Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.

Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bi -polar radio frequency current ablation .Methods All patients in our study were divided into three groups including the ones who had accept -ed bipolar radio frequency current ablation because of atrial fibrillation ,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation .All patients accepted TTE before and after operation .Results The rate of transverse diameter change of ablation group (24.24 ±8.67)%was larger than those of other two groups (P<0.05).Left atrial chan-nel capacity volume change rate of ablation group (17.18 ±3.26)%were larger than the values of the group who were suffering atrial fibrilla-tion but refused ablation advice (0.86 ±0.26)(P<0.05).Left atrial total ejection fractions of ablation group (202.41 ±81.59)%were lar-ger than the values of the group who were suffering atrial fibrillation but refused ablation advice (109.53 ±60.91)%( P<0.05) .And its ac-tive ejection fractions(12.18 ±3.48)%,total ejection fractions(41.31 ±8.26)%and so forth were less than the group who maintained si-nus rhythm before operation(21.33 ±5.61)%,(45.05 ±7.37)%,respectively (P<0.05).Left atrial posterior wall center and cardiac basal segment strain(14.34 ±9.47)%,(13.20 ±8.38)%,respectively,and strain rate values after operation of ablation group were less than other segments .Conclusion Left atrial structure remodeling inversion was not obviously 3~6 months after bipolar radio frequency cur-rent ablation .And at the same time ,the improvement of left atrial storage function was not obviously compared with the group who refused ab -lation advice,left atrial channel function compensation degree descended obviously left atrial co -pumping function in ablation group increased obviously,left atrial posterior wall center and cardiac basal segment systolic and distolic function were less than other segments of left .

Objective To investigate the feasibility of contrast-enhanced CT with low tube voltage using iterative model reconstruction (IMR) technique.Methods Sixty patients were randomly assigned into 2 groups (group A and group B, 30 each) according to random number table.All patients underwent contrast-enhanced hepatic CT.Group A was scanned with 100 kV at arterial phase(AP) and 120 kV at portal vein phase (PVP), while group B was scanned with 120 kV at AP and 100 kV at PVP.All protocols were performed at the same tube current of 250 mAs.Raw data were reconstructed with IMR for AP images in group A and PVP images in group B;and reconstructed with FBP for AP images in group B and PVP images in group A.Images of 4 different groups were obtained: A1(AP,100 kV,IMR) , B1(AP,120 kV, FBP), A2(PVP, 120 kV,FBP) and B2(PVP, 100 kV, IMR).Subjective evaluation indexes for image quality including low-contrast detectability, lesion edge sharpness, image distortion and diagnostic confidence.Objective evaluation indexes included CT attenuation of hepatic parenchyma, image noise, SNR and CNR, which were assessed and compared between groups A1 and B1, groups A2 and B2.Effective radiation doses were calculated.Results Effective dose in group A1 was reduced 35.1％ compared toB1 (t=ll.05, P＜0.01), while a reduction of 37.7％ in group B2 compared to A2 (t=11.64,P ＜ 0.01).Subjective image quality score of low-contrast detectability and lesion edge sharpness were significantly higher in group A1 compared to B1 (Z =6.391, 3.200, P ＜ 0.01), as well as in group B2 compared to A2 (Z =6.559, 3.409, P ＜ 0.01).No differences were found in image distortion and diagnostic confidence between groups A1 and B1, groups A2 and B2, respectively (P ＞ 0.05).Significantly lower image noise and higher SNR/CNR were found in group A1 compared to group B1 (t =12.889, 15.458, 1.325, P ＜ 0.01) , as well as in group B2 compared to group A2(t =15.163, 15.308, 3.136, P ＜0.01).Conclusions Significant radiation dose reduction and image quality improvement in contrast-enhanced hepatic CT can be reached by using low tube voltage protocol combining with IMR technique.

