Objective To investigate whether sulfonylurea ( SU) increases the risk of stroke in patients with type 2 diabetes mellitus(T2DM). Methods A systemic meta-analysis including 17 random control trails(RCT) was performed to compare the risk of stroke between type 2 diabetic patients treated with SUs and comparators. Results 1 612 articles were retrieved, and finally 17 articles were included. Patients receiving SUs treatment had a higher relative risk of stroke (RR 1. 35, 95% CI 1. 13-1. 60) than those who received comparators. The I2 statistic for heterogeneity between 17 trails was 0. 0%(P=0. 687). No major asymmetry appeared in the funnel plot and Begg′adjusted rank correlation test(kendall′s score=22, P=0. 387). Conclusion The use of SUs may raise the risk of stroke which is already high in patients with T2DM.

OBJECTIVETo reveal the possible mechanism involved in patella-femoral degenerative arthritis (PFDA) in- duced by torsion-deformity of tibia via analyzing the relationship between torsion-deformity of the tibia in patients with PFDA and the disorder of patella-femoral joint under the static and dynamic conditions.

METHODSFrom October 2009 to October 2010, 50 patients (86 knees, 24 knees of male patients and 62 knees of female patients) with PFDA were classified as disease group and 16 people (23 knees, 7 knees of males and 16 knees of females) in the control group. The follow indexes were measured: the torsion-angle of tibia on CT scanning imagings, the patella-femoral congruence angle and lateral patella-femoral angle under static and dynamic conditions when the knee bent at 30 degrees of flexion. Based on the measurement results, the relationship between the torsion-deformity of tibias and the disorders of patella-femoral joints in patients with PFDA were analyzed. Finally,the patients were divided into three groups including large torsion-angle group, small torsion-angle group and normal group according to the size of torsion-angle, in order to analyze the relationship between torsion-deformity and disorders of patella-femoral joint, especially under the dynamic conditions.

RESULTSCompared with patients without PFDA, the ones with PFDA had bigger torsion-angle (30.30 ± 7.11)° of tibia, larger patella-femoral congruence angle (13.20 ± 3.94)° and smaller lateral patella-femoral angle (12.30 ± 3.04)°. The congruence angle and lateral patella-femoral angle under static and dynamic conditions had statistical differences respectively in both too-big torsion-angle group and too-small torsion-angle group. The congruence angle and lateral patella-femoral angle under static and dynamic conditions had no statistical differences in normal torsion-angle group.

CONCLUSIONTorsion-deformity of tibia is the main reason for disorder of patella-femoral joint in the patients with PFDA. Torsion-deformity of tibia is always accompanied by instability of patella-femoral joint,especially under the dynamic condition, thus causing PFDA. It can not only provide arrangement information and degenerative condition of patella-femoral joint,but also provide guidance through the analysis on the relationship for better clinical prevention and early treatment of degenerative bone and joint disease.

Adult ; Female ; Femur ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; etiology ; Patella ; diagnostic imaging ; Radiography ; Tibia ; diagnostic imaging ; Torsion Abnormality ; complications ; diagnostic imaging

Objective To study the preventive effect of spironolactone on renal tubulointerstitial fibrosis of diabetic nephropathy (DN)in rats.Methods Sixty adult SD rats were random divided into sham operation group(C),diabetic nephropathy group(D)and spironolactone interventional group(A).After diabetes WaS induced by administrating strep tozotocin(STZ),spironolactone was perfused into the stomach of rats in group A.On the 7th,14th,21st,28th days after treatment,rats were put to death,their kidneys were removed to observe the expressions of TGF-β1 and MMP-9 by immunohistochemistry method.The blood potassium,natrium,glucose, serum creatinine,cholesterol,triglyceride and urinary albumin quantification were measured.Results Urine protein in group A wag lower than that in group D.The blood potassium,natrium,glucose,serum creatinine,cholesterol and triglyceride had no difference between group A and group D(P＞0.05).Compared with group D,the expressions of TGF-β1 in group A Was decreased(P＜0.01),the expressions of MMP-9 in group A was hisher than that in group D(P＜0.01).Conclusion Spironolactone could decrease the expression of TGF-β1 and increase the expression of MMP-9 in the tubulointerstitial of diabetic nephropathy,which may delay the progress of renal tubulointerstitial fibrosis.

Objective To compare the clinical efficacy of proximal femoral nail anti-rotation ( PFNA ) fixation and hemiarthroplasty in the treatment of elderly unstable intertrochanteric fractures .Methods 72 cases with unstable intertrochanteric fractures were divided into the two groups by random number table ,each group had 36 ca-ses,the control group was given implementation of hemiarthroplasty while the observation group was given PFNA fixa -tion,the clinical therapeutic effect were compared between the two groups .Results It showed no significant differ-ence in operative time between the two groups (t =2.58,P>0.05);the blood loss of the observation group was (187.52 ±10.83)mL,which was significantly less than that of the control group (t=9.56,P<0.05),the load time of the observation group was (33.52 ±3.28)d,which was significantly more than that of the control group (t=10.31, P<0.05);there were no significant differences in the hip function excellent rate after 1 year and postoperative com-plication rate between the two groups (94.44% or 91.67%,11.11% or 8.33%,χ2 =2.01,1.69,all P>0.05). Conclusion PFNA fixation and hemiarthroplasty for treatment in elderly unstable intertrochanteric fractures have good effect ,and the patients should be based on the specific clinical circumstances , under strict control of surgical contraindications choose the right surgery .

