BACKGROUND: Epidemiologic studies have shown an association between higher insulin levels and coronary artery disease, and metabolic studies have associated insulin resistance and compensatory hyperinsulinemia with non-insulin-dependent diabetes mellitus, hypertension, obesity,and lipid disorders.OBJECTIVE: To investigate the relationship between insulin resistance (IR) and erythrocyte insulin receptors (EIRs) in the patients with cerebral infarction (CI).DESIGN: Case-control trial.SETTING: Department of Neurology, China-Japan Union Hospital of Jilin University.PARTICIPANTS: From January 2004 to October 2004, 40 patients with CI, who were in-patients in China-Japan Union Hospital of Jilin University,were selected for the study. Meanwhile, 30 healthy doctors or nurses were recruited as normal controls.METHODS: The levels of blood glucose and serum insulin under fasting and 2-hour after oral glucose tolerance test (OGTT) were detected in the 40 patients with CI and 30 healthy doctors or nurses. Fasting blood glucose multiplied by fasting serum insulin was insulin resistance index (IRI). The number of insulin receptors and their binding affinity on every erythrocyte were determined using modified Gambhir's method. The correlation between the number of EIRs and IRI was analyzed.MAIN OUTCOME MEASURES: Comparison of CI group with controlRESULTS: Data of 40 patients with CI and 30 controls were analyzed, and under fasting and 2-hour after OGTT: The level of serum insulin under fasting and blood glucose, serum insulin at 2-hour after OGTT in CI group were higher than those in normal group [(13.30±5.15), (9.85±4.36) mU/L,(8.27±1.65), (6.32±1.37) mmol/L, (75.21±21.12), (28.26±6.31)mU/L,P ＜ 0.01,EIRs: The number of insulin receptors with high and low affinity and maximum specific binding rate in the patients with CI were significantly less than those in normal group [20.30±4.50, 23.80±4.10; 2 223.80±509.30,2 610.10±435.10; (10.62±3.55)%, (13.21±2.94)%, P ＜ 0.01]. Multiple linear regression analysis and correlation analysis showed the numbers of two types of EIRs in the patients with CI were negatively correlated with IRI (r=-0.458, -0.439, P ＜ 0.01, both).CONCLUSION: Insulin resistance can lead to cerebral infarction. Decrease in insulin receptors may play an importance role in cerebral infarction induced by insulin resistance.

Adenocarcinoma ; pathology ; radiotherapy ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Consensus ; Esophageal Neoplasms ; pathology ; radiotherapy ; Humans ; Lymph Nodes ; pathology ; Lymphatic Vessels ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; pathology ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Computer-Assisted ; methods ; Radiotherapy, Image-Guided ; methods ; Tumor Burden

OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

Dideoxynucleosides ; False Positive Reactions ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Humans ; Inflammation ; diagnosis ; Neoplasm Staging ; Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; Positron-Emission Tomography ; methods ; Radiotherapy, Intensity-Modulated ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Treatment Outcome

Adult ; Breast Neoplasms ; radiotherapy ; surgery ; Cone-Beam Computed Tomography ; instrumentation ; methods ; Female ; Humans ; Mastectomy, Segmental ; Middle Aged ; Particle Accelerators ; Postoperative Period ; Radiotherapy Planning, Computer-Assisted ; instrumentation ; methods ; Respiration

Pregnancy ; Humans ; Female ; Cesarean Section/adverse effects* ; Abdominal Cavity ; Neoplasms

Objective To explore the possibility of hearing protection in acoustic neurinoma (AN) resection and to evaluate the effect of dynamic auditory monitoring and the effect of oto-endoscope for hearing protection. Methods From July 2003 to July 2007, there were a total of 138 cases of AN received surgical treatment. Continuous hearing monitoring was conducted in 18 cases with residual hearing. In these 18 cases, there were 6 males and 12 females, with 12 cases in left side and 6 cases in right. Fifteen cases were solitary AN, 3 cases were diagnosed as neurofibromeatosis Ⅱ. Maximal diameters of the tumor varied between 12 and 33 millimeters with an average of 19. 9 millimeters. All cases were operated on by retrosigmoid approach with routine facial nerve monitoring. Ten cases were assisted by oto- endoscope. Eighteen cases were performed accompanying continuous auditory brainstem response (ABR) and electro-cochleogram (EcochG). The patients were given routine hearing function test 7 to 10 days after operation, and reexamined 6 months to 1 year. The duration of follow-up ranged 6 months to 2. 5 years. Hearing data of the last time was thought as the judging result. Preoperative and postoperative hearing standard refer to (AAO-HNS)classifying. Results In all 18 cases, tumors were rsected completely in 16 cases, but sub-totally removed in 2 cases which were Ⅱ neurofibromeatosis. There was no mortality and no severe complication in this series. All the 18 cases had no facial paralysis before operation, and during operation facial nerves in 18 cases were kept anatomic integrity. According to House-Brackmann grade system, for 18 AN patients 7 days after operation only 50.0% (9/18) were kept at grade Ⅰ to Ⅱ, but 88.9% (16/18) were kept at grade Ⅰ to Ⅱ 6 months after operation. Out of 18 cases, hearing function were preserved in 11 cases (61.1%, 11/18) . After operation, there were 4 cases at hearing grade A, 4 cases at hearing grade B, 2 cases at hearing grade C and 1 cases at heating grade D. In all 18 cases, there were 5 cases with tumor diameter more than 20 millimeters, in which only 2 cases of them preserved hearing function (2/5). However, 9 cases preserved their hearing function in the other 13 cases whose tumors diameter less than 20 millimeters (69. 2% ,9/13). In 10 cases assisted by oto-endoscope, 8 cases obtained hearing protection (80.0% ,8/10)and 2 cases lost hearing. During operative monitoring, when drilling posterior lip of internal auditory canal (IAC), dragging and electric coagulating nearby IAC, especially clamping labyrinthine artery, removing tumor in IAC or electric coagulating arachnoid blood vessel on the top of tumor tissue, the ABR waves were affected greatly. Conclusions For the AN patient with preoperative residual hearing, it was necessary to protect hearing by combining continuous auditory monitoring with oto- endoscope technique. Based on these efforts the patient could preserve applicable hearing after operation. Whether or not arachnoidal on the top of AN remain and the conditions about blood supplying were the main factors that affect postoperative hearing. Moreover trauma of labyrinthine artery was the key to postoperative hearing loss.

