Current Situation and Influencing Factors of Delay in Seeking Medical Treatment Among Residents in Rural Areas of Sichuan Province / 中国医学科学院学报

Objective To understand the current situation and explore the influencing factors of delay in seeking medical treatment for common symptoms of residents in the rural areas of Sichuan province. Methods In July 2019,multi-stage random sampling was carried out in Zigong city,Sichuan province,and the data were collected by face-to-face questionnaire interview.The residents who had lived at hometown for more than half a year in the past year and had seen a doctor in the most recent month were surveyed.Logistic regression was adopted to predict the influencing factors of delay in seeking medical treatment. Results A total of 342 subjects were enrolled,and the incidence of delay in seeking medical treatment was 13.45%(46/342).Compared with the young and middle-aged(<65 years)people,the elderly(≥65 years)people were more likely to have delay in seeking medical treatment (OR=2.187,95%CI=1.074-4.457,P=0.031).The rural residents who gave higher score of the overall quality of township health centers were less likely to have delay in seeking medical treatment (OR=0.854,95%CI=0.735-0.992,P=0.039). Conclusions The occurrence of delay in seeking medical treatment for common symptoms of rural residents in Sichuan province is low.Age and the overall quality evaluation of township health centers affect the occurrence of delay in medical treatment among the rural residents in Sichuan province.Efforts should be made to improve the awareness of disease prevention among the elderly in rural areas.The investment in health resources in township health centers should be increased to strengthen the introduction and training of talents.These measures can improve the health services in township health centers,guide residents to make timely use of health resources,and reduce the occurrence of delay in seeking medical treatment.

Effects of Monoammonium Glycyrrhizinate on Stem Cell-like Characteristics, Oxidative Stress and Mitochondrial Function of Acute Promyelocytic Leukemia NB4 Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of monoammonium glycyrrhizinate on the stem cell-like characteristics, oxidative stress and mitochondrial function of acute promyelocytic leukemia cells NB4.@*METHODS@#CCK-8 method was used to detect the viability of acute promyelocytic leukemia cells NB4, and the appropriate dose was screened; Cloning method was used to detect the proliferation rate of NB4 cell; Western blot was used to detect the expression of cell cycle-related protein; flow cytometry was used to detect cell apoptosis and sort NB4 stem cells positive (CD133+); Stem cell markers (Oct4, ABCG2, Dclk1) were detected by RT-PCR; ROS was detected by fluorescence; The kit was used to detect the level of oxidative stress markers (MDA); The flow cytometry was used to detect the change of mitochondrial membrane potential; Western blot was used to detect the expression of mitochondrial damage index-related proteins (Bax/BCL-2).@*RESULTS@#Compared with the control group, if the concentration of MAG was less than 5 μmol/L, the cell NB4 viability showed no significant difference; if the concentration was higher than 5 μmol/L, the inhibitory effect on the growth of cell NB4 increased and showed significant difference (P<0.05), according to the results of CCK-8 experiment, four groups were set based on the concentration of MAG 0 μmol/L, MAG 5 μmol/L, MAG 10 μmol/L, and MAG 20 μmol/L; compared with the control group (MAG 0 μmol/L), the cells in MAG 5 μmol/L group showed no significant difference, while the proliferation rate, cyclin expression, mitochondrial membrane potential, stem cell CD133+ ratio, and marker mRNA level ( Oct4, ABCG2, Dclk1) of NB4 cell were significantly reduced (P<0.05); the apoptosis rate, reactive oxygen species, MDA content and Bax/BCL-2 expression of NB4 cell significantly increased (P<0.05).@*CONCLUSION@#Monoammonium glycyrrhizinate has a significant inhibitory effect on acute promyelocytic leukemia cells NB4, which may be related to the regulation of stem cell-like characteristics, oxidative stress and mitochondrial function.

