ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Chronic Disease ; Down Syndrome ; complications ; Heart Defects, Congenital ; complications ; Humans ; Infant, Newborn ; Leukemia ; congenital ; Male

Angiotensin II ; pharmacology ; Calcium ; metabolism ; Cell Hypoxia ; drug effects ; physiology ; Cells, Cultured ; Endothelial Cells ; drug effects ; metabolism ; physiology ; Humans ; Membrane Potential, Mitochondrial ; drug effects ; physiology ; Oxygen ; metabolism

Objective To evaluate the left atrial function and to explore its determinants in patients with hypertrophic cardiomyopathy by three-dimensional echocardiography (3DE).Methods 46 patients with HCM (obstructive HCM:25 cases,nonobstructive HCM:21 cases) and 46 healthy cases (controls) were enrolled in this study.Time-volume curve of left atrium was acquired by 3DE in all subjects.Left atrial maximal volume (LAVmax),left atrial minimal volume (LAVmin) and left atrial presystolic volume (LAVp) were acquaired.Left atrial volume index (LAVI),left atrial expansion index (LAEI),left atrium emptying fraction (LAEF),left atrium passive emptying fraction (LAPEF) and 1eft atrium active emptying fraction (LAAEF) were calculated.Comparative analysis between two groups was taken .The Spearman correlation analysis and multiple linear regression analysis between left atrial volume index (LAVI) with interventricular septal thickness (IVSd),left ventricular outflow tract peak gradient (LVOT-PG),mitral regurgitation (MI), left ventricular diastolic function (LVDF) were analyzed respectively .Results Compared to the controls LAVmax (45.67 ±11.96)ml,LAVmin (20.48 ±6.80)ml,LAVp (24.48 ±9.31)ml,LAVI 25.63 ±6.52, LAEI (1.32 ±0.49)%,LAEF (55.25 ±8.06)%,LAPEF (35.90 ±7.00)%and LAAEF (30.20 ±10.13)%, the patient with HCM had a significantly larger LAVmax (81.45 ±24.24)ml,LAVmin (44.60 ±18.96)ml, LAVp (61.00 ±21.64) ml and LAVI 45.39 ±14.17,there were significant differences among the groups (t=8.978,8.123,9.227,8.436,all P<0.01),lower LAEI(0.95 ±0.43)%,LAEF (46.15 ±11.12)%, LAPEF (25.64 ±9.09)%,there were significant differences among the groups (t=-3.865,-4.493,-6.504,all P<0.01),and slightly lower LAAEF (28.20 ±9.26)%,there were no significant differences among the groups (t=-0.656,P>0.01).There were significant positive correlation between LAVI and IVSd,LVOT-PG,MI,LVDF respectively (r=0.704,0.517,0.640,0.701,all P<0.01).Multiple linear regression analysis demonstrated that IVSd , LVOT-PG, MI and LVDF were correlated factors of LAVI (absolute standardized coeffients =0.264,0.515,0.614,0.341,all P<0.05).Conclusions 3DE could evaluate the left atrial volume and function in patients with HCM , with increased left atrial volume and decreased reservioer,conduit and booster pump function .Mitral regurgitation,obstruction of left ventricular outflow tract,left ventricular diastolic dysfunction and the thickness of left ventricular wall contributed to left atrial dysfunction at different levels ,among which mitrial regurgitation contributed the most .

Aiming at the characteristics of biochemistry and the advantages of web-based courses and combining with teaching practice,a kind of web-based courses has been constructed which practices in the internet.The key of construction will be detailed from general design,page design and some design skills.

Objective To explore a comprehensive method to correct lip-nasal deformities secondary to cleft lip repair. Method We developed a simple comprehensive method by combining several currently well-practiced surgical methods with appropriate modification. Chiefly, the Cupid's bow was reconstructed with full-thickness skin excision, and the vermilion deficiency repaired with the mucosal flap from the lower lip. The nasal deformities were corrected comprehensively by rhombic skin excision of the compromised nostril base, traction between the columella base and the lateral alar crus, M+T incision on the edge of the naris and expanded polytetrafluoroethylene (ePTFE) implantation into the nasal cavity. Results Twelve patients received surgeries with this approach, whose lip-nasal deformities were well corrected, and complications were not observed. A half-year follow-up demonstrated satisfactory long-term effect. Conclusion This comprehensive method is applicable in correcting moderate or severe secondary lip-nasal deformities with satisfactory effect.

