Objective To study angiography characteristics of myocardial infarction complicated with type 2 diabetes mellitus(DM). Methods A total of 389 cases confirmed by coronary angiography were divided into two groups according to the status if they had combined with DM(166 patients) or not(223 patients). Results The DM patients suffered more from hypertension than without DM patients(P

Background:Acute gastroenteritis is the second largest public health problem in the world. Rotavirus(RV)is one of the pathogens of acute gastroenteritis in adults,researches focusing on RV infection may provide the basis for prevention and control of the disease. Aims:To determine the epidemiological characteristics of RV infection in adults with acute gastroenteritis in Shanghai,China. Methods:From Jun. 2010 to Dec. 2013,stool samples and clinical data in adults with acute gastroenteritis in a designated hospital in Shanghai Changning District were collected. ELISA and PCR were used to detect RV infection and its genotypes. Results:A total of 1 554 eligible stool samples from acute gastroenteritis patients were recruited,of them 691 were males and 863 were females,the mean age was(46. 19 ± 15. 59)years old. RV was detected in 189 patients with a detection rate of 12. 2% ,163(10. 5% )were categorized as group A RV and 26(1. 7% ) were group B/ C RV;the most common genotypes in group A RV were G9(30. 1% )and G1(25. 2% ). Watery stool and vomiting were more prevalent in RV-positive patients than in RV-negative patients(P < 0. 05). The detection rates in years 2010,2011,2012 and 2013 were 12. 2% ,14. 9% ,6. 8% and 16. 3% ,respectively. When analyzed by age group,the detection rate was significantly lower in 18-39 years group than those in 40-59,60-79,and ≥80 years groups(8. 7% vs. 14. 8% ,14. 2% ,and 17. 1% ,P < 0. 05). The peak of epidemic was from Nov. to next Feb. Conclusions:RV infection in adults with acute gastroenteritis is more popular in middle aged and elderly people and shows a winter seasonality in Shanghai,China. The most common genotypes of group A RV are G9 and G1.

Objective To investigate the epidemiology of adults acute viral gastroenteritis in Shanghai Changning district. Methods All of 1 554 stool specimens of adults acute gastroenteritis in Shanghai Changning district from June 2010 to December 2013, and the enzyme-linked immunosorbent assay and multiple polymerase chain reaction was used to detecte different viruses. Results In all of 1 554 cases, the average age was (46.19 ± 15.59) years. Among them, 691 persons were male, 863 persons were female. Virus infection was detected in 407 cases, and the detection rate was 26.19%. Among them, 395 cases (97.05%) were single virus infection, and 12 cases (2.95%) were mixed infection. The peak of epidemic was from every November to next February. The incidence of watery diarrhea, vomiting and fever in virus positive group was significantly higher than that in virus negative group:95.09%(387/407) vs. 88.14%(1 011/1 147), 31.20%(127/407) vs. 18.83%(216/1 147), and 11.06%(45/407) vs. 7.59%(87/1147), P<0.01 or<0.05. Conclusions Rotavirus infection is common in adults with acute viral gastroenteritis. Patients with positive virus infection had a higher incidence of watery diarrhea, vomiting and fever. The peak of epidemic is winter.

Objective:To observe the effect of non-vitrectomy in the treatment of idiopathic macular epiretinal membranes (IMEM).Methods:This study is a randomized controlled trial. From December 2017 to December 2018, 60 IMEM patients (60 eyes) diagnosed in Weifang Eye Hospital were included in the study. BCVA, intraocular pressure (IOP) and OCT were performed in all patients. The BCVA examination was performed using the international standard visual acuity chart, which was converted to logMAR. The CMT was measured by OCT. According to the surgical methods, the patients were divided into non-vitrectomy group and control group, 30 patients (30 eyes) in each group. The age ( t=1.723), logMAR BCVA ( t=1.703), CMT ( t=-0.956), IOP ( t=-1.434) were not significantly different between the two groups ( P=0.090, 0.094, 0.343, 0.157). 23G vitreous cutting system was used in all eyes. The macular epiretinal membranes was removed by non-vitrectomy in the non-vitrectomy group and by vitrectomy in the control group. The relevant examination with the same equipment and methods before the operation at 1 week and 1, 3, 6 months after operation. The time of surgery, the changes of BCVA, CMT and postoperative complications in the two groups were observed comparatively. Variance analysis of repeated measurements was performed for the comparison of BCVA, CMT and IOP after surgery in the two groups. Wilcoxon rank sum test of two independent samples was performed for the degree of vision improvement. The incidence of postoperative complications was compared by χ2 test. Results:At 6 months after operation, BCVA increased in 24 eyes (80%) and unchanged in 6 eyes (20%) in the non-vitrectomy group. Compared with preoperative BCVA, the difference was statistically significant ( P<0.05). BCVA increased in 25 eyes (83.4%), unchanged in 4 eyes (13.3%) and decreased in 1 eye (3.3%) in the control group. Compared with preoperative BCVA, the difference was statistically significant ( P<0.05). There was no significant difference between the two groups in BCVA improvement degree after operation ( Z=-0.26, P>0.05). At 6 months after operation, the average logMAR BCVA was statistically significant compared with the preoperative in the non-vitrectomy group ( P=0.002, 0.005) and control group ( P=0.004, <0.001). Visual stability occurred 1 month after operation in the non-vitrectomy group and 3 months after operation in the control group. The effective operative time of the non-vitrectomy group and control group was 4.50±1.41 and 15.50±2.33 min, respectively. The difference of effective operation time between the two groups was statistically significant ( t=-22.12, P <0.05). After surgery, no significant complications were found in the non-vitrectomy group. In the control group, there were 3 eyes with low IOP and 1 eye with macular hole during operation. Conclusions:Non-vitrectomy and vitrectomy have similar effects on IMEM. Non-vitrectomy has short effective operation time, faster recovery after surgery and no obvious complications.