Sudden cardiac death in heart failure with preserved ejection fraction: an updated review

Despite the advances in medical and device therapies for heart failure (HF), sudden cardiac death (SCD) remains a tremendous global burden in patients with HF. Among the risk factors for SCD, HF has the greatest impact. Previous studies focusing on patients with systolic dysfunction have found several predictive factors associated with SCD, lead‑ ing to the subsequent development of strategies of primary prevention, like placement of implantable cardioverterdefibrillator (ICD) in high-risk patients. Although patients with HF with preserved ejection fraction (HFpEF) were less prone to SCD compared to patients with HF with reduced ejection fraction (HFrEF), patients with HFpEF did account for a significant proportion of all HF patients who encountered SCD. The cutoff value of left ventricular ejection frac‑ tion (LVEF) to define the subset of HF did not reach consensus until 2016 when the European Society of Cardiology proposed a new classification system by LVEF. There is a great unmet need in the field of SCD in HFpEF regarding risk stratification and appropriate device therapy with ICD implantation. In this article, we will approach SCD in HFpEF from HFrEF subsets. We also aim at clarifying the mechanisms, risk factors, and prevention of SCD in HFpEF.

Association of Dietary Diversity with Growth and Development of Children in Multi-ethnic Rural Areas of Sichuan Province / 中国医学科学院学报

Objective To understand the growth and dietary diversity status of children in multi-ethnic areas of Sichuan province,and to explore the associations of dietary diversity with growth and development indicators. Methods Children of 18-36 months old and their primary caregivers were selected with multi-stage cluster random sampling method from rural areas of Han,Tibetan,and Yi ethnic groups in Sichuan province. The sociodemographic information of children and their caregivers was collected using self-designed questionnaire.The dietary diversity score(DDS)was calculated according to the criteria in the Guidelines for Measuring Household and Individual Dietary Diversity released by the Food and Agriculture Organization of the United Nations.The body height(length)and body weight of each child were measured by standard equipment for anthropological measurement,and the height for age Z score(HAZ),weight for age Z score(WAZ),and weight for height Z score(WHZ) were calculated.Multivariate linear regression was performed to analyze the relationship between dietary diversity and growth indicators of children. Results A total of 1092 children were enrolled in this study,and the prevalence of stunting(HAZ<-2),underweight(WAZ<-2),and wasting(WHZ<-2)was 21.1%,4.9%,and 2.5%,respectively.The children had the mean DDS of 4.8±1.7,and 45.3% of children had poor dietary diversity(DDS≤4).The children of Han ethnic group(5.8±1.4)had higher DDS than those of Tibetan ethnic group(4.9±1.6)and Yi ethnic group(3.9±1.6)(P<0.001).The results of multivariate linear regression indicated that DDS was positively correlated with HAZ(β=0.206,95%CI=0.158-0.254,P<0.001)after adjustment of sex,age,birth weight,preterm birth,and parental body height.After further adjustment of family fixed assets,ethnic group,caregiver's type,and caregiver's education background,the correlation between DDS and HAZ remained significant(β=0.077,95%CI=0.026-0.128, P=0.003). Conclusions The children in the multi-ethnic rural areas of Sichuan province showed troublesome growth and development status and low dietary diversity,which were conspicuously different between ethnic groups,especially in the rural areas of Yi ethnic group.The dietary diversity was positively associated with HAZ.It is recommended to carry out nutrition and health education according to the local dietary characteristics and thus improve the growth and development of children in multi-ethnic rural areas in Sichuan.

Evaluation of Accuracy and Influencing Factors for Diagnosis of Two Chronic Diseases by Primary Healthcare Providers in Sichuan Rural Areas Based on Standardized Patients / 中国医学科学院学报

