Child ; Child Abuse ; prevention & control ; Humans

Objective To investigate the effects of Metformin on serum proprotein convertase subtilisin/kexin type 9(PCSK9)level in patients with type 2 diabetes(T2DM). Methods 48 healthy people with normal glucose tolerance were selected as the controls (NGT group). 93 newly diagnosed T2DM were randomized to Metformin treated group (Met,n= 47 )and Glipizide treated group (Gli,n=46).Serum PCSK9 was measured by ELISA in all participants. After treatment,the changes of serum PCSK9 were observed in Met group and Gli group. Results Serum PCSK9 levels in Met group and Gli group were higher than NGT group(P<0. 01). PCSK9 level was positively correlated with FPG,HbA1 c, HOMA-IR,FIns,TC,LDL-C,TG,hsC-RP,TNF-αand BMI (r= 0. 578,0. 638,0. 556,0. 610,0. 578, 0. 592,0. 589,0. 638,0. 561,0. 552;P<0. 05 or P<0. 01),and negatively correlated with HDL-C(r=-0. 614,P<0. 01). The levels of PCSK9 significantly decreased after treatment with Metformin(P<0. 05). PCSK9 levels had no significant differences before and after treatment with Glipizide. Multiple regression analysis showed that TNF-αand HOMA-IR were independent related factors of PCSK9. Conclusion T2DM patients have high levels of serum PCSK9 which can be decreased by Metformin.

Background Corneal transplantation is an effective treatment to severe corneal diseases,but the shortage of cornea donor limits its application.Tissue-engineered cornea is being a new approach to corneal diseases.Objective This study was to investigate the possibility of construction of tissue-engineered corneal epithelium by culturing human amniotic mesenchymal stem cells (hAMSCs) in vitro.Methods Fresh human amniotic membranes were obtained under the approval of Ethic Committee of Affiliated First Hospital of Jinan University and informed consent of maternal women.The 6 cm×6 cm amniotic membrane tissue explant was digested using trypsin+ EDTA,and then the amniotic epithelial cells (AECs) were scraped before putting into collagenase Ⅱ digestion medium to isolate hAMSCs.hAMSCs of passage 3 were cultured to achive 80％-90％ confluence,and then the ceils were incubated on rabbit deepithelial corneal stroma at a 1 ×105/ml density.The corneal stroma was co-cuhured with hAMSCs at an air-liquid interface till 14 days.Rabbit deepithelial corneal stroma with and without hAMSCs (experimental group and control group) were fixed in 4％ para formaldehyde, and sections were prepared for histopathological examination.Immunochemistry and immunofluorescence were empoyed to detect the expressions of cytokeratin3 (CK3) and CK12 in hAMSCs.Results hAMSCs grew well and formed a stratified epidermal structure resembling native corneal epithelium on rabbit corneal stroma in cultured 14 days in the experimental group,with the oval nucleus at basement and fusiform nucleus on the surface of corneal stroma.There was no cell structure in the control group.Immunochemistry revealed brown staining for CK3, CK12 in cytoplasm of hAMSCs on the rabbits corneal stroma,and the green fluorescence for CK3 and CK12 was also seen in the hAMSCs.However,the response for CK3 and CK12 was absent in the control sections either immunochemistry or immunofluorescence test.Conclusions hAMSCs can be induced to differentiate into corneal epithelioid cells at an air-liquid interface on the rabbit corneal stroma.

98%. Conclusion The developed method is simple, reproducible and easy to operate. The solvent is cheap, with low boiling point and easy to recovery property.

Adult ; Cardiac Catheterization ; Female ; Heart Septal Defects ; therapy ; Humans

The polymorphisms of paraoxonase 1 ( PON 1 ) and ApoE gene in 192 patients with type 2diabetes mellitus (DM group) , 116 cases of atherosclerosis (AS) without DM (AS group), and 105 normal subjects (NC group ) were detected by means of PCR-restriction fragment length polymorphism. The serum concentration of Ox-LDL was determined by enzyme linked immunosorbent assay. The results showed that plasma Ox-LDL level in DM group was higher than those in AS and NC groups[(754.2±279.9 vs 526. 1±186.2 and 421.1 ± 163.2 )μg/L, P<0.01]. Ox-LDL level in the patients with QQ genotype of PON 1 was higher than those in QR and RR genotypes in type 2 DM[(846.6±147.5 vs 763.4±126. 7 and 7 1 3.2 ±132.4 ) μg/L, P<0. 0l],and Ox-LDL level in the patients with ε3/4+ ε4/4 genotype of ApoE was also higher than those in ε3/3 and ε2/2 + ε2/3 geneotypes in type 2 DM[( 824.3 ± 173.5 vs 741.6± 182. 5 and 718.3 ± 167.5 ) μg/L, P<0.05], but the difference was not found in atherosclerosis without DM. Multiple regression analysis showed that disease duration, PON1 and ApoE genotypes were the independent predictors of plasma Ox-LDL level in patients with type 2 DM.

