Objective:To investigate the expression and clinical significance of glycosylated albumin(GA) and glycosylated hemoglobin(HbA1c) in patients with diabetic microangiopathy(MVCD).Methods:A total of 295 patients with type 2 diabetes admitted to Chaoyang Central Hospital of Liaoning Province from May 2017 to July 2019 were selected as case group, and they were divided into simple diabetes group (217) and microvascular disease group (78) according to whether the patients had microvascular lesions.Two hundred healthy people were selected as normal control group.The levels of GA and HbA1c were compared between the case group and the normal control group, and the levels of GA and HbA1c in the diabetic group and the microvascular disease group were compared.The risk factors of microangiopathy in patients with type 2 diabetes mellitus were analyzed by logistic regression analysis.Results:The levels of GA and HbA1c were (23.9±10.1)% and (8.6±2.3)% in the case group, which were (13.4±1.2)% and (5.0±0.6)% in the normal control group.The differences between the two groups were statistically significant( t=14.628, 21.636, all P<0.01). The levels of GA and HbA1c were (22.8±9.7)% and (8.4±2.0)% in the simple diabetes group and (25.4±10.3)% and (9.2±2.4)% in the microvascular disease group.The differences between the two groups were statistically significant( t=1.997, 2.869, P=0.047, 0.004). Logistic regression analysis showed that GA and HbAlc were risk factors for microangiopathy in patients with type 2 diabetes ( OR (95% CI) values were 1.088 (1.030-1.157) and 15.251 (1.756-131.157), P=0.003 and 0.014). Conclusion:The occurrence of MVCD is related to GA and HbA1c.Logistic regression analysis showed that GA and HbA1c levels were risk factors of MVCD, and could be used as predictive factors of MVCD.

Objetive Stress fracture is often misdiagnosed because of some misunderstandings. Our study is to explore the value of imaging in diagnosing the stress fracture. Methods We analyzed 64 cases of stress fracture,of which 27 were male and 37 were female. Plain X ray examinations were performed for all of them, and the ECT, MRI, CT examinations followed in 28 cases. Results We divided the stress fracture into fatigue fracture and insufficiency fracture. In our study, 12 cases were of the fatigue fracture, 18.7%in all cases; and the other 52 cases were of the insufficiency fracture, 81.3%in all cases. 36 cases were diagnosed by the plain films only, and other 28 cases by a combination of ECT, MRI, CT imaging. The fatigue fracture was dominantly seen in the tibia of the adolescent, while the thoracic and lumber spines of old female were the common area of the insufficiency fracture. Conclusion Generally the stress fracture can be diagnosed according to the clinical appearance and X ray plain film. But the ECT, and MR imaging are also necessary in diagnosing difficult cases and the fracture at its early stage.

OBJECTIVE:To optimize the ratio of glycerol in Chloramphenicol and Ephedrine Nasal Drops included in China's Hospitals Agents Norms.METHODS:By formula optimization and observation on clinical trials,the ratio of glycerol in Chloramphenicol and Ephedrine Nasal Drops was reduced from 300mL to 50mL.RESULTS & CONCLUSION:The Chloramphenicol and Ephedrine Nose Drops prepared in an optimized ratio of glycerol is of much less irritability,good transparency,good compliance in patients,more reliable efficacy,thus deserving to be popularized.

目的了解住院精神病患者并发躯体疾病的特点及解决办法。方法对住院期间并发躯体疾病的精神病患者进行调查。结果和结论住院精神病患者所患躯体疾病常涉及多个系统和器官;患者及家属对检查配合度不高,躯体疾病与精神疾病的治疗可能存在矛盾,导致住院期间并发躯体疾病精神病患者诊断、治疗困难。

Objective To evaluate the relationship between the expressions CyclinD1 and nm23H1 and the response to neoadjuvant chemotherapy (NACT) in cervical carcinoma. Methods 100 patients with cervical cancer were enrolled in this study. These patient were randomly divided into two groups. The observed group were treated by neoadjuvant chemotherapy followed by radical hyterectomy and lymphonectomy. The other 50 cases were treated by operation as control group. The expression of CyclinD1 and nm23H1 were examined by immunohistochemistry using post-operation specimens. Results The total response rate of neoadjuvant chemotherapy was 75 %( CR+PR). The expression rate of CyclinD1 was 76 % in experimental group, and 54 % in control group(P 0.05). Conclusion The neoadjuvant chemotherapy was helpful for the patients with local advanced stage of cervical carcinoma. CyclinD1 may be one of the path of NACT, but nm23H1 may not related to NACT.

With the transformation of medical model,technical improvement,and the development of various medical laws and regulations,requirement for medical ethics is being increased in clinical medical education gradually.Under this circumstance,medical simulation education come into being and evolves prosperously.However,present application of medical simulation education is imperfect and far from satisfaction in China.This article summarizes the relation of medical ethics and medical simulation education.

Objective To definite the correlation of hip muscle density with proximal femoral fracture in the elderly.Methods The study included 41 proximal femoral fracture cases [14 males and 27 females,at age of (64.1 ±5.1)years] and 14 normal cases [4 males and 10 females,at age of (64.8 ± 3.9) years] that underwent CT examination for hip joint.In fracture group,19 cases sustained femoral neck fracture and 22 intertrochanteric fracture.CT imaging data were reviewed to analyze the correlation of age with hip muscle density at the level of ischium tubercle.Hip muscle density was compared between fracture side and healthy side in fracture group and between control group and fracture group.Results Hip muscle density showed a downward trend with increased age (P ＜ 0.05).Hip muscle density did not differ significantly between fracture side and healthy side in fracture group (P ＞ 0.05).Regardless of age,gender and other factors,hip anterior muscle density [(34.8 ± 4.1) Hu] and posterior muscle density [(22.1 ±5.5) Hu] were lower in fracture group than in control group [(44.4 ±5.7)Hu,(39.2 ±5.3)Hu respectively,P ＜ 0.05] but there was no significant difference in hip medial muscle density between the two groups (P ＞ 0.05).Conclusions Hip muscle density decreases with age and has no strong correlation with fracture.Deadline of the hip muscle density may be a risk factor to proximal femoral fracture in the elderly.

