Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P＜0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P＜0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P ＜ 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.

Objective To study the effects of simvastatin on proliferation and apoptosis in rat mesangial cells in vitro, and to investigate the signal pathways involved in apoptosis induced by simvastatin. Methods Cultured mesangial cells were treated with simvastatin. Proliferation of mesangial cells was examined by MTT assay. Simvastatin-treated apoptotic mesangial cells were observed by electron microscopy. Propidium iodide (PI) staining and flow cytometry were employed for quantitative measurement of apoptosis. Caspase-3 activation was determined by CaspGLOW Green Caspase-3 Staining Kit. Results (1)Simvastatin significantly inhibited proliferation of mesangial cells compared with control (P

In our gastroenterology clinic from Jun. 2008 to Jan. 2009, 20. 9% (277/1320) patients were diagnosed with functional dyspepsia (FD) and 14. 8% (41/277) of them with psychological problems according to Minnesota Multiphasic Personality Inventory (MMPI). In those with psychological disorders,92.7% were found with somatization, 60. 9% with depression and anxiety, 97.6% with abdominal pain,75.6% with bloating, 63.4% with early fullness and 36. 6% with nausea. More than 80% patients with anxiety and depression complained irritability, worry, fatigue, poor concentration, memory loss and insomni.a. After 4 weeks of psychological consultation and anti-depression treatment, 5 patients had significant improvement, 31 had improvement and 3 had no response. The overall response rate was 87. 8%.In summary,there is a high prevalence of depression and anxiety in population with FD. Hypochondria and somatization are common among these patients. Psychological consultation with anxiolytic drugs may have good therapeutic effects.

Objective To observe the effects of bolus volume on pharyngeal and upper esophageal sphincter pressures and durations in healthy volunteers by using high-resolution manometry (HRM).Methods Twentyfour health subjects were recruited and asked to swallow three volumes of bolus (3 ml,5 ml and 10 ml) in the neutral head position.Pressure and duration measurements were acquired by utilizing a high-resolution solid-state manometer,with an emphasis on the hypopharynx and upper esophageal sphincter (UES).Variables including UES residual pressure,UES relaxation duration,maximum hypopharygeal pressure and hypopharyngeal pressure duration were analyzed across bolus volumes and consistencies by using three-way repeated measures analysis of variance (ANOVA) to investigate influence of bolus volume.Results UES residual pressure [-1.71 mmHg(3 ml thick liquid)vs.-4.68 mmHg(10 ml thick liquid)],UES relaxation duration[590.45 ms(3 ml thick liquid) vs.702.49 ms (10 ml thick liquid)],maximum hypopharygeal pressure [169.91 mmHg (3 ml thick liquid) vs.204.42 mmHg (10 ml thick liquid)] and hypopharyngeal pressure duration(P ＜0.05) varied significantly across bolus volumes when swallowing water or thick liquid.The UES relaxation duration,UES residual pressure and maximum hypopharyngeal pressure had a direct positive relationship with bolus volume.There was significant differences with regard to UES relaxation duration [685.75 ms(3 ml paste)vs.772.27 ms (10 ml paste)] but not to UES residual pressure (P ＞ 0.05) and maximum hypopharyngeal pressure (P ＞ 0.05) across bolus volume when swallowing paste.Conclusions Difference in hypopharyngeal pressure and duration,UES residual pressure and duration were detected across varying bolus volumes.Consideration of these variables is paramount in understanding normal and pathological swallowing.

