Objective To explore clinical characters of type 1 diabetes mellitus with different serum potassium levels in children and adolescent.Methods One hundred and seventy-five patients with type 1 diabetes mellitus were reviewed,they were divided into 3 groups according to the serum potassium level.The patients whose serum potassium

Objective To study the association of the expression of bone morphogenetic protein (BMP) antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease (CKD).Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group,which were trimmed off during arterial venous fistula operations.Splenic trabecular arteries were collected as specimens of the control group,which were removed from 38 patients with simple traumatic splenic rupture.All the arteries were examined histologically for calcification with yon Kossa stain.Expressions of gremlin and BMP-2,-7were detected by immunohistochemistry and their serum concentrations were detected by ELISA.Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0.SPSS 19.0software was used to perform statistical analysis.Results Significantly positive von Kossa stain was found in radial arteries from 12 of 40 patients (30％) in study group,which located in the layer of medial smooth muscle cells.However,there was no obvious positive stain in control group.Additionally,in study group,significant expressions of gremlin and BMP-2 were detected in those radial arteries of positive yon Kossa stain,which also located in the layer of medial smooth muscle cells.Positive correlations were found among gremlin expression level,BMP-2 expression level and yon Kossa stain intensity.However,the BMP-7 expression intensity in arteries of study group was much weaker as compared to control group.Conclusions Both gremlin and BMP-2 may be involved in the process that the smooth muscle cells of radial arteries in patients with stage 5 of CKD phenotypically transform into osteoblast-like cells.However,BMP-7 possibly prevents this process.

Adolescent ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1 ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Infant ; Male

OBJECTIVETo analyze factors on sleep apnea children's poor responding to adenoid tonsillectomy, and discuss the further treatment.

METHODSTwo hundred and forty three obstructive sleep apnea hypopnea syndrome (OSAHS) children who had adenoid tonsillectomy or adenoidectomy were reviewed, all cases had follow-up sleep study (polysomnogram, PSG) after surgery.

RESULTSAccording to the results obtained in 3 to 12 months after surgery with PSG, 221 cases (90.9%) were cured (apnea and hypopnea index, AHI, < 5/h), while the remaining 22 cases AHI > 5.0/h. In the latter group, 2 cases who only had adenoidectomy received tonsillectomy afterwards, 7 cases who have nasal congestion were treated with medication, 5 overweight cases and 3 cases with cerebral palsy, pectus excavatum or hyperplastic tori were treated with CPAP.

CONCLUSIONSAdenoid tonsillectomy is effective for OSAHS children. For the poor responding cases, suitable treatment should be selected accordingly.

Adenoidectomy ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Sleep Apnea, Obstructive ; surgery ; Tonsillectomy ; Treatment Outcome

OBJECTIVETo compare the effect and safety evaluation of catgut implantation at acupoint and drugs for levels of bone metabolism and free radicals in postmenopausal women.

METHODSSixty-five postmenopausal women were randomly divided into an acupoint catgut implantation group (33 cases) and a medication group (32 cases). Sanyinjiao (SP 6), Shenshu (BL 23) and Guanyuan (CV 4) were used as main points combined with adjunct points according to syndrome differentiation in the acupoint catgut implantation group, once two weeks. The medication group was treated with oral administration of 2 pills of Fu fuchun capsule, once a day. Three months constitute one course in the both groups. The scores of the symptoms and signs were evaluated, and elbow vein blood was drawn to detect the correlative index on the beginning and the ending day of the treatment respectively. The safety of catgut implantation at acupoint was evaluated after one course of treatment. Besides, the sex hormone test in ovulatory period was detected in twenty-eight normal women in reproductive age with regular menstrual cycle.

RESULTS1) The total effective rate of the acupoint catgut implantation group was 93.9% (31/33), and that of the medication group was 96.9% (31/32), there was no significant difference between the two groups (P>0.05). The contents of bone gla protein (BGP), calcitonin (CT), parathyroid hormone (PTH) and alkaline phosphatase (AKP) in the both groups had significant differences after treatment (P<0.05, P<0.01); 2) The content of estradiol (E2) in serum in the both groups was decreased more obviously than those of normal women in reproductive age (both P<0.001). The content of E2 in the both groups was obviously increased after treatment (P<0.05, P<0.01), this function in the acupoint catgut implantation group was weaker than that of the medication group (P<0.05), while the incidence rate of adverse effect in the acupoint catgut implantation group was lower than that of the medication group (P<0.05); 3) There were significant differences of the level of superoxide dismutase (SOD) and malondialdehyde (MDA) before and after treatment in the acupoint catgut implantation group, the level of SOD was obviously increased after treatment (P<0.01), while the level of MDA decreased obviously (P<0.001).

