Background:Emerging evidence suggests a link between metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiac arrhythmia. This study aims to investigate the potential relationship between MASLD and atrial fibrillation (AF). Methods:This retrospective cohort study included 8511 participants (age > 65 years) without a history of cardiovascular diseases, cancer, or severe kidney dysfunction. MASLD was diagnosed using hepatic ultrasound in the presence of at least one cardiometabolic risk factor. Poisson regression models were employed to estimate the relative risk (RR) of AF, adjusting for potential confounders. Results:Participants were categorized into MASLD (n = 3,926) and non-MASLD (n = 4,585) groups. During a mean follow-up period of 3.65 ± 1.20 years, 307 participants with MASLD developed AF, however, the number in the non-MASLD group was 144 (incidence rate 7.82 % vs. 3.14 %). After adjusting for multiple cardiovascular risk factors, MASLD was associated with increased risk of AF (RR = 1.55, 95 %, confidence interval (CI): 1.12-2.13). Positive correlations were observed between age, body mass index (BMI), systolic and diastolic blood pressure, low-density lipoprotein levels, and AF risk. Subgroup analysis revealed a stronger association between MASLD and AF in participants with BMI < 24 kg/m2 (P < 0.01). Conclusion:This study highlights a significant association between MASLD and an increased risk of developing AF. The elevated risk in patients with MASLD may involve mechanisms extending beyond traditional cardiometabolic factors, particularly in individuals with lower BMI. Further experimental research is warranted to elucidate the underlying pathways linking MASLD and AF.

Objective:The aim of this study was to determine serum I-309 levels in type 2 diabetes mellitus (T2DM) patients, as well as the association with clinical/laboratory phenotypes and disease complications. Methods:A total of 155 T2DM patients and 30 healthy controls (HC) were enrolled. The concentrations of serum I-309, interleukin-4 (IL-4), IL-6, IL-10, IL-12, IL-17, IL-23, tumor necrosis factor-α (TNF-α), and interferon (IFN)-γ were measured. The relationships between I-309 and various clinical and laboratory variables were analyzed. Results:The serum concentrations of I-309 were significantly higher in T2DM patients than in HC (P < 0.001). The serum I-309 levels were significantly elevated in T2DM patients with diabetic kidney disease (DKD), hypertension, coronary artery disease, peripheral neuropathy, peripheral artery disease, and diabetic ketosis (all P < 0.05), but reduced in drinkers (P = 0.018). The Spearman analysis showed that serum I-309 correlated positively with age, disease duration, CKD stages, urea, creatinine, urinary albumin-to-creatinine ratio, C-reactive protein, red blood cell distribution width, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, IL-6, IL-12, and IFN-γ, but negatively with estimated glomerular filtration rate (eGFR), fasting blood glucose, total bilirubin, albumin, lymphocyte count, red blood cell count, and hemoglobin. The multiple linear regression analysis indicated that serum I-309 was independently correlated only with eGFR and IFN-γ. The multivariate logistic regression analysis demonstrated that serum I-30 and IL-17A remained independently associated with DKD. Conclusion:Serum I-309 is markedly elevated in T2DM patients and is associated with increased DKD risk, suggesting its potential role as both a promising biomarker and a pathogenic mediator in the progression of T2DM, particularly DKD.

The aim of this study was to determine serum I-309 levels in primary Sjögren’s syndrome (pSS) patients, as well as the association with disease phenotype, systemic activity, and T helper cell-related cytokines. A total of 58 pSS patients and 30 healthy controls (HC) were enrolled in this study. The concentrations of serum I-309, interleukin-4 (IL-4), IL-6, IL-9, IL-13, IL-17, IL-22, IL-23, tumor-necrosis factor-α (TNF-α), interferon-γ (IFN-γ), IFN-α, and IFN-β were measured with multiplex immunoassay. The relationships between I-309 and various clinical and laboratory variables were analyzed. The serum concentrations of I-309 were significantly increased (median, IQR, 14.24, 10.99-–20.35, pg/ml) in pSS patients compared with HC (median, IQR, 8.27, 6.74-–9.62, pg/ml) (P < 0.001). Serum I-309 is increased in pSS, and may be associated with systemic inflammation, Th1-, Th17,- and Th9 cells, type

