Objective To compare the effects of intermittent high blood glucose and consistent hilgh blood glucose on pancreatic islet β-cell function and β-cell apoptosis in GK rats.Methods Twenty-two male GK rats were randomly divided into 2 groups consisting of consistent hish blood glucose group(HG)and intermittent high blood glucose group(FG).Eleven male Wistar rats were used as normal glucose controls(NG).The fluctuating high blood glucose animal model was induced by intraperitoneal injection of insulin and glucose at different time for six weeks.Intraperitoneal injection glucose tolerance test and insulin release test were performed.The area under curve of glucose(AUCg).the area under carve of insulin(AUCi)/AUCg and the ratio of insulin increment to blood glucose increment 15 min after glucose load(Δ115'/ΔG15')were calculated routinely.Then the pancreatic slides were stained with insulin antibody.The apoptotic β cells in islets were detected and quantified by the TUNEL technique.Results(1)The fasting plasma glucose and 15,30,60,and 120 min plasma glucose levels after glucose loading in FG group were significantly higher than those in control group(all P<0.01),and AUCg was also markedly increased[(1 012.14±82.62 vs 813.60±56.70)ng·ml~(-1)·h~(-1)·10~4,P<0.01].Insulin levels of FG group at 15,30,60,and 120 rain after glucose loading were significantly lower than those in HG group[(0.554± 0.18 vs 0.95±0.28.0.43±0.17 vs 0.85±0.21,0.47±0.11 vs 0.76±0.16,0.58±0.13 vs 1.08±0.26)ng/ml,P<0.05],along with decreased AUCi/AUCg and Δ115'/ΔG15'[(9.56±2.53 vs 21.36±4.16)×10~(-7);(3.95±3.45 vs 27.02±8.62)×10~(-7),both P<0.05].(2)Image analysis of pancreatic islet immunocytoehemistry showed that the insulin staining positive area,area ratio and total density of insulin positive cells per islet were significantly lower in FG group than those in HG group(P<0.05).(3)The percentage of β-cell apoptosis in the FG group was statistically higher than that in the HG group[(24.17±7.25 vs 16.55±5.11)%,P<0.01].Conclusion Compared with the consistent high blood glucose,intermittent high glucose could lead to further impairment of β-cell function and increased β-cell apoptosis may partially contribute to this process.

A dual-mode recording system used for synchronous detection of neuroeletrical and neurochemical signals was developed, and a dual-mode synchronous detection experiment was carried out using the instrument. The device comprised 64-channel neuroelectricity recording module with voltage resolution of 0. 3 μV and 4-channel neurochemistry recording module with current resolution of 1 pA. The software had many basic features, including Spike separation and sort, chronoamperometry, cyclic voltammetry, etc. In particular, the software could observe and analyze the dual-mode neural signals synchronously. The performance of the system was demonstrated in the single mode detection experiments. In neuroeletrical experiments, 64-channel simulate neural signals were detected and the signal to noise ratio ( S/N) of Spike recorded from cortex of Sprague-Dawley ( SD ) rat was 6. In the K3 [ Fe ( CN )6 ] and ascorbic acid measurement experiments, the current response of K3 [ Fe ( CN)6 ] in the range of 0. 1-10 mmol/L was obtained by cyclic voltammetry, with a correlation coefficient of 0. 9889, and the current response of ascorbic acid ( concentration:10-800 μmol/L) by chronoamperometry increased linearly with a correlation coefficient of 0. 9841. Based on the rat model of global cerebral ischemia, a dual-mode detection experiment was carried out. In the experiment, the neuroelectrical and neurochemical signals were synchronously recorded in the SD rat primary visual cortex. According to the experimental results, we got the conclusion that the concentration of ascorbic acid negatively related to the Spike firing in the SD rat primary visual cortex.

