Study on the causal relationship between body mass index and hypothyroidism / 中华健康管理学杂志

Objective:To explore the causal relationship between body mass index (BMI) and hypothyroidism using the two-sample Mendelian randomization model.Methods:A large-scale anthropometric genome-wide association study published in the GIANT database was used to select single nucleotide polymorphisms (SNPs) which were statistically significantly associated with BMI as an instrumental variable ( P<5×10 -8, linkage disequilibrium r 2<0.1). The causal relationship between BMI and hypothyroidism was determined by the inverse variance weighted (IVW), weighted median method and the MR-Egger method, respectively. A heterogeneity test, gene pleiotropy test, and sensitivity analysis were performed to evaluate the stability and reliability of the results. Results:A total of 89 SNPs related to BMI were screened out as instrumental variables. IVW analysis suggested that for every standard deviation increase in BMI, the risk of hypothyroidism increased by 0.9% (odd ratio ( OR)=1.009, 95% confidence interval ( CI): 1.006-1.012, P<0.001). Similar results were obtained with the weighted median method ( OR=1.007, 95% CI: 1.002-1.011, P=0.003) and the MR-Egger method ( OR=1.008, 95% CI: 1.001-1.015, P=0.006). The MR-Egger analysis showed that genetic pleiotropy did not bias the results (intercept=0.000 1, P=0.776), the one-by-one exclusion method did not show that a single instrumental variable SNP had a significant impact on the results, and the difference was not statistically significant ( P>0.05). Conclusion:Mendelian randomized analysis showed a positive causal relationship between BMI and hypothyroidism.

One case report of primary mucinous adenocarcinoma combined with signet-ring cell carcinoma of female urethra / 中华泌尿外科杂志

Primary female urethral adenocarcinoma is rare. This paper reports a case of primary urethral mucinous adenocarcinoma complicated with signet ring cell carcinoma. The patient underwent urethral tumor resection in another hospital. Postoperative examination indicated that the tumor remained, and the tumor was completely removed after urethral tumor resection. After 11 months of follow-up, there was no tumor residue or recurrence.

Nomogram for predicting Gleason grouping upgrading(GGU)in a cohort receiving radical prostatectomy based on 2014 ISUP grouping system: development and internal validation / 中华泌尿外科杂志

Objective:To analyze the predictive factors of GGU between biopsy and radical prostatectomy pathology based on 2014 ISUP grouping system, then establish and evaluate nomogram.Methods:Patients undergoing radical prostatectomy in Shanghai Ruijin Hospital from March 2012 to March 2019 were reviewed, and the clinical and pathological information were collected. Age(68.1±7.2), body mass indes(BMI) (24.2±3.2)kg/m 2, prostate specific antigen(PSA) 11.5(6.7-20.4)ng/ml, prostate specific antigen destiny(PSAD) 0.35(0.20-0.66). Before March 2017, the number of biopsy cores were 6 to 8; After then, all patients toke 12 cores systemic biopsy. Based on 2014 ISUP grouping system, the differences between biopsy and radical prostatectomy grades were counted. The independent predictors of GGU were analyzed by univariate and multivariate logistic regression analysis, then the nomogram for predicting GGU were established and evaluated. Results:429 patients were enrolled. There were 161 (37.5%) patients in GGU group and 268 (62.5%) patients in non-GGU group. After multivariate logistic regression analysis, body mass index (BMI)>28 kg/m 2( OR=2.54, P=0.021), prostate specific antigen density (PSAD)( OR=1.65, P=0.018)and 2014 ISUP grouping sysyem ( OR=0.53, P<0.001) of biopsy specimen were independent impact factors of GGU. The predicting model was established according to BMI, PSAD and 2014 ISUP grouping system. The area under the ROC cure of the model was 0.735 (95% CI 0.681-0.789). The nomogram model was well calibrated, with the mean absolute error of 6.7%, which means the prediction of GGU is fairly consistent with the actual situation. Conclusions:Based on the 2014 ISUP grouping system, BMI>28 kg/m 2, PSAD and 2014 ISUP grouping of biopsy specimen were independent predictors of GGU. The nomogram model for predicting GGU has a good statistical significance.

