OBJECTIVE To study the interventional effect and mechanism of 1，8-cineole on pancreatic β cell ferroptosis induced by type 2 diabetes. METHODS In vitro ferroptosis model was established in pancreatic β cells of mice by using high glucose. The effects of low-dose and high-dose 1，8-cineole （0.25， 0.5 μmol/L） on the level of Fe2+ in pancreatic β cells were investigated. The effects of 1，8-cineole （0.5 μmol/L） combined with ferroptosis inducer Erastin （20 μmol/L） and ferroptosis inhibitor Ferrostatin-1 （20 μmol/L） on the protein expressions of glutathione peroxidase-4 （GPX4） and cyclooxygenase-2 （COX2） were also detected. The type 2 diabetes model mice were established by feeding high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. The effects of low-dose and high-dose 1，8-cineole （50， 200 mg/kg） on the pathological morphology of pancreatic tissue， the content of iron as well as the protein expressions of GPX4 and COX2 were investigated. RESULTS The results of the cell experiment showed that compared with the model group， pretreatment with 1，8-cineole significantly reduced intracellular Fe2+ levels and upregulated GPX4 protein expression， while downregulated COX2 protein expression in pancreatic β cells （P＜0.05）. After combining with Ferrostatin-1， the expression trends of the above two proteins were the same， while there was no statistically significant difference after combining with Erastin. The results of animal experiments showed that compared with the model group， after intervention with 1，8-cineole， the structure of the pancreatic islets in mice recovered intact and their morphology improved； the iron content of pancreatic tissue and protein expression of COX2 were decreased significantly （P＜0.05）， while protein expression of GPX4 was increased significantly （P＜0.05）. CONCLUSIONS 1，8-cineole could ameliorate pancreatic β cell injury induced by diabetes， the mechanism of which may be related to reducing intracellular iron deposition and regulating ferroptosis-related proteins.

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson’s disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young’s modulus-ankle angle curve was constructed. The GM slack angle and baseline Young’s modulus (E 0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E 0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

Objective:To study the risk factors and microbial spectrum for infectious complications for patients with biliary tract cancer after major hepatectomy with cholangiojejunostomy.Methods:Enrolled into this study were 78 consecutive patients (57 patients with perihilar cholangiocarcinoma, 17 with intrahepatic cholangiocarcinoma and 4 with gallbladder cancer), who underwent major hepatectomy with cholangiojejunostomy at Nanjing Drum Tower Hospital between September 2010 and March 2019. The clinical data were reviewed using multivariate analysis to find independent risk factors for postoperative infectious complications. Microorganisms isolated from bile and infected sites were determined to study the microbial spectrum.Results:A total of 45(57.7%) patients suffered from postoperative infectious complications. Male sex ( OR=7.765, 95% CI=1.895-31.815, P<0.05) was the independent risk factor, whereas increased preope-rative red blood cell (RBC) ( OR=0.151, 95% CI=0.038-0.592, optimal cut-off value=3.7×10 12/L) and increased total cholesterol (TC) on postoperative day (POD) 1 ( OR=0.227, 95% CI=0.083-0.626, optimal cut-off value=3.5 mmol/L) were protective factors (both P<0.05). The area under the receiver operating characteristic (ROC) curve was 0.805 (95% CI=0.707-0.902, P<0.05). 205 and 230 microorganisms were cultured respectively from 286 and 681 specimens which were collected from pre-/intraoperative bile and potentially infected sites. Staphylococcus, enterococcus, acinetobacter, klebsiella and pseudomonas were the most common pathogens on bile culture. The first 5 most frequently isolated microorganisms from the infected sites were enterococcus, staphylococcus, klebsiella, candida and xanthomonas. Sixteen (61.5%) of 26 patients had at least one pathogen being isolated from the infected sites with the pathogen being previously isolated in bile culture. Conclusions:Male sex were independent risk factors of infectious complications. Increased preoperative RBC and inreased TC on POD were proteetive factors. For patients without a positive bile culture, a third-generation cephalosporin can be considered as a prophylactic antibiotic. It is important to identify high-risk patients and monitor perioperative pathogens actively to prevent and to cure postoperative infectious complications.

