Arteriosclerosis Obliterans ; surgery ; Graft Occlusion, Vascular ; therapy ; Humans ; Lower Extremity ; blood supply ; Stents

Objective To investigate the association of insulin dose with clinical factors of type 2 diabetes. Methods We reviewed the data of 214 type 2 diabetic patients who received insulin regimens.We compared the insulin dose and period at the targeted blood glucose levels among 6 groups according to different type of oral hypoglycemic agents. Results There existed statistically significant correlations of the glucose-targeted insulin dose with course,FPG,BMI,combination therapy with oral hypoglycemic agent(P<0.1,test level P=0.1).Merely metformin failure group took less insulin than the group admitted due to combination therapy failure (P=0.016, 0.53(0.35～0.62)U/kg and 0.63(0.51～0.75)U/kg respectively).The longest targeted period existed in the later. Relationship between the targeted bedtime insulin NPH dose and FPG level can be demonstrated by equation Y=0.255X+7.8. Conclusions The targeted insulin dose is influenced by synthetic factors. Patients admitted due to combination oral hypoglycemic drug failure have the maximal targeted insulin dose and the longest titration period. The final bedtime insulinNPH dose can be predicted by FPG level.

ObjectiveTo investigate the expressions of folate receptor alpha (FOLR1) in 40 esophageal cancerous tissues and its relevance of ABO blood group.MethodsABO blood groups were analyzed in 40 patients.Immunohistochemistry (IHC) and real-time quantitative reverse transcription PCR detection were used to detect the expression of folate receptor in cancer and adjacent tissues.Results20％of esophageal cancer was suspected positive (+), 50％ of cancer adjacent tissue was suspected positive (+), 10％ were positive (+), the difference was statistically significant (x2 = 14.48, P ＜0.01).Real Time RT-PCR analysis showed FOLRI low expression in esophageal cancer and adjacent tissues, compared to normal esophageal mucosa, the differences were statistically significant (F1 =53.247, F2 = 116.500, P ＜0.01).ABO blood type and FOLRi in esophageal cancer patients were not significant correlated (P =0.647, P ＞0.05).ConclusionsFOLRI expression was decreased in the esophageal lesions compared with adjacent tissues.Detection of FOLRl expression level in esophageal cancerous tissues and the paired adjacent tissues was helpful for judging the extent of disease and guiding surgery treatment.The FOLRI expression level in esophageal carcinoma tissues had no relationship with ABO blood types.

Objective To investigate the effect of persistent hypoglycemia on the cerebral oxidative stress and matrix metalloproteinase-2 (MMP-2) activity of newborn rats and to explore the potential mechanism of hypoglycemia-induced brain injury of newborn.MethodsSeven-day-old rats were injected insulin subcutaneously to induce persistent hypoglycemia.Cerebral cortex,hippocampus and thalamus were collected after 36 hours' observation and stored in -80 ℃.Glutathione (GSH)and glutathione disulfide (GSSG) were detected by commercial kit and GSSG/GSH was calculated.MMP-2 activity was detected by gelatin zymography. The data were analyzed by t test,one or two-wayanalysis of variance and Pearson correlation analysis.Six rats were set as the normal glucose group. ResultsThirty-six hours after induction of hypoglycemia, the cerebral GSSG and GSSG/GSH of hypoglycemic pups elevated about 1.5 times higher than those of control group [GSSG:(15.89 ± 5.46) vs (6.15 ± 3.42) mg/g protein,t =3.704,P =0.004; GSSG/GSH:(5.58± 1.79) ％ vs (2.79±1.76) ％,t =2.712,P=0.022].The GSSG and GSSG/GSH in thalamus of hypoglycemia were significantly higher than those of control [GSSG:(15.93 ± 5.75) mg/g protein vs (5.03±5.14)mg/g protein,P＜0.05; GSSG/GSH:(6.50±3.25) ％ vs (2.41±3.12) ％,P＜0.05],whereas there were no significant differences in the cortex ard hippocampus.The total MMP-2 activity of hypoglycemic animals (2.22±0.59) was significantly higher than that of control (1.21± 0.17)(t=4.064,P=0.002),and significant differences were found between the two groups in cortex (2.14 ± 0.5 vs 1.17± 0.27),hippocampus (2.31± 0.72 vs 1.22 ± 0.37) and thalamus (2.22±0.68 vs 1.24±0.18) with all P＜0.01].The activity of MMP-2 was positively related to GSSG (r=0.575,P=0.0002) and GSSG/GSH (r=0.484,P=0.0003).ConclusionsOxidative stress might play an important role in the persistent hypoglycemia induced brain injury of 7-day-old rat pups and thalamus might be most vulnerable to hypoglycemia.Hypoglycemia might also elevate MMP-2 activity which is positively related to GSSG level and GSSG/GSH of the brain.

