Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4 )and related factors in type 2 diabetic patients. Methods Eighty type 2 diabetic and patients 30 non-diabetic subjects were recruited into obese-diabetic group [body mass index (BMI) 1525 kg/m~2],normal-weighted diabetic group(BMI < 25 kg/m~2)and control group(BMI < 25 kg/m~2). Serum adiponectin(APN), RBP4 and hemoglobin A_1c (HbA_1c)triacylglycerol (TG),total cholesterol (TC).high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and were measured on fasting samples. BMI, waist/hips girth ratio (WHR) and insulin resistance index (HOMA-IR) were calculated. The correlation between RBP4 and other factors was analyzed. Results The concentration of RBP4 was significantly increased in obese-diabetic group and normal-weighted diabetic group compared with that in control group [ (30.02 ± 5.32), (20.10 ± 5.45), (12.02 ± 3.45) mg/L] (P < 0.01). The concentration of RBP4 was higher in obese-diabetic group than that in normalweighted diabetic group (P < 0.01). Univariate analysis showed serum RBP4 was positively associated with TG,BMI,FBG, WHR,FINS,HOMA-IR and negatively associated with APN (r = 0.225, 0.697, 0.323,0.557, 0.272, 0.461, -0.398). Conclusions The concentration of RBP4 is significantly higher in type 2 diabetic patients compared with that in normal subjects. RBP4 possibly plays an important role in the insulin resistance and the occurrence and development of type 2 diabetes.

A total of 100 patients with subacute thyroiditis hospitalized from January 2011 to October 2012 were recruited.Each received glucocorticoid treatment for 8 weeks and there was a 2-month follow-up period after drug withdrawal.After treatment,the short-term recurrence rate was 34％ (34/100).If thyroid ultrasound was abnormal,the recurrence rate was 52％ (30/58).And it was significantly higher than 10％ recurrence rate for those with normal thyroid ultrasound (4/42,x2 =9.67,P ＜ 0.01).The recurrence rate of different erythrocyte sedimentation rate groups of 40-100 mm/1 h and ＞ 100 mm/1 h was 37％ (22/60) and 30％ (12/40) respectively (P ＞ 0.05).

Objective To investigate the value of dynamic contrast-enhanced(DCE)-MRI and DWI for the early assessment of curative effects in NSCLC. Methods Forty patients from September 2012 to September 2014 with NSCLC proven by pathology were examined with DCE-MRI and DWI, at one week before the first chemotherapy and one month after treatment. DCE parameters (MER, slope, WR) and ADC values of the tumors were calculated on the workstation. According to the changes of the tumor-size after treatment, all patients were divided into two groups: good response group and poor response group. Pretreatment parameters were compared between the two groups with independent-samples t test, and parameter changes before and after treatment were compared with paired-samples t Test. ROC curve of tumor response characteristic was analyzed. Pearson correlation coefficient was used to study the correlation between post-treatment parameter changes and tumor size reduction. Results Pretreatment ADC, MER and slope value were (1.15 ± 0.09) × 10-3 mm2/s, 1.13 ± 0.28, (3.76 ± 1.27)% in the good response group(15 patients), and were (1.34±0.33)×10-3mm2/s, 0.78±0.16, (2.63±0.58)%in poor response group(25 patients), respectively. There was significant difference between tumors in two groups(t=2.329, 3.152, 4.556,P=0.027, 0.032, 0.009), the lower ADC value and the higher MER/slope value was observed in the good response group. The change rates of ADC after one month treatment in the two groups were (20.43±6.40)%, (2.98±1.65)%(t=3.485,P=0.009), and slope change were (-61.80±19.21)%, (-30.80±11.16)%(t=3.280, P=0.020). Both the rising rate of ADC and decreasing rate of slope value were significant higher in good response group than the poor response group. The ROC curve was used to analyze the change rate of ADC and slope after tumors treatment, the area under the ROC curve in ADC was largest(Az=0.790), the diagnosis efficiency was highest. We found significant positive correlation between ADC, MER, slope change rate and tumor maximum diameter reduction rate after chemotherapy(r=0.637, 0.396, 0.532,P<0.05). Conclusions DCE parameters and ADC values possess important clinical value to evaluate the early effect of chemotherapy in NSCLC. ADC value is more sensitive to early lung cancer response.

