Diabetic Ketoacidosis (DKA) is a condition biochemically characterized by the combination of hyperglycemia, hyperketonemia and acidemia. The extracellular concentration of glucose and ketone bodies in human body can respectively increase 5 and 20 times as more as usual, and the pH of arterial blood can decrease below 7.0. Accumulation of gluccse, ketone bodies and hydrogen must be due to the imbalance of the rate of production, ulilization, and excretion of these substance. In DKA, the metabolism of several hormones and substances is probably involved in the initiation and maintenance of ketone body over-production. At present, 14 patients with DKA have been investigated and it has been found that relative insulin deficiency appears to be necessary, and the excess production of growth hormone, glucagon and catecholamincs (the urine adrenaline and noradrenaline were measured) may be also important in the pathogenesis of DKA.

BACKGROUND: Some studies have considered the influence of body mass index (BMI) on the function following total knee replacement (TKR), but the cases were few and follow-up time is short in most of them.OBJECTIVE: To analyze the function outcome influenced by BMI after TKR. METHODS: A total of 320 osteoarthritis patients who were admitted in Department of Bone and Joint at Peking University People's Hospital, were involved in this study. They all received primary knee joint patellar resurfacing, including both knees replacement in 200 case of 520 knees, left 219 and right 301. The involved 320 patients underwent primary TKR performed by a single surgeon with the same type of prosthesis (Scorpio posterior stable prosthesis). The patients were divided into four groups based on obesity (overweight group, BMI 25.1-27.0 kg/m2; obese group, BMI 27.1-30.0 kg/m2; morbidly obese group, BMI > 30 kg/m2; control group, BMI < 25 kg/m2). According to the Hospital for Special Surgery (HSS) rating scale, their knee score and functional scores were recorded before replacement and at follow-ups, as well as maximal range of flexion and extension, complications. Preoperative and postoperative assessment was based on the HSS score. RESULTS AND CONCLUSION: A total of 320 patients received clinical recheck at 28.3 months (range 12-46 months). Compared with control group, patients in overweight, obese and morbidly obese groups had lower preoperative functional score (P < 0.05), but knee scores were not significantly different for any patient group. The postoperative mean HSS score of all the groups rose significantly at the last follow-up. These differences were not statistically significant among groups (P > 0.05). The rate of perioperative complications was significantly higher in the obese and morbidly obese patients (P < 0.05). Of the 181 knees in obese and morbidly obese patients, 14 knees (9.2%) had a wound complication, 1 knee (0.5%) had an infection, and 2 knees (1.3%) had an avulsion of the medial collateral ligament. The infected case developed within ten weeks after the operation, and was associated with a wound complication. Among 266 knees in the overweight patients, 6 knees (2.3%) had a wound complication. There was 1 knee (1%) of the 81 knees in the control group had a wound complication. No death or pulmonary embolism cases were observed in perioperative period. It is suggested that BMI has no obvious influence on the functional outcome following TKR in the short-term.

0.05). The operation time in the intertrochanteric fracture group was significantly longer than the femoral neck fracture group (P

OBJECTIVE To improve the standardized management of medical waste disposal and prevent the spread of the disease to protect the human health.METHODS Establishing hospital monitoring committee of medical waste through the director of hospitce as the first responsible figure.The management system and education training for all levels staffs and inspection were established.RESULTS By making the management measures scientific and effective,it was praised by many patients and social departments for providing good diagnosing environment.CONCLUSIONS Improving the standardized management of medical waste disposal is an important messure to secure the prevention of hospital cross-infection and improve the quality of medical care.

Objective Leucine -rich repeat (LRR) -containing G protein -coupled receptor 6 (Lgr6) is glycoprotein hormone receptor and a part of G protein -coupled receptors (GPCRs).Lgr6 is composed of 977 amino acid residues of a polypeptide chain.Having 17 leucine -rich repeats and seven transmembrane domain.In the N -and C -termini are connected with cysteine -rich sequences.It is highest homologous to Lgr4 and Lgr5,but less relationship with thyroid stimulating hormone receptor,progesterone receptor,and follicle -stimulating hormone recep-tor.Research found out that Lgr6 marks in the hair follicles of stem cells can differentiate into all cells in the skin and Lgr6 expression in tumor also has important biological significance.

