Objective To study the association of SNP of the AdipoR1 gene with T2DM in Xi’an population. Methods The amplification refractory mutation system(ARMS) analysis and gene sequencing were used to investigate the AdipoR1 gene polymorphism in 100 type 2 diabetics and 84 normal control subjects. Results (1) The genotype and allele frequencies of -106A/G, 5843A/G were not significantly different between type 2 diabetics and normal control subjects. (2) The diagnosis age of diabetics was significantly younger in AdipoR1 5843GG genotype group than in other genotype groups. Conclusions The data implicate that the AdipoR1 gene -106A/G and 5843A/G polymorphism may be not associated with pathogenesis of T2DM. AdipoR1 5843 GG genotype may be associated with the earlier diagnosis of T2DM

Objective To explore more safe and effective method for the treatment of common bile duct stones combined with cavernous transformation of the portal vein (CTPV).Methods We report 2 cases of post-treated patients in this series.In order to avoid severe bleeding caused by dissection of bile duct,we applied different methods to remove common bile duct stones compared with traditional operation.We removed common bile duct stones in one patient through cystic duct approach during operation.Two years later,we performed endoscopic duodenal incision (endoscopic sphincterotomy,EST) for him because of lower common bile duct stenosis with sand like stone.Another patient,on the other hand,we conducted the duodenal papilla incision during operation and removed common bile duct stones with choledochoscope through the bottom of common bile duct.Result Of the two patients,all of the three kinds of operation had good curative effects.Conclusions For the patients with common bile duct stones combined with CTPV,we should select appropriate treatments to avoid dissection of bile duct in front of the dilated and tortuous collateral veins during the operation,which is the key to guarantee the safety and success of the operation.EST is the preferred method of the treatment.Open operation with choledochoscopy via cystic duct approach or duodenal papilla incision through distal common bile duct to perform stone extraction also appears to be effective and safe.

Hepatic carcinomas were induced with the administration of diethyl-nitrosamine (DEN) in rats. The morphological changes of the liver tissues in the course of carcinogenesis could be divided into 3 successive stages: the nonspecific changes reacting to the drug toxicity, non-cancerous hyperplastic nodules of hepatocytes and ductular cystadenomatous lesions,and the lesions of genuine malignancy including hepatocellular carcinoma and cholangiocarcinoma.The ultrastructural alterations of hepatocellular carcinoma showed a complicate picture and were related to the differentiation of the tumor cells. In one case of cholangiocarcinoma, numerous cytoplasmic dense-core granules similar to the neurosecretary granules seen in apudoma were found in some of the tumor cells, which is postulated to be a special type of cholangiocarcinoma. On the basis of the results, Ihe histogenesis of the neoplasms after DEN administration is considered to originate from hyperplastic nodules of hepatic cells and ductular hyperplasia.

[Objective]To evaluate the application value of minimally invasive release operation about congenital vertical talus(CVT).[Method]All operation were operated with single method by author.Firstly,Achilles tendon,capsulotomy of the ankle and subtalar joint were released through a small straight posterior inside of Achilles tendon end point.Secondly,astragaloscaphoid and subtalar front joint were released bluntly through a straight posterior incision.Thirdly,based on circs subtalar joint were released through calcaneocuboid articulation outside foot.Then one K-wire were passed through the body of talus from its axis,and passed through instep after reposition of astragaloscaphoid joint.Two K-wires was passed through calcaneus to talus from planta.[Result]Eight cases were available for follow-up from 17 to 36 months(mean,28 months),follow-up results was evaluated by using a version of Adelaar and Kodros score,there were excellent result in 1 foot,good in 5,fair in 2.The presence of hindfoot valgus and forefoot abduce were noted in one foot,forefoot pronation was appeared in one foot.Two parameters-talar and calcaneus axis-first metalarsal base angles,calcaneus talus angles of eutopic and lateral radiograph were basally normal.[Conclusion]Operative reduction has been advocated as the only effective treatment for CVT,it is the best choice to use minimally invasive release operation for infant.

AIM　To study the protective effect of Gn-3 (a stilbene polymer isolated from Gnetum parvifolium) against liver injury induced by CCl4, N-acetyl-p-aminophenol (APAP) and Bacillus Calmette-Guerin (BCG) plus bacterial lipopolysaccharide (LPS) in mice. METHODS　The experimental model of liver injury were induced by 0.1% CCl4 ip (10 mL*kg-1*d-1 for 3d), APAP ip (150 mg*kg-1) or BCG (5 mg) plus LPS (7.5 μg) in mice. The levels of ALT in serum, MDA and GSH in liver tissues were detected. The histopathologic changes were observed by light microscope. RESULTS　Gn-3 was shown to markedly reduce the elevated serum ALT levels, liver tissue MDA and improve the histopathological changes in all the three experimental liver injury models. No effect of Gn-3 was observed on the liver GSH level in liver injury mice. CONCLUSION　Gn-3 was found to inhibit the development of liver injury caused by CCl4, APAP, or BCG plus LPS. This means that Gn-3 has liver protective effects.