ObjectiveAlzheimer’s Disease (AD) is increasingly recognized as being associated with metabolic disorders, including Metabolic Associated Steatotic Liver Disease (MASLD). This study aimed to assess the relative risk of AD in individuals with MASLD.MethodsIn this retrospective cohort study, we analyzed data from individuals aged over 65 who underwent health check-ups between January 2018 and June 2023. MASLD was diagnosed based on ultrasound findings and cardiometabolic criteria. AD incidence was identified using ICD-10 codes and self-reports. Poisson regression models estimated the relative risk of AD in relation to MASLD, adjusting for age, BMI, sex, SBP, HbA1c, HDL-c, triglycerides, hs-CRP, GGT, and estimated GFR.ResultsThe study included 4,582 MASLD patients and 6,318 controls. MASLD patients showed a higher incidence of AD (127 cases) compared to controls (61 cases). The fully adjusted Poisson regression model indicated an increased AD risk in MASLD patients [RR: 2.80 (95% CI: 1.79-4.38)].ConclusionOur findings suggested MASLD as an independent risk factor for AD, underlining the role of metabolic dysfunctions in AD pathogenesis. The study emphasized the need for comprehensive metabolic health management in AD prevention strategies, particularly among high-risk groups.

Background and AimMany studies reported the prevalence of extrahepatic conditions (EHC) of primary biliary cholangitis (PBC), but the great heterogeneity existed across different studies. Therefore, we conducted the systematic review and meta-analyses to determine EHC prevalence and association with PBC.MethodsWe searched PUBMED and included observational, cross-sectional and case-controlled studies. A random or fixed effects model was used to estimate the pooled prevalence and odd ratio (OR) as appropriate.ResultsOf 5370 identified publications, 129 publications with 133 studies met the inclusion criteria. Sjögren's syndrome had the highest prevalence (21.4% vs. 3% in non-PBC individuals), followed by Raynaud's syndrome (12.3% vs. 1%), rheumatoid arthritis-like arthritis (5% vs. 3%), systemic sclerosis (3.7% vs. 0%) and systemic lupus erythematosus (2% vs. 0%). The prevalence of overall thyroid diseases (11.3%), autoimmune thyroid diseases (9.9%), osteoporosis (21.1%), celiac disease (1%) and chronic bronchitis (4.6%) was also increased among PBC patients.ConclusionThis is the first exhaustive study on the old theme about EHC of PBC. Given increased prevalence of many EHCs in PBC patients, promptly recognizing these EHCs are of great importance for timely and precise diagnosis of PBC.

The exposure to an unhealthy environment in utero can lead to the occurrence of cardiovascular diseases in the offspring. Glucocorticoids (GC) are essential for normal development and maturation of fetal organs and is a first-line treatment for pregnant women affected by autoimmune diseases. However, excess prenatal GC exposure might program the development of fetal organs and cause a number of chronic diseases in later life. Our previous studies indicated that cardiac functions were significantly compromised in rat offspring prenatally exposed to the synthetic glucocorticoid dexamethasone (DEX), only after ischemia–reperfusion. In the present study, we further observed that DNA hypermethylation of bone morphogenetic protein 4 (Bmp4) promoter in cardiomyocytes caused by prenatal DEX exposure substantially dampened the binding activity of transcription factor HIF-1α induced by cardiac ischemia. Therefore, prenatal DEX exposure inhibits the induction of BMP4 upon I/R and attenuates the protective effects of BMP4 in cardiomyocytes, which eventually manifests as malfunction of the adult heart. Moreover, we employed two cardiac-specific Bmp4 knock-in mouse models and found that in vivo BMP4 overexpression could rescue the cardiac dysfunction caused by prenatal GC exposure. In depth mechanistic research revealed that BMP4 protects the cardiomyocytes from mitophagy and apoptosis by attenuating mitochondrial PGC-1α expression in a p-Smad and Parkin-dependent manner. These findings suggest that prenatal GC exposure increases the susceptibility of the offspring’s heart to a “second strike” after birth, due to the failure of hypoxia-induced HIF-1α transactivation of the hypermethylated Bmp4 promoter in cardiomyocytes. Pretreatment with the DNA methylation inhibitor, 5-Aza-2′-deoxycytidine, could be a potential therapeutic method for this programming effect of GC exposure during pregnancy on neonatal cardiac dysfunction.