Role of calf circumference in the evaluation and diagnosis of sarcopenia in the elderly in Shanghai / 中华临床营养杂志

Objective:To investigate the relationship between calf circumference and appendicular skeletal muscle mass (ASM) index, handgrip strength and gait speed in the elderly in Shanghai, and to explore the optimal cut-off point of calf circumference as a simple proxy marker of skeletal muscle mass, strength and function.Methods:A total of 2 294 participants were recruited from physical examination centers in Huadong Hospital Affiliated to Fudan University and 4 communities (954 males and 1 340 females) with an average age of (71.6±8.7) years. Appendicular skeletal muscle mass (ASM), Upper (UMM) and lower (LMM) limbs skeletal muscle mass were measured by bioelectrical impedance analysis (BIA). The ASM index (ASM/height 2) were calculated.Gait speed was measured.Muscle strength was measured by handgrip strength using an electronic hand dynamometer.Height, weight, right calf circumference and waist circumference were measured. Results:The age, body mass index (BMI), waist circumference and gait speed were not statistically different (all P>0.05) between both genders. Height, weight, ASM, ASM/height 2, UMM, LMM, handgrip strength, calf circumference were significantly higher in men than in women (all P<0.05). The calf circumference of the elderly with age ≥ 80 was significantly lower than that of the 70-79 age group and 60-69 age group ( P<0.05). The calf circumference of older women (age≥80) was significantly lower than that of the elderly women in the 70-79 age group and 60-69 age group ( P<0.05). Calf circumference was correlated negatively with age( P<0.01) and positively with ASM/height 2, height, weight, BMI, handgrip strength, UMM and LMM( P<0.01). There was no correlation between calf circumference and gait speed ( P>0.05). In the receiver operating characteristic curve (ROC), the cut-off value of calf circumference for low muscle mass was 35.1 cm for male(specificity, 0.721; sensitivity, 0.803, ROC, 0.809) and 33.6 cm for female(specificity, 0.774; sensitivity, 0.778; ROC, 0.827). Conclusions:Calf circumference decreases with ageing in the elderly. The optimal cut-off value of calf circumference for low muscle mass is 35.1 cm for males and 33.6 cm for females. We should pay attention to the importance of calf circumference in evaluation and diagnosis of sarcopenia.

The clinical experience of diagnosis and treatment on adrenal metastases (report of 55 cases) / 中华泌尿外科杂志

Objective To discuss the clinical characteristics of adrenal metastases,and summarize the experience of diagnosis and treatment.Methods From January 2008 to June 2018,the clinical data of 55 patients with adrenal metastases treated in our hospital were analyzed retrospectively.This study included 34 male patients and 21 female patients and the median age was 60 years old (ranged 55 to 84 years old).The median value of maximum diameter of adrenal metastases was 3 cm (ranged 1.9 to 10.3 cm);with 35 cases on the left side,13 cases right and 7 cases bilateral.The primary sites of malignant tumors were pancreas (18 cases,32.7％),lung (12 cases,21.8％),liver (6 cases,10.9％) and colorectum (6 cases,10.9％),respectively.Thirty-four cases were confirmed by pathology after adrenalectomy and 21 cases were confirmed by needle biopsy.Thirty cases were diagnosed synchronously with the primary tumor and 25 cases were metachronous.The median time from diagnosis of primary tumors was 13.3 months (ranged 2.0 to 97.4 months).42 cases of these 55 cases were diagnosed within one year.Treatment options for adrenal metastatic lesions included single adrenalectomy in 18 cases,adrenalectomy combined with radiotherapy 16 cases,single intravenous chemotherapy 10 cases,intravenous chemotherapy combined with non-operative treatment 10 cases and single radiotherapy 1 case.Results The main pathological types were adenocarcinoma (19 cases,34.5％),ductal adenocarcinoma (10 cases,18.2％),hepatocellular carcinoma (6 cases,10.9％) and clear cell carcinoma (4 cases,7.3％).Two cases were lost follow-up and the follow-up rate was 96％,the median follow-up time was 8 months (ranged 1 to 135 months).The median overall survival (OS) time of 55 patients was 5.3 months (ranged 1 to 134 months).The one-year survival rate was 23.6％ (13/55),the two-year survival rate was 12.7％ (7/55),the three-year survival rate was 9.1％ (5/55) and the five-year survival rate was 1.8％ (1/55).Conclusions Pancreatic cancer was the most common type of malignant tumor for adrenal metastases in our hospital.Most primary tumors and adrenal metastases were diagnosed synchronously or within one year.Comprehensive treatment with retroperitoneal adrenalectomy may improve the OS,however the overall prognosis is poor.

