Abstract:Objective：To detect the effects of obesity on pulmonary inflammation and function in mice. Methods：Male ICR mice were fed with high fat diet for 150 d from the 21st d postnatal after weaning to establish obese mice model（high fat group） while those in control group were given standard chow diets. Mice in high fat group with weight 10%-20% heavier than the normal were classified into overweight group；mice in high fat group with weight 20% heavier than the normal were classified into obesity group. Basic lung function was recorded；pathological HE staining and immunohistochmistry labeling macrophages（F4/80） were performed to measure lung inflammation. Results：（1）Pathological HE staining and immunohistochmistry（F4/80） of pulmonary tissues showed that inflam－matory cell infiltration in alveolar septum and around bronchus was increased in obesity group than in control group and overweight group（especially macrophages）. （2）Pulmonary function（peak inspiratory flow；peak expiratory flow；50% tidal volume expiratory flow） showed no significant difference between these groups. Conclusions：Obesity enhances lung inflammation，however，makes no difference in ventilation function.

Abstract:Objective：To investigate the safe limit of warm ischemia time（WIT） for kidney graft after uncontrollable cardiac death（CD） in rat. Methods：Totally 140 SD rats were randomly divided into 7 groups according to the WIT（CD0，CD10，CD20，CD30，CD40，CD50，CD60 groups）. Each group had 20 rats，10 as donors and 10 as recipients. The left kidneys were harvested from the donor rats at 0，10，20，30，40，50，60 min after CD and the harvested left kidneys were transplanted into the left nephrectomized recipient rats whose right renal pedicles were ligated. The survival of recipient rats，recovery of renal function and degree of fibrosis were observed and checked. Results：Cold ischemic time was similar in all groups（P >0.05）. The survival rate，serum creatinine level and allograft fibrosis in CD10，CD20，CD30 groups were all equivalent to those of CD0 group（P >0.05） and the same results were acquired in CD40 group except that the serum creatinine level was higher than that of CD0 group（P<0.01）. All rats implanted with grafts for more than 40 min after CD（CD50 and CD60 groups） died within 7 d. Conclusions：WIT of the donor kidneys should be limited to less than 40 min for rat kidney graft from an uncontrollable CD donor；kidneys with WIT lasting for 30-40 min should be seriously considered for transplant.

Abstract:Objective：To investigate the relationship between aldosterone escape phenomena and left ventricular hypertrophy（LVH）in essential hypertension（EH） treated by angiotensin-converting enzyme inhibitor（ACEI） and angiotensinⅡ receptor inhibitor blocker（ARB）. Methods：Totally 95 cases of EH complicated with LVH were randomly divided into enalapril group（n=48） and irbesartan group（n=47）. AngiotensinⅡ（AngⅡ），aldosterone（Ald），interventricular septal thickness（IVST），left ventricular posterior wall thick－ness（PWT）and left ventricular end diastolic diameter（LVDD） levels were examined before therapy and at 1，3，6 months after thera－py. Results：（1）Levels of blood pressure were decreased in both groups and there was no significant difference between two groups（P >0.05）. （2）In enalapril group，AngⅡlevels were all decreased significantly（P <0.05） at 1，3，6 months after therapy. AngⅡlevels were slightly increased at 3，6 months after therapy compared with those at 1 month after therapy，but without statistical differences（P >0.05）. Ald levels were decreased significantly at 1 month after therapy compared with those before therapy（P <0.05） but they were increased at 3，6 months after therapy，reaching the levels before therapy（P >0.05）. In irbesartan group，AngⅡlevels were increased at 1 month after therapy compared with those before therapy，without statistical differences but they were increased at 3，6 months af－ter therapy compared with those before therapy，with statistical differences（P <0.05）. Levels of Ald were all decreased significantly at 1，3，6 months after therapy compared with those before therapy（P <0.05）. （3）IVST，PWT，LVDD levels were decreased in both groups after therapy compared with those before therapy（P ＜0.05） but there was no significance between two groups. Ald levels of some patients（19 patients in enalapril group and 2 patients in irbesar－tan group） were initially decreased but were increased after 3 months’ therapy compared with those before therapy，which was called Ald escape. LVH ameliorations of these paitents were quiet. Conclusions：Ald escape may occur in EH treated by ACEI and ARB. LVH ameliorations in these paitents with Ald escape phenomena are quiet.

