Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; methods ; Shoulder Dislocation ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective:To optimize the formula of Junduqing dispersible tablets .Methods:Using appearance , disintegration time and dispersing uniformity as the indices ,the types of filler, disintegrating agent and adhesive were optimized by single factor tests;the amount of filler and disintegrating agent was optimized by orthogonal experiments with the disintegration time as the index ; using ap-pearance and sticking as the indices , the single factor tests were also used to optimize the lubricant , and the adding method of disinte-grating agent was optimized using disintegration time as the index .Results: For 500 tablets, the amount of Junduqing extract was 61.25 g, microcrystalline cellulose (52.5 g) and dextrin (17.5 g) were used as the fillers, crospolyvinylpyrrolidone (8.75 g) and croscarmellose sodium (26.25 g) were applied as the disintegrating agents , 70% ethanol was the binder , magnesiumstearate (3 g) and talcum powder (2.25 g) were used as the lubricants , and stevioside (3.5 g) was the flavoring agent .Conclusion:The formula is reasonable and feasible ,which provides reference for the preparation of Junduqing dispersible tablets .

Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.

Objective To study the influence of hemodiafiltration on high-sensitivity C-reactive protein (hs-CRP),serum parathyroid hormone (iPTH) and cardiac function in uremic patients undergoing maintenance hemodialysis (MHD).Methods Forty patients with uremia were divided into hemodiafiltration (HDF) group (n =20) and hemodialysis(HD) group(n =20) by random numbers.Serum hs-CRP and iPTH were measured before treatment and at 6 months after treatment.Their left ventricular diastolic diameter (LVEDD),left ventricular end-systolic dimension (LVESD),interventricular septal thickness (IVST) and left ventricular ejection fraction(LVEF) were measured by echocardiogram.Ten healthy volunteers were recruited as the normal controls.Results After treatment,serum hs-CRP and iPTH decreased significantly in the HDF group (hs-CRP:(3.32±1.t4) mg/L vs.(7.84 ±2.21) mg/L,t =2.072,P =0.046;iPTH:(155.36 ±81.33) ng/L vs.(190.25 ±82.31) ng/L,t =2.121,P =0.023).No significant difference of serum hs-CRP and iPTH was observed in the HD group before and after treatment (hs-CRP:(7.91 ±2.11) mg/L vs.(7.68 ± 1.86) mg/L,t =1.731,P =0.111 ; iPTH:(177.43 ± 85.43) ng/L vs.(184.35 ± 87.21) ng/L,t =1.331,P =0.210).Color Doppler indices of cardiac structure of the HDF group significantly improved after treatment compared with before treatment (LVEDd:(55.3 ±3.7) mm vs.(58.8 ±4.3) mm,t =2.345,P =0.015 ;LVESd:(33.5 ±2.6) mm vs.(36.4±4.3) mm,t=2.178,P=0.046;IVST:(10.2±1.7) mmvs.(13.1 ±1.8) mm,t=2.630,P=0.012;LVEF:(55.3 ±2.6)％ vs.(42.5 ±3.3)％,t =2.860,P =0.010;LVMI:(132.5 ±9.1)g/m2 vs.(137.4 ± 8.7) g/m2,t =2.871,P =0.009).After treatment,cardiac structure of the HDF group was significantly better than that of the HD group (LVEDd:(55.3 ± 3.7) mm vs.(59.1 ± 4.2) mm,LVESd:(33.5 ±2.6) mm vs.(36.1 ±3.4) mm,IVST:(10.2±1.7) vs.(12.4 ±1.3) mm,LVEF:(55.3 ±2.6)％vs.(43.4±2.7)％,LVMI:(132.5 ±9.1) g/m2 vs.(139.4 ±8.9) g/m2;P ＜0.05).During the six month treatment,the incidence rate of cardiovascular events of the HDF group was significantly less than the HD group (36.39％(524/1440) vs.(72.08(1038/1440),x2 =21.583,P＜0.01).Conclusion HDF may efficiently remove iPTH,improve cardiac function of uremic patients,and help them recover from micro-inflammatory state.