Relationship between calf circumference and skeletal muscle mass, strength and function in the elderly / 中华临床营养杂志

Objective To investigate the relationship between calf circumference and skeletal muscle mass, strength and function in the elderly in Shanghai. Methods A total of 401 old people were recruited from physical examination centers in our hospital with the mean age of (71. 8±7. 4) years, including 202 males and 199 females. Adipose tissue, skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM) were measured by bioelectrical impedance analysis. The ASM index ( ASM/height2) and SMM index ( SMM/height2) were calculated. Muscle function was measured by testing gait speed (m/s). Muscle strength was measured by handgrip strength (HGS) using an electronic hand dynamometer, with the dominant hand gripping for three times and taking the maximum value. Height, weight, right calf circumference and waist circumference were measured. Results Height, weight, ASM, ASM/height2, SMM, SMM/height2and HGS were significantly higher in men than in women ( P<0. 01); adipose tissue was significantly higher in women than in men (P<0. 05). The age, body mass index, calf circumference, waist circumference and gait speed were not statistically different (P=0. 426, P=0. 143, P=0. 425, P=0. 093, P=0. 143). There were linear correlations between calf circumference and height, weight, BMI, waist circumference, ASM, ASM/height2, adipose tissue, grip strength, SMM and SMM/height2( P=0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P<0. 001, P=0. 003, P<0. 001, P<0. 001). There was no linear correlation between calf circumference and pace and age (P=0. 818, P=0. 078). Multiple stepwise regression analysis showed that height, BMI, ASM/height2and SMM were correlated with the calf circumference. Conclusions Skeletal muscle mass and strength are higher in men than in women, while adipose tissue is higher in women than in men. Skeletal musle mass is an important factor affecting the calf circumference. There is a linear correlation be-tween skeletal muscle strength and calf circumference.

Preparation of chitosan-gelatin porous microspheres by high voltage electrostatic method combined with freeze-drying and ionic cross-linking method / 上海交通大学学报（医学版）

Objective·To prepare chitosan-gelatin porous microspheres by high voltage electrostatic method combined with freeze-drying and ionic cross-linking method and investigate the factors that influence the formation of porous medium.Methods·Porous chitosan microspheres and chitosangelatin porous microspheres were prepared using high voltage electrostatic method combined with freeze-drying and ionic cross-linking method,with sodium tripolyphosphate (STPP) as crosslinking agent.Factors that affect the porous structure and pore size of porous microspheres were compared,such as different chitosan-gelatin ratio,freezing temperature,curing time with saturated STPP in 85％ ethanol solution.The morphology,surface and internal structure,particle size of the porous chitosan microspheres and chitosan-gelatin porous microspheres were observe by using light microscope,scanning electron microscope and hematoxylin-eosin staining.Results·Microspheres prepared by freeze-drying with an electrostatic and ionic cross-linking method have open,interconnected and highly macroporous,with good spherical surface.Saturated STPP ethanol solution (85％ ethanol) was chosen as the crosslinking agent to prevent destruction of the porous structure.The order of freeze and crosslinking,cross-linking time and the second freezing temperature,can influence the pore size of porous microspheres.Gelatin and chitosan can form polyelectrolyte complexes,and can also be used as porogen in porous structure.Conclusion·The preparation of porous chitosan-gelatin microspheres via this method has a large pore size (diameter 100-200 μm),suitable for cell growth and the migration.

