Objective To explore the related risk factors and control measures for senium patients with type 2 diabetes and to provide basis for making control and prevention measures.Methods A retrospective case-control study was conducted.548 cases of type 2 diabetes patients in our hospital were selected as case group and other 640 cases of normal people who accepted physical examination in our hospital were selected as control group.Results Exposure rates of smoking,drinking,obesity,hypertension,hypedipidemia and family history in case group were obviously higher than those of control group(P ＜0.05).Conclusion Smoking,drinking,obesity,hypertension,hyperlipidemia and family history were risk factors of type 2 diabetes.Comprehensive intervention measures related to the risk factors,such as maintaining a good way life,were importantto prevent and control type 2 diabetes.

OBJECTIVE:To investigate effectiveness and safety of rh-endostatin in the treatment of keloid.METHODS:Sixty-four keloid patients in Nanchong Central Hospital during Jan.2015-Jan:2016 were divided into observation group and control group by random number table,with 32 cases in each group.Both group received fractional CO2 laser treatment.After surgery,control group was given antioxidant drug and antibiotics routinely.Observation group was additionally given Rh-endostatin injection 0.1-0.2 mg/cm2 via keloid body,once a month,for twice,on the basis of control group.Clinical efficacy,symptom score after laser treatment and 2 months after laser treatment,wound healing time,wound pigmentation area and keloid area before and after treatment,the occurrence of ADR were compared between 2 groups.RESULTS:There was no statistical significance in total re sponse rate (93.75％ vs.87.50％) and the incidence of ADR (15.63％ vs.12.50％) between observation group and control group (P＞0.05).There was no statistical significance in symptom score of control group between after laser treatment and after 2 months of treatment (P＞0.05).The erythema,edema and pigmentation scores of observation group were significantly lower than before treatment and control group,with statistical significance (P＜0.05);there was no statistical significance in skin itching and burning sensation score between 2 groups (P＞0.05).The wound incrustation time,decrustation time and wound healing time of observation group were significantly shorter than those of control group,with statistical significance (P＜0.05).Pigmentation area and keloid area of 2 groups were significantly smaller than before,and the observation group was significantly smaller than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Rh-endostatin can alleviate erythema,edema,pigmenta tion and other symptoms effectively,shorten healing time,and inhibit pigmentation and keloid regeneration effectively with good safety.

Objective To study application of surface plasmon resonance(SIR)system in detection of clinical pathogen with a gene chip.Methods 27 clinical samples were detected by SPR-based gene chip system.These samples were composed by 8 positive blood samples,3 positive pyoid samples,9 positive leucorrhea samples and positive reproductive tract pyoid samples,1 positive biopsy sample and 6 negative biopsy samples.Specific primers and probes for target pathogens were designed by bioinformatics methods and validated by PCR and enzyme-labelled chemiluminescence,respectively.SPR-based gene chip was prepared and utilized to detect clinical samples by SPR system.Results The primers and probes showed good specificity and accuracy,which can be applied to perform PCR and application of the gene chip.Compared with the clinical analysis,gene chip analysis of 26 clinical samples showed the consistent results.Conclusions SPR detection system proved to be accurate and reliable.The chip will have a promising prospect in application.

OBJECTIVE: To analyze the causes for misplacement of pedicle screw in thoracolumbar spine.METHODS: From January 2002 to January 2008, 19 patients with misplacement in thoracolumbar spine were treated in Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, including 12 males and 7 females with an average age of 52.5 years (range 23-68 years). The diagnoses were thoracolumbar fracture in 5 cases, lumbar spondylolisthesis in 8 and degenerative lumbar disease in 6. The fixation systems were Steffee used in 4 cases, DRFS in 3, RF in 6, AF in 4 and GSS in 2. X-ray and CT scanning were used to observe pedicle screw location, including screw,pedicle and membranous sac and great vessels.RESULTS: The time of misplacement of pedicle screw was 5-69 days with an average time of 18.5 days, including 7 cases of screw penetrating into lateral cortex, 4 of screw penetrating into medial cortex, 2 of screw penetrating into pedicle cortex, 2 of overplacement, 2 of intervertebral foremen placement and 2 of intervertebral space placement.CONCLUSION: The causes for screw misplacement were anatomic variation and poor surgical skills, and the key factors in precise insertion of pedicle screw are fine surgical skills, carefully study of preoperative image and the intra-operative monitoring.

Objective To present our initial experience of using transumbilical multi-stab laparoscopic pyeloplasty(TMLP) as a treatment for the infants younger than 3 months with severe hydronephrosis caused by ureteropelvic junction obstruction (UPJO).Methods Seventy-two infants younger than 3 months with severe hydronephrosis caused by UPJO underwent TMLP from June 2010 to March 2013 in our center.The average age received operation was 34 days (7-87 days).The operative indications included:① prenatal diagnosis of Society of Fetal Urology Grade 4 hydronephrosis; ②ipsilateral differential renal function being less than 40％.Patients were followed up with physical examinations,ultrasound and radionuclide scans.Results The operations were successfully performed in all the 72 patients.Neither conversion nor additional trocars placement was required and there was no intraoperative complication.The average operative time was 75 min (range,53-118 min).The patients were followed up for 6-36 months (mean,12 months).The renal pelvic anteroposterior diameters were reduced and the renal functions were improved (P＜ 0.05).The anastomoses were proved to be patent and the renal parenchymal thickeness increased.In addition,the scars were barely noticeable.Conclusions TMLP for the infants younger than 3 months with severe hydronephrosis caused by UPJO is feasible,safe and less invasive.The cosmetic results are excellent.But the surgery must be operated by rich experienced surgeon.

