Vitamin D plays an important role in cellular differentiation and Calcium phosphate metabolism.At the same time,the role of Vitamin D in glycolipid metabolism had attracted a lot of attention.Bariatric surgery is an effective treatment to achieve therapeutic endpoints for comorbidities associated with obesity,but vitamin D status is always insufficient before and after surgery.In this review,the author aim to (1) discuss the deficiency of vitamin D in bariatric patients,(2) to summarize the impact of vitamin D on glycolipid metabolism and the outcome of bariatric surgery,(3) to discuss the supplementation for the deficiency of vitamin D.

Objective To investigate the Laparoscopic management for Nutcraker Syndrome(NCS) with resection of fibrous ring and placing extravascular stent.Methods This was a retrospective analysis of clinical data and treatment process of cases from March 2010 to February 2015 in urology department,affiliated hospital of Guizhou medical university.Five cases with NCS,4 males and 1 female;age were 28-40 years,mean age was 35 years,all cases were afflicted with gross hematuria and flank pain,the history of gross hematuria were 6-72 months.3 cases were afflicted with proteinuria.Duplex ultrasound scanning before surgery revealed the compressed left renal vein (LRV) between the aorta and the superior mesenteric artery(SMA),with peak velocity 110-132 cm/s,an average of 121 cm/s.The flow velocity of LRV in the renal hilum were 18-25 cm/s,an average of 21 cm/s.CT scanning showed that the stricture segment diameter of LRV were 1.2-2.5 mm,an average of 1.8 mm;and the max diameter of proximal dilatation of the LRV in renal hilum were 8.3-15.2 mm,an average of 10.1 mm.The ratio between the dilated segment inner diameter and the stricture segment were 3.4-9.5.Bleeding from the left ureteral orifice was detected by cystoscopy in 3 cases.5 cases were treated by resection of fibrous ring and placing extravascular stent with Laparoscopic management,and the average length of extravascular stent was 4.0 cm.Results The operation was successful in the 5 cases.The average operation time was 83 min.The average blood loss was 65 ml.Hematuria gradually reduce 5-6 days and resolved 7-20 days after surgery in 5 patients.Proteinuria was disappeared successful 2 weeks after surgery in 3 patients.There was no recurrence at 8-24 months' follow-up.3 days after surgery Doppler ultrasound showed the stricture segment diameter of LRV were 3.8-5.6 mm,an average of 4.9 mm;the ratio between the dilated segment inner diameter and the stricture segment decreased were 1.1-2.0,an average of 1.6;the peak velocity of compressed LRV were 25-45 cm/s,an average of 34 cm/s.6 months after surgery,CTA result showed no LRV compression in the aortomesenteric region;the max diameter of LRV in renal hilum were 7.9-9.8 mm and 6.0-8.8 mm in the aortomesenteric region of LRV.Conclusion Etiology of NCS exist a fibrous ring around the left renal vein outflow of the inferior vena cava besides the commonly anatomic extrinsic compression on the LRV as it crosses between the superior mesenteric artery and the aorta.The Laparoscopic management for NCS with resection of fibrous ring and placing extravascular stent is an effective minimally invasive treatment.

To explore the mechanism of the absorption enhancement of Angelica dahurica extract (Ade), the absorption mechanism of baicalin in the Scutcllaria water extraction as well as the effect of Angelica dahurica extract on absorption of baicalin were investigated. In order to determine the main absorption site, everted intestinal sac model was used to study the effect of Angelica dahurica extract on the absorption of baicalin at duodenum, jejunum, ileum and colon. In situ single pass intestinal perfusion model was performed to study the absorption of various concentrations of baicalin and the effect of Angelica dahurica extract on the absorption of baicalin at the main absorption site. To authenticate the consequence of perfusion by getting the blood from the hepatic portal vein and determine the concentration of the baicalin in the blood. The result showed that baicalin could be absorbed at all of the four intestinal segments with increasing absorption amount per unit as follows: ileum > colon > jejunum > duodenum. The absorption ofbaicalin in the duodenum significantly increased with Angelica dahurica extract, thus, duodenum was chosen to be the studying site. Apparent permeability values (Papp) and absorption rate constant (Ka) of baicalin in the duodenum increased gradually with higher concentrations. When the concentration of baicalin rises to a certain degree, the absorption increase had a saturable process, the absorption of baicalin may be an active transportation. Baicalin may be not a substrate of P-gp as verapamil which had not significantly affected the Papp and Ka of baicalin. The absorption of baicalin in the duodenum significantly increased (P < 0.01) in the two models with Angelica dahurica extract and the concentration of baicalin in the blood from the hepatic portal vein showed that the Angelica dahurica extract can increase the absorption of baicalin.

