Objective To investigate the clinical characteristics,peripheral insulin sensitivity,and β-cell function in patients with ketosis-prone diabetes(KPD).Methods Thirty-one patients with newly diagnosed ketosisprone diabetes were admitted to West China Hospital from January 2004 to December 2009.They were divided into 2 groups according to their body mass index (BMI):OB-KPD (BMI ≥ 25 kg/m2,n =22) and Lean-KPD (BMI ＜ 23 kg/m2,n =9).10 patients with newly-onset type 2 diabetes free from ketosis (OB-DM:BMI ≥ 25 kg/m2,n =10) were enlisted as control.Detailed assessments of medical history and symptoms of hyperglycemia were performed.The islet cell antibody (ICA),insulin autoantibody (IAA),anti-glutamic acid decarboxylase antibody (GAD-Ab),fasting plasma glucose,serum insulin,C-peptide and free fat acids concentrations were measured.All of the subjects underwent oral and intravenous glucose tolerance tests,euglycemic-hyperinsulinemia and hyperglycemia clamp test,to evaluate the insulin secretion and insulin sensitivity respectively.Insulin sensitivity was determined by glucose disposal rate (GDR) of steady state during euglycemic clamp and acute insulin secretion was calculated by insulin area under curve(AUCins 0-10 min) during IVGTT.Maximal insulin secretion was determined by glucose infusion rate (GIR) and serum insulin concentration of steady state during hyperglycemic clamp test.Results Age,sex,duration of diabetes were matched among groups.A family history of diabetes was strongly associated with those patients with obesity,compared with lean ketosis prone diabetes(16/22 vs 1/9).GDR was (4.91 ± 1.82) mg · kg 1 · min-1 in subjects with OB-KPD,being lower than that in Lean-KPD patients[(6.26 ± 1.89) mg · kg 1 · min-1] and OB-DM group[(6.78-± 1.69) mg · kg 1 · min-1,P＜0.01].Serum insulin and C-peptide in OB-KPD patients were higher than Lean-KPD patients.Area under the insulin curve [AUCins0-10min (183.86 ± 31.1) mIU/L] and GIR[(2.65 ±1.53) mg · kg-1 · min-1] in OB-KPD patients were lower than those in OB-DM group[(697.06-± 231.9) mIU/L,(6.53 ± 2.21)mg · kg 1 · min-1,P＜0.0 1],but slightly higher than the Lean-KPD group [AUCins0 10min (92.1 ±29.8) mUU/L,GIR (2.55 ± 1.49) mg · kg 1 · min-1,P＜0.05].Glucose disposal rate (GDR) was strongly associated with casual plasma glucose (r =-0.502,P＜0.01),HbA1C(r =-0.553,P＜0.0 1) and FFA eoneentrations (r=-0.504,P＜0.01) on admission.Conclusions Insulin resistance and β-cell dysfunction coexist in all KPD patients.OB-KPD patients exhibit more severe insulin resistance,while Lean-KPD patients have lower insulin secretion.KPD patients had severe hyperglycemia,hypertriglyceridemia,and high plasma FFA levels on admission,suggesting that hyperglycemia and elevated FFA levels could result in serious insulin resistance,β-cell dysfunction,and diabetic ketosis in patients with KPD.

The physiological and pathological phenomenon along the running courses of meridians such as enrichment of small charged molecular, low-resistance, isotope migration, electromyography phenomenon, acoustical conductivity, thermal radiation, magnetic phenomenon and optical-electrical characteristics, etc. are explored in this article. And based on the above mentioned studies, it is concluded that as a physiological sensation along meridians, propagated sensation could only be the result of the reflection of nerve excitation. The direct stimulator of the neural electrical activities of the propagated sensation is the enrichment of charged small biological molecular at the corresponding site of the organism. The root cause of the enrichment is the unique electrophysiological mechanism and distribution discipline of the human nerve fiber, which formed an electric field of biological source for the concentration of the small molecular. Thus, it is concluded that the electric field along the running courses of meridians is an isopotential balanced line formed by multiple neural bioelectrical activities in different spaces closed to meridians.
Electrophysiological Phenomena ; Humans ; Meridians ; Nervous System ; physiopathology

Animals ; Animals, Newborn ; Brain ; blood supply ; metabolism ; pathology ; Carrier Proteins ; genetics ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; genetics ; Gene Expression ; Hypoxia-Ischemia, Brain ; genetics ; pathology ; In Situ Hybridization ; Protein Tyrosine Phosphatase, Non-Receptor Type 13 ; Protein Tyrosine Phosphatases ; genetics ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

