Objective To investigate relationship between insulin sensitivity and beta-cell function with body mass index (BMI) and age in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Totally, 304 patients with T2DM newly-diagnosed at admission to the first hospital affiliated to Nanjing Medical University, Jiangsu province, during 2006 to 2007 were recruited in the study. The patients were divided into three groups based on WHO criteria of obesity in Asia Pacific Region in 2003, 68 cases with normal weight ( 18. 5≤ BMI ＜ 23.0), 69 in overweight (23.0 ≤ BMI ＜ 25.0), and 167 in obesity (BMI≥25.0). Fasting serum glucose, glycesylated hemoglobin Alc (HbAlc) and lipids were measured for all the subjects, as well as oral glucose tolerance test (OGTr), C-peptide releasing tests and determination of serum insulin performed. Homeostasis model assessment of insulin resistance index (HOMA-IR), insulinogenic index (AI30/AG30) and modified beta-cell function index (MBCI) werecalculated to evaluate their insulin sensitivity and beta-cell function of the islets. All these parameters werecompared between the three groups and subgroups. Results HOMA-IR and MBCI were significantly higherin T2DM patients with obesity than those in the groups with normal weight and over-weight ( P < 0. 05 ).AI30/AG30 in obesity group was significantly higher than that in the group with normal weight (P <0. 05).Multiple linear regression analysis showed that BMI independently correlated with HOMA-IR ( P < O. 05 ).Sub-group analysis showed that △I30/△G30 and MBCI were significantly higher in those aged 60 years and over with obesity than those in the groups aged less than 60 years ( P ＜ 0. 05 ). Conclusions Non-obese patients with newly diagnosed T2DM have more severe impaired insulin secretion than that in obese ones,and their insulin resistance increases with BMI. Age has no significant correlation with pancreatic beta-cell function or insulin sensitivity.

Objective To evaluate the effects of electroacupuncture (EA) at the Baihui (DU 20) and Dazhui (Bill) points on brain derived neurotrophic factor (BDNF) around the area of cerebral infarction and evaluate the relation between learning and memory ability and BDNF. Methods Forty-eight male adult Wistar rats were divided randomly and equally into EA and control groups. The EA group was sub-divided into 1 week, 2 weeks and 3weeks sub-groups. EA was started 24 h after establishing a model of ischemic brain injury and continued for one, two or three weeks. The control group was reared conventionally and was not given any treatment. Morris' water maze test was used to evaluate the rats' learning and memory ability. The expression of BDNF in the CA3 region of the hippo campus was detected using immunohistochemical techniques. Results Learning and memory in the EA groups were better than in the control group, and spatial probe ability was also significantly better. Positive expression of BDNF was detected in the hippocampal CA3 region of the EA group rats, and it was significantly greater than that in the control group. Conclusion Learning and memory after cerebral infarction can be affected by EA at the Baihui and Dazhui points. The effect might be related with increased BDNF expression in the hippocampal CA3 region.

OBJECTIVETo explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine ( Fuchunsan ) on the treatment of postburn hyperplastic scar.

METHODSSixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan). Patients were divided into early stage group (E, n = 35), middle stage group (M, n = 25), and late stage group ( L, n = 3) according to the formation time of scar, which was respectively 3 weeks to 3 months, longer than 3 months and less than or equal to 6 months, and 3 to 15 years in groups E, M, and L. The number of times of laser treatment of patients in each group was recorded. The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1, 2, and 3 times. The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1, 3, and 5 times. Patients in group L did not receive VSS assessment but were evaluated by clinical observation only. Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect. Data were processed with t test.

