Objective To investigate the mechanism for rhein to improve the insulin sensitivity in diabetes mellitus. Methods Male Wistar rats were randomly divided into normal control group (NC,n=15) and diabetic group (DM,n=40) induced by STZ and high-fat diet.Diabetic rats were randomly divided into diabetic control group (DM-C,n=15) and diabetic group treated with rhein (DM-T,n=15).Then DM-T group was given intragastric administration with rhein at the dose of 100 mg/ (kg-1?d-1) for 11 weeks.FBG,fasting serum insulin (FIns),triglyceride (TG),total cholesterol (TC),insulin sensitivity index (ISI) and other biochemical parameters in each group were measured.The protein expressions of PPAR-? and GluT-4 were determined by immunohistochemistry and Western blot. Results At the end of the 17th week,compared with NC group,DM-C group showed higher FBG and TG,lower ISI,lower protein expressions of PPAR-? and GluT-4 in the adipose tissue.Compared with DM-C group,DM-T group showed lower FBG [(15.73?3.08 vs 22.57?3.23) mmol/l,P

Objective To explore the protective mechanism of metformin in the process of cultured human umbilical vein endothelial cells (HUVECs) injury induced by palmitic acid (PA). Methods HUVECs were cultured in the media of blank,PA,metformin,or PA combined metformin for 24 h,48 h,72 h respectively. Expressions of monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1) were determined by RT-PCR and the expressions of ICAM-1,nuclear factor kappa B p65 (NF-?B p65) and phospho-I?B? was evaluated by Western blotting. Results Significant increase of the expressions of MCP-1 and ICAM-1 was found in PA group compared with in the control group (P

Objective:To investigate the differences in the expression levels of miR-196a-5p and miR-105-5p in serum of patients with benign and malignant pulmonary nodules and their diagnostic value of malignant pulmonary nodules.Methods:The expression levels of miRNAs in cancer tissues of lung adenocarcinoma and lung squamous cell carcinoma and paracancerous tissues in The Cancer Genome Atlas (TCGA) database were analyzed, and the miRNAs with significantly different expression levels in cancer tissues and paracancerous tissues were selected as target miRNAs. A total of 72 patients with pulmonary nodules admitted to Weifang People′s Hospital of Shandong Province from June 2019 to July 2020 were selected. The expression levels of target miRNAs in serum of patients with pulmonary nodules were detected by qRT-PCR. Receiver operating characteristic (ROC) curve was used to compare the diagnostic value of target miRNAs with tumor markers Cyfra21-1, NSE and CEA in malignant pulmonary nodules.Results:After screening, the target miRNAs were identified as miR-196a-5p and miR-105-5p. Twenty-six patients in the benign pulmonary nodules group and 46 patients in the malignant pulmonary nodules group were included. The levels of serum miR-196a-5p [ M ( P25, P75)] in the benign and malignant nodules group were 0.63 (0.09, 2.15) and 1.93(0.93, 4.97) respectively, and the levels of miR-105-5p in the two groups were 2.03 (0.54, 7.95) and 10.65 (5.94, 18.39) respectively. Compared with the benign pulmonary nodules group, the levels of serum miR-196a-5p and miR-105-5p in the malignant pulmonary nodules group were increased, and there were statistically significant differences ( Z=-3.083, P=0.002; Z=-4.092, P<0.001). The levels of serum Cyfra21-1 in the benign and malignant pulmonary nodules group were 2.48 (1.84, 3.78) and 2.20 (1.47, 3.32) μg/L respectively, the levels of serum NSE in the two groups were 15.58 (12.45, 18.95) and 14.43 (12.07, 17.87) μg/L respectively, and the levels of serum CEA in the two groups were 1.16 (0.55, 2.11) and 1.17 (0.61, 1.68) μg/L respectively. There were no significant differences in serum Cyfra21-1, NSE and CEA between the benign and malignant pulmonary nodules group ( Z=-1.161, P=0.246; Z=-0.305, P=0.761; Z=-0.271, P=0.786). The area under the curve (AUC) of the combination of miR-196a-5p and miR-105-5p for the diagnosis of malignant pulmonary nodules was 0.762 (sensitivity 89.1%, specificity 61.5%), which was higher than the value of the combination of Cyfra21-1, NSE and CEA for the diagnosis of malignant pulmonary nodules (AUC=0.591, sensitivity 58.7%, specificity 64.5%). Conclusion:The combination of serum miR-196a-5p and miR-105-5p can assist in the diagnosis of malignant pulmonary nodules and has higher diagnostic value.

Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.

