Objective:To evaluate the relationship between red blood cell distribution width (RDW) and metabolic syndrome (MS) in patients with impaired glucose tolerance (IGT).Methods:A total of 415 patients with abnormal glucose tolerance were screened by oral glucose tolerance test in Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) from October 2015 to September 2019. General data were collected and blood routine and biochemical indexes were detected. There were 193 cases in the observation group and 222 cases in the control group. The RDW and other clinical indicators were compared between the two groups, the correlation between RDW and other indicators was analyzed, and the risk factors of metabolic syndrome were analyzed.Results:⑴ The RDW, systolic blood pressure (SBP), diastolic blood pressure (DBP), height (Ht), weight (Wt), waist circumferenc (Wc), triglyceride (TG), cholesterol (CHOL), low density lipoprotein (LDL), creatinine (Cr), uric acid (UA), alanine aminotransferase (ALT), high sensitive C-reactive protein (hs-CRP), body mass index (BMI) of the observation group were significantly higher than those of the control group, while the high density lipoprotein (HDL) was significantly lower than that of the control group, with statistically significant difference ( P<0.05); ⑵ correlation analysis showed that RDW was positively correlated with SBP, DBP, Ht, Wt, Wc, TG, CHOL, Cr, UA, ALT, hs-CRP, BMI, and negatively correlated with HDL ( P<0.05); ⑶ binary logistic regression analysis showed that RDW, Wt, Wc, CHOL, HDL, LDL and hs-CRP were independent risk factors for MS in patients with impaired glucose tolerance. Conclusions:The increase of RDW is a predictor of metabolic syndrome in people with abnormal glucose tolerance, which may provide some reference value for the prevention and treatment of metabolic syndrome.

Objective To investigate the expression difference of vascular endothelial growth factor (VEGF)between lung cancer and lung benign disease,and its relation to clinical characteristics and prognosis of non-small cell lung cancer(NSCLC),and to research the possible role of VEGF in the growth of lung can- cer.Methods The expression of VEGF and microvascular density(MVD)were detected in 60 lung cancer tissues and 30 lung benign disease tissues after operation by immunohistochemical method and put up statisti- cal analysis.Results The positive rate of VEGF expression(63%)and MVD(45.13?10.27)in lung cancer tissues were both higher than those in lung benign disease tissues(27%,33?6.49)(P

A 10 year-old female child developed erythema on the scalp,perioral area,neck,trunk,buttocks,palms and soles within 1 month after birth.Her skin was dry and rough,and the hairs were fine,soft,sparse and easily broken.As age advanced,typical hyperkeratosis and thickening of the skin occurred on an erythematous base.At the age of 5 years,the child developed photophobia and vision impairment.When the child was 8 years old,progressive hearing loss was observed.Physical examination revealed that the height and weight were 109 centimeters and 19 kilograms respectively.Skin examination showed fine,soft,sparse and easily-broken hair,large areas of brown plaques with crusts on the scalp,perioral area,neck,trunk and buttocks,and fissured,purulent and foul-smelling verrucous hyperplasia over these plaques.Brown to black hyperkeratotic plaques were scattered over the extremities,and diffuse hyperkeratosis occurred on the palms and soles.Both fingernails and toenails became thickened,cloudy and white with distal separation and deformation of the nail plate.As ophthalmic examination showed,the patient had photophobia,bilateral bulbar conjunctival hyperemia,corneal opacity and corneal vascular proliferation,and the visual acuity was 0.5 in the left eye and 0.2 in the right eye.Otolaryngological examination revealed moderate binaural sensorineural deafness.Stomatological examination showed enamel hypoplasia and diastema widening.Genetic testing showed a heterozygous mutation (c.C50T) in exon 2 of the gap junction protein beta 2 (GJB2) gene.Based on these clinical manifestations and examinations,the patient was diagnosed with keratitis,ichthyosis,and deafness (KID) syndrome.Skin lesions of the patient were significantly improved after the treatment with oral acitretin.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Objective To put forward a method for 3D electrical impedance finite element joint modeling and simulation using COMSOL for visual modeling and Visual C++ for programming.Methods A model was established with COMSOL,and then transformed into a.stl file and introduced into Visual C++ simulation platform.Delaunay tetrahedral mesh generation algorithm was used for finite element meshing,calculation and simulation,and joint modeling and simulation were realized finally.Results Simulation result showed that the method could be used to introduce COMSOL model and complete 3D finite element simulation.Conclusion The method proves its compatibility with the models generated by multi software and practicability for joint modeling and simulation.

