Objective:To explore the association of serum leptin(LEP)level in patients of type 2 diabetes mellitus and periodontitis with clinical periodontal indexes.Methods:30 healthy subjects(group A),30 chronic periodontitis patients(group B)and 30 type 2 diabetic patients with chronic periodontitis(DMCP)(group C)were included.Probing depth(PD),attachment loss(AL),plaque index (PLI)and bleeding on probe(BOP)were examined.High performance liquid chromatography detection was used to determine the ex-pression of the fasting plasma glucose (FPG),glycated hemoglobin(HbA1c)in plasma samples.Serum level of LEP was measured by ELISA.Results:Levels of serum HbA1c,FPG and LEP in group C were significantly higher than those in group B and A(P <0.05);serum LEP in group B were significantly higher than those in group A(P <0.05).However,no virtual disparity was found in serum HbA1c and FPG between group A and B(P >0.05);The r values of plasma LEP level to PD,AL,PLI and BOP were 0.506,0.551, 0.519 and 0.582 respectively(P <0.05).Conclusion:The LEP level is elevated in patients with DMCP.Circulating LEP level is positively related to PD,AL,PLI and BOP.

Objective To observe the expression of insulin-like growth factor 1 (IGF-1),insulin-like growth factor binding protein 3 ( IGFBP-3) in rats’ serum with non-alcoholic fatty liver disease ( NAFLD) and the impact of Polyene phosphatidyl choline .Methods NAFLD model was induced by feeding the SD rats with a high-fat diet, with Polyene phosphatidyl choline to intervene .Observe the pathological changes of the rats ’ liver tissue dynamically after HE staining . Detect the contents of IGF-1,IGFBP-3 in serum dynamically through the immuno radio metric assay ( IRMA).Results There were no obvious exception of the liver tissue pathology in the normal group at each time .With the extension of a high-fat diet,the liver tissue of the model group increased on fatty change ,the degree of inflammation ,the balloon sample change , the NAFLD activity score at 4,8,12weeks.IGF-1,IGFBP-3 in serum were decreased significantly ,and the model set was significantly lower than the normal group at the same phase .After the application of polyene phosphatidyl choline ,the degree of rat liver tissue inflammation and the NAFLD activity score were reduced significantly when compared with model group , while the level of IGF-1,IGFBP-3were significantly higher .Conclusion The levels of IGF-1,IGFBP-3 in the rats’ serum reduce in the development of non-alcoholic fatty liver disease .

Objective To study the phonetic characteristics of patients with abnormal plosive consonant of functional articulation disorders (FAD) and the possible treatment approaches.Methods A total of patients of 4~26 years old with abnormal plosive consonant of FAD received speech assessment and the phonetic characteristics.Incorrect articulation patterns and forms of plosive consonant /b/,/p/,/d/,/t/,/g/ and /k/ were analysed.The targeted speech treatment was established to correct the erroneous places and types of pronunciation.Results The error rate of /t/ (82/87)was the highest,followed by /k/(77/87),/d/(67/87),/g/(60/87),/p/(59/87) and /b/(3/87) which was the lowest.The error rate of fricative was 65.52% as the highest among all the erroneous patterns,followed by unaspiration(63.22%),forward movement of the tongue(54.02%),distortion(33.33%),bilabial(32.18%),and backward movement of the tongue(18.39%).Seventy-one cases were completely cured,and 16 cases partially cured after 2 to 10 times of treatment.The number of incorrect words of plosives decreased to 4.03±2.71 after the speech therapy from 67.97±18.56 prior to that.The differences were statistically significant (t =34.301,P<0.001).Conclusion The articulation errors of plosives occur mainly on /t/,/k/,/d/,/g/and /p/,/b/.The incorrect types of pronunciation are fricatives,unaspiration,distortion and omission.The incorrect places of articulation are forward movement of the tongue,bilabial and backward movement of the tongue.The targeted speech therapy established according to the erroneous places and types of articulation is significantly effective.

SUMMARY National Institutes of Health (NIH) released the biomedical research project NIH Roadmap Initiatives, including 3 themes, new pathways to discovery,research teams of the future,and re-engineering the clinical research enterprise. The purpose of the project is to catalyze to transform our new scientific knowledge into tangible benefits for people. Now,Mostly of the Project have begin to carry into practice.