Objective To explore a comprehensive method to correct lip-nasal deformities secondary to cleft lip repair. Method We developed a simple comprehensive method by combining several currently well-practiced surgical methods with appropriate modification. Chiefly, the Cupid's bow was reconstructed with full-thickness skin excision, and the vermilion deficiency repaired with the mucosal flap from the lower lip. The nasal deformities were corrected comprehensively by rhombic skin excision of the compromised nostril base, traction between the columella base and the lateral alar crus, M+T incision on the edge of the naris and expanded polytetrafluoroethylene (ePTFE) implantation into the nasal cavity. Results Twelve patients received surgeries with this approach, whose lip-nasal deformities were well corrected, and complications were not observed. A half-year follow-up demonstrated satisfactory long-term effect. Conclusion This comprehensive method is applicable in correcting moderate or severe secondary lip-nasal deformities with satisfactory effect.

Objective To explore the incidence of post-transplant diabetes mellitus (PTDM) by means of fasting plasma glucose (FPG) and other associated risk factors in patients surviving for more than 1 year after renal transplantation.Methods A total of 428 non-diabetic patients,who underwent kidney transplantation from 1 January,1993 to 31 December,2008,were followed up in order to ascertain the prevalence of PTDM after transplantation and other associated risk factors by means of FPG.Results Of the 428 patients,87 developed PTDM (20.3％) within a mean follow-up of (5.65 ± 3.68) years after renal transplantation.The onset of PTDM occurred in 57 patients (65.5％ of total PTDM) primarily within the first year after transplantation.Univariate analysis showed that older age,body mass index (BMI),smoking history,family history of diabetes mellitus,deceased donor transplantation,hepatitis C virus infection,cytomegalovirus infection,FPG before transplantation as well as 1 week after transplantation,total cholesterol and triglyceride before transplantation,switching from cyclosporine to tacrolimus(FK506),and peak plasma concentration of cyclosporine in the first 6 and 12 months were associated with the onset of PTDM.The prevalence of PTDM was markedly elevated in the group who has cyclosporine converted to FK506 (P＜0.05),but not in the group with cyclosporine converted to rapamycin.By multivariate analysis,FPG before transplantation,age,BMI,and deceased donor transplantation were independently associated with the onset of PTDM.Conclusions There is high incidence of PTDM in patients following renal transplantation; and early diagnosis,treatment as well as prevention are mandatory.

Objective To analyze the clinical and pathological features of follicular variant of papillary thyroid carcinoma (FVPTC).Methods Clinical data of 131 FVPTC patients diagnosed and treated between January 2006 and June 2012 were retrospectively analyzed.Results Of the 131 FVPTC patients,the median age at diagnosis was 45 years and 74.0％ patients were female.Pathologically 29％ (38 patients) of the FVPTC patients were encapsulated,and 71％ (93 patients) were nonencapsulated.Compared with classical papillary thyroid carcinoma (CPTC),FVPTC patients were more likely to have lower ultrasound diagnostic accuracy rate,frozen section accuracy rate,tumor muhicentricity,tumor bilaterality,lymph node metastasis,lateral lymph node metastasis rate,N staging,TNM stage,ATA risk and higher M staging and concomitant chronic thyroiditis rate (all P ＜ 0.05).Moreover,there were significant differences between nonencapsulated and encapsulated follicular variant of papillary thyroid carcinoma in tumor size,TSH level,ultrasound diagnostic accuracy rate,extrathyroid invasion,T staging,lymph node metastasis,N staging,TNM staging,ATA risk and recurrence rate (all P ＜ 0.05).Conclusions Compared with CPTC,FVPTC have different clinical and biological features.It's necessary for different management strategies for different FVPTC patients.

Carcinoma ; classification ; pathology ; Carcinoma, Papillary ; Female ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; classification ; pathology ; Tracheal Neoplasms ; secondary