Objective To explore dose-effect relationship of biomechanical parameters in treating atlantoaxial joint disor-der by slimming manipulation.Methods From October 2022 to May 2023,18 patients with atlantoaxial joint disorders were treated,including 10 males and 8 females;aged from 24 to 27 years old with an average of(25.50±l.10)years old;CT of cer-vical vertebra showed 16 patients with right side distortion and 2 patients with left side distortion.The mechanical parameters of treatment of atlantoaxial joint disorder by tendon relaxation manipulation were measured by wearing massage manipulation gloves.The magnitude,frequency and mechanical curve of force during tendon relaxation and starting force,pulling force,pulling time and mechanical curve during rehabilitation were quantified,the differences between the affected and contralateral manipulations were compared.Results The maximum force and frequency of Fengchi(GB20)on the affected side were(19.82±2.02)N and(116.83±14.49)times/min,and opposite side were(13.87±2.19)N and(188.89±16.03)times/min,re-spectively.There were statistically difference in the maximum force and frequency of both sides(P＜0.05).The maximum force and frequency of Quepen(ST12)on the affected side were(14.44±3.27)N and(139.06±28.47)times/min,and those on the opposite side were(9.41±1.38)N and(142.50±28.47)times/min.There was difference in maximum force on both sides(P＜0.05).The starting force,turning force and turning time of the affected side were(14.16±5.98)N,(11.56±6.63)N,(0.14±0.03)S,and the contralateral side were(8.94±3.39)N,(8.30±4.64)N,(0.18±0.04)S,respectively.The difference of starting force,turning force and turning time on both sides were statistically significant(P＜0.05).Conclusion By applying a light re-laxation force on the affected side,the mechanical balance between cervical vertebrae could be restored,and recovery trend of atlantoaxial joint disorder could be strengthened.On this basis,the atlantoaxial odontoid process could be reversed by applying a light rotation force,which reflects the characteristics of high safety of the manipulation.

Objective To establish a human-head phantom with realistic skull anatomy and resistivity distribution in order to provide an accurate experimental platform for brain electrical impedance tomography(EIT).Methods Firstly a skull model with 3-layer structure was constructed with double-nozzle 3D printer,and every layer had its specific resistivity verified on the accuracy. Then brain parenchyma with its resistivity was modelled using 3D printer and cerebrospinal fluid and scalp were mimicked using NaCl solution;after the whole phantom was assembled,imaging test using EIT was performed.Results The skull model was similar to the realistic one in terms of anatomy and resistivity distribution;the EIT experiment on the new phantom showed similar results to simulation.Conclusion The proposed phantom has realistic skull anatomy,resistivity distribution and multi-layer anatomical structure, which reflects the features of skull resistivity and thus is suitable for experiments on brain EIT.

Objective To propose a method for accurately controlling the resistivity of 3D printing materials to facilitate to establish a human-head volume conductor model.Methods Two kinds of ABS/CB composite conductive printing materials covering the resistivity ranges of parenchymal and skull were selected through resistivity measurement and analysis. The correlation between the proportions and resistivities of the two kinds of ABS/CB materials and the empirical formula on the correlation between the resistivity and proportion was obtained through exponential function fitting. Results The selected ABS/CB composite material behaved well in frequency stability and time stability,and the obtained empirical formula had high-correlation coefficient.Conclusion Accurate control of 3D printing model resistivity is realized,and it's facilitated to gain 3D printing material with the same resistivity as those of skull and parenchymal.

