Objective To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) in newly diag-nosed type 2 diabetes mellitus(T2DM ) and to evaluate the treatment regimen conversion after CSII therapy .Methods 72 patients with newly diagnosed T2DM were treated with CSII for 2 weeks .Then they were randomly divided into two groups :the basal insu-lin group(glargine) and the oral anti-diabetic drug(OAD) group .Both groups were followed up for 2 years .Blood glucose ,insulin and HbA1c were measured before and after CSII and during the 2-year follow-up .Results CSII significantly controlled the glucose levels ,reduced the TG ,TC ,LDL levels and the homeostasis model assessment of insulin resistance ( HOMA-IR) and increased the homeostasis model assessment of insulin secretion (HOMA-IS)(all P< 0 .05) .During 1-year follow-up ,HbA1c in the glargine group and the OAD group was (6 .13 ± 0 .47)% and(6 .21 ± 0 .38)% respectively .During 2-year follow-up ,the HbA1c values in the two groups were (6 .91 ± 0 .57)% and(6 .43 ± 0 .62)% respectively .T HOMA-IR and HOAM-IS obtained the long tern improve-ment without significant body weight increase .Conclusion Short-term intensive insulin therapy can effectively control the blood glucose ,improve the sensitivity of insulin and the β-cell function ;after CSII ,adopting basic insulin and oral antidiabetic drugs can a-chieve the ideal glycemic control .

Objective To make a status survey on type2 diabetic patients with metabolic Syndrome in middle-aged inhabitants.Methods 338 inpatients with type 2 DM including 179 male and 159 female,aged 46?5 years,with complete records in the computer database.Results The prevalent rates of the complications in group of 40～yrs type2 diabetic patients were 17.8% combined with coronary atherosclerotic heart disease,50.9% with hypertension,18.1% with left ventricular dilatation,53.6% with hypertriglyceridemia,46.2% with lower HDL,54.7% with obesity and 38.8% with metabolic Syndrome,respectively.These prevalent rates in the 40-year-old group were all lower than those in groups above 60 years,and the rates was higher in patients whose BMI was above 25(kg/m2).Conclusion There was high prevalence in type 2 diabetic patients with metabolic Syndrome,and was related with the age and obesity.Obesity was an independent risk factor for MS.

AIM:To study the clinical effect of silica gel drainage tube combined with lomefloxacin hydrochloride eye ophthalmic gel in the treatment of lacrimal duct obstruction.METHODS:Totally 86 cases (138 eyes) of lacrimal duct embolism treated in our hospital from February to December 2015 were divided into 43 cases (68 eyes) as control group and 43 cases (70 eyes) of the observation group according to whether they were treated with lomefloxacin hydrochloride eye ophthalmic gel.Patients in the control group were treated with silica gel drainage, while the observation group was treated with lomefloxacin hydrochloride eye ophthalmic gel on the basis of the control group.The total effective rate, serum hypersensitivity C-reactive protein (h-CRP) level, complications and recurrence rate were observed and compared between the two groups.RESULTS:The total effective rate in the patients with obstructive nasolacrimal duct, common lacrimal duct obstruction, and lacrimal duct obstruction in observation group were 95.2%, 100.0%, 96.7%, higher than those in control group (P<0.05).There was no significant difference between the two groups in preoperative serum h-CRP levels (P>0.05).The serum levels of h-CRP in patients in the observation group at 3d and 7d after operation respectively were 2.40±0.84g/mL, 1.94±0.84g/mL, lower than those of control group at the same time (P<0.05).The complication rate of the observation group was 1.4%, which was lower than that of the control group (P<0.05).Follow up for 6-18mo, the recurrence rate was 11.4% in the observation group, which was significantly lower than the control group (P<0.05).CONCLUSION:The combination of silica gel drainage tube and lomefloxacin hydrochloride eye ophthalmic gel in the treatment of obstruction of lacrimal duct has good clinical efficacy, low inflammatory reaction, low complication rate and low recurrence rate.

