Objective To investigate the relationship among HbA1c、urine microalbuminuria (UmAlb)and blood lipids in pa-tients type 2 diabetes mellitus.Methods 120 patients with type 2 diabetes in the hospital were enrolled in the study in 2012.Ac-cording to the test results of HbA1c,the people enrolled in the study were divided into two groups,group A:HbA1c <6.5%,60 cases totally;group B:HbA1c≥6.5%,60 cases totally.UmAlb and blood lipids were measured.Results Compared with group A, UmAlb、TC、TG and LDL-C concentrations increased significantly in group B(P <0.05),while HDL-C decreased significantly(P <0.05).Conclusion In type 2 diabetic patients whose HbA1c≥6.5%,UmAlb,TC,TG and LDL-C concentrations increased obvi-ously and the risk of diabetic complications increase.

Objective To detect the best phase and best tube voltage for the diagnosis of small (diameter ≤ 3 cm) clear cell renal cell carcinoma with dual-energy dual-phase CT.Methods Image manifestations of 27 patients with small (diameter ≤ 3 cm) ccRCCs confirmed by pathology were retrospectively analyzed.All subjects underwent dual-energy biphase (early corticomedullary and delayed phase) scan preoperatively.Two senior radiologists analyzed the images in consensus.The definition of images in different phases and with different tube voltage was classified into 4 levels and was compared by Wilcoxon and Friedman test.The attenuation of the lesions and the adjacent renal parenchyma,the SD value of the anterior abdomen fat were measured.The contrast noise ratio (CNR),lesion kidney ratio (LKR) and the early corticomedullary phase and delayed phase value were calculated.They were all compared with oneway ANOVA.Results The score of definition of lesions in early corticomedullary phase at 80 kV,140 kV and average-weighted 120 kV were 3.30 ± 0.87,2.81 ± 0.92 and 3.11 ± 0.85,respectively,which in delayed phase were 3.70 ±0.54,3.30 ±0.82 and 3.52 ±0.64,respectively.Definition of lesions was better in delayed phase than that in early corticomedullary phase (Z =-2.296,-2.446 and-2.392,respectively; P ＜ 0.05).Either in early corticomedullary phase or in delayed phase,CT value,noise value and CNR were the highest on 80 kV images,which were(302 ± 80)HU,(16.2 ± 2.2) and (4.1 ± 3.4) in corticomedullary phase and (152 ± 31) HU,(16.4 ± 2.7) HU,and (4.7 ± 1.7) in delayed phase.The change of lesion attenuation between early corticomedullary phase and delayed phase on 80 kV,140 kV and averageweighted 120 kV images were (150 ± 76),(72 ± 33) and (96 ± 46) HU,respectively.There was significant difference among the three groups (F =4.541,P ＜ 0.01).Conclusions Delayed phase scan is in favor of small clear cell renal cell carcinoma display.80 kV images are the best for detecting and qualitation of small clear cell renal cell carcinoma when compared with 140 kV and the average-weighted 120 kV images.

Obiective To analyze the characteristics of antibacterial drugs caused adverse drug reactions (ADR) and correlation with DDDs in Ezhou Central Hospital,and provide reference for safe and rational use of antibacterial drug in clinic.Methods ADR reports of antibacterial drugs in Ezhou Central Hospital from September 2011 to August 2016 were entered into Microsoft Excel 2000 software,Statistical analysis was performed on the categories of antimicrobials,drug names,clinical manifestations,and DDDs,composition ratio of ADR and ratio ofB/A.Results Involved in 151 ADR cases and 10 kinds of antibacterial drugs,the top 3 antibacterial drugs respectively were Fluoroquinolones,Cephalosporins,and Penicillins,the top 3 DDDs respectively were Cephalosporins,Fluoroquinolones,and Macrolides,and the B/A values of Cephalosporins,Macrolides,and Antifungal agents were over 1.The top 4 ADR composition ratios respectively were Levofloxacin,Moxifloxacin,Cefmetazole,and Cefotiam,and the top 4 DDDs respectively were Levofloxacin,Cefodizime sodium,Azithromycin,and Cefmetazole,and the B/A ratios of Cefodizime sodium,Metronidazole,and Azithromycin were over than 1.Levofloxacin and moxifloxacin had a higher risk of severe ADR,and Levofloxacin and Cefotiadine had a higher risk of new ADR.Conclusion The ADR rate of antibacterial drugs is basic consistent with its DDDs.Clinical should pay more attention to the individual drugs with higher rates of ADR,such as Cefodizime sodium,metronidazole,and azithromycin etc.