BackgroundThere is a lack of single marker reflecting systemic activity of primary Sjögren's syndrome (pSS). Our aim is to determine the association between interleukin(IL)-7 and pSS by combining a single-center study and a systematic scoping review.MethodsThere were 58 patients with pSS and 30 healthy controls (HCs) included in the single-center study. The multiplex immunoassay was used for detecting concentrations of IL-7, IL-4, IL-9, IL-10, IL-17, interferon(IFN) -γ, INF-α and INF-β in sera. pSS patients were evaluated for systemic activity in accordance with the European League against Rheumatism SS Disease Activity Index (ESSDAI). In the systematic scoping review, all studies regarding association of IL-7 with pSS were included.ResultspSS patients showed higher serum IL-7 levels (P = 0.028 vs HCs) which were associated with neutrophil, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphacyte ratio(PLR), red blood cell distribution width(RDW), erythrocyte sedimentation rate(ESR), immunoglobulin(Ig)G, C-reactive protein (CRP), fever, lymphadenopathy and ESSDAI. Serum IL-7 correlated with Th cell related cytokines. Findings of the systematic scoping review on 15 articles were as follows. Firstly, IL-7 expression in salivary glands (SGs), serum and saliva increased in pSS, while IL-7 receptor(IL-7R) expression increased in SGs but decreased in peripheral blood. Secondly, increased IL-7 was mainly from SGs of pSS patients, but whether IL-7 was mainly produced by SG epithelial cells remained to be validated. Thirdly, IL-7 could exert a key role in pSS immunopathology. Although IL-7 had no direct effect on SGECs, it could activate B and T cells and stimulate secretion of IL-17, IL-4 and IFNs.ConclusionNot only are IL-7 and soluble IL-7R potential biomarkers for monitoring pSS activity, but also targeting IL-7/IL-7R pathway may be a promising therapeutic strategy.

Placenta is the only link between the pregnant woman and fetus, and the basis for maintaining the normal pregnancy process and fetal development. Maternal stress is the maternal physiological and psychological changes caused by various factors, characterized by the increased level of glucocorticoid, which affects the hypothalamic-pituitary-target gland axis and regulates the expression of target genes. Maternal stress also changes the weight, metabolism and nutrient transportation of the placenta, which will substantially influence the development of fetus. This paper will firstly summarize the characteristics of maternal stress and its influence on offspring. Then, the changes in the body under maternal stress will be described. Finally, we will clarify the proven mechanisms underlying maternal stress and raise some important problems that have not been clarified in this area. The study of maternal stress on fetus and its underlying mechanisms will serve as theoretical basis for the diagnosis and treatment of the stress-related pregnant diseases and disorders.

