Objective To investigate the level of leptin in the serum of GDM mothers and their neonates and the variation of the leptin expression in placenta. Methods The concentrations of serum insulin and leptin in 24 GDM and 26 healthy mothers and neonates were examined by radioimmunoassay (RIA).The level of leptin mRNA in 50 placentas was examined by reverse transcription-polymerase chain reaction(RT-PCR). Results (1) The serum levels of leptin and insulin in GDM group [(18.62?7.86) ?g/L and (13.47?5.11) mIU/L] were significantly higher than those in control group [(14.21?7.59) ?g/L and (8.98?4.23) mIU/L,P 0.05) in both groups. But the leptin level in umbilical blood of the two group was positively related to the insulin level ( r=0.53,P

Objective To explore the functionalternation of human cholangiocarcinoma cell line HUCCA-1 by silenc?ing Gab1 expression;to detect its effect on PI3KCA and Akt1 expression at protein and mRNA levels and to explore the role of Gab1,PI3KCA and Akt1 expressions in the malignant behavior of cholangiocarcinoma. Methods Gab1 siRNA was trans? fected into cholangiocarcinoma cell line HUCCA-1. Proliferation, apoptosis, migration/invasion of cells were examined by MTT, flow cytometry and Transwell assay respectively after transfection. PI3KCA and Akt1 expressions were detected by Western blotting and qPCR. Results Transfection efficiency was satisfactory and reaches 65%~70%;PI3KCA and Akt1 expressions were down-regulated at both protein and mRNA levels upon silencing of Gab1. Meanwhile, proliferations of HUCCA-1 cells were inhibited (P<0.01);apoptosis rate increases(P<0.05);and migration and invasion were both inhibit?ed upon Gab1 silencing(P<0.05). Conclusion The proliferation, migration and invasion are all inhibited while apoptosis is attenuated after Gab1 was down-regulated by Gab1 siRNA transfection. PI3KCA and Akt1 expressions are up-regulated with down-regulation of Gab1. Therefore, Gab1 may enhance the maglinant behavior of cholangiocarcinoma cells through up-regulating PI3KCA and Akt1 expression and it can be used as a candidate for cholangiocarcinoma therapy.

Hyperglycemia has been identified as one of the important factors involved in the microvascular complications of diabetes, and has been related to increased cardiovascular mortality. Endothelial damage and dysfunction result from diabetes; therefore, the aim of this study was to determine the response of endothelial cells to stressful stimuli, modelled in normal and high glucose concentrations in vitro. Eahy 926 endothelial cells were cultured in 5 mmol/L or 30 mmol/L glucose conditions for a 24 hour period and oxidative stress was induced by exposure to hydrogen peroxide (H2O2) or tumour necrosis factor- α (TNF- α ), following which the protective effect of the glucocorticoid dexamethasone was assessed. Apoptosis, necrosis and cell viability were determined using an ELISA for DNA fragmentation, an enzymatic lactate dehydrogenase assay and an MTT assay, respectively. High glucose significantly increased the susceptibility of Eahy 926 cells to apoptosis in the presence of 500 μmol/L H2O2, above that induced in normal glucose (P<0.02). A reduction of H2O2- and TNF- α -induced apoptosis occurred in both high and low glucose after treatment with dexametha-sone (P<0.05). Conclusion high glucose is effective in significantly augmenting stress caused by H2O2, but not in causing stress alone. These findings suggest a mechanism by which short term hyperglycemia may facilitate and augment endothelial damage.

