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 air quality in the basements of high science-technologic buildings. Methods Continuous tests of air quality parameters of physics, chemistry and microbiology were conducted in 11 rooms of the basement used for working and living. Results At every test point the average room temperature was 25.5 ℃, the average relative humidity was 78.7 per cent, the average wind velocity was 0.057 m/s. Between the relative humidity and temperature(r=-0.850, P

Objective To evaluate the effectiveness of an improved uterooperator in the interventional treatment of tube obstructional infertility, and to make a comparison with other motheds. Method One hundred cases of infertile women with tubal obstruction were divided into 3 groups and treated separately under TV fluoroscopy with 3 different methods and follow-up examination was made up to 24 months. Among the 100 cases, 60 cases were treated with improved uterooperator(109 tubes), 20 with Cook cupped coaxial catheter (36 tubes), and 20 with emulsoid double-cavity tube (20 tubes). Result Among the improved uterooperator group, Cook cupped coaxial catheter group, and emulsoid double-cavity tube group, the successful rate of selective catheterization was 92.7%, 80.6%, and 80.0%, respectively. The successful rate of recanalization was 72.3%, 72.4%, and 71.4%, respectively. The pregnancy rate was 36.4%, 35.7%, and 36.4%, respectively. Improved uterooperator has the highest successful rate in selective catheterization(? 2=4.275 5, P

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.

BACKGROUND: Impaired glucose tolerance(IGT) is mainly related to genetic factors and environmental factors including excessive calorie intake and obesity. Insulin resistance(IR) plays a major role in the onset of IGT.OBJECTIVE: To investigate the relationship between erythrocyte insulinase activity(EIA) and IR in patients with IGT soas to provide theoretic basis for improving IR in patients with IGT by exercise.DESIGN: Observational and comparative study based on IGT patients as the subjects and adults with normal glucose tolerance as controls.SETTING: Department of endocrinology of a hospital affiliated to a military medical university.SUBJECTS: The study was conducted in the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA, from January 2001 to April 2003. A total of 50 inpatients and outpatients with IGT, 26 males and 24 females aged(52 ± 7) years, were randomly selected. Inclusion criteria: those whose diagnosis met the WHO 1999 for criteria oral glucose tolerance test (OGTT) and whose heart, liver and kidney functions and blood test were within the normal range without taking any antidiabetics. Exclusion criteria: those who had liver and kidney diseases, infection, malignant tumor, coronary heart disease, cerebrovascular disorder and connective tissue disease. The patients with IGT were divided into 2 subgroups according to the presence of abnormal fasting plasma glucose (FPG).Subgroup A consisted of 20 patients (9 males and 11 females) with IGT accompanied with impaired FPG. Subgroup B was composed of 30 IGT patients (17 males and 13 females) with normal FPG. Twenty adults with normal glucose tolerance were set as control group(20 females and 10 males) with the age of(48 ± 12)years.METHODS: EIA was measured with the method of radioenzymatic assay in all subjects. Blood sugar, serum insulin and glycosylated hemoglobin were also measured, and homeostasis model analysis-insulin resistance (HOMA-IR) index was calculated for estimation of insulin sensitivity.MAIN OUTCOME MEASURES: The differences and correlation between EIA and HOMA-IR in IGT patients of each group.RESULTS: EIA, serum fasting insulin and HOMA-IR indexes of the patients with IGT were significantly higher than those of the controls ( P < 0.01 or P < 0.05) . EIA and HOMA-IR of the patients in subgroup A was significantly higher than those in subgroup B ( P < 0. 01 ). Linear regression analysis showed that EIA had significant positive correlation with serum fasting insulin, glycosylated hemoglobin and HOMA-IR indexes( r = 0.51, 0.44,0.49, P <0.01).CONCLUSION: The degradation rate of erythrocyte insulinase in patients with IGT tolerance is significantly higher than that of normal persons, and is closely related to the onset and development of insulin resistance.

Objective To explore the effects of beraprost sodium (BPS) on angiotensin Ⅱ(AngⅡ)-induced podocyte apoptosis and the relationship between BPS and peroxisome proliferator activated receptor δ(PPARδ). Methods Differentiated mouse podocytes were exposed to AngⅡ, further treated with BPS (or GSK0660) for 24 h. Podocyte apoptosis was detected by flow cytometry and AnnexinV-FITC staining. Bax , Bcl-2 and PPARδ mRNA were assessed by RT-PCR. Results AngⅡ promoted podocyte apoptosis and Bax mRNA expression significantly, down-regulated Bcl-2 and inhibited PPARδ mRNA (P < 0.05). Conversely, treatment with BPS reduced AngⅡ-induced podocyte apoptosis and Bax mRNA expression and promoted Bcl-s expression significantly resulting in an increase of PPARδ mRNA expression (P < 0.05). With the inhibition of PPARδ, podocyte apoptosis and Bax mRNA expression increased while Bcl-2 mRNA expression reduced. Conclusion BPS can effectively reduce AngⅡ-induced podocyte apoptosis , which is associated with the activation of PPARδand regulation of Bcl-2/Bax mRNA expression.