Background: There is now no single score or marker useful for evaluating disease activity of primary Sjogren's syndrome (pSS). This study was designed to explore the associations of circulating YKL-40, interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) with systemic activity and phenotypes of pSS. Methods: This study included 58 pSS patients and 30 healthy controls (HC). The sera were measured by multiplex immunoassay for YKL-40, IL-6 and TNF-alpha concentrations. The disease activity of pSS patients was evaluated by European league against rheumatism (EULAR) SS disease activity index (ESSDAI). Local severity was assessed in accordance with the Tarpley score. Results: Serum YKL-40, IL-6 and TNF-alpha levels significantly elevated in pSS patients compared with those in HC (all P < 0.001). These cytokines correlated with ESSDAI, ESR, CRP, and IgG (all P < 0.05). Serum YKL-40 level correlated markedly with age (r = 0.405, P = 0.002), neutrophil count (r = 0.399, P = 0.002) and neutrophil-to-lymphocyte ratio (NLR) (r = 0.401, P = 0.002), while IL-6 did weakly with NLR (r = 0.296, P = 0.024) and C3 (r = 0.288, 0.036). Serum levels of all three cytokines were substantially lower in patients with eye/mouth dryness vs. those without (all P < 0.05). Additionally, patients with pulmonary, renal involvement or anemia had remarkably higher concentrations of YKL-40 (all P < 0.05), while those with leukocytopenia had lower levels (P = 0.01). Fever or anemia patients showed higher serum concentrations of IL-6 (both P < 0.05), while serum levels of TNF-alpha were much higher in patients with presence of ANA, anti-SSA or anti-SSB antibodies (All P < 0.05). Serum IL-6 level correlated strongly with YKL-40 (r = 0.452, P < 0.001) and TNF-alpha (r = 0.743, P < 0.001) in pSS patients. A significant correlation was also found between YKL-40 and TNF-alpha (r = 0.308, P = 0.022). Conclusion: The circulating YKL-40, IL-6 and TNF-alpha levels increase in pSS, and all of them are significantly correlated with indicators (ESSDAI, ESR, CRP, and IgG) for systemic inflammation of pSS. Each cytokine is separately associated with specific pSS phenotype.

检验实习教学是检验医学专业学生从理论向临床实践过渡的阶段,是培养高素质、创新型检验人才的关键阶段.文章介绍检验实习教学的现状和问题,阐述检验实习生临床科研创新能力培养的重要意义,积极探索临床科研创新能力培养模式的实施方法,以更好地推动现代检验医学复合型人才的培养.

Concerning the first navigational practice for the military medical university students, a"united-separated"integrated training mode was carried out in the ocean-going navigation of a large-scale surface fleet of Chinese Navy, and achieved favorable effects. With the navigational practice as its premise, medical practice as its foundation and overall qualities promotion as its goal, this training mode proved to be an effective practical exploration on cultivating medical service talents for a powerful navy.

The intra-uterine and external environmental factors not only affect the early development of fetuses, their interaction with genesis will also substantially program the physiological functions of offspring throughout life. Synthetic glucocorticoid (GC) is widely used for the management of women at risk of preterm birth or undergone autoimmune diseases. However, excess GC might cause a number of chronic diseases in later life. In the present study, we set up a programming rat model by daily injection of dexamethasone (DEX) since 14.5 dpc until labor, and found that the cardiac functions were significantly compromised in the male offspring compared with that exposed to NS, especially after ischemia/reperfusion (I/R), due to the increased infarction and apoptosis of myocardium. Using MeDIP sequencing, we identified four genes involved in the cardiac muscle cell differentiation and development pathway exhibited increased methylation in their promoter regions, among which, bone morphogenetic protein-4 (BMP4) expression is coordinately decreased in myocardium from male mice prenatally exposed to DEX. The programming effect of DEX on cardiomyocytes apoptosis was found to be dependent on mitochondria dysfunction, whereas the breakdown of mitochondrial membrane potential (ΔΨm) and the decrease of ATP production from mitochondria caused by prenatal DEX exposure both can be restored by BMP4 predisposing on neonatal cardiomyocytes 24 h prior to I/R. Inversely consistent with ΔΨm and ATP production, the release of reactive oxygen species was dramatically elevated in cardiomyocytes, which was significantly inhibited in the presence of BMP4 prior to I/R. These findings suggested that the excess GC exposure during pregnancy increases the susceptibility of male offspring’s heart to “second strike”, due to the decrease of BMP4 expression caused by the hypermethylation on Bmp4 promoter and the absence of BMP4 protective effect in cardiomyocytes, making the addition of BMP4 a promising treatment for the congenital heart disease under such circumstances.