Objective We used standardized patients to evaluate the accuracy and explore the influencing factors of the diagnosis of unstable angina pectoris and type 2 diabetes by primary healthcare providers in Sichuan rural areas,aiming to provide a scientific basis for improving the diagnosis accuracy of primary healthcare providers for the two chronic diseases. Methods A multi-stage stratified random cluster sampling method was adopted to select 100 villages from 50 townships in 5 districts/counties in Zigong city,Sichuan province. General and internal medicine practioners who were on duty on the survey day were enrolled in the survey.Two rounds of data collection were conducted.In the first round,the basic information of providers from township health centers and village clinics was collected.One month after the the first survey,standardized patients were used to collect the information related to the diagnosis of unstable angina pectoris and type 2 diabetes by rural primary providers.Logistic regression was carried out to analyze the factors influencing the diagnosis accuracy. Results A total of 172 rural primary healthcare providers were enrolled in the survey,who completed 186 standardized patient visits and showed the correct diagnosis rate of 48.39%.Specifically,the correct diagnosis rates of unstable angina pectoris and type 2 diabetes were 18.68%(17/91) and 76.84%(73/95),respectively.The providers with medical practitioner qualifications were more likely to make correct diagnosis(OR=4.857,95%CI=1.076-21.933, P=0.040).The providers who involved more necessary consultation and examination items in the diagnosis process had higher probability of correct diagnosis(OR=1.627,95%CI=1.065-2.485, P=0.024).Additionally,the providers were more likely to make a correct diagnosis for type 2 diabetes than for unstable angina pectoris(OR=6.306,95%CI=3.611-11.013, P<0.001). Conclusions The overall diagnosis accuracy of unstable angina pectoris and type 2 diabetes was relatively low among primary healthcare providers in Sichuan rural areas.The training of diagnosis process can be taken as a key for improving providers' practice ability so as to increase the diagnosis accuracy of chronic diseases.

Effect of short-chain thioesterase deficiency on P(3HB-co-LA) biosynthesis in Escherichia coli / 生物工程学报

Polyhydroxyalkanoates (PHAs) have obtained much attention in biomaterial fields due to their similar physicochemical properties to those of the petroleum-derived plastics. Poly(3-hydroxybutyrate-co-lactate) [P(3HB-co-LA)] is one member of the PHAs family, and has better toughness and transparency compared to existing polylactic acid (PLA) and poly[(R)-3-hydroxybutyrate] [P(3HB)]. First, we confirmed the one-step biosynthesis of P(LA-co-3HB) with the lactate fraction of 23.8 mol% by introducing P(3HB-co-LA) production module into Escherichia coli MG1655. Then, the lactate fraction was increased to 37.2 mol% in the dld deficient strain WXJ01-03. The genes encoding the thioesterases, ydiI and yciA, were further knocked out, and the lactate fraction in the P(3HB-co-LA) was improved to 42.3 mol% and 41.1 mol% respectively. Strain WXJ03-03 with dld, ydiI and yciA deficient was used for the production of the LA-enriched polymer, and the lactate fraction was improved to 46.1 mol%. Notably, the lactate fraction in P(3HB-co-LA) from xylose was remarkably higher than from glucose, indicating xylose as a potent carbon source for P(3HB-co-LA) production. Therefore, the deficiency of thioesterase may be considered as an effective strategy to improve the lactate fraction in P(3HB-co-LA) in xylose fermentation.

Application of Williams Life Skills Training in depressive adolescents with non-suicidal self-injury / 四川精神卫生

ObjectiveTo discuss the efficacy of Williams Life Skills Training （WLST） in depressive adolescents with non-suicidal self-injury （NSSI）. MethodsA total of 88 depressive adolescents with NSSI hospitalized in Suzhou Guangji Hospital from January to June 2019 were selected and grouped according to admission order. The corresponding random number was even in intervention group （n=44） and odd as control group （n=44）. Both groups received a 4-week routine depression care， based on this， intervention group received WLST. All selected individuals were assessed using Hamilton Depression Scale-17 item （HAMD-17）， General Self-Efficacy Scale （GSES） and adolescent student life satisfaction scale at the baseline and end of treatment. Then the incidence of NSSI behavior during hospitalization and the reduction rate of HAMD-17 score at discharge were compared between the two groups. ResultsThe incidence rate of NSSI behavior during hospitalization showed significant difference between groups （χ2=11.702， P=0.001）. HAMD-17， GSES and satisfaction scores at discharge were significantly different from those at admission （tcontrol group=-5.256， 10.690， -21.220； tintervention group=-12.540， 11.300， -32.840， P<0.01）. HAMD-17， GSES， satisfaction scores and the reduction rate of HAMD-17 score also showed significant differences between groups （t=0.851， -12.809， -4.883， χ2=75.990， P<0.05 or 0.01）. ConclusionApplication of WLST in depressive adolescents with NSSI may reduce the incidence rate of NSSI behavior， alleviate the degree of depression， enhance the sense of self-efficacy， and improve life satisfaction.

