Objective To explone the therapeutic effect and mechanism of Quyuhuatan decoction in treating type 2 diabetes mellitus combined with abnormal metabolism of lipid. Methods 85 cases of type 2 diabetes mellitus combined with abnormal metabolism of lipid were recruited into a control group and a treatment group randomly. The treatment group (45cases) was treated with Quyuhuatan decoction and subcutaneous insulin injection while the control group(40cases) was treated with subcutaneous insulin injection exclusively. Both groups received the treatment for for 8 weeks. The result of TC, TG, LDL-C, and HDT-C were observed before and after the treatment. Results The improvement of blood lipid in the treatment group was superior to that in the control group (t=0.011, P<0.05) . Conclusion Quyuhuatan decoction is effective in treating type 2 diabetes mellitus combined with abnormal metabolism of lipid. The mechanism might be related with its cutting off pathological paths of hyperlipidemia.

0.05),but FECW was superior to Kirschner tension band at comminuted fracture model(P

Objective To compare the curative effects of two different approaches in the surgical treatmentof small breast.Methods Fourty-seven patients with small breast were treated at our department.Twenty-eight sides of patients adopted an approach of prosthesis while the nineteen sides of patients were treated in the approach of autologous fat granules injection.Clinical assessment was done by analyzing operation time,blood loss volume,hospitalization duration and recent and long-term complications in breasts.All the pa-tients were followed up for thirty-two months on average.Results During follow-up period the appearance ofbreast was satisfied.Silicone gel breast prosthesis was well tolerated and the whole operation time was about (35±5 )min,the amount of blood loss was (35±5 ) mL,hospitalization duration was (2±1 ) days,during thefollow-up period prosthesis capsular contracture after hematoma occurred in one patient.The use of autolo-gous fat granules injection to breast augmentation was found limited,and the whole operate time was about (35±5 ) rain,the amount of blood loss was (15±5 ) mL,hospitalization duration was (1±1 ) days.With in-jection(2±l)times.During the follow-up period,one patient had infection,one patient liquefied fat,andone patient the induration.Conclusion Each treatment approach has its own advantages and disadvanta-ges.The approprite one should be selected according to the special situation of patients.

Objective To compare the diagnostic efficacy of digital mammography,ultrasonography and MRI for breast non-mass enhancement (NME).Methods The digital mammography,ultrasonography and MRI data of 1 1 6 patients with 123 NME lesions on MRI were analyzed retrospectively.Results 99 lesions were malignant and 24 lesions were benign according to the pathologiacl result.The sensitivity of digital mammography,ultrasonography and MRI was 72.73%,65.66%,and 84.85%,respectively;The specificity was 66.67%,79.1 7%,and 79.1 7%,respectively;The accuracy was 71.54%,68.29%,and 83.74%,respectively;The positive pretictive value was 90.00%,92.86%,and 94.88%,respectively;The negative pretictive value was 37.21%,35.85%,and 55.88%,respectively.The sensitivity,specificity,accuracy,positive pretictive value and negative pretictive value of MRI were obviously higher than those of digital mammography and ultrasonography (P <0.05).The difference between the combinations and MRI alone were no statistically significant.Conclusion MRI have better diagnostic value,and could be used as the first choice examination for breast NME lesions.

Objective To assess the value of contrast enhanced mammography (CESM) in the detection of breast cancer. Methods A total of 145 patients who were suspected of breast abnormalities by clinical examination or ultrasound were prospectively collected. All patients underwent bilateral breast CESM and MRI examinations. Breast CESM and MRI examination were completed in the same week. The pathological specimens were analyzed and the maximum diameters of pathological lesions were measured. The lesions were observed on low energy(LE), CESM and MRI images, and then the maximum diameters of lesions on the above images were measured. Using pathology results as the gold standard, the diagnostic efficacy of LE, CESM and MRI were analyzed by ROC curve, and Z test was used to compare the areas under the ROC curves among different imaging methods. Bland-Altman method was used to analyze the consistency of the maximum diameters of the lesions obtained with different imaging methods. Results One hundred and fifty three lesions were found in 145 patients, in which 36 were benign and 117 were malignant. The LE, CESM and MRI showed 140, 151 and 149 lesions respectively, and the qualitative diagnostic errors were 25, 8 and 11, respectively. The areas under ROC curves of LE, CESM and MRI were 0.87, 0.96 and 0.97 respectively. There was significant difference of the area under ROC curve between CESM and LE, so did the MRI and LE (P<0.05), but there was not significant difference between CESM and MRI (P=0.51). The sensitivity, specificity and accuracy in the diagnosis of malignant breast lesions were 88.98%, 65.71% and 83.66% for LE, while they were 95.80%, 91.18% and 94.77% for CESM, 94.17%, 87.88%and 92.81%for MRI. The average difference of diameters between LE, CESM, MRI and pathologic size was-1.7, 1.1 and 0.3 mm, respectively, with 95%consistency interval range of-18.6 to 15.1,-9.8 to 12.1,-10.6 to 11.2 mm, respectively. There was best consistency between the pathological size and the size on MRI. Conclusion CESM can significantly improve the diagnostic efficacy of breast lesions, which is comparable with MRI.