OBJECTIVETo determine the clinicopathologic characteristics and the relationship between related gene expression and pathobiologic behavior of pancreatic mucinous noncystic adenocarcinoma.

METHODSAmong the 249 pancreatic carcinoma cases from the department files, 6 tumors were identified to meet the pathologic criteria of colloid carcinoma. Envision immunohistochemical staining technique was used to detect expression of p21(ras), p21(WAF1), p16, p33(ING1), p53, ATM, MDM2, PCNA, Cyclins (D1, D3, A, B and E). Intra- and extra- cellular mucin production were determined by AB-PAS staining. Clinically, all of 6 cases were followed to June, 2003.

RESULTSIn all 6 cases, the tumors were located in the head of the pancreas and all displayed similar microscopic findings. Duodenal invasion was seen in 4 cases and perineural invasion was seen in 1 case. Tumor metastasis in the liver was seen in 2 cases and in the regional lymph nodes in 2 cases. Positive immunostaining was seen in 5 cases with p21(ras), 3 cases with p21(WAF1), 1 case with p16, 4 cases with p33(ING1), 2 cases with p53, 3 cases with ATM, 3 cases with MDM2, 6 cases with PCNA, 3 cases with cyclinA, 3 cases with cyclinD1, 4 cases with cyclinD3, 4 cases with cyclinB and 6 cases with cyclinE. Both extracellular and intracellular mucin was strongly positive for AB-PAS staining. Clinical follow-up found that 2 patients died of their tumors at 14 and 20 months. Three patients were alive after 28, 49 and 87 months of follow-up. One case were lost contact.

CONCLUSIONSPancreatic mucinous noncystic adenocarcinoma has distinct morphologic features and biologic behavior. Multiple gene products including many cyclins may be involved in the pathogenesis of pancreatic colloid carcinoma. The tumor has an aggressive behavior with a high frequency of invasion and metastases, though the prognosis could be better than that of ordinary ductal adenocarcinoma of pancreas.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; secondary ; Aged ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Duodenal Neoplasms ; pathology ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms ; metabolism ; pathology ; Prognosis ; Proto-Oncogene Proteins p21(ras) ; metabolism

OBJECTIVETo report a case of critical illness polyneuropathy (CIP) with Parkinson disease and discuss the development, clinical features and early diagnosis of this condition.

METHODSThe clinical data of a patient with CIP and Parkinson's disease and the relevant literature were reviewed.

RESULTSThis case showed no typical disease course of sepsis, and the condition exacerbated rapidly. The patient presented initially with abnormal homeostasis, followed by rapid onset of respiratory muscle weakness to require mechanical ventilation, but no limb weaknesses were detected. Intravenous antibiotics and aggressive treatment of sepsis did not produce any positive responses to wean from mechanical ventilation. Examinations of creatine kinase and cerebrospinal fluid showed no abnormalities. Electromyography and nerve conduction studies demonstrated declined nerve conduction velocity and decreased sensory and motor muscle action potentials, suggesting the possibility of CIP.

CONCLUSIONIn patients with Parkinson disease, the occurrence of sepsis with prolonged mechanical ventilation and limb weakness indicates the necessity of neurophysiological examination, muscle biopsies and laboratory tests, which may help detect CIP in the early phase. Proper interventions of sepsis may reduce the likeliness of CIP. Elimination of the risk factors and aggressive management of sepsis can be effective measures for preventing CIP.

Aged ; Humans ; Male ; Parkinson Disease ; complications ; Polyneuropathies ; complications ; diagnosis ; Respiration, Artificial ; Respiratory Insufficiency ; complications ; Sepsis ; complications