Objective To explore the correlation between sarcopenia and body fat percentage(BF%)in elderly male patients with type 2 diabetes mellitus(T2DM).Methods A total of 291 elderly male T2DM patients who were hospitalized in the Endocrinology Department of Xuanwu Hospital,Capital Medical University were enrolled in this study from December 2018 to September 2019.All the patients were divided into sarcopenia group(n=35)and non sarcopenia group(n=256).BF%,skeletal muscle mass index(SMI),grip strength,gait speed,HbA1c,hemoglobin(Hb),blood uric acid(SUA),albumin and vitamin D(Vit D)were measured in all the participants.Results Compared with the non sarcopenia group,age,HbA1c and BF%were increased,while BMI,Vit D,SMI,Hb,SUA,ALB,grip strength,and gait speedwere decreased in sarcopenia group(P＜0.05 or P＜0.01).Pearson correlation analysis showed that SMI was positively correlated with BMI,Vit D,Hb,and SUA(P＜0.05 or P＜0.01),and negatively correlated with HbA1c(P＜0.01).Grip strength and gait speed are positively correlated with Vit D and Hb(P＜0.01),and negatively correlated with BF%(P＜0.01).Logistic regression analysis showed that age and BF%were risk factors for sarcopenia,while BMI and Vit D were protective factors for sarcopenia.Conclusions High BF%significantly increases the risk of sarcopenia in elderly male T2DM patients.

Objective:To investigate the clinical efficacy of oxcarbazepine versus carbamazepine combined with baclofen in the treatment of trigeminal neuralgia. Methods:A total of 74 patients with trigeminal neuralgia who received treatment in Haiyang People's Hospital from May 2019 to May 2021 were prospectively included in this study. They were randomly divided into an observation group and a control group ( n = 37 per group). The observation group was treated with oxcarbazepine combined with baclofen, while the control group was treated with carbamazepine combined with baclofen. Both groups were treated for 4 successive weeks. Clinical efficacy, adverse reactions, Visual Analogue Scale (VAS) scores before and after treatment, levels of pain transmitters [substance P (SP), 5-hydroxytryptamine (5-HT), β-endorphin (β-EP)], and quality of life were compared between the two groups. Results:The total effective rate in the observation group was 97.3% (36/37), which was significantly higher than 83.8% (31/37) in the control group (χ 2 = 3.95, P < 0.05). Before treatment, there were no significant differences in VAS score, SP, 5-HT, β-EP levels, and EQ-5D Health-Related Quality of Life Questionnaire (EQ-5D) score between the two groups (all P > 0.05). After treatment, VAS score, SP, 5-HT levels, and EQ-5D score in each group were significantly decreased compared with those before treatment. After treatment, VAS score, SP and 5-HT levels in the observation group were significantly lower than those in the control group [(3.1±0.8) points vs. (4.2±0.9) points, (240.1 ± 34.1) ng/L vs. (314.1±40.1) ng/L, (38.2 ± 6.1) ng/L vs. (52.1±9.1) ng/L, all P < 0.001]. After treatment, β-EP level in each group was significantly increased compared with that before treatment ( P < 0.001). After treatment, β-EP level in the observation group was significantly higher than that in the control group [(268.1 ± 38.1) ng/L vs. (214.1 ± 29.0) ng/L, P < 0.001]. After treatment, EQ-5D scores in the observation group were significantly lower than those in the control group (all P < 0.001). There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Oxcarbazepine combined with baclofen has superior efficacy in the treatment of trigeminal neuralgia to carbamazepine combined with baclofen. The former can more obviously relieve pain, reduce pain neurotransmitter levels, improve quality of life, and has less adverse reactions.

