Objective To explore the levels of serum 25(OH)D in glomerular disease patients and investigate its influence on the impaired glucose metabolism after treated with glucocorticoid. Methods A total of 61 patients with glomerular disease confirmed by clinical diagnosis and renal biopsy were included in the case group before receiving steroid therapy. 16 cases were selected as control at the same period. Before and six weeks after the treatment of glucocorticoid, all subjects took oral glucose tolerance test (OGT). According to the results of OGT, patients were divided into normal glucose regulation (NGR) group, impaired glucose regulation (IGR) group and steroid diabetes mellitus (SDM) group. Serum 25(OH)D levels were detected with enzyme?linked immunosorbent assay (ELISA), and other clinical data including albumin(Alb), Scr and urine protein were collected. Results (1) Before treated with glucocorticoid, the serum 25(OH)D levels in the control group [(64.09±13.53) nmol/L]were significantly higher than that in NGR group [(50.81 ± 12.44) nmol/L], while the latter was significantly higher than that in IGR group [(42.71 ± 8.09) nmol/L, all P<0.05]. In the glomerular disease patients, 18 cases (29.51%) were 25(OH)D insufficiency and 39 cases(63.93%) were 25(OH)D deficiency. 25(OH)D levels in patients with nephritis were significantly higher than in patients with nephroitic syndrome[(56.94 ± 10.41) nmol/L vs (45.88 ± 11.55) nmol/L, P<0.05]. (2)6 weeks after the treatment, incidence of steroid diabetes in IGR group was significantly higher than that in NGR group (61.11% vs 20.93%, P<0.05). Baseline levels of 25(OH)D in NGR group and IGR group were all significantly higher than that in SDM group [(55.68 ± 13.09) nmol/L, (48.97 ± 9.91) nmol/L vs (40.91 ± 7.82) nmol/L, all P<0.05]. (3)Serum levels of 25(OH)D were positively correlated with serum albumin and serum calcium, and negatively correlated with BMI, urinary protein, cholesterol and the 2 hours postprandial blood glucose. (4)Logistic regression analysis indicated that 25(OH)D<50 nmol/L and HbA1c>5.6% increased the risk of developing steroid diabetes 5.586 and 5.197 times, respectively. Age increased 10 years or insulin resistance index increased one, the risk of occurred SDM increased 2.443 and 2.755 times, respectively. Conclusions Most glomerular disease patients are serum 25 (OH)D deficiency or insufficiency. Low level of serum 25(OH)D is one of the main risk factors of steroid diabetes in patients with glomerular disease when treated with glucocorticoid.

Objective To investigate the feasibility and superiority of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of chest trauma feasibility and superiority.Methods 60 cases were randomly selected and divided into the observation group (n =30) and control group (n =30) by random number table.The observation group was treated with VATS and the control group was treated with traditional methods.Incision length,after the first three days of pain,blood transfusion,closed drainage time,drainage,postoperative hospital stay,postoperative day 7 1S forced expiratory volume (FEV1) and other related indicators were compared between the two groups.Results Incision length of the observation group was (7.41 ± 5.52) cm,which was significantly shorter than (18.62 ± 4.11) cm of the control group (t =7.54,P ＜ 0.05).Amount of blood transfusion and drainage of the observation group were (199.88 ± 23.00) mL and (199.52 ± 18.48) mL,which were significantly less than (465.67 ± 41.88) mL and (560.02 ± 44.98) mL of the control group (t =6.38,6.98,all P ＜ 0.05).In the observation group patients after the first three days VAS score was (3.61 ±0.20) points,lower than (6.01 ±0.25) points of the control group (t =6.64,P ＜ 0.05).Postoperative hospital stay was (6.50 ± 0.45) d,shorter than (11.33 ± 0.50) d of the control group(t =7.95,P ＜0.05).Conclusion VATS has the advantages of intuitive and strong,trauma,pain,faster recovery,shorter hospital stay,less closed thoracic drainage,fewer complications and so on in chest injury diagnosis and treatment.