Objective To compare the differences of clinical characteristics between genotype B and C chronic hepatitis B(CHB)patients and to summarize clinical factors related to genotype C hepa- titis B virus(HBV)infection.Methods Seventy eight CHB patients who were diagnosed with genotype B or C infection by liver puncture biopsy and genotyping were enrolled.Their serum HBV DNA levels were detected.Severe hepatitis,liver cirrhosis,hepatocellular carcinoma and HBeAg positive rate were analyzed to determine the pathologic inflammation and fibrosis degree of liver tissue.Chi square test and Logistic multiple regression analysis were employed for the statistical analysis.Results The serum albumin and pre-protein were lower in genotype C CHB patients than that in genotype B.The alanine aminotrans- ferase,total bilirubin and prothrombin time were higher in genotype C CHB patients than that in genotype B.The rates of genotype C patients increased significantly with the grade of liver necroin- flammation progressing from GO to G4(1.8%,11.1%,20.4%,33.3%,33.3%) and the stage of liver fibrosis progressing from SO to S4(5.6%,5.6%,14.8%,33.3%,40.7%),but the rates of genotype B patients did not change significantly with the grade of liver necroinflammation(16.7%, 25.0%,25.0%,20.8%,12.5%)and stage of liver fibrosis progressing(16.7%,29.2%%,20.8%, 16.7%,16.7%).There was statistical significance in grades of liver necroinflammation(X~2= 11.49,P=0.022)and stages of liver fibrosis(X~2=13.56,P=0.006)between genotype B and gen- otype C patients.The rates of genotype C CHB patients were higher than,similar with and lower than the rates of genotype B patients of HBV DNA level above 1.0?10~6 copy/mL,between 5.0?10~2-1.0?10~6 copy/mL and under 5.0?10~2 copy/mL,respectively(51.8% vs 12.5%,35.2% vs 45.8% and 13.0% vs 41.7%).There was statistical significance of HBV loads between genotype B and genotype C patients(X~2=13.25,P=0.001).HBeAg positive rate in genotype C patients was significantly higher than that in genotype B patients(61.1% vs 25.0%,X~2=8.67,P=0.003).The rates of decompensated cirrhosis,compensated cirrhosis and no-cirrhosis in genotype C patients were higher than,similiar with and lower than the rates in genotype B patients,respectively(40.7% vs 4.2%,22.2% vs 20.8% and 37.0% vs 75.0%).There was statistical significance of the rate of cirrhosis between genotype B and genotype C patients (X~2=12.47,P=0.002).Conclusions The degree of liver necroinflammation and fibrosis,the HBeAg positive rate and the incidence of cirrhosis are all related with genotype C HBV infection.

IgG4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition of autoimmune etiology in recent twenty years, mainly manifesting as mass-forming lesions in single or multiple organs. In the past, it was often missed or misdiagnosed as inflammation or tumor. Patients may die from multiple organ failure due to end-stage fibrosis if they are not treated promptly. However, the number of clinically confirmed cases has gradually increased with the improvement of diagnostic level in recent years, and these patients have benefited greatly after receiving early treatment. Although patients generally respond well to traditional immunosuppressors including glucocorticoids and disease-modifying anti-rheumatic drugs, refractory and recurrent cases, even patients with glucocorticoid contraindication are common. Important mechanistic insights have been derived from studies of B-cell depletion therapy, but greater awareness of the pathophysiology of IgG4-RD is still badly needed to identify novel therapeutic targets. In this article, we reviewed the pathogenesis progress and promising therapy of IgG4-RD to seek better clinical management of IgG4-RD.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Liver Cirrhosis, Experimental ; enzymology ; Male ; Pancreatic Elastase ; biosynthesis ; genetics ; Rats ; Rats, Wistar

Aged ; Aged, 80 and over ; Delivery of Health Care ; Family Characteristics ; Female ; Home Care Services ; Humans ; Male ; Middle Aged ; Rural Population ; Surveys and Questionnaires

OBJECTIVETo investigate the expression of SOX2 in cervical intraepithelial neoplasia (CIN) and cervical cancer and explore its association with the clinical features.

METHODSSOX2 expressions were examined using immunohistochemical method in 10 normal cervical tissue specimens, 36 cervical intraepithelial neoplasia specimens (including 10 cases of grade I, 12 of grade II, and 14 grade III) and 40 cervical cancer specimens (including 21 cases of stage I and 19 of stage II). The correlation between the immunohistochemical results and the clinical features of the patients was analyzed.

RESULTSSOX2 expression was negative in normal cervical tissues, and was positive in 41.6% of CIN specimens (10.0% in CIN I, 41.7% in CIN II, and 64.3% in CIN III) in 82.5% of cervical cancer specimens (78.2% in stage I and 88.2% in stage II). The patients with cervical cancer had a significantly higher positivity rate of SOX2 than normal control group (P<0.05). The positivity rate of SOX2 increased with the evolution of cervical disease. SOX2 protein expression was significantly correlated with the histological grade and lymph node metastasis (P<0.05), but not with the age or clinical stage of the patients (P<0.05).