RESULTSPatients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ± 2.1) times respectively. In group L, the treatment was stopped in 2 patients after laser treatment for 5 times, and 1 patient received laser treatment for 12 times. The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time, and the number of patients scoring 1-4 point(s) in NRS increased from 5 cases to 38 cases. After treatment for 2 and 3 times, the increase in the number of patients scoring 1-4 point (s) in NRS was on a small scale. Before treatment and after treatment for 1 time, VSS scores of patients in groups E and M were similar (with values respectively 0.641 and 0. 082, P values above 0. 05). After treatment for 3 and 5 times, VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points, which were significantly lower than those in group M [ (9.7 ± 1.0) and (8.2 ± 1.0) points, with values respectively -1.993 and -4.433 , P < 0.05 or P < 0.01]. After treatment for 3 times, the rate of improvement in appearance was respectively 88.6% (31/35) and 72.0% (18/25) in groups E and M, and it was respectively 100.0% (35/35) and 96.0% (24/25) after treatment for 5 times. No significant effect in appearance was found in the 3 patients in group L.

CONCLUSIONSEarly application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.

Burns ; Cicatrix ; etiology ; prevention & control ; Humans ; Lasers, Gas ; therapeutic use ; Medicine, Chinese Traditional ; Postoperative Care ; methods ; Postoperative Complications ; prevention & control ; Treatment Outcome

Objective:To investigate the regulation of proliferation and differentiation of bone marrow mesenchymal stem cells(BM-SCs)by CKIP-1 in vitro.Methods:BMSCs from CKIP-1 nock out(KO)and wild type(WT)C57 mice were isolated and cultured u-sing adherence method in vitro.BMSCs of the 3rd passage were induced to osteogenic and adipgenic differentiation.Cell proliferation was examined by MTT assay.Cell surface markers were tested by FCM.The osteogenic and adipogenic differentiation was studied by alkaline phosphatase (ALP)staining,alizarin red staining and oil red O staining.Results:The proliferation and cell marke expression of the 2 groups were similar.ALP staining of KO group was strong than that of WT group after osteogenic induction.Alizarin red stai-ning showed that there were more mineralized nodules in BMSCs of KO group than in those of WT group.Oil red O staining of KO mice BMSCs was stronger than that of WT.Conclusion:CKIP-1 deficiency can enhance the osteogenic and adipogenic differentiation without influence on the proliferation of BMSCs.

Objective To evaluate the effects of electroacupuncture (EA) on synaptic interface structures around a cerebral infarct and evaluate how learning and memory relate to synoptic structure. Methods Forty-eight male, adult Wistar rats were divided randomly and equally into an EA group and a control group after models of ische-mic brain injury had been established. Each group was then divided into 1 week, 2 week and 3 week sub-groups. In the EA group EA was started 24 hours after the operation at the Baihui (DU20) and Da Zhui (BUI4) points and continued for one week, two weeks or three weeks. The control group was fed in normal cages and had no special treatment. Synoptic substructures in the hippocampal CA3 area of the ischemic side were assessed morphologically and quantitatively. Results The synaptic curvatures and postsynaptic density (PSD) an well as the width of the ac-tive area increased significantly in the EA group compared with the control group. Morris water maze learning ability in the EA group exceeded that in the control group. Spatial probe test results also significantly improved in the EA groups compared with the control groups. Conclusions Learning and memory improved in the injured rats following EA, and this is likely to be related to synaptic changes and synaptic plasticity increasing.

Objective To evaluate the impact of depression on 5-year survival rate of elderly patients with chronic obstructive pulmonary disease (COPD).Methods From January 2002 to June 2004, a total of 401 elderly inpatients with COPD were enrolled.They were assigned into two groups according to their HAD-D scores: depression group (HAD-D scores≥8) and non-depression group (HAD-D scores<8).The follow-up time was 5 years.Results The 5-year survival rate was lower in depression group than in non-depression group (log-rank test, χ~2 = 6.94, P<0.01).Depression was independently associated with mortality in elderly patients with COPD (HR: 1.84, 95% CI: 1.08 to 3.11).Conclusions Depression in elderly COPD patients is associated with poor 5-year survival rate, and it is an independent influencing factor of 5-year mortality.