Objective:To compare the treatment outcomes of neoadjoint therapy combined with liver transplantation versus radical hepatectomy for patients with surgically resectable hilar cholangiocarcinoma.Methods:A retrospective study was performed on the data of 64 patients with resectable hilar cholangiocarcinoma operated from January 2009 to December 2014 at the Organ Transplantation Department of the First Central Hospital of Tianjin. There were 43 males and 21 females, with an average age of 61.2 years. There were 45 patients who underwent radical hepatectomy in the liver resection group, and 19 patients who underwent combined neoadjuvant therapy (radiotherapy combined with 5-fluorouracil intravenous drip, transcatheter lumen radiotherapy, capecitabine oral administration) and liver transplantation in the liver transplantation group. The recurrence rates and survival rate were compared between groups.Results:The 1, 3 and 5 years cumulative survival rates of the liver transplantation group were 89.5%, 73.7% and 63.2%, respectively, which were significantly better than those of the liver resection group (80.0%, 53.3% and 35.6%) ( P<0.05). The postoperative tumor recurrence rate in the liver transplantation group was 31.6% (6/19), which was significantly lower than that in the liver resection group of 60.0% (27/45) ( P<0.05). Subgroup analysis using postoperative pathological results showed the cumulative survival rates of patients without lymph node metastasis (N 0) and those with negative resection margins (R 0) were not significantly different between groups ( P>0.05). However, for patients with regional lymph node invasion (N 1) and with R 0 resection margin, the cumulative survival rates at 1, 3 and 5 years after liver transplantation were 83.3%, 66.7% and 50.0%, respectively, which were significantly superior to the 64.3%, 28.6% and 14.3% of the liver resection group ( P<0.05). Conclusion:Hepatectomy is recommended for patients with N 0 R 0 resectable hilar cholangiocarcinoma. For patients with hilar cholangiocarcinoma with marginally resectable N 1R 0, neoadjuvant therapy combined with liver transplantation resulted in significantly better long-term overall survival than resection.

Objective To compare the difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation (LDLT). Methods Clinical data of 272 donors and recipients undergoing LDLT were retrospectively analyzed. According to different patterns of hepatic artery reconstruction, all recipients were divided into the magnifying glass group (n=189) and microscope group (n=83). The operation time, intraoperative blood loss, hepatic artery reconstruction site, diameter of anastomosis, incidence of postoperative complications and survival rate of recipients were statistically compared between two groups. Results Compared with the microscope group, the operation time, hepatic artery reconstruction time and intraoperative blood loss were significantly less in the magnifying glass group (all P < 0.001). The most common site of hepatic artery reconstruction was the right hepatic artery in two groups, and the diameter of anastomosis was (2.1±0.9) mm in the magnifying glass group and (2.1±0.8) mm in the microscope group, with no statistical significance between two groups (P > 0.05). The 1-, 2- and 3-year survival rates of recipients in the magnifying glass group were 88%, 86% and 85%, which did not significantly differ from 89%, 87% and 86% in the microscope group (all P > 0.05). The incidence of postoperative complications did not significantly differ between two groups (all P > 0.05). Conclusions The efficacy and safety of hepatic artery reconstruction in LDLT under surgical magnifying glass are equivalent to those under surgical microscope, with less operation workload and intraoperative blood loss. For experienced transplantation surgeons, it is recommended to perform hepatic artery reconstruction assisted by surgical magnifying glass.

Objective To investigate the effects of Maiqi-Jiangtang pill on the glycolipid level in type 2 diabetic ob/ob mice.Methods The 8-week old male ob/ob mice were randomly divided into Maiqi-Jiangtang pill high- (8 g/kg), medium- (4 g/kg), low- (2 g/kg) dose groups. All the mice orally adiministered with the drugs once a day for 10 weeks. The same week age normal C57BL/6J control mice and ob/ob model group mice were orally administered with the equal volume solvent. The body weight per week were recorded. The fasting blood-glucose (FBG) was measured by glycemic instrument. The content of TG, TC, HDL-C, LDL-C in serum, and TG and TC content in liver were determined by biochemical method. The liver index was calculated.Results Compared with ob/ob model group, there was no significant change in body weight of mice administered with Maiqi-Jiangtang pill for 10 weeks. Compared with the model group, the low-, medium- dose Maiqi-Jiangtang pill could significantly decrease the FBG (7.43 ± 1.71 mmol/L,7.84 ± 1.09 mmol/L vs.8.95 ± 0.96mmol/L), the high- dose Maiqi-Jiangtang pill could significantly reduce the TG (0.93 ± 0.16 mmol/L vs.1.18 ± 0.26 mmol/L) and LDL-C (2.10 ± 0.51 mmol/L vs.2.56 ± 0.44 mmol/L) content in serum of ob/ob mice (P<0.05), increase the HDL-C/LDL-C ratio (2.40 ± 0.39vs.1.96 ± 0.24) in serum (P<0.01), decrease the liver weight (3.52 ± 0.26 gvs. 3.98 ± 0.35 g) and the liver index (0.063 ± 0.004vs. 0.071 ± 0.006) (P<0.05). Compared with the model group, the low dose Maiqi-Jiangtang pill could also significantly decrease the TG level (0.63 ± 0.25 mmol/gvs. 1.05 ± 0.67 mmol/g) in liver and significantly increase the HDL-C/LDL-C ratio (2.30 ± 0.44vs. 1.96 ± 0.24) in serum (P<0.05).Conclusions The Maiqi-Jiangtang pill can reduce lipid in serum and liver of ob/ob mice while it can decrease the blood glucose, which need to further study its mechanism.