BACKGROUND: Preliminary study has proved that the bone marrow-derived mesenchymal stem cells (MSCs) in a rat emphysema model produced by use of trypsin alone can "homing" to the lesioned lung tissues, and participate in the formation of pulmonary arteries to promote lung tissue repair. Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) play equally a powerful role in promoting angiogenesis. OBJECTIVE: To observe the influence of bFGF, VEGF and MSCs in regeneration of pulmonary capillary and pathological repair of pulmonary emphysema rats. METHODS: Except normal control group, the remaining 5 groups of rats were exposed to tobacco smoke and received a single intratracheally instillation of porcine pancreatic elastase to induce emphysema models. Following successful modeling, rats of bFGF group were intratracheally injected with 400 U bFGF and rats of VEGF group with 2 μg VEGF, once a week for three times. MSCs group was injected 1 mL suspension of 4×10~9/L MSCs into tail vein. MSCs+VEGF group was injected MSCs into tail vein and intratracheally injected VEGF (2 ug, three times) at the same time. Model control and normal control groups were intratracheally injected with equal volume of sodium chloride. Four weeks after treatment, arterial blood gas analysis was performed to observe pathological and morphological changes of lung tissues. CD34~+ expression in lung tissues was determined using immunohistochemistry method. RESULTS AND CONCLUSION: Compared with model control group, PaO_2 values dramatically increased in VEGF group (P <0.05), while other indices remained unchanged (P > 0.05); there were no obvious changes in each index in other groups (P >0.05). Gross and microscopic observations showed that, lung was smooth, pale pink, and elastic in normal control group, with uniform size of pulmonary alveoli on cross-section; pathological changes of chronic obstructive pulmonary emphysema existed in model control group, but improved in other 4 groups. Compared with model control group, mean pulmonary alveoli number and CD34~+ relative positive area dramatically increased in bFGF, VEGF, MSCs, MSCs+VEGF groups (P < 0.05), mean linear intercept and mean alveoli area were significantly reduced (P < 0.05). No significant difference was observed in each index among these 4 groups (P > 0.05). bFGF, VEGF and MSCs could improved the pathology of pulmonary emphysema models produced by tobacco smoking and intratracheally instillation of porcine pancreatic elastase. The possible mechanism of recovering the pulmonary emphysema is the proliferation of pulmonary capillary and enlargement of pulmonary artery, improved blood flow in the lung, improved ventilation/perfusion shunt, reduced pulmonary alveolus size and volume of the lung through self-compensation.

Objective To study the clinical significances of serum lipoprotein (LP),high sensitivity C- reactive protein (hs CRP),cystatin (Cys-C),apolipoprotein (Apo) in type 2 diabetic mellitus (T2DM) patients with early renal impairment.Methods Totally 96 patients were divided into two groups:50 cases in simple diabetic group (DM) aged 60-73 years,46 cases in diabetic nephropathy group (DN) aged 61-72 years,and 50 healthy persons as normal control group aged 61-68 years.Serum levels of LP(a),hs-CRP,Cys-C,ApoA1 and ApoB were detected.Results Serum levels of LP (a) [(214.8±182.3) mg/L vs.(113.1±76.2) mg/L],Cys-C[(0.95±0.16)mg/L vs.(0.46±0.17) mg/L],hs-CRP (2.57± 1.84) mg/L vs.(1.07±0.38)mg/L] and ApoB [(1.12±0.18) g/L vs.(0.81 ±0.15) g/L ]were higher in T2DM patients than in normal control group(all P＜0.01),while ApoA1 level was lower than in control[(1.02±0.17)g/L vs.(1.27±0.14)g/L,P＜ 0.01].The levels of LP (a) (455.6 ± 263.5 ) mg/L,Cys-C (2.14 ± 0.68 ) mg/L,hs-CRP (7.24±4.55)mg/L and ApoB(1.22±0.17)g/L in DN group were increased compared with DM group (all P＜0.01).Serum levels of ApoA1 were decreased in DN group compared with DM group [(0.88±0.17) g/L vs.(1.02±0.17) g/L,P＜0.01].The serum levels of LP (a) (r=0.487,P＜0.05),Cys-C(r=0.55,P＜0.05),hs-CRP(r=0.478,P＜0.01) and ApoB(r=0.505,P＜0.05) were positively correlated with urinary mAlb in T2DM patients,while ApoA1 was negtively related with mAIb(r=-0.52,P＜0.05).Conclusions The serum LP (a),Cys C,Apo and hsCRP could be sensitive markers of early renal impairment,and their combinatorial measurement offers more value in patients with T2DM.

