orally, then the effects on serum glucose, triglyceride, c holesteral, free fatty acid and insulin concentrations were determined. RESULTS　Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fat ty acid and insulin concentrations were significantly higher in model rats. More over, gluconeogenesis increased significantly, and insulin tolerance showed abno rmal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliora te all these metabolic disorders. CONCLUSION　Obesity and insuli n resistance were induced by injecting monosodium glutamate (MSG) to neonatal Wi star rats. Pioglitazone can significantly improve the insulin sensitivity of MSG rats. These results suggested that MSG obese rats can be used as an easily acce ssible and inexpensive insulin resistance animal model for evaluating the effica cy and mechanisms of antidiabetic agents.

Peroxisome proliferator activated receptor(PPAR), a member of the hormone receptor superfamily, is a key regulating factor in adipocyte differentiation and lipids metabolism. Recently, with the increased understanding of the precise mechanisms of TZD, thiazolidinedione class of insulin sensitizer, PPAR? has also been identified as the major functional receptor for the drugs. In the study of the relationship between PPAR and insulin resistance, considerable gaps appeared. TZD induced activation of PPAR? is known to promote insulin sensitivity. More interestingly, however, PPAR? +/- heterozygous mice were shown to be less susceptible to insulin resistance. These findings suggest that the relationship between PPAR activation and insulin sensitivity improvement is not simplely positively related. A better understanding of the role of PPAR in insulin action system will be critical in developing more efficacious and safe agents that act on PPAR and benefit patients with type 2 diabetes.

AIM To study the glucose and lipids metabolism and insulin sensitivity of MSG rats during their growing period, and to evaluate the effects of insulin sensitizer pioglitazone on the model rats. METHODS Body weights were measured regularly, and glucose and insulin tolerance tests were taken. In their 3 and 10 months old, rats were given insulin sensitizer pioglitazone orally, then the effects on serum glucose, triglyceride, cholesteral, free fatty acid and insulin concentrations were determined. RESULTS Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fatty acid and insulin concentrations were significantly higher in model rats. Moreover, gluconeogenesis increased significantly, and insulin tolerance showed abnormal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliorate all these metabolic disorders. CONCLUSION Obesity and insulin resistance were induced by injecting monosodi- um glutamate (MSG) to neonatal Wistar rats. Piogli- tazone can significantly improve the insulin sensitivity of Msc rats. These results suggested that MSG obese rats can be used as an easily accessible and inexpensive insulin resistance animal model for evaluating the efficacy and mechanisms of antidiabetic agents.

Objective To analysis the therapeutic effect of microsurgery through single-nostril transsphenoidal approach on pituitary adenomas and to study the surgical skill and postoperative complications about microsurgery for pituitary adenomas.Methods The clinical manifestations,pathological type, removal percentage,postoperative complications and follow-up data of 241 cases with pituitary ademoma by microsurgery through single-nostril transsphenoidal approach were analysed retrospectively.Results 171(7 1%)cases were achieved total tumor removal,28(11.6%)cases were achieved subtotal tumor removal,26(10.7%)cases were achieved most tumor removal and 16(6.6%)cases were achieved partial tumor removal.Most of patients achieved better results,however there were 38(15.8%)eases with diabetes insipidus,12(4.9%)cases with transient worse sight,4(1.6%)cases with cerebrospinal fluid leakage,2(0.8%)cases with oculomotor paralysis,and no death.The postoperative complications were cured and outcome was considered as good.The follow-up period was 1-36 months in 241 patients and the clinical symptoms were improved by different degrees.Conclusion Pituitary adenomas can be treated by microsurgery through single-nostril transsphenoidal approach due to the time of operation shorten,the postoperative complications.

Objective To evaluate the lung V/Q imaging in the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH).Methods Seventy-six patients (46 males,30 females,age 27-84 y) with clinically suspected CTEPH who had undergone lung V/Q imaging,CT pulmonary angiography (CTPA),pulmonary angiography (PA) and right heart cardiac catheterization were studied.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of lung V/Q imaging in detecting CTEPH were calculated and compared with those of CTPA.The x2 test was used for statistical analysis with SPSS 11.5.The distribution of involvement of segments in 47 patients with CTEPH was analyzed.Results Forty-seven patients had a final diagnosis of CTEPH and 29 had non-CTEPH etiology.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of lung V/Q imaging were 97.9％ (46/47),86.2％ (25/29),93.4％ (71/76),92.0％ (46/50) and 96.2％ (25/26),while those of CTPA were 78.7％ (37/47),93.1％ (27/29),84.2％ (64/76),94.9％ (37/39) and 73.0％ (27/37),respectively.The sensitivity (x2 =5.818,P=0.012) and negative predictive value (x2 =5.693,P =0.017) for lung V/Q imaging were significantly higher than those of CTPA.V/Q imaging could identify patients with CTEPH from those with idiopathic PAH and familial PAH based on the almost normal ventilation imaging.The lung perfusion SPECT imaging detected 585 (62.2％) of involved segments among 940 segments in 47 patients with CTEPH,with an average of 12.4 involved segments in each patient.The number of involved segments in the right lung was significantly higher than that in the left lung (36.2％ (340/940) vs 26.1％ (245/940) ; x2 =40.85,P＜0.01).Conclusions Lung V/Q imaging plays an important role in diagnosis of CTEPH and in identification of CTEPH from other types of PAH.A normal V/Q imaging can effectively exclude CTEPH.In addition,V/Q imaging can provide more diagnostic information in patients with a clinical suspicion of CTEPH who had negative results by CTPA and PA.

