Objective To investigate the risk of cardiovascular and other target organs damage in the patients with type 2 di abetes mellitus(T2DM) and different body mass indexes (BMI).Methods One hundred and twenty-six patients with T2DM admitted to our hospital from January 2014 to January 2016were prospectively collected,including 57 cases in the study group (BMI≥25 kg/m2) and 69 cases in the control group (18.5 kg/m2≤BMI＜25 kg/m2).The clinical featuresof the two groups were analyzed,and the correlation between BMI and related indexes of target organ damage [carotid arte ry intima media thickness (IMT),arterial stiffness index,coronary heart disease index and glomerular filtration rate] were analyzed.Results There was no statistically significant difference in fasting blood glucose between the two groups (P=0.953),BMI in the study group was significantly higher than that in the control group (P=0.000).When compared with the.control group,the study group showed a significantly increase in age (P=0.038);a significant increase in systolic blood pressure (P=0.000);a significantly increase in diabetic family history (P=0.000);a significant increase in total cholesterol (P=0.012);a significant increase in triglycerides (P=0.000);a significant decrease in high density lipoprotein (P=0.003);a significant increase in HOMA-IR level (P =0.000);a significant decrease in HOMA-β level (P=0.000);a significant increase in IMT level (P=0.000);a significant increasein arterial stiffness index (P=0.000);a significant increase in coronary heart disease index (P:0.001);and a significant decrease in glomerular filtration rate (P=0.000).The Pearson linear correlation analysis showed that BMI was correlated with IMT,atherosclerosis index,coronary heart disease index and glomerular filtration rate,the r values were 0.234,0.257,0.294 and 0.211 respectively(all P=0.000).Conclusion The BMI level in the patients with T2DM is related to cardiovascular and renal function damage.

A dispersive solid phase extraction method combined with reversed phase liquid chromatography was investigated for the determination of benzo ( a ) pyrene ( BaP ) residues in edible oil and oil products. The developed “one-step” sample preparation method integrated with the adsorbent activation, sample extraction and sample cleaning. Using Alumia-N as the adsorbent, good cleaning effect and high recovery ranging from 81. 5% -97. 5% was achieved. In addition, coupled with fluorescence detector (FLD), high sensitivity was obtained with LOD of 1. 0 μg/kg (S/N=3). Furthermore, SPSS was used to design orthogonal optimization experiments and establish the optimal condition. Under the optimized condition, the standard calibration curve was linear over the concentration range of 0. 5-10. 0μg/L, with the regression efficiency (R2) of 0. 9997. The relative standard deviation (RSD) of peak area was between 2. 6%-4. 9%, showing good repeatability and the reliability.

Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192 Ir source accident,in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity,slit-lamp examination,fundus examination,automated perimetry,optical coherence tomography (OCT) examination,fundus photography,and fundus fluorescein angiography (FFA).The patient was followed-up for 20 months.Comparative analyses were made of the follow-up results.Results One month after 192Ir radiation exposure,the visual acuities in both eyes were 1.0.Mild age-related opacities were observed in peripheral cortex,but the fundus looked normal.Twenty months later,the patient was followed-up.The visual acuities reduced to about 0.6,evident powder-and punctuate-like opacities could be observed in the cortex of the right lens,and mild turbid foci in the posterior polar and capsule.Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye.The macular fovea thickness was not changed significantly in the right eye.Examination with fundus photography demonstrated mild optical nerve atrophy,drusens,and pale optic discs,while FFA examination showed punctuate or flocculent leakages in both eyes.Conclusions The lens opacity could be induced or accelerated by radiation exposure.In addition to the posterior capsule and pole cataracts,punctuate opacity within cortical layer may also occur.It also suggests that cataract and fundus injuries may occur later during long-term follow-up,even though the eyes may look normal during early examination after the patient exposed to the radiation.

Objective:To evaluate the efficacy and safety of raltitrexed plus oxaliplatin combined with concurrent radiotherapy for advanced esophageal carcinoma. Methods:A total of 54 patients with stageⅡ/Ⅲadvanced esophageal carcinoma according to the clinical staging of esophageal carcinoma nonsurgical methods were treated with raltitrexed plus oxaliplatin combined with concurrent radiotherapy. The patients were irradiated with a dose of 60 Gy in 30 fractions. Two cycles of concurrent chemotherapy were adminis-tered during radiotherapy, with 100 mg/m2 oxaliplatin and 2.6 mg/m2 raltitrexed on d1 and d22. Results:The complete response rate was 16.7%(9/54), and the partial response rate was 68.5%(37/54). The total response rate was 85.2%. The no response and progression rate was 14.8%(8/54). The one-and two-year local control rates and overall survival rates were 75.4%, 57.3%and 70.4%(95%CI, 0.6-0.8), 46.6%(95%CI, 0.3-0.6), respectively. The incidence rates of radiation-induced esophagitis, leucopenia, acute diarrhea, neuro-toxicity were 100%, 72.2%, 16.7%, and 44.4%, of which 7.4%, 7.4%, 1.9%, and 0%were≥grade 3, respectively. Conclusion:Ralti-trexed plus oxaliplatin combined with concurrent radiotherapy can enhance the response rate and prolong the survival of patients with advanced esophageal carcinoma. The regime has mild toxicity and is worthy of further study in PhaseⅢ.

