Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2681 type 2 diabetic patients who visited our hospital between January,2007 to December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-＜ 1.3) in 2362 cases (88.1％),while below 0.9 in 277 cases (10.3％) and equal or over 1.3 in 42 cases (1.6％).The elderly patients (≥ 60 years) had a higher prevalence of low ABI than the non-elderly patients(20.41％ vs.4.10％,P ＜ 0.01).The prevalence of DF was 25.63％,3.05％,26.19％ in ABI ＜ 0.9,0.9-＜ 1.3 and ≥ 1.3 groups,respectively,and the prevalence in groups ABI ＜ 0.9 and ≥ 1.3 was higher than that in group ABI 0.9-＜ 1.3.Similar U-shape distribution was observed in the prevalence of abnormal ABI and DF.ABI was negatively correlated with age,diabetes duration,uric acid (UA),24 hours microalbuminuria,while positively correlated with body mass index (BMI),diastolic blood pressure,triacylglyceride,total cholesterol and glycosylated hemoglobin A1c (HbA1c).Abnormal ABI was independently correlated with age,diabetes duration,HbA1c,UA,24 hours microalbuminuria,diabetic kidney disease,diabetic retinopathy,diabetic peripheral neuropathy and diabetic vascular diseases.Conclusion The prevalence of abnormal ABI is higher in the elderly patients with type 2 diabetes.Abnormal ABI could be an early predictor for DF.

Objective To investigate the association between Down's syndrome(DS) and congenital heart diseases(CHD).Methods A total of 575 cases with DS from Jan.1997 to Mar.2013 in Children's Hospital of Chongqing Medical University were recruited.Retrospective study was conducted to analyze the prevalence and types of CHD in DS children,the relationship between the karyotype of DS and the types of CHD,and pulmonary hypertension (PH) and operation treatment.Results There were 370 cases(64.35％,370/575 cases) with CHD in 575 cases with DS.Among the 370 cases of CHD,322 cases (87.03 ％) were septal defects.In which,57 cases (15.41％) were atrial septal defects,36 cases (9.72％) were ventricular septal defects,12 cases (3.24％) were atrioventricular septal defects,and 157 cases(47.30％) were complex septal defects.Forty-eight cases(12.97％,48/370 cases) were nonseptal defect types of CHD (including patent ductus arteriosus,tetralogy of Fallot,double outlet right ventricle,pulmonary atresia,and so on).There was no statistical significance between the karyotype of DS and the types of CHD.There were 246 cases(66.49％,246/370 cases) with PH.Seventy cases(18.92％,70/370 cases) had interventional or surgical operations.All of them had descending pulmonary artery pressure after operation.Forty cases had other malformations such as gastrointestinal tract malformation,polydactylism / polydactyly,visual impairment,and so on.Conclusions The most common type of CHD with DS was atrial septal defect,and the second one was ventricular septal defect.There was no relationship between the karyotype of DS and the types of CHD.The patients with CHD in DS were prone to develop PH.So the comprehensive treatment plan should be developed as early as possible.

The pathogenic basis of degenerative retinal diseases is structural and functional abnormality of neuron of retina.The irreversible damage of visual function is the unfortunate results of degenerative retinal diseases,and some effective treating approach to these blindness eye diseases is still in expectation.In recent years,stem cells replacement therapy is increasingly developed and is a prospective way for degenerative retinal diseases.But some formidable challenges for successfully grafting cells to the retina are waiting for further solving,such as migration,survival,and differentiation of the stem cells etc.Recent studies showed that retinal tissue engineering technique may be a good alternation to address all the problems mentioned above.The current advances in stem cell and tissue engineering retina researches,including selectable seed cells,appropriate scaffold materials and transferring method in vivo,are reviewed in this paper.

Idiopathic orbital inflammatory pseudotumor(IOIP) is a common orbital disease.It is a nonspecific inflammatory process,and the etiology is still unknown.IOIP occurs at any position of orbit.The clinical manifestation varies according to the anatomic involvement and the degree of inflammation progress.IOIP can clinically mimic many other orbital diseases,especially serious type of this disease can present similar clinical characteristics as the malignant tumor,so it is comprehensive to make a clinical diagnosis.Currently,the diagnosis of IOIP is allowed based on the differentiation from an exclusion of other diseases by a thorough medical history and clinical manifestations,and then acquire some assistant information by radiologic evaluation and laboratory tests and observe the response to steroid treatment.The final diagnosis still requires histopathological examination.

The response of rat mesenteric microvessels to noradrenaline (NA) in different stages of endotoxic shock was investigated by using vital microscope with video television recorder. It was found that the diameter of the microvessels showed a dose-dependent decrease to local NA application from the low to high concentration. The constricted response curve was remained unchanged at the experimental duration. The constricted response to NA was increased significantly at early stage of shock but was decreased at late stage (both P

