Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in patients with type 2 diabetes in special care unit.Methods Two thousand three hunrded and sixty patients with type 2 diabetes were selected as our subject in The Sixth People's Hospital Affiliated to Shanghai Jiaotong University from Jan.2010 to Jul.2012.Among these patients,462 patients from special care unit were served as special care group and 1 898 patients from endocrinology ward were assigned to control group.The disease history information was recorded and physical examination and biochemical tests,including blood lipids,blood pressure,fasting glucose,glycosylated hemoglobin,serum insulin,C peptide were measured.Results (1) In special care group,there were 335 male (72.5％) and the prevalence of smoking,alcohol drinking and the proportion of the high income people were 40.5％,24.9％,76.6％ respectively,higher than that of control group (56.6％,24.6％,10.7％,12.7％ ;x2 =32.1,16.9,12.3,32.8 ;P ＜ 0.01).The body mess index (BMI),levels of waist circumference,alanine aminotransferase (ALT),gamma glutamyhransferase (γ-GT),triglyceride (TG),serum uric acid and fasting C peptide in special care group were ((25.6 ± 3.7) kg/m2,(91.0 ± 9.5) cm,(27.8 ±19.7) U/L,(34.1 ±26.3) U/L,(2.35 ±2.31) mmol/L,(333.7 ±85.5) μmol/L,(2.11 ±1.04) μg/L) higher than those of control group ((24.8 ± 3.5) kg/m2,(89.1 ± 10.3) cm,(23.0 ± 16.1) U/L,(29.2 ±23.2) U/L,(1.82 ±1.64) mmol/L,(317.1 ±85.2) μ mol/L,(1.74 ± 1.05) μg/L;F =11.44,6.90,16.65,8.35,18.23,7.34,21.21 ; P ＜ 0.01).The age,duration of diabetes,systolic blood pressure,level of serum high-density lipoprotein-cholesterol (HDL-C),and glycosylated hemoglobin were ((52.9 ± 11.1) years,5 (2,10) years,(126.7 ± 15.2) mmHg,(1.02 ± 0.32) mmol/L,(8.44 ± 1.99) ％) lower than those of control group((60.4 ± 12.2) years,7 (2,12) years,(131.9 ± 17.3) mmHg,(1.10 ± 0.32) mmol/L,(9.16 ±2.32)％;F =79.41,12.71,18.93,12.78,18.52; P ＜ 0.01); (2) The rate of overweight/obesity,dyslipidemia and MS prevalence rates in special care group were 55.6％,68.4％,60.2％,significantly higher than the control group(46.1％,52.9％,50.6％ ;x2 =7.59,18.76,7.18,P ＜ 0.01).While the prevalence of hypertension in special care group was significantly lower than control group(39.6％ vs 50.7％,x2 =10.15,P =0.01).There was on significant difference between male and female in term of the prevalence of the MS in the special care group(61.2％ vs 57.5％,x2 =0.01,P =0.92).According to age,patients in special care group were divided into three groups and that were ＜45 years group,45-59 years group and ≥60 years group.With the increase of age group of female,the prevalence of MS was increasing(33.3％,48.0％,74.1％ ;x2 =4.43,P =0.04).Among the male patients,there was no significant different was seen among three groups (58.8％,62.5％,55.6％ ;x2 =0.05,P =0.87).(3) Multiple Logistic regression analysis showed that the independent risk factors of MS in special care group including age(OR =1.071,95％ CI(1.027-1.117),P =0.01),BMI (OR =1.391,95％ CI(1.112-1.739) ; P =0.013),waist circumference (OR =1.126,95％ CI(1.039-1.222) ; P =0.004),TG (OR =1.747,95 ％ CI(1.124-2.717) ; P =0.013) and diastolic blood pressure (OR =1.111,95％CI(1.045-1.180);P =0.001).HDL-C(OR=0.048,95％CI(0.005-0.464) ;P =0.009) were protective factors of MS in special care group.Conclusion Approximately 3/5 patients with diabetes in special care unit got MS.The factors including age,BMI,waist circumference,diastolic blood pressure,TG,HDL-C were related to MS occurrence.