ObjectiveTo retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a point just cephalad to the posteroseptal commissure.The suture was tied with positioning a 27-29 mm valve siser across the tricuspid valve.At last, a 3-5 mm width felt strip was prepared and was sutured to the plicated posterior annulus region with interrupted mattress sutures of 2 to 3 2-0 prolene.A favorable result was considered when TR was not marked by saline injection.Echocardiography was routinely examined one week postoperatively and patients were followed up 6 month after discharge.ResultsThere is no death in all patients.The CVP diminished significantly from 16mmHg preoperatively to 8mmHg postoperatively (P = 0.0021).The systomic pulmonary pressure diminished from 59 mmHg preoperatively to 41 mmHg postoperatively (P = 0.038).Echo one week postoperative showed no tricuspid regurgitation in 56 patients and mild in 18 patients, while 2 had moderate tricuspid regurgitation.The diameter of right atrium diminished significantly postoperatively, too.The ejection fraction was improved even though there was not significant difference as compared with preoperative data.The cardiac function of all patients improved and the signs of right heart failure were alleviated or disappeared.Follow up 1 to 36 months showed no change of the regurgitation except for one become moderate from mild when discharged.No hepatic congestion or edema was observed in all patients.ConclusionThese new modifications make the technique more selective in the remodeling of the tricuspid annulus.It could achieve better coaptation of the anterior leaflet with the others, successful annular reduction, better maintenance of the contractile property of the tricuspid ring, better distribution of pursing force in the more dilated region.It could prevent the tear of the endocardium in the posteroseptal region in the long period of time postoperatively.

Objective:To investigate the influence of B-lymphocyte chemoattractant on the immune response of CVB3 fusion gene vaccine pcDNA3/C3d3-sVP1.Methods:BALB/c mice were divided into 4 groups randomly, and injected intramuscularly with pcDNA3,pcDNA3/BLC,pcDNA3/C3d3-sVP1 and the combination with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1.At a certain time,they were measured for the titers for neutralizing antibodies,specific CTL cytotoxic activity.The protective efficacy of DNA vaccinations was evaluated by titers of blood viruses and survival rate.Results:The titers for antibodies increased with the time of inoculation.More specifically,the antibody titers (42.17±1.43) and the specific CTL cytotoxic activity (41.3%±3.51%) of the mice in the combination group were remarkably stronger than in the mice with pcDNA3/C3d3-sVP1(P＜0.05),but the virus titers of blood was lower.After lethal CVB3 challenge,the protection of mice from death in the combination group with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1 was 44%.Survival curves indicated that the survive state of combination group was better than others.Conclusion:BLC can strongly enhance the specific immunity induced by C3d3-sVP1.

Objective To evaluate physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colonic surgery. Methods The clinical data of 158 patients with colonic cancer who were admitted to the West China Hospital from August to October, 2009 were retrospectively analyzed. E-PASS was applied to evaluate the surgical risk. Three indexes of the E-PASS system,including preoperative risk score (PRS), surgical stress score (SSS) and comprehensive risk score (CRS) were compared with actual postoperative outcomes. Correlation between PRS, SSS, CRS and postoperative risks was analyzed using multiple linear regression analysis. Results Of the 158 patients, 27( 17.1% ) had postoperative complications, and the predictive value was 19.4% ± 2.0% according to the E-PASS. Dukes stages, physical performance indexes, severe heart disease, severe pneumonia disease, length of operation time were correlated with the incidence of complications (r = 0. 193, 0. 410, 0. 183, 0. 174, 0. 198, P ＜ 0.05). PRS, CRS and SSS had good predictive effect on postoperative risks (r = 0. 299, 0. 349, 0. 183, P ＜ 0. 05 ). Conclusions E-PASS system is a relatively simple, fast and user friendly tool for predicting the risk of short-term postoperative complications.