Preliminary study on appendicular skeletal muscle mass, muscular strength and function in the elderly / 中华老年医学杂志

Objective To investigate the status of appendicular skeletal muscle mass,muscular strength and changes of muscle function in the elderly in Shanghai.Methods A total of 402 participants were recruited from physical examination centers in our hospital.Appendicular skeletal muscle mass (ASM) was measured by bioelectrical impedance analysis (BtA).The ASM index (ASM/height2) was calculated.Muscle function was measured by testing gait speed (m/s).Muscle strength was measured by handgrip strength (HGS) using an electronic hand dynamometer.Results The ASM index significantly declined with age in both men and women (F＝2.133 and 3.124,both P＝0.000).For women,there was a significant difference in HGS only between the youngest age group (aged 60～69 years) and the oldest age group (aged≥80 years)(P＝0.005).For men,HGS was significantly different among all age groups (all P＜0.05).There was no significant difference in gait speed between 60-69 years group and 70-79 years group in both genders (both P＞0.05),while the significant differences in gait speed were observed between the 70-79 years old groups and ≥80year old group in both genders (both P＜0.05).Conclusions Appendicular skeletal muscle mass,strength and function are decreased with ageing in the elderly.The muscle strength decreases faster in the elderly man than in the elderly woman,and muscle function decreases significantly in both genders after 80 years old.

Antiepileptic drug valproic acid and topiramate effects on body weight and plasma leptin levels:a meta analysis / 中华行为医学与脑科学杂志

Objective To systematic evaluation the antiepileptic drug valproic acid and topiramate effects on body weight and plasma leptin levels.Methods By searching the Cochrane Library,PubMed,EMBASE,CNKI,VIP Chinese Scientific Journals Database and Articles Database (from building a database to August 1,2014),qualified RCT was chosen from those articles according to inclusion and exclusion criterias and evaluated their quality.Then the meta-analysis was performed by Rev Man 5.3.Results (1) A total of 70 documents retrieved for the evaluation,12 of the literatures could be incorporated into the Meta-analysis,including a total of 634 participants,9 literatures using valproate to treat epilepsy,4 literatures used topiramate.(2)Meta-analysis:compared with other drugs,valproic acid treatment increased body mass index and leptin level in patients with epilepsy,BMI combined MD=0.88(95％ CI:0.45-1.31),leptin level in the combined MD=0.58(95％ CI:0.07-1.09);compared with other drugs,topiramate affect body mass index and leptin level in patients with epilepsy had no statical difference,BMI combined MD=-0.02 (95％ CI:-0.62-0.58),leptin levels in the combined MD =-0.05(95％ CI:-0.31-0.20).Conclusion Antiepileptic drug valproic acid may increase patients' BMI and serum leptin levels,yet topiramate in do not have influence in patients BMI and serum leptin levels;more basic and clinical researches are needed to explore serum leptin levels and the exact therapy mechanisms of antiepileptic drugs for clinicians to select antiepileptic drugs.

Effects of ketogenic diet on neurobehavioral damages and expression of ZIP7 in cerebral cortex of rat following recurrent neonatal seizures / 中华行为医学与脑科学杂志

Objective To explore the intervention effect of ketogenic diet (KD) on neurobehavioral damages after flurothyl-induced neonatal recurrent seizures in rats and on the expression of ZIP7.Methods Postnatal day 8 SD rats (n=24) were divided into four groups randomly:normal group (NS+ND group),non-seizure and ketogenic diet group (NS+KD group),seizure and normal diet group (RS+ND group),seizure and ketogenic diet group (RS+KD group),n=6 in eacb group.At postnatal day 31,the grip-strength test and open field test were monitored.At postnatal day 32,rats were sacrificed and the expression of ZIP7 protein level in cerebral cortex was detected with Western blot.Results (1) The grip-strength test:compared with NS+ND group ((32.67±2.42) s),the time needed to hold on glass bar in RS+ND group ((19.17±2.48) s) was shorter significantly (P＜0.05).Compared with RS+ND group,the time needed to hold on glass bar in RS+KD group ((26.25±2.87) s) was significantly longer (P＜0.05).(2) Open field test:compared with NS+ ND group ((2.00± 0.63) times),the times of grooming in RS+ND group ((4.00±0.63) times) were more (P＜0.05).Compared with RS+ND group,the times of grooming in the RS+KD group ((2.17±0.75) times) were fewer (P＜0.05).(3)Western blot:compared with NS +ND group,the level of ZIP7 of the RS+ND group in cerebral cortex were lower (P＜0.05).Compared with RS+ND group,the level of ZIP7 of the RS+KD group in cerebral cortex were higher (P＜0.05).Conclusion Neonatal recurrent seizures may damage neurobehavior,and the neuroprotective effects of ketogenic diet may be associated with the increasing of ZIP7 in cerebral cortex.