Objective To screen gastric infiltrating carcinoma from gastric high grade intraepithelial neoplasia (HGIEN) checked again by regular gastroscopy and confocal laser endomicroscopy(CLE).Methods From January 2005 to December 2010,82 patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN were collected at Department of Gastroenterology,Ruijin Hospital,Jiaotong University.61 male patients and 21 female patients were collected,of which 38 patients underwent common gastroendoscopy and the other 44 patients were underwent CLE besides common gastroendoscopy.The pathological diagnosis of endoscopic biopsy tissues were compared,and patients with indications were referred to surgery and pathological examination again.Results A total of 82 patients were confirmed by repeated examination,and there were 8 cases of inflammation or benign ulcers (24.4％),12 cases of low grade intraepithelial neoplasia (14.6％),10 cases of HGIEN (12.2％),52 cases of infiltrating carcinoma (63.4％).36 cases of differentiated carcinoma and 16 cases of undifferentiated carcinoma.Of the 21 infiltrating carcinoma cases diagnosed by CLE,17 cases (81.0％) were consistent with the pathological diagnosis.The consistent parameter value of κ between CLE diagnosis and pathological diagnosis was 0.7250.Conclusion It is necessary to make differential diagnosis of infiltrating cancer in patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN.

Twenty-five hybrid dogs were injected intravenously with oleic acid of the dose 0.3 ml/kg of body weight to prepare a model of respiratory distress syndrome (RDS) . The animals were killed 24 hours after injection. PaO2, PaCO2 and pH of the arterial and mixed venous blood were determined before and immediately, 0.5, 1?2, 4, 6, 22 and 24 hours after injection. The average pulmonary arterial pressure was measured hourly. The chest x-ray films were taken 2,4, 6 and 24 hours after injection. The electrolytes T3, T4, the hematocrit and RBC count, and the serum corticosteroid level were measured before and 24 hours after injection.25 dogs were divided into two groups; the control group consisted of 8 dogs and the therapeutic group consisted of 17 dogs, among which nine were treated with hyosine hydrobromide and 8 with dexamethasone. The histologic specimens of the animals of the control group and hyosine hydrobromide treated group were examined with both light and electron microscopes but the specimens of the animals of dexamethasone treated group were examined with light microscope only.It was found that dexamethasone is effective in the treatment of RDS produced with oleic acid injection while hyosine hydrobromide is of no value.

Objective: To discuss and analyze the respective clinical effects of autologous fat filling for facial rejuvenation in the same period of three months after incisions. Methods: From June 2015 to January 2018, 117 patients with facial rejuvenation admitted to the Plastic Surgery Hospital of Weifang Medical College were randomly divided into A, B and C groups. Group A (39 cases, male 3 cases, female 36 cases, age 44-67 years old) received simple rhytidectomy. Group B (39 cases, male 4 cases, female 35 cases, age 45-67 years old) underwent rhytidectomy and autologous fat filling at the same time. Group C (39 cases, male 3 cases, female 36 cases, age 45-65 years old) received autologous fat filling 3 months after rhytidectomy. We compared the improvement of facial depression (nasolabial groove and mouth angle), the effect of facial rejuvenation after fat filling in three groups and the incidence of complications in group B and C. Results: 15 cases in group A, 12 cases in group B and 2 cases in group C had no obvious improvement in facial atrophy, the remaining 88 cases had obvious improvement compared with before operation, and achieved the effect of facial rejuvenation. The incidence of complications in group C (7.69%) was significantly lower than that in group B (35.90%), the excellent or good rate of facial improvement and the nasolabial groove and peri-oral depression improvement in group C (87.18%, 92.31%) was significantly higher than that in group B (64.10%, 64.10%) and group A (33.33%, 17.95%) (P<0.05). Conclusions Comparative analysis of fat filling after 3 months of wrinkle removal to improve facial soft tissue atrophy and collapse is more obvious and more permanent in effect than fat filling, which is worthy of clinical promotion.