Subacute thyroiditis can cause destruction of thyroid follicles and subsequent transient thyrotoxicosis.In cases of simultaneous occurrences of subacute thyroiditis and Graves' disease,the former may be missed and thus may further exacerbate thyrotoxicosis.Herein,we report in detail a case with abrupt onset of thyrotoxic heart disease when taking anti-thyroid medications,in order to call attention to the diagnosis and treatment of concomitant Graves' disease and subacute thyroiditis.

Acetylcysteine ; analogs & derivatives ; urine ; Adolescent ; Adult ; Deoxyguanosine ; analogs & derivatives ; urine ; Female ; Furans ; urine ; Humans ; Hydrocarbons, Aromatic ; analysis ; Male ; Occupational Exposure ; analysis ; Young Adult

OBJECTIVE:To evaluate the economic effectiveness of different pharmacotherapeutic schemes for peptic ulcer and chronic gastritis with infection of Helicobacteria pylori(Hp) METHODS:To perform cost-effectiveness analysis of three ther_apeutic schemes for Hp infection RESULTS:The cost-effectiveness ratios of three therapeutic schemes were 8 71,10 12 and 13 99 CONCLUSION:Scheme A(omeprazole+amoxicillin+clarithomycin) is the best one

Objective To evaluate the feasibility and efficacy of catheter-directed thrombolysis (CDT) for the treatment of non-acute (history ＞ 14 days) deep venous thrombosis (DVT) of the lower extremity.Methods Clinical data of 63 patients of non-acute DVT of lower extremities treated by CDT and adjunctive angioplasty and stenting from July 2009 to August 2013 were analyzed retrospectively.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results A total of 63 limbs with DVT with a mean symptom duration of (22 ± 5) days were treated by a continuous combined with pulse-spray infusion of urokinase of (1.21 ± 0.69) million IU/d for (74 ± 21) hours.Significant recanalization was achieved in 77％ (48 of 63) of the treated limbs.After thrombolysis,percutaneous angioplasty was done for 15 residual lesions and stent placement was performed in 11 iliac veins and 1 femoral vein.Minor bleeding occurred in 6 (10％) patients,no patients suffered from major bleeding or symptomatic pulmonary embolism.During follow up (mean:15 ±6 months),the veins were patent in 45 (71％) limbs.15 (24％) limbs developed mild post-thrombotic syndrome (PTS),and none had severe PTS.Conclusions CDT combined with adjunctive angioplasty and stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower extremity DVT.

Objective To explore the expressions of hypoxia-inducible factor-1 alpha (HIF- lα)and nestin in the hippocampus of developing rats after pentylenetetrazol (PTZ)-induced starus epilepticus (SE),and the correlation between HIF-1α level and proliferation of neural stem cells (NSCs). Methods A total of 768 SD rats,including rats of postnatal 7 days (P7,n-192),rats of postnatal 14 days (P14,n=192),rats of postnatal 21 days (P21,n=192) and rats of postnatal 28 days (P28,n=192),were equally randomized into vehicle group (n=96) and control group (n-96),respectively; SE rat models of the vehicle group were induced by intraperitoneal injection of 1％ PTZ (80 mg/kg); and rats of the control group were received injection of normal saline (NS); 6 and 12 h,and 1,2,3 and 7 d after the inducement,the mRNA and protein expressions of HIF-1α in the hippocampus of rats in these 8 groups were examined by RT-PCR and immunohistochemistry, respectively. Another 48 21-d- old SD rats were equally randomized into vehicle I group (n=24) and intervention group (n=24); and rats in the intervention group received injection of HIF-lα antisense oligodeoxynucleotides (ASODN) into the right hippocampus and NS into the left hippocampus; 6 h after the injection,these 48 rats were induced into SE models by intraperitoneal injection of 1％ PTZ (80 mg/kg); 2 d after the inducement, the mRNA expression of HIF-1α in the hippocampus was examined by RT-PCR; and 7 and 14 d after theinducement, the protein expressions of HIF-1α and nestin in the hippocampus were examined by immunohistochemistry. Results The mRNA expression of HIF-1 α in the hippocampus of all the rats in the vehicle group after SE increased significantly with similar trend.Six h after SE,the HIF-1α mRNA expression significantly decreased with time prolongation (P＜0.05). Major HIF-1α positive cells were located in different areas at different time after SE. In intervention experiment, the HIF-1α mRNA expression 2 d after SE and the number ofnestin positive cells 7 and 14 d after SE in the vehicle I group and the left hippocampus of intervention group(being intervented with ASODN) obviously decreased as compared with those in the right hippocampus (being intervented with NS,P＜0.05). Conclusion The mRNA and protein expressions of HIF-1α in the hippocampus of developing rats are enhanced after SE with a correlation of age-in-days; correlativity between HIF-1α and proliferation of NSCs might exist after SE.

