Objective To explore the role of P38 mitogen-activated protein kinase (P38 MAPK) in the development of cerebral hypoxic preconditioning. Methods Healthy male BALB/C mice weighted as18～20 g were randomly divided into 7 groups as follows: normoxic control (H0), early (H1～H4) and delayed (H5 and H6) hypoxic preconditioned mice groups. SDS-PAGE, Western blot and Gel Doc imagine systems were applied to quantitatively analyze the level of P38 MAPK phosphorylation and protein expression in the brain of mice. Results The phosphorylation levels of P38 MAPK increased in cortex, hippocampus and hypothalamus of mice in both early (H1～H4) and delayed (H5 and H6) hypoxic preconditioned groups, and the statistic significance (P

Objective To investigate the relationship between glomerular filtration rate (GFR) and diabetic retinopathy (DR) and macular thickness in patients with type 2 diabetes mellitus (T2DM).Methods A total of 161 T2DM inpatients were enrolled in this study.There were 95 males (95 eyes) and 66 females (66 eyes),with an average age of (62.2±11.0) years.The average duration of diabetes was (14.8±7.9) years.The patients were grouped according to the degree of DR.Among them,91 patients were no DR,24 patients were mild non-proliferative DR (NPDR),24 patients were moderate NPDR,13 patients were severe NPDR and 9 eyes were proliferative DR (PDR).Severe NPDR and PDR were combine into severe DR group for statistical analysis.All patients underwent direct ophthalmoscope,fundus colorized photography,spectral domain optical coherence tomography (SD-OCT),fasting blood-glucose,glycated hemoglobin and renal function examinations.GFR was evaluated by 99 mTcDTPA.DR degree was evaluated by direct ophthalmoscope and fundus colorized photography.Central subfield (CSF),central macular volume and mean retinal thickness (MRT) were measure by SD-OCT.The correlation between GFR and DR staging and macular retinal thickness were analyzed by Spearman correlation analysis and Pearson correlation analysis.Logistic regression analysis was used to analyze the correlation between GFR and presence of DR.Results GFR was gradually decreased in patients with no DR,mild NPDR,moderate NPDR and severe DR (F=12.32,P＜0.001).Pearson correlation analysis demonstrated that GFR was negatively correlated to CSF (r=-0.202,P=0.010);but no correlation with MRT (r=-0.087,P=0.272).Spearman correlation analysis demonstrated that GFR was negatively correlated to DR staging (r=-0.325,P ＜ 0.001).The difference of DR prevalence rate in normal,slight abnormal renal function and renal insufficiency patients was significant (x2=12.32,P=0.002).Logistic regression analysis demonstrated that lower levels of GFR was significantly associated with presence of DR (95％ confidence interval=1.71-4.32,odds ratio=2.72,P＜0.001).Conclusion In T2DM patients,GFR is negatively correlated to DR staging and CSF.Lower GFR is independent risk factors for DR.

Composite Resins ; therapeutic use ; Dental Restoration, Permanent ; methods ; Humans

Background In recent years,some researches show that getting younger over the diabetes mellitus (DM) was an obrious trend.But studies of early diabetic retinopathy in young people with diabetes were few.Both patients and doctors did not put enough importance on it.Objective This study was to evaluate the earlier dynamic changes of retina morphology and function caused by type 2 DM in young population.Methods A cohort study was designed.One hundred and thirty-six young patients who were initially diagnosed as type 2 DM in Cangzhou Central Hospital were included from January to March in 2010 and 91 healthy individuals with the matched age were enrolled at the same period.Glycated hemoglobin (HbAlc) level in blood was assayed yearly,and ophthalmoscope,optical coherence tomography (OCT) and visual contrast sensitivity (CS) examinations were performed to evaluate the dynamic changes of retinal nerve fiber layer (RNFL) thickness around optical disc,retinal function and retinal microvessels of DM patients.In addition,the correlation between RNFL thickness or CS and average HbAlc level in DM patients was assessed.This study followed Declaration of Helsinki,and written informed consent was obtained from each subject.Results The levels of HbAlc in DM patients were (7.5 ±1.6) ％,(7.2 ±1.6) ％,(7.4 ±1.6) ％,(7.6±1.6)％ and (7.7 ±1.6)％ in 2010,2011,2012,2013 and 2014,respectively,and HbAlc≥7.0％ was observed in 74 patients (54.4％).The RNFL thicknesses of full optic disk and superior 1/4 quadrant of the optic disk were significantly declined in 2012,2013 and 2014 in the DM group compared with the normal control group (full disk:t =2.216,5.003,7.303;all at P ＜ 0.05.superior 1/4 quadrant:t =2.382,5.657,7.194;all at P ＜ 0.05),but no significant differences were found between them in 2010 and 2011 (all at P＞0.05).In the DM group,RNFL thicknesses of full optic disk were (99.94±10.01) μm and (96.32±10.32) μm in 2013 and 2014,which were significantly lower than (104.55±9.23) μm in 2010 (t=7.819,13.959,both at P＜0.05);the RNFL thicknesses of superior 1/4 quadrant around disk were (118.64± 13.98) μm and (115.06 ± 14.35) μm in 2013 and 2014,which were significantly lower than (127.48± 13.67) μm in 2010 (t =10.504,14.758,both at P＜0.05),However,the RNFL thicknesses were not significantly changed among the different time points in the normal control group (all at P＞0.05).In addition,the CS values of 3.0,6.0,12.0,18.0 c/d in 2013 and 2014 in the DM group were lower than those in the normal control group (all at P＜0.05),and the CS values in 2013 and 2014 were reduced in comparison with 2010 in the DM group (all at P＜0.05).Positive correlations were found between the differences of RNFL thickness or CS and the average HbAlc level in the DM group (r =0.640,F =8.991,P =0.000;r =0.541,F =7.572,P =0.000).Retinal microaneurysms were seen in two type 2 DM patients by ophthalmoscope at the end of follow-up.Conclusions The young people with type 2 DM have poor blood glucose control.The RNFLs are thinning and visual functions are declining in young type 2 DM patients with the lapse of disease course,and these retinal damages are associated with poor control of blood glucose.

