Objective To evaluate the underlying causes of death of the in - patients with type 2 diabetes in Peking Union Medical College Hospital. Methods A cohort of 247 known dead in - patients with type 2 diabetes(132 men and 115 women) was identified from 1991 ～ 2003 in Peking Union Medical College Hospital. Underlying causes of death were obtained from death certificates and were coded according to the International Classifecation of Diseases (ninth revision). Results In our study, carduvascular disease was the most com-mon underlying cause of death and 110 death cases were attributable to it, and 64 to neoplasms,36 to respiratory disease, 14 to digestive disease, 10 to diabetes - related diseases, 1 to traffic accident cause, 13 to other natural causes. Conclusion This study confirms the im-portance of carduvascular disease as the major cause of death in people with type 2 diabetes. The evidence of an early effect on mortality suggests that prevention , early diagnosis, and treatment should be improved.

BACKGROUND:Studies have shown that Ganoderma lucidum polysaccharides have biological activities of anti-viral, anti-tumor, enhance immunity, anti-oxidative and anti-aging. OBJECTIVE:To observe the biological effect of Ganoderma lucidum polysaccharides on the antioxidant capacity of D-galactose induced aging mice skin tissues, and to observe the effect in postponing skin aging. METHODS:Forty-four 2-month-old Kunming mice were randomly divided into four groups:normal control group, aging model group, vitamin E group, and Ganoderma lucidum polysaccharide group. Rats in the last three groups received subcutaneous injection (nape area) of Ganoderma lucidum polysaccharide to establish rat aging models, and intragastric administration of corresponding drugs or saline was performed. After 42 days, pathological sections of back skin were obtained to assess the morphological changes of skin tissues, measure the epidermal and dermal thickness, and detect the superoxide dismutase levels and the expression of CuZn-superoxide dismutase mRNA. RESULTS AND CONCLUSION:The epidermal and dermal thickness in the vitamin E group and Ganoderma lucidum polysaccharide group were increased when compared with the aging model group. The superoxide dismutase levels in the Ganoderma lucidum polysaccharide group were significantly higher than those in the other two groups. The decreased degree of cycle threshold value in the Ganoderma lucidum polysaccharide group was lower than that in the other two groups. The results indicate that Ganoderma lucidum polysaccharide can increase the epidermal and dermal thickness, improve the skin tissue structure, and enhance the superoxide dismutase levels and the expression of CuZn-superoxide dismutase mRNA.

AIM:To investigate the process and advantages of wound repair at one stage after repair of nasal skin defect with bilobed flap.METHODS:Under local infiltration anesthesia,nasal skin defects were repaired by bilobed skin flaps.The normal skin around the defect was designed for bilobed island skin flaps.The maximum size of the flaps was 1.8 cm?2.5 cm,and the minimum size was 0.8 cm?1.0 cm.And then the flaps were transferred to repair the defects.The distances from incisions to margin of lesions were as follow:hemangioma was 0.2 cm,basal cell carcinoma was 0.5-0.7 cm,and melanoma was 1.0 cm.The depths of incisions reached superficial fascia layer.Complete hemostasis of wound was performed.RESULTS:Fifty of 92 patients were followed up for 6 months,and 42 of them were followed up for 12 months.In all patients,the nasal skin defects were repaired completely with primary healing.The color and texture of the flap were the samilar with the adjacent skin,and the nose contour and cosmetic results were satisfactory.CONCLUSION:Repair of bilobed island skin flap for nasal skin defeets was simple,and the efficacy was satisfactory.

Carcinoma of the esophagus is the second most common cause of cancer-related-death in women,and fourth in men in China.The prevalence rate of adenocarcinoma of esophagus has increased in the western countries recently too.Unfortunately,the treatment result of esophageal cancer is very poor,and only 15%～20% of all esophageal cancer patients will be alive 5 years after diagnosis.With the development of radiologic techniques and molecular biology,the esophageal cancer patients are given on individualized treatment modality.This paper reviewed several interesting topics,including operation for esophageal cancer,new technologies for pre-operative staging,multidisciplinary treatment as well some data from the Shanghai Cancer Hospital.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Pancreatitis ; diagnosis ; etiology ; therapy ; Prognosis

Objective To study the relationship between the level of fluoride in urine and the prevalence of dental caries in children before and after the defluoridation, and to provide a basis for assessment of the effects of defluoridation projects and for control of dental caries.Methods Wamiao Village, in Jiangsu Province, a formerly severe endemic fluorosis area, was selected to carry out the study.All children aged 8-13 years old before the defuoridation were investigated from September to November in 2002, and children 8-10 years old who were born after the defluoridation were investigated from September to November in 2013.Urinary fluoride level of the children and the prevalence of dental caries were determined, and their relationships were analyzed.The urina sanguinis samples of children were collected in the morning, and the urine fluoride level was tested using the fluoride ion selective electrode.Dental caries diagnoses was referenced to Dental Caries.Results Totally children's urine samples were 236 and 68 respectively before and after defluoridation.Urinary fluoride level of the children was significantly decreased from (3.53 ± 1.81)mg/L (before defluoridation) to (1.39 ± 0.66)mg/L (after defluoridation, t =9.506, P ＜ 0.01);the prevalence of dental caries was increased from 52.73％ (29/55, before defluoridation) to 63.24％ (43/68, after defluoridation), however, the difference was not significant (x2 =1.383, P ＞ 0.05).The DMFT increased from 1.18 (before defluoridation) to 1.68 (after defluoridation), and the epidemic levels of dental caries were all at lower levels.The relationship between urine fluoride level and the prevalence of dental caries as well as the DMFT before defluoridation was a U-shape dose-response curve;which was gone after defluoridation.Conclusions The urinary fluoride level is significantly decreased after defluoridation for 10 years, the prevalence of dental caries is increased but not significantly.The results of this study indicate that the measure of fluoridation to prevent dental caries needs to be further validated.