Objective:To compare the efficacy and safety of intravitreal injection of anti-vascular endothelial growth factor drug conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema (DME).Methods:A randomized controlled clinical study was performed.Thirty-six DME patients (36 eyes) were enrolled in Weifang Eye Hospital from March 2018 to June 2019.The patients were randomized into Ozurdex group and conbercept group via a random number table, with 18 eyes in each group.Patients received Ozurdex injection once, which was maintained for 6 months, or conbercept injection once a month for 3 times according to grouping.Before and after treatment, the best corrected visual acuity (BCVA) was examined with the International Standard Visual acuity chart and converted to logarithm of minimal angle resolution unit.The intraocular pressure (IOP) was measured using a non-contact tonometer.The central retinal thickness (CRT) was detected by optical coherence tomography (OCT).This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Weifang Eye Hospital.Results:All patients were followed up for 6 months.In Ozurdex group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection was 0.59±0.22, 0.53±0.20, 0.41±0.16, 0.38±0.19 and 0.56±0.19, respectively.The BCVA at 1 month, 3 and 4 months after the first injection were better than that before injection, and the differences were statistically significant (all at P<0.05).In conbercept group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection were 0.60±0.23, 0.51±0.17, 0.29±0.13, 0.56±0.18 and 0.60±0.18, respectively.The BCVA at 1 month and 3 months after the first injection were better than that before injection, showing statistically significant differences (all at P<0.05).The CRT at 1 month, 3 and 4 months after the first injection were significantly lower than that before treatment in both the two groups (all at P<0.05).The CRT pre-injection was (498.61±77.14)μm in Ozurdex group, which was significantly higher than (462.17±48.74)μm at 6 months after the first injection ( P<0.05).No significant difference in CRT was found between pre-injection and 6 months after the first injection in conbercept group ( P>0.05).The incidence of high IOP in Ozurdex group was 33.3%(6/18), which was higher than 5.56%(1/18) in conbercept group, with a significant difference ( χ2=4.433, P=0.035).No adverse effects such as aggravation of cataract, lens injury, endophthalmitis, vitreous hemorrhage and retinal detachment was found during the follow-up. Conclusions:For DME, both conbercept and Ozurdex can improve BCVA and reduce CRT.Ozurdex shows durable efficacy and needs fewer injections than conbercept, but conbercept has less effect on IOP and is safer than Ozurdex.

Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P<0. 01). No difference was found in in-hospital mortality among three groups (2. 9% vs. 2.3% vs. 2. 2%, P> 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.

Objective:To compare the safety and effectiveness of direct stenting versus deferred stenting for the treatment of acute ST segment elevation myocardial infarction(STEMI)with a high thrombus load in patients aged 60 years and above.Methods:In this study, we analyzed 252 elderly STEMI patients with a high thrombus load(thrombus score ≥ 4 points)who received percutaneous coronary intervention(PCI)at Beijing Anzhen Hospital Affiliated or at the Affiliated Hospital of Beihua University from January 2015 to December 2018.They were divided into the direct stent group(n = 126)and the deferred stent group(n = 126)according to whether the stent was inserted immediately or not.Baseline information, surgical information, clinical outcomes and major adverse cardiac events were compared between the two groups at 1 year follow-up.Cox regression analysis was used to determine whether deferred stent implantation was a prognostic factor.Results:There were no significant differences in the distribution of infarct-related arteries, time from onset to balloon dilatation, thrombus load scores and the number of stents between the two groups(all P> 0.05). The diameter and length of the stent were(3.20 ± 0.47)mm and(18.33 ± 5.06)mm in the deferred stent group and(3.03 ± 0.50)mm and(22.60 ± 5.08)mm in the direct stent group, respectively, with a significant difference between the two groups( t=2.926, 6.678, P=0.004, 0.000). The incidences of slow blood flow, distal embolism and low myocardial perfusion staining in the deferred stent group were 2.38%(3/126), 3.17%(4/126)and 2.38%(3/126), respectively, significantly lower than those in the direct stent group, which were 15.87%(20/126), 24.60%(31/126)and 20.63%(26/126), respectively( χ2=13.827, 24.188, 20.614, all P=0.000). The left ventricular ejection fraction(LVEF)at 1 year in the deferred stent group was (0.60±0.05)%, significantly higher than that in the direct stent group(0.57±0.05)%( t=3.859, P=0.000). There was no significant difference in major adverse cardiac events between the two groups at 1 year follow-up( P> 0.05). Cox regression analysis results showed that deferred stent implantation was not a factor affecting the clinical outcome( HR=0.827, 95% CI: 0.288~2.372, P=0.724). Conclusions:Deferred stent implantation and direct stent intervention are equally safe and effective for STEMI patients aged over 60 with a high thrombus load if admitted to the hospital within 12 hours after onset.Deferred stent implantation can significantly improve the infarct-related artery blood flow classification, reduce the distal embolism rate, increase the grade 3 rate of myocardial perfusion staining, increase the diameter of the stent, reduce the length of the stent and improve left ventricular ejection fraction.