Congresses as Topic ; Humans ; Lysosomal Storage Diseases

Objective To explore the change of 25 hydroxyvitamin D level and its correlation with glucose metabolism and bone mineral density in elderly men with type 2 diabetes mellitus(T2DM).Methods Hospitalized 53 elderly male patients with T2DM (T2DM group) and 51 patients without T2DM (NDM group) were chosen.Blood.biochemical indexes and 25 hydroxyvitamin D level were measured.Bone mineral density of lumbar (L2_4),left proximal femur was measured by dual energy X-ray.Results The serum 25 hydroxyvitamin D level in T2DM group was lower than that in NDM group [(12.38 ±5.12)μg/L vs.(17.35 ± 5.52) μ g/L],and there was significant difference(P＜ 0.05).The serum 25 hydroxyvitamin D level was negatively associated with fasting blood glucose level and glycosylated hemoglobin (r =-0.225,-0.499,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with fasting insulin and homeostasis model insulin resistance index (r =-0.050,-0.082,P ＞ 0.05).The incidence of osteoporosis in T2DM group was higher than that in NDM group [30.19％(16/53) vs.11.76％(6/51)],and there was significant difference (P ＜0.05).The serum 25 hydroxyvitamin D level was positively associated with bone mineral density of femur neck,greater trochanter of femur and Ward triangle(r =0.773,0.762,0.812,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with bone mineral density of lumbar (L2_4)(r =0.116,P ＞ 0.05).Conclusions The prevalence of vitamin D deficiency is found in elderly men with T2DM.Vitamin D level can affect blood glucose control and increase the risk of the occurrence of osteoporosis.Therefore,T2DM patients,especially elderly patients,should be routine vitamin D testing.Vitamin D supplementation to the patients of vitamin D insufficiency in time may be beneficial to glucose metabohsm and the prevention and treatment of osteoporosis.

Objective To study pharmacodynamic changes of combined anesthesia with remifentanil at different target plasma concentrations and isoflurane at different minimal alveolar concentrations(MAC) in laparoscopic operations. Methods Forty-five patients with ASA status Ⅰ~Ⅱ,receiving selective laparoscopic cholecystectomy or laparoscopic oophorocystectomy,were included.The patients were randomly divided into three groups with 15 patients in each group.In the Group A,anesthesia was maintained with isoflurane inhalation at the MAC of 1.3;in the Group B,anesthesia was maintained with both isoflurane inhalation at the MAC of 0.6 and remifentanil target-controlled infusion at 4 ng/L;and in the Group C,anesthesia was maintained with both isoflurane inhalation at the MAC of 0.4 and remifentanil target-controlled infusion at 6 ng/L.Pharmacodynamic parameters and recovery characteristics,including bispectral index(BIS),heart rate variability(HRV),mean arterial pressure(MAP),heart rate(HR),time to additional administration of muscle relaxants,time to the recovery of spontaneous breathing,time to eye opening,time to endotracheal extubation,time to the recovery of orientation,and follow-up survey of "awareness during operation",were compared among the 3 groups.Results ①The BIS value was lower in the Group A than in the Group B and C at the time of pneumoperitoneum for 2 min and removal of the gallbladder or the ovarian cyst.The measures of HRV were higher in the Group A than in the Group B and C at the time of pneumoperitoneum for 2 min and removal of the gallbladder or the ovarian cyst.The measures of MAP and HR in the Group A were higher than those in the Group C at the time of pneumoperitoneum for 2 min,and were lower than those in the Group C at the time of the endotracheal extubation and the recovery of consciousness.②Either isoflurane inhalation at the MAC of 0.6 combined with remifentanil target-controlled infusion at 4 ng/L or isoflurane inhalation at the MAC of 0.4 combined with remifentanil target-controlled infusion at 6 ng/L provided satisfactory anesthetic maintenance.③Significantly shorter time to endotracheal extubation,to eye opening,and to the recovery of orientation were recorded in the Group B and C than in the Group A.Conclusions Anesthesia with target-controlled infusion of remifentanil combined with inhalation of isoflurane can be used for laparoscopic surgery.Pharmarcodynamic parameters and recovery characteristics show that combined use of remifentanil infusion at 4 ng/L and isoflurane inhalation at the MAC of 0.6 provides optimal anesthetic maintenance.