Objective To discover the risk factors of acute renal insufficiency(ARI) in perioperative of non-small cell lung cancer(NSCLC).Methods We took a retrospective study to analysis and summarize the clinical features of 33 ARI cases and 721 controls,all subjects were histopathologically confirmed NSCLC from January 2007 to October 2013.Logistic regression analysis was conducted to analyze the association between the risk factors and ARI.Results There were significant differences between the two groups in operation age,level of preoperative creatinine,preoperative rehydration and the use of plasma substitutes.After adjustment by confounding factors,operation age older than 60 years old and the use of plasma substitutes had higher risk of ARI [adjusted OR was 2.93 (1.30-6.62),95 ％ CI was 6.04 (1.41-25.87),respectively].Preoperative rehydration was protective factor of ARI(adjusted OR was 0.37,95％ CI was 0.17-0.83).Conclusion Operation age (≥ 60 years old) and the use of blood substitutes are independent risk factors of ARI,while preoperative rehydration can reduce the incidence of ARI after surgery.

Objective:To evaluate the clinical effects of short fiber ribbon combined with resin bonding technology for the treatment of food impaction between posterior teeth. Methods:98 cases of vertical food impaction between posterior teeth( total of 135 vertical food impaction units) were included. 73 units were treated by short quartz fiber ribbon combined with resin bonding technology( SQFRB) and 63 by resin bonding(RB). 12, 24 and 36 months after restoration, clinical effects were evaluated referring to the Modified United States Public Health Service (USPHS) Criteria, data were statistically analyzed. Results:12, 24 and 36 months after treatment the cure rate of SQFRB was 97. 3%, 97. 3% and 95. 9%, inefficacy rate was 0, 0 and 0;the cure rate of RB was 85. 5%, 82. 2% and 82. 2%, the inefficacy rate was 4. 8%, 11. 3% and 12. 9%, respectively(between groups, P<0. 05). Conclusion:Minimally inva-sive restorations using short fiber ribbon combined with resin bonding technology is effective in the treatment of vertical food impaction between posterior teeth.

Objective To observe the visual acuity change in patients with different patterns of optical coherence tomography (OCT) of diabetic macular edema (DME) after intravitreal ranibizumab injection and/or laser photocoagulation.Methods A retrospective observational case series.Seventy patients (99 eyes) with DME were enrolled.Best-corrected visual acuity (BCVA) was evaluated using the international vision test chart,and then convert the result to the logarithm of the minimum angle of resolution (logMAR).According to the morphological characteristics of OCT,the DME was divided into 3 patterns,including diffuse macular edema (DRT),cystoid macular edema (CME) and serous neuroepithelial layer detachment.The average follow-up was (80.43 ± 74.89) days.The patients were divided into 3 groups according to the different treatments,including intravitreal ranibizumab injection group (group A,21 patients,25 eyes),intravitreal ranibizumab injection and laser photocoagulation group (group B,23 patients,26 eyes),laser photocoagulation group (group C,26 patients,48 eyes).The changes of absolute BCVA (ABCVA) and improved visual acuity were compared between different treatment groups and different OCT patterns.ABCVA =logMAR BCVA before treatment-logMAR BCVA after treatment.Improvement more than 0.3 of logMAR value was considered as improved visual acuity.Results There was no significant difference in ABCVA between different treatment groups (F=0.050,P＞0.05).The improved visual acuity in group A and B were great than group C (x2=5.645,6.301;P＜0.05).In group A,B and C,there was no significant difference in ABCVA and improved visual acuity between different OCT patterns (P＞0.05).Improved visual acuity of DRT and CME eyes were higher in group A&B (70.59％ and 50.00％) than in group C (26.47％ and 14.29％),the difference was statistically significant (x2=5.075,4.453;P＜0.05).Conclusions There is no obvious change of visual acuity in patients with different OCT patterns of DME after the same treatment by intravitreal ranibizumab injection and/or laser photocoagulation.The improved visual acuity is not consistent in same OCT patterns after different treatment.