Objective To characterize the mutation of phenylalanine hydroxylase (PAH) gene in patients with phenylketonuria(PKU) in Ningxia area,China.Methods Seventy-three children diagnosed with PKU at the Child and Maternal Healthcare Hospital of Ningxia Hui Autonomous Region between January 2010 and June 2013,and 100 non-PKU children randomly chosen from children with normal results in PKU screening were enrolled in the study.Venous blood was collected and the PAH gene sequence was determined by direct DNA sequencing after amplification with the polymerase chain reaction technique.The new gene mutations were defined based on the national and international literature search and databases.The source of the newly discovered mutations was also measured by examining and sequencing the blood samples of their parents.The Chi-square test was used for statistical analysis.Results Among 146 alleles of the 73 PKU children,the detection rate of mutation of PAH gene was 79.5％ (116/146),including 37 types of mutations occurring in 11 exons other than exon 2 and exon 13.The 37 different mutations included 22 missense mutations (59.5％,22/37),six nonsense mutations(16.2％,6/37),six splice site mutations(16.2％,6/37) and three deletion mutations(8.1％,3/37).p.R243Q(17.1％,25/146),EX6-96A ＞ G (6.8％,10/146),p.R241C(6.2％,9/146),p.R413P (5.5％,8/146),p.Rl11X(4.8％,7/146) and IVS4-1G ＞ A(4.8％,7/146) were found to have a higher mutation frequency.Meanwhile,p.R243Q was the most common mutation among Han and Hui ethnic groups with a frequency of 18.8％(12/64) and 15.9％ (13/82),respectively.In contrast,p.R241C showed a significant higher frequency in the Hui group [9.8％(8/82) vs 1.6％(1/64),x2=4.17,P=0.04].Four new mutations of PAH genes,including p.Q304K,p.H107R,p.F392I and p.N223I,were discovered after literature search and comparative studies.Conclusions PAH gene mutations in children with PKU in Ningxia area are unique and are characterized by the diversity and complexity of mutation occurrence in this ethnic region.

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in patients undergoing postoperative early enteral nutrition (EEN) with radical resection for hilar cholangiocarcinoma.Methods The clinical data of 48 patients with hilar cholangiocarcinoma who were admitted to the Drum Tower Clinical Medical College of Nanjing Medical University from July 2006 to September 2014 were retrospectively analyzed.All the 48 patients underwent radical resection for hilar cholangiocarcinoma,including 24 patients receiving postoperative EEN (EEN group) and 24 patients receiving total parenteral nutrition (TPN group).The serologic indices and liver function were detected regularly after operation.Ten percent of albumin (Alb) 10 g was administered by intravenous infusion when Alb ＜ 30 g/L.The indexes of all the 48 patients were compared in the 2 groups at postoperative day 3 and 7,including the serologic indices and liver function,the exhaust time,the volume of Alb infusion,the complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and the duration of hospital stay.The patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as x ± s,comparison between groups and count data were analyzed using the t test and chi-squared test,respectively.Results Patients in the 2 groups were cured successfully and discharged,and no patient died perioperatively.Patients in the EEN group had a good tolerance for EEN and no occurrence of EEN-related complications was detected.The level of the GGT was (108 ± 73) U/L in the EEN group,which was significantly lower than (225 ± 121) U/L in the TPN group at postoperative day 3 (t =4.041,P ＜ 0.05).The level of the GGT was (142 ± 86) U/L in the EEN group,which was no significantly different from (183 ± 107)U/L in the TPN group at postoperative day 7 (t =1.477,P ＞ 0.05).The postoperative time to anal exsufflation and the duration of hospital stay were (73 ± 18) hours and (15 ± 4) days in the EEN group,which were significantly different from (97 ± 21) hours and (18 ± 4) days in the TPN group,and the volume of Alb infusion was (44 ± 29)g in the EEN group,which was significantly lower than (101 ± 92) g in the TPN group (t =4.295,2.615,2.916,P ＜ 0.05).All the 48 patients were followed up for 1 to 71 months (mediantime,10 months),no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of postoperative EEN in enhanced recovery of patients undergoing radical resection for hilar cholangiocarcinoma is safe and effective,it could accelerate the recovery of enteral function,shorten the postoperative duration of hospital stay and reduce the supplement of extrinsic Alb,which is helpful for the fast recovery of patients.

OBJECTIVETo investigates the surgical treatment for congenital anophthalmia.

METHODSThe operation was performed in two steps. At first, the orbit was enlarged and the tarsus was reconstructed with cartilage transplantation. At the second step, blepharoptosis was corrected with levator shortening or frontalis muscle suspension.

RESULTSFive cases have been treated successfully with this method and satisfactory results were obtained.

CONCLUSIONOrbit amplification and tarsus reconstruction along with ptosis correction is an effective treatment for anophthalmia both aesthetically and functionally.