?AlM:To evaluate and observe the efficacy of silicon oil ( SO ) , perfluoropropane ( C3 F8 ) and balanced salt solution ( BSS ) that can be used as tamponade during vitrectomy to treat proliferative diabetic retinopathy ( PDR) complicated with vitreous hemorrhage ( VH) .
?METHODS: Studied retrospectively on 74 eyes of 60 patients who underwent vitrectomy surgery with diabetic vitreous hemorrhage in our hospital during June 2008 and June 2014. Based on repeated prior examines on fundus details and the vitrectomy tamponades were chosen. All the patients had been followed up at least 3mo. Depending on different tamponades, the paitents were nonrandomized in three groups and contrasted as visual acuity, intraocular pressure ( lOP ) and complications respectively.
?RESULTS: There was statistically significant difference among these three groups in preoperative eyesight ( P<0. 05 ). Moreover, the preoperative eyesight was statistically different between SO and BSS (P<0. 05), and difference for the rest being not remarkable(P>0. 05). The difference being statistically difference in the postoperative vision among these three groups ( P <0. 05). The further analysis showed that the paired-comparisons were statistically significant difference between SO and BSS ( P<0. 05 ), while the rest two groups of comparison were non-respectively(P>0. 05). The preoperative visual function was in contrast to the postoperative (P<0. 05). The lOP before surgery was not statistically significant difference(P>0. 05). However,the difference among three groups being statistically in the postoperative vision(P<0. 05), in addition,the difference existed in each group through pairwise comparison ( P<0. 05) . The occurence rate of complications after surgery in this survey was 47%, the SO group was 50%, the C3 F8 was 56%, the BSS group was 44%.
? CONCLUSlON: Vitrectomy is a safe and effective treatment that can help patients who have diabetic vitreous hemorrhage obtain better visual improvement. Because of the physicochemical properties and different conditions, there still has complications after surgery.

OBJECTIVE:To establish HPLC fingerprint for the leaves of Camptotheca acuminante in Guizhou.METHODS:HPLC method was performed.The determination was performed on Gemini-NX C18 column with mobile phase consisted of acetonitrile-0.2％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 370 ran,and the column temperature maintained at 30 2.The sample size was 10 μtL.Using sorbitol as a reference,HPLC fingerprints of 14 batches of the leaves of C.acuminante were determined.The chromatographic fingerprint was analyzed with Similarity Evaluation System for Chromatographic Fingerprint of TCM (2004 A) in terms of common peak indentification,similarity evaluation and cluster analysis.RESULTS:There were 10 common peaks in HPLC fingerprints for 14 batches of the leaves of C.acuminate.And the similarity of 13 batches of the leaves of C.acuminate was greater than 0.90,and that of another one was less than 0.90.The leaves of C.acuminate were classified into 3 groups.CONCLUSIONS:The established fingerprint can provide reference for identification and quality evaluation of the leaves of C.acuminate.

Objective To explore the effects of saline instillation on sputum and cardiopulmonary functions of neonates with mechanical ventilation when endotracheal suctioning.Methods Totals of 20 neonates with mechanical ventilation were recruited.Saline instillation was implemented before endotracheal suction at different doses and concentrations.Sputum and cardiopulmonary parameters were recorded after saline instillation and 1 minute,2 minutes,10 minutes after suctioning,including SpO2,PIP,HR,SBP and DBP.Results The 0.5 ml saline instillation group has more sputum than that of no saline instillation group,and the difference was statistically significant [ ( 1.27 ± 0.77 ) ml vs (0.74 ± 0.55 ) ml; P =0.006 ],while no significant difference was found between 0.5 ml saline instillation group and 1.0 ml saline instillation group [ ( 1.27 ±0.77) ml vs (0.99 ± 0.66 ) ml; P =0.072 ].There was no significant effect of the different dose and concentration of saline instillation on sputum of the neonates ( P ＞ 0.05) and on the cardiopulmonary parameters (P＞0.05).SpO2,HR and SBP were significantly changed with time (F =41.567,39.088,6.715,respectively ;P ＜ 0.05 ).SpO2 in the points of 2 minute and 10 minute after suctioning were higher than that in the points of saline instillation and 1 minute after suction; HR in the points of 1 minute and 2 minute after suctioning were higher than that in the point of saline instillation; SBP in the points of 1 minute and 2 minute after suctioning were higher than that in the points of saline instillation and 1 minute after suction.PIP and DBP were not significantly changed with time ( P ＞ 0.05 ).Conclusions Instillation of 0.5 ml normal saline in neonates with mechanical ventilation when endotracheal suctioning may increase sputum and have little side effects on cardiopulmonary function.

OBJECTIVETo analyze the regularity of selection of meridians and acupoints for treating migraine in past dynasties.