ObjectiveTo study the effect of exercise training on β-amyloid polypeptide (Aβ) and β-secretase(BACE) in the hippocampus of the rats with vascular dementia (VD).Methods 30 Sprague-Dawley (SD) rats were carried out to an exercise group (n =10 ),a model group (n =10 ),and a sham-operation group ( n =10 ).VD rat models were made by the ligation of bilateral common carotid arteries.Morris water maze test were carried out 4 weeks after the operation to assess the ability in learning and memory of the rats and Aβ and β-secretase (BACE)expression was detected in the hippocampus of the rats using immunohistochemical techniques.ResultsIn the Morris water maze test,the model group showed reduction in the learning and memorizing ability,with obvious longer escape latencies ( ( 101.34 ± 19.67 ) s,(95.42 ± 23.89 ) s,( 89.39 ± 22.67 ) s,( 90.12 ± 19.77 ) s,respective-ly) than that of sham-operation group ( ( 62.13 ± 11.38 ) s,( 24.84 ± 13.69 ) s,( 16.98 ± 12.51 )s,( 11.41 ± 8.93 ) s,correspond-dingly) (P ＜ 0.05 ),and the exercise group was improved in the learning and memorizing ability ( corresponding to ( 80.15 ± 21.56 ) s,( 51.24 ± 20.91 ) s,( 43.78 ± 22.36) s,( 45.67 ± 20.87 ) s ),compared with the model group(P＜0.05).The grey values of Aβ in the hippocampus of the rats for the exercise group was ( 130.12 ± 19.01 ),( 116.77 ± 23.67 ) for the model group and ( 148.44 ± 17.67 ) for the sham-operation group(P＜ 0.05).The grey values of BACE in the hippocampus of the ratsfor the exercise group were( 131.21± 25.25 ),( 120.53± 10.21 ) for the model group(P＜ 0.05 ) and ( 162.38 ± 28.11 ) for the sham-operation group (P ＜ 0.05).ConclusionExercise training can lower the expression of BACE and Aβ in the hippocampus of rats with VD,therefore improving the learning and memory ability of rats with VD.

Objective To investigate the effects of rehabilitation training on hippocampal amyloid-beta peptide (Aβ) and insulin-degrading enzyme (IDE) levels in vascular dementia (VD).Methods Thirty female Sprague-Dawley rats were randomly assigned to a rehabilitation group (n =10),a model group (n =10) or a sham-operation group (n =10).An experimental VD model was established in the rats of the first 2 groups by bilateral common carotid artery permanent ligation.The rats in the rehabilitation group then received 1 h of rehabilitation training daily.Learning and memory were assessed at 4 weeks aftet the operation.Immunohistochemical staining was used to detect Aβ and IDE expression in the hippocampus dentate gyrus (DG) area.Results The rats in the rehabilitation group showed significantly better learning ability compared with the model group.The expression of Aβ in the rehabilitation group was significantly less than in the model group.The expression of IDE in the rehabilitation group was significantly greater Conclusion Rehabilitation can accelerate the recovery of learning and memory in VD,at least in rats The mechanism is possibly related to decreased accumulation of Aβ in the hippocampus due to up-regulation of the expression of IDE.

Objective:To explore an effective treatment method for mycobacterial infection of multiple abscesses in the face and breast after autologous fat injection.Methods:Six patients with non-tuberculous mycobacterial infection after autologous fat injection in the face and chest were treated from June to September in 2018. All patients underwent preoperative ultrasound localization. The small incision was opened for debridement and the necrotic granular tissues were completely scraped. Vacuum aspiration therapy in the sinus was used to promote wound growth, in line with the standard anti-tuberculosis drug treatment.Results:All six patients in this group were being followed up for 10-14 months. The average follow-up time was 12 months. All the infected patients were recovered, and the appearance of the infected site was satisfied by the patients.Conclusions:Small incision debridement with vacuum aspiration therapy combined with a variety of anti-tuberculosis drugs can effectively treat non-tuberculous mycobacterial infection after autologous fat injection, and achieve good results.

Objective To review and sum up the experience of diagnosis and surgical treatment of cardiac myxoma. Methods 133 patients with cardiac myxoma of different locations from January 1990 to May 2007 admitted in Qilu Hospital of Shandong University and Department of Cardivovascular Affdiafed Zhong shan Hospital of Xiamen Unversity were clearly diagnosed by two dimensional echecardiography. The tumors of 109 patients were located in left atrium ,22 in right atrium and 2 in both cardiac atria. All the patients underwent tumor extirpation under extracor-poreal circulation. Atrioventricular valve plasty was performed when necessary. 11 underwent bicuspid valvuloplasty and 6 underwent tricuspid valvuloplasty at the same time. All the minors were sent to histopathology examination. Re-suits Two patients died of low cardiac output syndrome in early postoperative period. Cerebral embolism happened in 6 cases,left lower extremity embolism and pulmonary embolism in 1 ease respectively. Other patients' symptoms were improved and the physical sign disappeared. All the tumors were demonstrated to be benign cardiac myxoma. Conclusions Most cardiac myxoma is benign but its clinical consequence is severe. So tumor extirpation should be performed as soon as possible and the following-up is important after operation. Prevention of tumor defluvium is im-portant. Two dimensional echocardiography is preferred in the diagnosis of cardiac myxoma.

