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.

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 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.

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 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.

BACKGROUND: D-galactose-induced aging animal model is similar tohuman natural aging. Whether the expression of protein phosphatase-1(PP-1) in the brain of D-galactose-induced aging mice is related to cerebralaging process or not should be researched further. OBJECTIVE: To investigate the effect of the APP17 peptide and theliquid extract ofjiunao yizhi capsule on regulating the expression of PP-1 inhippocampal neurons of the aging mice induced by the D-galactose (D-gal). DESIGN: A random controlled study. SETTING: Department of Pathology, College of Basic Medical Sciences, Capital University of Medical Sciences and Beijing Research Laboratory forBrain Aging, Xuanwu Hospital of Capital University of Medical Sciences. MATERIALS: The study was completed between July 2003 and July2004 in the Experimental Center of Capital University of Medical Sciences. Forty male Kunming mice (SPF grade) with a body mass fron 28 g to 32 gwere purchased from Chinese Academy of Medical Sciences Institute ofMaterial Medical.METHODS: Kunming mice were randomly divided into 5 groups: control group, D-gal group, APP17 peptide treatment group, low dose herb treatment group, and high dose herb treatment group with 8 mice in each group. In Dgal group, APP17 peptide treatment group, low dose herb treatment group and high dose herb treatment group, galactose was injected subcutaneously (50 nmg/kg). Meanwhile, 0.1 mL normal saline containing 0.35 μg of APP17 peptide was injected subcutaneously into the mice in APP17 peptide treatment group, once a day for 3 months; liquid extract of jiunao yizhi capsule (provided by Beijing Chaoyangmen Hospital and Shanxi Quwo Traditional Medical Institute; the main component: dangshen, baizhu, guijia and chuanshanjia, etc.) was perfused by stomach (0.3 g/kg and 1.0 g/kg respectively) in low dose herb treatment group and high dose herb treatment group, once a day. And equivalent normal saline was injected and perfused in the two control groups. After 3 months of survival, the mice were killed and their brains were cut into sections. The immunohistochemical staining of these sections was then performed with PP-1 antibody.MAIN OUTCOME MEASURES: The results of immunohistochemical staining analysis of PP-1.RESULTS: Forty mice entered the final analysis without any loss. PP-1 positive cells in the hippocampus were poorly stained in the D-gal mice. In contrast, PP-1 positive neurons were widely distributed in the hippocampus of those normal mice, the APP17 peptide-treated D-gal mice and the high liquid extract of raw herb-treated D-gal mice. These cells were darkly stained in cytoplasm. The unexpected result was that in the low liquid extract of raw herb-treated D-gal mice the number of PP-1 positive neurons did not increase to normal.CONCLUSION: The results demonstrated that the expression of PP-1 decreased in the hippocampus of D-gal mice. The APP17 and low dose liquid extract of raw herbs can regulate the distribution of PP-1 in the brain of D-gal mice and make them recover to normal situation.

BACKGROUND: In brain insulin does its work through the insulin receptor substrate (IRS). Amyloid beta protein precursor 17 (APP17) peptide has the neurotrophic function, which may improve diabetic encephalopathy resulted from insulin deficiency by affecting insulin receptor substrate.OBJECTIVE: The mouse diabetic model was produced to observe the effect of APP17 peptide on the distribution of IRS-1 in brain tissues.DESIGN: Randomized control animal experiment.SETTING: Staff Room of Pathology, College of Basic Medical Sciences,Capital University of Medical Sciences; Beijing Research Laboratory for Brain Aging of Xuanwu Hospital.MATERIALS: The experiment was performed in Staff Room of Pathology,College of Basic Medical Sciences, Capital University of Medical Sciences and Beijing Research Laboratory for Brain Aging of Xuanwu Hospital from September to October 2003. Totally 18 male kunming mice were employed,and randomly assigned into control group, diabetic group and APP17 peptide treatment group with 6 mice in each group.METHODS: ①The mice were subjected to intraperitoneal injection of streptozotocin (STZ, Sigma) by 200 mg/kg, and 3 days later, the tail blood was sampled to examine non-fasting blood glucose, and the blood glucose over 15 mmol/L was set as the criteria for successful diabetic model establishment. ②In APP17 + diabetes mellitus group, the mice received subcutaneous injection of 0.35 μg APP17 peptide once daily for 2 weeks. The mice in the normal control group were not interfered. ③Then brain was removed and crystat sections were prepared. Immunohistochemical staining was done for IRS-1 at four weeks after giving streptozotocin.MAIN OUTCOME MEASURES: Pattern and distribution of IRS-1 positive cells of mice in each group.RESULTS: Totally 18 mice were involved in the result analysis. ①In the brains of diabetic mice the IRS-1 immunohistochemical positive cells distributed at cortex, hippocampus, thalamus, hypothalamus and so on, while the positive cells distributed only at cortex and hippocampus in the normal control group and APP17 peptide treatment group, lightly stained. ②Numbers of immunohistochemical positive cells of IRS-1 of cerebral hippocampus in the diabetic group, normal control group and APP17 peptide treatment group were (28.7±1.5), (9.2±1.5), (10.1±1.4) piece per 10 power object lens, and that in the diabetic group was higher than that in the other two groups (P ＜ 0. 001 ). CONCLUSION: Neurons in many regions of brains of diabetic mice have plenty of IRS-1 positive cells. APP17 peptide can make part and quantity of IRS-1 positive cells normality so as to ameliorate the degeneration of hippocampal neurons of diabetic mice.