Objective To investigate the relationship between the severity of diabetic retinopathy and serum bilirubin level. Methods From August 1 2008 to December 31 2009, hospitalized patients of 1062 cases with type 2 diabetes were divided into three groups according to fundus examination: no diabetic retinopathy (NDR) group (457 cases), non-proliferative diabetic retinopathy (NPDR) group (484 cases)and proliferative diabetic retinopathy (PDR) group ( 121 cases). The difference in serum bilirubin level was compared. Results Total bilirubin in PDR, NPDR and NDR group were (9.96 ± 3.84), ( 11.41 ± 3.82),( 13.38 ± 3.98) μ mol/L respectively. There was significant difference among three groups (P ＜ 0.01 ). Logistic multivariate regression analysis showed that a drop in serum total bilirubin level was an independent risk factor of diabetic retinopathy. Conclusions Bilirubin level and the severity of diabetic retinopathy have some relationship. The antioxidant bilirubin and anti-inflammatory effect should be paid attention to.

Objective To investigate the type 2 diabetic patients with glomerular filtration rate and urinary albumin value as renal finction evaluation.Methods A total of 1217 patients with type 2 diabetic nephropathy from August 1,2010 to June 31,2012 were selected.Evaluated glomerular filtration rate (eGFR) was calculated according to the currently recommended simplified modification of diet in renal disease study (MDRD) formula.According to the K/DOQI guidelines for chronic kidney disease,patients were divided into three groups:group A [eGFR ≥90 ml/ (min ·1.73 m2)] of 891 cases,group B [60 ml/(min· 1.73 m2) ≤eGFR ＜ 90 ml/(min· 1.73 m2)] of 256 cases,group C[eGFR ＜ 60 ml/(min· 1.73 m2)]of 70 cases,respectively.Eight-hour urinary albumin excretion rate (UAER) was compared between and among the groups; according to 8-hour UAER,patients were divided into three groups:group a (8-hour UAER ＜20 μg/min) of 946 cases,group b (20 μg/min≤8-hour UAER ＜200 μg/min) of 193 cases,group c(8-hour UAER ≥ 200 μ g/min) of 78 cases.eGFR was calculated and compared between and among the groups.Results Eight-hour UAER was (32.71 + 79.62),(57.56 + 130.59),(107.50 + 222.64) μ g/min in group A,B,C,and the difference among three groups was statistically significant (P＜0.05).eGFR was (110.78 ±32.75),(108.26 ±45.78),(94.96 ±32.30) ml/ (min ·1.73 m2) in group a,b,c,and the difference between group a and group c,or between group b and group c was statistically significant (P ＜0.05),but the difference between group a and group b was not statistically significant (P ＞0.05).Conclusion When evaluating the function of type 2 diabetic nephropathy,two indicators should be considered:glomerular filtration rate and urinary albumin.