Objective To evaluate the efficacy of a type of endotracheal tube of extended with terminal swelling and resistance bending pressure for airway management during mechanical ventilation in children in prone position.Methods Sixty pediatric patients with cerebral palsy of both sexes,aged 3-7 yr,weighing 11-23 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective selective functional posterior rhizotomy,were randomly allocated into 2 groups (n =30 each) using a random number table:endotracheal tube of extended with terminal swelling and resistance bending pressure group (group E) and reinforced tracheal tube group (group C).After induction of anesthesia,the type of endotracheal tube of extended with terminal swelling and resistance bending pressure was inserted in group E,and the reinforced endotracheal tube was inserted in group C.The tidal volume,minute ventilation,dynamic lung compliance,arterial oxygen saturation and end-tidal pressure of carbon dioxide in pressurecontrolled ventilation mode were recorded in the two groups.Tube shedding caused by using of the extended tube was recorded during operation.Blood samples were collected from the femoral artery for blood gas analysis.Results Compared with group C,the tidal volume and minute ventilation were significantly increased (P＜0.05),and no significant change was found in dynamic lung compliance,arterial oxygen saturation and end-tidal pressure of carbon dioxide in group E (P＞0.05).Compared with the value before anesthesia,no significant change was found in pH value,arterial oxygen partial pressure and partial pressure of arterial carbon dioxide at the end of operation in the two groups (P＞0.05).In group C,the extended tube wasused in 3 patients,and among the 3 cases,one patient developed tube shedding which was treated immediately.Conclusion The type of endotracheal tube of extended with terminal swelling and resistance bending pressure provides better efficacy than the reinforced endotracheal tube when used for airway management during mechanical ventilation in children in prone position.

Objective To study the value of 320 slice volume CT venography (CTV)and ultrasound in the diagnosis of lower limb deep vein thrombosis(DVT).Methods 51 patients with DVT confirmed by DSA were analyzed retrospectively,with comparing detection rate by direct method of CTV and ultrasound of the emboli in different parts of lower limb.Results In 5 1 patients,48 cases with DVTs were detected by CTV,including 124 thrombi,and 46 cases by ultrasound,finding 86 thrombi.CT diagnosed 34 pelvic deep vein thrombi,and ultrasound found 10.CT diagnosed 25 tibiofibular vein thrombi,and ultrasound found 5.CT diagnosed 2 femoral deep vein thrombi,and ultrasound found 1 1.Conclusion Direct method of CTV and ultrasound have high clinical value in the diagnosis of deep venous thrombosis,the former is better for the thrombosis in the pelvic deep veins and tibiofibular vein,while the latter is better for the thrombosis in the femoral deep vein.

AIM　To investigate the antithrobosis effects of glycol mannate sulfate(GMS). METHODS　Vein thrombus was formed in rat by ligating postcava. Thrombus formation in vitro was observed by Chandlers method. Clotting indexes were measure by ACL200 congulation system. RESULTS　GMS dosage of 20、40 mg*kg-1 could inhibit the vein thrombus formation in rats (P<0.01). GMS could inhibit the thrombosis in rabbit, in vivo, and the inhibitory action was enhanced along with the increase of dosage. The CT,TT,CT,APTT,RT and PT were prolonged, and the fibrinogen and the activity of Ⅱ and Ⅱa were decreased. The activity of ATⅢ was enhenced. CONCLUSION　GMS has antithrombotic effect and the mechanism may be related to the anticongulat effect.

Objective To establish a carotid siphon aneurysm model in dogs in order to test the mechanical features of a newly-designed Willis covered stent-graft and to investigate the histological reaction of the stent-implanted vessel during a follow-up period of 12 months.Methods Twenty-four saccular sidewall aneurysms were surgically created in twelve dogs(group A)and 12 carotid siphon aneurysms in another twelve dogs(group B).A Willis stent-graft was implanted in each aneurysm.Angiography was performed immediately after the procedure and 1,3,6 and 12 months after the implantation to investigate the aneurysm isolation,endoleak,stent angulation,and the patency or restenosis of the parent artery.Light and scanning electronic microscopy were used to identify aneurysmai sac thrombi,intima hyperplasia and endothelial progress of the stent-loaded arterial segment.Results In group B,postoperative immediate angiography demonstrated that two aneurysms had mild endoleak and three stents became angulated.Follow-up exam 12 months after the procedure revealed that all previous endoleaks disappeared,one parent artery became occluded and three parent arteries developed mild stenosis(＜50%).In group A.occlusion of parent artery was seen in one and mild stenosis(＜50%)in 2 cases.Electronic microscopy revealed new intima formation in all stents,and all aneurysmal sacs were filled with thrombi.In group B.the endothelialization process was not completed until 12 months after the stent implantation,and a marked correlation existed between endothelial cell arrangement and the hemodynamic orientation.Conclusion It is feasible to treat carotid-siphon aneurysm in dog with a Willis stent-graft.The complete endothelialization of the covered stent in tortuous vessel takes longer time than that in rather straight vessel.