Abstract:Objective：To investigate the expressions of nuclear factor with BRCT domain 1（NFBD1） in nasopharyngeal carcinoma and their clinical significances. Methods：Expressions of NFBD1 protein in 40 cases of nasopharyngeal carcinoma（NPC）tissues and 20 cases of chronic nasopharyngitis tissues were detected by immunohistochemical SP method. Expressions of NFBD1 mRNA in 34 cases of NPC tissues and 23 cases of chronic nasopharyngitis tissues were observed by qRT-PCR and their correlations with patients’gen－der，age，cervical lymphnode metastasis and clinic stage were analyzed. Results：Expressions of NFBD1 protein and mRNA were sig－nificantly higher in NPC tissues than in chronic nasopharyngitis tissues（ ?字2=9.600，P=0.002；t=3.206，P=0.002）. Expressions of NFBD1 mRNA in NPC tissues were not significantly correlated with patient’gender（t=0.937，P=0.356），age（t=0.382，P=0.698），cervical lym－phnode metastasis（t=1.037，P=0.322） and clinic stage（t=0.293，P=0.771）. Conclusions：Overexpression of NFBD1 may be involved in the tumorigenesis of NPC，but it is not significantly correlated with nasopharyngeal carcinoma invasion and metastasis.

Abstract:Objective：To investigate the expressions and significances of circadian clock gene Per1 in patients with oral squamous cell carcinoma（OSCC）. Methods：Expressions of Per1 in 38 cases of buccal squamous cell carcinoma and the adjacent non-tumor tissues were examed by immunohistochemical SP method and Western blot method and the significances of Per1 were studied combined with the clinicopathological parameters. Results：Expressions of Per1 were significantly decreased in buccal squamous cell carcinoma tis－sues than in adjacent non-tumor tissues（P=0.025）. In buccal squamous cell carcinoma，expressions of Per1 were significantly higher in stageⅠ，Ⅱ period and T1，T2 grade than in stage Ⅲ，Ⅳ period and T3，T4 grade（P=0.007）（P=0.030），meanwhile the expressions of Per1 were significantly higher in group without lymph node metastasis than in group with lymph node metastasis（P=0.008）. Ex－pression of Per1 was in no correlation with patients’ gender，age and pathological grade（P >0.05）. Conclusions：Expression of Per1 may play an important role in the development，invasion and metastasis of patients with OSCC，and may provide a new way of thinking for OSCC diagnosis，prognosis assessment and treatment.

Abstract:Objective：To observe the expressions of LINGO-1 in the brain of rats after exercise training and to explore the possible molecular mechanism of exercise training promoting neurological functional recovery after stroke. Methods：Middle cerebral artery oc－clusion（MCAO） model was made and rats were randomly divided into sham operation group，model group and exercise training group. Observation was made at 3，7，14 d after MCAO. Training method was treadmill exercise. Neurological functional recovery was evalu－ated by Longa’s score；expressions of LINGO-1 mRNA and protein were detected by imunohistochemistry and RT-PCR. Results：Sham group had no obvious neurological deficiency（Longa score was 0） but small amount of mRNA and protein expressions of LIN－GO-1. mRNA and protein expressions of LINGO-1 in model group were reached the peak at 3 d after MCAO and decreased gradual－ly later（P<0.05）. There was no difference in mRNA and protein expressions of LINGO-1 between exercise training group and model group at 3，7 d after MCAO（P >0.05）. Longa score and mRNA and protein expressions of LINGO-1 were decreased at 14 d after MCAO in exercise training group compared with those in model group（P<0.05）. Conclusions：Expressions of LINGO-1 in the is－chemic brain are increased significantly. Decreased neurological score and LINGO-1 mRNA and protein expressions induced by prop－er exercise training might be one of the molecular mechanisms of neural function recovery after acute cerebral infarction.

Abstract:Objective：To investigate the effects of high mobility group box 1（HMGB1） preconditioning on spinal cord ischemia reper－fusion injury（SCII） in rats. Methods：Various concentrations of HMGB1 were injected into lateral ventricle of male SD rats at 18 h before ischemia. SCII model was completed by clamping the abdominal aorta for 45 min according to modified Zivin. At 6，12，24 h after reperfusion，blood samples were collected to measure the levels of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） and the spinal cord segment was harvested to detect the activity of nuclear factor-κB（NF-κB） and expression of inhibitor κ B-α（IκB-α）. Meanwhile，functional evaluation on hind limbs was done and pathological change of spinal cord was observed. Results：Preconditioning with HMGB1 significantly improved the hind-limb motor function scores and increased the numbers of normal motor neurons，which was accompanied with reduction of levels of TNF-α and IL-6 in serum as well as degradation of IκB-α and activity of NF-κB in spinal cord. Conclusions：Preconditioning with HMGB1 protects spinal cord against ischemia-reperfusion injury by at－tenuating inflammatory response.

