Objective To explore the impacts of subclinical hypothyroidism (SCH) on chronic complications of type 2 diabetes mellitus. Methods Totally 448 patients with type 2 diabetes were divided into diabetes plus SCH group (n=148) and control group (T2DM without SCH,n=300).The patient's general information,past medical history,chronic complications of diabetes including diabetic nephropathy ( DN ), diabetic retinopathy ( DR), diabetic peripheral neuropathy ( DPN ),peripheral arterial disease (PAD),diabetic foot (DF),ancillary and laboratory test results were analyzed. Results The age,duration of diabetes,incidence of coronary heart disease and levels of fasting C-peptide,total cholesterol,triacylglycerol,lipoprotein (a),hs-CRP,LDL-C,UAER and thyroid stimulating hormone (TSH) [(6.8 ± 3.5) mIU/L vs. (2.1 ± 1.3) mlU/L], antithyroidperoxidase antibody (TPO-Ab) [(253.6 ± 287.1 ) kU/L vs. (46.2 ± 80.7)] kU/L and thyroglobulin antibodies (TG-Ab) [( 57.8 ± 83.5 ) kU/L vs. ( 39.4 ± 45.3 ) kU/L] were significantly higher,but the ankle brachial index(ABI) and E/A value were lower in diabetes plus SCH group than in control group (P＜0.01 or 0.05).The prevalences of DN( 63％ vs.46％,P＜0.01),DR (40％vs.29％,P＜0.05),DPN (34％ vs.24％,P＜0.05),PAD (51％ vs.38％,P＜0.05) and DF (22％ vs.12％,P＜0.01) were higher in diabetes plus SCH group than in control group.Logistic regression analysis demonstrated that high level of TSH was independent risk factor for DN(β=0.1273,OR =1.1361) and DF (β=0.1153, OR =1.1222). Conclusions Subclinical hypothyroidism is an independent risk factor for diabetic nephropathy and diabetic foot,so the elderly with longer duration of diabetes should regularly be checked in thyroid ffunction to early find hypothyroidism.

Objective To evaluate the efficacy of topicalJinhuang unction combined with oralSangqin mixture forthe patients with moderate to severe acnevulgaris.Methods A total of 72 patients with moderate to severe acne (Pills bury grade 2 or grade 3) were included and divided into a study group and a control group by random number table method, 36 in each group. The patients were treated for 2 months in the study group with topicalJinhuang unction combined with oralSangqin mixture, and in the control group with topical fusidic acid combined with oralSangqin mixture. The number of lesions and the Global Acne GradingSystem (GAGS) score for each patient were obtained and evaluated. The number offollicularPropionibacterium acnes was determined with real-time fluorescence quantitative polymerase chain reaction.Results After treatment, the number of papule (28.69 ± 10.50vs. 36.61 ± 10.10;t=3.262,P=0.002) was significantly less than that in the control group. The pustules was 1(0, 3) and the nodules was 0 (0, 1) in the study group, which were significantly less than those of 3(0, 15) and 0 (0, 4) in the control group (P<0.01). The GAGS scores was 13(6, 24), which was significantly less than those of 20(17, 32) in the control group significantly lower (Z=-6.482,P<0.01). The number reduction rate of follicular Propionibacterium acnes per unit area in the study group were 43.07% (-57.14%, 86.23%), which was significantly higher than that of 12.68% (-34.52%, 51.11%) in the control group (Z=-2.705,P=0.007). Conclusions TopicalJinhuang unction combined with oralSangqin mixture may reduce the damage of the skin, decrease the numbers of papule, pustules and nodules, depressPropionibacterium acnes in patients with moderate to severe acne vulgaris. TopicalJinhuang unction combined with oralSangqin mixture is superior to topical fusidic acid combined with oralSangqin mixture for the treatment of moderate to severe acne vulgaris.

Objectives:To evaluate the long-term complications of percutaneous kyphoplasty(PKP) for osteoporotic vertebral compression fractures (OVCF),and to provide evidence for clinical procedure.Methods:Databases including CNK1,CBM,PubMed,The Cochrane Library(lssue 2,2017),Wiley Online Library,ELSEVIER Science Direct(SDOS) were used to collect the randomized controlled trials(RCTs) which compared PKP with conservative treatment in the treatment of OVCF from inception to February 2017.The diagnosis of thoracolumbar vertebral compression fracture was confirmed by X-ray,CT and MRI.The presence of thoracolumbar osteoporotic T which was less than or equal to-2.5,was confirmed by bone mineral density measurement.All the patients were 50 years or older,and disease duration was less than 6 months;postoperative outcomes included at least one of the following indicators:new vertebral fractures,adjacent fractures,serious adverse events,visual analogue score.Cochrane system evaluation manual 5.0.1 was referred to evaluate the quality of the included literatures.Results:Five RCT studies included four English literatures and one Chinese literature.Methodological quality assessment of 4 articles were more than or equal to 4 points,one article scored 3 points.PKP group consisted of 417 cases,conservative treatment group of 458 cases.The results of meta-analysis showed that there was statistical difference in VAS between the two groups after 3 to 6 months' treatment(mean difference=-0.36;95％CI-0.07 to-0.65;P=0.02).However,there was no statistical difference in new vertebral fractures,adjacent fractures or serious adverse events.Conclusions:Application of PKP in OVCF can reduce the patients' long-term (3-6 months) VAS pain score and does not increase the risks of new vertebral fractures,adjacent fractures and serious adverse events.