Objective To investigate the relationship between serum uric acid level and renal function decline by retrospective cohort study.Methods Through the physical examination system of the First People's Hospital of Foshan,the physical examination data from 2015 to 2018 of a public institution in Foshan city were obtained.The gender,age,blood cell analysis,liver function,serum creatinine,uric acid,fasting blood glucose were obtained.The change of eGFR (△eGFR=eGFR2018-eGFR2015) was analyzed.Results A total of 2505 subjects were followed up for four years.The subjects were divided into △eGFR ≥0 group and △eGFR ＜ 0 group.There were 845 subjects in △eGFR ≥0 group,and 1660 subjects in △eGFR ＜ 0 group.Compared with that in △eGFR ＜ 0 group,the base-level of uric acid in △eGFR ≥ 0 group was higher [(349.48±87.62) μmol/L vs (325.72±82.58) μmol/L,t=6.669,P ＜ 0.001],but the rate of uric acid decline was greater [-15.00(-53.50,17.00) μmol/L vs 15.50(-18.00,49.00) μmol/L,Z=-13.470,P ＜ 0.001].According to the levels of uric acid in 2015 and 2018,then the subjects were divided into four groups,normal to normal group (N-N,1551 cases),normal change into high uric acid group (N-H,299 cases),high uric acid drop to normal group (H-N,238 cases),and high to high uric acid group (H-H,417 cases).The △eGFR was-1.58(-4.17,1.01) ml · min-1 · (1.73 m2) 1 in N-N group,and-3.60(-7.24,-0.98) ml · min-1 · (1.73 m2)-1 in N-H group,-0.20(-3.14,3.27) ml· min-1· (1.73 m2)-1 in H-N group,-0.96(-4.07,1.93) ml· min-1· (1.73 m2)-1 in H-H group,respectively.The △eGFR decreased most significantly in N-H group than the other three groups (x2=103.130,P ＜ 0.001).Multivariate logistic regression analysis showed that elevated uric acid was an independent risk factor for eGFR decline (OR=1.739,95％CI 1.587-1.906,P ＜ 0.001),while elevated indirect bilirubin (OR=0.968,95％CI 0.943-0.993,P=0.013),elevated red blood cells (OR=0.815,95％ CI 0.680-0.976,P=0.026) were independent protective factors for eGFR decline.Conclusion Elevated uric acid is an independent risk factor for the decline of renal function.Good control of hyperuricemia is beneficial to the protection of renal function.

Objective:To investigate the characteristic of mammography, magnetic resonance imaging (MRI), ultrasonography and pathology of mucinous breast carcinoma (MBC); and to study the differential diagnosis value of the three methods in pure MBC (PMBC) and mixed MBC (MMBC).Methods:One hundred and three lesions in 100 MBC patients confirmed by surgery and pathology in the Affiliated Cancer Hospital of Fudan University from January 2011 to January 2018 were retrospectively analyzed. According to the 2013 version of the breast imaging report and data system (BI-RADS) criteria, the three imaging findings of lesions were described, evaluated and classified. According to pathological results the lesions were divided into two groups, PMBC and MMBC, and their imaging features and differences were analyzed.Results:On mammography, most of the mammary glands were c-types (55/76, 72%), and the lesions were mostly masses (71/76, 93%), most of which were round, oval, high-density masses with circumscribed, microlobulated or indistinct margins. Suspected malignant calcification was showed in 21% (16/76) of these lesions. Eight patients had ipsilateral axillary lymphadenopathy. On MRI, most lesions showed masses (69/72, 96%). Sixty-seven lesions (31/72, 43%; 36/72, 50%) showed equal and high signals on T 1WI, and 54 lesions (54/72, 75%) showed higher signals on T 2WI. The margins were mostly irregular and burrs (53/69, 77%). Masses enhancement was dominated by heterogeneous enhancement (32/69, 46%) and rim enhancement (33/69, 48%). The patter of time-signal intensity was dominated by progressive curves (41/72, 57%) and platform curves (24/72, 33%). The lesions had heterogeneous high signal on DWI. The ADC signal was slightly higher than normal gland. Seven patients were accompanied with thickening of the skin and nipple retraction. Eight patients had ipsilateral axillary lymphadenopathy. One patient had multiple lung metastases. On ultrasonography, most lesions showed irregular masses, heterogeneous hypoechoic, well-defined margins, posterior echo enhancement (75/97, 77%). Color Doppler imaging showed vascularity in 65% (63/97) of these lesions. Nine patients had ipsilateral axillary lymphadenopathy. There was significant difference in margins between PMBC and MMBC ( P < 0.05) on MRI and ultrasonography. It showed significant difference in vascularity between 2 groups ( P < 0.05) on MRI. Conclusions:MBC has some typical features in mammography, MRI and ultrasonography. Realizing its features can improve the diagnostic accuracy of MBC, and it also can contribute to the differential diagnosis of PMBC and MMBC.