Objective Artificial atrial septum defect combining pulmonary artery banding to create a model of congenital heart defect with decreased pulmonary blood flow to explore the morphological changes of immature pulmonary vascular. Methods Choose twenty piglets with about one to two-month-old, which are exclusively for experiment used. The piglets were randomly divided into three groups: normal control group (group C, n = 6), Small incisions on the right chest, produced a transient reduction in pulmonary blood; low-medium pulmonary artery stenosis groups ( group T1, n = 7 ) : Did artificial room septostomy creation by self-dilators which were delivered into the surface of the right atrium and controlled Systolic trans pulmonary artery banding pressure (Trans-PABP) at pressure of 20 - 30 mmHg; severe pulmonary artery stenosis groups ( group T2, n = 7): T2 were the same surgical procedures with group T1 ,and controlled Trans-PABP ≥ 30 -50 mmHg. Monitored ultrasound after operation , carried out 64-slice computed tomography scanning after one month, to measure the proximal vessel diameter and TransPABP , after two month surgical exploration on the left chest. When the animals were sacrificed, the heart and lung tissue was cut to measure atrial septal defect, pulmonary artery and the banding diameter. By weihgt elastic fiber and van Cieson staining to observe the morphological pathological changes, three groups took lung tissue with right middle lobe lateral segment about 1.0 cm × 0.8 cm × 0.8cm at the end of surgery and 2-months after operation respectively. Results The models were all successfully in the survival animal of the two test groups. One pig died from tracheal intubation accident in the C group, there was one case died due to bowel obstruction in the T1 group, And there were two cases died result from acute right heart failure and chronic heart failure respectively in T2 group. 64-slice CT angiography showed that BD was significantly lower than the AOD in the two test groups, the proximal pulmonary vascular expansion result from stenosis, distal pulmonary vascular scarce. Histopathology showed that the pulmonary artery inside diameter of T1 and T2 was significantly higher than group C(P ＜0. 05,P ＜ 0.01), and the NAPSC of two experimental groups were significantly lower than group C 2-month after operation( P ＜0.01).Conclusion This type of Piglet model is closer to clinical pathological and physiological ,64-slice spiral CT combined with lung histopathology observed for the evaluation of pulmonary vascular hypoplasia is a reliable method. Tunica media of pulmonary arterioles hypoplasia with the number reducing, with pulmonary artery banding increased,the degree of pulmonary arterioles hypoplasia gradually increased.

Objective To analyze the quality of life and its influence factors in patients with peptic ulcer.Methods The SF-36 was used to survery 120 patients with peptic ulcer.The QOL scores at different levels of some factors including gender,age,na-tionality,occupation,marriage,medical forms,economic,cultural level,treatment method and clinical type were compared by meth-ods of two sample t-test and analysis of variance.Results Peptic ulcer patients′scores in the domain of RE,PF,RP,BP,GH,VT, SF,RE,PCS and MCS are lower than that of the normal,exception of the domain of MH(P <0.05).The differences were statisti-cally significant.Six factors can be influenced some domain or total score of the scale(P <0.05)and the differences were statistical-ly significant.Conclusion Find out the influencing factors on peptic ulcer patients′quality of life can be provided the basis for clini-cal treatments.