Specialist training is an important part of specialist system,which is pilot stage in our country.Quite a few key issues should be discussed deeply,including the leading role of the government,the management degree of the government,bases development,teachers training,assessment criteria,training generally or directed,training expenditure,and so on.

0.05). There were no adverse events or severe adverse events in all these 72 cases. Conclusion Ozone is effective and safe in the treatment of bacterial vaginosis.

Objective To study the relationship between carotid artery atherosclerosis and serum C-reactive protein(CRP) in elderly patients with essential hypertension. Methods 100 hypertensive patients(mean age 73?7 years), including 93 males and 7 females were enrolled in this study. Colour Doppler ultrasonography was used to measure intima-media thickness(IMT) and atherosclerotic plaque of carotid arteries. Serum CRP was determined with immunological method. The relationship between the result of ultrasonography and CRP concentration was analyzed. Results CRP concentration was positively correlated with IMT(P

Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.

Objective To explore the high-risk factors of the abdominal wound undesirable healing in gynecologic operations and its prevention and treatment.Methods A retrospective clinical study reviewed 58 cases in gynecologic operations.To investigate and analyze its frequent clinical risk factors.Results The risk factors in these wound healing defect such as the fat liquefied:3 cases(48.3%),the anaemia and/or hypoproteinemia:13 cases(22.4%);combined with diabetes:3 cases(5.2%),hypertension:6 cases(10.3%),wound infection:2 cases(3.5%)and wound hematoma:1 case(1.7%);two high risk factors coexisted:22 cases(37.9%),three or more risk factors coexisted:11 cases(19.0%).The complication of such wound healing defect such as effusion:26 cases(44.8%),flare and induration:28 cases(48.3%),low-grade fever:5 cases(8.6%).Conclusion The fat liquefaction is the important reason of the wound dehiscence in gynecology operations;the effusion,flare or induration is the precipitation of the wound healing defect.If we can treat these high-risk groups positively,we will improve the clinical prognosis.

Objective To observe the effect of curcumin on the expression of smad7 and TGF-β1 in rats renal tubular cells of with Ang II, and discuss the mechanism of curcumin to improve renal interstitial fibrosis.Methods Cultured rat renal tubular epithelial cells were divided into the blank group, the Ang II control group and the low, medium and high dose curcumin group. The rest of the groups were intervened by 10-8 mol/L Ang II except the blank group; the low, medium and high dose groups of curcumin were intervened by 2.5, 5.0, 10.0μmol/L curcumin. Then Western blot was used to detect the expression of TGF-β1 and smad7 protein, RT-PCR was used to detect the TGF-β1 and smad7 mRNA expression.Results Compared with the blank group, the expression of TGF-β1 protein (0.23 ± 0.03vs. 0.16 ± 0.01), and TGF-β1 mRNA (1.89 ± 0.20vs. 1.00 ± 0.00) significantly increasedin AngⅡ control group (P<0.05), and the expression of smad7 protein (0.19 ± 0.03vs. 0.24 ± 0.02), and smad7 mRNA (0.48 ± 0.05vs. 1.00 ± 0.00) significantly reduced in AngⅡcontrol group (P<0.05). Compared with the AngⅡ control group, the expression of TGF-β1 protein in low, medium and high dose curcumingroup (0.18 ± 0.02, 0.17 ± 0.02, 0.16 ± 0.03vs. 0.23 ± 0.03) and TGF-β1 mRNA (1.58 ± 0.11, 1.34 ± 0.16, 0.97 ± 0.19vs. 1.89 ± 0.20) significantly decreased (P<0.05), and the expression of smad7 protein (0.28 ± 0.04, 0.31 ± 0.03, 0.34 ± 0.04vs. 0.19 ± 0.03) and smad7 mRNA (0.68 ± 0.07, 0.80 ± 0.06, 0.98 ± 0.09vs.0.48 ± 0.05) increased significantly (P<0.05).Conclusions Curcumin can thus play its role in renal protection by counteract the AngⅡ mediated renal interstitial fibrosis. Its mechanism may be related to the reduction of TGF-β1 protein and its mRNA expression, up regulation of smad7 protein and its mRNA expression.

Objective To investigate the malnutrition status among the elderly in age care institutions in Shanghai suburb and analyze its potential influential factors.Methods The MiniNutritional Assessment (MNA) was adopted to evaluate the nutritional status of the 190 elderly people in age care institutions.The dietary supply by the institution canteen and the quantity of residual food left by the malnourished elderly people were weighted.Results In the age care institutions,the malnutrition rate reached 23.7％,47.9％ of the elderly people were at the risk of malnutrition,and only 28.4％ of the elderly people were well nourished.Logistic regression analysis showed that the major influential factors for malnutrition in the elderly people were food intake ability,mobile capability,chewing and swallowing ability,ageing and mental Illness.The malnourished elderly people had the most residual meat and vegetables,and insufficiency of nutrient intake was the main cause for the malnutrition in the elderly people.Conclusions The elderly people in age care institutions in Shanghai suburb have the higher risk of malnutrition.The malnutrition occurs under influence of many factors,of which some are unavoidable,however,some factors like dietary factors can be changed to improve the nutritional status of the elderly people in age care institutions.