Analysis of string-overalls-suture pancreaticojejunostomy in preventing of postoperative pancreatic fistula / 中华内分泌外科杂志

Objective:To investigate the influence of string-overalls-suture pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy (PD) .Methods:Clinical data of 70 cases receiving PD in the Affiliated Zhongshan Hospital of Dalian University from Jan. 2011 to Dec. 2018 were retrospectively studied. All cases were divided into experimental group and control group according to the different ways of pancreaticojejunostomy. Patients in experimental group received string-overalls-suture pancreaticojejunostomy, and those in control group received pancreatic duct jejunal mucosa pancreaticojejunostomy. The 70 cases were performed by the same team. Operative time and the incidence of postoperative complications between the two groups were compared and analyzed.Results:There was no statistical differences between the two groups in general data and intraoperative observations. The total operative time was (4.28±1.10) hours in the control group and (3.62±0.76) hours in the experimental group. It was significantly different between the two groups ( t=2.942, P=0.004) . There were 7 (28.0%) cases of POPF including 6 cases of grade B, and 1 case of grade C in the control group, and 3 (6.7%) cases of grade B in the experimental group. 6 (24.0%) cases had postoperative bleeding in the control group, 7 (15.6%) cases in the experimental group, 8 (32.0%) cases with abdominal infection in control group, and 8 (17.8%) cases in the experimental group. Delayed gastric emptying occurred in 3 (12.0%) cases in the control group, and 4 (8.9%) cases in the experimental group. It was significantly different for POPF between the two groups (χ 2=4.358, P=0.037) . And there were no significant differences for other postoperative complications between the two groups (all P>0.05) . Conclusion:The string-overalls-suture pancreaticojejunostomy has the advantages of simple and quick manipulation, wide indication, safe and reliable pancreaticojejunostomy, and has certain superiorities in shortening operation times and reducing POPF.

Value of impulse oscillometry technique in assessment of silicosis / 中国职业医学

OBJECTIVE: To investigate the value of impulse oscillometry(IOS) technique in the assessment of silicosis. METHODS: A judgment sampling method was used to select 90 patients with silicosis as the silicosis group, which includes 30 cases in each stage of silicosis(stage 1-3). Thirty workers with no exposure history to free silica dust were selected as the control group. All subjects underwent routine pulmonary function and IOS test. RESULTS: The total respiratory impedanceat at 5 Hz(Z5), reactance at 5 Hz(X5), airway resistance at 5 Hz(R5), airway resistance at 20 Hz(R20), difference of R5 and R20(R5-R20), low frequency reactance area(AX) and resonance frequency(Fres) were higher in silicosis group than those in control group(P<0.05). The above IOS indicators showed an upward trend with the higher stages of silicosis(P<0.05). X5 was positively correlated with forced vital capacity(FVC), one-second expiratory capacity(FEV_1), FEV_1/FVC(P<0.05). Z5, R5, R50-R20 and Fres were negatively correlated with FVC, FEV_1 and FEV_1/FVC(P<0.05). CONCLUSION: IOS detection is highly sensitive for early diagnosis of silicosis. The parameters of airway resistance in IOS is correlated with the parameters of ventilatory dysfunction in routine pulmonary function test, which is of great value for the evaluation of silicosis.