Objective To develop a superparamagnetic iron oxide nanoparticles ( SPIO ) based on MRI probe specifically targeting human epidermal growth factor receptor 2 (HER2) and explore its value as MRI positive contrast agents in vitro.Methods (1) The superparamagnetic iron oxide ( PS) was obtained by means of classical coprecipitation in polylactic acid solution , then coupled with fluorescein isothiocyanate (FITC) labeled LTVSPYW to develop the targeted probe ( FITC-LTVSPWY-PS).The particle size was measured under transmission electron microscope.Relaxation rate was detected by 3.0 T MR scanner.(2) Climbing films of human breast cancer cell MCF-7 were prepared and incubated with FITC-LTVSPWY-SPIO, then fluorescence distribution was observed under inverted microscope.And distribution of iron particles was confirmed by prussian blue staining.(3) MCF-7 and MDA-MB-231 cells were incubated with FITC-LTVSPWY-SPIO and PS, respectively.MCF-7 incubated with FITC-LTVSPWY-PS were used as experimental group, MCF-7 treated with PS as control group , and cells added with nothing as blank group.There were 3 samples in each group.The MR imaging was performed only once and T 2 WI signal intensity of cells was recorded.The comparison of T 2 signal intensity among groups was conducted by using one-way ANOVA.Results The core and surface size of nanoparticles were (13.9 ±1.6) nm and (122.0 ±5.5) nm respectively.Zeta potential and relaxation rate of the FITC-LTVSPWY-PS were ( -30.7 ±2.2 ) mV and 70.7 m· M-1 · s-1 respectively, and the PS were (28.1 ±2.8) mV and 72.1 m· M-1 · s-1 respectively.The fluorescence could be seen on the surface of MCF-7 cells, and the prussian blue staining showed that FITC-LTVSPWY-PS could specifically target HER 2-positive cells.The low signal on T 2 WI was observed in MCF-7 cells incubated with FITC-LTVSPWY-PS, whereas cells treated with PS and blank group showed equal signals , the T2 values were ( 61.8 ±5.7 ) , ( 101.6 ±2.5 ) and ( 103.5 ±1.9 ) ms respectively.Significant difference existed among these groups ( F =355.698, P <0.05 ).Conclusions The MR targeting probe FITC-LTVSPWY-PS was prepared successfully , its physical characterization and magnetic properties could target the HER 2 highly expressing on the surface of breast cancer cells and meet the need of targeted imaging.It provides an important tool for MR molecular imaging.

Objective To analyze the differences in paraoperative morbidity and lymph node dissection between thoracoscopic esophagectomy and open procedure.Methods From October 2012 to April 2014,207 patients with esophageal cancer underwent surgery.125 patients underwent video-assisted esophagectomy,and 82 underwent open procedure.In the minimally invasive group,there were 109 thoracoscopic cases and 16 thoracolaparoscopic cases.Results There were significant differences between the thoracoscope group and the open group in atelectasis(0.8％ vs.7.3％,P ＜ 0.05),pleural effusion (0 vs.4.9％,P ＜ 0.05),acute respiratory distress (0 vs.6.1％,P ＜ 0.05),ligation of thoracic duct (3.2％ vs.15.9 ％,P ＜ 0.05),recurrent laryngeal nerve paralysis (19.2％ vs.32.9％,P ＜ 0.05),c hylothorax (0 vs.4.9％,P ＜ 0.05),number of lymphonode along the right recurrent laryngeal nerve lymphatic chains[1.91 ± 0.73 vs.1.12 ± 0.81,P ＜ 0.05)] and achievement ratio(97.6％ vs.89.0％,P ＜0.05) and number of lymphonode along the left recurrent laryngeal nerve lymphatic chains (0.93 ± 0.71 vs.1.76 ± 0.84,P ＜ 0.05) and achievement ratio(52％ vs.76.8％,P ＜ 0.05).No significant differences were observed in pneumonia,anastomotic leak,thoracic abscess,esophago-tracheal fistula,re-laparotomy,re-thoracotomy,wound infection,arrhythmia,cardia failure,renal failure,hepatic inadequacy,cerbral infarction,and mortality(P ＞ 0.05).There were also no significant differences in number of lymphonode and achievement ratio of periesophagel lymph nodes,subcarinal lymph nodes and hilar lymph nodes (all P ＞ 0.05).Conclusion The thoracoscopic esophagectomy has some obvious advantage associated with less pulmonary complications,lower injury of thoracic duct and recurrent laryngeal nerve,more lymphonode and higher achievement ratio along the right recurrent laryngeal nerve lymphatic chains.But it has still a larger space for improvement of lymphadenectomy along the left recurrent laryngeal nerve lymphatic chains.