This study was aimed to evaluate levels of neutrophil‐ (NLR), monocyte‐ (MLR), eosinophil‐ (ELR), and basophil‐lymphocyte ratio (BLR) and their association with inflammatory markers in systemic autoimmune rheumatic diseases (SARDs). A total of 1139 SARD patients and 170 healthy individuals were enrolled. Clinical and laboratory data were extracted. NLR and MLR were significantly increased, but BLR decreased in most SARD patients (p < 0.05). ELR were significantly decreased in systemic lupus erythematosus (SLE) patients, but increased in those with other SARDs (p < 0.001). In SLE patients, C‐reactive protein (CRP) showed positive correlation with NLR, MLR, and BLR. IgG negatively correlated with NLR, and did positively with ELR. IgM negatively correlated with NLR and MLR. In those with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoarthritis (OA), NLR and MLR positively correlated with erythrocyte sedimentation rate (ESR) and CRP. In primary Sjögren's syndrome (pSS) patients, ESR showed positive correlation with NLR and MLR. IgA had positive correlation with BLR. In polymyositis/dermatomyositis (PM/DM) patients, ESR and CRP positively correlated with NLR. Additionally, significant correlations were also found between CRP and BLR, IgG and ELR, IgM and ELR. In systemic sclerosis (SSc) patients, clear correlations were only observed between CRP and NLR or MLR. In mixed connective tissue disease (MCTD) patients, NLR positively correlated with ESR and CRP, while NLR and MLR did negatively with IgM. In polymyalgia rheumatic (PMR) patients, MLR positively correlated with CRP, while ELR did negatively with IgG. This study demonstrated increased NLR and MLR and deceased BLR in most SARDs, decreased ELR in SLE and increased ELR in other SARDs. Furthermore, NLR and MLR may be useful tools to reflect inflammatory status of SARDs.

AIM To explore the clinical significance of changes of chemerin and EDA-fibronectin (EDA-FN) in serum of patients with atherosclerosis (AS).METHODS One hundred and two AS patients were divided into severe AS group (sAS group) and mild AS group (mAS group) according to the degree of AS.Fifty healthy subjects were included as normal control group (normal group).ELISA was used to measure the contents of chemerin and EDA-FN in serum of the three groups.RESULTS Contents of chemerin and EDA-FN in serum of the sAS and mAS groups were significantly higher than those in the normal control group (P ＜ 0.05).Contents of chemerin and EDA-FN in serum of the sAS group were significantly higher than those in the mAS group (P ＜ 0.05).CONCLUSION Levels of chemerin and EDA-FN in serum of AS patients increase significantly compared with those in healthy subjects and the levels are positively correlated with the degree of AS.Detecting the contents of chemerin and EDA-FN in serum is helpful in clinical diagnosis and prognosis of AS patients.

This study was aimed to evaluate levels of neutrophil- (NLR), monocyte- (MLR), eosinophil- (ELR), and basophil-lymphocyte ratio (BLR) and their association with inflammatory markers in systemic autoimmune rheumatic diseases (SARDs). A total of 1139 SARD patients and 170 healthy individuals were enrolled. Clinical and laboratory data were extracted. NLR and MLR were significantly increased, but BLR decreased in most SARD patients (p < 0.05). ELR were significantly decreased in systemic lupus erythematosus (SLE) patients, but increased in those with other SARDs (p < 0.001). In SLE patients, C-reactive protein (CRP) showed positive correlation with NLR, MLR, and BLR. IgG negatively correlated with NLR, and did positively with ELR. IgM negatively correlated with NLR and MLR. In those with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoarthritis (OA), NLR and MLR positively correlated with erythrocyte sedimentation rate (ESR) and CRP. In primary Sjögren's syndrome (pSS) patients, ESR showed positive correlation with NLR and MLR. IgA had positive correlation with BLR. In polymyositis/dermatomyositis (PM/DM) patients, ESR and CRP positively correlated with NLR. Additionally, significant correlations were also found between CRP and BLR, IgG and ELR, IgM and ELR. In systemic sclerosis (SSc) patients, clear correlations were only observed between CRP and NLR or MLR. In mixed connective tissue disease (MCTD) patients, NLR positively correlated with ESR and CRP, while NLR and MLR did negatively with IgM. In polymyalgia rheumatic (PMR) patients, MLR positively correlated with CRP, while ELR did negatively with IgG. This study demonstrated increased NLR and MLR and deceased BLR in most SARDs, decreased ELR in SLE and increased ELR in other SARDs. Furthermore, NLR and MLR may be useful tools to reflect inflammatory status of SARDs.