Objective In order to deeper understand DCIS,improve the rate of diagnosis and therapeutic efficacy.Methods The clinical data of 123 DCIS treated at the First Affiliated Hospital of China Medical University were retrospectively analyzed in regards to age at onset of disease,clinical features,breast ultrasound examination,mammography examination,pathology,immunohistochemistry examination,and surgical methods.Results(1) The average age at onset was(47.7?9.3) years.(2)The major features on physical examination were breast lump in 79cases,nipple discharge in 19cases,and breast pain with glandular thickening in 30 cases.(3)Among 45 cases that underwent both ultrasound and mammography examination,in 17cases(60%) and 30 cases(66.7%) respectively,might be positive for malignancy,but the difference between the 2 melhods was not significant.With the use of both methods togather,diagmosis of possible malignant lesion was made in 37 cases(82.2%).(4) Sixty-five cases underwent breast ultrasound examination,substantive mass was found in 43 cases(66%),blood flow signals in 41 cases(63%),ductal dilatation in 52 cases(80%) and intraductal spotty strong light beam in 33 cases(50.7%).(5) Fifty-two cases underwent breast mammography examination,which showed sand-like calcification,mass with calcification clusters,localized gland density and breast tumor.(6)The immunohistochemistry examination included estrogen receptor(ER),progesterone receptor(PR),p53 and c-erbB-2,but the rate of positive expressios of those indices showed no significance difference between DCIS and DIS with microvasion(DCIS-MI).(7)Six cases underwent radical mastectomy(of which there were 3 cases of DCIS-MI).Modified radical mastectomy was done in 86 cases,including 59 cases of DCIS,27 cases of DCIS-MI.Lymph node metastasis was found in 2 cases of DCIS,and 5 cases of DCIS-MI.ConclusionsCombined breast ultrasound and mammography can increase the rate of DCIS diagnosis.

BACKGROUND: Collagen type Ⅰ possesses low antigenicity and provides special functions of scaffold structure for cell migration, proliferation and secretion.OBJECTIVE: To observe the morphological change after combination of transformed human embryonic tendon cells and artificial materials with collagen type Ⅰ, so as to provide the experimental basis for constructing tissue-engineered muscle tendon in vitro.DESIGN: Randomized and controlled observation.SETTING: Department of Orthopaedics, West China Hospital, Sichuan University.MATERIALS: This experiment was carried out at the Department of Transplantation Immunology, West China University of Medical Sciences from July to September 1998. Human hair, carbon fiber and polyglycolic acid were combined with collagen and then set corresponding groups respectively. Simply hair, carbon fiber and polyglycolic acid control groups were set respectively. Artificial materials: Healthy adult hair (30 cm in length, 80 g in weight), carbon fiber knitted strip (Lanzhou carbon factory )and polyglyolic acid fasciculi (Johnson , American) were used in this experiment.METHODS: ①In the group of human hair combined with collagen,nine healthy adult hairs were chosen . Three hairs as one bundle were knitted into tendon with 0.8 cm in length and 0.4 cm in diameter and a knot was tied respectively at the two ends. ②In the carbon fiber combined with collagen group, the purchased carbon fiber knitted strip was separated and made into artificial materials with the same diameter and length as those of human hair tendon. Two ends of the artificial materials were packed with 5/0 silk thread. ③In the polyglycolic acid combined with collagen group, three polyglycolic acid fasciculi were weaved into bundle with the same diameter and length as those of human tendon,and two ends were packed with 5/0 silk thread. ④The process of knitting scaffold materials was the same in control groups as in the corresponding experimental groups. ⑤ Five pieces were prepared in each scaffold material. After sterilized by 60Co, the scaffold materials were put in collagen type Ⅰ solution for 0.5 hour, then taken out and dried at roomtemperature for use in the experimental groups. ⑥transformed human embryonic tendon cell, density for 3×106/mm3, was used for combined culture in each group, and cell number and morphology were observed at different time points after culture under an inverted microscope and scanning electron microscope.MAIN OUTCOME MEASURES: ① Observation of cell growth and adherence under an inverted microscope ② Observation of cell morphology and material adherence under scanning electron microscope RESULTS: ① Observation of cell growth and adherenceunder an inverted microscope :In each experimental group, at two hours after culture, cells gathered around the materials, and some cells adhered to materials presented round; At three days after culture, the number of cells adhered to materials began to increase, morphology changed from round to oval, and the co-existence of round and oval cells was seen;While in each control group, at two and three hours after culture, few cells adhered to the three materials. On day five after culture, in each experimental group, cell morphology turned into fusiform, the number of cells increased further and a great many fusiform cells grew among carbon fiber materials; while in the control group, most cells presented round and ellipse, and the number of cells was less as compared with the corresponding experimental group. ② Cell morphology and material adherence under scanning electron microscope: On day 5 after in vitro culture, most tendon cells on the surface of materials presented spindle-shape in each experimental group. Apophysis stretched out from the tendon cells, grew along longitudinal axon of the materials. Silk and piece-like substance appeared among the apophysis and weaved each other. While there were fewer cells adhered in control group than in corresponding experimental group, cells also presented fusiform or round, but no silk or piece-like substance was found, also no apophysis appeared.CONCLUSION: Human hair, carbon fiber and polyglycolic acid combined with collagen type Ⅰ will facilitate cell adherence. Cells increase around the materials and co-existence of round and oval cells could be seen, and cells turned into fusiform, suggesting that exogenous collagen facilitate the cells to adhere onto the materials and proliferate.