Soil-transmitted nematode infections and influencing factors in pupils from rural areas of Yi Ethnicity in Butuo County, Sichuan Province / 中国血吸虫病防治杂志

Objective To understand the current situation of soil-transmitted nematode infections and influencing factors of pupils in rural areas of Yi Ethnicity in Butuo County, Sichuan Province, so as to provide the evidence for the prevention and control of soil-transmitted nematode infections. Methods In 2016, the pupils of 2 villages in Butuo County were selected by the multi-stage random sampling method, and the relevant information was obtained by questionnaires, including social demographic information, diet and hygiene habits and acknowledge of parasitic disease prevention. The soil-transmitted nematode infections were examined by Kato-Katz technique. The results were statistically analyzed by the single factor analysis and multivariate logistic regression methods. Results A total of 160 pupils were investigated in this survey. The soil-transmitted nematodes included Ascaris lumbricoides, Trichuris trichiura and hookworm. The overall infection rate was 89.38%, and the multi-infection rate was 54.55%. The infection rates of A. lumbricoides and T. trichiura were higher. The infection densities were mild (75.68%) or moderate (22.97%). The logistic regression analysis showed that the protective factor of soil-transmitted nematode infections was the knowledge about correct diet and health habits notified by teachers (OR = 0.67), but the risk factor was drinking unboiled water (OR = 19.26). Conclusions The infection rate of nematodes is still high in the pupils in rural areas of Yi Ethnicity in Butuo County, Sichuan Province. Therefore, we should strengthen the prevention and control of soil-transmitted nematode infections, especially A. lumbricoides and T. trichiura infections, and mostly develop the teachers’function in health education.

Soil-transmitted nematode infections and influencing factors in pupils from rural areas of Yi Ethnicity in Butuo County, Sichuan Province / 中国血吸虫病防治杂志

Objective To understand the current situation of soil-transmitted nematode infections and influencing factors of pupils in rural areas of Yi Ethnicity in Butuo County, Sichuan Province, so as to provide the evidence for the prevention and control of soil-transmitted nematode infections. Methods In 2016, the pupils of 2 villages in Butuo County were selected by the multi-stage random sampling method, and the relevant information was obtained by questionnaires, including social demographic information, diet and hygiene habits and acknowledge of parasitic disease prevention. The soil-transmitted nematode infections were examined by Kato-Katz technique. The results were statistically analyzed by the single factor analysis and multivariate logistic regression methods. Results A total of 160 pupils were investigated in this survey. The soil-transmitted nematodes included Ascaris lumbricoides, Trichuris trichiura and hookworm. The overall infection rate was 89.38%, and the multi-infection rate was 54.55%. The infection rates of A. lumbricoides and T. trichiura were higher. The infection densities were mild (75.68%) or moderate (22.97%). The logistic regression analysis showed that the protective factor of soil-transmitted nematode infections was the knowledge about correct diet and health habits notified by teachers (OR = 0.67), but the risk factor was drinking unboiled water (OR = 19.26). Conclusions The infection rate of nematodes is still high in the pupils in rural areas of Yi Ethnicity in Butuo County, Sichuan Province. Therefore, we should strengthen the prevention and control of soil-transmitted nematode infections, especially A. lumbricoides and T. trichiura infections, and mostly develop the teachers’function in health education.

Multi-slice computed tomographic angiography in preoperative detection of hepatic arterial anomalies in patients undergoing pancreaticoduodenectomy / 中华肝胆外科杂志

Objective To assess the preoperative detection of hepatic arterial anomalies in patients undergoing pancreaticoduodenectomy using multi-slice computed tomographic angiography (MSCTA).Methods Between January 2014 and December 2017,60 patients who underwent pancreaticoduodenectomy were included in this retrospective study.The clinical and imaging data were analyzed.The types of hepatic artery found by preoperative MSCTA based on the Michels classification were compared with the actual hepatic arterial anatomy detected during surgery.Results Hepatic arterial anomalies were detected by MSCTA in 12 of 60 patients (20.0％).Using the Michels classification,there were 3 patients with type Ⅱ (25.0％),6 patients with type Ⅲ (50.0％),1 patient with type Ⅵ (8.3％),and 1 patient with type Ⅸ (8.3％).One patient (8.3％,1/12) had an anomaly which was not included in the Michels typing.All the hepatic arterial anomalies detected by MSCTA corresponded to those found in surgery (12 patients).The rates of accuracy,sensitivity,and specificity of MSCTA were all 100％.Conclusions MSCTA provided a high accuracy in diagnosing hepatic arterial anomalies.MSCTA should be routinely used before pancreaticoduodenectomy.