Objective To investigate and analyze the applications of liver grafts from donation after death children (≤5 kg) in pediatric liver transplantation.Methods A retrospective analysis was conducted on 18 cases of pediatric recipients using liver grafts from donation after death children (≤5 kg) during January 2013 to December 2015.The survival rate of patients,recovery of liver function,incidence of lung infection,vascular complications and biliary complications were observed,and the causes of deaths were analyzed.Results The median follow-up time of all the patients was 28.4 months (0.06-52.2 months).The 1-and 3-year cumulative survival rate was the same 88.9％,the incidence of lung infection was 22.2％,of vessel complications was 33.3％,and biliary complication rate was 11.1％.Two cases died after liver transplantation.Conclusion The applications of liver donation after death children (≤5 kg) were satisfactory,but there is still relatively limited experience,and further observation and research are needed.

Objective To investigate the rehabilitation effect of folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage on treatment of patients with high-risk diabetic foot (DF).Methods A total of 120 patients with high-risk DF were randomly divided into 4 groups.The control group was given routine therapy of diabetes.Besides the basic treatment,folic acid was given in the folic acid group.On the basis of the folic acid group,lipoic acid was used in lipoic acid group with oral taken after two weeks of intravenous drip.The massage group was treated with plantar acupoint massage on the basis of the lipoic acid group,and the treatment course was 6 months.The Toronto symptom and sign score,the brachial ankle pulse wave velocity (baPWV),the ankle brachial ratio (ABI) and the score of life quality of four groups were compared before and after the intervention.Results The homocysteine and the baPWV in the folic acid group,the lipoic acid group and the massage group were significantly lower than those in the control group (P ＜0.01).Except for the folic acid group,The Toronto symptom and sign score in the other two groups was significantly lower than that in the control group (P ＜ 0.01).Except for the folic acid group,ABI of the lipoic acid group and the massage group was significantly higher than that of the control group (P ＜0.01).The score of life quality in the lipoic acid group and the massage group were significantly lower than that in the control group (P ＜ 0.01).The oxidized low density lipoprotein in the lipoic acid group and the massage group were significantly lower than that in other two groups (P ＜ 0.01).Conclusion Folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage can improve the effect of DF patients.

Objective To investigate the rehabilitation effect of folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage on treatment of patients with high-risk diabetic foot (DF).Methods A total of 120 patients with high-risk DF were randomly divided into 4 groups.The control group was given routine therapy of diabetes.Besides the basic treatment,folic acid was given in the folic acid group.On the basis of the folic acid group,lipoic acid was used in lipoic acid group with oral taken after two weeks of intravenous drip.The massage group was treated with plantar acupoint massage on the basis of the lipoic acid group,and the treatment course was 6 months.The Toronto symptom and sign score,the brachial ankle pulse wave velocity (baPWV),the ankle brachial ratio (ABI) and the score of life quality of four groups were compared before and after the intervention.Results The homocysteine and the baPWV in the folic acid group,the lipoic acid group and the massage group were significantly lower than those in the control group (P ＜0.01).Except for the folic acid group,The Toronto symptom and sign score in the other two groups was significantly lower than that in the control group (P ＜ 0.01).Except for the folic acid group,ABI of the lipoic acid group and the massage group was significantly higher than that of the control group (P ＜0.01).The score of life quality in the lipoic acid group and the massage group were significantly lower than that in the control group (P ＜ 0.01).The oxidized low density lipoprotein in the lipoic acid group and the massage group were significantly lower than that in other two groups (P ＜ 0.01).Conclusion Folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage can improve the effect of DF patients.

