Objective To investigate the relationship between smoking and the occurrence of pulmonary tuberculosis among type 2 diabetics(DM-PTB).Methods A hospital-based case-control study was carried out at three hospitals in Tianjin from 2001 to 2002.87 cases of newly-diagnosed pulmonary tuberculosis with type 2 diabetes mellitus and 129 controls by frequency-matched by gander and age were recruited and interviewed.Univariate and multivariate unconditional logistic regression analysis was conducted.The adjusted odds ratio(OR) and 95% confidence interval(CI) were estimated.Results Higher smoking index(OR=1.399,95%CI=1.098～1.782)?beginning smoking at younger(OR=2.028,95%CI=1.076～3.821)?large consumption of cigarets per day(OR=1.349,95%CI=1.087～1.674)?no smoking cessation after diabetes diagnosis(OR=5.327,95%CI=1.703～16.661) were significantly associated with DM-PTB after adjusted for other risk factors.Among female diabetics large consumption of cigarets per day? beginning smoking at younger higher smoking index were generally associated with increased risk of pulmonary tuberculosis;while without smoking cessation after diabetes diagnosis might be risk factor among the male;higher smoking index might increase the risk of pulmonary tuberculosis among younger(youger than 60y) diabetics.Conclusion Smoking control or cessation among type 2 diabetics might decrease the risk of pulmonary tuberculosis.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

ObjectiveTo study diabetes self-management skills among outpatient diabetics and their influence on glycemic control.MethodsData were collectedfrom 281 diabetes patients recruited in Tianjin Medical University Metabolic Hospital using a questionnaire covering their diet, physical exercise and glycemic self-monitoring during the last three months.Additional HbA1c and blood lipid information were retrieved from medical records.Logistic regression modified by factor analysis was then conducted.ResultsMore than half patients did well in diet control, physical exercise and drug treatment.23% patients exceeded physician-recommended intervals for self-monitoring.Self-monitoring was primarily conducted through hospital testing or family-owned glucometers.Abnormal blood pressure (53%) or lipid (47%) levels were also common.Overall, self-management practices among men and the younger(<60yr)were worse than that among women and elderly people.The significant related factors for good glycemic control included higher socioeconomic status and positive treatment, but Abnormal cholesterol and inadequate self-monitoring were related with poor glycemic control with the adjusted odds ratios equaling to 059, 039, 189 and 183, respectively.ConclusionsMore attention should be taken on men and the younger (<60yr)to improve their skills of self-management.Self-monitoring, physical exercise, diet control, etc. independently influence blood glucose control.

Objective Hyalinizing trabecular tumor ( HTT) is often mistaken as thyroid papillary carcino-ma( TPC) ,which shares some morphological features with TPC .The aim of this study is to investigate HTT and TPC with immunohistochemical methods .Methods we detected the expression of the three Immunohistochemical index((CK19,HBME-1,MIB-1)in thirteen cases HTT and twenty cases TPC.Results In HTT samples, CK19:three of the thirteen were positive and focal positivity (1+);HBME-1:None of the thirteen samples was stained.MIB-1:ten in thirteen cases were stained in nucleus .In TPC samples,CK19:all of the twenty samples were intensely stained;HBME-1:nineteen of twenty samples were intensely stained;MIB-1:all of the twenty samples were stained in nucleus .The sensitivity and specific degrees of CK 19 and HBME-1 combination to diag-nosis HTT and TPC were 90.0%and 69.2%.Conclusion Our research could provide potent aid to differential diagnosis of HTT and TPC .The combination of CK19 and HBME-1 are adequate to identify HTT and TPC .

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Objective Demonstrate the implication of Emergency Severity Index (ESI) in pediatric emergency room (ER). Method ESI categories of 21 904 visitors to ER of Beijing Children's Hospital's international department were reviewed. SPSS statistic software was employed to compare the results of ESI categories by doctors and nurses separately using x2 analysis. Results There are highly consistency in ESI categories by doctors and nurses. ESI is an easy-learned and effective triage method. Conclusions ESI is capable in pediatric emergency room regarding recognizing serious cases and saving clinical resources.

Drug Resistance, Microbial ; Immunity ; Infection

Objective To explore the influence of personality and negative life events on the development of pulmonary tuberculosis among diabetic patients.Methods A hospital-based case-control study was conducted from March 2005 to February 2006.158 newly-diagnosed pulmonary tuberculosis patients with diabetes (DMPTB) were reemited as cases and 281 diabetic patients (DM) as control group.Information on personality and negative life events was collected using Eysenck Personality Questionnaire (EPQ) and Life Events Scale (LES),respectively.Odds ratios(OR) and 95% confidence intervals (95% CI) were estimated using logistic regression models and the potential confounding bias was controlled through adjusted by education,income,glycemic control,previous maximal BMI,weight loss ratio,physical xercises,smoking,negative life events or personality.Results The proportions of introversion,medium,extroversion personality in DM-PTB and DM group were 38.6% ,11.4% ,50.0% vs.53.0% ,11.1% ,35.9% (X~2=9.280,P=0.010).Those with introversion personality had 1.91 (1.26～2.90) times higher risk of DM-PTB than those with extroversion personality,while this association became insignificant after adjustment(P=0.111) ; 35.4% and 19.6% in the two groups had experienced life events during the last one year,and such persons had 2.26(1.15～3.50) (unadjusted) or 1.82(1.07～3.10)(adjusted) higher risk of DM-PTB than those without life events,especially among male and younger (＜60y) diabetics.Conclusion Negative life events are the independent risk factor of pulmonary tuberculosis among male and younger diabetics.Thus,mental measures should be taken in corresponding risk populations to improve their capability of dealing with life events.

Executive Function ; Humans ; Prefrontal Cortex ; physiology

Objective To study the etiology and the management of postcholecystectomy syndrome (PCS). Methods A review of 148 cases of PCS was made. Results Positive signs existed in 111 cases. Seventy-eight cases underwent operations with complete cure in 74 cases and improvement in 4 cases, whereas the other 70 cases received conservative therapies with complete cure in 9 cases, improvement in 48 cases and no change in the remaining 13 cases. Conclusions PCS is a series of symptoms with complicated reasons. Prevention should be put first.