Objective To study the relationship between stress rise of blood glucose and the PEEL prognostic index of the patients with acute myocardial infarction, and provide the basis for a quick judgement and evaluation of prognosis to nurses. Methods Taking the 6.8,7.8 and 8.8 mmol/L as demarcation point to study the PEEL prognostic index in 59 patients with acute myocardial infarction, and compare the PEEL score value on two sides of each demarcation point. Results No significant difference in PEEL evaluation score when taking 6.8 mmol/L as the demarcation point, there was significant difference when taking 7.8 mmol/L as the demarcation point, PEEL score in blood glucose > 7.8 mmol/L group was higher than that of ≤7.8mmol/L group, so was when taking 8.8 mmol/L as the demarcation point. Conclusions There was instructive signifi-cance for nurses to observe a stress rise of blood glucose timely in evaluating the prognosis of patients with a-cute myocardial infarction. Nurses should strengthen disease observation and preventive nursing of admission patients whose fasting blood glucose are above 7.8 mmol/L as well their blood glucose monitoring.

Objective To investigate the changes and clinical significance of platelet parameters and the hemorheological parameters in patients with diabetic kidney disease(DKD). Methods One hundred and eight patients with diabetics were divided into simplicity diabetes mellitus ( SDM ) group with 41 cases, early diabetic nephropathy( EDN) group with 36 cases and clinical diabetic nephropathy( CDN) group with 31 cases according to 24 hours urine albumin excretion rate( UAER) ,and 26 healthy persons were included into this study as control group. The platelet parameters(including mean platelet volume(MPV),platelet volume distribution width(PDW),platelet volume(PCT),and PLT) and hemorrheology were measured in all groups. Results Levels of MPV,PDW,PCT and PLT in diabetics group were (9.80±1.14) fl,(18.00±0.99) fl,(0.21 ±0. 05)% and (186±47)×109/L respectively,in control group were(7. 70±1. 11) fl,(13. 90±1. 02) fl,(0. 16 ±0.05)% and (234±51)×109/L respectively,the differences were significant(P=0.043,0.039,0.040, 0. 035). Levels of MPV,PDW,PCT and PLT in SDM group were (8. 40±1. 07) fl,(16. 40±0. 79) fl,(0. 19 ±0. 04)% and (195±49)×109/L respectively,in EDN group were (10. 20±1. 23) fl,(18. 30±1. 02) fl,(0. 20 ±0. 06) % and (188±52)×109/L respectively,in CDN group were (11. 40±1. 14) fl,(19. 60±1. 21) fl,(0. 25 ±0. 05)% and (172±40)×109/L respectively,the differences were significant between the groups( P=0. 032,
0. 039,0. 041,0. 008). The levels of erythrocyte aggregation index,capillary plasma viscosity,low/medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index in diabetics group were 1. 86±0. 13,1. 40±0. 14,(13. 83±1. 62) mPa·s,(7. 79±0. 84) mPa·s,(6. 46±0. 77) mPa·s,7. 54±1. 03,4. 73±0. 74,4. 16±0. 69 and 0. 55±0. 03 respectively,in control group were 1. 38±0. 05,1. 21±0. 08,(9. 35±1. 22) mPa·s,(5. 88±0. 87) mPa·s,(5. 02±0. 86) mPa·s, 4. 00 ±0. 75,3. 12±0. 65,2. 76±0. 56 and 0. 68±0. 06 respectively,the differences were significant between the two groups( P=0. 034,0. 020,0. 018,0. 044,0. 016,0. 014) . Furthermore,the results of erythrocyte aggregation index, capillary plasma viscosity, low /medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index were significantly different in sub group of diabetes( P=0. 004,0. 002,0. 001,0. 004,0. 003,0. 041,0. 025,0. 009,0. 042) . Conclusion It is important to measure the platelet parameters and hemorrheology in diabetes kidney disease patients. The platelet parameters and hemorrheology may be the early indicators to diagnosis the diabetic nephropathy.