Adenosine Triphosphatases ; genetics ; Alanine Transaminase ; blood ; Cation Transport Proteins ; genetics ; Ceruloplasmin ; metabolism ; Child ; Copper ; blood ; urine ; Copper-transporting ATPases ; Cornea ; pathology ; Diagnosis, Differential ; Genetic Testing ; Hepatolenticular Degeneration ; blood ; diagnosis ; genetics ; metabolism ; Humans ; Liver ; metabolism ; pathology ; Liver Function Tests ; Mutation

BackgroundHypoxia and hyperglycemia are the common causes of retinal neovascularization.In these states,H+ accumulates because of the elevated glycolysis and failure of retinal circulation,thus the retinas readily acidified. ObjectiveThe present study was to explore whether retinal acidosis independently regulates the production of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) and whether the regulation is related to oxidative stress.Methods The retinas from 2-week-old male SD rats were cultured with explant method in DMEM modulated by NaHCO3,and culture retinas were randomly divided into pH 7.2,6.8 and 6.5 groups for 24 hours.In addition,after 24 hours of culture as above described,retinas were washed using PBS two times and then followed by again culture in DMEM with pH 7.2 for another 24 hours.Also,antioxidant was added in different pH values of DMEM for culture as above described.The retinal samples were prepared for histopathological examination.The expressions of VEGF and PEDF proteins and their mRNA in retina tissue were detected by Western blot and fluorescence quantitative polymerase chain reaction (PCR) respectively.Results The retina showed the clear structure and morphology in pH 7.2 group and pH 6.8 group,but retinal vacuoles change was seen in pH 6.5 group after culture for 24 hours.No significant difference was seen in the expressing level of VEGF mRNA in retina between normal group and pH 7.2 group( 112％ ±11％ vs 100％ ±7％ ) (P=0.55),but those in pH 6.8 group and pH 6.5 group were significant increased in comparison with pH 7.2 group( 196％ ±43％ vs 100％ ±7％ ;251％ ±29％vs 100％ ±7％ )( P＜0.05 ).The expressing level of PEDF mRNA in retina in normal group was similar to that of pH7.2 group(86％ ±19％ vs 100％ ±33％) (P=0.64),but that in pH 6.5 group was significantly higher than pH 7.2 group( 230％ ±66％ vs 100％ ±33％ ) ( P＜0.05 ).The resemble results were found in the expressions of VEGF and PEDF protein.After pH reversion,the expressing levels of VEGF mRNA were 100％ ±13％,111％ ±9％,113％ ±9％ in pH 7.2 group,pH 6.8 group and pH 6.5 group respectively without significant difference among them (F=2.51,P=0.16).The expressing levels of PEDF mRNA were 100％ ±13％,110％ ±9％,108％ ±11％in different groups ( F =0.98,P =0.43 ).Under the presence of antioxidant,the expressing level of VEGF mRNA in pH 6.5 group increased in comparison with pH 7.2 group and pH 6.8 group ( P ＜ 0.05 ).The expressing levels of PEDF mRNA were significant different among pH 7.2 group( 100±31 )％,pH 6.8 group( 282±45 )％ and pH 6.5 group(480±117)％ (F=20.73,P=0.00). Conclusions VEGF can be induced by retinal acidification alone,which may be regulated by oxidative stress.Under the retinal acidification,antioxidants promote the expression of PEDF,suggesting that oxidative stress inhibits the production of PEDF.