Abstract:Objective：To study the role of melatonin and vitamin E in protecting bladder tissues of diabetic rats from oxidative stress injury and complications caused by the imbalance between oxidants and antioxidants. Methods：Diabetic rat models were established through lumbar injection of streptozotocin and the rats were divided into three groups：diabetic control group，vitamin E treatment group and melatonin treatment group. Besides，another normal control group was brought in the experiment. Vitamin E（50 mg/kg） and melatonin（2 mg/kg） were respectively given to rats in vitamin E treatment group and melatonin treatment group. Rats in diabetic con－trol group and normal control group received 4% ethanol physiological saline with a dosage of 2 ml/kg once daily. After four weeks’ injection，changes in ultrastructures of the samples were observed by electron microscope and changes in malonaldehyde（MDA），glu－tathione（GSH） and superoxide dismutase（SOD） of the bladder samples were measured. Results：Results of electron microscope of di－abetic control group showed that mitochondrias of smooth muscle cells，vessel endothelial cells and mechanocytes were swelling and cavitating and thrombus-like structure was observed，which was much milder in vitamin E treatment group and melatonin treatment group than in diabetic group. Compared with those in normal control group，MDA of diabetic control group was distinctly elevated（P<0.01），while GSH（P<0.01） and SOD（P<0.01） were markedly lowered. After treatment with vitamin E and melatonin，MDA was obvi－ously declined（P<0.01），GSH（P<0.01） and SOD（P<0.01） were strengthened. Effects of melatonin on decreasing MDA and in－creasing GSH were much stronger than those of vitamin E（P<0.01），while there was no significant difference in enhancing SOD activity between melatonin and vitamin E（P=0.512）. Conclusions：Melatonin and vitamin E could regulate oxidative stress in the bladder tissues of diabetic rats and protect the mitochondrias of smooth musle cells，vessel endothelial cells and mechanocytes. The protective effect of melatonin is stronger than that of vitamin E.

Abstract:Objective：To explore the effects of epimedium total flavonoids on sex hormone in rats with polycystic ovary syndrome （PCOS）. Methods：Letrozole（1 mg/kg） was intragastrically administered in SD rats for 21 d to establish PCOS model. The PCOS rats were randomly divided into 5 groups（n=10）：PCOS model group，Diane-35 group（240 mg/kg），epimedium flavonoids group（50，100，200 mg/kg）. In addition，normal control group（n=10） was established. After continuous oral administration for 21 d，rat body weight and ovarian weight were measured and ovarian index was calculated. Serum testosterone（T），follicle stimulating hormone（FSH），estra－diol（E2），and luteinizing hormone（LH） were detected with radioimmunoassay. Results：Ovarian weight and ovarian indexes were sig－nificantly increased in PCOS group compared with those in normal control group（P<0.05）. Moreover，PCOS group had higher serum T，LH（P<0.001），LH/FSH（P<0.01） and lower E2 level（P<0.01）. After administration for 21 d，ovarian weight，ovarian index（P<0.05），serum T，LH（P<0.01） and LH/FSH（P<0.01） were decreased in 200 mg/kg epimedium flavonoids group compared with those in PCOS model group，but E2 level was significantly increased（P<0.01）. However，100 mg/kg and 50 mg/kg epimedium flavonoids had weak effects. Conclusions：Epimedium flavonoids can improve hyperandrogenism in PCOS rats，regulate LH/FSH，elevate E2 and improve ovarian function.

Abstract:Objective：To study the expressions of hypoxia inducible factor-1a（HIF-1a） and matrix metalloproteinases-9（MMP-9） in renal carcinoma tissues and to study their relationship with microvessel density（MVD） and tumor progression. Methods：Immunohis－tochemical staining was used to detect the expressions of HIF-1a and MMP-9 as well as angiogenesis in 60 cases of renal carcinoma tissues and 10 cases of adjacent normal kidney tissues and the relationships between HIF-1a，MMP-9，MVD and clinicopathological parameters were analyzed. Results：Positive expression rates of HIF-1a in renal carcinoma tissues and adjacent cancer tissues were 58.33% and 0% respectively；positive expression rates of MMP-9 in renal carcinoma tissues and adjacent cancer tissues were 63.33% and 20% respectively；mean values of MVD in renal carcinoma tissues and adjacent cancer tissues were （37.93±11.94）strip/HP and （22.30±7.89）strip/HP respectively. There were statistical significances in expressions of HIF-1a，MMP-9，MVD between renal carcinoma tissues and adjacent cancer tissues（P<0.05） and they were correlated with pathology classification and lymph node metastasis. Conclusions：Increased expressions of HIF-1a，MMP-9，MVD are found in renal carcinoma tissues. HIF-1a and MMP-9 are involved in the angiogenesis of renal carcinoma and are correlated with cancer invasion and metastasis. Combined detection of HIF-1a，MMP-9 and MVD can provide valuable index for judging invasion and metastasis of renal carcinoma.