Objective To provide reference for drug use in infant patients with Rhodococcus equi(R.equi) infection. Methods By participating in drug therapy for an infant patient with Rhodococcus equi infection,clinical pharmacist assisted physicians to develop treatment plan and provide reasonable pharmaceutical care. Results Therapeutic selection was improved through pharmaceutical care process. Conclusion Participation of clinical pharmacist can fully play their advantages in the field of drug efficacy,and improve the level of clinical treatment.

Objective: To investigate current status of screen-time in 2-6 years old preschoolers in Beijing, and to describe associated factors of high screen time, and to provide a reference for making interventional measures to prevent and control short-sightness. Methods: A total of 366 preschoolers were chosen through convenience sampling from 5 kindergartens in Beijing urban and rural areas. Questionnaire survey was administered to parents regarding child screen-time. Results: The average screen time of the preschool children in Beijing was (120.5±78.5)min/d, and the rate of high screen time was 75.8%. The average screen time during weekdays was (92.4±72.8) min/d, which was less than the average screen time at weekends (192.4±117.0) min/d. Logistic regression analysis showed that age (OR=1.69, 95%CI=1.19-2.38, P＜0.05) and without an habit of exercise among parents (OR=3.05, 95%CI=1.50-6.19, P＜0.05) were positively associated with, and being girl was the negatively associated with high screen-time (OR=0.49, 95%CI=0.25-0.99, P＜0.05). Conclusion A large proportion of the preschool children aged 2-6 in Beijing have too long screen time, especailly during weekend, and gender, age, parental habit of exercising and so on have impacts on their screen time. Therefore, the education and prevention work should be conducted to reduce their screen time.

Objective By taking usage of bioinformatics screening methods,this medical research aimed at exploring how the miRNAs in endothelial progenitor cell exosomes relate to the regulation of angiogenesis.Methods miRNAs in endothelial progenitor cells exosomes and angiogenesis-related miRNA was intersected from the existing database to obtain the candidates of miRNA molecules related to angiogenesis in endothelial progenitor exosomes.Results 160 and 50 miRNAs in endothelial progenitor cell candidates were obtained through experimental data analysis and literature searching respectively.600 candidates of angiogenesis-related miRNAs were obtained through literature searching;the top 20 with the highest frequency were selected out.Finally,9 miRNA candidates (miR-126,miR-21,miR-221,miR-92a,miR-199a,miR-210,miR-214,miR-155,miR-146a) that may be highly expressed in endothelial progenitor exosomes and associated with angiogenesis were obtained for the following research.Conclusions Based on data analysis and literature searching,bioinformatics could screen out the target miRNAs for follow-up studies easily and reliably,it is worthy to be widely applied and popularized.

OBJECTIVETo optimize the protocols for isolation, in vitro culture, identification and induction of hepatic differentiation of rat bone marrow mesenchymal stem cells (BMSCs).

METHODSRat BMSCs were separated and purified by differential adherent culture for 1.5 h with the first medium change at 12 h. The surface markers of BMSCs were detected by flow cytometry. The cells were induced to differentiate into adipogenic, osteogenic, and chondrogenesis lineages. A 3-step protocol including sequential addition of growth factors, cytokines and hormones was used to induce the BMSCs to differentiate into hepatocyte-like cells.

RESULTSThe cells isolated using this protocol were positive for CD29, CD44, and CD90 and negative for CD29 and CD45. The adipogenic, osteogenic, and chondrogenic differentiation of the BMSCs were verified by Oil red, Alizarin red, and toluidine blue staining. The BMSCs induced with the 3-step protocol differentiated into hepatic-like cells that expressed hepatocyte-specific proteins (ALB and AFP) and genes.

CONCLUSIONThe optimized protocol allows simple and efficient isolation of highly purified populations of BMSCs, which can be induced into hepatic lineages in specific microenvironment.