Decoy receptor 3 (DcR3) is a newly discovered member of the tumor necrosis factor receptor (TNFR) superfamily, expresses highly in the digestive system neoplasms. DcR3 inhibits cellular apoptosis and produces cellular modulation by competitively combining with FasL, LIGHT and TL1A, therefore it deeply relates to the digestive system neophlasm's generation and progression. DcR3 is supposed to be the new tumor-specific marker that may cast the light to the digestive system neoplasms' generation, diagnosis,treatment, prognosis and effect observation. DcR3 is expected to open a new chapter in clinical application.

Humans ; Intestinal Diseases ; physiopathology ; Sepsis ; physiopathology

Objective To investigate the specific CT findings of gastrointestinal stromal tumors (GIST).Methods The CT imaging of 12 cases of GISTs confirmed operatively and pathologically were reviewed and analyzed.The gross pathologic findings of the tumors were compared with the manifestations of CT study.Results Two of the GIST were from the stomach,2 from the duodenum,4 from jejunum,and 1 from the junction of jejunum and ileum,ileum,rectum and mesenterium respectively.5 of 8 cases with GIST from intestine had history of hemafecia or positive of fecal occult blood test.9 of the 12 GISTs were malignant,1 of them was potentially malignant,1 was not sure to be malignant or benign.CT studies of 11 of the 12 tumors showed as exogenous mass of 3-20 cm,only 1 with less than 5 cm and 8 of them with over 5 cm.in the max diameter the tumors were cystic-solid with inhomogenous attenuation.The solid potion of tumors enhanced moderately to markedly after the contrast media administered.Ulcer was seen in the tumors of 2 cases,and the diameter of both of them were over 12 cm.Punctate calcification was seen in 1 GIST.Conclusion CT findings of GIST were specific to a certainty.CT study is helpful for locating the tumor and observation of the relationship of the tumor and surrounding structures.

OBJECTIVETo explore incidence rate, influencing factors, leakage routes,and preventative measures of bone cement leakages in vertebral internal reinforcement operation including percutaneous vertebroplasty and percutaneous kyphoplasty.

METHODSFrom January 2010 to January 2012,94 patients with osteoporotic vertebral compressive fracture,vertebral metastases and vertebral hemangioma were treated by vertebral internal reinforcement operation. Among them, there were 39 males and 55 females aged 55 to 86 with an average of 69.4 years old. The reasons, types, incidence and complications of bone cement leakage were analyzed.

RESULTSTotally 21 patients (26 vertebral) occurred bone cement leakage, the main routes included basivertebral veins, and bone cortex, which mainly located on adjacent intervertebrae and around vertebral body, and most of them were asymptomatic leakage. For the treatment of OVCFs, incidence of bone cement leakage in PKP was lower than that of PVP (P < 0.05), while incidince of PVP in treating vertebral metastases was worse than in treating OVCFs (P < 0.05).

CONCLUSIONBone cement leakage is a common complication in PVP and PKP. Careful analysis before operation, cautiously monitors and grasp operation indication in operation can decrease incidence of it.

Aged ; Aged, 80 and over ; Animals ; Bone Cements ; adverse effects ; China ; epidemiology ; Female ; Fractures, Compression ; surgery ; Humans ; Incidence ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; epidemiology ; etiology ; Spinal Fractures ; surgery ; Vertebroplasty ; adverse effects

Objective To assess the association of subclinical thyroid dysfunction with fractures. Methods Medline, Embase, Pubmed, Cochrane Library, CBM, CNKI, Wan Fang, and VIP databases were systematically searched from January 1990 to August 2015 to identify prospective cohort studies which have studied the risk of fracture in patients with subclinical thyroid dysfunction. The relative risks ( RR) of cohort studies were pooled respectively, depending on the result of heterogeneity test among the individual studies search. The Stata (version 13. 0) software was used for meta-analysis. Results Nine prospective cohort studies including 292460 participants were identified as eligible for the meta-analysis. RR of subclinical hyperthyroidism for fracture was 1. 39(95%CI 1. 24-1. 55);for hip fracture, RR was 1. 24(95%CI 1. 10-1. 40);for nonspine fracture, RR was 1. 32 (95%CI 1. 09-1. 60). Different gender for subclinical hyperthyroid was associated with higher fracture rates:for females, RR was 1. 15(95%CI 1. 04-1. 27); for males, RR was 1. 31 (95% CI 1. 08-1. 59). The incidence of fracture in patients with subclinical hyperthyroidism was higher during the follow-up. For subclinical hypothyroidism, the RR was 1. 21(95% CI 1. 03-1. 42). Subgroup analysis indicated that there were significant differences between endogenous/exogenous subclinical hyperthyroidism and euthyroid, but no differences between endogenous/exogenous subclinical hypothyroidism and euthyroid were found. Conclusion Subclinical hyperthyroidism is associated with an increased risk of fracture in the population, especially hip fracture and nonspine fracture. During the course of subclinical hyperthyroidism, the incidences of fracture should be noticed both in females and males. However, there is no evidence which could prove a definite association between subclinical hypothyroidism and the risk of fracture.