Objective Complicated aneurysms located in the cisternal segment of the internal carotid artery(ICA-CSA)present unique therapeutic difficulties.This study is to discuss the feasibility of the Willis stent-graft in treating complicated ICA-CSA by comparing its effect with that of coiling therapy.Methods Willis covered stents were employed in 19 complicated ICA-CSAs(group A),while coils were used in 17 complicated ICA-CSAs(group B).Follow-up angiography was performed to investigate aneurysm recurrence,endoleak and parent artery(PA)stenosis.Kaplan-Meier curves were constructed to compare the recurrencefree and PA stenosis-free rate in both groups.Results Total exclusion was immediately achieved in 13 ICACSAs and minor endoleaks presented in 5 cases in group A.Total or near-total occlusion was achieved in 7 ICA-CSAs.subtotal occlusion in 8 and partial occlusion in 2 cases in group B after coiling.Acute thrombosis occurred in 1 patient in either group and re-hemorrhage happened in 1 patient after coiling.Follow-up angiography in group A revealed that 16 ICA-CSAs were completely isolated,with two parent arteries showing mild in-stent stenosis.Eighteen months after the procedure,Kaplan-Meier analysis showed that the recurrence-free rate was 93.3%and 50%,while the stenosis-free rate of parent artery was 87.5%and 100% in group A and in Group B,respectively.In group A and group B the clinical neurological symptoms were fully recovered in 9 and 9,obviously improved in 3 and 5,unchanged in 2 and 2,and aggravated in one and 0 patients,respectively.Conclusion The implantation of Willis stent-graft is a feasible endovascular therapy for complicated ICA-CSAs.When the parent artery is very tortuous or when the risk that a main collateral branch may be wrongly covered and occluded is present,the implantation of Willis covered stent can not be taken as the treatment of first choice.

Objective To construct an eukaryotic expression vector of retinoblastoma gene (pIRES-Rb94), and investigate the radiosensitising effect of Rb94 on lung adenocarcinoma cell line A549 and the mechanism. Methods Recombinant expression plasmid pIRES-Rb94 was constructed and then transfected into A549 cells using lipofectamine 2000. Steadily transfected cells were obtained using G418 se-lecting system. Cell counting method was used to produce the growth curve and the population doubling time was then calculated. The radiosensitivity of A549 cells was assessed by clonogenic assay. The expression of bTERT and Bcl-2 mRNA was detected by real-time RT-PCR. Cell cycle distribution was measured by flow cytometry. Results Steadily transfected cell line pIRES-Rb94-A549 was aquired. Compared with A549 cells, the population doubling time of pIRES-Rb94-A549 cells was increased from 31.5 h to 39.5 h (t=5.15, P<0.01). The expression of hTERT and Bcl-2 mRNA was both down-regulated (0.02:1.00, t= 18.99,P<0.01,0.01:1.00,t=13.73,P<0.01). The number of cells was increased in G2/M phases (35.91%:4.53%, t =36.78,P=0.00), whereas decreased in G0/G1 and S phases (47.02%:74.07%, t =11.71,P=0.00;17.07%:22.32%, t =2.30,P<0.05). The sensitizing enhancement ratio was 1.30. Conclusions Rb94 has marked radiosensitizing effect on A549 cells by G2/M phase blockage and down-regulation of hTERT and Bcl-2 mRNA expression. Rb94 may also inhibit the ability of cell proliferation by regulating cell cycle distribution.

Objective To explore the relationship between plasma homocysteine levels and diabetic retinopathy (DR).MethodIn 40 DR patients and 63 non-DR patients,the indexes including plasma homocysteine concentrations,duration of diabetes,ages,blood pressure,preprandial blood glucose(PBG),plasma GHbA,e,plasma lipids,serum folie acid and semm vitamin B12 were analyzed.ResultsPlasma homocysteine level was significantly higher in DR patients (12.9μmol/L) than that in non-DR patients (7.8μ.mol/L) (P＜0.01),and the relationship remained significant correlation after adjusted for duration of diabetes,GHbA1c,ages,serum folic acid and serum vitamin B12(OR = 1.23,P＜0.05).ConclusionHyperhomocysteinimia is a risk factor and an independent predieator of DR.