CONCLUSIONSOX2 expression may serve as a useful indicator for evaluating metastasis and malignancy of cervical cancer.

Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; pathology ; Humans ; Lymphatic Metastasis ; Neoplasm Grading ; Neoplasm Staging ; SOXB1 Transcription Factors ; genetics ; metabolism

OBJECTIVETo investigate the risk factors of community-acquired pneumonia (CAP) in patients with primary Sjogren's syndrome (pSS).

METHODSThe clinical data were collected from 121 inpatients with pSS and univariate analysis and logistic regression were conducted to analyze the risk factors of CAP.

RESULTSThe incidence of CAP in the 121 patients with pSS was 27.3%. Age, disease course, low while blood cells, low complement levels, liver and kidney dysfunction, low albumin, hyperglobulinaemia, renal tubule acidosis, interstitial lung disease (ILD) and immunosuppressive agents were closely related to CAP in these patients. Logistic regression analysis identified ILD, low complement levels and hyperglobulinemia as the risk factors for CAP in patients with pSS.

CONCLUSIONVigorous control of pSS and minimizing the risk factors may prove effective to lower the incidence of CAP in patients with pSS.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Community-Acquired Infections ; epidemiology ; etiology ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Pneumonia ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors ; Sjogren's Syndrome ; complications ; Young Adult

Background:Andersson lesions (ALs),also known as spondylodiscities,destructive vertebral lesions and spinal pseudarthrosis,usually occur in patients with ankylosing spondylitis (AS).Inflammatory and traumatic causes have been proposed to define this lesion.Different surgical approaches including anterior,posterior,and combined anterior and posterior procedure have been used to address the complications,consisting of mechanical pain,kyphotic deformity,and neurologic deficits.However,the preferred surgical procedure remains controversial.The aim of this study was to illustrate the safety,efficacy,and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in AS.Methods:From June 2008 to January 2013,23 patients (18 males,5 females) at an average age of 44.8 years (range 25-69 years) were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our department.All sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the follow-up period.Assessment of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading system.Ankylosing spondylitis quality of life (ASQoL) and visual analog scale (VAS) scores were performed to evaluate improvements in daily life function and back pain pre-operatively and post-operatively.Paired t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric comparisons.The radiographic data change was evaluated by repeated measure analysis of variance.Results:The mean operative duration was 205.4 min (range 115-375 min),with an average blood loss of 488.5 mL (range 215-880 mL).Radiographical and clinical outcomes were assessed after a mean of 61.4 months of follow-up.The VAS back pain and ASQoL scores improved significantly in all patients (7.52 ± 1.31 vs.1.70 ± 0.70,t=18.30,P ＜ 0.001;13.87 ± 1.89 vs.7.22 ± 1.24,t=18.53,P＜0.001,respectively).The thoracolumbar kyphosis (TLK) changed from 40.03±17.61° pre-operatively to 13.86 ± 6.65° post-operatively,and 28.45 ± 6.63° at final follow-up (F =57.54,P ＜ 0.001),the thoracic kyphosis (TK) changed from 52.30 ± 17.62° pre-operatively to 27.76 ± 6.50° post-operatively,and 28.45 ± 6.63° at final follow-up (F =57.29,P ＜ 0.001),and lumbar lordosis (LL) changed from-29.56 ± 9.73° pre-operatively to-20.58 ± 9.71° post-operatively,and-20.73 ± 10.27° at final follow-up (F=42.50,P ＜ 0.001).Mean sagirtal vertical axis (SVA) was improved from 11.82 ± 4.55 cm pre-operatively to 5.12 ± 2.42 cm post-operatively,and 5.03 ± 2.29 cm at final follow-up (F=79.36,P ＜ 0.001).No obvious loss of correction occurred,according to the lack of significant differences in the sagittal balance parameters between post-operatively and the final follow-up in all patients (TK:27.76 ± 6.50° vs.28.45 ± 6.63°,TLK:13.86 ± 6.65° vs.14.42 ± 6.7°,LL:-20.58 ± 9.71° vs.-20.73 ± 10.27°,and SVA:5.12 ± 2.42 cm vs.5.03 ± 2.29 cm,all P ＞ 0.05,respectively).Conclusions:The modified posterior wedge osteotomy is an accepted surgical procedure for treating thoracolumbar kyphosis with ALs in AS and results in satisfactory local kyphosis correction,solid fusion,and good clinical outcomes.