Objective To study on the changes of the IL-6、IL-8、TNF-? in the type 2 diabetes with insulin resistance and the relation of plasma glucose or insulin resistance and cytokines. Methods (1) To assay the serum level of cytokines in 90 cases with type 2 diabetes mellitus (T2DM) and 30 normal controls. (2)To measure the level of fasting plasma glucose (FPG),hemoglohin A_1c (HBA_1c),fasting insulin(FINS),fasting C-peptide (FCP).(3) To analysis the relation of the level of FPG,HBA_1c,FINS,FCP and cytokines. Results (1) The serum levels of cytokines in T2DM group were significantly increase than in control groups,IL-6 and TNF-? in T2DM group with insulin resistance were significantly increase than in T2DM group without insulin resistance (2) There was significantly positively correlated between insulin resistance and the increasing of cytokine levels. Conclusion There is an excess activation of cytokines in T2DM,which is significantly correlated with insulin resistance. Cytokines play the important role in the occurrence and development of T2DM and insulin resistance.

Objective To investigate the early fluid resuscitation of patients with traumatic shock.Method Two hundred and ninty-eight patients with traumatic shock were retrospectively analyzed.Survivors within 24 hours after admission were regarded as survival group and dead patients as dead group.The comparison was made in regard to injury severity score(ISS)and volume of fluid infusion and blood-transfusion between two groups within 24 hours after admission.At the same time,the comparison in respct of mortality between operation group and non-operation group was also made.Results Of the 298 patients,230(77.2%)survived and 68 (22.8%)died within 24 hours after admission.The ISS and the volume of fluid infusion and blood-transfusion in the dead group were significantly higher than those in the surviving group(P

By analyzing scientific research misconduct and its causes,this paper revealed the conflicts between interests of researchers and management,and proposed measures and suggestions to construct scientific integrity system in Chinese institutions by drawing on experiences from Australia、UK and America.

BACKGROUND: It has been recently found that endothelial progenitor cells (EPCs) can promote injured endothelial healing. There is a supposition that in-stent restenosis possibly correlates with the number and/or activity of EPCs.OBJECTIVE: To comparatively observe the number and activity of circulating EPCs in patients with and without coronary in-stent restenosis, and to verify the above-mentioned supposition.DESIGN, TIME AND SETTING: This study, a comparative observation, was performed at the Department of Internal Medicine, Beijing Shijitan Hospital, Department of Internal Medicine, First Hospital, Peking University, and Department of Physiology and Pathophysiology, Peking University Health Science Center between March 2005 and May 2007.PARTICIPANTS: According to the coronary angiography, 15 patients were recruited into the restenosis group and 17patients with patent stents were selected into the control group.METHODS: Total peripheral mononuclear cells were isolated from blood of patients with restenosis or control subjects by Ficoll density-gradient centrifugation. These cells were plated on dishes coated with human fibronection. After 7 days in culture, the nature of adherent cells was confirmed by direct fluorescent staining with the use of 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanide percholate-labelled acetylated low-dencity lipoprotein and fluorescein isothiocyanate-labeled ulex europaeus agglutinin-Ⅰ under a laser scanning confocal microscope. Cells demonstrating double-positive fluorescence were identified as differentiating EPCs.MAIN OUTCOME MEASURES: After 7 days of culture, EPCs were counted under an inverted microscope. Proliferation of EPCs was determined using the MTT colorimetric assay. Migration of EPCs was assayed using the scratch assay qualitatively. EPCs adhesion was performed by replating cells on fibronectin-coated dishes and then counting the adherent cells.RESULTS: The number of EPCs was significantly reduced in patients with in-stent restenosis compared with that in the control group (P = 0.001). The proliferative activities were impaired in the in-stent restenosis group than in the control group(P < 0.05). In addition, the migrative activities were also impaired in the in-stent restenosis group, but no significant difference in adherent activities existed between the two groups (P > 0.05).CONCLUSION: The number and functional activities of proliferation and migration of EPCs were decreased in patients with in-stent restenosis, which may be related to the number and/or activities of EPCs.