Objective:To observe the therapeutic effect of nerve block therapy guided by electric stimulation on the relief of pain and the improvement of function in patients with low back pain(LBP).Method:A total of 78 LBP patients were divided into nerve block treatment group(n=40)and traditional treatment group(n=38)randomly.The nerve block treatment group was injected with Betamethasone compound 2mg and Lidocaine 2ml guided by electric stimulation.The physical modalities and exercises therapy were applied in the traditional treatment group.The pain was evaluated with visual analogue scale(VAS)before treatment and 1 d,1 and 2 weeks after treatment.The function of lumbar was assessed before and after the treatment with performance assessment scale for the treatment of lumbar vertebral diseases.Result:The effective rate in treatment group was 100.0%,in traditional group was 86.8%:the improvement rate in treatment group was 96.6%.in traditional group was 64.3%:there were significant differences between two groups (P<0.01).Conclusion:Nerve block therapy guided by electric stimulation display significant effect on relief the low back pain and improve the function of lumbar vertebrae.

The clinical data of 118 patients with bacterial liver abscess admitted to a tertiary hospital from January 2007 to December 2009 were analyzed retrospectively.Etiology study showed that 45.8％(54/118) cases of bacterial liver abscess were cryptogenic,40.7％ (48/118) were biliary source and 13.5％ (16/118) were hematogenous.The positive rate of pus culture was 57.1％ (36/63),among which klebsiella pneumoniae accounted for 72.2％ (26/36).The positive rate of blood culture was 31.2％(20/64) and klebsiella pneumoniae accounted for 95％ (19/20).One hundred and sixteen patients (98.3％) underwent color ultrasound examination with an accuracy rate of 93.2％.84 patients (71.2％)underwent the CT scan with an accuracy rate of 95.3％ and 20 patients underwent MRI with an accuracy rate of 85％.Seventy five patients (63.6％)accepted ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotic therapy; 40 patients(33.9％)were treated with antibiotics alone.On the discharge 27 patients(22.9％) achieved clinical cure,87 patients (73.7％) were classified as effective,4 patients (3.4％) had no effect and no death in this group of patients.The average length of hospital stay was 16 days.Cryptogenic was the most common cause of bacterial liver abscess,biliary source took the second place.Kleibsiella pneumoniae was the predominant organism.Detailed medical history inquiry,physical examination and assistant examination may increase the accuracy rate of diagnosis.Needle biopsy should be performed if necessary.Ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotics should be the first-line treatment.

Total 118 patients with pyogenic liver abscess admitted to Zhongshan Hospital were classified into pypgenic liver abscesses of cryptogenic origin (PLAC,n =54),pyogenic liver abscesses of biliary origin (PLAB,n =48) and pyogenic liver abscesses of hemagenous origin (PLAH,n =16)according to the causes.The clinical features of three groups were compared and analyzed.The results showed that no statistically significant difference existed among three groups in clinical manifestation and signs.Compared to PLAB,the abscesses in right lobe of liver were more common in PLAC,diabetes mellitus was more prevalent in PLAC,but the co-existing diseases including chronic liver disease,non biliary malignant tumor and ALP elevation were less in PLAC.Klebsiella pneumoniae was frequently detected in PLAC,but there was no significant difference comparing to other two groups.No significant difference was found among three groups in the choice of therapeutic methods,the course of antibiotics,length of hospital stay and the days from admission to diagnosis.

Objective To analyze the clinical characteristics of intestinal infection caused by Aeromonas and their drug suscepti-bility .Methods The data of 52 patients infected with Aeromonas were analyzed retrospectively .Aeromonas strains were identified with Vitek Ⅱ Compact .Drug susceptibility was determined by disk diffusion methods .Cefoxitin combined with ceftazidime ,aztreo-nam ,cefotaxime and ceftriaxone were used to detect inducible expression of AmpC β-lactamase .Results Abdominal pain ,watery di-arrhea ,tenesmus occurred in 75 .0% ,48 .1% ,and 38 .0% of the patients ,respectively .White blood cell tests were positive in 50 .0%patients′stools .52 strains of Aeromonas were isolated ,including 38 strains of Aeromonas hydrophila ,13 strains of Aeromonas so-bria ,and 1 strain of Aeromonas veronii .All strains were sensitive to carbapenems ,the second ,third generation of cephalosporins , monobactam ,fluoroquinolone ,aminoglycosides .The susceptibility rates to chloramphenicol ,trimethoprim-sulfamethoxazole ,cefox-itin ,cefazolin ,and amoxicillin/clavulanic acid were 94 .2% ,92 .3% ,76 .9% ,51 .9% and 23 .1% ,respectively .75 .0% isolates exhibi-ted inducible expression of AmpC β-lactamas .Conclusion Diarrhea caused by A eromonas has different clinical manifestations .Ceph-alosporins ,monobactam ,fluoroquinolone ,aminoglycosides are available for empirical therapy of diarrhea caused by A eromonas .But the third generation of cephalosporins should be cautiously used because of high prevalence of inducible AmpC β-lactamase in A ero-monas .