Low fat milk powder containing esterified plant sterols improves the blood lipid profile of adults with hypercholesterolemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the impact of plant sterol esters (PSE) mixed in low fat milk powder (2.5 g of PSE/day) on plasma cholesterol levels in hypercholesterolemic subjects during a 6-week intervention period.</p><p><b>METHODS</b>In this double-blind, randomized, placebo-controlled study, 59 subjects (19 males, mean age (60.28 ± 6.98) years) with primary hypercholesterolemia (fasting LDL cholesterol between 3.4-6.0 mmol/L) were randomly divided into two groups (treatment group, 2.5 g of plant sterol esters a day, n = 30) and placebo group (n = 29). Blood samples were collected at week 0, 3 and 6. The primary outcome was change in plasma LDL-cholesterol (LDL-C). Secondary outcomes were changes in total cholesterol (TC), HDL cholesterol (HDL-C), triglycerides (TG), anthropometry and blood biochemistry.</p><p><b>RESULTS</b>LDL-C significantly reduction from baseline (4.18 ± 0.54) mmol/L to (3.44 ± 0.61) mmol/L (-17.7%, P < 0.05) at week 3 and (3.35 ± 0.39) mmol/L (-19.9%, P < 0.05) at week 6 in the treatment group, whereas in placebo group from (4.11 ± 0.54) mmol/L at baseline to (3.47 ± 0.60) mmol/L (-15.57%, P < 0.05) and (3.61 ± 0.39) mmol/L (-12.17%, P < 0.05) at week 3 and week 6, respectively. TC was reduced from (6.30 ± 0.86) mmol/L at baseline to (5.92 ± 0.75) mmol/L (-6.03%, P > 0.05) at week 3 and (5.43 ± 0.77) mmol/L (-13.8%, P < 0.05) at week 6 in treatment group, from (6.20 ± 0.76) mmol/L at week 0 to (5.70 ± 0.76) mmol/L (-8.06%, P < 0.05) at week 3 and (5.84 ± 0.75) mmol/L (-5.81%, P < 0.05) at week 6 in placebo group. PSE-enriched milk did not affect plasma HDL-C level and TG level at both week 3 and week 6. After normalization to the placebo group, the treatment group showed significant reduction in LDL-C and total cholesteron after 6 weeks. The observed difference of reduction was 7.69% (-0.33 mmol/L, P < 0.05) for LDL-C and 8.00% (-0.51 mmol/L, P < 0.05) for TC between the two groups. There were no significant changes in safety parameters, including blood biochemistry tests during the study period.</p><p><b>CONCLUSION</b>Plant sterol ester enriched milk powder is effective in reducing LDL-C among Chinese hypercholesterolemic subjects at a dosage recommended by EFSA.</p>

