Objective To observe the curative effect of acupuncture on insulin receptor substrate 1 ( IRS-1) , IRS-2 and glucose transporter 4 (GLUT4) in skeletal muscle of experimental rats with insulin resistance (IR) . Methods Thirty-two rats were randomly divided into normal group, model group, acupuncture normal group and acupuncture model group. The fasting plasma glucose ( FPG) level was detected with glucose oxidase method, fasting insulin and C-peptide ( C-P) were examined with enzyme linked immunosorbent assay ( ELISA) , insulin sensitivity index ( ISI) was calculated, and IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of skeletal muscle were observed by real-time PCR-based fluorescent assay in each group. Results Compared to the normal group, the FPG, FINS, C-P levels were increased dramatically (P<0.01), ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the model group declined remarkably ( P<0.01). Compared to the model group, the FPG, FINS, C-P levels declined evidently ( P<0.05 or P<0.01) , and ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the acupuncture model group were increased dramatically ( P<0.01). Conclusion The curative mechanism of acupuncture for insulin resistance is probably related to the increase of IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA expression in skeletal muscle which contributes to the improvement of PI3K signal pathway.

Objective To investigate the feasibility and clinical significance of D2 lymphadenectomy for distal gastric cancer in which the pancreas were regarded as the central landmark. Methods 26 patients of advanced distal gastric cancer were performed D2 lymphade-nectomy centered on the pancreas from March 2012 to February 2013. The operation time, amount of bleeding,number of lymph nodes,and postoperative complications were recorded. Results All the 26 patients underwent the operation successfully. The amount of bleeding was 50~200 mL(averagely 110 mL),and the number of lymph nodes which were cleaned was 16~35 (averagely 26). One patient had intra-ab-dominal hemorrhage and one patient had lymphorrhagia after the operation,and they were cured finally. There was no local recurrence,no dis-tant metastasis,and no death case occurred during the follow-up. Conclusion D2 lymphadenectomy for distal gastric cancer with pancreas as the central landmark is safe and feasible, and it is of lower incidence of complications .

BACKGROUND: At present, the scale for evaluating cervical vertigo symptoms and functions applied in clinic can evaluate the overall curative effect in patients with cervical spondylosis of vertebral artery type (CSA).However, this scale lacks the content of functional status and emotional function for evaluating daily life function.OBJECTIVE: To develop a functional scale for cervical spondylosis of vertebral artery type (FS-CSA) including functional status and emotional function based on the vertigo disorder scale made abroad.DESIGN: Cross-sectional survey, interview evaluation after pretest, internal consistency, retest consistency and construct validity were measured by the method of Chronbach's c, Pearson correlation coefficients and factor analysis, respectively.SETTING: Clinical Epidemiology/DME Center, Guangzhou University of Traditional Chinese Medicine.PARTICIPANTS: Totally 111 consecutive patients with CSA, 30 men and 81 women aged 31 to 72 years, in the Clinic for Cervical Spondylosis of Guangdong Provincial Hospital of Traditional Chinese Medicine were recruited from May 2001 to March 2002. Altogether 36 patients had risk factors of vertebral-base artery atherosclerosis. There were 14 cases of mild vertigo, 61 cases of moderate vertigo, and 36 cases of severe vertigo. Informed consent was obtained from the participants.METHODS: FS-CSA was made according to clinical actual condition Functional status (going for a walk during the day by yourself, walking around the house in the dark, doing strenuous housework, social activity,traveling for business or recreation, getting into or out of bed, reading books or newspaper; each item was divided into three categories "No,anxious, worried about your illness, and feeling frustrated; each item consisted of three categories "No, Sometimes, and Yes"). Patients with CSA were evaluated by means of interview and 14 of them were retested. Internal consistency, construct validity and correlation coefficients of the scale were measured with SPSS 10.0 software.tional status dimensionality, emotional functional dimensionality as well as internal consistency of the total scale in FS-CAS: Chronbach's α value was 0.875 9, 0.645 3 and 0.859 5, respectively; retest consistency value was extracted common factor was consistent with the two dimensionalities.tool quantifies the life quality of the patients with CSA and can make a uate curative effects of drugs or screen the best treatment scheme; therefore, it has clinical application value.