[ABSTRACT]AIM:Toinvestigatetheapplicabilityanddegradabilityoftheantigen-extractedxenogeneicbone carrying recombinant human bone morphogenetic protein 2 ( rhBMP-2) as a scaffold in repairing the mandibular defect in vivo.METHODS:New Zealand rabbits (n=28) with 28 mandibular defects were divided into 3 groups at random:anti-gen-extracted xenogeneic cancellous bone /rhBMP-2 group (group A), antigen-extracted xenogeneic cancellous bone group ( group B ) and blank control group ( group C ) .Twelve bone defects each in group A and group B were classified into 3 time points (4, 8 and 12 weeks).Observation in general, X-ray test and hematoxylin and eosin staining and bone density measurement were conducted on each rabbit in group A and group B .Four bone defects were classified into group C .Ob-servation in general , X-ray test and hematoxylin and eosin staining were also conducted on each rabbit in group C .RE-SULTS:The X-ray showed that the implanted materials were degraded after a period of time , and were replaced by autoge-nous bone.At the 12th week, the implanted materials in group A were entirely degraded and replaced by autogenous bone . The bone density measurement showed that the bone density was enhanced after implantation .At the 12th week, there was an obvious difference between group A and group B .The hematoxylin and eosin staining showed there were more neovascu-larization, new fibrosis and new bone formation in group A than those in group B .The implanted material in group A de-graded much faster than that in group B .The significant difference in the new bone area ratio between the 2 groups among all weeks was observed .CONCLUSION: An antigen-extracted xenogeneic cancellous bone has good biocompatibility , which can act as a scaffold in bone repairment .It is the carrier of rhBMP-2 to continue the bone formation .Therefore, anti-gen-extracted xenogeneic cancellous bone is a kind of good material for bone repairment .

Presented in this study were three cases of lung cancer undergoing pulmonary venoplasty. In the 3 patients with central type of carcinoma of lung involving pulmonary vein, the main branch of right superior pulmonary vein and the distal end of the superior-lobe vein were occluded. The root part of the vein of right-middle lobe, plus part of vessel of of right superior vein was resected. The right superior vein was reconstructed by continuous 6-0 Prolene sutures. After the operation, the reconstructed was patent and the surgical margin was tumor-free. Postoperatively, clinical manifestations and plain chest films did not show any signs of venous blockade. The patients were discharged healed 3 weeks after the operation. The technical details of the surgery were presented, the improvements on the basis of traditional methods were discussed and its clinical application was evaluated. It is concluded that pulmonary venoplasty is a safe and feasible operation. Further improvement of the surgery will help conserve more lung tissue and benefit more patients because of expanded indications.
Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pulmonary Veins/*surgery ; Vascular Surgical Procedures/*methods

Objective To explore the role of calcium/calmodulin-dependent protein kinase Ⅱ ( CaMK Ⅱ ) in the development of cerebral hypoxic preconditioning(HPC). Methods Healthy male BALB/c mice were randomly divided into 7 groups as follows; normoxic control (H0) , early(H1～H4) and delayed (H5～H6) hypoxically preconditioned mice groups. SDS-PAGE, Western blot and Gel Doc imagine systems were applied to quantitatively analyze the level of CaMK Ⅱ phosphorylation and protein expression level in the brain of mice. Results Compared with H0 group, the phosphorylation level of CaMK Ⅱ increased in cortex and hippocampus of mice in H3～H5 hypoxically preconditioned groups (P<0.05). However, there was no significant changes in total CaMK Ⅱ protein expression in cortex and hippocampus of hypoxic preconditioned mice. Similarly, enhanced p-Thr286 CaMK Ⅱ was also observed in the hippocampus and cortex of mice by immunostaining following hypoxic exposures (H3 and H6). Conclusion The increased phosphorylation of CaMKⅡ may be involved in the development of cerebral HPC in mice.