CONCLUSIONCatgut implantation at acupoint can improve the low level of estrogen of postmenopausal women, with good safety. It can regulate the levels of bone metabolism and free radicals of postmenopausal women, so it is very meaningful to prevent and treat postmenopausal degenerative diseases including the osteoporosis and to delay the process of apolexis.

Absorbable Implants ; adverse effects ; Acupuncture Points ; Adult ; Bone and Bones ; metabolism ; Catgut ; adverse effects ; Free Radicals ; metabolism ; Humans ; Middle Aged ; Postmenopause ; metabolism ; Treatment Outcome

OBJECTIVETo explore biological exposure markers, we investigated the chromium content in peripheral erythrocytes from occupational population with broad ranges of soluble chromate exposure, as the candidate biomarker may provide the scientific evidence for health risk assessment in occupational chromate-exposed population.

METHODSA cross-sectional study was conducted in chromate exposed workers employed at a chromate factory in a district of Jinan city, Shandong Province. The studied population contained 114 workers from different processes of the chromate plants, which included 74 males and 40 females, with an age range from 25 to 52 years old, averaging at (35.83 +/- 6.14) years old; the length of service was ranging from 1 year to 37 years, an average of (14.20 +/- 6.77) years. In addition, 30 farmers in the countryside one hundred kilometers away from the factory, without exposure to chromate matched with exposed subjects by age, gender and smoking status were identified as a control group, which included 22 men and 8 women, with age ranging from 25 years old to 47 years old, having an average age of (36.13 +/- 6.17) years old. Personal information on age, chromate exposure, medical history, smoking habit and alcohol consumption was obtained at an interview. The air concentration of personal exposure was determined by individual sampling for 8 hours per day as shift work, and chromium was assayed by atomic absorption spectrometry. The chromium content in the erythrocytes from peripheral blood was determined by graphite furnace atomic absorption spectrometry. The potential plasma reduction capacity was determined by dibenzene anthracoamid dihydrazide spectrophotometry. The content of total vitamin C and reductive ascorbic acid were determined by 2, 4-dinitrobenzene hydrazine. The data were analyzed by SPSS10.0 software for statistical significance.

RESULTS(1) The results showed that the chromium levels in erythrocytes in the exposed group [(15.79 +/- 31.01) microg/L] were significantly higher than those in the control group [(3.21 +/- 2.20) microg/L] (P < 0.01). (2) There existed a dose-response relationship between the personal airborne chromate concentration and the chromium content in erythrocytes. As airborne chromate concentration lowered to 106.00 microg/m(3), the chromium content in erythrocytes increased, depending on the air concentration of chromate. (3) Correlation analysis showed that there was a significant positive correlation between airborne chromate concentration and the chromium content in erythrocytes (P < 0.01). (4) In multiple regression analysis, it was found that the potential plasma reduction capacity and reductive ascorbic acid may be a good indicator for oxidative stress produced by chromate exposure and be used to evaluate the effects on intracellular uptake of chromium (VI).

CONCLUSIONOur findings suggested that the chromium content in erythrocytes should be used as an effective exposed biomarker in the risk assessment for occupational chromate-exposure.

Adult ; Air Pollutants, Occupational ; analysis ; Biomarkers ; blood ; Chromates ; analysis ; Chromium ; blood ; Erythrocytes ; chemistry ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; analysis

OBJECTIVETo observe the influence of acupoint catgut-embedding therapy on the quality of life (QOL), the reproductive endocrine and bone metabolism of postmenopausal women.

METHODSA total A total of 65 women with climacteric syndrome were enrolled and randomly assigned to two groups, thirty-three in the treatment group on whom acupoint catgut-embedding was performed with Shenshu (BL23), Sanyinjiao (SP6) and Guanyuan (CV4) as main acupoints, and thirty-two in the control group who were only medicated with Fufuchun Capsule (妇复春胶囊). The treatment course for both groups was 3 months. Before and after Before and after treatment, the clinical symptoms, the QOL score, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)), testosterone (T), osteocalcin (BGP), parathyroid hormone (PTH), calcitonin (CT) and alkaline phosphatase (AKP) were measured. In addition, another 28 women with childbearing potential and normal regular menstrual cycle were selected and the reproductive endocrine hormone were tested in the ovulatory period as controls.

