Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

Objective To explore the effect of a training based on instructional video modeling designed from the mirror neuron theory on executive dysfunction after stroke. Methods 40 stroke inpatients with executive dysfunction from July, 2014 to July, 2015 were divided into control group (n=20) and observation group (n=20). The control group accepted executive rehabilitation training, while the observation group were asked to see the video of executive rehabilitation task before training. They were assessed with Behavioral Assessment of the Dysexecutive Syndrome (BADS) before and after intervention. Results The total score and scores of subtests except Rule Shift Cards and Key Search increased more in the observation group than in the control group (t>2.9, P<0.05). Conclusion Rehabilitation video as a visual stimulus for exercise training based on the mirror neuron theory could improve executive function recovery of stroke patients with executive dysfunction.

Objective To explore the susceptibility of Candida albicans biofilms to micafungin. Methods In vitro model of C. Albicans biofilm was established in 96-well microtiter plates with 30 C. Albicans isolates from the Department of Mycology, Changhai Hospital, Shanghai. The susceptibility of C. Albicans biofilms to fluconazole, amphotericine B and micafungin was evaluated by colorimetric XTT-reduction assay. Sessile MIC80 (SMIC80), defined as the lowest antifungal concentration at which an 80% reduction in fungal growth was achieved, was determined. Results Of the 30 C. Albicans isolates grown in sessile states, all were resistant to fluconazole (SMIC80≥64 μg/mL), 4 sensitive to amphotericine B (SMIC80≤1 μg/mL), 26 resistant to amphotericine B (SMIC80 > 1 μg/mL), 27 sensitive to micafungin (SMIC80 < 16 μg/mL), 3 resistant to micafungin (SMIC80 >16 μg/mL). Statistical analysis revealed a significant difference in the activity against C. Albicans biofilms between micafungin and fluconazole (χ2=736.36, P<0.01), micafungin and amphotericine B (χ2=529.95, P<0.01), but not between anphotericine B and fluconazole (χ2=2.29, P>0.05). Conclusion C. Albicans biofilms are resistant to routine antifungal agents such as fluconazole and amphotericine B, but relatively more sensitive to micafungin.

Objective To study the expressions of matrix metalloproteinases-2 (MMP-2) and its tissue inhibitor-2 (TIMP-2) and microvessel density (MVD) in human endometrial carcinoma tissues and their relations with the invasion and metastasis of endometrial carcinoma. Methods Immunohistochemistry was used to measure the MMP-2, TIMP-2, and MVD protein levels in 33 patients with endometrial carcinoma and 8 normal endometrial samples. Results The MMP-2, TIMP-2 and MVD protein expressed in both normal endometrial samples and endometrial carcinoma. The positive expression proportions of MMP-2, TIMP-2, and MVD protein in endometrial carcinoma tissues were higher than those in normal endometrial samples (P

Objective To investigate the pathogenic types and clinical features of children with lobar pneumonia. Methods Eighty children with lobar pneumonia diagnosed from April 2013 to May 2015 were enrolled. Bronchoalveolar lavage lfuid (BALF) of patients were collected. FQ-PCR was used to detect and analyze pathogens in BALF. Results In 80 cases, 59 cases were Mycoplasma pneumoniae, and 2 cases were Chlamydia pneumoniae, 12 cases were Streptococcus pneumoniae, 1 case was Klebsiella pneumoniae, 8 cases were adenovirus, 1 case was respiratory syncytial virus, 14 cases were of mixed infection. The prevalence of MP lobar pneumonia in children of 7-14 years old age group were higher than that of other age groups. Conclusions The pathogen of children with lobar pneumonia varied from Mycoplasma pneumoniae, Chlamydia pneumoniae, bacteria, virus and so on, and Mycoplasma pneumoniae was the common pathogen in lobar pneumonia.

