Objective To investigate the clinical characteristics of diabetes complicated with peripheral neu- ropathy and increase the cognition of diabetic peripheral neuropathy in clinical work.Methods The clinical data of 160 diabetic patients were analyzed with retrospective analysis.Results 118 diabetic patients had different levels neuroelectrophysiologic abnormality,and the incidence rate was 73.8 %.The cure rate of diabetic peripheral neuropa- thy was 11.0%.Conclusion The incidence of peripheral neuropathy is high in diabetic patients,neuroelec- trophysiologic examination is a sensitive index in diagnosis of diabetic peripheral neuropathy,and the therapeutic ef- fect of diabetic peripheral neuropathy is poor.

OBJECTIVETo investigate the clinical characteristics of Segond fracture combined with injuries, and to explore the operative method and opportunity.

METHODSFrom June 2010 to December 2014, 10 patients with Segond fracture were treated. There were 10 males, ranging in age from 26 to 69 years old, with a mean of 42 years old. Under arthroscopy examination within 7 to 10 days after injury, 6 patients had compete rupture of anterior cruciate ligament and meniscus injury; 2 patients had tibial avulsion fractures of the ACL combined with meniscus injury. At 4 to 8 weeks after injury, 2 patients were performed with arthroscopy examination; 1 patient had complete rupture of anterior and posterior cruciate ligament combined with meniscus injury; and the other patient had complete rupture of anterior cruciate ligament alone. All the patients with cruciate ligament rupture were treated with reconstruction of cruciate ligament; 9 patients had meniscus injuries were treated with menisus plasty or suture; and 2 patients had tibial avulsion fractures of the ACL were treated with non-absorbable Ethicon suture fixation under arthroscopy. After operation, the Lysholm scoring system was used to evaluate clinical effects.

RESULTSEight patients were operated within 10 days after injury, the knee joints swelling was obvious at the 3rd day after operation, and blood oozing was found by joint puncture. These 8 patients did out-of-bed activity with assistance at 1 week postoperatively. Other 2 patients performed operation in 4 to 8 weeks after injury without knee joint obvious swelling at the 3rd day after operation, and no blood oozing was found by joint puncture. These 2 patients did out-of-bed activity with assistance after 3 days postoperatively. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 18 months. Postoperative Lysholm score of all patients was higher than preoperative scor, and the results were satisfactory.

CONCLUSIONFor Segond fractures, firstly, it is important to gain early diagnosis for treatment. Secondly, it is often associated with the rupture of anterior cruciate ligament and meniscus injuries, and the best time of cruciate ligament rebuilding and meniscus repairing maybe between 4 to 8 weeks after injury. Thirdly, personalized treatment should be chosen according to different complications.

Adult ; Aged ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Humans ; Male ; Middle Aged ; Tibial Fractures ; complications ; diagnosis ; surgery ; Tibial Meniscus Injuries

Objective To determine the median effective dose (ED50 ) of ropivacaine for spinal anesthesia when combined with sufentanil in patients undergoing caesarean section. Methods Twenty-eight ASA Ⅰ or Ⅱ parturients, aged 18-40 yr, weighing 50-110 kg, undergoing cesarean section under combined spinal-epidural anesthesia, were enrolled in this study. Combined spinal-epidural anesthesia was performed at L2,3 interspace. The mixture of ropivacaine and 5 fig sufentanil was injected into the subarachnoid space over 30 s. The initial dose of ropivacaine was 11 mg. The dose was increased/decreased by 1 mg in the next patient. The ED50 and 95% confidence interval were calculated by up-and-down method. Results The ED50 of ropivacaine was 7.780 mg (95% confidence interval 6.850-8.836 mg). Conclusion When combined with sufentanil 5 μg, the ED50 of ropivacaine for spinal anesthesia is 7.780 mg in patients undergoing caesarean section.

OBJECTIVETo explore the effects of interaction between environmental exposure factors and genetic polymorphism in toxicant metabolizing enzymes on risk of occupational chronic benzene poisoning.

METHODSOne hundred and fifty-two cases of chronic benzene poisoning were analyzed for the risk by case-only study.