Objective To compare the effect of proximal femoral intramedullary nail fixation and femoral retrograde intramedullary nail combined with hollow lag screw fixation in the treatment of ipsilateral femoral neck and shaft fractures.Methods Data of 42 patients with ipsilateral femoral neck and shaft fractures who were admitted in our hospital from January 2007 to January 2016 were retrospectively analyzed.According to different fixation methods,the patients were divided into two groups:single intramedullary nail group (SIN group) (20 cases,treated with single proximal femoral intramedullary nail,15 males and 5 females with an average age of 39.4);combined internal fixation group (CIF group) (22 cases,treated with femoral distal intramedullary nail combined with femoral neck hollow lag screw,17 males and 5 females with an average age of 42.2 years).In the SIN group,4 cases were type A,9 cases type B,7 cases type C according to AO classification.And 14 cases belonged to Ⅰ or Ⅱ (stable fracture),6 cases of type Ⅲ or Ⅳ (unstable fracture) according to Garden classification.In the CIF group,3 cases were type A,10 cases type B,9 cases type C according to AO classification.And 16 cases belonged to type Ⅰ or type Ⅱ,6 cases type Ⅲ or Ⅳ according to Garden classification.The incision length,operation time,intraoperative blood loss,fracture healing time,postoperative weight time,stability of internal fixation,hip function score,pain in the knee and postoperative complication rate were compared between the two groups.Results There was no significant difference in gender,age and fracture classification between the two groups.The operation time (75.0±10.2 min),intraoperative blood loss (150.6±80.4 ml),hip Harris score excellent rate (80％) of incidence of knee pain in postoperative 3 months (10.0％) of the SIN group were significantly lower than those of the CIF group (105.2±18.4 min,180.0±56.8 ml,86.4％ and 31.8％).The length of incision (8.3±1.4 cm) in the SIN group was significantly longer than that in the CIF group (4.0±0.6 cm).There was no significant difference in fracture healing time (SIN group 20.O±4.0 weeks,CIF group 19.6±4.2 weeks) and postoperative weight time (SIN group 8.2±4.0 weeks,CIF group 8.0±4.2 weeks) between the two groups.The main complications of the two groups were delayed union (3 cases of SIN group and 1 case of CIF group),nonunion of fracture (1 case of SIN group) and,coxa vara (1 case of SIN group).The complication of SIN group (30％) was significantly higher than that of CIF group (4.5％),which occurred mainly in unstable femoral neck fracture cases.Conclusion Both proximal femoral intramedullary nail fixation and femoral retrograde intramedullary nail combined with hollow lag screw can effectively treat femoral ipsilateral femoral neck and shaft fracture.Femoral retrograde intramedullary nail combined with hollow lga screw has more therapeutic advantages for unstable femoral neck fractures (Garden Ⅲ and Ⅳ).

Phosphatase and tensin homologue deleted on chromosome 10(PTEN) is a tumor suppressor which can inhibit proliferation and migration and control apoptosis in a number of cell types,mainly through inhibiting the phosphoinositide 3-kinase(PI3K) signaling pathway.A number of in vitro and in vivo studies has been instrumental in uncovering a direct correlation between deregulated PTEN/PI3K signaling and changes in neuronal morphogenesis,which is likely to have profound bearings upon the pathogenesis of neurological symptoms.This review outlines recent work on the function of PTEN during the formation and maintenance of neuronal circuits in the brain.

OBJECTIVE: Mitochondrial deoxyribonucleic acid (mtDNA) 8344 A>G (m.8344A>G) mutation is the common mutation associated with mitochondrial myoclonus epilepsy with ragged-red fibers (MERRF) syndrome. Herein we report a rare case with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes/MERRF/Leigh (MELAS/MERRF/Leigh) overlap syndrome caused by m.8344A>G mutation. METHODS: The clinical and imaging data of the patient were collected and an open muscle biopsy was carried out. We further employed molecular genetic analyses to detect mtDNA mutation in the proband and his mother. And then a clinical and neuroimaging follow-up was performed. RESULTS: This patient was a 25-year-old male, who developed exercise intolerance since the age of 6. At age 10, he suffered from acute episodes of hemianopia, and cranial magnetic resonance imaging (MRI) showed occipital stroke-like lesions and cranial magnetic resonance spectroscopy (MRS) revealed a lactate peak corresponding to the lesion. After that the patient presented slowly progressive psychomotor decline. He had myoclonic seizures and cerebellar ataxia since the age of 12. At age 21, he was admitted to our hospital because of confusion and cranial MRI revealed symmetrical lesions in bilateral posterior putamen, thalami and midbrain. Then repeated MRI showed progression of original lesions and new frontal multiple stroke-like lesions. Symptomatic and rehabilitation treatment relieved his condition. Follow-up cranial MRI at age 24 showed the lesions in basal ganglia and thalami diminished, and the midbrain lesions even completely vanished. Muscle pathology indicated the presence of numerous scattered ragged-red fibers (RRF), suggestive of a mitochondrial disorder. Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) detected the m.8344A>G mutation of the MT-TK gene encoding mitochondrial transfer RNA for lysine in the patient's blood. Next generation sequencing (NGS) of the whole mitochondrial genome identified that the proportion of m.8344A>G was 90%, and no other mtDNA mutation was detected. Sanger sequencing further identified this mutation both in the proband and his mother's blood, although the mutation load was much lower in his mother's blood with approximately 10% heteroplasmy. CONCLUSION The present study is the first to describe a patient with m.8344A>G mutation in association with the MELAS/MERRF/Leigh overlap syndrome, which expands the phenotypic spectrum of the m.8344A>G mutation.
Acidosis, Lactic ; Adult ; Child ; DNA, Mitochondrial/genetics* ; Humans ; Male ; Mitochondrial Encephalomyopathies ; Mutation ; Stroke ; Young Adult