BACKGROUND:Numerous studies have shown that air wave pressure therapy plays an important role in prevention of deep venous thrombosis of lower limb after a major operation on the hip.
OBJECTIVE:To explore the efficacy of air wave pressure therapy on deep vein thrombosis of the lower extremity in patients with total knee arthroplasty.
METHODS:A total of 80 patients with total knee arthroplasty were randomly divided into experimental group and control group. Patients in the control group were treated only with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise;patients in the experimental group were treated with air wave pressure therapy at 2 days postoperatively, and were also treated with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise. Swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were recorded in both groups.
RESULTS AND CONCLUSION:At 2 weeks after treatment, swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were significantly reduced in the experimental group, and its effects were significantly better than those in the control group (P<0.05). Early use of air wave pressure therapy after total knee arthroplasty can al eviate limb swel ing effectively and have obvious advantages in improving coagulation index and blood coagulation condition and in preventing deep vein thrombosis of the lower extremity after total knee arthroplasty.

Objective To investigate the expression and the significance of toll-like receptor 3 (TLR-3)in placenta,tumor necrosis factor-α(TNF-α)in maternal and cord blood of idiopathic fetal growth restriction(IFGR),and their correlation with the pathogenesis of symmetric and asymmetric IFGR.Methods From April 2008 to April 2009,42 primiparae of singleton pregnancy and their IFGR babies,who delivered at term through cesarean section, in the Third Affiliated Hospital of Zhengzhou University were enrolled. All subjectects were divided into symmetric IFGR group (n=20) and asymmetric IFGR group (n =22). Another 42 non-IFGR pairs were randomly selected as the control group. The polink-2 plus polymerized horseradish peroxidase (HRP) immunohistochemical method and the enzyme linked immunosorbent assay (ELISA) were applied to detect TLR-3 and TNF-α levels. Results (1) The expression of TLR-3 protein were observed in all maternal placenta of the three groups. TLR-3 essentially expressed in syncytiotrophoblasts and hofbouer cells in the symmetric IFGR and control group, but expressed mostly in hofbouer cells and less in syneytiotrophoblasts in the asymmetric IFGR group. (2) The expression of TLR-3 in the syncytiotrophoblasts of the symmetric and asymmetric IFGR group was significantly lower than in the control group (111±14 and 118±11 vs. 156 ± 9, P<0. 01). The number of TLR-3 positive in Hofbourer cell in the symmetric IFGR group was lower than the control group (8. 9±2. 8 vs 17.5±2. 8, P <0. 01 ), but the number in the asymmetric IFGR group was higher (23.8±3.7) compared with the control group (P <0. 01). (3) The TNF-α levels in the maternal and cord blood of the symmetric and the asymmetric group were higher than that of the control group [maternal : (90±10) μg/L and ( 86±11 ) μg/L vs. (73±9) μg/L;cord blood: (92±12) μg/L and (96±8) μg/L vs. (79±9) μg/L;P<0.01]. (4) Neither symmetric nor the asymmetric IFGR group showed any correlations between the maternal and cord blood levels of TNF-α (P>0. 05). (5) Significant correlation was found between the TNF-α level of the cord blood and TLR-3 expression in the placenta in both the symmetric and asymmetric IFGR group(P<0. 05),but no relationship was found between the maternal blood TNF-α level and TLR-3 expression in the placenta (P>0. 05). Conclusions The variantions of TLR-3 expression in placenta and the increased expression of TNF-α in cord blood are associated with the genesis IFGR. The reduced expression of TLR-3 may related to symmetric IFGR, while the increased TLR-3 level in hofbouer cells may lead to asymmetric IFGR.

Objective To investigate the predictive factors and prognosis of early intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC).Methods Clinicopathological dats of 184 HCC patients with intrahepatic recurrence after curative resection were collected.Thirteen clinicopathological factors and prognosis after recurrence were retrospectively analyzed. Results Univariate analysis showed that preoperative scrota alpha-fetoprotein(AFP)>100 ng/ml,tumour size>5 cm,venous invasion and intra-operative blood transfusion were predictive factors of early intrahepatic recurrence,and selum albumin<35 g/L was marginally predictive factor.Multivariate analysis showed that serum AFP>100 ng/ml,tumour size>5 cm and venous invasion were independent predictive factots of early intrahepatic recurrence.The survival of patients suffering from early recurrence was significantly shorter than those with late recurrence.with median survival period of 12 mos vs 18 mos(P=0.012).Conclusion Serum AFP,tumour size and venous invasion were independent predictive factors of early intrahepatic recurrence in HCC patients after radical resection of the primary tumor.Early intrahepatic recurrence implies poor prognosis.