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass(LYGB) on body fat distribution,and relationship between the changes of body fat distribution and improvement of insulin resistance.Methods A total of 65 patients with type 2 diabetes who underwent LYGB were selected for a retrospective analysis.Metabolic parameters,anthropometric measurements,body composition and fat distribution measured by dual-energy X-ray absorptiometry (DEXA) were collected separately before and 6 months post LYGB.All data of pre-and postoperation were compared with pair t test,Pearson correlation analysis was used to evaluate correlation of two variables.Results Weight,body mass index,waist circumference,waist-to-hip ratio,triglyceride,fasting plasma glucose,fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly decreased in 6 months after surgery (P ＜ 0.05).Total fat mass,body fat mass of trunk,upper and lower limbs decreased significantly (P ＜0.05).Percent fat mass at the whole body,Android region,upper and lower limbs decreased significantly (P ＜0.05).After 6 months postoperatively,abdominal obesity indices waist circumfernce decreased from (98.10±13.03) cm to (91.60±7.68) cm (P＜0.01) and percent fat mass at the Android region decreased from (35.71 ±10.24)％ to (29.44 ± 12.11) ％ (P＜0.05),HOMA-IR decreased from 3.62 ± 5.18 to 1.79 ± 1.52 (P ＜ 0.05).The improvement of postoperative insulin resistance is positively correlated with the changes in waist circumference (P ＜0.01) and percent fat mass of Android region (P ＜0.05).Conclusions The body fat distribution changes after LYGB,change of abdominal fat distribution is positively correlated to the improvement of insulin resistance.

OBJECTIVE：To esta blish a method for determining the contents of lupenone and stigmasterol in the rhizome ，stem and leaf of Mosa basjoo from the same plant ，and to provide reference for the substitute resource for the effective components of M. basjoo . METHODS ：UPLC method was adopted. The determination was performed on Zorbax Rrhd Eclipse Plus C 18 column （100 mm×2.1 mm，1.8 μm）with mobile phase consisted of acetonitrile-methanol （78.5∶21.5，V/V）. The detection wavelength was set at 210 nm；the flow rate was 0.15 mL/min；the column temperature was 30 ℃ and the sample size was 1 μL. The results of content determination of lupinone and stigmasterol in the rhizome ，stem and leaf of 9 batches of M. basjoo from the same plant were analyzed by the methods of comparative analysis between groups ，principal component analysis and cluster analysis. RESULTS：The mass concentration of lupenone and stigmasterol had a good linear relationship with the corresponding peak area within the range of 11.16-357.10 and 8.83-160.40 g/mL（R2 were 0.999 2 and 0.999 1，respectively）. RSDs of precision ， repeatability and stability tests were all less than 3％. The average recovery rates of lupenone and stigmasterol were 101.44％ and 98.32％，and the RSDs were 1.77％ and 1.81％（n＝6），respectively. The average contents of lupenone and stigmasterol in stems of M. Basjoo were significantly higher than those of rhizome and leaves of M. basjoo （P＜0.05）. There was no statistical significance in the contents of lupenone and stigmasterol between stem and leaf of M. basjoo from same plant （P＞0.05）. Results of principal component analysis showed that the contents of lupanone and stigmasterol were different in rhizome ，stem and leaf of M. basjoo from the same plant. Rhizome ，stem and leaf of M. basjoo were divided into three types through cluster analysis ，among which the rhizome had significant difference with the other two parts. CONCLUSIONS ：The method is simple ，rapid，specific， reproducible and accurate. It can be used for the content determination of lupenone and stigmasterol in different parts of M. basjoo . The stem of M. basjoo can replace the rhizome of M. basjoo as the source of lupinone and stigmasterol.

OBJECTIVE： To establish a UPLC fingerprint of Ficus tikoua. METHODS： UPLC method was adopted. The determination was performed on Waters ACQUITY UPLC BEF C18 column with mobile phase consisted of 0.2％ aqueous acetic acid-acetonitrile （gradient elution）； the detection wavelength was 254 nm； the flow rate was 0.1 mL/min； the column temperature was 25 ℃， and sample size was 2 μL. UPLC fingerprints of 10 batches of samples and 2 batches of adulterants were determined by using No. 14 peak as reference. The similarity evaluation was carried out by using the TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition） so as to determine common peak. The cluster analysis was performed by using SPSS 20.0 software. SIMCA 13.1 software was used to conduct the principal component analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）. RESULTS： There were 28 common peaks in UPLC fingerprint of 10 batches of F. tikoua. The similarity of 10 batches of F. tikoua was between 0.839 and 0.935， and the similarities of the 2 batches of adulterants were 0.503 and 0.173 respectively， which indicated that F. tikoua could be distinguished from adulterants. 10 batches of F. tikoua could be divided into 2 categories by cluster analysis and principle component analysis， and S3-S5， S9 and S10 were grouped into one category， and the remaining batches were grouped into one category. 7 components with a variable importance in projection （VIP） value ＞1 were screened by OPLS-DA analysis. These 7 components may be the main components that caused the quality difference of 10 batches of F. tikoua samples. CONCLUSIONS： Established fingerprint， cluster analysis， principle component analysis and OPLS-DA can be used for the identification and quality control of F. tikoua.