Anophthalmos ; surgery ; Blepharoplasty ; Blepharoptosis ; congenital ; surgery ; Cartilage ; transplantation ; Facial Muscles ; surgery ; Humans ; Oculomotor Muscles ; surgery ; Orbit ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Treatment Outcome

Traditional Chinese medicine (TCM) reference standards plays an important role in the quality control of Chinese herbal pieces. This paper overviewed the development of TCM reference standards. By analyzing the 2010 edition of Chinese pharmacopoeia, the application of TCM reference standards in the quality control of Chinese herbal pieces was summarized, and the problems exiting in the system were put forward. In the process of improving the quality control level of Chinese herbal pieces, various kinds of advanced methods and technology should be used to research the characteristic reference standards of Chinese herbal pieces, more and more reasonable reference standards should be introduced in the quality control system of Chinese herbal pieces. This article discussed the solutions in the aspect of TCM reference standards, and future development of quality control on Chinese herbal pieces is prospected.
Drugs, Chinese Herbal ; standards ; Humans ; Medicine, Chinese Traditional ; standards ; Quality Control ; Reference Standards

Objective To study the conventional MRI and dittusion weighted imaging(DWI) features of Japanese encephalitis(JE)in children.Methods Sixteen patients with JE were included. Conventional MRI and DWI sequences were performed in all patients.Seven patients received MRI within 10 days of onset and 9 after 10 days.The appearances on DWI and T_2 WI were recorded.The ADC values of lesions were calculated,and then were correlated with the corresponding time interval between onset of neurological symptoms and MRI scanning.Results The lesions of JE mainly showed long T_1 and long T_2 signal intensity on MRI.The thalami were the most frequently involved areas,and 15 out of 16 showed thalamic involvement and 6 patients only showed thalamic abnormalities without other lesions.Seven patients within 10 days of onset showed lesions with high signal intensity on both DWI and T_2WI,but whole or partial lesions showed clearer on DWI than on T_2WI,and 2 patients showed extra lesions that were invisible on T_2WI.As for the other 9 patients after 10 days of onset,the lesions showed clearer on T_2WI than on DWI. There was a direct correlations between thalamic ADC values and the disease duration (r=0.84,P

OBJECTIVETo find an effective operative procedure against reflux after esophagogastric anastomosis with mucosal valve.

METHODSFour hundred and sixty-four patients with esophageal or cardiac cancer were randomly divided into three groups according to anastomosis modes. Group A underwent esophagogastric anastomosis with mucosal valve (175 cases), group B with mechanical stapler (151 cases) and group C one layer anastomosis with handcraft suture (138 cases). The gastroesophageal reflux index (GERI) was examined by isotope,and 24 h esophageal pH was also monitored. The esophageal motor function was compared among three groups.

RESULTSThe reflux rates were 0, 33.3%, and 6.7% in group A, B, C respectively. The esophageal motor function and the 24 h esophageal pH monitoring indicated that the various indexes were approaching to the normal level in group A, but the various indexes in group B and C were significantly different from the normal values (P< 0.05).

CONCLUSIONThe esophagogastric anastomosis with mucosal valve has better antireflux effect and can prevent the reflux esophagitis after esophageal or cardiac cancer eradication.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; therapy ; Esophagus ; surgery ; Female ; Gastroesophageal Reflux ; prevention & control ; Heart Neoplasms ; therapy ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Stomach ; surgery

This paper introduces an EMG multi-gateway analysis diagnosis and information management system. The clinical applications show that this system has higher efficiency and standard report contents, and easy statistical analysis. And it also offers EMG standard figure, normal value data, nerve and muscle select scheme etc, for reference.
Automatic Data Processing ; Computers ; Electromyography ; instrumentation ; methods ; Equipment Design ; Humans ; Information Storage and Retrieval ; methods ; Management Information Systems ; Medical Records Systems, Computerized ; standards ; Software

OBJECTIVETo analyze the value of preoperative routine donor leg angiography in free fibula flaps.

METHODSEighty-nine consecutive potential candidates for free fibula reconstruction were reviewed. They were further divided into two groups, group one received preoperative routine donor leg angiography, group two received only preoperative evaluation of dorsalis pedis and tibial posterior artery and without angiography.

RESULTSThere were 49 patients in group one and 40 patients in group two. In group one, the results of preoperative angiography resulted in a change of the surgical plan in two patients. In group two, all the patients showed normal dorsilis pedis and tibial posterior artery, and fibula flap was harvested without preoperative angiography. One patient in each group showed venous deformity during the operation, and flap harvesting was abandoned.

CONCLUSIONSRoutine preoperative angiography in free fibula flap is unnecessary. The following three conditions that require an angiography are: abnormal pedal pulses, significant previous lower leg trauma, and suspected vascular diseases.

Adolescent ; Adult ; Aged ; Angiography ; Child ; Female ; Fibula ; Humans ; Leg ; blood supply ; Male ; Middle Aged ; Preoperative Care ; Surgical Flaps