Objective To observe the effect of rosiglitazone on nonalcoholic fatty liver disease (NAFLD) in type 2 diabetic patients. Methods The 95 newly diagnosed type 2 diabetics with CT scan displayed NAFLD were enrolled and divided into three groups randomly:(1) rosiglitazone group (R group) were treated for six months with rosiglitazone,4mg once daily,(2) metformin group (M group) were treated with metformin,0.5g three times daily,(3) control group were treated with other medicines except for thiazolidinedione and metformin. Results The CT value ratio of liver to spleen,disappearance rate of fatty liver and ISI were much higher in R group than in M group,while those were much higher in M group than in control group. HOMA-IR was lowest in R group and highest in control group. FIns in R group and M group was much lower than in control group. Conclusions Rosiglitazone can treat NAFLD,increase the insulin sensitivity and improve the insulin resistance in T2DM patients. The therapeutic effects of rosiglitazone are better than metformin. Rosiglitazone has no damage on liver function in our study

Objective To systematically compare propofol and isoflurane for myocardial protection in patients undergoing coronary artery bypass grafting (CABG).Methods Electronic databases were searched for randomized controlled clinical trials comparing propofol and isoflurane for myocardial protection in patients undergoing CABG.Data which were extracted independently by two reviewers included the general data of patients,premedication,induction of anesthesia and anesthetics applied during maintenance of anesthesia,level of cardiac troponin I (cTnI) before operation and at 6,12,24 and 48 h after operation,requirement for positive inotropic agents during operation,and development of myocardial infarction within 24 h after operation.Meta-analysis was conducted using Review Manager 5.0.2.Results Sixteen randomized controlled clinical trials involving 794 patients were included in this meta-analysis.The patients were divided into 2 groups:propofol group (n =405) and isoflurane group (n =389).There were no significant differences between the two groups in the plasma concentration of cTnI after operation,incidence of myocardial infarction within 24 h after operation,and requirement for positive inotropic agents during operation (P ＞ 0.05).Conclusion There is no significant difference between propofol and isoflurane for myocardial protection in the patients undergoing CABG.

Objective To evaluate the value of three dimensional CT angiography in the diagnosis of intracranial aneurysms by the comparison with DSA.Methods CTA and DSA were performed in 30 patients(aged 34~76 years) who were highly suspected with intracranial aneurysms.Feasible endovascular treatment were performed simultaneously.The sensitivity,specificity,accuracy in detecting the aneurysms,in demonstrating the neck of the aneurysms and the relationship of parent artery were compared between CTA and DSA.Results 26 intracranial aneurysms were detected by CTA,the sensitivity,sepcificity and accuracy were 95.5%,87.5% and 93.3% respectively.There were no statistical differences among the sensitivity,specificity,accuracy between CT and DSA(?

Objective To identify the factors those regulate CCCP-induced non-canonical autophagy.Methods Different cells expressing GFP-LC3 were treated with or without CCCP (30μM) for 6 h.Fluorescent images were taken and cell lysates were analyzed by western blot assay.Real-time PCR was used to measure the mRNA levels of LC3B.FIP200-KO MEF cells were cultured and treated by 30 μM CCCP with or without water channel inhibitors, for 6 h.Cell lysates were analyzed by Western blot assay.Results CCCP could not induced autophagy in Atg5-KO MEF cells.CCCP could induce non-canonical autophagy in ULK1-KO MEF, FIP200-KO MEF, and Beclin1-KD U251.CCCP treatment in FIP200-KO MEF cells had no effect on the expression level of LC3B mRNA.We also found two distinct aquaporin water channel inhibitors could inhibit the generation of LC3 which was induced by CCCP.Conclusion CCCP induced non-canonical autophagy was Atg5-dependent, but Beclin1-, ULK1-and FIP200-independent.Osmotic imbalance could regulate CCCP-induce non-canonical autophagy.