Expression of peroxisome proliferator-activated receptor γ and uncoupling protein-1 after sleeve gastrectomy in obese diabetic rat / 中华内分泌外科杂志

Objective To investigate the expression of peroxisome proliferator-activated receptor γ (PPARγ) and uncoupling protein-1 (UCP-1) after sleeve gastrectomy in Zucker rats and to discuss the weight loss mechanisms.Metbods 30 male Zucker rats aged 10 weeks were randomly divided into 3 groups:the operation group (10 rats),the sham operation group(10 rats) and the diet-pairing group (10 rats).The rats were decapitated to retrieve the retroperitoneal adipose.mRNA and protein expressions of PPARγ and UCP-1 were detected by RT-PCR and Western blot.Results As for the operation group,the weight decreased significantly after the operation compared to the other two groups((250±5.8) g,(370±10.0) g,(310±9.6) g,respectively,P＜0.05).The expressions of PPARγ and UCP-1 gene of mRNA and protein were all significantly higher in the operation group (P＜0.05).Conclusions SG can up-regulate the expressions of thermogenic gene PPARγand UCP-1 in adipose in Zucker rats,browning the white adipose tissue,which was one of the important mechanisms of weight loss.

Effect of gastric bypass surgery on intestinal flora and some serum indexes in rats with type 2 diabetes mellitus / 中华内分泌外科杂志

Objective To observe the effect of gastric bypass (GBS) on intestinal flora and some serum indexes in spontaneous type 2 diabetic rats (GK rats),and to explore the mechanism of improving insulin resistance.Methods 30 Goto-Kakizaki rats,aged 8 weeks,were randomly divided into GBS operation group,sham operation group and diet matching group (n=10).Another 10 8-week-old male SD rats served as blank control group (free eating and drinking).The levels of fasting blood glucose(FPG) and fasting insulin(FINS) were measured and compared before and 4 weeks after operation.The insulin resistance index(HOMA-IR) was calculated before and 4 weeks after operation.Fresh feces of rats were collected 4 weeks after operation and DNA was extracted.The intestinal flora composition of each group was detected by real-time polymerase chain reaction (RT-PCR) at 4 weeks after operation.Results Four weeks after operation,FPG level in GBS group decreased from (13.83±0.35) mmol/L to (5.73±0.21) mmol/L(P＜0.05),HOMA-IR in GBS group decreased from(5.71±0.27) to (2.15±0.17) (P＜0.05).The DNA content of Firmicutes(22.71±12.81)(P=0.020),Enterobacterium spp.(3.11±4.17) (P=0.043) decreased significantly,and the DNA content of Bacteroides (30.74± 17.33) (P=0.013)increased significantly.Conclusion GBS can down-regulate the intestinal thick-walled bacterium,Enterobacteriaceae and upregulate the content of mimetic bacterium in type 2 diabetic rats,improve insulin resistance and insulin sensitivity.