Objective To investigate the possible association between vascular endothelial growth factor (VEGF), endostatin (ES) and type 2 diabetic nephropathy. Methods The level of serum VEGF and ES were measured by ELISA in eighty type 2 diabetic patients including thirty subjects without diabetic nephropathy , twenty with microalbuminuria and thirty with macroalbuminuria, and the correlation was analyzed. Results The level of serum VEGF and ES in patients with macroalbuminuria were both significantly higher than that of patients with and without microalbuminuria (P < 0.05). The level of serum VEGF and ES in patients with microalbuminuria were significantly higher than that of patients without diabetic nephropathy (P<0.05). Both VEGF and ES level were positively correlated with the level of microalbuminuria (mAlb) (r=0.226, P<0.01; r=0.491, P<0.01), and negatively correlated with the level of estimated glomerular filtration rate (eGFR) (r=-0.237, P<0.05;r=-0.620, P<0.01). There was a significantly positive correlation between VEGF and ES in patients with microalbuminuria and macroalbuminuria (r1=0.633, P1<0.01; r2=0.532, P2<0.05). However, there was no correlation between VEGF and ES in patients without diabetic nephropathy (r3=0.175, P3>0.05). Conclusion The levels of VEGF and ES in type 2 diabetic nephropathy had varying degree of increasing in different diabetic nephropathy stage , and closely related to mAlb and eGFR. Disequilibrium of VEGF and ES may speed up the progression of diabetic nephropathy.

Objective To investigate the efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection.Methods Fifty pediatric patients with acute abdomen complicated with respiratory infection,of ASA physical status Ⅰ or Ⅱ,aged 6 months-5 yr,were randomly divided into test group (group A) and control group (group B),with 25 cases in each group.Immediately after admission to the operating room,ambroxol 1 mg/kg and penehyclidine hydrochloride 0.02 mg/kg were injected intravenously in group A,and atropine 0.02 mg/kg was given in group B.Extubation time and development of laryngospasm,bronchospasm and hypoxemia were recorded.The patients were followed up for 72 h after surgery and the development of postoperative pulmonary complications was recorded.Results Compared with group B,the incidence of hypoxemia and pulmonary complications was significantly decreased,and extubation time was shortened in group A.Conclusion Ambroxol combined with penehyclidine hydrochloride can prevent pulmonary complications after surgery due to acute abdomen and is helpful for prognosis in pediatric patients with upper respiratory tract infection.

Objective To investigate the risk factors of albuminuria in type 2 diabetes nephropathy patients. Methods 870 hospitalized patients with type 2 diabetes mellitus were included in the study. The patients were divided into normal buminuria group (n = 634) and persistent albuminuria group (n = 236) according to the 24h urinary albumin excretion. Diabetic chronic complication and related biochemical indicators were analyzed. Independent risk factors associated with diabetic nephropathy were analyzed. Results The differences in duration of diabetes, age, SBP, DBP, Hb, HbA1C, UA, TG, CHOL-C, HDL-C, diabetic retinopathy (DR), cardiovascular and cerebrovascular disease were statistically significant between two groups (P < 0.01). Regression analysis showed that independent risk factors of albuminuria of DN included duration of diabetes, SBP, Hb, UA, TG and DR. Conclusions Such risk factors of duration of diabetes, SBP, UA, TG, Hb and DR may be associated with the occurrence and severity of albuminuria of DN.

Objective To explore the feasibility of team-based learning (TBL) for practice teaching of the aerospace nutrition and food hygiene.Methods A total of 90 students were investigated,and were divided into the TBL group (n=46) and the TL group (n=44) by simple random sampling.After the experiment teaching,a test and questionnaire were used to compare the teaching effect of TBL group and TL group.SPSS 18.0 was used for date and the data was analyzed by Independent-Samples t test and Chi-square test.Results Students in TBL group achieved higher mean test scores (85.70 ± 3.47) compared with students (74.10±2.41) in TL group and the difference was statistically significant (t=8.703,P=0.000).The results of the questionnaire showed that,compared with the TL group,TBL group students more agreed with the positive impact of the teaching methods on their team work ability,interpersonal skills,communication ability,problem-solving and self-learning and other aspects,and the differences between two groups were statistically significant (P＜0.05).In addition,the majority of the respondents in TBL group [93.5％ (43/46)] were satisfied with TBL.Conclusions TBL teaching is better than the TL teaching,and it can significantly improve students' comprehension of knowledge and enhance their learning effect.