RESULTSThe frequency of non-null GSTT1 gene in benzene poisoning workers with moderate benzene exposure level was higher than that in cases with lower benzene exposure (68.63% vs 38.00%, OR(adj) = 4.32, 95% CI 1.75 - 10.66, P = 0.002). The frequency of NQO1 C.609T/T gene in alcohol drinking group was higher than that in non-drinking group (61.11% vs 20.00%, OR(adj) = 8.03, 95% CI 2.28 - 28.25, P = 0.001), moreover, it was higher in workers with smoking and drinking than that in the rest group, and in drinking x exposure level workers than that in non-drinking x exposure level workers (85.71% vs 22.76%, OR(adj) = 18.62, 95% CI 2.01 - 172.72, P = 0.01 and 61.11% vs 20.00%, OR(adj) = 3.18, 95% CI 1.55 - 6.52, P = 0.002 respectively). The frequency of non-null GSTM1 gene was also higher in drinking x exposure level workers than that in non-drinking x exposure level workers (66.67% vs 47.06%, OR(adj) = 1.99, 95% CI 1.05 - 3.76, P = 0.036).

CONCLUSIONThere is interaction between the polymorphism of GSTT1 gene and moderate benzene exposure level; non-null GSTM1 gene and drinking x exposure level increase the risk of occupational chronic benzene poisoning; polymorphism of NQO1 gene C.609 also interacts with drinking, while polymorphism of NQO1 gene and drinking x smoking may further increase the risk of occupational chronic benzene poisoning.

Adult ; Benzene ; metabolism ; poisoning ; Cytochrome P-450 CYP2E1 ; biosynthesis ; genetics ; pharmacology ; Female ; Genetic Predisposition to Disease ; Genotype ; Glutathione Transferase ; biosynthesis ; genetics ; pharmacology ; Humans ; Male ; Middle Aged ; NAD(P)H Dehydrogenase (Quinone) ; biosynthesis ; genetics ; pharmacology ; Occupational Diseases ; enzymology ; genetics ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Risk Factors

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

Aim To explore the inhibitory effect of Euonymus alatus on hepatic fibrosis induced by carbon tetrachloride (CCl4) in mice and its mechanism. Methods Eighty C57BL/6 male mice were randomly divided into eight groups: normal group, CCl4model group, Euonymus alatus(EA) ethanol extracts groups in early stage(EAE), EA ethanol extracts groups in later stage(EAL),two drug groups with low/medium/high dose(EAE-L/M/H, EAL-L/M/H), with 10 mice in each group. Fibrosis model was established by injecting CCl4in peritoneal cavity,and the study lasted for 30 days. Different doses of drugs were given from 1 st day to 15 th day in EAE while from 16 th day to 30 th day in EAL,then all mice were sacrificed to for the observation of the morphological changes and collage-nous fiber by HE and Masson staining. Liver index, ALT,AST and TNF-α were tested by ELISA. The ex-pressions of α-SMA and CollagenⅠwere measured by immunohistochemistry and Western blot. Results Compared to normal group, liver index, ALT, AST, TNF-α, α-SMA and CollagenⅠ in EA groups were lower than those in model group in a dose-dependent manner(P<0.01 or P<0.05). Liver morphology and collagenous fiber in EAE and EAL were better than those in model group in a dose-dependent manner. The effect of EAE were superior to that of the EAL in HE, Masson, α-SMA, Collagen Ⅰ indexes(P <0.05). Conclusions Euonymus alatus may inhibit the process of hepatic fibrosis in mice with dose-effect de-pendence, and drug treatment in early stage performs better,which may be related to the decrease of TNF-α that affects the expression of α-SMA and Collagen Ⅰ.

Objective To summarize the clinical experience in the replacement of the damaged sec- ond metacarpophalangeal joint with the second metatarsophalangeal joint with a pedicle of dorsal pedis artery and great saphcnous vein.Methods The damaged second metacarpophalangeal joint,distal part of the sec- ond metacarpal and proximal part of the proximal phalanx were dissected.The metatarsophalangeal joint was transferred to the region of metacarpophalangeal joint of hand.The dorsal pedis artery was anastomosed to the radial artery,and the great saphenous vein was anastomosed to the cephalic vein at anatomical snuff-box.The dissected bones of the hand removed of the cartilage of joint and soft tissue were grafted back to the donor site of the foot.Results A 5～30 month follow-up study in 8 out of 11 cases showed that satisfactory functional recovery was achieved in clinical practice.The movement of second metacarpophalangeal joint was excellent. Conclusion The function of the second metacarpophalangeal joint can be effectively recovered by the trans- fer of the vascularized second metatarsophalangeal joint.