The metabonomics method was used to study the intervention effect of Psoraleae Fructus and Myristicae Semen in "Ershen pill" on the changes in serum endogenous metabolites in spleen-kidney Yang deficiency diarrhea rats before and after processing, screen out differentiated metabolites related to spleen-kidney Yang deficiency diarrhea and explore the metabolic patterns related to spleen-kidney Yang deficiency diarrhea and the processing synergy mechanism of Psoraleae Fructus and Myristicae Semen in "Ershen pill". Efforts were made to detect SOD and MDA of each group, test rat serum metabolic fingerprints in different stages by using GC-MS, analyze by PCA and PLS-DA methods and screen out potential biomarks through VIP and t test. The results revealed that "Ershen pill" could enhance the level of SOD and decrease the level of MDA and identified 10 differentiated metabolites related to spleen-kidney Yang deficiency diarrhea. Compared with the model group, all of metabolites recovered to varying levels after being intervened with "Ershen pill", with the best effect shown in the "Ershen pill" IV group (salt-processed Psoraleae Fructus + bran-roasted Myristicae Semen). It is speculated that that Psoraleae Fructus and Semen Myristicae in "Ershen pill" show a synergistic effect by inhibiting peroxide, improving aglucolipid, amino acids and energy metabolism, with multiple target sites.
Animals ; Chemistry, Pharmaceutical ; Diarrhea ; drug therapy ; metabolism ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Energy Metabolism ; drug effects ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Metabolomics ; Myristicaceae ; chemistry ; Psoralea ; chemistry ; Rats ; Rats, Sprague-Dawley ; Spleen ; drug effects ; metabolism ; Yang Deficiency ; drug therapy ; metabolism

OBJECTIVETo study the effect of osthole (Ost) on adrenocortical function in Y1 mouse adrenocortical tumor cells.

METHODSY1 mouse adrenocortical tumor cells were taken as subjects in this experiment. In 10.0%, 1.0%, and 0.1% serum DMEM-F12 medium, Y1 cells were treated with 1, 10, 25, 50, 100, and 200 micromol/L Ost for 24 and 48 h. 0.1% Dimethyl Sulfoxide (DMSO) was taken as negative control group and 1 mmol/L (Bu) 2cAMP as positive control group. Cell growth morphology was observed under inverted microscope. Contents of corticosterone were tested by ELISA. Expression levels of steroids synthase such as Star, Cyp11a1, Cyp21a1, Hsd3b2, Cyp11b1, Cyp11b2, Cyp17a1, and Hsd17b3 mRNA were detected by Real time quantitative PCR (RT-qPCR).