Objective: To explore the effects of different doses of dopamine on organ function of rats at early stage of severe scald. Methods: Thirty-two male Wistar rats aged 8 to 12 weeks were divided into sham injury (SI) group, simple resuscitation (SR) group, small dose (SD) group, and moderate dose (MD) group according to the random number table, with 8 rats in each group. After rats in the 4 groups were performed cardiac catheterization, rats in group SI were sham injured on the back by immersing in 37 ℃ warm water for 18 s, and rats in the other 3 groups were inflicted with 30% total body surface area (TBSA) full-thickness scald on the back by immersing in 97 ℃ hot water for 18 s. Rats in group SI were not treated after the injury, while rats in the other 3 groups were performed fluid resuscitation for 24 h through jugular vein catheter with micro syringe pump according to the Parkland formula. They were given 4.0 mL·kg^-1·% TBSA^-1 normal saline during the first 24 h, of which they were given half of the total amount for the first 8 h, and they were given half of the total amount for the second and third 8 h. Rats in group SR were infused normal saline only, while rats in group SD and group MD were infused normal saline+ 1.25 μg·kg^-1·min^-1dopamine and normal saline+ 6.00 μg·kg^-1·min^-1 dopamine respectively. Volume of 0.5 mL venous blood of all rats were taken through the cardiac catheter with serum separated at post injury hour (PIH) 1, 3, 6, 12, and 24. Serum content of cardiac troponin I (cTnI) was determined by enzyme-linked immunosorbent assay; serum content of diamine oxidase (DAO) was detected by ultraviolet spectrophotometer; serum content of β₂-microglobulin (β₂-MG) was determined by latex-enhanced immunoturbidimetric assay; serum content of total bile acid (TBA) was determined by enzyme colorimetry; serum content of lactic acid, malondialdehyde, and myeloperoxidase (MPO) was determined by ultraviolet spectrophotometer. Data were processed with analysis of variance for repeated measurement, one-way analysis of variance, least significant difference test, and Bonferroni correction. Results: (1) At PIH 1, 3, 6, 12, and 24, serum content of cTnI of rats in group SR, group SD, and group MD [(2.69±0.19), (3.04±0.19), (4.96±0.25), (6.88±0.28), (4.75±0.31) μg/L, (2.70±0.14), (3.08±0.13), (5.06±0.19), (7.11±0.21), (4.89±0.16) μg/L, (2.18±0.14), (2.54±0.09), (3.97±0.14), (5.46±0.34), (3.32±0.33) μg/L] were higher than that in group SI [(1.70±0.08), (1.70±0.08), (1.69±0.11), (1.69±0.08), (1.70±0.08) μg/L, P<0.05], serum content of cTnI of rats in group SR and group SD was similar (P>0.05), and serum content of cTnI of rats in group MD was lower than that in group SR and group SD (P<0.05). (2) At PIH 1 to 24, serum content of DAO of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of DAO of rats in group SR and group MD was similar (P>0.05), and serum content of DAO of rats in group SD was lower than that in group SR and group MD (P<0.05). (3) At PIH 1 to 24, serum content of β₂-MG of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of β₂-MG of rats in group SR and group MD was similar (P>0.05), and serum content of β₂-MG of rats in group SD was lower than that in group SR and group MD (P<0.05). (4) At PIH 1 to 24, serum content of TBA of rats in group SR, group SD, and group MD was similar (P>0.05) and higher than that in group SI (P<0.05). (5) At PIH 1 to 24, serum content of lactic acid of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of lactic acid of rats in group SR and group MD was similar (P>0.05), and serum content of lactic acid of rats in group SD was lower than that in group SR and group MD (P<0.05). (6) At PIH 1 to 24, serum content of malondialdehyde and MPO of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of malondialdehyde and MPO of rats in group SR and group MD was similar (P>0.05), and serum content of malondialdehyde and MPO of rats in group SD was significantly lower than that in group SR and group MD (P<0.05). Conclusions With effective liquid recovery, dopamine of MD can improve early cardiac function of rats with severe scald, while dopamine of SD can alleviate tissue ischemia and hypoxia, reduce oxygen free radical damage in internal organs, and improve functions of intestine and kidney.

