Based on the results of oral glucose tolerance test( OGTT )and the levels of 1-h plasma glucose ( 1 hPG),793 subjects were classified into three groups:583 with NGTN ( normal 1 hPG in OGTT),127 with NGT1 H( higher 1 hPG in OGTT) and 83 with IGT( impaired glucose tolerance).NGT1H group had large waist circumference,higher body mass index,fasting plasma glucose( FPG),triglyceride,and lower high density lipoprotein-cholesterol than those of NGTN group.NGT1 H group had higher homeostasis model assessment insulin index ( 1.2 ± 0.6),lower homeostasis model assessment β3 ( HOMA-β ) (4.5 ± 0.7 ) and insulinogenic index (2.1 ±0.7) than those of NGTN group(0.5 ±0.6,4.8 ±0.7,2.7 ±0.9,respectively,all P ＜0.05 ).HOMA-β of NGT1 H group was higher than that of IGT group(4.5 ±0.7 vs.4.4 ±0.6,P ＜0.05 ).The results indicate that 1 hPG in OGTT may identify a condition of glucose metabolic abnormalities characterized by insulin resistance and reduced β-cell function.

Five patients with pulmonary alveolar proteinosis admitted to Taihe hospital from 2006 to 2008, were treated by whole lung lavage under intravenous anesthesia, the clinical data were collected and analyzed retrospectively. The patients were followed up for 2 to 20 months, and their symptoms and pulmonary function were improved significantly after lung lavage treatment. Our experiences showed that lung lavage with intravenous anesthesia is the most effective treatment for pulmonary alveolar proteinosis.

A cross-section study was designed to investigate clinical utility of lipid measures for prediction of insulin resistance(IR).A total of 793 healthy volunteers were divided to IR group or non-IR group based on the value of HOMA-IR.Area under receiver operating characteristic curve(ROC)found that TG/HDL-C was more related with IR in comparison with other lipid ratios,and could be used as a measure in predicting IR.

Objective To evaluate the performance of fast Treponema pallidum(TP) detection in voluntary blood donors and optimize the strategy for pre-donation screening.Methods Before blood donation,the gold standard TP test strip was used to make a fast detection.After blood donation,the TP-ELISA was used to test the blood.Then,analyze the donors′ anti-TP positive rate,times and intervals of donating,false positive and negative of TP fast detection.Results From 2014 to 2015,among 73 990 donors who were tested by using fast TP detection,0.71% of them(529 donors) were positive.Among the positive donors,89.2% of them(472 donors) were first-time blood donors.35 donors′ donating intervals were more than 3 years,who accounted for 61.4% of the donors who had donated for more than once.The numbers of the false positive obtained from fast TP detection were 5 and the false negative was 15.By applying the fast TP detection before blood donation,the rate of anti-TP positive had been declined from 0.71% to 0.17%.Conclusion The rejection rate of TP positive can be significantly reduced by using fast TP detection before blood donation.The fast TP detection can be used to optimize the pre-donation screening and promote blood donation service efficiency and level,while donating times and intervals of the blood donors were also considered.

Objective To evaluate the efficacy of pressure bladder indicator in guiding epidural puncture.Methods Test Ⅰ Thirty-two patients scheduled for epidural puncture were studied. After successful epidural puncture, the end of the epidural needle was connected to a pressure sensor to measure the epidural space pressure. Test Ⅱ Seventy patients scheduled for epidural puncture were studied. The epidural puncture was performed using the pressure bladder indicator. The successful condition of the pressure bladder indicator in guiding epidural puncture was recorded. Results The epidural space pressure was ( 10 ± 4) cm H2O. Seventy patients completed epidural pucture under the guidance of the pressure bladder indicator. The success rate was 100%.Conclusion The pressure bladder indicator can serve as an assistance for epidural puncture and has clinical application value.

Objective To investigate the value of preoperative neutrophil?to?lymphocyte ratio(NLR) as a prognostic predictor after radical resection of bladder cancer for muscle?bladder cancer. Methods Two hundred and fifty?two cases consecutive muscle?invasive bladder cancer patients treated with total excision radi?cal bladder at the Rology Surgery Department of Affiliated Hospital of Weifang Medical College from January 2006 to March 2010 were retrospectively analyzed,and all patients were diagnosed bladder cancer by pathological examination. Based on the cut?off value of 2. 7,all the patients were divided into two groups:a low NLR(<2. 7,n=142) group and a high NLR(≥2. 7,n=110) group. None accepted neoadjuvant therapy. Results The 5?year overall survival rate was 75. 2% in patients of the low NLR group and 53% in the high NLR group,the difference was significant(P=0. 005). Univariate analysis showed that NLR(P=0. 002),tumor size(P=0. 035),T stage (P=0. 0022),tumor grade(P=0. 04),hydronep?hrosis or no(P=0. 031),Lymph node metastasis or no(P=0. 003) were associated with survival. Cox multivariate analysis revealed that NLR was independent risk factors of prognosis(HR:2. 586;95%CI:1. 256-2. 851;P=0. 039). Conclusion Preoperative NLR≥2. 7 may be a convenient biomarker to predict patients with a poor prognosis after radical cystectomy for muscle?invasive blad?der cancer.