Abstract:Objective：To investigate the relationship between transforming growth factor β1（TGFβ1） signaling pathway and respiratory tract infection induced inflammation and to explore the effects of TGFβ1 on immunological function of respiratory system. Methods：BACB/C mice fulfilling grade Ⅱ clean animal criteria were artificially infected with pseudomonas aeruginosa while TGFβ1 was blocked with LY364947（4-[3-（2-pyridinyl）-1H-pyrazol-4-yl]-quinoline）. Inflammation reactions of the infected mice and pathologi－cal changes of pulmonary tissue were histochemically evaluated when TGFβ1 was blocked and unblocked respectively. CD4 and CD8 levels were tested through Western blot. Results：Blocking of TGFβ1 obviously blunted the phosphorylation of p38（10% lower than the control levels），significantly intensified the inflammation reaction and increased the CD4 levels but didn’t affect CD8 levels. Conclusions：TGFβ1 has inhibitory effect on respiratory tract infection induced inflammation and TGFβ1 blockers may enhance the immune regulation of respiratory tract infection.

Abstract:Objective：To observe the effects and mechanism of dexamethasone intervention on variations of tumor necrosis factor-α（TNF-α）、interleukin-8（IL-8） and IL-10 in serum of rabbits with acute respiratory distress syndrome（ARDS） induced by oleic acid at different time points. Methods：Totally 40 rabbits were randomly divided into normal control group（n=8）， ARDS group（n=8） and dexamethasone-treated group（n=24）. Animal model of ARDS was established by intravenous injection of oleic acid to rabbits’veins through ear margin. Dexamethasone-treated group was subdivided into three groups（n=8） by injecting dexamethasone at differ－ent time points（instantly，1，2 h）. Levels of TNF-α，IL-8 and IL-10 in serum were measured using radioimmunoassay and enzyme linked immunosorbeng assay（ELISA）. Results：Levels of TNF-α and IL-8 in serum were significantly higher in ARDS group than in normal control group（P<0.01）. Level of IL-10 in serum was significantly lower in ARDS group than in normal control group（P<0.01）. After dexamethasone treatment，levels of TNF-α and IL-8 in serum were lowered while level of IL-10 in serum was increased. Levels of TNF-α，IL-8 and IL-10 in serum were statistically different between dexamethasone-treated group and ARDS group（P<0.01）. Differ－ent variations of TNF-α，IL-8 and IL-10 levels in serum were observed when dexamethasone was given at different time points. Conclusions：TNF-α，IL-8 and IL-10 may play an important role in the inflammatory process of oleic acid ARDS in rabbits. Dexam－ethasone may relieve lung injuries by intervening the secretion process of TNF-α，IL-8 and IL-10. At the same time，the possible re－lationships may exist between the progression of inflammation and the intervention time of dexamethasone.

Abstract:Objective：To compare the transfection efficiencies among adenovirus，lentivirus and Lipofectamine 2000 and to explore an efficient way for U937 cells transfection. Methods：U937 cells were transfected with Lipofectamine 2000-plasmid（pGPHI/GFP/Neo），adenovirus vector（Adv-GFP-NC） and lentivirus vector（LV-GFP-NC），respectively. Expressions of green fluorescence protein（GFP） were detected under fluorescence microscopy respectively at 48 h after Lipofectamine 2000 transfection，at 96 h after adenovirus vector（Adv-GFP-NC） transfection and at 96 h after lentivirus vector transfection. U937 cells were collected for GFP-positive cells count with flow cytometry. Meanwhile，Trypan blue staining was employed to determine the cell viability. Results：GFP-positive cells were rare in Lipofectamine 2000 group and adenovirus vector group，with percentages of GFP-positive cells less than 4%. But in lentivirus group，the percentage of GFP-positive cells was about 90%（multiplicity of infection=100）. Trypan blue staining showed that the ratios of living cells were significantly higher in adenovirus group and lentivirus group than in Lipofectamine 2000 group（P<0.01）. Conclu－sions：Lentivirus，other than Lipofectamine 2000 or adenovirus，can efficiently transfect exogenous genes into U937 cells for gene ex－pression and it is an ideal vehicle for U937 cell transfection.