ObjectiveTo investigate the correlation between neutrophil to lymphocyte ratio (NLR) and cerebral microbleeds (CMBs) in patients with acute ischemic stroke.MethodsThe consecutive inpatients with acute ischemic stroke were prospectively enrolled.Gradient echo-T2*-weighted imaging was used to evaluate CMBs and their quantity.Univariate analysis was used to compare the baseline data between the CMB group and the non-CMB group.Multivariable logistic regression analysis was used to identify the independent correlation between NLR and CMBs.ResultsA total of 218 patients with acute ischemic stroke were prospectively enrolled, including 66 (30.3%) with CMBs.The age (64.7±6.6 years vs.66.9±8.6 years;t=2.052, P=0.041), high sensitive C-reactive protein (7.0[2.3-13.9] mg/L vs.8.9[4.0-28.1] mg/L;Z=2.008, P=0.045) and NLR (1.9[1.4-2.9] vs.2.3[1.7-3.6];Z=2.071, P=0.038) in the non-CMB group were significantly lower than those of the CMB group.Multivariate logistic regression analysis showed that NLR (odds ratio 1.276, 95% confidence interval 1.008-1.670;P=0.045) and age (odds ratio 1.044, 95% confidence interval 1.002-1.087;P=0.040) were the independent risk factor for CMBs.Spearman correlation analysis showed that NLR was significantly positively correlated with the severity of CMBs (r=0.210, P=0.007).ConclusionsIn patients with acute ischemic stroke, NLR was associated with CMBs and their severity, suggesting that inflammatory reaction might be involved in the occurrence of CMBs.

Objective:To express human epididymis protein 4 (HE4) in prokaryotic cells,purify the expressed product and de-termine its activity by immunoassay kit.Methods: The gene encoding HE 4 was cloned using RT-PCR technique from total RNA of ovarian carcinoma cells ES-2,the amplified HE4 gene was cloned into prokaryotic expression vector pGEX-4T-1 and PET26b respective-ly.The recombinant plasmid pGEX-4T-1-HE4 and PET26b-HE4 were constructed and transformed into E.coli BL21 cells respectively, and protein ( GST-HE4 and His-HE4 ) expressions were induced by IPTG and identified by SDS-PAGE and commercial ELISA kit.Results:Restriction analysis and sequencing proved that recombinant plasmid pGEX -4T-1-HE4 and PET26b-HE4 were constructed correctly.The expressed recombinant proteins ,with the relative molecular mass of about 38 000 and 12 000 ,showed specific binding to monoclonal antibody against HE 4.Conclusion:Two kinds of recombinant HE 4 protein are successfully expressed in prokaryotic cells , which laid a foundation of preparation of immunoassay reagents.

OBJECTIVE: To explore the distribution of allergen tested by skin prick test (SPT) in about 5,843 allergic rhinitis patients in south Shanghai. METHOD: SPT test was conducted in 5,843 allergic rhinitis patients who came to our clinic from January 2007 to August 2012. The result was analyzed by age, sex and year. RESULT: The top three allergens by percentage are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus among 15 common allergens. Incidence rate between male and female in each year had statistical significance, both of which showed no increasing trend with year. Incidence rates among different age groups aging from 6 to 17 years' old had no statistically significant difference, but statistically significant difference among different age groups existed in other age groups. Incidence rate showed increasing trend with year in age group of 40-65, which was not observed in other groups. The incidence rate showed decreasing trend with age in male and female, while the incidence rate in male was always higher than female. CONCLUSION In south Shanghai, primary allergens causing allergic rhinitis are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus. Statistically significant difference about allergic rhinitis existed in age and sex. SPT has important significance in diagnosis of allergens.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

Objective To investigate effects of ACUMED self-orientated elbow plate system in treatment of comminuted distal humeral fractures (type C) in adults.Methods Thirty-two adult cases of comminuted distal humeral fractures treated by open reduction and internal fixation with parallel dual plates from May 2009 to October 2010 were enrolled in the study.There were 17 males and 15 females,at average age of 60 years (range,21-85 years).All cases were subjected to closed fractures,involving left side in 15 cases and right side in 17.Besides,two cases had associated ulnar nerve injury.According to AO classification,there were 12 cases of type C1,12 of type C2 and eight of type C3 fractures.The time from injury to operation averaged 5.6 days.Distal humeri were exposed through posterior median incision of elbow and V shape osteotomy of olecroanon.Muscular contractile and relaxant functional exercise was taken within 24 hours postoperatively.Clinical results were assessed based on Mayo elbow performance score (MEPS) and X-ray films.Results X-ray films showed that all cases obtained primary bone healing in the follow-up (mean 12 months).Three cases of type C3 fractures had heterotopic ossification.All cases had no complications like infections or implant loosening postoperatively.Range of motion in elbow flexion and extension averaged 85° (range,8°-140°).MEPS was average 90 points (range,60-100 points),including excellent outcomes in 13 cases,good in 15,fair in one and poor in three,with excellence rate of 88％.Conclusion ACUMED parallel dual plate fixation technique based on stability theory of arch structure achieves solid fixation of adult comminuted distal humeral fractures,successfully reconstructs bone structure of distal humeri,and effectively restores elbow joint function in response to early rehabilitation exercise.