Objective To investigate the possible role of high mobility group box 1 protein (HMGB1) and its advanced gly‐cation end products receptor (RAGE) in the pathogenesis of systemic lupus erythematosus (SLE) .Methods The enzyme‐linked immunosorbent assay (ELISA) was used to determine the level of plasma HMGB1 in 52 cases of SLE (SLE group) and 40 healthy females undergoing physical examination (HC group) ,at the same time real time quantitative polymerase chain reaction (RT‐qPCR) was employed to detect the expression of HMGB1 and RAGE mRNA in peripheral blood mononuclear cells (PBMCs) .The correlation between plasma HMGB1 ,PBMCs HMGB1 and RAGE mRNA levels with clinical indicators was analyzed .Results The levels of plasma HMGB1 ,PBMCs HMGB1 mRNA in the SLE group were significantly higher than those in the HC group ,the differences were statistically significant (P< 0 .05) ,while the level of PBMCs RAGE mRNA had no statistical difference (P>0 .05);the Spearman correlation analysis showed that the level of plasma HMGB1 was positively correlated with antinuclear anti‐bodies titers and SLEDAI score in the SLE patients (P<0 .01) ,while had no obvious correlation with the other clinical and labora‐tory indicators(P>0 .05);the HMGB1 mRNA expression level was positively correlated with the RAGE mRNA expression level and SLEDAI scores(P<0 .01 ,P<0 .05) ,and had no obvious correlation with other clinical and laboratory indicators (P>0 .05) . Conclusion The abnormal expression of plasma HMGB1 and PBMCs HMGB1 mRNA in SLE patients prompts that which might be involved in the occurrence and development of SLE ,might participate in the immune and inflammatory regulation of SLE .

Objective To explore the operative technique of liver retransplantation.Methods The clinical data of 24 patients who underwent liver retransplantation in the recent 4 years in our center were reviewed.In all of the patients a modified piggy-back liver transplantation was adopted.Extracorporeal venous bypass was used in 6 cases,and no bypass was used in 18 cases.We anastomosed the suprahepatic inferior vena cava to the annexed vena cava in a modified piggy-back figuration.The portal vein was reconstructed by end-to-end anastomosis.In 17 cases the hepaticy artery was anastomosed end-to-end,and in the other 7 cases was(anastomosed) to abdominal aorta by interposition graft.In 6 cases the biliary tract was reconstructed by(end-to-end) anastomosis,and in the others by choledochojejunostomy.All of the patients were routinely followed up after operation.Results Postoperative mortality of liver retransplantation was 41.6%(10/24).The cause of death was sepsis in 7 patients,intraoperative bleeding in 2,and cerebral hemorrhage in 1.The other patients(14/24,58.4%) successfully recovered after liver retransplantation.The complication rate in this group was 21.4%%(3/14),including biliary tract complications in 2 patients,and wound dehiscence in 1.Conclusions There was no significant difference in operative time and blood loss between liver(retransplantation) and primary transplantation.The key for success is to adopt individuation in selection of(methods) for liver retransplantation.The difficulty of liver retransplantation is exposure and mobilization of(inferior) vena cava. The probability of interposition graft from hepatic artery to abdominal aorta and(choledochojejunostomy) is higer than that of primary liver transplantation.

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.

