Objective To determine 1 hour plasma glucose cutoff value during OGTT to screen diabetes and IGR and its relationship with islet β cell function and insulin sensitivity. Methods 4731 subjects were recruited to perform an OGTT.The cutoff value of 1h-plasma glucose during OGTT was analyzed by receiver operating characteristic curve (ROC curve).And according to the two cutoff values,we classified all the subjects to three groups,and compared HOMA-IR,HOMA-β,insulinogenic index and shape index among groups,then analyzed its correlation with each parameter. Results According to ROC results, to diagnose type 2 diabetes mellitus,the optimal cutoff value of 1h plasma glucose during OGTT was 12.935mmol/L,with sensitivity of 81.52%,specificity of 86.94%. To diagnose impaired glucose regulation(IGR),the optimal cutoff value of 1h plasma glucose was 9.815mmol/L,with sensitivity of 74.96% and specificity of 77.86%. We classified all the subjects to three groups, and among the three groups the insulinogenic index, shape index, HOMA-IR, HOMA-β showed statistically significant difference (all P＜0.01). There was a negative correlation of OGTT-1hPG with insulinogenic index and HOMA-β(all P＜0.01) and a positive correlation of OGTT-1h PG with shape index and HOMA-IR (all P＜0.01). Conclusions To diagnose type 2 diabetes mellitus,the optimal cutoff value of 1h plasma glucose during OGTT is 12.935mmol/L.To diagnose impaired glucose regulation(IGR),the optimal cutoff value of 1h plasma glucose is 9.815mmol/L.And 1h PG can reflect the islet β-cell function and insulin resistance.

Objective To investigate the depression status among the elderly living alone in a community of Shanghai and to analyze the influencing factors.

Breast cancer is by far the most common cancer for females.The recent researches focus on early diagnosis,optimal adjuvant therapy and curative effect surveillance.The paper summarizes the application of tissue and fluid tumor markers in the diagnosis,treatment,curative effect surveillance and prognostic prediction of breast cancer,which include widely-accepted estrogen receptors,HER2-neu and CA15-3,and novel ones such as Cyclin E,TIMP-1,RAR-?,hK10 and BRCA-1.

Objective:To probe distribution law and pathogenesis of TCM complex symptoms of functional dyspepsia and irritable bowel syndrome.Methods:Generally recognized criteria was to establish database of comprehensive analysis of the data gained by the four methods of diagnosis,and analyze with SPSS8.0.Results:Syndrome distribution was most closely related with spleen deficiency,accounting for 66.7%;and the next,with stagnation of liver-Qi,accounting for 40.3%;the last,with the kidney,only accounting for 5.6%.Conclusion:Cause of disease and inducing factors of this disease are closely correlated with pathogenic cold, diet of lipids,mental depression,prolonged disease,wound due to abdominal operation.The disease is located at the stomach, intestine with most coexistence of deficiency and excess,and spleen deficiency is the key of pathogenesis.

Objective To evaluate the pathophysiology of paraplegia during transarterial chemoembolization in liver cancer and investigate effective management and prevention for improving clinical situation and relieve major symptoms.Method 2758 patients accepted TACE procedure because of liver cancer(and/or combined with remote metastasis),demonstrated 4 cases suffering from paraplegia(3 males,1 female)since Mar.2003 to Feb.2005,with mean age of(51?14)years old,The operative records and the clinical features after chemoembolization were summarized in detail.Results The incidence of paraplegia was 0.145%,with major symptoms of dysesthesia and hypokinesise emerging within 4 hours after TACE,and most symptoms aggravating gradually within 24-48 hours untill paraplegia appeared,and then turned to stabilization about 5-7 days,with their body functions partial recovery in 2 months.Conclusion More attention should be paied to prevent ectopic embolization of spinal cord vessels originating from extrahepatic collateral arteries during TACE or TAE.