Objective To manage calcaneal fractures with an U-shaped external fixator combined with close manipulative reduction. Methods From February 1997 to November 2002, 31 patients with 34 calcaneal fractures were treated with self-designed U-shaped external fixator combined with close manipulative reduction. All patients were males aging from 7 to 50 years with an average of 32 years. The external fixation device consisted of two partial rings, three modular connecting rods and several pins. According to Essex-Lopresti classification, there were 10 extra-articular fractures without involving the subtalar joint, and 24 intra-articular fractures involving the subtalar joint. Two upper pins were inserted in cross through the distal tibia, and one of two lower pins was inserted laterally through the anterior part of calcaneus, the other was posterior into the calcaneous tuberosity or larger fragment connecting with Achilles tendon. After the manipulative reduction, the frames were applied. Results 31 calcaneal fractures were found with satisfactory reductions after manipulation. The widths of the heels were restored in certain extent; the heights of foot arch and calcaneus were resumed to normal; the B hler angle increased from 15? to 40? (mean, 25?). The duration of hospitalization was on an average of 7 days. The duration of external fixation was averagely 8 weeks. All patients were followed up with a mean period of 8 months (range, 6 to 12 months). All of the fractures healed well. No nonunion, delayed healing of bone or other complications was found. All patients resumed to walk on foot after 2 to 4.5 months. According to Fernandez scoring system, results were graded as excellent and good in 31(91%). Conclusion Using U-shaped external fixator combined with close manipulative reduction is a satisfying technique to treat calcaneal fractures. By ankle joint spanned traction and fixation, this technique overcomes displacement of fragments caused by contracture of tendo calcaneus, maintains width of heel and biodynamic anatomy of foot, avoids complications of wound caused by open reduction and internal fixation.

Objective To investigate the effect of intraoperative hypothermia and warming on hemostasis using thromboelastography(TEG)during radical esophagus cancer operation performed under general anesthesia combined with thoracic epidural block.Methods Sixteen ASA Ⅰ or Ⅱ patients undergoing elective radical esophagus cancer operation were randomly allocated to one of two groups(n=8 each):control group and warming group.The patients were unpremedicated.The operating room temperature was set at 21℃.Epidural catheter was placed at T_(7,8) and advanced 4 cm into epidural space.Correct epidural placement was confirmed by a test dose of 4 ml 1% lidocaine.0.375% bupivacaine was used during operation.General anesthesia was induced with fentanyl,thiopental and succinylcholine and maintained with isoflurane inhalation and intermittent i.v.boluses of vecuronium after endobronchial intubation with double lumen catheter.The patients were mechanically ventilated (V_T=8-10 ml?kg~(-1),RR=10-12 bpm,I:E=1:2,FiO_2=100%).In warming group TC-2000 wanning system (Thermacave,USA)was used.The lower part of the body was warmed for 45 min before induction of anesthesia (temperature was set at 38℃).After induction warming was continued(temperature was set at 43℃).In control group no wanning was provided.The fluid infused during operation was all warmed to 37℃.Tympanic temperature measurement was started from 20 min before induction and recorded every 10 min afterwards.TEG was performed before induction of anesthesia(T_0) and at 150 min after induction(T_1).The blood samples were divided into 2 aliquots of which one was tested at 37℃ and the other at patient's actual core temperature.Results The two groups were comparable with respect to age,sex,body weight duration of operation and the amount of fluid infused during operation.At T_1 the tympanic temperature was 34.7?0.4℃ in control group and 36.5?0.3℃ in warming group.At T_1 in control group the reaction time(R)and clot formation time(K)were significantly prolonged and a angle was significantly reduced when TEG was measured at core temperature compared with those measured at 37℃ (P＜0.05).At T_1 when TEG was measured at core temperature R and K were significantly shorter and a angle was significantly wider in warming group than in control group (P＜0.05).There was no significant difference in MA between the two groups at T_1.Conclusion Mild hypothermia developed during operation can impair bemostasis.Maintenance of normal body temperature(core temperature)during operation is necessary.

Animals ; Arrhythmias, Cardiac ; chemically induced ; etiology ; Female ; Heart ; drug effects ; In Vitro Techniques ; Lysophospholipids ; pharmacology ; physiology ; Male ; Random Allocation ; Rats ; Rats, Wistar

An instrumental analysis method for the determination of stable silicon isotope ratio using multi-collector inductively coupled plasma mass spectrometry ( MC-ICP-MS) was established. In dry plasma mode, silicon isotopes suffered from the spectrum polyatomic interferences of C, N, O, H at medium resolution. The sample gas flow had significant effect on the silicon sensitivity and signal stability. Besides, higher sample gas flow lead to higher production of 14N16O. Consistent δ29Si and δ30Si within 0. 04‰ (1σ) could be obtained over a mass range of ca. 9 milli-amu at the lower mass side of silicon at medium resolution. The analyte concentrations of the sample and reference material were matched within 20% to avoid concentration effect on the determination of silicon isotopes using standard-sample-bracketing correction method. The measurements were not sensitive to the acid molarity and Cl matrix. An internal precision of less than 8×10-6(1σ) could be achieved for 29 Si/ 28 Si and 30 Si/ 28 Si by taking an integration time of 8 seconds. The long-term reproducibility of 0 . 06‰-0 . 10‰ ( 2σ, n=20 ) was obtained for δ29 Si and δ30 Si by repeating the analysis of the silicon reference materials, whilst the determined isotopic value for GBW04421 and GBW04422 were in good agreement with the recommended data, suggesting the precision and robustness of this method. The measured silicon isotopic values of fresh waters ( river and lake waters ) , saline waters and seawater demonstrated the capability of applying this method to trace the biogeochemical processes of silicon in natural waters.

Adolescent ; Adult ; Anemia, Aplastic ; blood ; Case-Control Studies ; Female ; Humans ; Isoenzymes ; metabolism ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Protein Kinase C ; metabolism ; Protein Kinase C-theta ; T-Lymphocytes, Cytotoxic ; cytology ; Th1 Cells ; cytology ; Young Adult