HbA1c has already been one of the standard diagnostic criteria for diabetes and pre-diabetes.However,disorders of iron metabolism could affect glucose metabolism through various pathways,and influence HbA1c level directly or indirectly.So under certain circumstances,it may affect the diagnosis of glucose metabolic status.Here we reviewed researches about the interference of iron metabolism disorders on HbA1c.

One case with dedifferentiated liposarcoma in proximal tibia accompanied by angiosarcoma was analyzed. The dedifferentiated liposarcoma was further analyzed by imaging, clinical and pathological features. One 51-year-old male patient was suspected to bone tumor due to space occupying lesion for 6 days in left proximal tibia and admitted in Changhai Hospital of Second Military Medical University of Chinese PLA in May 2007. The clinical features, including onset features, physical examination, blood routine, imaging alterations, pathological characteristics, operation approach, and follow-up period were retrospectively analyzed. The tumor was treated by curettage and inactivation, iliac grafting, bone cement filling, tibial plateau T type plate and screw internal fixation and tumor tissue biopsy. However, tumor relapsed 40 days postoperatively, and the patient was treated by amputation surgery. Two weeks after surgery, the patient developed emptysis and died due to multiple organ failure. Dedifferentiated liposarcoma accompanied by angiosarcoma displays no noticeable characteristics in imaging, clinical manifestation, and laboratory examination, which make it difficult to diagnose it. This tumor is highly malignant, and has short disease course, and poor prognosis.

Objective To explore feasibility and clinic results of the MIPPO (minimally invasive percutaneous plate osteosynthesis) technique in treatment of humeral fractures. Methods 14 patients with humeral fracture underwent the MIPPO operation in our department. 7 of them were injured in a traffic accident, 4 in sports and 3 in daily life. There were 11 males and 3 females, with their ages ranging from 16 to 72 years. Of the 14 cases, 9 were proximal ones and 5 mid- distal ones, 3 were multiple injuries and 1 pathological fracture. Results The average intra- operative time was 80 minutes (ranging from 55 to 130 minutes). No patient received blood transfusion. The intra- operative blood loss was 100 to 200 mL. 14 cases were followed up for 8 weeks to 14 months. Their cuts healed at the primary stage. Their shoulder and elbow functions were fine. The fracture segments got satisfactory reduction with good apposition and alignment radiologically. The callus appeared 4 to 8 weeks postoperatively. Conclusion MIPPO is a safe and effective treatment for the humeral fracture with the benefits of less invasion, fewer complications and higher union rate.

Gastric cancer is one of the high incidence of malignant tumors in China,the incidence of which is in the second among the world and is only inferior to Japan.But the mortality of gastric cancer in China is 2 times of world's average level,which is often associated with low early diagnostic rate,big regional differentials in the surgical quantity of gastric cancer (especially D2 radical gastrectomy) and prognosis of patients influenced by surgical quantity.Therefore,a standardized treatment of gastric cancer is the current development trend and hotspot.The correct and programmed staging,evaluation,operation methods,approaches,lymph node dissection and digestive tract reconstruction are selected,thus improving the long-term survival of patients with advanced gastric cancer and reducing mortality in China.

BACKGROUND: The endothelial-mesenchymal transition is known to play a central role in the pathological process of heterotopic ossification. OBJECTIVE: To verify the inhibitory effect of SMAD7 on endothelial-mesenchymal transition such as myofibroblast transformation and to explore whether it is a potential target for heterotopic ossification.METHODS: A lentivirus overexpressing SMAD7 was contructed and the optimal titre and transfection efficiency in rat aortic endothelial cells were determined. The lentivirus was then injected into a rat model of Achilles tendon injury, while the controls were given the injection of normal saline. Expressions of endothelial and mesenchymal markers at the injured site were analyzed by quantitative PCR and western blot assay. The heterotopic ossification was observed radiologically and histologically.RESULTS AND CONCLUSION: Local injection of SMAD7-delivering lentivirus resulted in an upregulation of CD31 and VE-cadherin, and a downregulation of N-cadherin and vimentin, suggesting that the endothelial-mesenchymal transition is blocked due to local SMAD7 overexpression. The inhibitory effect became more evident at 10 weeks than at 6 weeks after modeling. Radiology and histological staining further confirmed that the ossified structures in the tendon tissue disappeared after injection of SMAD7-delivering lentivirus, as opposed to the control group. These data suggest that local overexpression of SMAD7 can prevent postoperative heterotopic ossification with no effect on wound healing.

AlM: To investigate the relationship among carotid atherosclerosis, homocysteine ( Hcys ) and anterior ischmic optic neuropathy( AlON) .METHODS: Sixty-five AlON patients enrolled in AlON group and 70 non - AlON controls enrolled in control group. All the participants in 2 groups were examined by carotid artery color doppler flow imaging to evaluate the incidence of carotid atherosclerosis. Plasma levels of Hcys, vitamin B12 and folate were measured by automatic biochemical analyzer. The incidence of carotid atherosclerosis, plasma levels of Hcys, vitamin B12 and folate were compared statistically between AlON and control group.RESULTS: Fifty - six AlON patients ( 86%) exhibited carotid atherosclerosis, which was found in 43 control subjects ( 61%) . Fifty - nine AlON patients ( 91%) exhibited increased plasma levels of Hcys compared with that in 38 control subjects ( 54%) . Lowered vitamin B12 was found in 37 patients with AlON ( 57%) and in 43 control subjects ( 61%) . Lowered folate was found in 54 AlON patients ( 83%) and in 32 control subjects ( 46%) . The incidence of atherosclerosis in carotid artery ( P =0. 001), mean Hcys level (P=0. 0005) and lowered folate ( P = 0. 0006 ) were different statistically between AlON group and control group. Mean vitamin B12 level was indifferent between AlON group and control group ( P=0. 0722). Logistic regression analysis showed that carotid atherosclerosis was an a risk factor for AlON (OR=1. 312, 95%CI:0. 927~1. 772), whereas elevated Hcys level (OR=2. 378, 95% CI: 1. 479 ~ 3. 821 ) was also shown to be significant risk factor for AlON. CONCLUSlON: Carotid atherosclerosis and elevated Hcys were related with AlON. Reducing above-mentioned risk factors related to thrombus may be crucial to the prevention and cure of AlON.