Objective To evaluate the expression and clinical significance of miRNA in plasma of patients with primary biliary cirrhosis.Methods Plasma from 19 PBC patients,10 healthy volunteers and 10 viral hepatitis patients were selected from Shanghai Songjiang Hospital from december 2010 to January 2013.Among them 3 PBC patients' plasma and 3 healthy volunteers' plasma were detected by miRNA microarray for miRNA expression profile examination.Real-time PCR was used to verify the results of microarray,miRNA target gene predictior software was used to predict the target genes of differentially expressed miRNA.ROC was used to determine the clinical value of plasma miRNA.Results According to microarray,a total of 16 miRNAs were found to be differentially expressed.As revealed by qRT-PCR,the expression of miRNA-92a-3p and miRNA-4516 decreased while the expression of miRNA-572 and miRNA-575 were up-regulated in PBC group compared with healthy controls (P ＜ 0.05).In comparison with nonPBC cirrhosis group,only miRNA-92a-3p and miRNA-4516 were down-regulated (P ＜ 0.05).The area under the curve (AUC)of miRNA-92a-3p for the diagnosis and differential diagnosis of PBC were 0.92 and 0.84,respectively.while for The area under the ROC curve of miRNA-4516,the AUC for diagnosis and differential diagnosis PBC were 0.89 and 0.76,respectively.The optimal cut-off values for identifying PBC from healthy controls were defined as 1.26 ng/μl.for miRNA-92a-3p (sensitivity,92％ ;specificity,80％)and 1.16ng/ul for miRNA-4516 (sensitivity,85％ ;specificity,70％)respectively.The optimal cut-off values for identifying PBC from viral hepatitis were defined as 1.08 ng/μl.for miRNA-92a-3p (sensitivity,89％ ; specificity,81％)and 1.06 ng/μl for miRNA-4516 (sensitivity,77％ ;specificity,68％).Conclusion The results indicate that plasma from patients with PBC has a unique miRNA exprssion profile and these differentially expressed miRNA can be used as clinical biomarkers of PBC.

[ABSTRACT]AIM:ToestablishandevaluateahyperbilirubinemiaandkernicterusmodelinneonatalSDrats. METHODS:Three-day-old SD rats were randomly divided to 7 experimental groups by litter and body weight , and were in-traperitoneally injected with physiological saline (control group), and 6.25μg/g (T1), 12.5μg/g (T2), 25μg/g (T3), 50μg/g (T4), 100μg/g (T5) and 200μg/g (T6) bilirubin, respectively, twice every day for 3 d.All rats were photo-graphed , weighed and killed 12 h after the last injection .The contents of the stomach were drawn and weighed , and the index was calculated .The liver/body weight ratio was determined , the total and unconjugated bilirubin in the serum and total bili-rubin in the brain were calculated , and the contents of ATP and water in the brain were measured .HE and Nissl staining were used to observe the pathological changes .RESULTS:Along with the increase in bilirubin , gradual exacerbation of the general performance of the rats , and yellowish discoloration of the skin and mucous membranes were observed .The degree of the activity gradually reduced , and the weight gain was suppressed .The weight of T6 group showed negative growth , and the 72 h mortality rate was close to 100%.The mortality rate in T4 and T5 groups continued to rise 1 week after injection .Com-pared with control group , the weight of stomach contents and stomach content index in T 3~T5 groups significantly decreased (P<0.01).The liver/body weight ratio in T5 group was significantly higher (P<0.05).The concentrations of serum total and unconjugated bilirubin and brain bilirubin levels in T 1~T5 groups were gradually increased , while the brain water con-tent had no difference among groups .The brain ATP content in T1~T5 groups increased at the beginning and reached its peak in T3 group, but compared with control group , that in T4 group and T5 group significantly reduced (P<0.05).HE re-sults showed that , with the increase in bilirubin concentration , the number of the neurons in the cerebral cortex of the rats de-creased.In T4 group and T5 group, the neuronal structural disorder , cell swelling, nuclear pyknosis, fragmentation and dis-solution, increase in non-homogeneous structure of the material dyed red , and disappearance of nuclear staining were ob-served.Nissl staining showed that , compared with control group , in T1 group and T2 group, the cortical neurons became smaller, Nissl bodies decreased , and cytoplasmic staining changed little .The cortical neuronal tigroid body color became light gradually, neuron cells become small , and Nissl bodies decreased obviously in T 3, T4 and T5 groups.The T4 and T5 rat ce-rebral cortical neurons dissolved or even disappeared .CONCLUSION:Newborn 3-day-old SD rats receiving intraperitoneal injection of bilirubin at doses of 12.5, 25, 50 and 100μg/g, 2 times a day, can induce hyperbilirubinemia , and 50 and 100μg/g can cause bilirubin encephalopathy .