Objective To evaluate the effects of dexmedetomidine on the expression of phosphor-cAMP response element binding protein (p-CREB) in isoloated hippocampal neurons of fetal rats.Methods SpragueDawley rats on 16-18 days of gestation were sacrificed and the fetal rats were obtained.The hippocampi of fetal rats were isolated and hippocampal neurons were seeded in culture medium for 8 days.The cells were then divided into 4 groups (n =12 each) using a random number table:control group (group C),dexmedetomidine 0.001 μmol/L group (group D1),dexmedetomidine 0.010 μmol/L group (group D2),and dexmedetomidine 0.100μmol/L group (group D3).In D1.3 groups,dexmedetomidine with the final concentrations of 0.001 μmol/L,0.010 μmol/L,and 0.100 μmol/L was added to the culture medium,respectively,and then the cells were incubated for 3.5 h.The apoptosis in hippocampal neurons was detected by flow cytometry.The expression of p-CREB in hippocampal neurons was determined by RT-PCR and Western blot.Results Compared with group C,apoptosis rate was significantly decreased and the expression of p-CREB was up-regulated in D1.3 groups.Conclusion Dexmedetomidine inhibits apoptosis in isolated hippocampal neurons of fetal rats by up-regulating the expression of p-CREB.

Objective To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone(FSH) in polycystic ovarian syndrome (PCOS) patients. Methods Base on the ratio of LH/FSH,total 95 patients with PCOS were divided into two groups,including 49 cases in higher ratio group (LH/FSH≥2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay(ELISA). Ovarian sexual hormones,fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. Results (1) AMH: the serum level of AMH were (7.2±4. 3) μg/L in higher LH/FSH group, (5. 2±3. 8) μg/L in normal LH/FSH group and (3.7 ±2. 2) μg/L in control group, which all reached significant difference among those 3 groups(P < 0. 01). (2) The correlation between AMH and biological metabolic index: estradiol (E2) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0. 318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0. 493,0. 362,0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0. 301), but negatively correlated with E2 (r = -0. 429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0. 428). Conclusion The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

Objective To investigate the impact of desmoglein 3 (Dsg3) on the proliferation of peripheral T lymphocytes from patients with pemphigus vulgaris (PV).Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 12 patients with PV and 22 normal human controls,cultured with or without the presence of Dsg3 or phytohemagglutinin for 3 days.Flow cytometry was performed to detect the changes of T-lymphocyte subsets in PBMCs stimulated with Dsg3 and proliferation of T-lymphocytes.Results In patients with PV,the percentage of Th2 and Th1 cells was 12.17%±5.32% and 4.08%±1.50%,respectively in Dsg3stimulated PBMCs,9.84%±5.41% and 3.91%±1.38%,respectively in non-stimulated PBMCs.Increased percentage of Th2 cells was observed in Dsg3-stimulated and non-stimulated PBMCs from patients with PV compared with those from normal human controls (both P<0.05).After stimulation with Dsg3,there was a significant proliferation of T cells from patients,and the proliferation rate of CD4+T cells was 4.65%±3.28%,which was significantly higher than that from normal controls(P<0.05).Conclusion Dsg3 can induce the specific proliferation of CD4+T cells,especially Th2 type CD+4 T cells,from patients with PV.