The mitochondria-mediated caspase activation pathway is a major apoptotic pathway characterized by mitochondrial outer membrane permeabilization (MOMP) and subsequent release of cytochrome c into the cytoplasm to activate caspases. MOMP is regulated by the Bcl-2 family of proteins. This pathway plays important roles not only in normal development, maintenance of tissue homeostasis and the regulation of immune system, but also in human diseases such as immune disorders, neurodegeneration and cancer. In the past decades the molecular basis of this pathway and the regulatory mechanism have been comprehensively studied, yet a great deal of new evidence indicates that cytochrome c release from mitochondria does not always lead to irreversible cell death, and that caspase activation can also have non-death functions. Thus, many unsolved questions and new challenges are still remaining. Furthermore, the dysfunction of this pathway involved in cancer development is obvious, and targeting the pathway as a therapeutic strategy has been extensively explored, but the efficacy of the targeted therapies is still under development. In this review we will discuss the mitochondria-mediated apoptosis pathway and its physiological roles and therapeutic implications.
Animals ; Antineoplastic Agents ; pharmacology ; therapeutic use ; Apoptosis ; drug effects ; Caspases ; metabolism ; Cytochromes c ; metabolism ; Humans ; Inhibitor of Apoptosis Proteins ; antagonists & inhibitors ; metabolism ; Membrane Potential, Mitochondrial ; drug effects ; Mitochondria ; drug effects ; metabolism ; Neoplasms ; drug therapy ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism

Objective:To assess the diagnostic value of whole-lesion intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in differentiating benign and malignant thyroid nodules based on turbo spin echo (TSE) sequence.Methods:Totally 57 patients with thyroid nodules diagnosed by pathology were prospectively collected at the Affiliated Lianyungang Hospital of Xuzhou Medical University from March 2019 to December 2019. A total of 62 nodules were included for analysis, including 27 benign nodules and 35 malignant nodules. All patients underwent routine MRI scan and IVIM-DWI based on TSE sequence before surgery. The regions of interest were drawn along the edge of the lesion on multiple consecutive slices to cover the entire nodule, and the apparent diffusion coefficient (ADC), diffusivity (D), pseudo-diffusivity (D *) and quantitation of perfusion fraction (f) values were measured, and the mean value of the multilayer measurement was recorded for further analysis. The differences of the parameters between benign and malignant thyroid nodules were analyzed using independent samples ttest (normal distribution) and Mann-Whitney U test (non-normal distribution). The diagnostic efficacy of parameters with statistical significance was evaluated using the receiver operating characteristics (ROC) curve. Results:The ADC, D and D *values in the malignant nodules were lower than those in benign nodules, the differences were statistically significant ( t=3.821, P=0.001; t=2.034, P=0.046).There were no statistical differences of D * and f values ( t=-1.170, P=0.247; Z=-0.559, P=0.577).The optimal cut-off values of ADC and D were 1.90×10 -3mm 2/s and 1.10×10 -3mm 2/s, with both sensitivity of 81.5%, specificity of 73.5% and 61.8%, respectively. The area under ROC curve of ADC and D were 0.782 and 0.688, and the statistical difference was found ( Z=2.098, P=0.040). Conclusion:The whole-lesion IVIM parameters (ADC and D) based on the TSE sequence provide imaging features for preoperative differentiation of benign and malignant nodules of the thyroid gland.