Relationship between the maxillofacial skeletal pattern and the morphology of the mandibular symphysis: Structural equation modeling / 대한치과교정학회지

OBJECTIVE@#The purpose of this study was to investigate the relationship between the facial skeletal patterns and the shape of the mandibular symphysis in adults with malocclusion by using a structural equation model (SEM).@*METHODS@#Ninety adults who had malocclusion and had records of facial skeletal measurements performed using cone-beam computed tomography were selected for this study. The skeletal measurements were classified into three groups (vertical, anteroposterior, and transverse). Cross-sectional images of the mandibular symphysis were analyzed using generalized Procrustes and principal component (PC) analyses. A SEM was constructed after the factors were extracted via factor analysis.@*RESULTS@#Two factors were extracted from the transverse, vertical, and anteroposterior skeletal measurements. Latent variables were extracted for each factor. PC1, PC2, and PC3 were selected to analyze the variations of the mandibular symphyseal shape. The SEM was constructed using the skeletal variables, PCs, and latent variables. The SEM showed that the vertical latent variable exerted the most influence on the mandibular symphyseal shape.@*CONCLUSIONS@#The relationship between the skeletal pattern and the mandibular symphysis was analyzed using a SEM, which showed that the vertical facial skeletal pattern had the highest effect on the shape of the mandibular symphysis.

Hepatic phosphoenolpyruvate carboxykinase expression after gastric bypass surgery in rats with type 2 diabetes mellitus / 中华内分泌外科杂志

Objective To investigate mRNA expression of hepatic phosphoenolpyruvate carboxykinase (PEPCK) after gastric bypass surgery (GBS) in rats with type 2 diabetes mellitus (T2DM).Methods 36 male Goto-Kakizaki rats,aged 12 weeks,were randomly divided into GBS,sham operation with diet restriction (SO),and sham operation alone(control) groups(n=12 per group).The blood lipid levels and fasting plasma glucose (FPG)levels in rats before and 8 weeks after surgery were measured and compared.The insulin sensitivity index (ISI)was calculated.Real-time polymerase chain reaction (RT-PCR) and Western blot were used to detect the expression of PEPCK mRNA and protein in hepatocytes at 8 weeks after operation.Results 8 weeks after operation,the blood lipid levels [TC(1.25±0.08) mmol/L,TG (0.93±0.10) mmol/L,FFA(0.88±0.12) mmoUL] in GBS group were significantly lower than those before operation [TC (2.31 ±0.52) mmol/L,TG(1.44±0.27) mmol/L,FFA (1.08±0.06) mmol/L] (P＜0.05).The fasting blood glucose levels in GBS decreased from (11.73±0.37) mmol/L to (5.13±0.22) mmol/L (P＜0.05),and ISI in GBS group increased from (-5.78±0.10) to (-4.64±0.15) (P＜0.05).PEPCKmR-NA (3.97±0.30) and protein (1.60±0.31) expression significantly reduced (P＜0.05).Conclusion GBS can reduce blood glucose in T2DM rats while improving glucose tolerance and hyperglycemia,and the mechanism appears to be associated with a decrease of hepatic PEPCK mRNA and protein expression.

Expression of hormone sensitive lipase and carnitine acyl transferase-1 in obese diabetic rats after sleeve gastrectomy / 中华内分泌外科杂志

Objective To investigate the expression of hormone sensitive lipase (HSL) and carnitine acyl transferase-1 (CAT-1) in Zucker rats after sleeve gastrectomy and to discuss the weight loss mechanism.Methods 30 male Zucker rats aging 10 weeks were randomly divided into 3 groups:the operation group (10 rats),the sham operation group (10 rats) and the diet-pairing group (10 rats).The rats were decapitated to retrieve the retroperitoneal adipose,mRNA and protein expression of HSL and CAT-1 gene of were detected by RTPCR and Western blot.Results As for the operation group,the weight decreased significantly after the operation comparing to the other two groups ((250±5.8) g,(370±10.0) g,(310±9.6) g,P＜0.05).mRNA and protein expressions of HSL and CAT-1 gene were all significantly higher in the operation group (P＜0.05).Conclusion SG can up-regulate the expressions of lipolysis gene HSL and CAT-1 in adipose in Zucker rats,promoting fat hydrolysis and increasing the energy expenditure,which is one of the important mechanisms of weight loss.

