Objective To investigate the pathogenesis of hepatogenic diabetes.Methods The fasting and 2-hour postprandial plasma glucose,fasting sertum insulin,glutamate decarboxylase antibody,insulin release index (IRI)and insulin sensitivity index(ISI)Was determined and analyzed in 135 liver cirrhosis patients.Results The incidence of hepatogenic diabetes wag 39.3%(53/135)in liver cirrhosis patients.The incidence of hepatogenic diabetes in post hepatitis C liver cirrhosis patients(53.3%.16/30)was muchh igher than that in post hepatitis B liver cirrhosis patients(37.1%,26/70)and alcohofic liver cirrhosis patients(31.4%.11/35)(P＜0.01).The fasting serum insulin,IRI and the positivity rate of glutamate decarboxylase antibody was much higher in hepatogenic diabetes than that in controls(P＜0.01),and ISl was much lower than that in controls(P＜0.01).Conclusions The development of hepatogenic diabetics is relsted with the etiological factor of liver cirrhosis.Besides impairment of the hepatocellular function and insulin resistance,viral infection and immunologic derangement and so on results in impairment of beta cell of islet function.Relative or absolute deficiency of insulin secretion is an important influential factor in the development of hepatogenic diabetics.

Objective To observe the effect of combination of traditional Chinese medicine and western medicine on the treatment of post-operation endometriosis.Methods 60 cases with post-operation endometriosis were randomly divided into two groups.Patients in control group(n=30)were treated only by routine therapy (gestrinone twice a week).Patients in treatment group(n=30)were treated by combination of traditional Chinese medicinc(a decoction promoting blood flow)and western medicine.The effects were observed before and after treat- merit in both groups for 3 months.Results The accumulative total recurrence rate in treatment group(13.33 %) was lower than that in control group(30.00%,P

Objective To explore the pathogenesis of thrombocytopenia in chronic type B hepatitis. Methods The serum thrombopoietin (TPO) levels, bone marrow megakaryocyte (MK) count, platelet-associated immunoglobulin G (PAIgG), splenic index (SPI), prothrombin activity (PTA) were measured in 76 chronic type B hepatitis patients with thrombocytopenia. Results The regression analysis revealed that the platelet count was correlated with parameters including the serum TPO levels, bone MK count, SPI and PTA (r was 0.450, 0.521, -0.438, 0.428 respectively, P<0.05). The regression equation was Pt=36.38+0.23 TPO-0.57 SPI+0.69 MK, R<'2>=0.57, F=18.78, P<0.01. Conclusion It suggests that decline of thrombopoiedn, myelosuppression and hypersplenism may contribute to thrombocytopenia in chronic type B hepatitis patients.

Adult ; Ankle ; blood supply ; surgery ; Dermatologic Surgical Procedures ; Female ; Foot ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin ; blood supply ; Surgical Flaps ; Tibial Arteries ; surgery ; Young Adult

OBJECTIVETo compare the efficacy and safety of segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) guided by EnSite NavX system in patients with atrial fibrillation (AF).

METHODSEighty-five patients with paroxysmal AF and persistent AF were enrolled in this study. Forty patients (30 with paroxysmal AF and 10 with persistent AF) underwent SPVI procedure, and 45 (31 with paroxysmal AF and 14 with persistent AF) underwent CPVA guided by EnSite NavX three-dimensional electrophysiological mapping system. All the patients were followed up for over six months.

RESULTSThe success rate was 65% in the SPVI group and 84.4% in the CPVI group (P=0.0332), with incidence of major complications of 17.5% and 6.7%, respectively (P=0.0845). In the SPVI group, 12.5% patients had pulmonary vein stenosis after the operation, which occurred in none of the patients in the CPVI group (P=0.0312). The total procedure time was 200.4+/-37.0 min in the SPVI group, significantly shorter than that in the CPVI group (226.5+/-26.1 min, P=0.002). The fluoroscopy time in the SPVI group was obviously longer than that in the CPVI group (54.7+/-9.7 vs 27.1+/-3.1 min, P<0.001).

CONCLUSIONSCPVI guided by EnSite NavX system is more effective than SPVI for treatment of atrial fibrillation with significantly shortened fluoroscopy time but prolonged procedure time. The two procedures results in comparable incidences of major complications, but CPVI is associated with reduced rate of pulmonary vein stenosis in comparison with SPVI.

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; adverse effects ; methods ; Electrophysiologic Techniques, Cardiac ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; physiopathology ; surgery

For in vitro studies, both CD34+ selected cell and mononuclear cell (MNC) can be used to expand hematopoietic stem/progenitor cells. To investigate the expansion characteristics of mononuclear cells (MNC) and CD34+ selected cells the two cell fractions were cultured in the medium containing cytokine cocktails of SCF + IL-3 + IL-6 + FL + Tpo. It was found that the CD34+ selected cells had presented a high proliferation potential. The expansion of CD34+ selected cells could be maintained for 8 weeks while that of MNCs declined after 4 weeks. During the culture period, the maximum expansion of total cells in CD34+ selected cell culture achieved 31,270.9 +/- 8640.5 times, while that of MNC reached 50.9 +/- 8.2 times only. In the culture of MNCs, the colony density and the proportion of CD34+ cells increased from day 0 to day 7. However, in the culture of CD34+ selected cells, both the colony density and the proportion of CD34+ cells declined continuously during the whole culture period. During the ex vivo culture of CD34+ selected cells, the maximum expansion of CFU-GM and CD34+ cells achieved 185.7 +/- 14.1 fold and 191.7 +/- 188.8 fold, respectively. They are much higher than that of MNC, which were 12.4 +/- 3.2 fold and 50.6 +/- 33.2 fold only. While the BFU-E of both cell fractions only expanded by few times, which were 7.2 +/- 5.2 and 10.1 +/- 3.4 times, respectively. The results showed that the CD34+ selected cells culture could obtain more CFU-GM cells and CD34+ cells during the whole culture period.
Antigens, CD34 ; analysis ; Cell Count ; Cell Separation ; Cells, Cultured ; Fetal Blood ; cytology ; Hematopoietic Stem Cells ; physiology ; Leukocytes, Mononuclear ; cytology