Abstract:Objectives：To identify the risk factors for the sequelae in children with mycoplasma pneumonia pneumonia（MPP） and to provide instructions for the clinical therapy to minimize the risks of the sequelae. Methods：Clinical data of 875 children with MPP from September 2007 to September 2010 in the Children’s Hospital，Chongqing Medical University were retrospectively reviewed. Based on the findings of X-ray and/or CT scan，the subjects were divided into two groups：sequelae group（n=58） and control group（n=60）. Comparison was made between the two groups in age，fever course，wheeze，pleural effusion，complications，manifestation of pneumonia on X ray and/or CT scan，white blood cell count and C-reaction protein. Results：Incidences of fever course lasting more than 10 d，large pleural effusion，pneumonia located at the right upper lung，large patchy shadow and multiple system damage out of the lung were significantly higher in sequelae group than in control group（P<0.05）. Conclusions：Long fever course，large pleural effusion，pneumonia located at the right upper lung，large patchy shadow in the lung，multiple system damage out of the lung are the clinical risk factors for sequelae of MPP.

Abstract:Objective：To investigate the role of electrophysiological test and MRI in the diagnosis of Hirayama disease. Methods：Ｃlinical features，electrophysiological characteristics and MRI findings of 14 patients with Hirayama disease were retrospectively re－viewed. Results：All symptomatic upper limbs had normal sensory nerve conduction velocity and motor nerve conduction velocity in the median and ulnar nerves. Compound motor active potentials（CMAPs） were normal in median nerve. Ulnar nerve CMAPs were de－creased by 20% of the normal value in 8 patients. Fourteen patients had neurological damage in muscles innervated by lower cervi－cal anterior horn cells（C7-8，T1） in the symptomatic limbs. Four patients had neurological damages in the symptomatic upper limbs. Seven patients had neurological damages in both upper limbs. Three patients had diffused neurological damages. No abnormality was observed in 10 patients according to MRI of cervical vertebra at normal physiological position. Four patients had atrophy of the cervi－cal and thoracic spinal segments. MRI of cervical vertebra at head-down position indicated anterior displacement of dura mater in the cervical and thoracic spinal segments in 14 patients with spinal cord being compressed and atrophic. Conclusions：Most patients with Hirayama disease have anterior horn damage in the lower cervical spinal segment on electromyography. Electrophysiological exam is important in the diagnosis of Hirayama disease. Diffused neurological damage could also be noticed in patients with Hiraya－ma disease. All patients with suspected Hirayama disease should have MRI scan of the cervical spinal cord at both normal physiological position and head-down position.

Abstract:Objective：To analyze the effects of fluor protector on microhardness and morphology of cold light bleached enamel. Meth－ods：Totally 40 premolars extracted for orthodontic reasons were selected，whose buccal surfaces were made into enamel slabs（5 mm×5 mm）. Those enamel slabs were subjected to group A，B，C and D randomly. Group A’s microhardness before bleaching，after bleach－ing and after using fluor protector were evaluated. Groups B，C and D were evaluated under scanning electronic microscopy. Group B was bleached，group C used fluor protector after bleaching and group D was taken as blank control group. Results：Microhardness of enamel was decreased significantly after bleaching compared with that before bleaching（P<0.05），microhardness of bleached enamel with fluor protector was higher than that without fluor protector，however，microhardness of enamel before bleaching and after using fluor protector were not statistically significant（P >0.05）. Scanning electronic microscopy（SEM） indicated the roughness of enamel surface was increased and some random depression spots became noticeable. After using fluor protector，the surface of enamel became less rough and sediments were seen. Conclusions：Using fluor protector after cold light bleaching makes the microhardness and mor－phology of enamel recover quickly.

Abstract:Objective：To observe the relationship among resistance index（RI） of transvaginal color Doppler flow imaging（TV-CD－FI），tumor angiogenesis evaluation criterion-microvessel density（MVD） and clinical stage，to evaluate carcinoma angiogenesis from different perspectives and to discuss the value of TV-CDFI in cervical cancer diagnosis and prognosis. Methods：Hospitalized pa－tients from the Maternal and Child Health Hospital of Guiyang were divided into the 2 groups：cervical cancer group（n=30） and con－trol group（n=30）. Patients in cervical cancer group were confirmed by pathology and were subdivided into two groups（n=15） accord－ing to clinical stage Ⅰ and Ⅱ. Patients were examined by TV-CDFI before operation. Morphological features of tumors，arterial blood flow signals within tumors and RI were recorded for later analysis. RI of uterine arteries was measured in control group. Cervical tis－sue slice were made by using excised cervical specimen of patients. Immunohistochemistry Envision method was adopted to detect MVD levels in cervical tissues in cervical cancer group and control group. Results：RI values detected by TV-CDFI were decreased significantly and CD34 marked MVD levels were increased markedly in cervical cancer group compared with those in control group，with statistical differences（P<0.05）. MVD and RI in cervical cancer group showed negative linear correlation（rs=-0.56，P<0.05）. Clini－cal stage Ⅰ and stage Ⅱ in cervical cancer were positively correlated with RI values，P<0.05，but not with MVD levels. Conclusions：Angiogenesis characteristics of cervical cancer can be reflected by RI and MVD，which are negative correlated.With the advantages of higher sensitivity，non-invasive，repetable and preoperation acquisition，RI is more effective in detecting angiogenesis of cervical can－cer than TV-CDFI and has greater values in clinical application.

