Objective To explore the effect of Astragalus polysaccharides (APS) on the function and quantity of islet β cells in rats with type 2 diabetes mellitus (T2DM). Methods SD rats were randomly divided into normal control group, T2DM model group and APS treatment group, with 8 rats in each group. The T2DM rats in the T2DM model group was induced by the combination of high fat diet and streptozotocin, and the rats in the APS treatment group was treated with APS (700 mg·kg-1·d-1, content of APS being 70%). The rats were sacrificed after 8 weeks of drug intervention, and the serum samples were collected to measure fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting insulin (FINS), and to calculate insulin secretion index (HOMA-β value). Pancreas tissues were extracted and stained with Hematoxylin-Eosin to observe the pancreatic histopathological characteristics, and the quantity of islet β cells was observed and calculated with immuno-histochemical method. Results (1) Compared with the normal control group, the rats in T2DM model group had significant increases in the FBG, TG and LDL-C, and significant decreases in the HDL-C, FINS and HOMA-β (P<0.05); compared with the T2DM model group, the rats in APS treatment group had significant decreases in the FBG, TG and LDL-C (P<0.05), and significant increases in the FINS and HOMA-β (P<0.05). (2) Compared with the normal control group, the rats in T2DM model group showed a significant atrophy of the islet accompanied by loss of granular and vacuolar degeneration, and the number of the islet β cells was significantly reduced (P<0.05); compared with the T2DM model group, the rats in APS treatment group showed a significant increase in the islet volume accompanied by improvement of islet degranulation and vacuolar degeneration, and had a significant increase in the number of islet β cells (P<0.05). Conclusion APS can improve the glucose and lipid metabolisms of the T2DM rats, which may be caused by increasing insulin secretion through the protective effect on pancreatic islet β cells.

Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role.This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR),the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients.One thousand consecutive CAD patients were divided into two groups based on age 60.The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records.The NLR and GRACE score were calculated.In the elderly (≥60 years),patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) had significantly higher NLR than did those with unstable angina (UA) and stable angina pectoris (SAP) (P＜0.01).The NLR was considerably elevated in older AMI patients compared with their younger counterparts (＜60 years) (P＜0.05).In elderly AMI patients,the NLR was considerably higher in the high-risk group than in both the low-risk and medium-risk groups based on the GRACE score (P＜0.05 and P＜0.01,respectively),and the NLR was positively correlated with the GRACE score (r=0.322,P＜0.001).Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group (P＜0.05).By curve receiver operator characteristic curve (ROC) analysis,the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve (AUC) 0.771 and 0.787,respectively,P＜0.001].It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

Objective To compare the effects of hepatic vein occlusion with tourniquet and Satinsky clamp in reseeting liver tumor involving the second hepatic portal.Methods From Jan 2003 to Jun 2006,180 patients underwent major liver resection with the selective hepatic vascular exclusion (SHVE).According to methods of hepatic vein occlusion,they were divided into two groups:Occlusion with tourniquet(tourniquet group,n=95)and occlusion with Satinsky clamp(Satinsky clamp group,n= 85).In tourniquet group,the hepatic veins were encircled and occluded with tourniquet,and in Satinsky clamp group,the hepatic veins were not encircled and clamped directly with Satinsky clamp.Data regarding the intraoperative and postoperative courses of the patients were analyzed.Results There was no difference between the two groups regarding the operating time,ischemia time,intraoperative blood loss and postoperative complications rate.The dissecting time of hepatic veins was significantly shorter in Satinsky group(6.2?2.4 min vs 18.3?6.2 min).lu the tourniquet group,five hepatic veins(one fight hepatic vein and four common trunk of left-middle hepatic veins)could not be dissected and encircled because of the tumors involving the cava hepatic junction.Another patient's common trunk of left-middle hepatic vein was inadvertently lacerated during the dissection.Hepatic veins in these 6 patients were occluded with Satinsky clamp successfully.Conclusion Occlusion with Satinsky clamping is safer and easier procedure than tourniquets in the resection of liver tumor involving the second porta hepatis.

Aneuploidy ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Male ; Spermatozoa ; ultrastructure

OBJECTIVEAutophagy is involved in several neurodegenerative diseases and recently its role in acute brain injury has won increasing interest. Spinal cord injuries (SCIs) often lead to permanent neurological deficit. Therefore, in this study, we examined the pro?les of autophagy-linked proteins (MAP-LC3) after SCI to investigate whether the expression of autophagy contributes to neurological deficit after SCI.

METHODSAdult female Sprague-Dawley rats were used and randomly divided into control and SCI groups. All the rates received laminectomy at T8-T10 level. Those in the SCI group received additional exposure of the dorsal surface of the spinal cord, followed by a weight- drop injury. Thereafter we investigated the expression levels of MAP-LC3, beclin-1, Cathepsin D and the beclin-1-binding protein bcl-2 by western blot analysis at 12 h, 24 h, 3 d, 7 d, 21 d and 28 d. One-way ANOVA with Tukey post hoc test was used to compare data between groups.