Prognostic value of clinical and pathological factors for surgically treated localized clear cell renal cell carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgical resection is the most effective treatment for renal cell carcinoma (RCC). Currently several prognostic factors and models are used for outcome prediction. However, whether intratumoral changes are independent prognostic factors for RCC or not remains unclear. The aim of the study was to investigate the prognostic roles of intratumoral changes in surgical treated localized clear cell renal cell carcinoma (ccRCC).</p><p><b>METHODS</b>Patients who received partial or radical nephrectomy between 2004 and 2009 in our center were retrospectively reviewed. Univariate and multivariate analyses were used to assess gender, age, body mass index (BMI), intratumoral hemorrhage, tumor necrosis, cystic degeneration, sarcomatoid change, Ki-67 expression, Fuhrman grade, and T stage on recurrence-free survival (RFS) and cancer-specific survival (CSS).</p><p><b>RESULTS</b>A total of 378 patients were included in our study. In univariate analysis, age, BMI, intratumoral hemorrhage, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors for RFS. Age, BMI, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors effecting CSS. In multivariate analysis, age, BMI, tumor necrosis, sarcomatoid change, Ki-67, Fuhrman grade, and T stage were independent prognostic factors for both RFS and CSS.</p><p><b>CONCLUSION</b>Intratumoral changes such as tumor necrosis and sarcomatoid change are independent prognostic factors for ccRCC.</p>

Comparative research of the effect of routine and every other day ketogenic diet on neurobehavioral damages induced by recurrent seizures in neonatal rats / 中华行为医学与脑科学杂志

Objective To compare the effect of routine ketogenic diet and every other day ketogenic diet on neurobehavioral damage induced by recurrent seizures in neonatal rats.Methods 48 postnatal day 8 (P8) SD rats were randomly divided into four groups with 12 in each group:the control group (CONT),the recurrent seizure group(RS+ND),recurrent seizure + routine ketogenic diet group(RS+KD) and recurrent seizure+ every other day ketogenic diet group(RS+KOD).The recurrent seizures model was induced by flurothyl at p9 and last for 8 days.After a day of fasting the postnatal 28 day rats were placed on either ordinary or ketogenic diet according to packet design.Plane righting experiment,cliff avoidance test and negative geotaxis test were used to assess the neurobehavioral performance at p35.Results (1) Plane righting experiment:the plane fighting time of RS+ ND group ((0.17±0.39) s) was significantly shorter than that of NS+ND group ((0.67 ±0.49) s) (P＜0.05) ; and the plane righting time of RS+KD group((0.58±0.52) s) was significantly longer than that of RS+ND group ((0.17±0.39) s) (P＜0.05).There was no statistical significance between RS+KOD group((0.17±0.39) s) and RS+ND group ((0.17±0.39) s) (P＞0.05).(2) Cliff avoidance test:the cliff avoidance time of RS+ND group ((12.58±4.83) s)was significantly longer than that of NS+ND group ((1.92±0.90) s),RS+KD group((3.33± 1.50)s) and RS+ KOD group (P＜0.05) ;and the cliff avoidance time of RS+KOD group((5.58± 1.93)s) was significant longer than that of RS+KD group ((3.33± 1.50) s) (P＜0.05).(3) Negative geotaxis test:the negative geotaxis time of RS+NDgroup((3.17±1.70)s) was significantly longer than that of NS+ND group((1.42±0.67) s) and RS+KD group ((1.42±0.52)s) (P＜0.05).There was no statistical significance between RS+KOD group and RS+ND group(P＞0.05).Conclusion The ketogenic diet can improve neurobehavioral damage caused by flurothyl-induced recurrent seizures in neonatal rats.The every other day KD group shows a weak intervention effect comparing with the routine KD group.

Expression of cortex clusterin and intervention effect of ketogenic diet on neonatal rats with recurrent seizures / 中华实用儿科临床杂志