Objective To research the variety and the imaging features of bone tumor and tumor-like lesions in the talus.Methods The imaging features of 33 cases of tumor and tumor-like lesions in the talus were reviewed retrospectively.All cases were confirmed by operation and pathology,All of 33 cases were performed X-ray examination,23 cases were examined by CT,and 11 cases were taken by MR.Results In 33 cases,24 cases were males,9 cases were females; including 7 cases of chondroblastoma(21.2％),7 cases of giant cell tumor(21.2％)(1 case of recurrence),6 cases of osteochondroma(18.2％),2 cases of osteoid osteoma(6.1％),7 cases of adjacent joint bone cyst(21.2％,2 cases of fibrous dysplasia of bone(6.1％),1 case of bone cyst(3％),1 case of malignant fibrous histiocytoma(MFH) of bone(3％).6 cases showed pathological fractures.The X-ray and CT imaging features of chondroblastoma,giant cell tumor,adjacent joint bone cyst,fibrous dysplasia of bone,bone cyst demonstrated cystic bony destruction.The common location of chondroblastoma were the posterior of talus(57％),expanding growth slightly,margin were mild osteosclerosis.The margin were osteosclerosis irregularly and osteal ridges showed in giant cell tumor.MRI features were different on pathologic basis,isointense and hypointense signal on T1WI and hyperintense signal on T2WI usually.The osteochondroma showed osseous protuberance connecting the talus,some cases showed calcification in the cap.The imaging of MFH in the talus X-ray and CT showed ill-defined osteolytic bony destruction,soft tissue-mass,no periosteal reactions and bone formation.MRI showed isointense and hypointense signal on T1WI and isointense and hyperintense signal on T2WI.The extent of tumour invasion clearly displayed.Conclusion Tumor and tumor-like lesion in the talus were rare.But there are great varieties.The benign tumor was more common than malignant tumor.Chondroblastoma,giant cell tumor,osteochondroma,osteoid osteoma and adjacent joint bone cyst were relatively common and had some imaging features.Malignant tumor rarely happened in the talus,but it is possible.

Objective To investigate the relationships of pulmonary arterial pressure (PAP) with serum protein S100B, cytokines and plasma procalcitonin (PCT) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A prospective controlled study was conducted, 160 subjects admitted in the Critical Care Medicine and Respiratory Disease Departments in the Affiliated Hospital of Shanxi Medical University/Changzhi Municipal People's Hospital from January 2012 to August 2013 were enrolled in the study, including 80 patients with AECOPD (AECOPD group) and 80 COPD under stable condition (SCOPD group). Meanwhile 100 healthy people having passed physical examinations were chosen as healthy control group. The levels of blood routine and plasma PCT were examined, PAP was evaluated by modified Simpson, sequation with echocardiography, serum S100B was measured by radioimmunoassay, and enzyme linked immunosorbent assay (ELISA) was used to measure interleukins (IL-18, IL-1β) and tumor necrosis factor-α(TNF-α). The linear correlation analysis was carried out for the various indicators. Results The gender and age in different groups were matched. Compared with the healthy control group, the levels of white blood cell count (WBC), ratio of neutrophil granulocyte (PMN), PAP, PCT and S100B, IL-18, IL-1β, and TNF-αwere significantly higher in SCOPD and AECOPD groups [WBC (×109/L):0.84±0.22, 1.94±0.64 vs. 0.73±0.12, PMN: 0.70±0.09, 0.85±0.08 vs. 0.54±0.05, PAP (mmHg, 1 mmHg = 0.133 kPa): 39±5, 47±8 vs. 24±5, PCT (μg/L): 0.41±0.08, 6.35±2.14 vs. 0.11±0.01, S100B (μg/L): 0.081±0.017, 0.101±0.028 vs. 0.041±0.011, IL-18 (ng/L): 162±19, 181±27 vs. 112±19, IL-1β(ng/L): 55±12, 75±14 vs. 34±10, TNF-α(ng/L):67±17, 89±18 vs. 35±17, all P<0.05], and the increase in level of indexes was more significant in AECOPD group than that in the SCOPD group (all P < 0.01). Serum S100B was significantly positively correlated with PCT, IL-18, PMN and PAP (r value was 0.36, 0.41, 0.39, 0.35, all P<0.05), and plasma PCT was also significantly positively correlated with PMN and PAP (r value was 0.41, 0.37, both P<0.05). Conclusion The level of serum S100B might have positive obvious correlation to the changes of plasma PCT, cytokines and PAP.

Chronic pain is a common clinical disease,which brings great burden to the patients.However,the pathogenesis underlying of chronic pain is complicated,which is affected by many factors,such as physiology,psychology and society.Therefore,the treatment of chronic pain has been a problem in clinical practice.Considering its complexity,a single way of treatment usually could not reach satisfactory results,so combination therapy is often used to treat chronic pain at present.The combination therapy includes pharmacological treatment,psychological approaches,interventional treatment,self management and so on.The treatment plans are distinct for different types of chronic pain,even the individual patients with the same kind of pain.The emergence of interdisciplinary rehabilitation programs shed light upon the treatment of chronic pain recent years.This paper reviewed the research on chronic pain treatment,in order to provide theoretical basis for clinical practice.