Objective To investigate the relationship between ?3 adrenergic receptor(?3AR) gene Trp~(64)Arg mutation and insulin resistance(IR) in Chinese.Methods The 120 patients with type 2 diabetes mellitus(group DM) and 80 nondiabetic subjects as normal controls(group N)were involved in the study.Polymerase chain reaction(PCR) and the restriction fragment length polymorphism analysis(PCR-RFLP) were used to determine the ?3AR genotype.The indexes such as body weight,height,waist circumstance,hip circumstance,blood pressure,lipids,fast plasma glucose and insulin were detected in all subjects.The IR was estimated by homeostasis model assessment(HOMA-IR).The patients in the diabetes group were divided into relative insulin sensitive group and relative insulin resistant group by the 75th percentile HOMA-IR.Results The BMI of the patients with the ?3AR Trp~(64)Arg mutation was significantly higher than that of those without the mutation(P

Objective To investigate the clinical effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune.Methods Fifty patients scheduled for esophagus cancer resection randomized into two groups (n =25 each):the temperature protection group (group W)and the control group (group C).The intraoperative nasopharyngeal temperature was recorded before induction (T1 ),2 hours after operation (T2 ),the end of operation (T3 ),postoperative 2 hours (T4 ).The anesthesia wakening time,the occurrence of postoperative shivering and infection,hospitalization time were also recorded.Venous blood samples were taken at T1 ,T3 ,two days (T5 )and five days after the operation (T6 )for analysis of T-lymphocyte subsets by flow cytometry.Results Compared with T1 ,the nasopharyngeal temperature was significantly de-creased at T2 ,T3 and T4 in group C, and the nasopharyngeal temperature in group W was significantly higher than those in group C at T2 ,T3 and T4 (P <0.05).The anesthesia wakening time and the occurrence of postoperative shivering in group C was significantly more than those in group C (P <0.05).Compared with T1 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly decreased and the percentage of CD8 + cells increased in both groups at T3 (P <0.05).Compared with group C at T3 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly increased and the percentage of CD8 + cells decreased in group W (P <0.05).Conclusion The clinical use of forced-air warming system combined with infusion heating technology can protect the patient??s body tempera-ture,shorten the anesthesia wakening time,reduce the occurrence of postoperative shivering,which protects the patient??s immune function and accelerates recovery after surgery.

Objective To know the cognition,attitude and needs among middle-aged andaged women with urinary incontinence(UI) in communities. Methods A questionnaire survey wasconducted in 66 middle-aged and aged women with UI in two communities and the results were an-alyzed. Results Most patients lacked the knowledge of UI;UI had impact on their physical andmental heahh.Must patients wished to know about the treatment knowledge,and health education of med-ical staff was the most promising way.The mastering degree of knowledge about disease was not related tothe serious degree of disease and age,but was positively related to education degree and economic income.Conclusions We should publicize the knowledge about UI and provide health education and emotionalsupport to patients.And we should emphasize the training about UI among medical staff.

0.05).The plasma PAI 1 activity in the diabeties with nephropathy was higher than that in the subjects without nephropathy ( P

Objective To investigate the effects of multimodal analgesia of parecoxib and fentanyl on perioperative immune functions in patients of hepatocellular carcinoma (HCC).Methods Eighty HCC patients scheduled for hepatectomy were randomly divided into two groups:parecoxib sodium combined with fentanyl group (group P,40 cases) and fentanyl group (group C,40 cases).The percentages of CD3 +,CD4+,CD8+,CD4+/CD8+ T cells,CD3-CD16+ CD56+ (NK),interleukin-4 (IL-4),interferon-γ (IFN-γ) and the ratio of IFN-γ/IL-4 were detected at the following time points:30 minutes before induction of anesthesia (T0),at the end of the surgery (T1),24 h after surgery (T2) and 72 h after surgery (T3).The analgesic effects were estimated by visual analogue scale (VAS) after surgery.Total fentanyl consumption and adverse effects were also recorded.Results The percentages of CD3 + T cells were significantly lower in group C than that in group P at T2 (t =2.155,P ＜0.05).The percentages of NK in group P were recovered nearly to baseline (T0) at T2,which was higher than that of group C (t =2.791,P ＜0.05).In group C,the percentages of CD3 + T cells and NK has not recovered to baseline at T3 (respectively t =3.065,3.231,P ＜ 0.05).In group P,IL-4 serum levels were significantly lower than those in group C,while IFN-γ serum levels were significantly higher than those in group C at T2 (respectively t =2.173,2.100,P ＜0.05).From T2 to T3,the ratio of IFN-γ/IL-4 significantly increased in group P than those in group C (respectively t =3.259,2.203,P ＜ 0.05).VAS scores at rest and on cough in group P were significantly lower than those in group C at 2 h,6 h,12 h and 24 h after operation (respectively t =8.661,9.726,9.147,7.109,P＜0.05;t =8.569,9.614,9.144,8.509,P＜0.05).The total fentanyl consumption in group P was lower than that in group C (t =2.636,P ＜ 0.05).There were no significant differences regarding the incidence of adverse effects between the two groups.Conclusions Perioperative multimodal analgesia of parecoxib sodium combined with fentanyl enhances the analgesic efficacy,and reduces the dosage of opioid consumption,helps recover the cell immunity function of HCC patients after hepatectomy.