Objective To explore the correlation of the gene polymorphism of the two single nucleotide polymorphisms(SNPs)rs1443434andrs925489onforkheadboxEl(FOXE1)withthehighnormalthyroidstimulating hormone ( TSH) level in Chinese Han population. Methods 1 400 subjects with normal serum TSH and thyroid peroxidase antibody(TPOAb) levels were included. According to TSH or TPOAb levels, the subjects were divided into high normal TSH group(H-TSH group,n=195) and normal TSH control group(TSH control group,n=1 205) or high normal TPOAb group ( H-TPOAb group, n=711 ) and low normal TPOAb group ( L-TPOAb group, n=689 ) , respectively. The genotypes on the two SNPs of all the subjects were performed by whole-genome genotyping chips. Results There were significant differences in rs925489 genotypic distributions and allele frequencies between H-TSH group and TSH control group(both P<0. 05). The genotype TT and allele T in H-TSH group were significantly higher than those in TSH control group(89. 75% vs 83. 15%, 94. 62% vs 91. 29%). The normal TSH levels were positively associated with rs925489 genotypic distributions after adjustment for sex, age, and high density lipoprotein cholesterol(P<0. 01). There were no significant differences in rs1443434 genotypic distributions and allele frequencies between two TSH groups or two TPOAb groups. Conclusion FOXE1 rs925489 gene polymorphism may be correlated with the high normal TSH level in Chinese Han population.

OBJECTIVE:To provide reference for better improving the risk perception of Omeprazole sodium for injection in nurses in a third-grade class-A hospital,strengthening risk management of ward drugs and ensuring safety of patients. METHODS:Nurses in the clinical departments in a third-grade class-A hospital where usage frequency of Omeprazole sodium for injection was relatively more were adopted as study subjects and a self-designed questionnaire was used to investigate on related knowledge on medication risk in nurses in emergency department,gastroenterology department,ICU and CCU in 2012 and 2014. RESULTS:51 and 81 questionnaires were distributed in 2012 and 2014,and 51 and 81 were effectively received with effective recovery of 100%and 100%,respectively. In both surveys,100% surveyed nurses could correctly choose one solvent at least,1.96% and 3.70%nurses could correctly choose 2 solvents;correct answering rates of intravenous administration time were 94.12% and 96.30%,re-spectively;correct answering rates of stable duration after preparation were both lower than 9%;correct answering rates of adverse reaction of this drug were 3.92% and 1.23%,respectively;correct answering rates of interaction of this drug were 1.96% and 6.17%,respectively;correct answering rates of stable formulation of this drug were 17.65%and 22.22%,respectively;the propor-tion of nurses observing ADRs were 25.49% and 13.58%,respectively;the proportion of nurses finding inappropriate compatibility were 15.69% and 22.22%,respectively,Ornidazole and sodium chloride injection was the most used incompatible drug;45% or more nurses hoping to strengthen the continuing education of nursing personnel. CONCLUSIONS:Nurses in this third-grade class-A hospital lack certain knowledge on the medication risk of Omeprazole sodium for injection,the drug risk management is not sufficient,and awareness prevention of drug risk is relative weak. It is suggested that the hospital should strengthen drug risk management system,nurses should strengthen the learning about drug risk and play the role of clinical pharmacists in the drug risk management to reduce the related drug risk and incidence of adverse reactions.

OBJECTIVE:To provide reference for the understanding of quality status of Insulin injection and improvement of related standards. METHODS:The statutory methods of Insulin injection were adopted to test 32 batches of samples(including ap-pearance,identification,capacity,visible foreign matter,sterility and potency determination of biological method). Consulting specification of other similar products,RP-HPLC was conducted to determine the related impurities,content and phenol in sam-ples;HPSEC was conducted to determine the high molecular weight proteins and atomic absorption spectrophotometry was conduct-ed to determine the Zn content. RESULTS:Results of all the 32 batches of samples were qualified by the test of statutory methods. According to the method of other similar products,the determination result of A21 desamido insulin was 15.6%-39.2% and general-ly greater than 5.0%, which was the highest limit of similar products;insulin was 93.2%-102.7%;protein polymer was 0.5%-0.6%;phenol was 2.34-2.51 mg/ml and Zn was 12.3-14.8 μg/100 U. CONCLUSIONS:The statutory specification of Insulin injection is short of many key specification items such as impurities and content determination;the contents of protein polymer, phenol and Zn were in good control;the contents of A21 desamido insulin are generally high,and stability of insulin main peak is relatively poor.