Objective To investigate dynamic expressions of cortex clusterin (CLU) and intervention effect of ketogenic diet (KD) on neonatal rats with recurrent seizures.Methods Thirty-six-8-day postnatal SD rats were randomly divided into 3 groups:normal control group (NS + ND group,n =12),and the recurrent-seizure and normal diet group (RS + ND group,n =12),and the recurrent-seizure and KD group (RS + KD group,n =12).From 9 d,rats in RS + ND group and RS + KD group were subjected to recurrent seizures induced by volatile flurothyl 30 min each day for consecutive 8 days.Rats in NS + ND group were placed into the container for an equal amount of time to their counterpart without exposure to flurothyl.Scores on neurological behaviors at 35 days postnatally were examined.CLU protein levels in cerebral cortex were determined by Western blot at 58 days postnatally.Results Neurodevelopmental indicators analysis:in the plane righting experiment,there were significant differences between NS + ND group [(1.03 ± 0.54) s],R S + KD group [(0.89 ± 0.16) s] and RS + ND group [(0.64 ± 0.30) s] about the time of plane righting (all P ＜ 0.05) ; in the negative geotaxis reaction experiment,the rats of NS + ND group [(1.92 ± 0.90) s],and RS + KD group [(5.17 ± 0.72) s] about the time of negative geotaxis reaction were significantly different compared with RS + ND gouup [(7.33 ± 0.65) s] (all P ＜ 0.01).In the cliff avoidance test,there were significant differences between NS + ND group,R S + KD group [(4.33 ± 2.54) s,(8.75 ± 2.26) s] and R S + ND group [(16.58 ± 4.25) s] about the time of cliff avoidance (all P ＜ 0.01).Western blot showed that the expression of CLU in cerebral cortex of the RS + ND group [(2.24 ± 0.53) s] was obviously increased compared with NS + ND group [(1.44 ± 0.11) s] (P ＜0.01),and there also had significant difference between RS + KD group [(1.56 ±0.24) s] and RS + ND group (P ＜ 0.05).Conclusions It shows that the up-regulated expression of CLU in cerebral cortex may be associated with recurrent neonatal seizure-induced brain damage,while KD may protect them from recurrent neonatal seizure-induced brain damage by down-regulating expression of CLU.

Neurobehavioral changes and the prevention effect by melatonin for neonatal rats with recurrent seizures / 中华行为医学与脑科学杂志

Objective To explore neurobehavioral changes in rats with recurrent seizures and the prevention effect of melatonin.Methods 6-day-old (P6) SD rats were randomly divided into four groups of 24 (n =6):the control group (CONT),melatonin per se group (MEL),recurrent neonatal seizure group (RS) and melatonin administration prior to RS group (RS + MEL).Rats in RS group were subjected to 5 seizures with flurothyl during the first 14 days of life.In RS + MEL group,melatonin was injected at 8:00 before seizures were induced.Neurobehavioral tests including Plane righting experiment,Cliff avoidance test,the grip-strength test and negative geotaxis test were implemented on P24,while open field test on P35.Results (1) Plane righting experiment:the time of plane righting in RS group ((0.33 ± 0.51)s) was significantly shorter than that in the CONT group ((1.17 ± 0.40) s) and RS + MEL group ((0.50 ± 0.54) s) (P ＜ 0.05).(2) Cliff avoidance test:the time of cliff avoidance in RS group ((16.00 ± 6.32) s) was significantly longer than that in CONT group ((4.00 ± 2.60) s)(P ＜ 0.01),while the time of cliff avoidance in RS + MEL group ((7.67 ± 3.26) s) was shorter than that in the RS group (P ＜ 0.05).(3) The grip-strength test:compared with CONT group ((49.50 ± 28.96) s),the time needed to hold on wire in RS group((11.67 ± 7.58)s)was significantly shorter (P ＜ 0.05) and longer in RS+ MEL group ((24.83 ± 6.61) s) (P ＜ 0.05).(4) Negative geotaxis test:the time for rats to turn 180° upward in RS group((7.67 ± 1.36) s) was longer than that in the CONT group ((4.50 ± 2.66) s) and RS + MEL group ((6.17 ± 0.75) s) (P ＜ 0.05).(5) Open field test:the time for rats to begin to run in the RS group ((8.17 ± 3.86) s) was longer than that in the CONT group ((3.00 ± 1.41) s) (P ＜ 0.05).Conclusion The neurobehaviors are damaged following flurothyl-induced recurrent neonatal seizures,and melatonin can reduce the neurobehavioral injury.

