AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

Adolescent ; Adult ; Female ; Health Education ; Health Knowledge, Attitudes, Practice ; Health Services Needs and Demand ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Rural Population ; statistics & numerical data ; Surveys and Questionnaires ; Transients and Migrants ; statistics & numerical data ; Young Adult

Objective To evaluate the clinical results of a combination of lateral buttress plate and medical antiglide plate internal fixation for biocondylar tibia plateau fractures. Methods A total of 26 biocondylar tibia plateau fractures belonged to type Ⅴ and type Ⅵ according to Schatzker classification and treated with open reduction. Lateral buttress plate and medical antiglide plate were applied for limited internal fixation. The follow up continued till fracture healing to observe if there existed bone dislocation and determine the range of knee motion and Iowa knee score. Results No obvious shift of fragment was found in 26 cases with mean range of knee motion for 92? and mean Iowa knee score for 93 points. Conclusion Combination of lateral buttress plate and medical antiglide plate is a good method for internal fixation of biocondylar tibia plateau fractures,but the conclusion needs large number of clinical verifications.

Arthroplasty, Replacement ; methods ; Clavicle ; injuries ; Fractures, Bone ; surgery ; Humans ; Joint Instability ; surgery ; Shoulder Fractures ; surgery ; Shoulder Injuries ; Shoulder Joint ; surgery

Disease Notification ; Humans ; Occupational Diseases ; diagnosis

Inservice Training ; Occupational Health Services ; organization & administration

Background Vascular endothelial growth factor(VEGF) has been shown to be associated with the pathogenesis of age-related macular degeneration (AMD),therefore VEGF is a target for the treatment of wet AMD.However,the mechanism of VEGF in the pathogenesis of AMD is not clearly understood.Studying the correlation between VEGF gene polymorphism and AMD is becoming a new research hotspot,but relevant studies on Han Chinese have not been performed.Objective This study was to investigate the association between the VEGF +936C/T gene polymorphism and AMD in the Chinese population.Methods A pilot prospective and nonrandomized controlled trial was designed.This protocol complied with Declaration of Helsinki and was approved by the Ethic Committee of Chinese PLA Second Artillery General Hospital.Written informed consent was obtained from each subject prior to entering the study.Two hundred AMD patients and 200 age-and gender-matched normal controls were enrolled in this study.The genomic DNA was extracted from the peripheral blood samples of the subjects,and analysis of the VEGF polymorphisms at the +936 position in the promoter and 3＇-untranslated regions was performed by the restriction fragment length polymorphism method.Frequencies of the VEGF+936C/T genotype were compared between the two groups,and the risk of the VEGF+936C/T gene polymorphism in pre-disposing AMD was evaluated.Results No significant differences were seen in the incidence rates of smoking(P ＝ 0.76),hypertension(P ＝ 0.84),hyperlipidemia (P=0.71),diabetes mellitus (P=0.86) and cardiovascular disease(P=0.89) between the AMD group and the normal control group,and BMI was matched between the two groups (P =0.18).The prevalence of the TT genotype was 9.0％ (18/200)in the AMD group,but that in the normal control was 3.5％ (7/200),showing a significant difference between the two groups (P =0.03).The odds ratio (OR) was 2.73 with a 95％ confidence interval(CI) of 1.11 to 6.68 for AMD in this genotype.The CC and CT genotypes were not significantly different between the two groups (P =0.52,P =0.57).The genotype frequency and allele frequency conformed to HardyWeinberg equilibrium law.There were no significant differences found in the CC,CT,TT genotype frequencies among the early AMD,geographic atrophy AMD and choroidal neovascular AMD (all at P＞0.05).Conclusions The VEGF+936TT genotype is associated with AMD in Han Chinese population.

Objective To retrospectively analyze the effect of preemptive treatment on cytomegaloviras (CMV) infection in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The data of one hundred and three patients who underwent alIo-HSCT with preemptive treatment to prevent CMV associated diseases were retrospectively analyzed. Fluorescence quantitative PCR was used to detect CMV-DNA. The incidences of CMV viremia and CMV associated diseases were analyzed. Results CMV viremia was confirmed 63 times in 51 of the 103 patients. The incidence of CMV viremia was 49. 5% and the median time of onset was 40 days after transplantation. All the patients with CMV viremia received preemptive antiviral therapy and 19 of them developed CMV associated diseases, including 14 hemorrhagic cystitis, 3 CMV associated pneumonia and 2 CMV associated enteritis. The total incidence of CMV associated diseases was 18. 4%. After treatment with ganciclovir and/or foscarnet, 60 of the 63 times of CMV viremia disappeared. One patient was not included in the analysis because he died of intracranial hemorrhage and GVHD only 3 days after the treatment. The total response rate was 96. 8% (60/62). The remaining two cases who did not respond to treatment died of CMV associated pneumonia in combination with acute GVHD. The direct mortality rate of CMV infection was 1.9% (2/103). Conclusion The incidences of CMV viremia and CMV associated diseases do not increase in patients receiving preemptive therapy as compared with those receiving prophylaxis therapy. Preemptive treatment can not only prevent the progression of CMV viremia to CMV associated diseases in majority of the cases but also control CMV associated diseases effectively.

Objeetive To investigate the effects of fluoride on ultra-structure of thyroid in rats.Methods Eighty SD rats were randomly divided into 4 groups,20 rats in each group.One was control group,the other tree groups were respectively administered 1.19×10-3 mol/L(LF),2.38×10-3 mol/L(MF),and 4.76×10-3 mol/L(HF) of sodium fluoride in drinking water,respectively.The total feeding experiment lasted 1 50 days.Thyroid tissues of rats were collected and ultra-thin sections were made and thyroid ultra-structure wa8 observed under electronic microscope.Results In LF group,nuclear pycnosis and cell vacuolization were observed.In MF group,the electron density decreased,and mitochondria reduced in number.In HF group,some mitochondria were Seen swelling,colloid of thyroid follicles aecumulated,the electronic density in this site increased,microvilli of thyroid endothelial cells decreased significantly,and the amount of lysosome significantly increased.In MF and HF group,organelle disordered,vacuolization in cell endoplasm appeared,membranes of rough endoplasmic reticulum(RER)broke,ribosomes ablated,mitochondria swollen and vacuolated,some cristaes of mitochondria disrupted or disappeared.Conclusion Fluoride can damage the ultra-structure of thyroid,especially the bio-membranes of thyroid cells.

Culture environment is the key factor in the construction of dermal skin.It was investigated that the effects of the culture methods,including the static culture and spinner flask culture,and stir speeds on the cells proliferation,metabolism and distribution within collagenchitosan sponges.A higher cell density and specific growth rate was obtained with spinner flask culture versus static culture,especially,the 80 r/min spinner flask culture.The cell distribution in dermal substitutes from stirred culture system was more uniform than static culture,as well as that with increase of stir speeds in spinner flask.In summary,the spinner flasks culture with proper stir speed shows promise for the construction of dermal substitutes in vitro.