METHODSThe data were collected from 178 kinds of literature concerning acupuncture and moxibustion from the Pre-Qin Dynasty to the end of the Qing Dynasty, based on which bibliographic database in ancient acupuncture and moxibustion for treating migraine was established. By way of data excavation and analysis, meridians and acupoints and their combinations frequently used for the treatment in successive dynasties were screened, and the potential regularity was searched.

RESULTSIn the treatment of migraine, the Gall Bladder Meridian was the meridian used most frequently, and both local and remote points in the four extremities were used. Acupoints in yang meridians, especially Fengchi (GB 20), Sizhukong (TE 23) and Shuaigu (GB 8) in Shaoyang meridians were used most frequently. In terms of classification of the special points selected, besides the Crossing Points with meridian qi passing through and crossing in the head, points below the elbow and knee joints, such as Source points, Luo Points, Eight Confluence Points, as well as Five Shu Points were also much frequently used.

CONCLUSIONAccording to data excavation and analysis of references recorded on the treatment of migraine by acupuncture and moxibustion in past dynasties, it is concluded that meridian theories are the foundation and prerequisite for guiding clinical treatment and point selection, in which special acupoints are the main components and the core in point prescription.

Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 19th Century ; History, 20th Century ; History, Ancient ; History, Medieval ; Meridians ; Migraine Disorders ; therapy ; Moxibustion ; history ; methods

Objective To evaluate the swallowing function of patients with dysphagia after brainstem injury using manofluorography (MFG),analyzing the abnormal biomechanical and kinematic parameters as well as any correlation between changes in the pharynx and the upper esophageal sphincter (UES) measured manometrically and changes in the kinematics of the hyoid bone.Methods Thirteen patients with dysphagia after brainstem injury (the patient group) and 13 healthy participants (the control group) underwent manofluorography.Kinematics and biomechanical changes during swallowing were compared between the two groups and the correlations between the observations were analyzed.Results The patient group showed significantly lower maximum pressure and rate of pressure change at the base of the tongue and in the hypopharynx,as well as less hyoid anterior displacement,smaller and briefer UES opening,but significantly higher minimum pressure at UES relaxation.The duration of tongue root elevation and hypopharynx pressure was also shorter than in the control group,on average.There was a negative correlation between hyoid anterior displacement and the minimum pressure on UES relaxation in the control group,and a positive correlation between hyoid anterior displacement and the maximum pressure at the base of the tongue and in the hypopharynx in the patient group.Conclusions The concurrent use of manometry and video-fluorography for evaluating dysphagia can be an objective and effective diagnostic tool for the comprehensive evaluation of swallowing function.

Objective To compare the clinical application of Da Vinci robot surgical system (RSS) with traditional open surgery (TOS).Methods From Feb 2015 to Jul 2016,48 cases of upper abdominal surgical disease patients were divided into RSS group (23 cases) and TOS group (25 patients) randomly.Results The anesthesia time [(194 ±16)min vs.(181 ±11)min,t=3.262,P=0.002] and operation time [(167 ± 14) min vs.(158 ± 14) min,t =2.292,P =0.027] were much longer in the RSS,while the blood loss during operation significantly less than the TOS [(128 ± 62) ml vs.(190 ± 86) ml,t =-2.886,P =0.006].The RSS has obvious advantages in 24 h-drainage [(69 ± 27) ml vs.(114 ± 54) ml.t =-3.680,P =0.001],time to out-of-bed activity [(27.7 ± 8.0) h vs.(35.7 ± 9.9) h,t =-3.067,P =0.004],BPS,postoperative exhausting time[(27.2 ±5.9)h vs.(32.8 ±8.3)h,t =-2.690,P =0.01] and length of hospital stay [(10.4 ± 1.8) d vs.(11.8 ± 1.9) d,t =-2.600,P =0.013].But the total hospital cost was higher in RSS [(117 000 ± 10 000) yuan vs.(77 000 ± 8 000) yuan,t =15.087,P =0.000)].Conclusions The RSS is a much minimally invasive surgery,reducing blood loss and postoperative pain,promoting rapid recovery,shortening hospital stay.