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Academic Dissertations as Topic

Objective To determine 1 hour plasma glucose cutoff value during OGTT to screen diabetes and IGR and its relationship with islet β cell function and insulin sensitivity. Methods 4731 subjects were recruited to perform an OGTT.The cutoff value of 1h-plasma glucose during OGTT was analyzed by receiver operating characteristic curve (ROC curve).And according to the two cutoff values,we classified all the subjects to three groups,and compared HOMA-IR,HOMA-β,insulinogenic index and shape index among groups,then analyzed its correlation with each parameter. Results According to ROC results, to diagnose type 2 diabetes mellitus,the optimal cutoff value of 1h plasma glucose during OGTT was 12.935mmol/L,with sensitivity of 81.52%,specificity of 86.94%. To diagnose impaired glucose regulation(IGR),the optimal cutoff value of 1h plasma glucose was 9.815mmol/L,with sensitivity of 74.96% and specificity of 77.86%. We classified all the subjects to three groups, and among the three groups the insulinogenic index, shape index, HOMA-IR, HOMA-β showed statistically significant difference (all P＜0.01). There was a negative correlation of OGTT-1hPG with insulinogenic index and HOMA-β(all P＜0.01) and a positive correlation of OGTT-1h PG with shape index and HOMA-IR (all P＜0.01). Conclusions To diagnose type 2 diabetes mellitus,the optimal cutoff value of 1h plasma glucose during OGTT is 12.935mmol/L.To diagnose impaired glucose regulation(IGR),the optimal cutoff value of 1h plasma glucose is 9.815mmol/L.And 1h PG can reflect the islet β-cell function and insulin resistance.

Objective To explore the significances of the endoscopic diagnosis for chronic atrophic and histological assessment gastritis (CAG). Method Five hundred patients with CAG were determined by gastroscopy and the samples of gastric mucosa were examined by the pathology. Results Among 500 cases of CAG by gastroscopy, 429 cases were similar with the pathologic results and the coincidence rate of diagnosis with endoscopy and pathology was 85.8%(429/500), 370 cases had a change of atrophic gastritis in cirumjacent mucosa. Conclusion The coincidence rate of diagnosis under endoscopy and pathology is quite good in CAG.

Objective To study the value of plasma D-dimer ＜ 500 μg/L level in diagnosis of pulmonary thromboembolism occurred in patients.Methods The clinical data of the patients with pulmonary embolism confirmed by imaging examination with plasma D-dimer levels ＜ 500 μg/L admitted from January 1st 2008 to June 30th 2011 were analyzed retrospectively.Results Totally,there were ten pulmonary embolism patients with plasma D-dimer levels ＜ 500 μg/L.The 10 eligible patients were assessed for the possibility of pulmonary embolism by using the Wells score (i.e.Wells clinical pretest probability prediction model).Of them,0 cases was evaluated as low clinical pretest probability (grade ＜2),7 cases as moderate clinical pretest probability (grade 2 ～6) and 3 cases as high clinical pretest probability (grade ＞ 6).Conclusions Pulmonary thromboembolism was easily misdiagnosed for lacking specific clinical manifestations and the missed diagnosis in patients caused high mortality,so it was difficult to exclude acute pulmonary embolism simply depending on the D-dimer levels ＜ 500 μg/L.Therefore,in case of plasma D-dimer levels less than 500 μ g/L,the possibility of pulmonary embolism cannot be ruled out in patients with moderate or high Wells clinical pretest probability.