Objective To assess the application value of real time three-dimensional (RT-3D) ultrasonography in diagnosis of fetal corrected transposition of the great arties (cTGA). Methods Data of 14 fetuses diagnosed as cTGA clinically were reviewed. With 2D ultrasonography, diagnosis views were obtained and then studied using cardiac three-section analytic method. With real time 3D (RT-3D) ultrasonography, volume datasets were acquired at the level of four chamber view, and spatio-temporal image correlation (STIC) was then used to analyze the relationship of the two great arties. Confirmed by infant echocardiography and the autopsy findings, the accuracy of RT-3D and 2D ultrasonography in evaluation of fetal cTGA and complications were compared. Results The accuracy rate of RT-3D and 2D ultrasonography in diagnosis of fetal cTGA was 92.86% and 71.43% (χ~2=2.19, P=0.14). The procedure time of RT-3D ultrasonography was significantly shorter than that of 2D ultrasonography (t=10.23, P＜0.001). Conclusion RT-3D ultrasonography can evaluate fetal cTGA and its complications more quickly and exactly than conventional 2D ultrasonography.

ObjectiveTo evaluate the clinical value of prenatal ultrasonography combined with maternal serology screening for chromosomal abnormality in 15 to 20+6 gestational weeks.MethodsSix hundred and twenty-eight pregnant women (628 fetuses) in 15 to 20+6 gestational weeks were selected to undergo prenatal ultrasonography, who were in critical risk of trisomy 21 or trisomy 18 by maternal serology screening. Transabdominal ultrasonography were performed and fetal nasal bone and nuchal fold were detected. Those who had nasal bone hypoplasia, thickened nuchal fold (NF>6 mm) and other abnormal fetal soft markers underwent amniocentesis for karyotyping analysis. ResultsThere were 6 cases of nasal bone hypoplasia (0.96%, 6/628), including one case of thickened nuchal fold, two cases of echogenic bowel, two cases of choroid plexus cysts and 1 case of echogenic cardiac focus. All these 6 cases underwent amniocentesis and 2 were trisomy 21 (33.3%, 2/6). The other 4 cases had no significant chromosomal abnormality.ConclusionsPrenatal ultrasonography may improve the detection rate of chromosomal abnormality for those pregnant women who are in critical risk of chromosomal abnormality prompted by serology screening. But invasive procedures are still needed to verify the chromosomal abnormality.

Aim To observe the effects of promethazine on the analgesia,hypnosis,amnesia and therapeutic index of isoflurane.Methods The experiments were designed to study promethazine on the analgesic effect of isoflurane by hot-plate test and writhing test,and to study the effect of promethazine on the sleeping time of isoflurane by the method of righting reflex,and the amnesia of isoflurane by Morris water maze,and the ED_(50),LD_(50) by sequential method in mice.Results The result of hot-plate test and writhing test indicated that promethazine could enhance the analgesic effect of isoflurane(P＜0.05 or P＜0.01);through the experiment of righting reflex, sleeping time of isoflurane in mice was extended by promethazine(P＜0.01);in Morris water maze experiment, the average latency in the combination of promethazine and isoflurane was longer than that of the promethazine group or isoflurane group(P＜0.05 or P＜0.01), while aiming to the residence time, the combination of the two was shorter than that in the third quadrant(P＜0.01 or P＜0.05),the TCPP of the group of isoflurance was more than that of the combination group;promethazine could decrease the ED_(50) of isoflurance(P＜0.01),but it did not obviously affect its LD_(50)(P＞0.05).Conclusion Promethazine can not only reinforce the effect of isoflurance on analgesia,hypnosis and amnesia, but also boost the therapeutic index of isoflurance.