AIM:To investigate the safety and effect of femtosecond laser-assisted cataract surgery with Cionni modified capsular tension ring (MCTR) implantation in the management of traumatic lens subluxation.METHODS: Totally 11 patients (11 eyes) with traumatic lens subluxation were divided into three groups according to the severity of lens dislocation, ranging from 90° to 120° (4 eyes), 120° to 180° (5 eyes) and 180° to 270° (2 eyes).The contact LenSx femtosecond laser cataract surgery platform was applied to create the capsulotomy, prepare nuclear fragmentation and make corneal wound creation.Anterior vitrectomy was performed in some patients during the surgery.After capsular retractors insertion and phacoemulsification, the MCTR was inserted to the capsular bag and fixed to the sclera.Finally, the IOL was implanted into the capsular bag.Postoperative visual acuity, intra-and post-operative complications, anterior capsular opening, IOL and MCTR position and intraocular pressure (IOP) were assessed.RESULTS:The duration of follow-up was 2mo.All the operations were completed successfully.Five eyes underwent cataract surgery combined with anterior vitrectomy.Four eyes had been inserted with 2-eyelet MCTR and seven eyes with 1-eyelet MCTR.The best corrected visual acuity (BCVA) after operation was better than 0.5 in 4 eyes, between 0.3 and 0.5 in 3 eyes, between 0.1 and 0.3 in 3 eyes, and less than 0.1 in 1 eye.Compared with preoperative BCVA, the difference was statistically significant (P<0.05).All the IOLs were stably centered and the eyelet of MCTR was fixated steadily between the iris and the anterior capsule.The common intra-and post-operative complications were subconjunctival hemorrhage, incomplete capsulotomy, residual cortex, secondary glaucoma and posterior capsular opacification.CONCLUSION:Femtosecond laser-assisted cataract surgery can improve the success rate of capsulorhexis, and reduce the difficulty of nuclear fragmentation.Femtosecond laser-assisted cataract surgery combined with MCTR implantation is an ideal surgical method for traumatic lens subluxation.

Objective To investigate the changes in cortisol (COR) secretion in the acute phase of traumatic brain injury (TBI) .Method Seventy-five patients admitted to the hospital at 2-24 h after TBI were divided into 3 groups based on the Glasgow Coma Scale score: mild TBI group (group TBI1, n = 30), moderate TBI group (group TBI2, n = 12) and severe TBI group (TBI3, n = 33). Thirteen patients with cervical spondylosis or osteoma of the skull (admitted to the hospital at the same period) were regarded as control group (group C). Venous blood samples were taken on the first day after admission to measure the serum concentrations of total COR, adrenocorticotropin (ACTH) and corticosteroid-binding globulin (CBG). Free COR concentrations and free COR index were calculated. High blood COR was recorded. Result Compared with group C, the serum concentrations of total COR and ACTH, free COR levels and free COR index were significantly increased in TBI1, TBI2 and TBI3groups (P ＜ 0.05). The parameters mentioned above were significantly higher in TBI2 and TBI3 groups than in TBI1 group ( P ＜0.05). There was no significant difference in serum CBG concentrations among the four groups.The incidence of high blood COR was significantly higher in TBI1, TBI2 and TBI3 groups than in C group, and in TBI3 group thanin TBI1 and TBI2 groups (P ＜0.05). Conclusion COR secretion is increased in the acute phase of TBI and the level of COR secretion is related to the severity of brain damage.

OBJECTIVETo evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruc- tion of the anterior teeth area following periodontitis.

METHODSThirteen adult patients with anterior teeth displacements were treated. The probing pocket depth (PD; 102 teeth, 612 sites), bleeding on probing (102 teeth, 204 sites), papilla index (PI; 128 papillae), and papillary height (PH; 128 papillae) of each patient were assessed at baseline, 3 months after the initial therapy, and the end of the orthodontic treatment. Non-parametric and paired-sample t tests were carried out for the statistical analysis of the data.

RESULTSThree months after initial therapy, the sites with PD ≤ 3 mm accounted for 79.58% (487/612) of the observed teeth, and 88.73% (181/204) of the buccal and lingual sites of the teeth showed negative bleeding on probing. These findings were better than those at baseline [26.31% (161/612) and 22.06% (45/204), respectively] (P < 0.05), but no sig- nificant difference was observed compared with pro-orthodontic treatment (P > 0.05). Prior to orthodontic treatment, the levels of the PI of 8 and 21 papillae were III and II, respectively, among the 128 observed papillae. After the orthodontic treatment, 51 papillae were at level III and 68 papillae were at level II. The PH of the 102 papillae was 2.84 mm ± 0.62 mm after ortho- dontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm ± 0.57 mm) (P < 0.05).

CONCLUSIONAfter initial therapy, moderate orthodontic teeth movements may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level and resolution of the periodontal defects.