Objective To investigate the relationship between smoking and the occurrence of pulmonary tuberculosis among type 2 diabetics(DM-PTB).Methods A hospital-based case-control study was carried out at three hospitals in Tianjin from 2001 to 2002.87 cases of newly-diagnosed pulmonary tuberculosis with type 2 diabetes mellitus and 129 controls by frequency-matched by gander and age were recruited and interviewed.Univariate and multivariate unconditional logistic regression analysis was conducted.The adjusted odds ratio(OR) and 95% confidence interval(CI) were estimated.Results Higher smoking index(OR=1.399,95%CI=1.098～1.782)?beginning smoking at younger(OR=2.028,95%CI=1.076～3.821)?large consumption of cigarets per day(OR=1.349,95%CI=1.087～1.674)?no smoking cessation after diabetes diagnosis(OR=5.327,95%CI=1.703～16.661) were significantly associated with DM-PTB after adjusted for other risk factors.Among female diabetics large consumption of cigarets per day? beginning smoking at younger higher smoking index were generally associated with increased risk of pulmonary tuberculosis;while without smoking cessation after diabetes diagnosis might be risk factor among the male;higher smoking index might increase the risk of pulmonary tuberculosis among younger(youger than 60y) diabetics.Conclusion Smoking control or cessation among type 2 diabetics might decrease the risk of pulmonary tuberculosis.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

Objective Hyalinizing trabecular tumor ( HTT) is often mistaken as thyroid papillary carcino-ma( TPC) ,which shares some morphological features with TPC .The aim of this study is to investigate HTT and TPC with immunohistochemical methods .Methods we detected the expression of the three Immunohistochemical index((CK19,HBME-1,MIB-1)in thirteen cases HTT and twenty cases TPC.Results In HTT samples, CK19:three of the thirteen were positive and focal positivity (1+);HBME-1:None of the thirteen samples was stained.MIB-1:ten in thirteen cases were stained in nucleus .In TPC samples,CK19:all of the twenty samples were intensely stained;HBME-1:nineteen of twenty samples were intensely stained;MIB-1:all of the twenty samples were stained in nucleus .The sensitivity and specific degrees of CK 19 and HBME-1 combination to diag-nosis HTT and TPC were 90.0%and 69.2%.Conclusion Our research could provide potent aid to differential diagnosis of HTT and TPC .The combination of CK19 and HBME-1 are adequate to identify HTT and TPC .

ObjectiveTo study diabetes self-management skills among outpatient diabetics and their influence on glycemic control.MethodsData were collectedfrom 281 diabetes patients recruited in Tianjin Medical University Metabolic Hospital using a questionnaire covering their diet, physical exercise and glycemic self-monitoring during the last three months.Additional HbA1c and blood lipid information were retrieved from medical records.Logistic regression modified by factor analysis was then conducted.ResultsMore than half patients did well in diet control, physical exercise and drug treatment.23% patients exceeded physician-recommended intervals for self-monitoring.Self-monitoring was primarily conducted through hospital testing or family-owned glucometers.Abnormal blood pressure (53%) or lipid (47%) levels were also common.Overall, self-management practices among men and the younger(<60yr)were worse than that among women and elderly people.The significant related factors for good glycemic control included higher socioeconomic status and positive treatment, but Abnormal cholesterol and inadequate self-monitoring were related with poor glycemic control with the adjusted odds ratios equaling to 059, 039, 189 and 183, respectively.ConclusionsMore attention should be taken on men and the younger (<60yr)to improve their skills of self-management.Self-monitoring, physical exercise, diet control, etc. independently influence blood glucose control.

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Drug Resistance, Microbial ; Immunity ; Infection

Executive Function ; Humans ; Prefrontal Cortex ; physiology

Objective Demonstrate the implication of Emergency Severity Index (ESI) in pediatric emergency room (ER). Method ESI categories of 21 904 visitors to ER of Beijing Children's Hospital's international department were reviewed. SPSS statistic software was employed to compare the results of ESI categories by doctors and nurses separately using x2 analysis. Results There are highly consistency in ESI categories by doctors and nurses. ESI is an easy-learned and effective triage method. Conclusions ESI is capable in pediatric emergency room regarding recognizing serious cases and saving clinical resources.

Objective:To evaluate the wear resistance of four types of composite resin when they were opposed by human enamel antagonist. The relationship between pH value and wear resistance was also evaluated. Methods:Mutual wear between four types of composite resins(3 mm?20 mm?1 mm),Beautifit(B),SureFilTM(S),TE-Econom(T),Charisma (C),with same rough surface and opposing enamel was evaluated using a wear simulator of UMT-2 (n=10).Wear resistance was assessed as weight loss(g).The worn surfaces were observed with scanning electron microscope(SEM).All data were statistically analyzed with SPSS14.0.Results:SEM observation showed that the fillers particles of resin B,S were bigger than that of the others. Fillers of resin C was the smallest and the most well-distributed. Many filler particles were lost. In the acid environment,the enamel surface had the special appearance. The S,C,T composite resins were less worn. The weight loss of the T,B,S composite resins increased when pH value fell down to 4.0 (P0.05).Conclusion:The wear resistance among the different brands of composite resins are discrepant. The weight loss might be accelerated with the decreased pH value.

Objective To explore the clinical features of pulmonary tuberculosis complicated with DM and related factors. Method The manifestations of 87 newly diagnosed PTB patients with type 2 DM(DM-PTB group) at two hospitals in Tianjin during October 2003 to October 2004 were compared to 88 PTB patients without DM who were randomly choosen from the same hosipital.The factors related to sputum-positive TB or cavity were explored through unconditional logistic regression model. Results DM-PTB patients showed significanly lower frequencies of cough(66.7% vs 83.0%),toxicity symptoms(37.9% vs 62.5%) and haemoptysis(16.1% vs 33.0%) than those of PTB group.Positive-sputum(63.2% vs 34.1%),cavity(56.3% vs 13.6%),wide lesions and bilateral lesions on chest radiographs was more common in DM-PTB group than in PTB one.Introversion(OR=1.582, 95%CI:1.063 ～2.355),type 2 DM(OR =2.186,95% CI:1.082 ~4.420)and cavity(OR =2.793,95% CI:1.308 ～5.964)were factors independently associated with positive-sputum TB.The factors related to cavity included diabetes(OR=14.199,95%CI:5.376~ 37.501),cough,postive sputum and lore-up lobe lesion.Conclusion This study confirmed that clinical manifestations and chest radiographs of PTB patients complicated with type 2 DM significantly departed from the typical presentation.Type 2 DM seems to have a negative effect on postive-sputum and cavity.So it should be alarmed that DM-PTB patients who tend to have untypical clinical symptom and higher rate of positive sputum become the reservoirs of infection to cause the transmission of TB.