RESULTSY1 cell proliferation was obviously inhibited by 100 and 200 micromol/L Ost, and its inhibitory effect was more significant in 0.1% serum medium. Compared with the negative control group, gene expressions of Star, Cyp11a1 , Cyp21a1, Hsd3b2, Cyp11b1, Cyp17a1, and Hsd17b3 were significantly enhanced in the posi- tive control group (P < 0.05). Y1 cell corticosterone levels significantly increased in 50 micromol/L Ost treatment group after 24-and 48-h intervention (P < 0.05). Contents of corticosterone increased more obviously in 25 and 50 +/- mol/L Ost treatment groups after 48-h intervention, as compared with 24-h intervention (P < 0.01). After 24-h intervention, expression levels of Star, Cyp21a1, and Hsd3b2 genes were significantly up-regulated in 25 and 50 lLmol/L Ost groups (P < 0.05). Star gene expression was further enhanced after 48-h intervention (P < 0.05). However, Ost showed no effect on Cyp11a1 (P > 0.05). Additionally, gene expressions of Cyp11b1 and Cyp17a1 were significantly enhanced by 10, 25, and 50 pLmolIL Ost after treatment for 24 and 48 h (P < 0.05). Ost showed no obvious effect on Cyp11b2 and Hsd17b3 expressions.

CONCLUSIONOst could regulate adrenal cortex function and promote corticosterone synthesis and secretion through strengthening gene expressions of steroidogenic enzymes.

Adrenal Cortex ; drug effects ; Adrenal Cortex Neoplasms ; pathology ; Animals ; Corticosterone ; biosynthesis ; Coumarins ; pharmacology ; Gene Expression ; Mice ; RNA, Messenger ; metabolism ; Tumor Cells, Cultured

OBJECTIVETo explore therapeutic effect and action mechanism of regulating spleen-stomach needling on diabetic nephropathy (DN).

METHODSUsing multi-centric, randomized, controlled and blind principles, 144 cases of DN were divided into an observation group and a control group according to random digital tab, 72 cases in each one. Based on regular treatment of diabetes, the regulating spleen-stomach needling was applied at Zhongwan (CV 12), Quchi (LI 11), Hegu (LI 4) and Xuehai (SP 10), etc. in the observation group while Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), etc. were selected in the control group by reference of Acupuncture and moxibustion. The treatment was given twice a day, six days as a treatment session with interval of one day between sessions. Totally six weeks were required. Changes of clinical symptoms and signs, fast blood glucose (FBG), urinary albumin excretion rate (UAER), beta2-microglobulin (beta2-MG), monocyte chemotactic protein-1 (MCP-1), lymphocyte membrane cholesterol, propanediol (MDA), PCO, 8-hydroxydeoxy guanosine (8-OHdG), superoxide dismutase (SOD), CD3+, CD4+, CD8+, and CD4+/CD8+ were observed before and after treatment in two groups.

RESULTSAs for improving clinical symptoms and signs, total effective rate was 84.29% (59/70) in the observation group and 55.56% (40/72) in the control group, which had statistical difference between two groups (P<0.01). As for regulating glycometabolism [(6.25 +/- 0.32) mmol/L vs (8.09 +/- 0.63) mmol/L], reducing UAER [(154.43 +/- 55.14) mg/24h vs (268.91 +/- 77.65) mg/24h], restraining over-expression of MCP-1 [(137.59 +/- 36.15) pg/mL vs (166.89 +/- 42.82) pg/mL], regulating level of oxidative stress, prohibiting oxidation of protein and adjusting quantity and activity of T lymphocyte subgroup, the observation group was superior to the control group (P< 0.05, P<0.01).

CONCLUSIONThe regulating spleen-stomach needling is an effective method for treatment of DN, which cold improve glycometabolism disturbance-induced progressive kidney injury, recover glomerular filtration, reduce urinary albumin excretion rate, restrain overexpression of MCP-1, adjust level of oxidative stress, prohibit oxidation of protein, increase protectiveness of membrane, adjust quantity and activity abnormity of T lymphocyte subgroup, leading to repairing lymphocyte damage and improving immune expression to delay kidney damage.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Diabetic Nephropathies ; immunology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Spleen ; physiopathology ; Stomach ; physiopathology

Child, Preschool ; Fatal Outcome ; Female ; Humans ; Respiratory Tract Infections ; complications ; Shock, Septic ; etiology ; Streptococcal Infections ; complications