RESULTSThe levels of serum FSH and LH of postmenopausal women were higher, and serum E(2) and T were lower than those of normal women (P<0.01). After treatment, the levels of serum E(2) In both groups and T in the treatment group were increased, while in the control group the serum E(2) increase was more significant than that in the treatment group (P<0.05), and serum T showed no statistical difference. The levels of serum FSH, LH, BGP, CT, PTH and AKP were reduced significantly in both groups after treatment (P<0.05). The QOL scores were Increased remarkably in both groups on physiological functioning, bodily pain, general health, vitality, and mental health after treatment (P<0.05),but the improvement of bodily pain and mental health in the treatment group were better than those in the control group (P<0.01). There was no significant difference in the therapeutic effect between the two groups after treatment (P>0.05).

CONCLUSIONSAcupoint catgut-embedding showed an obvious effect on climacteric syndrome, and enhanced the QOL in postmenopausal women. The therapy could regulate the hypothalamic-pituitary-ovarian axis to raise the serum E(2) level which may be significant in preventing and curing the osteoporosis in postmenopausal women.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Bone and Bones ; metabolism ; Catgut ; Endocrine System ; metabolism ; Female ; Hormones ; blood ; Humans ; Middle Aged ; Postmenopause ; blood ; metabolism ; Quality of Life ; Reproduction ; physiology

Objective To determine the value and the optimal cutoff point of waist circumference (WC) in screening diabetes mellitus (DM) and to provide evidence for DM prevention and identifying population at risk in mid-western rural areas of Shandong province.Methods A sample consisting 16 341 rural residents was selected and studied.All participants were physically examined on height,weight,WC and fasting plasma glucose (FPG).Oral glucose tolerance test (OGTT) was performed for subjects with FPG valued from 6.1 to 7.0 mmol/L.DM was defined according to the criteria set by WHO in 1999.Area under the curve (AUC),sensitivity,specificity and Youden index were computed based on the receiver operating characteristic (ROC) curve analysis.Optimal cutoff point was determined by the maximum of Youden index.Results The prevalence rates of DM for males and females increased along with the rise of WC (trend test X2=72.01,122.65,P＜0.01 ).It appeared significantly higher in those with WC 85 cm in females and≥80 cm in males,with those WC ＜85 cm for females and ＜80 cm for males,in particular.AUCs were 0.639 and 0.655 for males and females respectively and both had significant differences (t=7.22,11.07,P ＜0.01 ).However,the AUCs did not show significant difference (t=0.70,P ＞ 0.05) between males and females.The Youden index reached maximum when WC approached 85 cm for females (24.90%) and 80 cm for males (24.39%).The sensitivity and specificity were 58.04%and 66.86%for males,and 67.08%and 57.31%for females.Conclusion WC seemed to be an effective indicator for screening the DM.The optimal cutoff point of WC would be 85 cm for females and 80 cm for males in screening DM and defining the population at risk in this area.

OBJECTIVETo investigate the spectrum of pathogens for community-acquired pneumonia (CAP) in children, and to provide a basis for the diagnosis and treatment of CAP.

METHODSRespiratory secretions and venous blood samples were collected from 1560 children with CAP aged from one month to 9 years within 2 hours after admission, for detection of multiple pathogens. Respiratory virus antigens in nasopharyngeal swab specimens were detected by immunofluorescence. Sputum was used for bacterial culture. Levels of Mycoplasma pneumoniae (MP)-IgM and Chlamydia pneumoniae (CP)-IgM in venous blood were measured by enzyme-linked immunosorbent assay.

RESULTSA total of 579 strains of bacteria were isolated from all respiratory secretions, including 213 (36.8%) Gram-positive strains and 366 (63.2%) Gram-negative strains. The five most common strains were Haemophilus influenzae (7.50%), Streptococcus pneumoniae (6.73%), Staphylococcus aureus (6.35%), Moraxella catarrhalis (5.19%), and Escherichia coli (3.46%), wherein the beta-lactamase-producing strains accounted for 3.3% of all strains. The non-bacterial pathogens mainly included respiratory syncytial virus (12.88%), MP (7.88%), and CP (8.91%). Mixed infection of pathogens was serious, and the mixed infection of respiratory syncytial virus with Haemophilus influenzae infections were the most common. For most pathogens, the infection rate was higher in children aged under one year than in those aged over one year.

CONCLUSIONSHaemophilus influenzae, respiratory syncytial virus, MP and CP are the main pathogens for children with CAP. For most pathogens, the infection rate is higher in children aged under one year than in those aged over one year. Mixed infection rate of pathogens is high.

Child ; Child, Preschool ; Coinfection ; etiology ; microbiology ; Community-Acquired Infections ; etiology ; microbiology ; Female ; Humans ; Infant ; Male ; Pneumonia ; etiology ; microbiology

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.