Objective To propose an improved discrete wavelet transform (DWT ) and to apply it in multimodal medical im‐age fusion .Methods Firstly ,the source medical images were initially transformed into the high frequency and low frequency images by DWT ;then the high frequency part adopted the big direction absolute values ,which effectively preserved the detailed informa‐tion of image ,while the low frequency part used the fusion rule of local energy ratio for preserving the most of image information ;finally ,the discrete wavelet reverse transform was used for reconstructing the fusion sub‐images into fusion image .Results By comparing the fusion images by 3 groups of medical images ,this proposed algorithm was superior to other existing algorithms in the aspects of subjective visual effect and objective evaluation indicators .Conclusion The proposed algorithm of medical image fusion is rapid and accurate ,has excellent performance in the noise environment and clinical examples ,can obtain the high quality fusion im‐age and has higher clinical application value .

Objective To explore the association between PI3K polymorphisms in insulin signal transduction pathway and Alzheimer's disease (AD)risk.Methods There were three groups,including 112 cases for AD +T2D group,231 cases for only AD group,and 231 cases for healthy controls group.The polymorphisms in PI3K gene was sequenced by PCR and the concentration of PI3K in serum was tested by enzyme -linked immunosorbent assay (ELISA).Results Overall,there was significantly statistical difference in PI3K rs3730087 polymorphism among three groups (χ2 =20.99,P =0.000 3).The CC frequency of PI3K rs3730087 polymorphism in AD with T2D group and AD control group was significantly higher than that in the healthy control group.The PI3K protein level of differ-ent genotype was statistically significant (F =27.450,P <0.000 1).As for CC genotypes of PI3K rs3730087 poly-morphism,the PI3K protein level was statistically different among these three groups (F =8.096,P =0.000 6).Moreover,the PI3K protein level of the three groups was different (F =9.034,P =0.000 1),which in both AD group was lower as compared with healthy control group.Conclusion The study suggested that CC genotype of PI3K rs3730087 polymorphism in insulin signaling transduction pathway might be a risk factor for AD with T2D and it also affects the expression level of PI3K protein.However,the polymorphism is not shown to be exclusive in AD patients with T2D.

Objective To present the surgical technique of transumbilical laparoendoscopic singlesite pyeloplasty (LESS-P) for pediatric patients with ureteropelvic junction obstruction (UPJO).Methods Twenty-four pediatric patients with UPJO had transumbilical LESS-P performed by the same surgeon from June to December 2010.Sixteen patients were male and eight female aged from 2 to 62 months with an average age of 14 months.Eighteen patients had obstruction on the left side and six on the right side.Dismembered LESS-P was carried out with the Anderson-Hynes anastomosis where 5-0 sutures were uswed over a double J ureteric stent.Results All operations were successful.None was converted to open surgery and no additional sheath tube or incision besides the umbilicus was needed.No intraoperative complications occurred.Ectopic blood vessels were found in two patients during surgery.The mean operative time was 145 min,and the average blood loss about 10 ml.Abdominal drainage tubes remained for 2 -9 d after surgery.The mean postoperative hospital time was 7 d.Two patients had postoperative urinary fistula,which naturally disappeared at 4 and 7 d postoperation,respectively.Follow-up with ultrasound and diuretic renal scintigraphy found 23 patients had significantly decreased renal pelvis diameter,the remaining case showed no obvious change,but diuretic renography showed significantly improved excretion.ConclusionsPediatric transumbilical LESS-P could be safe and effective.LESS-P could achieve comparable clinic outcomes to standard laparoscopy.

OBJECTIVETo assess the image quality, diagnostic accuracy and effective radiation dose of prospectively ECG- triggered high-pitch spiral double scanning (Double Flash) mode of computed tomography coronary angiography (CTCA) using dual-source CT for the diagnosis of significant coronary stenoses.

METHODSPatients underwent both CTCA in Double Flash mode and conventional coronary angiography (CAG) and were divided into two groups according to heart rate (HR), namely group A with HR <65/min (62 cases) and group B with HR between 65 and 80/min (52 cases). All the coronary segments were evaluated by two blinded and independent observers for image quality on a four-point scale and for the presence of significant coronary stenoses (defined as a diameter narrowing exceeding 50%). CAG served as the reference standard for analyzing the diagnostic accuracy of Double Flash mode images on the level of both patients and vessels. Radiation dose values were calculated using the dose-length product.

RESULTSA total of 114 patients were enrolled and 1725 vessel segments were displayed. In terms of image quality, the diagnosable segments accounted for 98.5% (919/933) in group A and 97.3% (770/792) in group B. In the per-patient analysis, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 100%, 90.5%, 88.2%, 100% and 96.7% in group A and were 100%, 88.5%, 94.5%, 100% and 96.2% in group B, respectively. The mean effective radiation dose was 1.63∓0.52 mSv.

CONCLUSIONDouble Flash spiral protocol of dual-source CTCA can acquire good image quality and yield high diagnostic accuracy for assessment of coronary artery stenoses at a low radiation dose in patients with HR between 65 and 80/min.

Aged ; Cardiac-Gated Imaging Techniques ; Coronary Angiography ; Coronary Stenosis ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Coronary Vessels ; diagnostic imaging ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, Spiral Computed