BACKGROUND:Electrospun polylactic acid/polycaprolactone nanofibers (ENF) are a kind of self-synthesized biodegradable material. Our preliminary studies have indicated that the biomaterial exhibits excel ent biocompatibility;however, the research about its mechanics is stil little. OBJECTIVE:To explore the effects of static pressure on the cytocompatibility of adipose-derived stem cel s on the ENF scaffold. METHODS:Adipose-derived stem cel s were seeded onto the ENF scaffold, and then cultured in the low-glucose DMEM supplemented with 10%fetal bovine serum. The mixed constructs were submitted to the static pressure at 0, 15, 30, and 45 kPa for 4 hours using a static pressure device, respectively. Subsequently, the proliferation, adhesion and viability of adipose-derived stem cel s on the ENF scaffold were detected using MTT assay and living/dead staining to evaluate the cytocompatibility. RESULTS AND CONCLUSION:MTT assay showed that there were significant differences in absorbance values among groups by one-way analysis of variance after 4 hours of loading with different static pressures in vitro. Under 0-30 kPa static pressure, the absorbance values increased with static pressure, but the absorbance values declined until the pressure reached 45 kPa, and multiple comparisons between groups showed significant difference. The significant differences in the cel attachment percentage by MTT assay could be found among groups. The living/dead staining results supported the above findings. Furthermore, the significant differences in percentage of living cel s among groups were shown using either one-way analysis of variance or paired t test. In conclusion, the appropriate static pressure can promote the cytocompatibility, proliferation, adhesion and viability of adipose-derived stem cel s on the ENF scaffold. But the excessive pressure is likely to inhibit the cel ular biological behaviors, thus affecting cytocompatibility of adipose-derived stem cel s with the ENF scaffold.

Objective To compare the difficult degree,differences in gastric pouch volume,the complications,and postoperative weight loss effect of two gastric pouch practices in laparoscopic gastric bypass for bariatrics.Methods We retrospectively analyzed laparoscopic gastric bypass surgery in 76 bariatrics cases from May 2010 to May 2012.Two methods were used to create gastric pouch,among which 39 cases were operated with the dissection landmark method (called dissection),and 37 cases with bougie airbags 30 ml (called the bougie).Parameters were compared between the 2 groups including operation time for gastric pouch,the amount of staple cartridges,intraoperative complications,blood loss,and postoperative excess weight loss percentage (EWL ％),the postoperative bleeding,obstruction,fistula and other complications.Results All patients were followed up for more than one month.The dissection group used longer time in creating gastric pouch than that in the bougie group [(58 ± 27) min,(42 ±21) min,P ＜ 0.01].The number of staple cartridges used were significantly different between the two groups [(6.2 ±3.0),(4.3 ± 2.0),P ＜ 0.01].There were 10 cases of complications in the dissection group (26％),and 3 cases in the bougie group (8％) (P ＜0.05).One month after the surgery,one each patient had transient hematochezia.There was no gastric pouch-related complications in the two groups postoperation.There was no difference in excess weight loss (P ＞ 0.05).Conclusions The two methods can achieve the same effect on excess weight loss.The bougie method used less time in creating the gastric pouch,less consumable materials,and less complications occurred in creating gastric pouch.

Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.

Objective To evaluate the effects of propofol on the proliferation of hippocampal neurons in fetal rats in vitro.Methods Pregnant Sprague-Dawley rats at 16-18 days of gestation,were sacrificed and the fetal rats were taken out from the abdominal cavity.The hippocampal neurons of the fetal rats were isolated and seeded in culture plates.After being cultured for 9 days,the neurons were divided into 7 groups using a random number table(n =36 each):control group (C group),intralipid group (I group) and propofol 0.1,1.0,10.0,100.0,1 000.0 μmol/L groups (P1-5 groups).In group I,10％ intralipid was added to the culture media until the final concentration reached 100 μmol/L.In P1-5 groups,propofol was added to the culture media until the final concentration reached 0.1,1.0,10.0,100.0 and 1 000.0 μmol/L,respectively.The neurons were then incubated for 3 h.The proliferation of hippocampal neurons was determined by MTT assay at 12,24,36,48,60 and 72 h after the end of incubation with propofol.Results Compared with group C,the proliferation of hippocampal neurons was significantly decreased in P1-5 groups (P ＜ 0.05),while no significant change was found in group I (P ＞ 0.05).Compared with group P1,the proliferation of hippocampal neurons was significantly decreased in group P5 (P ＜ 0.05),while no significant change was found in P2-4 groups (P ＞ 0.05).Conclusion Propofol can decrease the proliferation of hippocampal neurons in fetal rats in vitro.