OBJECTIVETo investigate the efficacy and safety of circumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping in patients with atrial fibrillation (AF).

METHODSThirty-eight patients with drug refractory paroxysmal or persistent AF underwent circumferential pulmonary vein ostial isolation and were followed up to investigate the efficacy and safety of the treatment.

RESULTSAll cases reached the endpoint of the ablation, and both sides of the pulmonary vein were completely isolated, with an average procedure time of 200.4-/+37.0 min, X-ray exposure time of 54.7-/+9.7 min, and three-dimensional left atrial geometry reconstruction time of 27.5-/+7.5 min. During the follow-up for 9-/+3 months, the success rate of initial ablation was 89.5%, and the incidence of procedure-related complications were 7.9%.

CONCLUSIONSCircumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping can be effective and safe for AF treatment.

Adult ; Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Electrophysiologic Techniques, Cardiac ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery ; Treatment Outcome

Recent years found a series of severe incidents of injuring or killing medical workers in several places in China,deteriorating patient-physician relations,and disturbing medical orders.Beijing Administration of Hospitals,since its founding,has attached great importance to the management of medical disputes,as evidenced in the full-process management covering pre-during-post disputes.The administration guided the hospitals in their dispute resolution,and included resolution rate of disputes as an index of municipal hospital performance evaluation.By means of the guidance of such evaluation, medical disputes and major medical accidents have been resolved satisfactorily,and fine management of service quality of such hospitals in terms of medical service,pharmacy,nursing and medical technology has been intensified all the time.

Objective To observe the therapeutic effect of endovascular treatment on patients with epileptic attack induced by carotid artery or vertebral artery stenosis.Methods Two epileptic attack patients,diagnosed as having symptomatic carotid artery or vertebral artery stenosis by DSA,were performed endovascular stenting and balloon dilation.Case one had a serious artery stenosis at the left original internal carotid artery and moderate artery stenosis at the right proximal internal carotid artery and vertebral artery.Case two had 1 occlusion at the right original intemal carotid artery and serious artery stenosis at the clinoid segment of left internal carotid artery and the double proximal vertebral arteries restenosis after percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic ostial vertebral artery stenosis.Two patients were treated with PTAS and balloon angioplasty.Follow up was performed for one to three years.Results The clinical symptoms of these two patients disappeared aftter the operation.Case one was followed up for almost 3 years and case two for more than one year; no relapse was noted for their regular taking platelet aggregation inhibitor and without taking antiepileptic drug.Conclusion Endovascular treatment is a safe and efficient method for treating patients with epileptic attack induced by carotid artery or vertebra-basilar artery stenosis.

OBJECTIVETo understand the genotypic mapping of Mycobacterium leprae identified in China and to compare with those from other countries to select suitable alleles for epidemiological investigation in the transmission chain of leprosy.

METHODSVarious number of tandem repeat(VNTR) in genomic DNA of Mycobacterium leprae was used in the present genotyping study. 33 skin biopsies from Wenshan prefecture,Yunnan province and 17 from other parts of China were studied. DNA extracted from skin biopsies of leprosy patients was subjected to PCR followed by agarose gel analysis and DNA sequencing to determine the number of repeats.

RESULTSLoci GGT-5,12-5,21-3 and 23-3 were as highly homogenous as 100%; The homogeneity of loci AC-8, 18-8, 27-5 and rpoT were 97%, 94%, 97% and 85% respectively. Loci GTA-9, AC-9 and 6-7 showed significant allelic diversity in isolates and the diversity of GTA-9 in Mycobacterium leprae isolated from China was also different from those identified other countries. We had subjected loci GTA-9 and the ten loci to phylogenetic tree analysis respectively.

CONCLUSIONThe present study revealed that the genotype of Mycobacterium leprae identified from China was close to the strains from the Philippines and India although a few loci were somehow differentiate. Locus 12-5 manifested as only 3 copies in China whereas 4-5 copies predominating in other countries. 12-5 locus might serve as a useful marker to diffrentiate Chinese strains from those in other countries. However, further study on the diversity of GTA-9 was needed in China. The molecular typing of Mycobacterium leprae from different geographic areas might be useful in studying the transmission of leprosy.

Alleles ; China ; epidemiology ; DNA, Bacterial ; Genotype ; Humans ; Leprosy ; epidemiology ; transmission ; Molecular Epidemiology ; Mycobacterium leprae ; genetics ; isolation & purification ; Polymerase Chain Reaction ; Skin ; microbiology