Abstract:Objective：To determine the clinical value of transarterial chemotherapy embolization（TACE） plus high-intensity focused ultrasound（HIFU） in the treatment of hepatocellular carcinoma at middle-late stage. Methods：Totally 138 patients with hepatocellu－lar carcinoma at middle-late stage were devided into two groups. Patients in treatment group were treated by TACE plus HIFU while those in control group were treated by TACE only. Therapeutic effects were observed. Results：Symptoms and signs were allivated，tu－mor size was narrowed and 3-year survival rate was improved in treatment group compared with those in control group，with statisti－cally differences between the two groups（P<0.05）. Conclusions：TACE plus HIFU is an effective treatment method for hepatocellular carcinoma at middle-late stage.

Abstract:Objective：To analyze the results of the 75 g oral glucose tolerance test（OGTT） in gestational diabetes mellitus （GDM） at 6 weeks after delivering and to investigate the relationships between the results of OGTT and adiponectin，pregnancy related index. Methods：Clinical data of 36 women with GDM in our hospital from 2011 April to 2011 November were collected and retrospectively analyzed. According to the results of 75 g OGTT at 6 weeks after delivering，the patients were reclassified into two groups：normal group（Ⅰ group） and abnormal group（Ⅱ group）. Levels of leptin，adiponectin and fasting insulin were detected and pregnancy relat－ed index and 6 weeks postpartum glucose metabolism were analyzed. Results：According to the results of pregnancy related index，inci－dence of family diabetes history was lower in Ⅰ group than in Ⅱ group（P<0.05） and the mean GDM diagnosing time was significant－ly later in Ⅰ group than in Ⅱ group（P<0.05）. There was no significant difference in pregnant age，pregnant BMI，fasting blood glu－cose level when making definite diagnosis between two groups（P >0.05）. Based on the clinical indicators，level of postpartum fasting blood glucose was much lower in Ⅰ group than in Ⅱgroup（P<0.05） and the mean leptin concentration was significantly higher in Ⅰ group than in Ⅱ group（P<0.05）. There was no significant difference in age，BMI，fasting insulin level，adiponectin and homeostasis model assessment-insulin resistance（HOMA-IR） between two groups（P >0.05）. Multiple Logistic regression model showed that the leptin concentration was negatively correlated with fasting blood glucose（R=-0.51，P=0.02） and was positively correlated with HOMA-IR（R=0.7，P=0.003）. There was no significant correlation between BMI，age，adiponectin and fasting blood glucose，HOMA-IR. Conclusions：（1）Fasting blood glucose is much lower inⅠ group than in Ⅱ group while leptin concentration is significantly high－er in Ⅰ group than in Ⅱ group.（2）Leptin concentration is negatively correlated with fasting blood glucose but is positively correlated with HOMA-IR. Leptin could act on GDM through the varying of HOMA-IR and increased postpartum leptin level can be a new target in recovery of GDM in the future. （3）There was no significant correlation between adiponectin and BMI，fasting blood glucose. （4）Dignosing time of GDM and family history of diabetes mellitus are the risk factors that trigger postpartum abnormal blood glucose of GDM patients.

Abstract:Objective：To improve the diagnosis for atypical parathyroid adenoma（APA） by exploring the clinical and pathological manifestations of APA. Methods：Clinical data of 11 cases of APA in our hospital were retrospectively studied. The diagnosis was confirmed by operation and pathology. Eighty-one patients with parathyroid adenomas were admitted between January 1993 and March 2010，among which 11 patients（13.6%） were diagnosed as APA （7 males，4 females；aged 22-68 year-old with an average of （39.4±13.1） year-old）. Results：There were 7 patients（63.6%） with bone disorders and 4 patients（36.4%） with bone and urinary disorders among 11 patients with APA.Serum level of calcium was raised in 10 patients，phosphorus was decreased in 9 patients and parathyroid hormone（PTH） was elevated in all patients.Histological findings were as follows：incomplete invasion of the capsule（8 patients/11 patients），focal infiltration into the fibrous connective tissue of the tumor（1 patient/11 patients），trabecular growth pattern （2 patients/11 patients），thick fibrous bands（3 patients/11 patients），atypia or mitotic figures（5 patients/11 patients） and no clear tu－mor capsule（1 patient/11 patients） were observed. Eight patients were followed up for 8-47 months，averaged （19.0±13.1） months；2 recurrent patients（25%） were observed and 1 patient developed parathyroid carcinoma proved by pathological diagnosis.Another 1 patient was found with recurrent hypercalcemia，high PTH level and ultrasonography revealed a nodule in the thyroid region，but the patient refused another surgery. Conclusions：Among considerable cases of parathyroid neoplasms，it is hard to judge the benign and malignant tumor at the initial diagnosis. Clinical manifestations of this group are in accordance with the characteristics of hyper－parathyroidism. Because of the risk of recurrence and malignancy of APA，vigilant follow-up by serum biochemistry and imaging ex－amination is recommended.