Objective To investigate the effects of levodopa benserazide hydrochloride combine with dl-3-butyl phthalide capsule on patient's limbs function after stroke. Methods Ninety patients with stroke were randomly divided into rehabilitation group,treatment group and control group,and 30 cases for each group. Patients in rehabilitation group were treated with exercise therapy,in treatment group were given exercise therapy and levodopa Benserazide and Dl-3-butylphthalide capsules,and in control group were given placebo treatment. Adult hemiplegic motor function score(FMA)and motor function assessment scale(MAS)were used to assess the motor function and lower extremity function before treatment and 8 weeks after treatment. Results Before treatment,FMA and MAS in rehabilitation group,treatment group and control group were(22. 6 ± 3. 6), (23. 1 ± 2. 5)and(20. 3 ± 2. 9),and(1. 6 ± 0. 6),(2. 1 ± 0. 5),(1. 7 ± 0. 9),respectively. There was no significant differences between the two groups( F = 1. 64,P > 0. 05;F = 1. 66,P > 0. 05). After 8 weeks of treatment,FMA and MAS in rehabilitation group and treatment group were(60. 6 ± 3. 5),(14. 6 ± 1. 1),and (75. 7 ± 4. 5),(17. 7 ± 4. 5),significant improved more than that before treatment(t = 1. 738,1,716,1. 732 respectively;P < 0. 05). Meanwhile,patients in the treatment group improved more than that in rehabilitation group(P < 0. 05),and they were superior to patients in control group((31. 0 ± 3. 6),(5. 5 ± 1. 1);P < 0. 05). Conclusion Benserazide combined with dl-3- butyl phthalide capsule can further improve the limbs function.

ObjectiveToexplorethedynamicchangesofoxidativestressandcytokinesinMongoliangerbilswith nonalcoholic fatty liver disease ( NAFLD) and their significance.Methods Forty-eight healthy male gerbils were randomly divided into normal group and model group , 24 in each group .Gerbils of the model group were fed with high fat diet while those of the normal group with normal diet .Eight gerbils in each group were killed at the end of 4 w, 8 w and 16 w, respectively .MDA content and SOD , GSH-PX and T-AOC activity in the liver tissue were detected by chemical method, and serum TNF-α, INF-γand IL-10 levels were determined using liquid suspension chip .Results With the development of NAFLD , MDA content in liver increased gradually , and the MDA contents were all significantly higher than those of the normal group ( P<0.01 ); T-AOC level slightly increased , and then decreased , the levels at 4 w and 16 w were markedly decreased compared with those of the normal group (P<0.05);SOD level was significantly increased and then markedly reduced, the level of the model group at 4 w was significantly increased (P<0.05), while that at 8 w and 16 w were significantly decreased (P<0.05, P<0.01).The level of GSH-PX was decreased gradually , the levels at 8 w and 16 w were significantly lower than those of the normal group (P<0.05).With the progression of NAFLD,serum TNF-αand IFN-γwere increased gradually , while the level of IL-10 decreased gradually , and the levels at 8 w and 16 w were significantly lower than those of the normal group ( P <0.05, P <0.01).Conclusions The oxidative stress-related indicators and inflammatory cytokines in the gerbil NAFLD models induced by high fat diet are significantly changed as simple fatty liver develops into steatohepatitis , liver fibrosis and cirrhosis , and participate in the development and progression of NAFLD .

Objective To summarize the experience with resurgery for recurrent valvular heart diseases.Methods From June 2004 to June 2015, 28 patients (15 males and 13 females) with ages ranging from 44 to 67 years (55.6±6.5 years) with recurrent heart valve disease underwent resurgery. The reasons for resurgery included perivalvular leakage (7 cases), bioprosthetic valve decline (6 cases in mitral valve and 3 in tricuspid valve), mechanical prostheses dysfunction (2cases), infective endocarditis after valve replacement (2 cases), restenosis of repaired native valve (1 case), and severe tricuspid insufficiency after left-side valve surgery (7 cases). Resurgery included mitral valve replacement in 18 patients and tricuspid valve replacement in 10. All the patients underwent third or fourth or even fifth cardiac surgery for valve replacement.Results There were 2 hospital deaths with a mortality of 7.1% (2/28). The main causes of early-stage deaths were low cardiac output syndrome. The main postoperative complications were respiratory failure in 3, low cardiac output syndrome in 2, reexploration for bleeding in 2 and serious infectious shock in 1. All the patients were found with the great improvement in heart function and the re-implanted prostheses worked well during follow-up.Conclusions Although resurgery for recurrent heart valve disease poses a continuing challenge to cardiac surgeon, it could be performed with the satisfactory results. The keys to a successful cardiac resurgery include appropriate operational timing, refined surgical technique and reasonable perioperative managements.