Objective To investigate the application of neurophysiological monitoring and microsurgi-eal technique in acoustic neurinoma resection, exploring the significance of neurophysiological monitoring in facial and auditory nerve reservation of acoustic neuronma microsurgery. Methods Accompanied with EMG and BAEP nerve monitoring, 113 patients harboring acoustic neuroma were treated surgically by the subocipi-tal retrosigmoid approach for reserving facial and auditory nerve. The facial nerve was stimulated to evaluate its function during late-operation. Postoperative facial and auditory nerve function were valuated in all the postop-erative following up. Results All of them were treated microsurgically via the suboccipitai retrosigmoid ap-proach. Total tumors resection was achieved in 102 cases (90.3%), subtotal resection in 6 cases(5.3%) and partial resection in 5 case (4.4%). The facial nerve was preserved anatomically in 98 cases (86.7%), the functional valuation of facial nerve according to the House-Brakman (H-B) postoperatively: 86 cases (76.1%) in class Ⅰ -Ⅱ , 12 cases(lO.6%) in class Ⅲ-Ⅳ and 15 cases (13.3%) in class Ⅴ-Ⅵ. The acoustic nerve was preserved anatomically in 40 cases (35.4%). It denoted the good function of facial nerve responsing sensi-tively to electrostimulation ≤ 4mA at the end of operation. Conclusion Assisted with the intraoperative electrophysiological monitoring techniques, it would be greatly facilitate the preservation of facial and auditory nerve in acoustic neuroma resection. Simultaneously, it would valuate the functional convalescence by late-op-erative electrostimulation in the postoperation.

OBJECTIVETo assess the anxiolytic effect of Anshenfang granules (ASF), a compound traditional Chinese medicinal preparation, on anxiety in rats and the mechanism of its actions.

METHODSMale Wistar rats with anxiety induced by chronic emotional stress were randomized to receive treatments with diazepam or ASF at high, medium or low doses. The behavioral changes of the rats were evaluated using plus-maze test, after which the rats in normal control group, model group, and medium AFS dose group were sacrificed to measure the hippocampal contents of glutamic acid and γ-aminobutyric acid (GABA) using high-performance liquid chromatography (HPLC); immunohistochemistry was employed to evaluate the expressions of GABAA receptor and N-methyl-D-aspartate receptor 1 (NMDAR1).

RESULTSPlus-maze test showed obvious anxiety behaviors in the model group, which were significantly meliorated by diazepam and ASF, especially at the medium dose. Hippocampal glutamate levels increased and GABA decreased significantly in the model group, and such changes were obviously attenuated, by comparable amplitudes, by treatments with diazepam and medium-dose ASF. The model group showed significantly diminished GABAA receptor-positive cells and increased NMDAR1-positive cells, which were improved by diazepam and ASF at the medium dose.

CONCLUSIONASF produces strong anxiolytic effect in rats by increasing the content of GABA in the brain, enhancing GABAA receptor expression, reducing glutamic acid content, and decreasing NMDAR1 expression.

Animals ; Anti-Anxiety Agents ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Glutamic Acid ; metabolism ; Hippocampus ; metabolism ; Male ; Rats ; Rats, Wistar ; Receptors, GABA ; metabolism ; Receptors, N-Methyl-D-Aspartate ; metabolism ; gamma-Aminobutyric Acid ; metabolism

Objective:To explore the change of blood-brain barrier (BBB) permeability in septic rats.Methods:A rat model of sepsis was established by cecal ligation and puncture. Rats were randomly (random number) grouped according to the intervention time: sham-operated group, sepsis 1-day group, sepsis 4-day group, and sepsis 7-day group. Fluorescein sodium was used to test the permeability of the BBB. Western blot and immunofluorescence methods were applied to detect the expression of tight junction proteins including Claudin-5, Occludin and ZO-1.Results:Compared with the sham-operated group, rats in the sepsis group presented quick breath, slow response, decreased intake of food and water, obvious abdominal distension and loose stools. After abdominal anatomy of sepsis rats, we found mesenteric adhesions, dilatation of proximal intestinal, black cecum ligation site with purulent exudate, enlarged liver and diffused bloody exudate. Compared with the sham-operated group, body weight of sepsis rats was reduced remarkably ( P < 0.05). The body weight of rats of sepsis 7-day group was the lowest, which was significantly lower than that of rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated group, the content of fluorescein sodium in sepsis 1-day rats was increased remarkably ( P< 0.05). The content of fluorescein sodium in rats of sepsis 7-day group was the highest, which was significantly higher than that in rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated rats, the expression of Claudin-5, Occludin and ZO-1 in sepsis rats were decreased remarkably (all P < 0.05). The expression of Claudin-5, Occludin and ZO-1 were the lowest in rats of the sepsis 7-day group, which were significantly decreased than those of rats in the sepsis 4-day group (all P< 0.05) and rats in sepsis 1-day group (all P < 0.05). Conclusions:Sepsis rats showed increased permeability of the BBB, and the permeability of BBB increased continuously along with the duration of sepsis.

Objective: The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated. Methods: Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check. Results: (1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01). Conclusions There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.

Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.