Objective To study the effects of Chinese herbs Yiyanheji on intestinal mucosa barrier in rats with SAP.Methods Animal models of SAP were induced by retrograde injection of 5% sodium taurocholate (0.1ml/100g) into the common biliopancreatic duct.90 healthy Wistar rats weighing (250?30)g were randomly divided into 3 groups:sham operation group (SO,n=30),SAP group (SAP,n=30) and Chinese herbs Yiyanheji treated group(SAP+YH,n=30).Treated group was treated with Yiyanheji after operation.The SAP group was treated with physiological saline.Three groups of rats were killed at 72 hours after operation or treatment.Bacterial cultures were performed in all animals.The changes of terminal ileum' tissue were observed by optical electron mi- croscopy.The data of test were analyzed by statistic software.Results The incidence of bacterial translocation was 22.5% in Yiyanheji treated group,and it was lower than that in SAP group which was 90.0 %.The difference was significant(P

Objective To investigate the effect of moderate pain on attentional bias towards emotional pictures among healthy subjects.Methods Thirty-two healthy college students aged from 17 to 26 (21.8±2.2;16 males and 16 females) participated in this study.A tourniquet was tied to each subject's left upper arm 1 to 2cm above the cubits horizontal grain.Pain was inflicted by inflating the tourniquet,and the pressure was maintained at 26.66kPa.While tourniquet was inflated (with pain) or not (no pain),each subject was asked to finish a pictorial dot-probe task with three kinds of pictures-emotionally positive,negative and neutral.In experiment 1,subjects performed the dot-probe tasks with the contralateral hand while the tourniquet was tied on the left upper arm without inflation.In experiment 2 the tourniquet was inflated until the subject completed the dot-probe task (for about 10min).The reaction times (RTs) and the error rates (Ers) in the recognition task were recorded,and the intensity of the subject's pain and discomfort were measured using a verbal rating scale.Results The subjects reported moderate to severe pain with the tourniquet inflated.The RT and ER data were analyzed using two-way analysis of variance (ANOVA) which showed a significant difference between the average RTs of the males (482±73ms without pain and 466±82ms with pain) and those of the females (536±90ms without pain and 519±100 ms with pain).The average ER was significantly different between the pain (2.38±1.49)％ and no pain (1.09±0.82)％ conditions in both groups.Holn-Sidak multiple comparison testing showed significant differences in both groups' average ER between the negative picture (3.81±1.73)％ and the positive picture (1.66±0.97)％,and between the negative and neutral pictures (1.68±0.8) ％ in the pain condition.Mild attentional avoidance was observed with the positive [pain condition (-5.1±4.8) ms and no pain (-4.6±4)ms] and negative pictures [pain condition (-3.43±6) ms and no pain (-0.79±4.1)ms],but no significant difference was found between the pain and no pain conditions.Conclusion The error rate in a pictorial dot-probe task is influenced by pain,especially with negative pictures.

Objective To evaluate the value of diagnosis and treatment of fallopian tube patency by using hysterosalpingocontrast sonography (HyCoSy) with SonoVue and transvaginal ultrasound for infertile women. Methods Two hundred and twenty-two infertile women were examined by HyCoSy-SonoVue to observe flowing condition in womb and fallopian tube,the results were compared with hydrotubation, X-ray hysterosalingography(HSG) and laparoscopy(hysteroscopy). Results In the 222 cases,73 cases were both side of fallopian tube patency, 72 cases were single fallopian tube patency, 13 cases were single partial obstruction,60 cases were both side of fallopian tube pinning,4 cases were both partial obstruction. There was a significant difference on pregnancy rates between the HyCoSy-SonoVue and hydrotubation (P 0.05). There was no difference on diagnostic rates of fallopian tube pateney between the HyCoSy-SonoVue and laparoscopy (hysteroscopy)(P>0. 05) ,the diagnostic rate of H yCoSy-SonoVue was higher than that of HSG. Conclusions The HyCoSy-SonoVue method is safety and it would be an effective diagnosis in the evaluation of fallopian tube pathology for infertile women.