RESULTSWe observed significant increase in the level of LC3 (LC3-II/LC3-I) at 3 d and 7 d after SCI when compared with the sham group. While the level of beclin-1 and ratio of beclin-1/bcl-2 was found to have increased from 12 h to 24 h after injury. Cathepsin D expression was also elevated at 7 d (P<0.01).

CONCLUSIONBased on the above mentioned data, we proposed that autophagy plays a role in the manifestation of cell injury following SCI.

Adaptor Proteins, Signal Transducing ; metabolism ; Animals ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; physiology ; Beclin-1 ; Blotting, Western ; Cathepsin D ; metabolism ; Disease Models, Animal ; Female ; Laminectomy ; Microtubule-Associated Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism

OBJECTIVETo explore the clinical efficacy of the percutaneous balloon kyphoplasty for osteoporotic vertebral compression fractures with osteonecrosis.

METHODSThe clinical data of 31 patients with osteoporotic vertebral compression fractures associated with osteonecrosis from January 2005 to January 2008 were analyzed retrospectively. There were 13 male and 18 female in this study. The mean age of the patients was 71 years (range from 57 to 84 years). The back pain lasted for 4.2 months (from 1 month to 10 years). Radiography, MRI and CT examination were performed. The patients were treated by percutaneous balloon kyphoplasty and the vertebral body tissue was extracted to perform common pathological examination. The anterior vertebral height was measured on a standing lateral radiograph before operation, after operation (one day after operation) and at the final follow-up. A Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) were chosen to evaluate pain status and functional activity.

RESULTSThe mean follow-up was for 27 months (range, 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from (34.7 +/- 3.1)% preoperatively to (71.4 +/- 2.3)% postoperatively, and to (70.2 +/- 2.5)% at the final follow-up. There was a significant improvement between preoperative and postoperative values (P < 0.05) and no difference between postoperatively and at the final follow-up (P > 0.05). The VAS was 8.7 +/- 0.4 preoperatively, 2.3 +/- 0.7 postoperatively, and 1.9 +/- 0.2 at the final follow-up; and the ODI was 89.1 +/- 2.7 preoperatively, 31.7 +/- 3.1 postoperatively, and 29.1 +/- 2.7 at the final follow-up. There was statistically significant increment in the VAS and ODI postoperatively compared with preoperatively (P < 0.05), while there was no statistically significant differences between postoperatively and at the final follow-up (P > 0.05). There was a significant increment between preoperative and final follow-up values (P < 0.05). Asymptomatic cement leakage occurred in two cases. New vertebral fracture occurred in one case.

CONCLUSIONBalloon kyphoplasty is a safe and effective procedure for osteoporotic vertebral compression fractures with osteonecrosis.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; complications ; etiology ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteonecrosis ; etiology ; surgery ; Osteoporosis ; complications ; Retrospective Studies ; Spinal Fractures ; complications ; etiology ; Vertebroplasty

OBJECTIVETo explore how to determine painful vertebrae treated by kyphoplasty in multiple-level osteoporotic vertebral compression fractures and clinical outcome.

METHODSFrom October 2002 to June 2005, 51 consecutive procedures with kyphoplasty were performed on 35 patients with multiple-level osteoporotic vertebral compression fractures. There were 51 painful vertebrae among 120 vertebral compression fractures. The painful vertebra was determined by the signal intensity changes in MR images, combined with radiography and local percussion pain before operation. Only painful vertebrae were treated by kyphoplasty. Preoperative, postoperative and final follow-up visual analog scale (VAS) and radiographic findings such as vertebral height and Cobb angle were recorded and analyzed.

RESULTSAll patients tolerated the procedure well with immediate relief of their back pain after kyphoplasty and they can walk at 1-3 days after the procedure. There were 3 vertebrae (3/51) occurred asymptomatic extravasation of cement. 31 cases were followed up for mean 16.2 months (range 6-44 months). VAS reduced from preoperative 8.7 to final follow-up 2.1 (P <0. 01). At final follow-up the vertebral height had a recovery rate of 59.17%, and the mean Cobb angle was improved 10.1 degrees. There was a significant improvement between preoperative and final follow-up values (P < 0.01).