AIM: Using optical coherence tomography angiography (OCTA) to observe the changes and clinical significance of macular blood flow density in patients with diabetic retinopathy (DR).METHODS: Totally 47 eyes (28 patients) with diabetic retinopathy (DR) were enrolled in the DR group.According to the international clinical grading criteria of diabetic retinopathy, 30 eyes (19 patients) with non-proliferative diabetic retinopathy were classified as the NPDR group, and 17 eyes (11 patients) with proliferative diabetic retinopathy were classified as PDR group.A total of 46 (27 subjects) healthy eyes with matched age were enrolled in the control group.All the subjects underwent the 3mm×3mm scanning of macular retina by optical coherence tomography angiography (OCTA), obtaining 4 levels of macular blood flow density map.The macular blood flow density at 3 levels, including superficial retinal layer, deep retinal layer and choroidal capillaries layer, were measured.RESULTS: The macular blood flow density of superfical retinal layer, deep retinal layer and choroidal capillaries layer in DR group were 0.4963±0.0840, 0.4798±0.0801 and 0.5290±0.0528, respectively.Among them, the blood flow density of each layer were 0.5064±0.0843,0.4983±0.0766,0.5345±0.0529, respectively, for the NPDR group, and were 0.4786±0.0830, 0.4473±0.0778,0.5192±0.0526, respectively, for the PDR group.For the control group, the density of each layers were 0.5919±0.0704, 0.6301±0.0527, 0.5691±0.0169, respectively.The macular blood flow density was significantly different in the superficial retinal layer, deep retinal layer and choroidal capillary layer between the control group and the NPDR group, as well as the PDR group and the DR group (total P<0.001).Statistically significant difference was found between the NPDR group and the PDR group in the deep retina layer (P=0.029), but not in the superficial retina layer and choroid capillary layer (P=0.236, 0.268).CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer in the patients with diabetic retinopathy decreased significantly.It indicated that the macular ischemia existed in both retina and choroid.By quantitatively measurement of the macular blood flow, OCTA may be used for monitoring the progression of diabetes, and early detection of diabetic retinopathy.

Objective To explore hearing loss , the expression of age-related changes of nerve growth factor receptor TrkA (NGFR TrkA ) in the cochlea of the senescence-accelerated mouse. Methods The senescence accelerated mouse/prone 8(SAMP8) at 3, 5, 7 months were chosen as analyzing subjects. The auditory thresholds was monitored by auditory brainstem respons (ABR). The expression of NGFR TrkA protein was analyzed by the optical density of immunohistochemical staining. Results The SAMP8 developed a progressive auditory threshold which showed an age-related significant increase (P < 0.05). There were NGFR TrkA protein expressed in the cochlea of the SAMP8 throughout the development, which developed an age-related significant descend (P<0.05). Conclusion The expression level of NGFR TrkA protein decreases when the SAMP 8 develops a progressive hearing loss which indicates that NGFR TrkA protein probably has relationship with maintaining functional status of the cochlea.

OBJECTIVETo observe the effect of Angong Niuhuang Pill (ANP) on Thl/Th2 in cerebral infarction patients and to explore the mechanism of phlegm-heat obstructing orifices.

METHODSRe- cruited were 30 cerebral infarction patients of phlegm-heat obstructing orifices syndrome (PHOOS) both in China and Indonesia. They were assigned to 4 groups according to the use of ANP, the Chinese treatment group, the Indonesia treatment group, the Chinese control group, and the Indonesia control group. Patients in the two control groups received conventional treatment, while those in the two treatment group additionally took ANP for 30 successive days. Their adverse reactions were observe, and levels of INF-γ and IL-4 were detected.

RESULTSThe INF-γ level and the INF-γ/IL-4 ratio significantly decreased, and the IL-4 level increased after treatment in the four groups with statistical difference (P < 0.05). Compared with the control group after treatment in the same country, the INF-γ level and the INF-γ/IL-4 ratio were lower, and the IL-4 level was higher in the two treatment groups (P < 0.05). Compared with the two Chinese groups, the INF-γ level and the INF-γ/IL-4 ratio were higher, and the IL-4 level was lower in the two Indonesian groups (P < 0.05). There was no statistical difference in the post-treatment indices between the two treatment groups.

CONCLUSIONSANP had moderating effect on Th1/Th2 in cerebral infarction pa- tients. Cerebral infarction patients of PHOOS might exist certain relation with Th1/Th2.

Cerebral Infarction ; drug therapy ; China ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hot Temperature ; Humans ; Indonesia ; Interferon-gamma ; metabolism ; Interleukin-4 ; metabolism

Animals ; Apolipoproteins E ; deficiency ; Female ; Hyperlipoproteinemia Type III ; blood ; metabolism ; Lipid Metabolism, Inborn Errors ; blood ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Calcitriol ; metabolism ; Vitamin D ; blood