Objective To evaluate the early and midterm effect by retrospective analysis of the cone reconstruction in Ebstein′s anomaly. Methods From January 2012 through June 2016,16 patients with Ebstein′s anomaly underwent the cone reconstruction in our hospital. There were 7 males and 9 females at mean age(28.21 ± 11.88)years,including 12 patients of Carpentier B type,4 patients of Carpentier C type. There were 9 patients in New York Heart Association(NYHA)functional class Ⅲ,5 patients in NYHA functional class Ⅳand the others in NYHA functional class Ⅱ. All patients had Tricuspid insufficiency ,including 2 patients with Grade 2 ,10 patients with Grade 3 and 4 patients with Grade 4. All patients were followed up over a period of 6 to 51 months (mean:24.36 ± 10.71). By comparing the details of pre-operation with post-operation and post-operation with current stage,we analyze the outcomes of early and midterm effects. Results All patients are well survived. There were one patient recovering from the low cardiac output syndrome with adding the strength of the positive inotropic drug in the first day after operation ,and one patient recovering from bigeminy of ventricular prematurebeat with the aid of amiodarone and lidocaine the third day after operation. The remaining patients recovered smoothly. Early post-operative echocardiograms showed good right ventricular morphology and reduction in tricuspid regurgitation grade from(3.13 ± 0.62)to(1.75 ± 0.45)(P<0.001)with the functional class improved from(3.19 ± 0.66)to(2.00 ± 0.52)(P<0.001). After mean follow-up of(24.36 ± 10.71)months,the situation is improving furtherly with the tricuspid regurgitation grade reducing to(1.31 ± 0.48)(P=0.016)and the functional class rising to(1.50 ± 0.52) (P = 0.031). Conclusions This surgical technique for Ebstein′s anomaly can improve the function of tricuspid valve and the right ventricular morphology. It showed a satisfactory performance in the early and midterm results by enhancing the Cardiac function and life quality. But indications should be strictly grasped and more experiences need to be accumulated. Long-term effect need to be furtherly explored.

Objective To screen college students contacts of tuberculosis index cases among colleges located in Haidian District,Beijing,so as to provide evidence for the modification of screening strategies for college students.Method The purified protein derivative test (PPD) and chest X-ray examination were carried out in colleges,located in Haidian District from March 2015 to March 2016.The basic demographic characteristics,tuberculosis infection and detection of patients,etc were analyzed.Results A total of 88 cases of tuberculosis index cases were diagnosed,and 3 604 college students contacts were detected 16 pulmonary tuberculosis cases were detected among close contacts,and all patients were negative,the detection rate was 443.95/100 000.Among the 3 604 close contacts,the positive rate of PPD was 8.32％.With the increase of the diameter of the PPD reaction,the detection rate of tuberculosis patients increased significantly (xtrend =8.06,P ＜0.001).During the period of outbreak,the PPD positive rate and the detection rate of patients were significantly higher than that of non-outbreak period,and the difference was statistically significant(all P ＜0.05).Conclusions It is necessary to strengthen the screening of tuberculosis among college students,and to find out the infected persons and patients as early as possible,so as to prevent the outbreak of tuberculosis.