Objective To evaluate the efficacy of Lianhua Dingchuan Tablets in bronchial asthma.Methods Fifty BALB/C mice were randomly and equally divided into control (Con) group,ovalbumin (OVA) group,dexamethasone (DEX) group,high-dose Lianhua group,low-dose Lianhua group.The mice were sensitized and challenged with OVA plus aluminium hydroxide to establish asthmatic model and were pre-treated 30 minutes before challenge.Specific airway resistance (sRaw) was used to evaluate airway hyperresponsiveness,and airway inflammatory changes were measured.ELISA and Magnetic Luminex(R) were used to quantified the levels of IL-4,IL-13 and INF-γ.Results Airway resistance significantly decreased in DEX group and High-dose Lianhua group (P＜0.05).Levels of inflammatory cells and IL-13 in BALF evidently reduced in DEX group,high-dose Lianhua group and low-dose Lianhua group (P ＜ 0.05),while IL-13 level in serum only decreased in DEX group.There was no significant changes in the levels of IL 4 and INF γ among those groups.Conclusions Lianhua Dingchuan Tablets might relieve the symptoms of asthma by reducing IL-13 level and inhibiting the airway inflammation.

Acute suppurative thyroiditis (AST) is a rare non-specific infectious disease of thyroid gland.The signs and symptoms of AST may mimic those of a variety of noninfectious inflammatory conditions or other anterior neck infectious diseases.AST is a progressive disease and is also potentially life threatening if devoid of prompt diagnosis and proper treatment.Herein,we report a case in order to call attention to the diagnosis and treatment of AST.

Objective The purpose of this study was to compare and develop the method for identification of Non-tuberculous Mycobacteria (NTM) using matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS),and evaluate the feasibility,accuracy and repeatability of MALDI-TOF MS to discriminate NTM.Methods Fifteen clinical strains were collected from January to March in 2012 and 68 environmental strains were retrospectively collected from 2011 to 2012.A protocol for sample pre-treatment and protein extraction was developed and utilized it to identify clinical and environmental isolates.The results from 16 s rRNA sequencing were served as control.Results Method A was more effective in protein extraction.Although all the three methods got the same species result,a total of 83 strains belonging to 10 distinct species grown in Middle brook 7H10 media were analyzed.All members of the NTM were identified accurately at the genus level and 80.7％ (67/83) of strains could be identified at the species level.Six strains were identified at the complex level.81.9％ (68/83) of NTM got high spectral scores.The identification of cultured colony could be completed in 1.5 hours.And it had good reproducibility.Conclusion MALDI-TOF MS can be used as a rapid and accurate method for identification of Mycobacteria in clinical microbiology laboratories,implying its good application prospects.

Objective To investigate the clinical characteristics,minimal invasive operation technique and perioperative management of lateral ventrieular tumors.Methods The clinical characteristics,image diagnosis,surgical approaches and postoperative management and surgical outcomes of 65 consecutive cases of lateral ventricular tumors were retrospectively analyzed.Results In our series,total resection was achieved in 54 cases,and subtotal resection was achieved in 11 cases.Lateral ventricular tumors were mostly found in male and in the left side.Headache caused by increased intracranial pressure was the most common clinical symptom.Ependymocytoma and astrocytic glioma are the most common pathologic diagnosis.Postoperative complications included fever (26 cases),hydrocephalus (9 cases),intraventricular hematoma (7 cases) of which 2 cases were evacuated by craniotomy,epilepsy (7 cases),wound infection (3 cases).Postoperative death was happened in 3 cases.Two of them died of respiratory failure due to postoperative epilepsy.Conclusion Early discovery of lateral ventricle tumors,meticulous operation,subtle micromanipulation and right postoperative treatment are the criticality to improve the rate of total resection of lateral ventricle tumors through microsurgical treatment and reduce postoperative complications and mortality.