Objective To investigate early diagnosis, clinical effect of surgical treatment and prognosis of a-cute appendicitis in elderly. Methods The clinical data of acute appendicitis in elderly undergoing surgical therapy between January 1994 and November 2008 was analyzed retrospectively, and predisposing factors, diagnostic meth-ods, therapeutic effect of operation and prognosis were studied. Results Acute appendicitis in elderly was diagnosed in 276 cases(114 female/162 male). There were 7 cases of deaths. MoRality was 2.5% (7/276). Stitches were taken out from 6 to 8 days after operation. Average stay was 8 days. 196 cases(71.0%) of wound healing at grade A, 43 cases(15.6%) at grade B ,37 cases(13.4%) at grade C. 86 cases(31.2%) with perforated acute appendici-tis, and 7 cases(2.5%) with periappendiceal abscess were confirmed after operation. 76 cases auompanied with con-comitant diseases, 87 cases auompanied with postoperative early complications, and 39 cases(14.1%) with postop-erative wound or intra-abdominal septic complications. Conclusion Key point of improvement of operative therapeu-tic effect and prognosis of acute appendicitis in elderly are early diagnosis, operation in time, and effective treatment of associated diseases and complications.

Objective To analyze etiopathogenisis, diagnosis and treatment of the aged with bowel obstruction. Methods The clinical data of 168 cases with bowel obstruction, whose age were more than 60 years,in our hospital from 1998 to 2007 were reviewed retrospectivly. Results In all the cases,32 patients' original disease were abdomenal hernia,6 patients were mesenteric vascular thrombus,75 patients were bowel tumor, 12 patients were feces,18 patients were false colonic obstruction and 25 patients were ankylenteron. 114 cases (67.68%) received operation,43 patients (25.59%) received expectant treatment and 11cases received colonofiberscope therapy. 138 cases (81.55%) were cured without any complication. 25 cases(14. 88%) had this or that kind of complication. 5 cases (2. 98%) were dead. Conclusion Firstly, the regular original disease of the aged with bowel obstruction were bowel tumor. Secondly,most elderly patients with bowie obstruct should be cured after operations. Thirdly,the aged with bowel obstruction would have higher complication rate,which should attract our enough attention.

Objective:To fabricate and to study the surface morphology and biological safety of a novel coating on microarc-oxidized titanium.Methods:The novel functional coating was fabricated by cross-linking the double-layer nanoparticles loading rhBMP-2 and SDF-1 with gelatin on microarc-oxidation coating on titanium implant surface.The surface topography was observed and optimized,and the biological safety of the novel coating was primarily evaluated by cell toxicity test,oral mucosa stimulation test and hemolysis test in vitro.Results:The novel functional coating possesses excellent morphology.The coating showed the cytotoxicity of score 1 and no mucous membrane irritation,the hemolytic rate of the coating was 4.6％.Conclusion:The coating possesses good morphology and biological safety.

Objective To study the influence of systematic respiratory training of patients with chronic ob- structive pulmonary disease(COPD)on their off-respirator pulmonary function and emotional depression.Methods Sixty COPD patients were divided into a treatment group and a control group.The patients in both groups were given routine treatment,while those in the treatment group were also given respiratory training in addition for 9-12 months after ceasing the mechanical ventilation.The index of pulmonary function such as FEV1 and depression(SDS score) were evaluated before and after the respiratory training.All data was analyzed by using SPSS 10.0.Results The FEVI of all patients was improved after 9-12 months of respiratory training(P

AIM:To compare the efficiency of fibrin glue to suture technique in pterygium surgery performed with limbal autograft under different methods of anesthesia.
METHODS: A prospective randomised clinical trial was carried out in 60 eyes of 55 patients operated for primary nasal pterygium, which were divided into two groups randomly: experimental group ( 30 eyes in 27 patients ) was under surface anesthesia ( oxybuprocaine ) and control group ( 30 eyes in 28 patients ) was under local anesthesia ( 20g/L lidocaine ). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera by a fibrin tissue adhesive after pterygium excision. Patients were followed up at least for 6mo. Time of operation, matching degree of graft and VAS score were mainly observed and recorded.
RESULTS: In experimental group the average surgery time was shorter (P=0. 008) and matching degree of graft ( 93%) was better than control group ( 83%) , the differences had statistical significance(P<0.05).
CONCLUSION: The surface anesthesia is enough when using fibrin glue for graft fixation in pterygium surgery, which will shorten surgery time and get better matching degree of graft.

Cochlear Implantation ; Humans ; Vestibule, Labyrinth ; physiology