10.3969/j.issn.1000-3606.2013.06.022

In recent years,there are gradually increasing attentions on diabetic osteoporosis.Diabeticosteoporosis is characterized by insidious onset,high incidence,and risk of disability.Metabolic disorders caused bydiabetes mellitus are related to an imbalance between osteoblastic bone formation and osteoclastic resorption.Diabetesalters bone mass and increases the risk of fracture.In this review the influence of diabetes on osteoporosis isdiscussed.

AlM: To comprehensively evaluate of visual quality after epipolis laser in situ keratomileusis ( EPl-LASlK) in mild to moderate myopia.METHODS: Sixty cases ( 120 eyes ) undergone EPl-LASlK with equivalent diopter ( SE ) were divided into two groups:mild myopia group (60 eyes) and moderate myopia group ( 60 eyes ) . Objective visual acuity, aberration, contrast sensitivity and glare sensitivity were measured before and 1wk; 1, 6mo after operation, and made comparative analysis. RESULTS: Postoperative uncorrected visual acuity ( UCVA ) of two groups were better than that of preoperative(P<0. 05). Postoperative 6mo, there were significant differences on total high RMS between two groups ( P < 0. 05 ). Before operation and 6mo after operation, higher - order aberrations had statistically significant difference between two groups (P<0. 05). After 1wk and 1mo, there were statistical significances at the five frequencies between two groups (P<0. 05). After 6mo, the mild myopia group returned to preoperative levels, however, moderate myopia group in the high frequency region ( 18. 0c/d ) had significant difference with before surgery (P<0. 05). 1wk after surgery, there were statistically significant differences on the 3. 0, 6. 0, 12.0, 18. 0c/d frequency in both groups (all P<0. 05), 1mo after surgery, there were significant difference at 12.0, 18.0c/d frequencies (all P<0.05), after 6mo, both groups returned to preoperative levels, showed no significant difference.CONCLUSlON:Visual quality is poorer in mild myopia patients than that in moderate myopia at early stage after EPl-LASlK. Better visual quality is observed at mid-late stage.

Objective To explore the preventive and therapeutic effects of diminazene (DIZE) on pulmonary arterial hypertension (PAH) in rats.Methods Left pulmonary lobectomy combined with injection of monocrotaline was used to establish a rat model of pulmonary arterial hypertension.One hundred adult male Wistar rats were randomly divided into blank control group (group A,n=20),DIZE control group (group B,n=20),PAH model group (group C,n=20),PAH model plus DIZE group (group D,n=20) and PAH model plus DIZE and C-16 group (group E,n=20).Angiotensin-converting enzyme 2 (ACE2),IL-6 and IL-8 levels were determined by fluorescence resonance energy transfer (FRET) and enzyme linked immunosorbent assay (ELISA),and the mean pulmonary arterial pressure (mPAP) and right ventricular hypertrophy index (RVHI) were measured.The wall thickness (WT) and intimal hyperplasia score were calculated,and the pulmonary vascular lesions were analyzed using elastic fiber staining.Results RVHI,ACE2 enzyme activity and WT in the group A were significantly different from those of the groups C,D and E (P<0.05).Those of the group D and E were significantly different (P<0.05).The five groups showed significant differences in the overall analysis of each index (P<0.05).Conclusions Diminazene can increase the ACE2 enzyme activity,and decrease the mPAP,RVHI and WT,while reducing the pulmonary arterial medial hypertrophy,and inhibit intimal hyperplasia of pulmonary arterioles.The results of this study provide an experimental basis for the use of diminazene in the treatment of human pulmonary hypertension.

Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.

Objective To study the correlation between the blood selenium level and glutathione peroxidase(GSH-Px)with the occurrence of gestational diabetes mellitus(GDM).Methods Among 1 360 pregnant women in our hospital from January 2011 to December 2012,68 cases GDM were diagnosed as GDM (observation group)and other 113 non-GDM pregnant women were ran-domly selected from these 1360 pregnant women as the control group.The serum selenium level and GSH-Px activity were com-pared between the two groups.Results The selenium level and GSH-Px activity in the control group were higher than those in the observation group.The selenium level was (3.07±0.51)mmol/L in the control group and (2.06±0.41)mmol/L in the observa-tion group,respectively;the GSH-Px activity was (197.23±18.73)U in the control group and (151.35±19.67)U in the observa-tion group,the differences between the two groups were statistically significant (P <0.05).Conclusion The decrease of serum se-lenium level and GSH-Px activity may be one of the pathogenic causes of GDM.