Objective:To explore the clinical effects of antegrade anterolateral thigh pedicled flaps in repairing wounds in the perineum or inguinal regions.Methods:The study was a retrospective observational study. From January 2022 to May 2024, 7 patients with wounds in the perineum or inguinal regions who met the inclusion criteria were admitted to Fujian Medical University Union Hospital, including 5 males and 2 females, aged 54 to 72 years. The wound area after debridement was 8 cm×6 cm to 16 cm×11 cm. During the operation, antegrade anterolateral thigh pedicled flaps with area of 9 cm×7 cm to 18 cm×13 cm were harvested to repair the wounds. The wounds in the flap donor sites were sutured directly or repaired with split-thickness skin grafts from the thigh. The survival of flaps and the healing of wounds and the survival of skin grafts in flap donor sites were observed after operation. During follow-up, the texture, color, and blood supply of flaps were observed, the muscle strength of the lower extremities on the affected side was evaluated according to Lovett muscle strength grading standard, the muscle tension of the lower extremities on the affected side was evaluated by modified Ashworth scale, and the recovery of lower extremity movement, wound recurrence, and scar formation in the flap donor sites were observed.Results:The flaps all survived successfully after operation. All the wounds in the flap donor sites healed and the skin grafts all survived. During 2 to 29 months of follow-up, the flaps were soft in texture, similar in color to the surrounding normal skin tissue with good blood supply. The muscle strength of the lower extremities on the affected side was evaluated as grade 4 in 2 patients and grade 5 in 5 patients. The muscle tension was grade 0 in all patients with no abnormality in movement. No wound recurred and no obvious scar deformity in the flap donor site was observed.Conclusions:The antegrade anterolateral thigh pedicled flap transplant is one of the effective methods to repair wounds in the perineum and inguinal regions. The procedure is easy to operate, with good postoperative appearances of the donor and recipient sites and good function of affected limbs, which is worthy of clinical promotion.

Objective: To investigate the significance of intestinal fatty acid binding protein (IFABP) in the evaluation of intestinal barrier dysfunction of mice at the early stage of severe burn injury. Methods: Thirty-six 8-week-old C57BL/6 male mice were collected and divided into normal control group (n=6) and scald group (n=30) according to random number table. Back of each mouse in scald group was placed into hot water of 90 ℃ for 10 s, causing full-thickness scald (hereinafter refer to as burn) of 30% total body surface area, while mice in normal control group were not inflicted with burns. Six mice in normal control group were taken, and 6 mice in scald group at 1, 2, 6, 12, and 24 h post injury were taken respectively. The portal vein blood of each mouse was extracted and the plasma was separated to measure intestinal permeability with fluorescin isothiocyanate-dextran fluorescence probe tracing method and plasma IFABP content by enzyme-linked immunosorbent assay. The distal ileum tissue of mice in normal control group and scald group at each time point post injury was collected to observe the morphology of the intestinal mucosa tissue by hematoxylin-eosin staining. Data were processed with one-way analysis of variance and Student-Newman-Keuls test, and pearson correlation test was used to analyze the correlation between intestinal permeability and plasma IFABP content of burned mice. Results: (1) At 1, 2, 6, 12, and 24 h post injury, the intestinal permeability of mice in scald group was 2.7±0.8, 5.4±2.5, 7.3±4.2, 12.4±6.1, 1.4±0.7, respectively, obviously higher than 1.0±0.4 of normal control group (P<0.05 or P<0.01). The intestinal permeability of mice in scald group showed an increasing trend post injury, reaching the peak at 12 h post injury, and rapidly falling back at 24 h post injury. (2) At 1, 2, 6, 12, and 24 h post injury, the plasma IFABP content of mice in scald group was (64±11), (59±12), (76±18), (111±22), and (66±10) ng/mL, obviously higher than (35±8) ng/mL in normal control group (P<0.05 or P<0.01). The plasma IFABP content of mice in scald group showed an increasing trend post injury, reaching the peak at 12 h post injury, and rapidly decreasing at 24 h post injury. (3) Uniform thickness of mucosa, intact epithelia, regularly arranged villi, and no inflammatory cell infiltration were observed in ileum of mice in normal control group. In ileum of mice in scald group, shortened villi of mucosa with different degrees, edema of lamina propria, and infiltration of neutrophils were observed at 1 and 2 h post injury; obviously damaged and partially exfoliated ileal mucosa, disorderly arranged and broken villi, degenerated and necrotic epithelial cells, dilated central lacteal, and infiltration of lymphocytes and neutrophils were observed at 6 and 12 h post injury; the damage of ileal mucosa was alleviated, and basically intact epithelia, dilated central lacteal, and infiltration of inflammatory cells were observed at 24 h post injury. (4) There was a significantly positive correlation between the intestinal permeability and the plasma IFABP content of burned mice (r=0.841, P<0.05). Conclusions The plasma IFABP can be used as a good biological indicator for the evaluation of intestinal barrier dysfunction of mice at the early stage of severe burn injury.