Objective To explore the feasibility and application of determining the center of the inferior portion of the glenoid on a standard anteroposterior view of the normal glenoid. Methods Seventy shoulders of 35 mature adults were measured in this study. A 64-slice CT 3D reconstruction was performed for each glenoid. A standard anteroposterior view and the scale of glenoid were made at a 3D workstation by one radiologist, and then transferred to software AutoCAD as 2D images. The 2D images were analyzed with AutoCAD respectively by 3 radiologists. The line was drawn between the most anterior and the most inferior points of the glenoid bony rim. On the same image, another line was drawn between the most posterior and the most inferior points of the glenoid bony rim. Two perpendicular bisectors of the 2 lines were drawn. The cross point of the 2 perpendicular bisectors was regarded as the circle center of the inferior part of the glenoid. The distances from the circle center to the anteroinferior and the posteroinferoir rims of the glenoid and the most posterior point were measured. Measurements were expressed as the mean ± standard deviation. Several related samples Friedman rank sum test was used to compare the measurements (the distance from the circle center to the most posterior point) by the 3 radiologists. Paired t tests were used to compare the differences between the left and right glenoids. Results The mean distance from the circle center to the most posterior point was ( 14. 1 ± 1.6) mm, the anteroinferior rim was ( 14. 0 ± 1.7) mm, and the posteroinferoir rim was ( 14. 1 ±1.6) mm. No significant differences were found ( P>0. 05) between measurements by the 3 radiologists. No significant differences were found ( P>0. 05) between the measurements of the both-side glenoids. Conclusions The method of determining the center of the inferior portion of the glenoid based on the most anterior,posterior and inferior points of the glenoid on a standard 3D anteroinferior view of the normal glenoid is easy,practical and highly repeatable. The radius of the left glenoid is comparable to the radius of the right side in normal shoulders. This method can be used to quantify a glenoid bone defect precisely.

BACKGROUND:Bone marrow mesenchymal stem cel s are the ideal cel s for tissue repair. Whether the ability of in vitro proliferation can be enhanced is a key factor to promote tissue repair.
OBJECTIVE:To observe the effect of transforming growth factorβ1 on the proliferation of bone marrow mesenchymal stem cel s in vitro.
METHODS:Blood samples were taken from the central artery of rabbits to prepare platelet-rich fibrin by centrifugation method which was then placed into fresh DMEM at 37℃for 7, 14, 21, 28 days to col ect exudates. The mass concentrations of transforming growth factor-β1 in the exudates of platelet-rich fibrin were detected. Rabbit bone marrow mesenchymal stem cel s were col ected and cultured in the conditioned medium made by the exudates of platelet-rich fibrin, and the proliferation of cel s was observed.
RESULTS AND CONCLUSION:Concentration of transforming growth factorβ1 was increased with time increasing, increased fastest at 21-28 days, and peaked at 28 days. Under the same stimulus concentration, the proliferation of bone marrow mesenchymal stem cel s was reduced at 0-1 day, increased obviously at 1-2 days, and entered into a steady phase at 2-3 days. Under 150 ng/L transforming growth factorβ1, bone marrow mesenchymal stem cel s proliferated fastest. Experimental findings indicate that with the increase of time, the concentration of transforming growth factorβ1 in the exudates of platelet-rich fibrin increase gradual y, and the conditioned media containing different concentrations of transforming growth factorβ1 play different roles in
promoting the proliferation of bone marrow mesenchymal stem cel s. Bone marrow mesenchymal stem cel s cultured in the conditioned medium containing 150 ng/L transforming growth factorβ1 for 2-3 days can proliferate fastest.

BACKGROUND:Studies have shown that arthroscopic al-inside technology for meniscus repair has achieved good outcomes, and arthroscopic suture combined with sodium hyaluronate has an important role in the cartilage repair. OBJECTIVE:To observe the therapeutic effect of arthroscopic al-inside suture repair combined with sodium hyaluronate injection in the repair of discoid meniscus tears. METHODS:Twenty-two patients with discoid meniscus injury were subjected to arthroscopic al-inside suture repair combined with sodium hyaluronate injection. Al cases were confirmed to have attached edge relaxation or longitudinal crack in operation. After repair, effective rehabilitation training was done. RESULTS AND CONCLUSION:The operations for the 22 cases were al successful and there was no complication. Al patients were fol owed up for over 18 months. According to Ikenchi’s method (Lysholm knee score criterion), 11 cases were rated excel ent, 8 were rated good, and 3 were rated fair, with an excel ent/good rate of 86.36%. It is demonstrated that the al-inside suture repair under the guide of arthroscopy in discoid meniscus cases can remain the most appropriate anatomical structure of the meniscus that can play an effective function, and has the advantage of minimal invasion. Arthroscopic al-inside suture repair combined with intra-articular injection of sodium hyaluronate and standard rehabilitation training result in a lower complication rate and effectively promotes the meniscus repair.