Objective To investigate the correlation between sperm-nucleporotein transition and sperm parameters and embryo development,also to evaluate the influence of pregnancy out comes of assisted reproductive technology (ART).Methods Sperm-nucleoprotein transition assay of a total of 676 patients underwent ART treatment were detected by aniline blue staining,and the correlation analysis between spermnucleoprotein transition and sperm parameters,DNA damage,acrosin activity,fertilization rate,cleavage rate,quality of early embryo development as well as blastocyst formation rate was performed.Results The sperm concentration,(a+b) ％ sperm,sperm count and acrosin activity was (66.5±4.6) × 109/L,(149.2±9.9)×109/L,(51.2±1.3)％ and (72.2±3.3) mU/106 sperm in abnormal group,and (91.9±2.7) ×109/L,(240.0±8.0) ×109/L,(57.3±0.8)％ and (85.7±1.9) mU/106 sperm in normal group,which reached significant difference (P＜0.01).DNA fragmentation index (DFI) was (17.3± 1.0)％ in abnormal group,which was significantly higher than (14.6±0.5)％ in normal group.The cleavage rate of 95.0％,D3/D5 high quality embryo rates of 34.2％ and 1.28％,D5 blastocyst formation rate and the total rate of blastocyst formation rate of 22.4％ and 38.6％ in abnormal group,which were significantly lower than that in normal group (96.9％,38.2％,2.70％,27.9％ and 46.4％) (P＜0.01).The rate of spontaneous abortion was 12.3％ in abnormal group,which was significantly higher than that in normal group (4.7％) (P＜0.01).However,there was no significant difference in biochemical pregnancy rate and ectopic pregnancy rate between the 2 groups (P＞0.05).Conclusions Sperm-nucleoprotein transition was positively related with sperm parameters,DNA damage,acrosin activity,and also has an adverse effect on embryo development and the outcomes of ART.It is suggested that the sperm-nucleoprotein transition should be detected before ART.

ObjectiveTo compare clinical and laboratory outcomes of in vitro maturation (IVM) with in vitro fertilization-embryo transfer (IVF-ET) in treatment of infertility associated with polycystic ovary syndrome (PCOS).MethodsFrom Jan.2007 to Dec.2010,infertile patients with PCOS underwent 701 cycles in First Affiliated Hospital of Wenzhou Medical College were studied retrospectively.Those were divided into 293 cycles of IVM group and 408 cycles of IVF/intra-cytoplasmic sperm injection ( ICSI ) group.The average transplantation rate,mean number of retrieval oocytes,maturation rate,fertilization rate,cleavage rate,high quality embryo rate,embryo implantation rate,pregnancy rate per transfer,pregnancy outcomes and incidence of ovarian hyperstimulation syndrome (OHSS) of the two methods of treatment were compared between two groups.ResultsThere were 275 cycles in IVM group and 342 cycles in IVF/ICSI group established embryo transfer.The transplantation rate was 93.9％(275/293)in IVM group and 83.8％ (342/408) in IVF/ICSI,which reached statistical difference (P ＜ 0.01 ).The maturation rate of 56.64％,cleavage rate of 88.08％,high quality embryo rate of 38.72％ and embryo implantation rate of 17.8％ in IVM group were significantly lower than 91.09％,94.91％,51.50％ and 25.4％ in IVF/ICSI group (all P ＜ 0.01 ).The clinical pregnancy rate per transfer were 37.8％ (104/275) in IVM group and 44.2％ (151/342) in IVF/ICSI group,which did not show statistical difference (P＞0.05).The mean number of oocytes ( 12.9 ±6.5 vs.12.9 ±7.9) and fertilization rate (76.52％ vs.70.75％ ) didn't show significant difference between IVM group and IVF/ICSI group ( P ＞ 0.05 ).The 21.3％ ( 87/408 ) cycles presented mild to moderate OHSS and 2.0％cycles(8/408)presented severe OHSS in IVF/ICSI group.While,no OHSS cycles were observed in IVM group.Conclusion IVM could get similar clinical pregnancy rates compared with IVF/ICSI in patient with PCOS,however,it can avoid occurrence of OHSS.

Objective To investigate iodine nutrition and thyroid health status among residents in Zhoushan archipelago, and to analyse their relationship.Methods A total of 3 284 residents in Zhoushan archipelago were surveyed by questionnaire and their thyroids were examined by B-mode ultrasound.The levels of urinary iodine and thyroid function were detected.Results The median level of urinary iodine in 3 284 residents was 226.0 μg/L, being 320.7 μg/L in citizens, 188.9 μg/L in farmers, 122.2 μg/L in salt-makers, 193.6 μg/L in fishers, and 271.7 μg/L in buddhist.The prevalence of diffuse goiter, nodular goiter, colloid goiter, thyroid adenoma, thyroid carcinoma, hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, and positve rate of TPOAb were 1.7% ,25.3% ,8.7% ,0.2% ,0.4% ,0.5% ,0.8% ,0.03%,1.0% ,and 9.5% repectively.The prevalence of thyroid diseases was increasing with aging, and higher in women than in men (P＜0.05).There was no significant relationship of the thyroid diseases with seafood, smoking,drinking, and tea (P＞0.05).Conclusions The citizens of Zhoushan archipelago have adequate iodine intake.It is pertinent to discuss Universal Salt Iodization.Excessive iodine intake may contribute to the high prevalence rate of thyroid diseases in Zhoushan.