Objective To investigate the features of PET-CT manifestation of pancreatic metastasis,and to improve its detection rate.Methods The PET-CT images of 31 cases of clinically diagnosed pancreatic metastases and 26 cases of primary pancreatic cancer were retrospectively evaluated.Two experienced specialists identified the lesion location in fused images.After frame by frame image analysis,the lesions with significantly increased radioactivity uptake were seen as positive,when compared with surrounding normal pancreatic tissue.The outline of regions of interest was drawn along the edge of the lesion shown in PET,and based on a semi-quantitative evaluation,the maximum standard uptake value (SUVmax) was calculated.If SUVmax ＞ 2.5,it was considered as positive.Results Among the 31 cases with pancreatic metastasis,22 cases of lung cancer,2 cases of gastric cancer 2 cases of colon carcinoma,1 case of maxillary sinus carcinoma,thyroid carcinoma,melanoma,renal cell carcinoma or gallbladder carcinoma were identified.Twenty-one cases (67.7％) were single,10 cases (32.3％) were multiple or diffuse lesions.Among the single lesions,7 (33.3％) were located in the pancreatic head and neck,14 in pancreatic body and tail.Among the 26 cases of primary pancreatic carcinoma,18 cases (69.2％) were located in the pancreatic head,8(30.8％) in the pancreatic body and tail.The sites of primary and metastatic pancreatic cancer were significantly different (x2 =6.012,P =0.014).CT scan showed only 17 nodular lesions with relatively low density and less clear boundary.PET images showed lesions in 31 cases of metastatic pancreatic cancer,and the mean SUVmax was 7.42 ± 3.48,which was significantly higher than that in primary pancreatic cancer group (5.39 ± 1.71,F =4.87,P =0.032).In addition,PET-CT identified 30 cases of other organs or lymph node metastasis.Conclusions PET-CT plays an important role in the diagnosis of metastatic pancreatic cancer.

Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.

OBJECTIVEIt aims to investigate the changes in composition and structure of bacterial communities developing on biological activated carbon (BAC) particles, and the bacterial functions.

METHODA pilot plant had been in service for 180 days, aiming to develop bacterial communities on activated carbon naturally. After 180 days of operation, the bacterial communities were determined by denaturing gradient gel electrophoresis (DGGE) analyses of PCR-amplified 16S rRNA genes. The study on community composition and the phylogenetic relationships of the organisms was complemented by a sequence analysis of cloned PCR products from 16S rRNA genes. Gas chromatography-mass (GC-MS) measurement was used to determine organic chemical composition of inflow and outflow water on the 300th day. TOC and NH(4)(+)-N were also tested in this experiment.

RESULTSIt showed that the stable bacterial structure did not develop on BAC particles until the 9th month during running time of the BAC filter. The communities were finally dominated by Pseudomonas sp., Ba-cillus sp., Nitrospira sp., and an uncultured bacterium. Stable bacterial communities played an important role in removal of NH(4)(+)-N and total organic carbon (TOC). Results from gas chromatography-mass (GC-MS) showed that 36 kinds of chemicals in feed water were eliminated, and concentrations of 5 kinds of chemicals decreased. These chemicals served as nutrients for the dominant bacteria.

CONCLUSIONThe findings from the study suggested that the stability of microbial structure was beneficial for improving NH(4)(+)-N and TOC removal efficiencies. The dominant bacteria had the advantage of biode-grading a wide range of organic chemicals and NH(4)(+)-N.

Ammonia ; chemistry ; Bacteria ; classification ; genetics ; Biofilms ; Carbon ; chemistry ; Filtration ; instrumentation ; methods ; Microscopy, Electron, Scanning ; Pilot Projects ; Waste Disposal, Fluid ; instrumentation ; methods ; Water Microbiology ; Water Purification ; instrumentation ; methods ; Water Supply ; standards

Objective To analyze the effects of anesthesia-induced thermoregulatory system impairment and low temperature environment of the operating room on the perioperative thermoregulation of individualized patients by constructing a computer simulation model. Methods A simple anesthesia model was proposed and then incorporated into the self-developed individualized thermoregulatory model, in which human body was represented as a cylinder with two layers of the core and the skin. The integrated model could be used to assess the effects of individualized characteristics such as age, obesity, and cardiovascular diseases on thermoregulation by modifying different physiological parameters involving sweating, shivering and cutaneous vasomotion. Simulation of the general anesthesia effects on human thermoregulation could be achieved by reducing basal metabolic rate and thresholds for vasoconstriction and shivering. Results The elderly people showed lower core temperature but higher skin temperature, compared with the young people. In a low temperature environment, an increase in fat thickness or an increase in severity degree of the left ventricular failure (LVF) might alleviate the decrease in core temperature, while an increase in wind speed or relative humidity could result in a decrease in core temperature. When the threshold setting of vasoconstriction was reduced by 0-5-3 ℃, the core temperature showed a significant decrease. Conclusions By comparing model simulations with experimental measurements, the reliability and validity of the model in predicting human transient thermal responses during varying external thermal environment was verified. The individualized characteristics of human body had an important influence on human body temperature in a low temperature environment. Moreover, the combination of individualized characteristics of human body and general anesthesia further complicated the body′s thermoregulation and posed significant challenges for clinicians.