Abstract:Objective：To explore emergency treatment strategies for patients with brain hernia combined with hemorrhagic shock after severe traumatic brain injury and to discuss their effects on prognosis． Methods：A retrospective analysis was made on 32 patients（ob－servation group） with brain hernia combined with hemorrhagic shock treated by selective strategies on the basis of integrative strate－gies from September 2009 to April 2011；another 22 patients（control group） with the same injuries were treated by routine strategies. Mortality within one week and glasgow outcome score（GOS） at six months after injury were compared between two groups. Results：Mortality rate was 34.4%（11/32） in observation group and 45.5%（10/22） in control group two weeks later（P >0.05）. GOS disability rating（Ⅰ，Ⅱ level） were higher in observation group than in control group at six months after injury；GOS disability rating（Ⅲ，Ⅴ level） were lower in observation group than in control group at six months after injury（ ?字2=4.909，P=0.027）. Conclusions：Early se－lective strategies based on degree of shock combined with integrative strategies may obtain better outcome for patients with brain her－nia combined with hemorrhagic shock after severe brain injury.

Abstract:Objective：To investigate the relationship between serum levels of leptin，fatty acid synthase（FAS），estrogen（E） and cardio－vascular calcification. Methods：Totally 187 patients were divided into two groups by coronary angiography：coronary heart disease group （n=98，53 males and 45 females） and non-coronary heart disease group（n=89，47 males and 42 females）. Coronary artery cal－cification scores were calculated respectively in two groups. Meanwhile，serum levels of leptin，FAS，E，triglyceride（TG），total cholesterol（TC），C-reactive protein（CRP），low density lipoprotein-cholesterol（LDL-C），high density lipoprotein-cholesterol（HDL-C），P3- and Ca2+ of the two groups were measured by radioimmunoassay. Results：Serum leptin and FAS concentrations as well as coronary artery calcification scores were significantly higher in coronary heart disease group than in non-coronary heart disease group（P<0.05）. But the serum level of E was lower in coronary heart disease group than in non-coronary heart disease group（P<0.05）. Level of cardiovascular calcification was positively correlated with leptin（r=0.640，P<0.05），FAS（r=0.420，P<0.05），TG（r=0.120，P<0.05），TC（r=0.179，P<0.05），CRP（r=0.125，P<0.05） but negatively with E（r=-0.453，P<0.05） and HDL-C（r=-0.110，P<0.05）. Stepwise multiple regression analysis showed that factors of leptin，FAS，E，TG，TC and HDL-C entered the regression equation. Conclusions：Serum level of E is lower in those with coronary heart disease，which suggests that E may protect cardiovascular by antagonizing vas－cular calcification. Serum leptin and FAS concentrations of those with coronary heart disease are significantly increased indicating that leptin and FAS may promote the development of cardiovascular calcification.

Abstract:Objective：To discuss the risk of cerebral thrombosis after implantation of metal stent via cerebral vascular intervention. Methods：Clinical data of 87 patients who underwent implantation of metal stent via cerebral vascular intervention in our department during 2009-2010 were retrospectively summarized，and the postoperative conditions were followed for 2 years. Serum D-dimer level and platelet level were monitored. Risk factors of new cerebral infarction at acute，subacute and advanced stages were tested by single factor analysis and Logistic regression. Results：There were 11 cases（12.64%） with new cerebral infarction after metal stent implanta－tion，7 at acute and subacute stages while 4 at advanced stage. Not taking aspirin on schedule，renal dysfunction，history of heart stent disease，higher level of platelet aggregation were high risk factors of new cerebral infarction at acute and subacute stages（P<0.05 or P≈0.05），while hypertension，not taking aspirin on schedule，diabetes，hyperlipidemia were high risk factors of cerebral thrombosis for－mation at advanced stage（P<0.05）. Failure to take aspirin on schedule was the independent risk factor at all stages. Conclusions：Regular using of anti-platelet aggregation therapy may reduce the risk of ischemic stroke after metal stent implantation via cerebral vascular intervention.