Cloning and expression analysis of 1-hydroxy-2-methyl-2-(E)-butenyl-4-diph- osphatereductase gene in Dendrobium officinale / 中草药

Objective: To clone the full-length cDNA encoding 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphatereductase (HDR) gene from Dendrobium officinale (DoHDR), then to analyze the expression difference in different tissues and expression patterns of DoHDR induced by signal molecule. Methods: RT-PCR and RACE technologies were used to clone the full length cDNA of DoHDR. The analyses of homologous comparison and phylogenetic tree were performed using DNAMAN and MEGA6.0 softwares, then the expression patterns of DoHDR were studied by real-time PCR. Results: The DoHDR gene was successfully obtained (GenBank accession number KC344827), and the full-length cDNA was 1 658 bp, coding the protein containing 460 amino acids. DoHDR had high homology (≥ 80%) with HDR proteins from other plants. Tissue expression analysis showed that DoHDR had the highest expression in the leaves, followed by roots, stems, and protocorm. Quantitative PCR results showed that DoHDR could be induced by signal molecule such as abscisic acid (ABA) and salicylic acid (SA). Conclusion: The cDNA encoding DoHDR is cloned. It is helpful for the future research on the mechanism of terpenoid biosynthesis in D. officinale.

Feasibility of a novel two-piece nasogastric feeding tube for patients with dysphagia

<p><b>INTRODUCTION</b>The exposed section of a traditional nasogastric (NG) tube can interfere with patients' social activities and thereby result in distress. This study was conducted to evaluate the feasibility and safety of a novel two-piece NG tube for patients with dysphagia.</p><p><b>METHODS</b>Ten patients with dysphagia were recruited between November 2011 and May 2012. Patients who were unconscious or in critical condition, had a traditional NG tube < 50 cm or > 60 cm in fixed length, or were unable to follow instructions or sign consent forms were excluded. The two-piece NG tube, which was placed in the patients for one week, comprised a removable external tube that can be joined to an internal tube via a T-connector, which was placed close to the naris. Events related to safety (e.g. nasal pressure sores, number of unplanned extubation, displacement and spontaneous migration of the NG tube, other unpredictable injuries) and effectiveness (e.g. liquid food spills, tube obstruction, perfusion rate, other adverse circumstances) were assessed daily.</p><p><b>RESULTS</b>All patients received feeding without complication using the two-piece NG tube and none experienced premature removal of the tube. No serious NG tube complications or malfunctions were observed.</p><p><b>CONCLUSION</b>The results of this study indicate that the two-piece NG feeding tube is a feasible option for patients with dysphagia. Future improvements to the connector may help enhance its performance. A rigorous randomised controlled trial to examine the effects of the two-piece NG tube on patients' quality of life and quality of medical care is being planned.</p>

Simultaneous reconstruction of composite tissue defects in two adjacent metacarpophalangeal joints of hand by split the 2nd toes / 中华显微外科杂志

Objective To explore the efficacy of simultaneous reconstruction of composite tissue defects in two adjacent metacarpophalangeal joints of hand by split the 2nd toes.Methods From December 2006 to December 2011,the second toe composite flap pedicled with the dorsalis pedis artery-first,second metatarsal dorsal artery-dorsal artery were designed,and split it into the second metatarsophalangeal joint composite flap pedicled with the dorsalis pedis artery-first dorsal metatarsal artery-tibial artery and the proximal interphalangeal joint composite flap pedicled with dorsalis pedis artery-second dorsal metatarsal arteryfibular dorsal artery.Then they were used to repair composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time after reconstruction.Results This group includes 14 metacarpophalangeal joints of 7 cases,twelve joints was successful,two joints of 1 case to give up because the first dorsal metatarsal artery variation.At 6-24 months follow-up study in 12 out of 14 cases showed that there was no joint degeneration in X-ray manifestation and the recovering of joint function was satisfying.According to the function evaluation standard of reconstraction of thrumb and finger issued by Hand Surgery Society Chinese Medical Association,the excellent and good rate was 83.3％.Conclusion It is feasible to reconstruct of composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time by split the 2nd toes,and can effectively improve the functions of injury metacarpophalangeal joint.