BACKGROUND:Human epididymis protein 4 (HE4) is an available tumor biomarker for detecting ovarian cancer. However, it is unknown if serum HE4 could be a novel biomarker for diagnosis of lupus nephritis (LN) and chronic kidney disease (CKD) in patients with systemic lupus erythematosus (SLE).METHODS:This study enrolled 209 SLE patients, 75 patients with renal dysfunction without SLE and 32 healthy subjects. HE4 concentrations were analyzed by ELISA (enzyme-linked immunosorbent assay; Fujirebio Diagnostics, Sweden). The receiver operating characteristic (ROC) curves were constructed to assess diagnostic accuracy of HE4 for LN or CKD in SLE.RESULTS:Serum HE4 level was significantly higher in SLE patients than that in healthy controls (P < 0.001), especially for those with LN or CKD. It was also higher in patients with renal dysfunction without SLE than healthy controls (P < 0.001), while there was no significant difference between these patients and those with SLE with CKD (P = 0.73). Multivariate analysis showed significant association between increased HE4 and LN or CKD after controlling for confounders. ROC curves showed the cutoff values were 150.1 pM (sensitivity, 76.8%; specificity, 91.1%) for the diagnosis of LN in SLE and 233.9 pM (sensitivity, 92.9%; specificity, 93.5%) for CKD in SLE.CONCLUSIONS:Increased serum HE4 level is closely associated with the development of LN or CKD in SLE patients. Furthermore, it can be used as a novel and useful biomarker for diagnosis of LN or CKD.

目的 揭示妊娠期暴露于糖皮质激素(glucocorticoids,GCs)对子代大鼠心脏功能的印迹效应,探索GCs对子代心肌保护性因子的调节作用及其可能机制.方法 构建妊娠后期GCs暴露大鼠模型,通过2,3,5-氯化三苯基四氮唑(TTC)染色观察子代心肌缺血再灌注损伤后的梗死程度;实时定量PCR检测心肌保护因子血清和糖皮质激素调节的蛋白激酶1(Sgk1)、促肾上腺皮质激素释放激素(CRH)受体2(Crhr2)、CRH家族肽urocortin (Ucn)和Ucn2等基因的表达;蛋白质印迹分析检测SGK1蛋白的表达;亚硫酸氢盐处理后测序确定Sgk1基因启动子的甲基化水平.结果 妊娠期GCs暴露大鼠子代出生时和成年后体质量减轻(P＜0.01),子代雄性大鼠心肌对缺血再灌注损伤的耐受性下降(P＜0.01);SGK1的mRNA和蛋白在子代雄性大鼠心肌中的表达降低(P＜0.01或P＜0.05);Ucn和Ucn2在子代雌性大鼠心肌中的表达下降(P＜0.05);Sgk1基因启动子区域存在多个CpG岛,且近端CpG岛的甲基化水平在妊娠期GCs暴露的子代雄性大鼠心肌中升高(P＜0.01).结论 妊娠期GCs暴露可能通过下调心肌保护因子SGK1的表达对子代雄性大鼠心肌功能产生印迹效应,而Sgk1基因启动子区域CpG岛的高甲基化改变可能是介导GCs对Sgk1的印迹效应的重要机制.