Objective To develop a Chinese military psychosomatic health scale(CMPHS) and examine its reliability and validity. Methods Based upon the previous researches, the Scale was compiled according to open-ended inventory survey. The data was collected from 1050 subjects chosen by random cluster sampling. 60 of them were tested with the CPSHS at the same time, while 61 of them were retested with the CMPHS after two weeks. The reliability and validity were examined by exploratory factor analysis ( EFA) and correlation analysis. Results According to the factor analysis results, 11 factors were extracted, namely espiratory apparatus, alimentary system,skeletal and musculature,integument,regeneration and endocrine,nervous system, anxiety, depression, psy-choticism and family history. There were 91 items in the formal scale when one lie subscale was added. The correlation between subscales were 0. 103 ～ 0. 778 (P < 0. 01) , the correlation between subscales and total scale were 0.600 ～0.859(P<0.01). The test-retest correlation coefficients of total scale and subscales were 0.427 ～0.901 (P < 0.01); the Cronbach (α) coefficients were 0. 643 ～ 0. 935 (P < 0. 01) ; and the split-half correlation coefficients were 0. 349 ～ 0. 855 (P < 0. 01 ). The correlation coefficients were 0. 425 ～ 0. 979 (P < 0. 05 or 0. 01 ). Conclusion The Chinese military psychosomatic health scale has acceptable psychometrics properties on reliability and validity.

Objective To investigate the correlation between the frustration tolerance and personality of medical college students and to discuss its promoting strategies.Methods Totally 460 college students were selected randomly.Questionnaire of frustration tolerance and scale of Eysenck personality inventory(EPQ) were used and the measurement data were compared with correlation analysis and regression analysis of SPSS 13.0.Results Correlation was significant between frustration tolerance (total score and 6 inducing factors) and personality (EPQ factors) of college students ； personality (EPQ factors)of students could predict their frustration tolerance and corresponding t value was -4.85,P ＜ 0.01 (psychoticism),6.93,P ＜ 0.01 (extraversion),-11.15,P ＜ 0.01 (neuroticism).Conclusions Personality of college students are greatly influenced by their frustration tolerance.Targeted anti-frustration ability training should be conducted according to the different personality characteristics.