Among 2625 patients with type 2 diabetes,body mass index,systolic blood pressure,HbA1C,triglyceride,ApoB,serum uric acid,highly-sensitive C reactive protein,tumor necrosis factor α levels,and common carotid artery intima-media thickness in hypertriglyceridemic-waist ( HTWC ) phenotype group were higher than those in non-HTWC group,while high-density lipoprotein cholesterol and ApoA1 levels were lower( all P＜0.05 ).HTWC phenotype was an independent risk factor for atherosclerosis of carotid artery in patients with type 2 diabetes mellitus (OR 1.45,95％CI 1.07-1.96).

The use of the breathing machine undoubtedly represents the progress in the field of respiratory insufficien-cy treatment,although it has saved many lives,but its side effects are also as everyone knows. Ventilator-associated pneumonia is the most important complication of mechanical ventilation ,it can make the cost of hospitalization and the mortality of patients increased significantly. Pathological biopsy and histological training as the “gold standard ”for di-agnosis of ventilator-associated pneumonia ,but it is the invasive operation and it difficult to fully implement , recently the diagnosis is still controversial. Emerged in recent years the biomarkers for the diagnosis research , but the diver-gence of the corresponding research conclusion is wide. Now , biomarkers that would be useful for diagnosis of ventila-tor-associated pneumonia are reviewed so as to it can improve people ’s understanding of the value of biomarkers in the diagnosis of ventilator-associated pneumonia.

Objective To investigate effective approach to decrease portal venous hypertension and high perfusion of portal vein caused by small-for-size (SFS) liver graft transplantation with the aim of improving hepatocellular microcirculation.Methods Rat models with SFS liver graft (n =62) were well estab lished and divided into SFS group and trans-portal intrabepatic portosystemic shunt (TPIPSS) group.Hemodynamic parameters,histopathologically morphologic changes,postoperative complications,accumulated survival rate were recorded and analyzed.Venous filling time after liver reperfusion,hemodynamic parameters were evaluated using t test and Kruskal-Wallis test.Kaplan-Meier method was performed for survival analysis.Results Venous filling time after liver reperfusion was remarkably prolonged with the application of multihole cone-shaped tubes.Compared with SFS group,the filling time was 4-second longer in TPIPSS.At each endpoints of reperfusion within 90 mins,the portal vein pressures were lowered in the TPIPSS group than those of SFS group.Liver grafts were present with more regular structures in TPIPSS group,with no sign of hepatic sinusoid congestion or irregular clearance extension.In the aspect of postoperative complications,all the rat receivers showed ascites in the SFS group.Nevertheless,there was no ascites observed in TPIPSS rats,and 50％ rats (5/10) experienced clinical manifestations of hepatic encephalopathy.Persistent fever over 7 days was showed in 10％ rats (1/10) of SFS group and 40％ rats (4/10) of TPIPSS group,respectively.The mean survival was superior in TPIPSS group (37.2 ± 23.5) d than SFS group (17.7 ± 13.5) d,P ＜ 0.05.Conclusion TPIPSS could be a safe and feasible approach to improve portal venous hypertension caused by SFS liver graft and hepatocellular reperfusion.

Objective To construct lentiviral vector of late endosomal／lysosomal adaptor, mitogen-activated protein kinase and mammalian target of rapamycin activator 2 ( lamtor2) gene, and to explore its regulatory role on inflammatory response of macrophages after Klebsiella pneumoniae infection.Methods Two pairs of mouse lamtor2 short hairpin RNA (shRNA) were designed and sub-cloned into PLKO.1-puro to construct lentiviral vector, and were transfected into the murine RAW264.7 macrophage.There were two experimental groups including pLKO.1-puro shlamtor 2-1(sh1 group) and pLKO.1-puro shlamtor 2-2 (sh2 group), and the RAW264.7 cells transfected with non-treated pLKO.1-puro was set as control.The expession of lamtor2 were detected by real-time quantitative polymerase chain reaction ( RT-qPCR ) and Western blot.The levels of inflammatory factors including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-αsecreted by the cells were detected by RT-qPCR.T test was used for comparison between groups.Results The recombinant lentiviral vector PLKO.1-shlamtor 2 transfected RAW264.7 cells successfully.The relative expressions of lamtor2 mRNA in the control group, the sh1 group and the sh2 group were 1.000 ±0.000, 0.596 ±0.125 and 0.120 ±0.080, respectively.The expression of lamtor2 in the sh2 group was significantly lower than that in the sh 1 group (t＝3.399, P＝0.015), and they were both significantly lower than the control group ( t ＝3.333 and 9.734, respectively, both P ＜0.05).After infection with Klebsiella pneumoniae, expression levels of IL-1β( t ＝15.20), IL-6 (t＝43.30) and TNF-α(t＝12.67) were significantly higher than those in the control group (all P＜0.01).Conclusion The lentiviral vector of lamtor2 can stably down-regulate the expression of lamtor2 gene in macrophages through RNA interference mechanism , which has a significant effect on the secretion of inflammatory factors of macrophages that are infected with Klebsiella pneumoniae.

The incidence of obstructive sleep apnea (OSA) is higher in pregnancy than in non-pregnancy,and obesity is a major risk factor.OSA in pregnancy can lead to multiple organ dysfunction and is associated with hypertensive disorders in pregnancy,gestational diabetes mellitus,premature birth,and fetal growth restriction. Therefore,early screening and diagnosis are essential for the prevention and treatment of OSA in pregnancy.
Diabetes, Gestational ; Female ; Humans ; Obesity ; Pregnancy ; Pregnancy Complications/epidemiology* ; Premature Birth ; Risk Factors ; Sleep Apnea, Obstructive/therapy*