目的:观察肉毒碱棕榈酰转移酶-1(CPT-1)的活性变化在饱和脂肪酸致乳鼠心肌细胞凋亡过程中的作用。方法:应用饱和脂肪酸棕榈酸盐(palmitate)处理乳鼠心肌细胞,使用CPT-1抑制剂(perhexiline)和CPT-1辅助因子左旋肉碱(L-carnitine)进行干预,采用流式细胞术观察心肌细胞凋亡变化情况。结果:palmitate组的细胞凋亡率较对照组(0.19±0.03vs0.07±0.02,P<0.01)及L-carnitine处理组(0.19±0.03vs0.14±0.02,P<0.01)显著升高,较perhexiline处理组(0.19±0.03vs0.29±0.03,P<0.01)显著下降。结论:心肌细胞对脂肪酸利用能力下降在palmitate诱导心肌细胞凋亡过程中具有重要意义。

Objective To detect the plasma endothelial lipase(EL) levels and the changes of EL levels after different hypoglycemic drugs therapy in type 2 diabetes rat.To explore the correlation of EL and type 2 diabetes mellitus,and evaluate the effect of different hypoglycemic drugs on the level of EL.Methods The type 2 diabetic rat model was set up by high-fat and high-sugar diet plus streptozotocin.Sixty adult male SD white rats were divided into two groups at random:the healthy control group(n = 15,HTL) and high-fat and high-sugar diet plus STZ-induced diabetic rats(n = 45),then the model rats were randomly divided into three groups:the diabetic group(n = 13,DM),insulin-treated DM group(n = 13,IDM) and gliclazide-treated DM group(n = 13,GDM).Body weight,fasting blood glucose,fasting insulin levels,insulin sensitivity index,triglycerides,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,C-reactive protein,EL were respectively measured at 1,9 and 13 weeks.Results At the end of 13 weeks,blood glucose in each group was measured.Compared with the HTL group,GDM group and IDM group,blood glucose in DM group increased obviously(P < 0.05),while there was no significant difference between IDM group,GDM group and HTL group(P > 0.05).At the end of 13 weeks,plasma EL levels were measured.Compared with the HTL group and IDM group,EL expression in DM group was significantly higher(P < 0.05),and there was no significant difference between IDM and GDM group(P > 0.05).EL expression in IDM group was significantly lower Compared with DM group(P < 0.05),but no significant difference was observed with HTL group(P > 0.05).Conclusions The expression of EL was significantly increased in type 2 diabetic rats.By insulin and gliclazide therapy,EL expression was not consistent.Insulin lowered blood glucose levels but also reduced EL,and gliclazide lowered blood glucose levels but did not reduce EL.The phenomena may be due to different regulation mechanisms of insulin and gliclazide for EL metabolism.

目的 探讨不同手术方式对长骨巨细胞瘤患者的治疗效果.方法 回顾分析1995年1月～2006年12月在我院骨科行手术治疗的长骨巨细胞瘤患者113例.Campanacci Ⅰ级17例,Ⅱ级58例,Ⅲ级38例.行囊内刮除术87例,其中囊壁处理使用苯酚22例,无水酒精46例,50%氯化锌19例.行囊外切除术26例.平均随访时间70.2个月(24～125个月).结果 刮除组共复发23例,切除术组复发2例.刮除组不同囊壁处理方式复发率差异无显著性意义(P=0.474).CampanacciⅢ级患者刮除术组和切除术组复发率差异有显著性意义(P=0.015).术后MSTS评分刮除组为26.5±2.9分,优良率97.2%.切除组为23.3±4.8分,优良率为85.4%.两组评分差异有显著性意义(P=0.006).结论 长骨巨细胞瘤患者应根据影像学分级,术后功能要求等不同因素个体化选择外科治疗方式.