Objective]To research professor Chang's experience in treating adolescaria functional metrorrhagia . [Method]By following professor Chang diagnosis long time,it summarizes professor Chang's experience in treating adolescaria functional metrorrhagia from the aspects of the reason and mechanism,syndrome differentiation and treatment,treating characteristics,and for a case. [Result]Professor Chang considers the adolescaria functional metrorrhagia connected with stagnation of liver Qi,insufficiency of kidney and deficiency of spleen Qi,weakness,stagnation,dampness.Treatment must address both the symptoms and root causes in accordance with seasonal conditions .She regulating menstrual cycle attaches great importance to the liver , spleen and kidney,and uses the auricular points,couplet medicines.The prescription rule is convenient and specialized.The recipe case embodies the evidence-based medicines, according to the menstrual period, the late, and the inter-phase and premenstrual period of drug treatment of yin and yang change. Professor Chang's ideas and characteristics curative effect are outstanding. [Conclusion]Professor Chang thinks the adolescaria functional metrorrhagia is complicated,then perfect pragmatic value is worthy of study and understanding.

Of 807 Cases of Diabetes mellitus, 100 were ketoacidosis with or with-ot coma(40 Cases among them with coma), 55 were males, 45 females. Therange of age was 5 to 76 years. There were 39 cases of ketonemia with ju-venile diabetes, and the incidence was 29. 5 per cent of 137 cases. 61 werefound to have ketonemia with adult dialetes, the incidence being 10. 2 percent of 594 cases. Blood glucose level was 166. 7 to 1000mg/dl. The mostcommon precipitating causcs of ketonemia were infection and the dis-continue of insulin treatment(58 per cent). According to the dosage of insu-lin, our patients were divided into two groups. One was a small dosagegroup(the total mean dose 25. 5 ? 3. 1 u), the other was a large dosage group(the first 8 hours' mean dose 121. 67 ? 102u, the fitst 24 hours' mean dose206. 62 ? 18. 01) There were on death and severe complications of insulintherapy in the small dosage group, but 13 (16 per cent) were died in thelarge dosage group, in which there took place such complications as hypo-kele mia(11 per cent), hypoglycemia (26 per cent) and encephaledema (3. 8per cent). Also, the negative acetone bodies occured faster in the smalldosage group. For this reason, we consider the effect of the treatment inthe small dosage group was better. Recently, we have controlled alkelidosage more strictly than before. 100-200ml of 4% Bicarbonate was givento the patient if the blood CO_2 combinedpower was lower than 20 Vol pe,

In this paper the investigation of using a new method-ABC-ELISA in assay of Autoimmune Thyroid Disease are presented. The sensitivity of ABC-ELISA is compared with that of standard ELISA; Its reliability is proven by the methods of detecting TSAb with FRTL-5. TRAb is detected by ABC-ELISA in 91% of untreated Graves'. TRAb is detected by Standard ELISA in 70% of untreated Graves'. The results of ABC-ELISA in 26 untreated Graves' are equal to that of the method of detecting TSAb with FRTL-5. Therefore, we consider that ABC-ELISA is a sensitive, reproducible, convenient method applicable to clinical practice.

A part of pathogenetic factors of hypertensionin twenty--seven patients with hypertensive NIDDM (group 1) were observed. The control groupsincluded non-hypertensive NIDDM (group 2, n=46 ), primary hypertension (group 3, n= 15) andhealthy persons (group 4, n= 15). The oral glu-cose tolerance test (OGTT), insulin releasing test(IRT ), atrial natriuretic peptide (ANP), an-giotensin I (ATI), aldosterone (ALD), wholeblood volume and urine protein were measured.The results showed that the plasma insulin andsodium levels and the whole blood volume weresignificantly higher in group 1 than those in con-trol group 2, the ANP level was rather lower than that in control group 4. Although the results werecorresponded with the theory that the circulatinghyperinsulinemia may lead to sodium retention andinhibited an adequate ANP stimulation by sodiumchallenge which turn to hypertension, nonhyper-tensive NIDDM patients (group 2) also have thesame findinge. So the retention of sodium and wa-ter can't be used to explain the mechanism of hy-pertension in NIDDM patients, the other patho-genetic factors especialy the factors related to thehyperinsulinemia such as PGE and PGI need to beinvestigated futher.

Purpose To study the refractive state of silicone oil tamponade eyes. Methods To calculate the theoretical refractive state of eyes with silicone oil based on clinical visual optics and to perform retinoscopy on 48 silicone oil filled eyes with pars plana vitrectomy (PPV) and 45 ones with PPV plus lensectomy with retinal reposition, and then study theoretical and experimental differences of diopter in silicone oil filled eyes. Results Postoperative diopter of the former increases (+6.26?1.20) D than preoperative diopter, while that of the latter is (+11.40?2.22) D. Conclusion Hyperopic changes are found in silicone oil tamponade eyes, and the experimental values are lower than the theoretical ones. This may be helpful in predicting the change of diopter of silicone oil tamponade eyes.