Objective To compare the effect of insulin pump continuous subcutaneous insulin (CSII) and multiple subcutaneous insulin (short-acting insulin before meals + glargine,MSII) for the short duration of type 2 diabetes mellitus (T2DM) patients.Methods Fifty-two newly diagnosed T2DM patients were randomly divided into CSII(n =29) and MSII(n =23) group.Patients in CSII group were given insulin pump continuous subcutaneous plus metformin.And patients in MSII group were given insulin by multiple subcutaneous insulin injection plus metformin.The treating periods was 2 weeks and followed up one month.Results The periods from point of insulin injection to blood glucose back to normal level in CSII group was (4.70 ±2.01) d,shorter than that in MSII group(6.90 ± 1.50) d,and the difference was significant(t =2.056,P ＜0.05).The levels of C peptide in two hours postprandial before and after treatment in CSII group were (4.24 ± 0.25) ng/L,(6.29 ± 0.56) ng/L,and (3.20 ±0.11) ng/L and (7.33 ±0.41) ng/L respectively in MSII group.The levels of C peptide in two hours postprandial after treatment were higher than that of before treatment in two groups (t =2.018,2.436 respectively,P ＜0.05),but there were no significant differences between two groups(t =0.985,P ＞ 0.05).Nineteen cases (65.5％) in CSII group were off insulin treatment in one month,and 9 cases (39.1％) in MSII group.There were significant differences in two groups(x2 =5.11,P ＜0.05).Conclusion The two treatment plans can make the improvement in terms of glucose control.However,CSII plan showed more effective than MSII.

Objective To identify novel biomarkers from urinary protein profiles for the early diagnosis of nephritis in patients with Henoch-Sch(o)nlein purpura by surface enhanced laser desorption/ionization time of flight-mass spectrometry (SELDI-TOF-MS) technique.Methods Urine samples were collected from 60 untreated patients with Henoch-Schonlein purpura,including 30 patients with nephritis and 30 without.SELDI-TOF-MS technique was used to characterize the protein profile in these urine samples,and the Zhejiang University Cancer Institute-Protein Chip Data Analysis System (ZUCI-PDAS) to identify urine protein markers and construct diagnostic model for nephritis in patients with Henoch-Schonlein purpura.Results Totally,154mass peaks were identified with high quality,and two proteins at a mass-to-charge ratio (m/z) of 2454.971 and 2439.686 showed significantly differential expression between the two groups of patients (P ＜ 0.05).Seven biomarkers were used to establish a diagnostic model.As estimated by the leave-one-out cross-validation,the diagnostic model distinguished patients with nephritis from those without with a specificity of 71％ and sensitivity of 84％.Conclusions The developed diagnostic model based on SELDI-TOF-MS technique and bioinformatics is somewhat specific and sensitive for the prediction of nephritis in patients with Henoch-Schonlein purpura.

Objective To investigate family history, sex, age of onset, disease severity and environmental predisposing factors in vitiligo patients. Methods Eight hundred and fifteen vitiligo patients were investigated by questionnaires. Patients with family history were compared with those without such history. SPSS 10.0 software package was applied for data analysis. Results Of 815 vitiligo probands, 128 had family history and 687 did not. The heritability rate was 15.7%. Compared with general population, vitiligo probands with affected fathers or mothers had a relative risk (RR) of 132 or 72, respectively. The RRs of those with affected first-degree relatives varied from 12 to 28. There was no significant difference of mean age of onset and disease severity between patients of paternal inheritance and maternal inheritance. No significant difference was found regarding sex and mean age of onset between the groups with and without family history. However, the patients with family history were more likely to have scattered, bilateral distributed and progressive vitiligo. Of the environmental predisposing factors, the mean daily sun-exposure time was closely related to vitiligo in patients with family history. Conclusion Genetic factors may play an important role in the pathogenesis and disease severity of vitiligo.