Objective To summarize the clinical characteristics and investigate the prognostic factors of primary duodenal carcinoma.Methods The clinical data of 122 patients with primary duodenal carcinoma who were admitted to the Shengjing Hospital Affiliated to China Medical University from November 2007 to May 2013 were retrospectively analyzed.All the patients received different operations according to the characteristics of tumors.Primary duodenal carcinomas of patients were confirmed by the postoperative pathological diagnosis.All the patients were followed up by outpatient examination, telephone interview and correspondence till November 30,2014.The treatment process, results of imaging examination and laboratory examination and postoperative survival were recorded.The clinical features, diagnostic criteria, therapeutic regimens and prognostic factors were analyzed.The survival rate and survival curve were analyzed and drawn by the Kaplan-Meier method.The univariate analysis was done using the Log-rank test, and multivariate analysis was done using the COX regression model.Results Among the 122 patients with primary duodenal carcinoma, jaundice as the first symptom was detected in 57 patients, abdominal pain and upper abdomen discomfort in 37 patients, gastrointestinal obstruction in 14 patients,anorexia and reduction of body weight in 4 patients, gastrointestinal hemorrhage in 3 patients, diarrhea in 3 patients, pyrexia in 3 patients and abdominal mass in 1 patient.The positive rates of CT examinations, endoscopic examinations, magnetic resonanced cholangio-pancreatography (MRCP), B-ultrasound examinations and upper gastrointestinal contrast examinations were 69.67％ (85/122), 85.56％ (77/90), 79.76％ (67/84), 12.73％ (7/55) and 75.00％ (36/48), respectively.Among the 122 patients, anemia was detected in 48 patients,positive fecal occult blood test in 94 patients, increasing level of CA19-9 in 71 patients, increasing level of CEA in 22 patients and increasing level of AFP in 9 patients.The tumors located at the descending part of duodenum,duodenal bulb and horizontal part of duodenum were detected in patients of 86.07％ (105/122), 7.37 ％ (9/122) and 6.56％ (8/122), respectively.The mean diameter of tumors was 2.3 cm (range, 1.0-15.0cm).All the 122 patients received operation.Pancreaticoduo-denectomy was performed in 100 patients, including combined with jejunostomy in 17 patients, pylorus-preserving pancreatoduodenectomy in 7 patients, segmental resection of duodenum and gastrojejunostomy in 5 patients, local resection of duodenal papilla in 6 patients and palliative gastrojejunostomy in 11 patients.Nineteen patients with complications were cured by symptomatic treatment.Of the 122 patients, adenocarcinoma, carcinoid tumor, lymphoma, small cell carcinoma, intraepithelial neoplasm combined with differentiated rhabdomyoma and with undifferentiated rhabdomyoma were detected in 116, 2, 1, 1,1 and 1 patients, respectively.The Ⅰ , Ⅱ , Ⅲ and Ⅳ stage of tumors were detected in 10, 4, 74 and 34 patients.There were 100 patients without lymph node metastasis, 13 patients with 0 ＜ metastatic lymph node ratio (MLR) ≤0.2, 4 patients with 0.2 ＜ MLR≤0.4 and 5 patients with MLR ＞ 0.4.One-hundred and twelve of 122 patients were followed up for 1-70 months with a median follow-up time of 20 months.The postoperative survival time, a median of survival time, postoperative 3-and 5-year survival rates were 1-70 months, 18 months, 36.6％ and 13.5％ , respectively.The results of univariate analysis showed that the lymph node metastasis, differentiated grade of tumor, MLR and with invasion of pancreas were risk factors affecting the prognosis of patients (x2 =8.465, 57.355, 16.232, 20.112, P ＜ 0.05).The multivariate analysis showed that the low-differentiation of tumor, invasion of pancreas, lymph node metastasis and MLR ＞ 0.4 were independent risk factors affecting the prognosis of patients (RR =3.330, 3.718, 2.623, 95％ confidence interval: 1.861-5.956, 1.292-10.696,1.624-4.236, P ＜ 0.05).Conclusions Most of the primary duodenal carcinomas are located at the descending part of duodenum without specific clinical symptoms in the early stage.The joint usage of assistant examinations can improve the diagnostic rate of primary duodenal carcinoma, and surgery is mainly therapeutic method.The low-differentiation of tumor, MLR ＞ 0.4 and invasion of pancreas are independent risk factors affecting the prognosis of patients.

OBJECTIVE: To discuss the potential problems caused by the exfoliation of the tunic albuginea after the low-temperature plasma operation. METHOD: To observe the occurrence of the tunic albuginea, exfolliating time, wound healing and its complications by following the patients received the low-temperature plasma operation from November in 2012 through June in 2013 (including 116 cases of tonsillectomy, 98 cases of adenoidectomy, 255 cases of the ablation of the inferior turbinate,8 cases of the ablation of the cyst of epiglottis, and 4 cases of the ablation of the tumor of larynx) together with reviewing the relevant literatures. RESULT: The tunic albuginea exfolliated about two weeks after tonsillectomy, bleeding was found in 3 cases, one of which was related with inappropriate eating; the exfoliation about two or three weeks after adenoidectomy, without the occurrence of the narrow nostril and pharyngeal cavity adhesion; about four weeks after the ablation of the cyst of epiglottis, bleeding was found in 1 case; about three or four weeks after the ablation of the inferior turbinate, massive bleeding was found in one case after two months; and the ablation of the tumor of larynx, one with severe atypical hyperplasia and carcinoma in situ, the theunic albuginea did not completely exfoliate four moths after the surgery and new creatures could be found, the wound looked smooth and healed well nine moths after the surgery. The full exfoliation occur four months after the surgery for one with the neurilemmoma in the left laryngeal ventricle and the new creatures could also be found. It exfoliated eighth days after the surgry for one patient with left subglottic epitheliaoid heman-gio endothelioma and it did not recur even six months after the surgery. Another one with the cyst of the left plica aryepiglottica failed to be followed. The first three patients did not suffer from such complications as bleeding, endogenous in trachea, etc. CONCLUSION Low-temperature plasma surgery has obvious advantages, but the potential problems caused by the surgery need to be taken in accounted, especially the exfoliating time of the tunia albuginea is different after the ablation of the tumor of larynx, which is inconsistent with what the literatures reported, it could partially due to the action time of low-temperature plasma surgery with surrounding tissues.
Adolescent ; Adult ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Young Adult

