Objective To discuss the clinical features and treatment strategy of patients with fulminant type 1 diabetes mellitus (FT1 DM).Methods Clinical and laboratory data of 4 patients diagnosed as FT1 DM in our hospital from January 2008 to February 2016 were retrospectively analyzed.Results 2 females and 2 males aged from 22 to 68 years old were included.They were developed to ketoacidosis rapidly after the appearance of diabetic symptoms in 2-6 days.Some cases complicated with shock,acute renal insufficiency and rhabdomyolysis.One case with late pregnancy had a stillbirth.The plasma glucose level was ranged from 35.6 to 67.8 mmol/L,HbA1c ranged from 5.8 % to 6.7%,fasting C peptide ranged from lower than 0.01 to 0.11 ng/mL and 2 -hour postprandial C peptide ranged from lower than 0.01 to 0.12 ng/mL.No improvement in C peptide levels were followed up for 9 -43 months.After acute phase,intensive insulin therapy was used to control blood glucose.The patients had a great glycaemia excursion and were subjected to hypoglycaemia.Conclusion FTlDM is a special type of diabetes developed rapidly with dangerous prognosis.It is often shown as ketoacidosis and the HbA1 c level is normal or mildly elevated.Serious cases are associated with other organ damage,pregnancy fetal death rate is very high.Because the serious impaired islet B -cell function,FTlDM patients has a great glycaemia excursion,continuous subcutaneous insulin infusion is the first choice to control plasma glycemia.

Objective To evaluate the decompression performance of anti pressure ulcer cushions with different materials and structures. Methods The common cotton cushion, sponge cushion, 3D fabric cushion, and upper 3D fabric and lower sponge cushion were analyzed by XSensor pressure sensor testing system. The pressure distribution, the pressure peak and the average pressure were analyzed to compare the decompression performance and the comfortable capability. Results and Conclusion The upper 3D fabric and lower sponge cushion can en-sure the decompression performance with excellent permeability. Both decompression and air comfort permeability should be the future di-rection of ulcer cushions research and production.

Objective To investigate which subfamily genes of T cell receptor (TCR) V? expand predominantly during the course of experimental allergic neuritis (EAN). Methods Using RT-PCR and in situ hybridization techniques,the expression levels of TCR V? 2,6,8,10,14 in the peripheral blood,lymph nodes,peripheral nerves of group EAN and those of the control group were compared. Results In group EAN,the expression of TCR V? 6?8 mRNA increased at the early phage(41.1?1.1 and 74.4?1.9 vs 25.9?1.5 and 26.1?1.6) and became more significantly at the peak of the disease,and resolved to normal at the recovery phage in the lymph nodes.But they amounted up gradually from the early stage to the peak,and then decreased a little in the infiltrating T-lymphocytes in peripheral nerves,the difference was significant.In addition,the expression of TCR V? 8 was notably higher than that of TCR V? 6 in the levels of mRNA. Conclusion The subfamilies of TCRV? genes which restrict the development of EAN due to recognizing the specific antigens are TCRV? 8 and TCRV? 6. T lymphocytes specifically expressing TCR V?6?8 genes are activated and clonally proliferated in the lymph nodes,and then migrate to the involved peripheral nerves,which might induce a series of immune lesions consequently.

To study the method of preparing the composite skin composed of keratinocytes and acellular dermis, and to investigate the efficacy as well as its histological changes after being grafted on wounds of athymic mice. Compared with keratinocyte sheet grafting, the wounds grafted with composite skin had better healing rate, appearance and less wound contraction rate. Moreover, histological examination revealed fully differentiated epidermis, organized proliferated collagen fibres, and distinct reconstruction of epidermis-dermis junction in composite skin group, with absence of acute immuno-rejection response. As a new kind of skin substitutes, the composite skin can improve the quality of wound healing.

Objective To evaluate the impact of sleep-disordered breathing(SDB)on the quality of life(QOL)in children with SDB and investigate the value of tonsillectomy and adenoidectomy in improving their QOL.Methods Questionnaire of disease-specific quality of life for children with obstructive sleep apnea with 18 items(OSA-18)was used to evaluate QOL in 168 children with SDB within four weeks before and six to 12 months after surgical operation,and correlation between OSA-18 scores to apnea hypopnea index(AHI)and minimum oxygen saturation(MiO2)in 62 of them was evaluated with polysomnography(PSG),with 50 healthy children without snoring as controls.Results Overall scores of OSA-18 in children of SDB group before surgical operation were significantly higher than those in children of control group(t=15.12,P＜0.01).and QOL was seriously affected in 30.4 percent of the children with SDB.Scores of OSA-18 correlated to AHI and MiO2 before surgical operation.QOL was improved significantly in 73.8 percent of children with SDB after tonsillectomy and adenoidectomy.Conclusions SDB has obvious impact on pediatric QOL,which can be improved by tonsillectomy and adenoidectomy.There exists significant correlation between OSA-18 scores and objective indicators of PSG,and the former can be used as clinical diagnosis for SDB in children and as quantitative evaluation for the effectiveness of intervention.

Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groups:TUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.

Antibodies ; immunology ; therapeutic use ; Asthma ; drug therapy ; Humans ; Interleukin-5 ; immunology

OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

Ganoderma lucidum is a traditional folk common rare medicinal herb, which plays an important role in maintaining human health. Among them, G. lucidum polysaccharide is one of the main bioactive components of G. lucidum, which has various pharmacological effects such as anti-cancer, immunomodulatory, antibacterial, antioxidant, and scavenging free radicals. Due to the complex etiology and pathogenesis of central nervous system diseases, the clinical manifestations are diverse, and the individual response to treatment varies widely, which brings great challenges to clinical treatment. The characteristics and mechanism of the central neuroprotective effect of G. lucidum polysaccharide are reviewed in this paper from the aspects of Alzheimer's disease, anti-epileptic, modulating microglia inflammatory response, etc., in order to provide relevant evidence for its clinical application.

Objective To compare the clinical efficacy of moxibustion Zhiyin with knee chest decubitus,ear acupoint magnetic bead press combined with knee chest decubitus and knee chest decubitus in correction of breech position,thus to provide more safe and effective correction method for the clinical treatment.Methods 150 pregnant women with breech were selected.They were randomly divided into observation group Ⅰ,observation group Ⅱ and control group according to the digital table,50 cases in each group.The control group was treated with knee chest decubitus to correct breech position,the observation group Ⅰ was given moxibustion Zhiyin combined with knee chest position,the observation group Ⅱ was given ear acupoint magnetic bead press combined with knee chest decubitus.Results The effective rates of the observation group Ⅰ and observation group Ⅱ were 96％,92％,respectively,which were higher than 76％ of the control group,the difference were statistically significant (χ2=5.09,4.18,all P＜0.05).The effective rate between the observation group Ⅰ and observation group Ⅱ showed no significant difference (P＞0.05).Conclusion Moxibustion Zhiyin combined with knee chest decubitus and ear acupoint magnetic bead press combined with knee chest decubitus in the correction of breech position have short course of treatment,high success rate,and are more economical and convenient,with high safety and good curative effect,which are worthy of promotion.