Objective To compare the clinical values of impedance method,optical method and microscopy when used to detect platelet abnormal results.Methods Platelet re-examinations by optical method and microscopy were carried out in case of low confidence degree in platelet test with impedance method by XE-2100 automatic hematology analyzer,and then the results by the three methods were compared.Results Most of the low-confidence-degree results by impedance method could be corrected by re-examination by optical method,and the remained had to turn to microscopy due to unsatisfied requirements of the instrument.Conclusion Optical method has to be involved to correct the platelet abnormal results by XE2100 automatic hematology analyzer,and microscopy should be applied in case optical method doesn't work.The three methods gains advantages and disadvantages of themselves,and can be supplementaries for one another.

Diagnostic Imaging Pediatric bone and joint system was a sub-branch of professional courses.The content was more difficult and learners were not relaxed to master the knowledge alone.It was easy,across time and space,resource sharing and interactive to operate on blackboard teaching platform.We can better accomplish teaching and learning task with pediatric bone and joint diagnostic imaging online course constructed by blackboard platform.

Objective To make a rapid dose estimation for a patient exposed locally to high dose radiation exposure in early stage of 5.7 192Ir source accident in Nanjing.Methods Based on source parameters,exposure pattern,and time duration,the doses were estimated using MCNP simulations with the aid of the proper East Asia adult male voxel phantom and main physiological parameters of the exposed patient.Result Absorbed doses to 16 organs or tissues were estimated to be in the range 0.03 to 9.16 Gy.Also,the iso-dose curves for the skin of legs showed clearly the dose difference between right and left legs.Absorbed doses to patient's testicles and prostrate,about 9.16 Gy,were higher than those to other organs or tissues.The skin of both legs was exposed locally to high dose radiation exposure,for which the estimated doses were in agreement with the results obtained from infrared thermal imaging.Conclusions Monte Carlo simulation technique and common software can be used for dose estimation in early stage of radiation accidents effectively with integrating proper models.

Objective To use three different methods in attempt to estimate the biological dose of the patient partially exposed to 192Ir source at5.7 accident in Nanjing,so as to provide dosimetric information for clinical remedy of exposed patients in the emergency of a nuclear accident.Methods Peripheral blood samples were collected on days 5 after exposure.The biological dose was estimated by the yields of dicentrics plus rings ( dic + r),cytokinesis-block micronuclei (CBMN) assay and nucleoplasmic bridge plus FHC (NPB + FHC).The homogeneity of radiation exposure was examined by Poisson distribution of dicentrics.Results By using three different methods,the whole body equivalent dose was dic + r estimated to be 1.51 Gy (95％ CI 1.40-1.61),1.47 Gy (95％ CI 1.36-1.60) by CBMN and 1.30 Gy (95％ CI 1.00-1.60) by NPB + FHC,respectively.A non-poisson distribution was also detected,suggesting partial body radiation exposure.Conclusions The estimated whole body equivalent dose ot a non-uniform radiation exposure was consistent with clinical diagnosis,suggesting that the yields ofdic + r,CBMN,as well as NPB + FHC,are efficient approaches to the estimation of biological doses.

Objective To explore the natural attenuation pattern of three biological dose estimation indexes in vivo by investigating the effect on biological dosimetry of peripheral blood sampling at different time points from the victim partially exposed to 192Ir radiation source at5.7 accident in Nanjing.Methods Peripheral blood of the patient was collected on days 5,40 and 280 after exposure,respectively.The yields of dicentrics plus rings chromosomes (dic + r),cytokinesis-block micronuclei (CBMN) and nucleoplasmic bridge + fusion + horse shoe + circular(NPB + FHC) were analyzed.The dynamic reduction and dose estimation were both observed using the biomarkers mentioned above after exposure.Results Compared to the estimates on days 5 after exposure,the dose values estimated on days 40 and 280 decreased by 34％ and 49％ fordic + r method,48％ and 79％ for the CBMN assay,and 48％ and 75％ for NPN + FHC method,respectively.Conclusions Three biological dose estimation indexes show a progressive decrease in vivo,with the half-life of dic + r/cell being 40 days.The doses estimated using these three indexes on days 40 after exposure showed a relative deviation more than 20％ compared with those on days 5 after exposure.

Objective To provide nutritional supportive scheme for patients with radiation injury through the treatment of the one exposed to Nanjing 192Ir source accident.Methods The reasonable nutrition treatment scheme was made on the basis of dietary survey and nutritional index monitoring during clinical stages of the patient,including body weight,body mass index(BMI),biochemical indexes,electrolyte,etc.,as well as metabolic cart determination of resting energy expenditure (REE).Results Patient on admission (days 5 post-irradiated) weighing 42.5 kg,172 days after the first irradiated (the first skin grafting) fell to a minimum of 36 kg,then gradually rise,hen rose back to normal range on days 383 before discharge.Normal admission hemoglobin was 135 g/L,172 d after irradiated to a minimum of 54 g/L,normal discharge;when lymphocytes admission low as 0.5 × 109/L,58 days back to normal after exposure,172 days after irradiated down to 0.4 × 109/L.Serum albumin was normal admission 41.2 g/L,172 days after irradiated down to 25.3 g/L.The normal level of serum prealbumin was 0.22 g/L,248 days to a minimum of 0.04 g/L,the basic return to normal at discharge was 0.17 g/L.Admission normal liver function,bilirubin index slightly higher,the all in one parenteral nutrition after about 2.5 months later,bilirubin and liver function indicators were gradually increased,the adjusted treatment and nutrition liver and gallbladder and other gradually returned to normal after treatment.REE and the body weight were determined by metabolic cart on days 294,308 and 342 for the energy requirements.Conclusions For patient with radiation injury,appropriate nutrition therapy is a key method for the clinical treatment and rehabilitation,which can maintain the nutritional status of patients and improve clinical treatment.