CONCLUSIONSThe painful vertebra can be determined by signal intensity changes in MR series images in multiple-level osteoporotic vertebral compression fractures. Selecting painful vertebrae to be treated by kyphoplasty can make patients with multiple-level VCFs gain an excellent result.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; diagnosis ; etiology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis ; complications ; Prospective Studies ; Spinal Fractures ; diagnosis ; etiology ; surgery ; Treatment Outcome ; Vertebroplasty ; methods

· AIM:To compared the therapeutic effect of improved macular hole surgery to traditional macular hole surgery for idiopathic macular hole (IMH).· METHODS:From April 2014 to June 2017,28 eyes of 28 IMH patients who were treated in our hospital were selected consecutively and received surgical treatment independently performed by the same physician in our hospital.The patients were divided into A (traditional group) and B (improvement group) groups.All 13 cases in Group A were treated with traditional vitrectomy internal limiting membrane peeling and C3 F8 tamponade,while all 15 cases in Group B were treated with improved indocyanine green-assisted internal limiting membrane peeling combined with macular hole reconstruction and air tamponade.All patients were reviewed at 1wk,1,3,and 6mo after surgery.The best corrected visual acuity (BCVA) before and after the operation,operation time,closure rate of the macular hole during the last review and prone time were compared between the two groups of patients.· RESULTS:There was no significant difference in closure rate between the two groups (P＞ 0.05).Postoperative BCVA increased in both groups compared with preoperatively and the differences were statistically significant (P ＜ 0.05).But there was no significant difference on BCVA between the two groups both preoperatively and postoperatively (P ＞ 0.05).The operation time in Group B was significantly shorter than that in Group A (P＜0.05).Prone time in Group B was significantly shorter than that in Group A,the difference was statistically significant (P＜0.05).· CONCLUSION:This study shows that compared with the traditional group,the improved indocyanine green-assisted peeling of internal limiting membrane combined with macular hole reconstruction and air tamponade can achieve similarly high closure rates while the operation procedure was simplified and the operation time was shortened.Reduced number of instruments into and out of the incision can reduce the incidence of complications.The postoperative patient's prone time is significantly shortened,with high comfort and good compliance.

OBJECTIVETo compare the effects of selective hepatic vascular exclusion (SHVE) and Pringle maneuver in resecting the liver tumors involving the second porta hepatis.

METHODSFrom January 2000 to October 2005, 2100 liver tumors were resected, among which 235 tumors adhered to or were very close to one or more hepatic veins. Both SHVE and Pringle maneuver were used to control the blood loss during the hepatectomy. They were divided into two groups: SHVE group (125 cases) and Pringle group (110 cases). Data regarding the intra-operative and postoperative courses of the patients were analyzed. SHVE group included total SHVE (clamping of the porta hepatis and all major hepatic veins) in 25 cases and partial SHVE (clamping of the porta hepatic and one or two hepatic veins) in 100 cases. Three methods were used to occlude hepatic veins: be ligated with suture, be encircled and occluded with tourniquets and be clamped with Shatinsky clamps directly.

RESULTSThere was no difference between the 2 groups regarding the age, sex, tumor size, cirrhosis and HBsAg positive rate, ischemia time and operating time (P > 0.05). Intra-operative blood loss and transfusion requirements were decreased significantly in the SHVE group. Hepatic veins ruptured with massive blood loss in 14 and air embolism in 3 in Pringle group, but there was no massive blood loss and air embolism in SHVE group. Postoperative bleeding, reoperation, liver function failure and mortality rate were higher in Pringle group (P < 0.05), ICU stay and hospital stay were longer in Pringle group (P < 0.05).

CONCLUSIONSSHVE is much more effective than Pringle maneuver for controlling intraoperative bleeding. It can prevent massive blood loss and air embolism resulting from hepatic veins ruptured and can reduce the postoperative complications rate and mortality rate. Clamping the hepatic veins with Shatinsky clamp is safer and easier than encircled and occluded with tourniquets.

Adolescent ; Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Infant ; Liver ; blood supply ; pathology ; surgery ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

OBJECTIVETo investigate the selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fracture.

METHODSTwenty-two consecutive procedures were performed in 17 aged patients with osteoporotic spinal compression fractures from April 2002 to June 2004. The signal changes in different sequences were confirmed by magnetic resonance imaging before the procedures. This operation involved the percutaneous insertion of two inflatable bone tamps into a fractured vertebral body transpedicularly under fluoroscopic guidance. Every patient was treated individually, according to the results of radiography and CT scan before operation. Preoperative and postoperative complications, visual analogue scale, and radiographic findings such as vertebral height and Cobb angle were recorded and analyzed.

RESULTSAll patients tolerated the procedure well with immediate relief of their back pain in 24 hours. There was no leakage of cement into the epidura. The mean loss percent of the anterior and middle vertebral heights were (35.32 +/- 13.15)% and (27.53 +/- 12.61)% before operation, and (14.21 +/- 12.43)% and (16.2 +/- 7.5)% after operation. The height restoration of vertebra was confirmed by X-ray after the procedure (P < 0.01). The mean kyphosis was improved from (25.3 +/- 4.2) degrees to (8.6 +/- 5.1) degrees. No complications occurred. No patient had nerve injury. The patients were allowed to walk next day after the procedure.

CONCLUSIONThe selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fractures has satisfactory short-term clinical efficacy. It is also an effective way to prevent complications.

Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Spontaneous ; etiology ; surgery ; Humans ; Kyphosis ; etiology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Osteoporosis ; complications ; Osteoporosis, Postmenopausal ; complications ; Spinal Fractures ; surgery