Adolescent ; Adult ; Aged ; Carbon-Nitrogen Ligases ; genetics ; Female ; Gene Expression ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Nasopharynx ; pathology ; Young Adult

Objective The aim of this study was to determine if isoflavone genistien has protective effects against high glucose-induced cell apoptosis in human aortic endlthelial cells,and investigate the possible mechanism for this protection.Methods Human aortic endothelial cells subjected to normal (5mmol/L) or high glucose (25mmol/L) were treated with genistein at 0,50,100nmol/L.Parallel experiments were performed with 100nM 17b-estradiol,and also in the presence and absence of the pure anti-estrogen ICI-182,780 (100nmol/L).The effects on cell apoptotic DNA fragmentation were determined using cell death ELISA,and the effects on cellular proliferation were determined using tritiated thymidine incorporation assay.Estrogen receptor expression was detected by Taqman quantitative PCR.Results Genistein at 100nmol/L significantly reduced high glucose-induced DNA fragmentation,and reversed cell DNA synthesis inhibition (P＜0.001) after 24 hours' incubation.The effect of genistein was completely blocked by ICI-182,780administration.Estrogen receptor beta,but not alpha was found to be expressed in these cells.Conclusion Isoflavone genistein shows protection against high glucose-induced cell damage through estrogen receptor beta,reducing apoptotic DNA damage and protecting from the inhibition of cell proliferation.

Objective To investigate the clinical application value of hand-assistant laparoscopy and total laparoscopy in radical right colectomy.Methods Five hundred and twenty-four patients were selected as our subjects who performed by hand-assistant laparoscopic radical right colectomy (213 cases) or total laparoscopic radical right colectomy (293 cases) in colon cancer therapy.The operation durations,bleeding volumes,postoperative pain scores,postoperative draining volumes,recovery time of gastrointestinal function,hospitalization times,hospitalization expenses,postoperative complications and cosmetic satisfactory scores were recorded and compared.Results The operation durations,bleeding volumes,postoperative draining volumes in hand-assistant laparoscopic group were (112.4±52.9) min,(105.6 ± 49.5) ml,(28.6± 15.7) ml,lower than those in total laparoscopic group((148.5±61.7) min,(171.5±72.4) ml,(28.6±15.7) ml;P=0.032,0.041,0.039).The recovery time of gastrointestinal function of hand-assistant laparoscopic group were (69.4±21.8) h,longer than total laparoscopic group ((53.4 ± 21.7) h;P =0.008).The hospitalization times,hospitalization expenses,postoperative complications of hand-assistant laparoscopic group were as same as total laparoscopic group(P＞0.05).Hand-assisted laparoscopic group mild pain in 35 cases,121 cases of moderate and severe 75 cases;Total 96 cases of mild pain in laparoscopic group,146 cases of moderate and severe in 51 cases,the difference was statistically significant(P=0.027).Beauty score incision of laparoscopic group was higher than in the whole hand-assisted laparoscopic group,the difference was statistically significant ((4.3 ± 0.9) score vs.(2.4±0.6) score;P=0.002).Conclusion Hand-assistant laparoscopic radical right colectomy is convenient and more quickly for operation.Total laparoscopic radical right colectomy has advantage in terms of less injury and the patients are more satisfactory.For practiced operators,total laparoscopic radical right colectomy is recommended cosmetic satisfactory score.

Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P ＜ 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95％ CI-0.096 ～-0.095,P =0.031),HDL-C (β =1.295,95％ CI 1.231 ～ 1.360,P =0.022) and sRAGE (β =0.119,95％ CI 0.118 ～ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.

In this paper,the mechanism,instrument design and clinical applications of interference electrotherapy in promoting bone healing are described.A new kind of electrotherapeutical instrument for bone injury is developed.With the variety of waveform and characterisics of easy operation,high intelligence and reliability,the instrument is improved obviously with the use of Single Chip Microcomputer.At the same time ,60cases with fracture were treated by interfere current stimulation in clinical research.It is achieved in accelerating bone healing,detumescence,comeback of tonicity.