Objective To observe the injuries of sodium citrate plasma(scP) on the growth and function of HepG2 cells.Methods The HepG2 cells were cultured.The viability,cell cycle and apoptosis,the leakage of LDH,total protein,glutathione and the changes on morphology of hepatocytes exposured to scP were investigated.Results The viability of HepG2 cells was inhibited when the cells were cultured in scP for 24h(F=37.108,P=0.001).After 48h,nearly all cells died except cells in 10% scP group.After the cells were exposed to scP for 24h,the percentage of S phase of the cell cycle and the rate of apoptosis were significantly increased compared to those of the control.The leakages of LDH were increased in the HepG2 following exposure to scP for 5h(P

OBJECTIVETo evaluate the efficacy and the relevant effect factors of acupuncture for type 2 diabetes mellitus (T2DM) in females.

METHODSOf 83 female patients of T2DM, 49 cases were deficiency of kidney yin syndrome and 34 cases were yin and yang deficiency syndrome. Acupuncture was adopted and the acupoints were selected according to the syndrome differentiation. In kidney yin deficiency syndrome, Taixi (KI 3), Shenmen (HT 7), Taichong (LR 3) and Sanyinjiao (SP 6), etc. were selected. In yin and yang deficiency syndrome, Shenshu (BL 23), Pishu (BL 20), Yishu (Extra) and Jingmen (GB 25), etc. were selected. In 3 courses of treatment, the changes in fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistace index (Homa-IR), index of islet beta-cell function (Homa-beta), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared before and after treatment between the two groups. The relationship of the efficacy was analyzed in terms of the syndrome differentiation, age, duration of sickness, obesity and hereditary factors.

RESULTSAfter the treatment, the levels of FPG, FINS, Homa-IR, TC, TG and LDL-C were reduced obviously (all P < 0.01) and the levels of ISI, Homa-beta and HDL-C were increased apparently (all P < 0.01). The total clinical effective rate was 80.7% (67/83), in which, that of kidney yin deficiency syndrome was 83.7% (41/49) and that of yin and yang deficiency syndrome was 76.5% (26/34). The efficacy was not different significantly between the two syndromes. But, the younger the age was, the better the efficacy was.

CONCLUSIONAcupuncture positively regulates the glucose and lipid metabolism in the patients of T2DM. This therapy improves insulin resistance, enhances the body sensitivity to insulin and improves insulin beta-cell function. The efficacy is related to the patient's age.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

The efficacy of patients infected with hepatitis C virus complicated with cirrhosis is not promising after treated with present standard therapy. With more and more new drugs against hepatitis C virus, many new regimens for the patients with chronic hepatitis C virus complicated with cirrhosis have come forth. Because the adverse reactions of the first generation HCV protease inhibi-tors telaprevir and boceprevir are severe, they are not recommended to be used in the patients with chronic hepatitis C virus complicated with cirrhosis. The other drugs, such as simeprevir, sofosbuvir and ledipasvir show good efficacy in the patients with chronic hepatitis C virus complicated with cirrhosis, however, the sustained virological response ( SVR) in the patients with chronic hepatitis C virus complicated with cirrhosis is lower than that in the patients with chronic hepatitis C virus without cirrhosis. Therefore, the regimens should be optimized in the future to narrow the gap in SVR.

Objective To assess the clinical features and treatment of children with long QT syndrome (LQTS)and syncope.Methods Eleven cases of children with LQTS and syncope between January 2009 and July 2014 in Hunan Children′s Hospital were retrospectively analyzed for clinical features,treatment and long term follow -up.Results There were 11 cases of children with LQTS aged 4.0 -14.5(9.16 ±2.71)years,8 male and 3 female, with syncope more than once.The range of QTc was 460 -521(483.72 ±22.90)ms.For 3 cases of acquired LQTS,1 case was parathyroid hypothyroidism causing hypocalcemia,1 case was myocarditis complicated with third degree atrio-ventricular block,and 1 case showed atrial flutter receiving amiodarone post congenital cardiac surgery.All patients re-covered after the inducement removed and primary illness cured.For 8 cases of congenital LQTS,3 cases of LQTS un-derwent genetic test (1 case of KCNQ1 gene mutation,2 cases of KCNH2 gene mutation).One case died after frequent torsade de pointes (Tdp)and ventricular fibrillation during hospitalization,the remaining 7 patients were given oral pro-pranolol,potassium chloride sustained -release tablets after discharge.Follow -up time was 8 to 75 months,an average of (45.73 ±24.42)months.One case died suddenly at home after 25 months of follow -up.The remaining 6 cases of children with congenital LQTS could withstand general activities without syncope,in which 4 cases had normal QTc by electrocardiography(ECG),and the findings in 2 cases did not change compared with those previously.The QTc re-turned to normal in children with acquired LQTS in the follow -up review.Conclusions Children with congenital LQTS should receive early genetic screening and genotyping for rational use of drugs.For children with higher risk of sudden death,drug therapy combined with implantable cardioverter defibrillator should be considered.For acquired LQTS,it should be better to remove the inducement and treat primary disease actively.