Inheirted metabolic disodrers(IMD)involves in multiple substance dysbolism,which usually results in irreversible neurological lesions because of various categories and complicated clinical manifestations.In resent years,IMD became one of the hot spots in medical domain around the world,original diagnostic technique and management progressed unceasingly.This paper provides an overview of the traditio-nal detection and treatment about IMD,and reviews the new techniques such as gene analysis,gene chip,organ transplantation and enzyme replacement therapy at the same time.

AIM:To investigate the differences of clinical signs and pathological structure of unilateral nasal pterygium and unilateral double pterygium.METHODS:Retrospective study.Totally 11 unilateral nasal pterygium and 11 unilateral double pterygium were collected to observe the size of the tissue area, the classification of blood vessels, the transparency and the break-up time of tear film.The 11 surgically excised double pterygia (11 eyes) and 6 samples of normal conjunctiva were collected for the study.With 40g/L paraformaldehyde fixation, paraffin sections were stained with Haematoxylin-Eosin, to observe the differences with nasal and temporal pathology under light microscope.RESULTS:In unilateral double pterygium, the tear break-up time was significantly shorter than that of unilateral nasal pterygium (t=3.410, P=0.003).In unilateral nasal pterygium, there was a significant negative correlation between tear film break-up time and tissue size(r=-0.927, P<0.01) and transparency(r=-0.764,P<0.01).In unilateral double pterygium, the tear break-up time was significantly negatively correlated with the growth time (r=-0.661, P<0.05), tissue size (r=-0.775, P<0.01) and transparency (r=-0.671,P<0.05).In unilateral double pterygium, compared with the temporal side, the quantity of the layers of corneal epithelial cells (t=-7.351, P<0.05), vessels (t=-7.400, P<0.05) and inflammatory cells (t=-7.481, P<0.05) increased.CONCLUSION:Compared with unilateral nasal pterygium, the tear film break-up time of unilateral double pterygium was poor.In unilateral double pterygium, with high activity, the degree of proliferation of squamous epithelium, hyperplasia and inflammatory reaction are significantly higher than those of the temporal side.

Objective To test the toxicity of genetically engineered strain R32 released to the environment.Methods Acute,chronic and cumulative toxicity test on mice,micronucleus assay of mice bone marrow cell and mice sperm malformation test were conducted to assess the toxicity of strain R32.Results R32 did not cause acute,chronic,cumulative and genetical toxic effect on mice before it absorbed heavy metal chromium.Although the mice bone marrow micronucleus frequency increased and some cumulative toxic effect emerged after R32 absorbed chromium,it did not cause acute and chronic toxicity effect on mice and mice sperm malformation rate did not increase neither.Furthermore,whether R32 absorbed heavy metal chromium or not,the effect of its secretion was not significant in all experiments compared with the control.Conclusion R32 can not cause toxic effect on mice before it absorbed chromium.Whether R32 absorbed chromium or not,the effect of its secretion was not significant in all toxicological experiments conducted in the present paper.Large content of R32 may cause some cumulative toxic effect in mice after it absorbed chromium.

[Objective]To explore the clinical effects of titanium plate and morselized hone grafting for the treatment of severe acetabular hone defect.[Method]A total of 27 patients with acetabular defects were treated with this procedure.According to AAOS,the acetabular defects were classified into various types:type Ⅰ in 6 cases,type Ⅱc in 4 and type Ⅲ in 17.The average preoperation Harris score were 37.The postoperative effect should be evaluated by clinical and X-ray manifestations.[Result]All patients were adopted this method to reconstruct the acetabular bone defects.The prosthetic dislocation was found in one case after operation,which was resulted from over-anteverted titanium plate impacted the greater trochanter.The part of trochanteric bone and impact factors were removed to healing.No complications were found in other patients.The average following up was 3 years and average Harris score was 87.The X-ray showed that none of the patients was presented the radiolucent lines in the acetabular mattress,bone transplantation,reconstructive titanium plate and interface of polyethylene liner.[Conclusion]The titanium plate and morselized bone grafting can repair the acetabular bone defects effectively and provide a solid initial fixation for prosthesis and restore the role of rotational center of hip.