Objective To analyze the colonization of Candida, Rhodotorula, Penicillium and Aspergillus in skin surfaces of patients with atopic dermatitis, and to assess the relationship between the four common fungal allergens and severity of atopic dermatitis. Methods Fifty patients with atopic dermatitis and 20 healthy controls were enrolled. Scales were scraped from lesional and non?lesional skin of flexural extremities of the patients, as well as from normal skin of the flexural elbow of healthy controls, then were subjected to microscopic examination and culture. Scale specimens were inoculated onto Sabouraud dextrose agar medium and cultured at 25 ℃ in a constant temperature incubator. Subsequently, suspected fungal or yeast?like colonies were collected for pure culture. Finally, fungal strains were identified according to colony morphology, color, growth speed, as well as microscopic features of spores and hyphae. Results No hyphae or pseudohyphae were found in any case by microscopic examination. Candida albicans and Rhodotorula were detected in 29(58%)and 17(34%)out of the 50 patients, respectively, and in 5(25%)and 2 (10%) out of the 20 healthy controls, respectively. The detection rates of Candida albicans and Rhodotorula were significantly higher in the patients than in the controls(χ2=6.23, 4.10, respectively, both P<0.05). Of 25 patients with severe lesions, 19(76%)and 12(48%)were colonized by Candida albicans and Rhodotorula respectively;among 25 patients with moderate lesions, 10 (40%) and 5 (20%) were colonized by Candida albicans and Rhodotorula respectively. An increase was observed in the detection rates of Candida albicans and Rhodotorula in the patients with severe lesions compared with those with moderate lesions(χ2=6.65, 4.37, respectively, both P<0.05). There was no significant difference in the detection rate of Penicillium or Aspergillus between the patients and health controls. Conclusion The colonization rates of Candida albicans and Rhodotorula on skin surfaces were higher in patients with atopic dermatitis than in healthy controls, and higher in patients with severe lesions than in patients with moderate lesions, indicating that the types of colonizing fungi are associated with the health status of skin and severity of symptoms in patients with atopic dermatitis.

Objective To research the association of IR and β-cell function with MS in T2DM.Methods 116 T2DM subjects were divided into two groups:MS(n=60)and T2DM(n=56),and FIns,FPG,BP and other items were measured.Results HOMA-IR was significantly higher in MS than in T2DM and control group(P<0.05).HOMA-β was significantly lower in MS than in T2DM and control group(P<0.05).And FPG,waist circumference(WC)in MS group were positively correlated with the IR level(P<0.05).Conclusions The HOMA-IR was highest in T2DM with MS,and HOMA-β was lowest in T2DM with MS

Objective To investigate the genotype and drug resistance of extended-spectrum beta-lac-tamases(ESBLs) -producing Shigella in pediatric patients.Methods A total of 59 strains of Shigella were isolated from stool specimens of hospitalized children with shigellosis in Beijing Children's Hospital from January 2004 to December 2008.Phenotypic confirmatory test,which is based on Clinical and Laboratory Standards Institute(CLSI),was used to detect the ESBLs-producing strains.Agar dilution method was used to determine the minimal inhibitory concentration (MIC).PCR amplification was performed for ESBLs producers to determine the genotype.PCR product was sequenced and then analyzed to confirm the subtype of ESBLs.Results Of the 59 isolates,21 (35.6%) strains were identified as ESBLs producers.The 21 strains of ESBLs-producing Shigella all carried the genes of CTX-M as shown by PCR,and CTX-M-1,CTX-M-9 accounted for 6,15,respectively.Among the 21 CTX-M producers,there were 4 strains accompanied by TEM-type and 6 strains accompanied by OXA-type.Nucleotide sequence analysis showed that there were CTX-M-3 (n = 1),CTX-M-15 (n = 2),CTX-M-57(n =3) of the 6 CTX-M-1-producing isolates.The subtypes of CTX-M-9,TEM,OXA were all CTX-M-14,TEM-1,OXA-1,respectively.The sensitive drugs to ESBLs producers were imipenem,meropenem,piperacillin/tazobactam,cefoperazone/sulbactam and cefoxitin,with resistance rate all less than 15%.The resistance to ceftazidime was remarkably variable among different CTX-M producers.Conclusion The prevalence of ESBLsproducing Shigella is in a high level in pediatric patients in this area.The genotypes of ESBLs are all CTX-M.Most of them are CTX-M-14,but some are CTX-M-3,CTX-M-15 and CTX-M-57.Most ESBLs-producing strains are multidrug resistant.Carbopenems should be the first choice for ESBLs producers.