Objective To explore the levels of serum leptin and insulin and their relationships with growth and development in premature infants.Methods The serum leptin and insulin concentrations of 37 premature infants were examined by the radioimmunoassay(day 1 and day 10,respectively),and anthropometric measurements were performed at birth.The blood sugar and triglyeride,cholesterol were tested at the same time.Twenty full-term newborn without severe diseases were controlled in 24 h after delivery and the level of leptin and insulin of them were detected,too.The results were analyzed by SPSS 10.0 software.Results The leptin and insulin levels in preterm infants were significantly lower than those in full-term infants[(6.45?2.24)?g/L vs(8.56?1.33)?g/L,(5.84?1.07)IU/L vs(10.85?5.24)IU/L Pa0.05).Serum leptin was positive correlation with serum insulin(Pa0.05).Conclusions Serum leptin and insulin can be the markers that reflect intrauterine nutrition status of preterm infants and the growth and development of fetus.A dipoinsular axis may be functional before 34 weeks gestation without maturity.The changes of leptin and insulin concentrations are useful for metabolism and growth in preterm infants.

OBJECTIVETo explore the clinical efficacy and mechanism of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients.

METHODSOne hundred and twelve patients were treated with acupuncture, followed by tapping method. The reinforcing method with lifting, thrusting and rotating needle technique was used at Taixi (KI 3), Shenmen (HT 7), Taibai (SP 3), Taiyuan (LU 9), Sanyinjiao (SP 6) and Zusanli (ST 36); and the even-needling technique was used at Taichong (LR 3), Hegu (LI 4), Xuehai (SP 10) and Fenglong (ST 40). The needles were remained for 30 min. After needle removal, the tapping method with plum-blossom needle was applied to Geshu (BL 17), Yishu (EX-B 3), Ganshu (BL 18), Shenshu (BL 23) and Pishu (BL 20), once every two days. The treatment of 3 months was required. The changes were observed before and after treatment in the relevant indices of fat-islet axis such as fasting plasma glucose (FPG), fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance (Homa IR), insulin secretion index (Homa-beta) and the indices of obesity and blood lipids in the patients.

RESULTSAfter treatment, the total effective rate was 84.8% (95/112), in which the efficacy on the stasis predominated syndrome was better than that of yin deficiency predominated syndrome [92.9% (52/56) vs 76.8% (43/56), P < 0.05]. Before treatment, FPG, FLP, FINS, Homa-IR, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), body mass, body mass index (BMI), fat percentage (F%) and obesity degree in the patients were higher obviously than those in the normal group (all P < 0.01); high-density lipoprotein cholesterol (HDL-C) and ISI were lower than those in the normal group (both P < 0.01). After treatment, FPG, FLP, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, F% and obesity degree were all reduced obviously as compared with those before treatment (all P < 0.01). ISI and HDL-C were increased apparently (both P < 0.01). The efficacy on mild obesity was superior to that on moderate and severe obesity, and the efficacy in the young patients was better than that in the elderly, the efficacy in the males was better than that in the females, but the differences were not significant (all P > 0.05). The efficacy in the cases with 10 years duration of sickness was superior to those with over 10 years duration of sickness (P < 0. 01).

CONCLUSIONAcupuncture and tapping therapy achieves the significant efficacy on type 2 diabetes of yin deficiency pattern combined with stasis and its effect mechanism is related to the positive regulation of glucose, lipid metabolism and fat-islet axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Female ; Humans ; Insulin ; metabolism ; Leptin ; metabolism ; Male ; Middle Aged ; Treatment Outcome ; Triglycerides ; metabolism ; Yin Deficiency ; metabolism ; therapy

Adult ; Aged ; Anesthesia ; methods ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Retrospective Studies