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

Objective To establish a reference range of cancellous bone ultrasonic backscatter coefficient (BSC) in term neonates,and to determine the significance of BSC in bone nutritional status in term newborns and infants.Methods Six hundred and sixty-five term newborns,who were born in Shanghai First Maternity and Infant Hospital from July 2014 to August 2014,were enrolled.On the third day and the 42nd day after birth,all infants underwent ultrasonic measurement of the calcaneum bone using a broadband-non-focus ultrasonic transducer at three frequencies (2.25,3.5 and 5 MHz).MATLAB software was used to analyze the backscatter signals.Clinical data of the infants,including gestational age,birth weight and birth age,were recorded at the same time.Statistical analyses of the data included variance analysis,Tukey's test,rank sum test,Dunn test and Pearson or Spearman correlation analysis.Results (1) Of the 665 infants,335 were male.The mean gestational age at birth was (38.0± 1.9) weeks,and the mean birth weight was (3 1524±226) g.(2) On the third day,there were significant differences in BSC values acquired at 2.25 and 3.5 MHz among the groups with different gestational ages or birth weights (2.25 MHz:H=9.842 and 17.271;3.5 MHz:H=6.275 and 21.450,respectively,all P＜0.05).At 3.5 and 2.25 MHz,BSC values were positively correlated with gestational age (r=0.047 and 0.035,respectively,both P＜0.05) and birth weight (r=0.125 and 0.186,both P＜0.05).(3) On the 42nd day,significant differences in BSC were observed at each frequency among the groups with different gestational ages or birth weights (gestational age:H=76.832,16.498 and 32.756;birth weight:H=70.014,18.095 and 34.126;all P＜0.01).Gestational age and birth weight were positively correlated with BSC value acquired at each frequency (r=0.397,0.286 and 0.272 for gestational age,0.451,0.223 and 0.196 for birth weight;all P＜0.01).Conclusions A preliminary BSC reference percentile in term-born infants is established.There are positive correlations between BSC value and newborn gestational age and birth weight at certain frequencies,which can reflect the status of the newborn's cancellous bone.Determination of BSC value should be performed during the follow-up period to assess the nutritional status of neonatal bone.

Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain-awakening and orifice-opening) needling plus thunder-fire moxibustion in treating vertebrobasilar ischemia.Method Fifty-five patients with vertebrobasilar ischemia were randomized into a treatment group of 26 cases and a control group of 29 cases. The treatment group was intervened byXing Nao Kai Qiao needling plus thunder-fire moxibustion, while the control group was by oral administration ofYangxue Qingnao granules. The blood flow of vertebrobasilar arteries were observed by using ultrasonic Doppler blood-flow detector before and after intervention, and the clinical efficacies were compared between the two groups.Result The recovery and markedly-effective rate and total effective rate were respectively 61.5% and 96.2% in the treatment group, versus 34.5% and 89.7% in the control group, and the differences were statistically significant (P<0.01,P<0.05). The VS and VD of vertebral arteries and VS of basilar arteries were significantly changed after intervention in the treatment group (P<0.05). The VS of basilar arteries was significantly changed after intervention in the control group (P<0.05). After treatment, The VS of vertebral and basilar arteries in the treatment group was significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiao needling plus thunder-fire moxibustion is an effective approach in treating vertebrobasilar ischemia.

Objective To investigate the effect of electro-acupuncture at Guanyuanshu, Xinshu, Neiguan points on cardiac function after acute myocardial ischemia in rabbits. Methods A total of 36 rabbits were randomly divided into a control group, a model group and a treatment group. Acute myocardial ischemia was induced with Jugular vein injection of pituitrin. At 10 min before modeling, 1 hour and 1 week after modeling, the levels of malondialdehyde (MDA) and creatine kinase(CK) were determined respectively, the cardiac function was assessed as the maximum rate of left ventricular pressure rise(dp/dtmax)and the peak left ventricular pressure (LVSP). Results After 1 week of treatment, the serum levels of CK and MDA in the treatment group reduced significantly(120.21±10.67 U/L, 21.35±2.04 mmol/L], compared to the model group (162.37±13.21 U/L, 30.13±2.75 mmol/L) (all P<0.05);the dp/dtmax and LVSP decreased percentage in the treatment group (20%±2.43%, 7.22%±0.97%) decrease significantly compared to the model group (31.5%± 4.14%, 12.19%±2.21%) (all P<0.05). Conclusion Electro-acupuncture of Guanyuanshu, Xinshu, Neiguan acupoints can significantly improve cardiac function after acute myocardial ischemia and protect against acute myocardial ischemia in rabbits.