Objective To study the clinical features of diagnosis and treatment in children with low-risk myelodysplastic syndrome(MDS) and improve the diagnosis and treatment.Methods The examinations of 17 children with low-risk MDS were analyzed.The blood concentrations of cyclosporine,one of the therapeutic drugs,were monitored and the responses to the treatments were evaluated.Results Exa-mination of full blood count showed that the reductions of 3 cell types,2 cell types and 1 cell type were 11 (64.7%)cases,5(29.4%)cases and 1(5.9%)case,respectively.Reticulocyte count showed an increase in 82.4% of the patients and normal in 3 cases.Fourteen in 17 cases were hyperplastic marrow and 3 cases were hypoplastic marrow.Among all cases,one lineage,2 lineages and 3 lineages dyspoiesis were seen in 8(47.1%),7(41.2%) and 1 (5.9%)cases,respectively.One case showed no dyspoiesis.Cytogenetics examination showed normal in 10(58.8%) cases and abnormal in 7(41.2%) cases.Fifteen (88.2%) cases had normal proportions of CD59 negative cells,while 2 cases had higher proportions.The blood concentrations of cyclosporine that were tested in 9 cases at the end of the third week were in a range of 95.3-316.5 ?g/L.The therapeutic effect of 10 cases were evaluated at the end of the third month after being treated.Eight cases achieved haematological improvement and 2 cases didn′t.The rate of improvement was 80%.Conclusions The patients of low-risk MDS are mostly school-aged children and pancytopenia is the most common sign.The combination of predisone,cyclosporine and stanozolol agents shows good effect to treat low-risk MDS.The absorption of cyclosporine is different individually,so it is significant to adjust the dosage of cyclosporine according to the concentration regularly in clinical practice.

Objective To explore the therapeutic effect and nursing points of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis (MHD) patients.Methods Sixty-four MHD patients with renal osteopathy disease were enrolled in the study.They were divided into two groups by random digits table method:the front connection group and the back connection group with 32 cases each.Their clinical data,serum parameters and complications were recorded.The therapeutic effect of two groups were compared.Results The serum level of intact parathyroid hormone(iPTH) was (191.36 ± 53.96) ng/L in the front connection group,while (133.02 ± 38.63) ng/L in the back connection group,and there was significant difference,t=3.517,P＜0.05.The incidence of lower blood pressure and blood coagulation were 8.85％(51/576),6.94％(40/576) in the back connection group,while 14.93％(86/576),15.97％(92/576) in the front connection group,and there were significant differences,x2=10.149,23.136,P＜0.01.Conclusion The back linked mode in hemodialysis combined with hemoperfusion can obviously decrease iP:TH of MHD patients combined with renal osteopathy disease and has less complications,worth clinical promotion.

Objective To explore the application value of Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with portal vein (PV) resection and artificial vascular graft and reconstruction.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with cancer of pancreatic head combined with biliary and duodenal obstructions who was admitted to the Southwest Hospital of the Third Military Medical University in November 2015 were collected.Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction were applied to the patient due to intraoperative tumor extensive invasion to the PV and angiogenesis around the tumor.The operation time,volume of intraoperative blood loss and transfusion,time of postoperative drainage-tube removal,postoperative complications,result of postoperative pathological examination,duration of postoperative hospital stay and results of follow-up were observed.The follow-up of outpatient examination and telephone interview was performed to detect the survival of the patient up to February 2016.Results The patient underwent successful Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction.The length of intraoperative excisional PV,operation time,volume of intraoperative blood loss,volume of red blood cell suspension and blood plasma infusions were 3 cm,670 minutes,600 mL,400 mL and 200 mL,respectively.The patient got out-off-bed activity at postoperative day 1 and fluid diet intake after gastric-tube removal at postoperative day 3,and drainage-tube was removed at postoperative day 8.No postoperative complication was detected.The patient had unblocked main PV without obvious stenosis and filling defect by computer tomography rescanning.Adenosquamous carcinoma of the pancreatic head was confirmed by postoperative pathological examination.There were negative resection margins from the proximal and distal duodenum to the pancreas.The patient was discharged from hospital at postoperative day 12 and followed up for 3 months,with a good survival.Conclusions Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction are safe and feasible in the treatment of the cancer of pancreatic head combined with biliary and duodenal obstructions,with a good short-term outcome.

Air ; Chromatography, Gas ; Solvents ; Workplace

[Summary] A selection of 528 unrelated subjects were enrolled(198 males, 330 females) with the mean age of(52. 23 ± 13. 41) years old. According to body mass index, 253 persons belonged to the normal weight group and 275 persons overweight/ obesity group. A total of 10 SNPs in CIDEB and CIDEC genes were detected. SHEsis online were used to get the haplotypes of these two genes. The relationship between above SNPs and obesity were analyzed under additive inheritance pattern. The main effects and interaction on obesity induced by two genes’ haplotypes were analyzed by logistic regression. rs2144493 in CIDEB gene was associated with obesity, C was a protective alleles, OR (95% CI) equals 0. 722(0. 525-0. 992). CCTT haplotype of CIDEB gene carriers and GCG haplotype of CIDEC gene carriers were more prone to obesity or overweight, there was an interaction between the haplotypes of 2 genes. CIDEB, CIDEC haplotypes may play independent and interactive roles in causing obesity.