Objective To explore the mechanisms of posterior pilon fractures and evaluate the curative effects of different types of fixation on the treatment of posterior pilon fractures.Methods We included in this retrospective study 20 patients with posterior pilon fracture who had been treated from January 2012 to January 2015 at our department.They were 10 men and 10 women,from 23 to 77 years of age (average,50.6 years).According to the classification by Yu Guangrong,5 cases belonged to type Ⅰ,3 to type Ⅱa,4 to type Ⅱb,and 7 to type Ⅲ.One was not indentified because of lacking CT examination.The mechanisms included ground level fall in 2 cases,motor vehicle accident in 7,fall off stairs in 5,sport injury in 2,fall from a bike in one and fall from a height in 3.More than 25％ of the articular surface was involved in 13 patients.Syndesmosis injury was identified in 6 patients by Cotton test during operation.Internal fixation varied accordingly.We recorded the mechanism,classification,proportion of the articular surface involved (more or less than 25％),and syndesmosis injury to figure out the characteristics of posterior pilon fractures.We used the Burwell-Charnley radiographic criteria to assess the postoperative reduction of the articular surface,and the Olerud-Molander scoring scale and visual analogue scale (VAS) to assess the ankle function.The curative effects of different types of fixation on the treatment of posterior pilon fractures were compared.Results Of the 20 patients,17 were available for follow-up for 6 to 36 months (average,17.8 months).Two patients received reoperation because of implant failure after cannulated screw fixation from anterior to posterior.The Burwell-Charnley radiographic evaluation revealed 12 anatoinical reducations and 8 fair reductions.The mean Olerud-Molander score for the 17 patients at the final follow-ups was 81.5 (range,from 35 to 100) and the mean walking VAS was 1 (from 0 to 3).Conclusions Posterior pilon fractures are mostly caused by medium to high energy violence,resulting from a combination of rotational and vertical forces.Since there is a high risk of implant failure,the cannulated screw fixation from anterior to posterior is not recommended.Good clinical outcomes are observed in the cannulated screw fixation from posterior to anterior and the plate/cannulated screw fixation for posterior pilon fractures.

Objective To investigate risk factors for postoperative delirium in elderly patients with hip fractures and determine whether the delirium can influence the outcome of hip fracture.Method A retrospective case control study was performed for 521 patients (≥60 years) with hip fractures treated surgically from January 2012 to December 2014.There were 170 males and 351 females, with the age of (79.3±8.3)years.Confusion assessment method (CAM) was applied to diagnose delirium after surgery, and the subjects were divided into delirium group (n=159) and control group (n=362) according to the presence of delirium.Univariate and multivariate analyses were performed to identify the riks factors for postoperative delirium, including age, gender, comorbidities, body mass index, American Society of Anesthesiologists (ASA) classification, type of fracture, haemoglobin, PaO2, albumen, type of anesthesia, type of anesthesia, amount of bleeding, time between admission to surgery, length of operation, type of operation and amount of blood transfusion.Perioperative complications and mortality within 1 year after operation were compared between the two groups.Results Univariate analysis revealed dementia, ASA classification, haemoglobin, PaO2, albumen, interval between admission to surgery, anesthesia method, operation time, and surgery methods were risk factors for postoperative delirium incidence (P<0.05).While multivariate analysis showed only dementia (OR=6.211, 95%CI 2.482-23.498), long interval between admission to surgery (OR=3.505, 95%CI 1.478-6.342), arthroplasty (OR=2.015, 95%CI 1.783-3.481), and PaO2≤60 mmHg (OR=2.766,95%CI 1.783-5.039) were the significant risk factors for postoperative delirium after hip surgery in the elderly.Incidences of lung infection, wound infection, cardiovascular events, cerebrovascular events and deep venous thrombosis in delirium group were higher than those in control group, but only incidences of lung infection and wound infection reached significant differences (P<0.05).Mortality in delirium group was higher than that in control group within 1 year after operation, but there was significant difference only within 3 months after operation (P<0.05).Conclusions Incidence of delirium is high after hip fracture surgery in the elderly.Dementia, long interval between admission to surgery, arthroplasty and PaO2≤60 mmHg are significant risk factors for postoperative delirium incidence, and the delirium patients are associated with high early mortality.

Objective To discuss factors related to clinical characteristics,biological behavior,and prognosis in gastric stromal tumors (GST).Methods We retrospectively analyzed clinical materials and records of 70 GST patients diagnosed after surgery and pathological examinations,all patients were contacted by telephone or mail for follow-up.Results (1) All GST patients had similar distribution of gender,and had age range of 50 to 69 years with mean age of 59.1 years.Clinical symptoms were non-specific,and main clinical manifestations included abdominal discomfort (42.9％),followed by abdominal pain (37.1％),and upper digestive tract hemorrhage (7.1％).(2) Sex,age,presenting symptoms,and original location of tumors were not significantly related to prognosis (P ＞ 0.05).However,size of the tumor,mitosis count,and the malignancy potential grading were significantly associated with patient prognosis.Among them,size of the tumor (maximum tumor diameter ＞ 5 cm vs ＜ 2 cm,HR =21.3,95％ CI:5.9-77.0;maximum tumor diameter 2-5 cm vs ＜ 2 cm,HR =2.3,95％ CI:1.2-7.8),and mitosis count (mitosis count ＞ 10/50 HPF vs mitosis count ≤5/50 HPF,HR =22.5,95％ CI:8.6-58.6;6-10/50 HPF vs ≤5/50 HPF,HR =11.1,95％ CI:9.9-12.3) were independently associated with GST prognosis.Conclusions Tumor size,mitosis count,and malignancy potential grading were associated with prognosis of GST.Among them,tumor size and mitosis count were independent predictors of prognosis.When the tumor size is larger,and mitotic count and the malignant potential grade is higher,prognosis of GST patients were worse.