Objective To investigate the effect of TiO2 nanotube arrays covalently modified by recombinant human bone morphogenetic protein-2(rhBMP-2) on the early bioactivity of mesenchymal stem cells(MSC) in vitro and to provide experimental evidence for the biochemical modification of titanium implants.Methods In the experiment group,double titanium nanotube arrays were prepared by anodization,and were chemically grafted with rhBMP-2.Mechanically polished pure titanium was used as blank control group,and titanium dioxide nanotubes was used as negative control A group,and titanium dioxide nanotubes + carbonyldiimidazole as negative control B group.Field emission scanning electron microscope(FE-SEM) and X-ray photoelectron spectroscopy(XPS) were used to detect the morphology and physicochemical properties of the experiment group,blank control group and the negative control group.Cell adhesion on the specimen surface of the experiment group,blank control group and negative control group on the 1st day was tested.Cell proliferation on the 1st,3rd and 5th day and alkaline phosphatase activity on the 5th,7th and 11th day was also tested.Results FE-SEM showed that the surface of titanium nanotubes loaded with rhBMP-2 possessed visible miliary particulate matter.XPS showed that nitrogen peak in the group of titanium nanotubes loaded with rhBMP-2 was significantly greater that those in the other groups.FE-SEM showed that the cells on the surface of the experimental group on the 1st day spread well,better than those in the control group and negative control group.Cell proliferation activity on the 1st day in different groups was not obvious(P＞0.05),the A value of the experimental group on the 3rd and 5th day (3.295±0.153,3.823±0.059) were significantly higher than those in the control group(2.479±0.064,3.131±0.096) and negative control A group(2.715±0.075,3.371±0.047) and negative control B group(2.756±0.132,3.637±0.047)(P＜0.05).Alkaline phosphatase activity on the 5th,7th and 1 1th day in the experimental group (0.0477 ± 0.0287,0.0615 ± 0.0016,0.0667 ± 0.0018) were better than those in the control group,negative control A group and negative control B group(P＜0.05).Conclusions Titanium nanotube arrays can be loaded with rhBMP-2 by biochemical methods and have good biocompatibility.

Objective To investigate the effects of expression of mitochondria long-chain fatty acid oxidative enzyme (long-chain 3 hyroxyacyl CoA dehydrogenase,LCHAD) and p38 mitogen activated proteinkinase (p38MAPK) signal transduction pathway in severe preeclampsia.Methods Serum-free trophoblast cells cultured in vitro were stimulated by early onset severe preeclampsia serum (E-PE group),late onset severe preeclampsia serum (L-PE group),HELLP syndrome serum (HELLP group),and normal pregnancy serum (NP group) respectively; each group was added DMEM/F12 medium,reduced form of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor (NADPH-Ⅰ) and p38 MAPK inhibitor (p38-Ⅰ)to stimulate cells.Expression of mRNA and protein of LCHAD in trophoblast cells were detected by real-time PCR and western blot.Results (1) The expression of mRNA of LCHAD:the level of mRNA of LCHAD in NP+DMEM,E-PE + DMEM,E-PE + NADPH-Ⅰ,E-PE + p38-Ⅰ,L-PE + DMEM,L-PE + NADPH-Ⅰ,L-PE + p38-Ⅰ and HELLP + DMEM,HELLP + NADPH-Ⅰ,HELLP + p38-Ⅰ groups were 1.00 ± 0.03,0.14 ±0.08,0.95 ±0.20,1.43±1.02,0.37 ±0.18,1.51 ±0.36,1.60 ±0.31,0.10 ±0.04,0.49 ±0.10,0.44 ± 0.21,respectively.The relative expressions of mRNA of LCHAD were significantly reduced in E-PE + DMEM,L-PE + DMEM and HELLP + DMEM groups compared with the NP + DMEM group (P ＜0.05).Compared with the NP groups,the relative expressions of mRNA of LCHAD were significantly increased in L-PE + NADPH-Ⅰ and L-PE + p38-Ⅰ group (P ＜ 0.05),while reduced in HELLP groups (P ＜0.05).(2) The expression of protein of LCHAD:the relative expressions of protein of LCHAD in NP +DMEM,E-PE + DMEM,E-PE + NADPH-Ⅰ,E-PE + p38-Ⅰ,L-PE + DMEM,L-PE + NADPH-Ⅰ,L-PE +p38-Ⅰ and HELLP + DMEM,HELLP + NADPH-Ⅰ,HELLP + p38-Ⅰ groups were 19.4 ± 2.2,10.7 ± 1.1,17.9±3.3,19.1 ±2.9,16.4 ±2.3,20.3 ±2.3,20.9 ±4.3,12.4 ±2.3,17.6 ±2.6,17.7 ±2.0 respectively.Compared with the NP groups,the protein expressions of LCHAD were significantly remarkably reduced in E-PE + DMEM,L-PE + DMEM and HELLP groups (P ＜ 0.05).Compared with the DMEM groups,the protein expressions of LCHAD were significantly increased in NADPH-Ⅰ and p38-Ⅰ groups of E-PE,L-PE and HELLP groups (P ＜ 0.05).Conclusions These studies demonstrate that long chain fatty acid oxidation was involved in the pathogenesis and development of preeclampsia.The expressions of gene and protein of LCHAD were remarkably affected by early onset severe preeclampsia and HELLP syndrome.NADPH-Ⅰ and p38-Ⅰ may allay the disorder of fatty acid oxidation.p38MAPK signal transduction pathway may contributed in this process.