Effect and mechanism of ketogenic diet on neurobehavioral demages induced by recurrent neonatal seizures / 中华行为医学与脑科学杂志

Objective To investigate the intervention effect of ketogenic diet (KD) on neurobehavioral demages after flurothyl-induced recurrent neonatal seizures in rats and on the expression of ApoE.Methods Postnatal day 8 (P8) SD rats (quantity:48) were randomly divided into two groups:the non-seizure group (NS group,n =24) and the recurrent-seizure group (RS group,n =24).From P9,rats in RS group were subjected to recurrent seizures induced by volatile flurothyl 30 min each day for consecutive 8 days.While rats in NS group were placed into the container for an equal amount of time to their counterpart without exposuring to flurothyl.At P28,each group was divided into two groups again:non-seizure and normal diet group(NS + ND group,n =12),non-seizure and ketogenic diet group(NS + KD group,n =12),recurrent-seizure and normal diet group (RS + ND group,n =12),recurrent-seizure and ketogenic diet group(RS + KD group,n =12).At P42,neurodevelopmental indicators were monitored.ApoE protein levels in cerebral cortex were determined by western blot at P58.Results Neurodevelopmental indicators were analyzed at P42:in the plane righting experiment,the rats of group NS + ND (1.0 ±0.14) about the time of plane righting was significant different comparing with group RS + ND ((0.75 ±0.32) s) (P ＜ 0.05).There was no significant difference between group RS + KD and group RS + ND about the time of plane righting(P＞ 0.05).In the negative geotaxis reaction experiment,the rats of groups NS + KD and RS + ND((3.17 ± 0.58)s,(6.75 ± 0.75)s) about the time of negative geotaxis reaction were significant different comparing with group NS + ND ((1.58 ±0.52)s) (P＜0.05).Compared with group RS + ND,the group RS + KD in the time of negative geotaxis reaction was obviously shortened (P ＜ 0.05).In the cliff avoidance test,there were significant differences between group NS + ND、RS + KD ((5.75 ± 2.90) s,(9.50 ± 4.36) s) and group RS + ND ((14.00 ± 4.79) s) about the time of cliff avoidance (P ＜ 0.05).In western blot,the expression of ApoE in cerebral cortex in the RS + ND group (1.26 ± 0.30) was obviously increased compared with group NS + ND (0.78 ±0.12) (P＜0.05),and there had also significant difference between group RS + KD (0.89 ±0.10) and group RS + ND (P ＜ 0.05).Conclusion The neuroprotective effects of ketogenic diet on recurrent neonatal seizure-induced neurobehavioral demages may be associated with the reduction of ApoE in cerebral cortex.

Effects of low-glycemic index meal replacement on management of patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

A total of 127 type 2 diabetic patients were divided into low glycemic index meal replacements (intervention) group and standard food-based diet (reference) group in an experiment for 12 weeks.The results showed that fasting plasma glucose,postprandial 2 h plasma glucose,fasting insulin,and homeostasis model assessment insulin resistance(HOMA-IR) in the intervention group decreased significantly after 12 weeks trial ( P＜0.05 or P＜0.01 ).However,there were no significant changes in lipid profile and HbA1C in intervention group.In addition,percentage of body fatty,visceral fatty area,and waist-hip ratio also decreased in intervention group( all P＜0.01 ).Superoxide dismutase and glutathione levels increased significantly in intervention group by the end of trial (both P＜0.01 ),while malondialdehyde was decreased (P＜0.01 ).There were no significant changes in the aforementioned indices in the reference group.Weight,body mass index,and waist circumferences were decreased in both groups,but without significant difference between the two groups.

Correlation of serum uric acid and early renal damage in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

The association of serum uric acid ( SUA ) and urine albumin-to-creatinine ratio ( ACR ) in patients with type 2 diabetes mellitus was explored. The ACR abnormal rate was higher in hyperuricemia group( P＜0.01 ). ACR level was positively correlated with SUA( P＜0.01 ). The general linear model showed that SUA was a risk factor in ACR. Patients with hyperuricemia and type 2 diabetes mellitus were apt to have abnormal ACR and develop early renal damage.

Cultivating clinical medical interns' thinking ability in the clinical teaching of urology / 中华医学教育探索杂志

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.