Objective:To explore the clinical value of serum sialic acid (SA) for brain glioma diagnosis.Methods:Sixty patients with brain glioma and 60 normal persons (control group) in Deqing People's Hospital from January 2016 to September 2018 were collected, and all the brain glioma patients were divided into low grade group and high grade group according to the pathological grading. The serum SA levels of all the subjects were detected by photocolorimetric method, and the results were analyzed statistically.Results:The positive rate of SA in control group, low grade group and high grade group was 1.7%(1/60), 59.1%(13/22) and 81.6%(31/38), and there was significant difference ( χ2= 6.49, P<0.05). The positive rate in high grade group was higher than that in low grade group and control group, the positive rate in low grade group was higher than that in control group, and there was significant difference ( P<0.05). The level of SA in control group, low grade group and high grade group was 50.9(46.1-58.1), 55.6(48.2-60.9), 64.8(57.9-73.9) mg/L, and there was significant difference ( H= 15.56, P<0.05). The level of SA in high grade group was higher than that in low grade group and control group, the level of SA in low grade group was higher than that in control group, and there was significant difference ( P<0.05). After operation, the level of SA was decreased. At 6 months after operation, the level of SA in low grade group and high grade group was significantly lower than that before operation [low grade group: 50.4 (48.0-59.1) mg/L vs. 55.6(48.2-60.9) mg/L; high grade group: 60.1 (46.0-62.4) mg/L vs. 64.8(57.9-73.9) mg/L] ( P<0.05). At 6 months after operation, the level of SA in high grade group was significantly higher than that in control group [60.1 (46.0-62.4) mg/L vs. 50.9(46.1-58.1) mg/L](P<0.05), but in lower grade group, there was no significant difference [50.4 (48.0-59.1) mg/L vs. 50.9(46.1-58.1) mg/L]( P>0.05). Conclusions:Serum SA can be used in auxiliary diagnosis and prognosis evaluation for brain glioma.

Objective:To evaluate the immunomodulating effect of oyster peptide on immunosup-pressed mice.Methods:ICR mice injected with cyclophosphamide (CTX)were adopted as the module group,with mice without treatment as the control group,and different dosages of oyster peptide (0.5 g/kg,1 .0 g/kg,and 2.0 g/kg)were given to the low,middle,and high groups for 1 5 days.The body weight,spleen,and thymus weight of the mice,structures under the microscope of the immune organs, numbers of white blood cells,ratios of T lymphocyte subsets,immune cytokines and numbers of nuclear cells,and DNA content in bone marrow were all assessed.Results:Compared with the control group, the structures of thymus and spleen of the mice in the CTX group appeared obscure and shrunk when ob-served under microscope,the number of their white blood cells declined (P =0.04),the proportion of their CD3 +T cells in peripheral blood declined (P =0.003),the proportion of their CD8 +T cells in pe-ripheral blood declined (P =0.002),the concentration of their IL-5 in peripheral blood significantly in-creased (P <0.01 ),the concentration of their nucleated cells and DNA density in bone marrow de-creased (P =0.04,P <0.01 ).Oyster could improve the structures of thymus and spleen of the immuno-suppressed mice.Compared with the CTX group,the number of white blood cells in 2.0 g/kg group in-creased (P =0.003),the proportion of CD3 +T cells in peripheral blood in 1 .0 g/kg group (P =0.04) and 2.0 g/kg group (P =0.02)increased,the proportion of CD8 +T cells in peripheral blood in 2.0 g/kg group increased (P =0.002),the concentration of IL-5 in peripheral blood in all the oyster treated groups increased (P <0.01 in 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups),the concentration of IL-1 7 in peripheral blood in 2.0 g/kg group decreased (P =0.03),the concentration of nucleated cells in bone marrow of all the oyster treated groups increased (0.5 g/kg vs.CTX,P =0.04;1 .0 g/kg vs. CTX,P =0.02;2.0 g/kg vs.CTX P =0.01 ),the DNA content in bone marrow of all the oyster treated groups increased (P <0.01 in the 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups).Conclusion:Oyster peptide could improve the structures of immune organs of the CTX-induced immunosuppressed mice,re-cover the imbalances of T lymphocyte subsets,improve the immune cytokines and increase numbers of nucleated cells and DNA content in bone marrow,thus improving the immunologic function.

OBJECTIVETo investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG).

METHODSForty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared.

RESULTSThere were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05).

CONCLUSIONSLaparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.