Abstract:Objective：To systematically evaluate the efficacy of primary closure（PC） versus T-tube drainage（TD） in laparoscopic common bile duct exploration（LCBDE） in the treatment of choledocholithiasis. Methods：Clinical trials，which compared the effi－cacy of PC versus TD LCBDE in the treatment of choledocholithiasis were electronically searched from the Cochrane Library，PubMed，EMbase，CBM，CNKI data bases from 2000 to 2012 and the RevMan 5.0 software was used for data analysis. Results：Five trials with 572 patients were included. Meta-analysis revealed that there was no significant difference in incidences of biliary related complications between PC and TD groups（RR=0.87，95%CI[0.46，1.63]，P=0.66）. Operating time（WMD=-28.66，95%CI[-34.00，-23.32]，P<0.000 01），postoperative hospitalization duration（WMD=-3.03，95%CI[-3.85，-2.47]，P<0.000 01） and total complication incidences（RR=0.55，95%CI[0.34，0.89]，P=0.01） were decreased in PC group compared with those in TD group. Conclusions：PC in LCBDE is safe and effective；it is a preferred option in the treatment of choledocholithiasis.

Abstract:Objective：To systematically review the advantages of minimally invasive percutaneous nephrolithotomy（MPCNL）. Meth－ods：Randomized controlled trials of minimally invasive and standard percutaneous nephrolithotomy were retrieved and their included references were investigated. Data analysis of literatures meeting the inclusion criteria was performed with the Cochrane Collaboration’s RevMan 5.0 software. Results：Five literatures were finally retrieved after screening and a total of 726 patients were included for Meta-analysis. Results showed that the patients in experimental group had the following features as compared with those in control group：①remarkable improvement of the calculi clearance rate（95%CI[1.00-1.21]，P=0.04）；②obvious decrease of the complication inci－dence（95%CI[0.40-0.79]，P=0.000 9）. Conclusions：With higher clearance rate，lower complication incidence，MPCNL is safer and more effective than standard percutaneous nephrolithotomy in treating upper urinary tract calculi. As the literatures and samples in this study are limited，high quality trials with lager sample and longer follow-up are recommended in order to provide reliable evidences for clinical application of MPCNL.

Abstract:Objective：To systematically review and evaluate the effctiveness of ultrasonic and monopolar electrosurgical scalpel in la－paroscopic cholecystectomy. Methods：Randomized clinical trials related with ultrasonic or monopolar electrosurgical scalpel used in laparoscopic cholecystectomy with adult patients of symptomatic gallstone disease were searched from PubMed，Cochrane library，EMbase，Ovid，CNKI，WanFang and VIP. Two reviewers independently assessed the quality and extracted the data. All data were ana－lyzed by using RevMan 5.1. Results：Ten trials with a total of 1 199 patients met the inclusion criteria（604 patients in ultrasonic scalpel group and 595 patients in electrosurgical scalpel group）. Meta analysis showed that compared with those in monopolar electro－surgical scalpel group：①average operating time was significantly shorter in ultrasonic scalpel group（WMD（-11.75），95%CI[-16.61，-6.89]，P<0.000 01）；②gallbladder perforation rate was lower in ultrasonic scalpel group（RR 0.40，95%CI[0.31，0.51]，P<0.000 01）；③average intraoperative blood loss was less in ultrasonic scalpel group（WMD（-24.38），95%CI[-40.88，-7.89]，P=0.004）；④av－erage hospital duration was shorter in ultrasonic scalpel group（WMD（-0.40），95%CI[0.68，-0.11]，P=0.006）；⑤visual ana－logue scale scores at 24 h postoperatively was significantly lower in ultrasonic scalpel group（WMD（-1.12），95%CI[-1.23，-1.01]，P<0.000 01）；⑥the postoperative complication risk was lower in ultrasonic scalpel group（RR 0.47，95%CI[0.25，0.88]，P=0.02）. How－ever，there was no statistical difference in rate of conversion to open surgery between the two groups（RR 0.54，95％CI[0.23，1.27]，P=0.16）. Conclusions：Ｒesults show that ultrasonic scalpel can shorten the operating time，reduce gallbladder perforation rate，blood loss，postoperative 24 h visual analogue scale scores and postoperative complication rate for patients with non-acute calculous chole－cystitis underwent elective laparoscopic cholecystomy. Because of the limits of the sample and quality of included studies，this con－clusion has to be verified with more strictly designed large scale randomized controlled trials.