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Objective:To study the correlation between serum bilirubin and cystatin C in patients with type 2 diabetes mellitus.Methods:A retrospective cohort study was conducted on 750 patients who were in the Affiliated Hospital of Jining Medical University from June 2017 to May 2018. The clinical data were collected, and the correlation between serum total bilirubin, direct bilirubin, indirect bilirubin and cystatin C was analyzed.Results:According to the results of single factor analysis, after adjusting the related confounding factors, the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin, indirect bilirubin and cystatin C. When the total bilirubin was <15.9 μmol/L, for every increase of 1 μmol/L in total bilirubin, cystatin C decreased 0.008 mg/L ( β = - 0.008, 95% CI - 0.014 to - 0.002, P<0.01); when indirect bilirubin was <11.5 μmol/L, for every increase of 1 μmol/L in indirect bilirubin, cystatin C decreased 0.011 mg/L ( β = - 0.011, 95% CI - 0.018 to - 0.003, P<0.01). When cystatin C was grouped according to the normal range (cystatin C<1.25 mg/L), after adjusting the related confounding factors, the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin and indirect bilirubin with cystatin C; when total bilirubin was <15.5 mol/L, for every increase of 1 μmol/L in total bilirubin, the risk of cystatin C exceeding the normal value was reduced by 17% ( OR = 0.83, 95% CI 0.71 to 0.96, P<0.01); when total bilirubin was ≥15.5 μmol/L, for every increase of 1 μmol/L in total bilirubin, the risk of cystatin C exceeding the normal value was increased by 12% ( OR = 1.12, 95% CI 1.01 to 1.25, P<0.05); when indirect bilirubin was <11.8 μmol/L, every increase of 1 μmol/L in indirect bilirubin, the risk of cystatin C exceeding the normal value was reduced by 20% ( OR = 0.80, 95% CI 0.67 to 0.95, P<0.01). However there was no significant correlation between direct bilirubin and cystatin C. Conclusions:There is a U-shaped relationship between total bilirubin, indirect bilirubin and cystatin C. At physiological concentrations, the increase of total bilirubin and indirect bilirubin can reduce cystatin C.
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Objective To investigate the X-ray,CT and MRI features of chondroblastoma (CB)and to improve diagnostic skills of this disease.Methods The X-ray,CT and MRI imaging of 27 cases with CB which were verified by histopathological examination and the misdiagnosed cases were analyzed retrospectively.Results Accurate diagnosis of preoperative images was made in 10 cases and all 10 cases were located in the epiphysis of long bone.X-ray and CT showed eccentric round and oval osteolytic bone destruction,with sclerotic rim and internal spotted calcification;MRI showed hypointensity on T1 WI and heterogeneous hypo-and hyperintensity on T2 WI,with peripheral regions of marrow edema and adjacent joint effusion.Seventeen cases were misdiagnosed preoperatively,including 8 cases in long bone epiphysis or apophysis,8 cases in short,flat and irregular bones and 1 case in metaphysis of long bone.Twelve cases showed expansive changes and 10 cases with associated aneurysmal bone cyst(ABC)showed fluid-fluid levels.Conclusion The CB shows sandy or stippled calcification,rim sclerosis,extensive surrounding bone marrow edema.CB in unusual sites usually shows expansive bone destruction,peripheral bone marrow edema,secondary aneurysmal bone cyst.Combined utilization of clinic,pathology and imaging features is helpful for the diagnosis.
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Objective To observe the effect of electroacupuncture (EA) plus oxygenmedicine (OM) on the expression of Bcl-2 and Bax in the hippocampal CA 1 area in cerebral ischemia/reperfusion injury (CI/RI) rats. Methods Thirty SD rats were randomized into sham-operation,model,EA,OM,EA+OM groups (n=6/group). CI/RI model was established by using modified Pulsinelli 4 vessel occlusion and reperfusion. EA (100 Hz,3.5 mA) was applied to "Baihui" (GV 20) and "Zusanli" (ST 36) 30 min,once daily for 4 days. Rats of OM and EA+OM groups were put into a box filled with oxygen and atomized herbal medicines containing Bingpian (Borneolum),Shexiang (Moschus),Huangjing (Rhizoma Polygonati),Shouwu (Radix Polygoni Multiflori),etc. for 30 min,once daily for 4 days. Bcl-2 and Bax expression of the hippocampal CA 1 area was detected by immunohistochemistry. Results Compared with sham group,the numbers of Bcl-2 immunoreaction (IR) and Bax IR positive cells,and the immunoactivity of Bcl-2 IR and Bax IR positive products in the hippocampal CA 1 area were increased significantly in model group (P0.05). Conclusion EA and OM and EA+OM can effectively regulate the expression of Bcl-2 and Bax in the hippocampal CA 1 area in CI/RI rats,and the effects of EA+OM are significantly superior to those of simple EA and simple OM,which may contribute to their effect in improving cerebral ischemia.