Objective To observe the impacts of different storage temperatures on the activities of adipose tissues and the extraction and proliferation of adipose-derived stem cells (ADSCs) situated in harvested fat.Methods Adipose tissues obtained by liposuctions in healthy females were kept in different temperature;all groups of adipose tissues were studied in context of the histomorphology and activity of GAPD as well as the extraction efficiency and proliferation of ADSCs.Results Adipose tissues cryopreserved at 4 ℃ within 24 hours could retain their activities effectively,but their activities would decrease rapidly if they preserved at room temperature.The efficiency of adipose tissues extracting stem cells and their proliferations were affected by storage temperatures and times.If adipose tissues were preserved at room temperature for over 1 hour,the extraction efficiency and proliferation of their ADSCs would be lower significantly.Conclusions Adipose tissues cryopreserved at 4 ℃ can effectively ensure their activities and their extraction efficiency and proliferation of ADSCs.It is important to preserve adipose tissues at low temperature after harvesting fat graft.

Objective To observe the curative effect of repairing the distal foot skin and soft tissue defect by using flap.Methods We used nutrient artery flap and low external ankle to repair the foot distal skin soft tissue defect in 16 cases.Results The flap survived,necrosis happened in small skin edge part and distal skin flap of sural nerve nutrient artery flap in two cases,and the skin graft healing with dots after removed the necrotic tissue and changed dressing.16 cases were followed up for 3-16 months,2 cases of flap slightly bloated,1 case back to the hospital got thin skin flap repairing technique;14 cases of walking were as usual,2 lame cases,related to some tissue defect in patients with forefoot injury.The use of flap to repair the foot injury,could maximially recover the limb function,reduce the rate of the sick.Conclusion Skin flap is a kind of operation which is simple,with smaller cost for skin area,beautiful and effective to repair skin and soft tissue defect of foot.

BACKGROUND: T-type or linear type external fixator is applied in transcervical fracture in the elderly. Because its fixing force is weak, so it is difficult to avoid the aggravation of complication due to long term lay up in severe osteoporosis. Based on this reason,percutaneous penetrating arch tri-claw external fixator is designed to treat elderly transcervical fracture with strong fixing force for the realization of early restoration to the active status before injury to reduce complication.OBJECTIVE:To design pereutaneous penetrating arch tri-claw external fixator for the treatment of elderly transcervical fracture for the investigation of its feasibility.DESIGN: A self-controlled study by employing patients as subjects.SETTING: Department of orthopedic surgery of the first affiliated hospital of a universityPARTICIPANTS: Thirty-one cases of elderly transcervical fracture including 18 males and 13 females aged between 71 and 86 years old with an average age of 79 years were admitted by the Department of Orthopedics of the First Affiliated Hospital of Nanhua University between December 2002 and June 2004.METHODS: Percutaneous penetrating arch tri-claw external fixator was applied in the treatment of 31 cases with elderly transcervical fracture for the observation of its clinical effects, and the force-bearing situation and stability of the external fixator during application were analyzed by theoretical mechanics.MAIN OUTCOME MEASURES: ① The functional effects of percutaneous penetrating arch tri-claw external fixator applied in the therapy of transcervical fracture(sub-femoral head type,transcervical type and femoral basilar type); 2② The force-bearing situation and the stability of the fixing point on the fixator; ③ The restoration of activity in hip joint and fracture union time RESULTS: ① Patients could sit and stand immediately after the applicationof the fixator, and its fixing reinforce was analyzed by theoretic mechanics during standing(the force on upper fixing point A, B or C was 1/22, 1/2 or 1/2 of the lower fixing point) . The unidirectional flexion and extension activity of the hip joint overcame hip-inversion and rotational disposition at the distal end of the fracture. The hip-joint axial compression board caused compact embedment and insertion of the fracture end and vertical crush to simulate fracture union by stability and compressive strain. ② The stability of percutaneous penetrating arch tri-claw external fixator: No disposition was found during the application except rotational disposition during activity in sub-femoral head type fracture. The fixation was stable, the operative trauma was less,and the operation was simple with good accommodation. No complication was found due to long-term lay up and no re-disposition due to the loosening of the external fixator was found. ③ The hip-joint flexion-extension function was restored within 7 days averagely and fracture healing time was about 2 to 3 months, average of 2.4 months.CONCLUSION: No re-injury is found dter the application of percutaneous penetrating arch tri-claw external fixator, which has small force bearing at upper fixing point with strong stability. There is strain stimulation on the cross section of the fracture to promote fracture healing. The articular function status before injury could be restored at early stage.