Objective To evaluate the key points of anesthetic management for retroperitoneoscopic nephrectomy combined with inferior vena cava ( IVC ) tumor thrombectomy. Methods Perioperative clinical data of 3 patients undergoing retroperitoneoscopic nephrectomy combined with IVC tumor thrombectomy from December 2010 to June 2014 were retrospectively analyzed.There were 2 cases of level Ⅰthrombus and 1 case of level Ⅱthrombus.All the patients were given general anesthesia with intubation.Brief inferior vena cava occlusion was performed in the patient with level Ⅱ thrombus. Results The operation was completed smoothly in all the cases without conversions to open surgery. The operating time was 244, 333, and 289 min, respectively. The total IVC control time for level Ⅱ thrombus was 10 min.No intraoperative pulmonary embolism and other severe anesthetic complications occurred. One patient with level ⅠIVC thrombus was extubated and sent back to surgical ward after surgery, and the remaining 2 patients underwent intensive care monitoring overnight and were extubated and discharged to surgical ward on the next day. Conclusions Retroperitoneoscopic nephrectomy and IVC thrombectomy is a brand-new, difficult but feasible procedure. Anesthesiologist should have a full recognition of surgical procedures and make perfect anesthetic plan to ensure close collaboration. Furthermore, circulatory swing during IVC clamping and perioperative severe complications such as pulmonary embolization and massive hemorrhage cannot be neglected.

Aim To observe the timed analgesic effects by butabital (B), acetaminophen(A) and caffeine (C) in combination (BAC), in which the proportion was fixed as1. 25∶ 8. 1∶1. Method Three types of experimental methods, including the tailflicking method, the hot plate method and the pressurizing tail method, weretaken to determine indices at different times after the animals were adminstered(ig) high, median and low BAC dose. Results and conclusion BAC had a stronganalgesic effect in three types of experiments. The effect began 30 min after ad-ministration, arrived maximum at 1 h, decreased at 2 h and disappeared at 4 h.There was a dose-effect relationship between large and little BAC dose.

Objective To investigate the diagnosis and treatment procedures of primary colonic malignant lymphoma(PCML). Methods Data of clinical and pathological findings, surgical treatment and prognosis of 12 cases with PCML verified by pathology were retrospectively analyzed, workups of barium clysma,colon-scopic examination and multislice spiral computed tomography(MSCT) were compared to evaluate their role in diagnosis. Results The classic presentation of PCML included abdominal pain, abdominal bulge, bowel obstruction, gastrointestinal bleeding, and serum levels of tumor markers were within the normal ran-ges. Six cases underwent procedure of barium clysma, and anomaly appeared in 2 cases, however, there were no indications of lymphoma, 6 cases underwent colon-scopic examination, anomaly in 3 cases, of which 1 revealed possibility of lymphoma, 10 cases underwent MSCT; 9 cases demonstrated tumor origin by CT scan of which diagnosis was established in 5 cases. All the patients underwent surgery. No incidence of peri-opreative death happened. Non-Hodgkin' s lymphoma was confirmed in all of cases. For all of the cases a T-cell origin was in 1 case and a B-cell origin in other cases. Ten cases were administrated postoperative chem-otherapy. 11 cases were followed up, and the overall 1-year and 3-year survival rates were 81.9% (9/11) and 54.5% (6/11), respectively. Conclusions Typical presentation is still lacking for PCML, workups of barium clysma and colon-seopic examination are little sensitive and specific to make the diagnosis. However, MSCT is useful in diagnosing PCML with its characteristic information as well as clinical findings. Surgical management and postoperative adjuvant-chemotherapy would be likely the optimal therapeutic maneuver of this disease in early period.

Objective To study the feasibility of preoperative acute hypervolemic hemodilution for decreasing perioperative blood use. Methods Thirty two patients(ASAI-II) undergoing spinal surgery were randomized into AHH group and control group. After anesthesia 6% HES(200/0.5) was given through internal jugular vein for AHH. The blood volume was increased by about 25%. During the operation, blood loss was replaced by HES in equal volume. Blood was transfused when the Hct dropped below 25%. The HR, MAP, CVP, SPO2, Hb, Hct., Plt, FIB, APTT, PT, amount of blood loss, blood transfused and urine output, volume of drainage 24h after operation and VAS score (0 means no effect, 10 means maximal effect) were observed before AHH, at the end of AHH, at the end of operation, and 24h after the operation. Blood volume expansion was calculated. Results (1) HR increased significantly in both groups(P