OBJECTIVETo explore the relationship between genetic polymorphisms of microsomal epoxide hydrolase (mEH) and susceptibility of chronic benzene poisoning (BP).

METHODA case-control study was conducted. 152 BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. Polymerase chain reaction-restrained fragment length polymorphism technique (PCR-RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) on c.113 and c.139 of mEH gene.

RESULTSThe risk of BP for individuals carrying mEHc.113 C/C genotype was 0.60 (OR = 0.60, 95% CI: 0.37 - 0.97, P = 0.04) of those carrying T/T and T/C genotypes. In non-smoking population, the risk of BP for subjects carrying mEHc.113 C/C genotype was 0.56 (OR = 0.56, 95% CI: 0.33 - 0.96, P = 0.03) of those carrying T/T and T/C genotypes, and in non-drinking population, the individuals carrying mEHc.113 C/C genotype was 0.51 (OR = 0.51, 95% CI: 0.30 - 0.86, P = 0.01) of those carrying T/T and T/C genotypes.

CONCLUSIONThe subjects carrying mEHc.113 C/C genotype and together with non-smoking or non-drinking habit may have lower risk of chronic benaene poisoning.

Adult ; Benzene ; metabolism ; poisoning ; Case-Control Studies ; Epoxide Hydrolases ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Life Style ; Male ; Middle Aged ; Occupational Diseases ; genetics ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

OBJECTIVETo explore the relationship between genetic polymorphisms in apurinic/apyrimidinic endonuclease (APE1) and ADP ribosyltransferase (ADPRT) and individuals' susceptibility to chronic benzene poison ing (BP).

METHODSA case-control study was conducted. One hundred and fifty-two B P patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. The mismatched bases combined to create restriction site with restrained fragment length polymorphism technique (CRS-RFLP) was used for detecting the single nucleotide polymorphisms (SNPs) at Asp148Glu of APE1 gene and Val762Ala of ADPRT gene.

RESULTSThere was no significant difference in the distribution of genotypes of APE1Asp148Glu and ADPRTVal762Ala between the patients and the control groups. Compared with individuals having genotype of APE1Asp148Glu T/T without habit of alcohol consumption, there was a 4.13 times increased risk of BP for the alcohol user with genotype of APE1Asp148Glu T/T (OR = 4.13, 95% CI: 1.07 - 15.85, P = 0.03). The analysis of Logistic regression showed that smoking may play some role in modifying the risk of cironic benzene poisoning (OR = 0.33, 95% CI: 0.14 - 0.75, P = 0.01).

CONCLUSIONThe genetic polymorphisms in APE1Asp148Glu, ADPRTVal762Ala are not related to the risk of BP. Potential interaction is found between alcohol consumption and polymorphism of APE1Asp148Glu. Further study is needed to elucidate this interaction.

ADP Ribose Transferases ; Alcohol Drinking ; genetics ; Benzene ; poisoning ; Case-Control Studies ; Chronic Disease ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; Genetic Predisposition to Disease ; Genotype ; Humans ; Occupational Exposure ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide

Objective To assess and optimize the dosage regimens of nor-vancomycin in patients with different renal functions.Methods The minimum inhibitory concentration ( MIC ) distribution was determined by agar dilution method with the target value of AUC 0-24/MIC≥638.Ten thousand cases in virtue of Monte Carlo simulation were performed in dif-ferent doses to obtain probabilities of target attainment ( PTA) and cumu-lative fractions of response ( CFR ) in patients with different renal func-tions.Results For the patients with normal renal function , when En-terococcus faecium and Enterococcus faecalis were treated with recommen-ded dose , from 0.8 to 1.6 g· d-1 , the CFR were lower than 59.77%.The CFR could reach to 83.95%and 73.10%when the dose was adjus-ted to 2.5 g· d -1.For the patients with moderate renal function insuffi-ciency , the CFR could reach to 82.81% at the dose of 0.8 g · d -1 against Enterococcus faecalis.The CFR could reach from 73.10% to 86.84%at the dose from 0.8 to 2.5 g · d-1 in the process of treating Enterococcus faecium.For the patients with severe renal function insuffi-ciency , the CFR could reach to 97.77% and 85.90% respectively a-gainst Enterococcus faecalis and Enterococcus faecium.Conclusion Monte Carlo simulation provides dosage regimens and the norvancomycin regimen is complemented and optimized.