BACKGROUND:The authors' experiments of the earlier stage proved that the hypocrellin B photodynamic therapy(HB-PDT) can cause selective injuries to choriocapillaries. It is not known whether changing the therapeutic parameters would gain a different result regarding the choriocapillaries after the hypocrellin B photodynamic treatment for a month.OBJECTIVE: To observe the features of Chinchilla rabbit choriocapillaries after HB-PDT treatment and to probe into the research prospect of using HB-PDT to treat choroidal neovascularization (CNV) and of using green light as the light source for PDT.DESIGN: A single sample study.SETTING: Laser Department of the Chinese PLA General Hospital.MATERIALS: The trial was conducted at the Laser Department and the Department of Pathology of the Chinese PLA General Hospital as well as the Department of Photoelectric Engineering of Beijing University of Science and Engineering. The materials included photosensitizing agent hypocrellin B (HB), a green laser transmitter, fundus fluorescence camera and transmission electronic microscope.METHODS: The 532 nm green laser transmitter and slit-lamp microscope were connected by light fiber. Chinchilla rabbits of 2.5 to 3.5 kg was narcotized generally and HB(1. 0 mg/kg) was injected into the marginal ear vein. HB was excited with the green laser of 532 nm. The power density of the light spot on fundus was 300 mW/cm2, and the energy density 30 J/cm2. Laser was applied immediately after HB injection and the diameter of the light spot was 2 000 μm. Direct observation of retina, fluorescein fundus angiography and observation with light microscope and electronic microscope were conducted on the 1st, 7th and 28th days respectively after PDT to find the biological features of retina and the choroid.MAIN OUTCOME MEASURES: Non-selective injury of retina through direct observation of the fundus; obliteration of the choriocapillaries detected through fluorescein fundus angiography; the position and extent of non-selective injury in retina and the structural changes of the choriocapillaries observed through the light microscope; the ultrastructural changes of the fundus observed through the electronic microscope.RESULTS: One day after PDT, photodynamic thrombosis was formed in choriocapillaries being illuminated and the external layer of retina was apparently injured. On the 7th day, injury of endothelial cells of the choriocapillaries was aggravated without obvious changes of the main vessels of choroid. On the 28th days, fibrous tissue appeared where the choriocapillaries had been and the glass membrane became thickened. Repair and proliferation of RPE cells appeared in the laser illuminated area.CONCLUSION: The biological effect in the target area and non-selective injury in the non-target area began to appear from the 1st to the 7th day after PDT and continued to aggravate. That would be repaired by fibrous tissues from the 28th day. It deserves further studies to treat age-related macular degeneration or other diseases in fundus characterized with choroidal neovascularization.

Objective To investigate the applied value of abnormalities of fetus with oligohydramnios in mid-pregnancy by anmioinfusion. Methods Fifty women with oligohydramnios diagnosed by ultrasonograph were analysed retrospectively. During the procedure 60-300 ml saline solution at 37 ℃ were infused into the amniotic cavity,made prenatal diagnosis at the same time necessarily. And examined the women to know whether the fetal anomaly existed or not after the amnioinfusion by the ultrasound. Results There were 15 cases with fetal anomaly, 8 cases with genitotirinary anomaly(2 cases associated with multiple organs anomaly), 1 case with single umbilical artery, 4 cases with chromosomal abnormality (2 cases associated with fetal growth restriction), 2 cases with pulmonary hypolasia. There was no significant difference in dilivery outcome between others and 35 cases with normal pregnant women (P >0.05). Conclusion Transabdominal amnioinfusion has double function on beth diagnosis and therapy for the oligohydramnios in the mid-pregnancy.

Objective To evaluate the diagnostic value of colonoscopy for patients with chronic diarrhea.Methods Data of 2449 patients with chronic diarrhea who underwent colonoscopy from January,1999 to December,2008 were reviewed.A total of 2110 patients who underwent colonoscopy screening for health checkup during the same period were used as controls.The rates of clinic-relevant abnormal endoscopic findings and negative finding were compared between two groups.Results Lesions with clinic significance were found in 44.1％ of patients with chronic diarrhea (1080/2449) and in 41.7％ of controls (870/2110,x2 =2.756,P =0.097).Compared with controls,incidence of non-IBD and noninfectious colitis (x2 =58.578,P ＜ 0.001),IBD (x2 =59.609,P ＜ 0.001),malignant tumor (x2 =21.649,P ＜0.001),terminal ileitis (x2 =6.275,P =0.012),infectious colitis (x2 =17.019,P ＜0.001),intestinal tuberculosis (x2 =7.021,P =0.008),melanosis coli (x2 =6.040,P =0.014) and parasitic infection (x2 =4.245,P =0.039) were all significantly higher in patients with chronic diarrhea.However,incidences of adenomatous polyps (x2 =14.124,P ＜ 0.001),non-adenomatous polyps (x2 =33.427,P ＜0.001) and diverticular disease (x2 =9.921,P =0.002) were significantly higher in the control group.There was no significant difference in incidences of the benign tumor (x2 =1.627,P =0.202) and angiodysplasia (x2 =0.231,P =0.631) between the two groups.The overall screening rate of colonic polyps,diverticulosis,and vascular lesions was 37.3％ in chronic diarrhea group.Conclusion Colonic polyps,diverticulitis,benign tumors and angiodysplasia may not be the causes of chronic diarrhea.Etiology of more than 1/3 patients with chronic diarrhea remains unknown after colonoscopy.

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.

Objective To conduct a scoping review to systematically review the literature reporting enteral feeding protocol in critical ill children. And extract elements of enteral feeding protocol. Methods The database of BIOSIS Previews, PubMed, MEDLINE, EMbase, China Biology Medicine Disc, China National Knowledge Infrastructure and Wan Fang data were searched. Data were extracted on the information of article, elements of enteral feeding, evaluation of feeding etc. Results Three historical controlled studies, three case-control studies, two cohort studies, one narrative review and one qualitative study were included. Totally 16 elements were got, such as nutrition evaluation, estimated energy requirement, contraindication, feeding intolerance etc. And all protocols defined advancement and feeding intolerance. Conclusions Enteral feeding protocol has been used in most PICUs to optimize nutrition. But we observed variability in the composition of protocols and lack of evidence-based recommendations in few elements.