Objective To study the change and the correlation of serum soluble vascular cell adhesion molecuh-1(sVCAM-1)level with diabetic retinopathy in type 2 diabetic patients.Methods 60 type 2 diabetic patients were selected for the study through the examination of ophthalmoscope and/or fundus fluorescence angiography by ophthalmologist.Diabetic patients were divided into three main groups:No signs of diabetic retinopathy(NDR)(n=20);Background DR(BDR)(n=20)Proliferative DR(PDR)(n=20).Healthy individuals matching sex and age of the patients were used as controls(n=20);Serum sVCAM-1 level was measured by ELISA,compared in diabetes without DR,with BDR,with PDR.These levels were compared with those of 20 controls.Results The serum level of sVCAM-1 in the DM patients with PDR or BDR and those without DR were significantly higher than those in healthy controls(all P＜0.001);Serum level of sVCAM-1 in PDR groups were higherthan those in DM patients with BDR or patients without DR(all P＜0.001);There was no difference between the patients with BDR and those without DR (P＞0.05).(4)In the DM patients,there was a positive correlation between serum sVCAM-1 and the course of diseases(r=0.338,P＜0.05),but no relationship with HbA1C,FBG,CHO,TG,LDL and INS.Conclusion Increased serum level of sVCAM-1 in different stage of DR patients suggested that they hagbe play an important role in the development of DR,and may assess the severity of diabetic retinopathy.The measuremem of serum sVCAM-1 levels in type 2 diabetic patients could be clinically useful for early diagnosis or treatment of diabetic retinopathy.

Objective To evaluate the diagnostic value of cerebral perfusion SPECT/CT combined with brain MRI in patients with ischemic cerebrovascular disease.Methods A total of 107 cases with ischemic cerebrovascular disease from August 2011 to August 2013 (71 males,36 females,age:33-84years) were retrospectively studied,including 31 cases with transient ischemic attack,40 cases with the first onset of cerebral infarction,36 cases with recurrent cerebral infarction.99Tcm-ECD SPECT/CT and brain MRI were performed within 7 d after attack.The interval between the two scans was within 5 d.The number of lesions and detection rate by SPECT/CT,SPECT,MRI,CT,and their combination were calculated respectively,and analyzed using x2 test.Results The detection rate was:SPECT/CT+MRI (97.20％,104/107)=SPECT+MRI (97.2％,104/107) ＞SPECT/CT (95.33％,102/107)＞SPECT (90.65％,97/107) ＞MRI (85.05％,91/107)＞CT (65.42％,70/107).No statistically significant difference was observed between the detection rate of SPECT/CT+MRI and SPECT+MRI,SPECT/CT (x2 =0.17,0.13;both P＞0.05),while there was statistically significant difference between SPECT/CT+MRI and SPECT,MRI,or CT (x2 =4.01,9.76,35.50;all P＜0.05).SPECT/CT detected more ischemic lesions located in brain gray matter and revealed crossed cerebellar diaschisis,while MRI was better for detecting small lacunar lesions in basal ganglia,brainstem and deep white matter.Conclusions SPECT/CT is valuable for the detection of ischemic cerebrovascular disease.hnproved assessment may be achieved by the combination of SPECT/CT and MRI.

OBJECTIVETo observe the effect of rectus femoris island myocutaneous flap for repairing bedsores in III and IV phases at the femoral greater trochanter area as a result of paraplegia.

METHODSThirteen paraplegic patients who suffered bedsores in III and IV phases at the greater trochanter of femur area were hospitalized from July 2009 to June 2013. The bedsores ranged from 4.5 cm×4.0 cm to 10.0 cm× 9.0 cm in area. After debridement, the size of soft tissue defect ranged from 5.0 cm×4.5 cm to 10.5 cm×10.0 cm. Rectus femoris island myocutaneous flaps were used to repair these defects, with flap area ranging from 5.0 cm×5.0 cm to 11.0 cm×10.0 cm and muscular pedicle length ranging from 8 to 12 cm. The donor sites of muscular pedicle were closed by direct suture, while those resulted from forming myocutaneous flap were closed by the transplantation of autologous skin obtained from thigh.

RESULTSNecrosis appeared at the edge of myocutaneous flap in one patient, and it was healed after dressing change. The other 12 myocutaneous flaps survived well. Patients were followed up for 2 to 30 months, and bedsore did not recur.

CONCLUSIONSRectus femoris island myocutaneous flap, with characteristics of reasonable design, large donor area, big rotation angle, and with wear-, tear-, and pressure-resistance, is suitable for repairing bedsores at III and IV phases at the greater trochanter of femur area in paraplegic patients.

Debridement ; Femur ; surgery ; Humans ; Myocutaneous Flap ; Paraplegia ; Pressure Ulcer ; surgery ; Quadriceps Muscle ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; Treatment Outcome