Object To establish a process for the preparation of QINGXUE JIANGZHI CAPSULE(Hemocathartic Antilipemia Capsule)  Methods The study was carried out by uniform experimental design guided by the content of total organic acid and polysaccharide in the resulting preparation, to optimize the ratio of solvents used for the extraction, time needed for the decoction and alcoholic concentration for precipitation Results The most favorable preparative conditions were: decocting the drug twice with 10 times of water for 60 min each time, and precipitate the product at a concentration of 50% alcohol Conclusion Products prepared by this process ensured the content of total organic acid with no loss of polysaccharides

AIM To study the effects of polydatin on free radical induced rat cortex mitochondria injury. METHODS Fe 2++VitC system was used to produce ?OH. The mitochondria was isolated. Mitochondria membrane fluidity, swelling and contents of phospholipid were determined to measure the function of mitochondria membrane. The activities of ATPase and Cytochrome C oxidase were determined to measure the ability of mitochondria energy metabolism. The activity of superoxide dismutase (SOD) and content of malondial dehyde (MDA) were determined to measure the ability of anti oxygenation. RESULTS ?OH resulted in severe neuronal mitochondria injuries and the injuries and the injuries was alleviated by Polydatin (content of 100,200,400 mg?L -1). The swelling of mitochondria was ameliorated, the decomposability of mitochondrion membrane phospholipid was decreased, the membrane fluidity of mitochondria was increased. Polydatin also significantly inhibited the decrease in SOD, Cytochrome C oxidase and ATPase activity and the increase in MDA levels caused by free radical. CONCLUSION Polydatin has a protective action against the rat neuronal mitochondria injuries induced by oxygen free radical. The mechanisms may be derived from scavenging free radicals, reducing lipid peroxides, and improving the energy metabolism.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

ObjectiveTo investigate the mechanism and prevention of invisible injury of recurrent laryngeal nerve (RLN) system in thyroid surgery, with the application of intraoperative neuromonitoring ( IONM ) system. MethodsThe type of invisible RLN injury and its protection with the application of IONM system were analyzed. ResultsThe causes of invisible RLN injury mainly included stretching of Berry ligament or the tumor,contusion, thermal injury, cutting of silk and suction injury. RLN invisible injury was recoverable through neurotrophic and symptomatic treatment. No permanent vocal cord paralysis occurred. ConclusionsWith the application of IONM system, some invisible type of RLN injuries can be found. The risk of RLN injury can be reduced if the surgical techniques are improved with the development of study on mechanism of IONM system.

Objective To build a supervision mechanism for independent clinical labs (ICL),surveyed the current situation of such novel institutions in China.Methods By way of the nationwide network of clinical labs,ICL in China were surveyed by written questionnaires and spot inspection.Results In the surveyed 38 ICLs,the maximum registered capital was 44 900 thousands,the minimum was 2 000 thousands.The maximum number of employee was 1 105,the minimum was 19.6 labs passed ISO15189 ratification,4 labs passed CAP ratification.17 labs participated in local external quality control,29 labs par-ticipated in national external quality control.Conclusion Although ICL in our country have developed well in the past dec-ade,such vulnerabilities as unbalanced staff ratio,full-range quality control bugs,cutthroat competition,asymmetrical infor-mation disclosure and bio-safety have loomed in the meantime.It is time to formulate a stricter industry access system and appropriate regulatory modes.

Objective To explore the awakening probabilistic prediction models of coma patients with traumatic brain injury on admission and six months after treatment,and develop and apply the software of the models.Methods Clinical data of 190 coma patients with traumatic brain injury,admitted to our hospital from September 2010 to October 2012,were analyzed retrospectively.Potential predictive factors at admission and after awakening were analyzed by binary Logistic regression analysis; based on these factors,the awakening probabilistic prediction models of coma patients with traumatic brain injury were established; C++ language was used to write the computer software that could predict the awakening probability of 103 patients with traumatic brain injury.Results Multinomial Logistic regression analysis showed that 6 factors,including age,pupillary light reflex,movement Glasgow coma scale (mGCS) scores,morphology changes of mesencephalon surrounding cisterna,eye opening time after treatment,and percentages of ischemic brain volume in CT images,were independent factors to predict the awakening probability of coma patients with traumatic brain injury.Model A and B owned high performance (C statistics of models:0.955 and 0.975; accept rate of models:90.5％ and 94.0％).The established software based on models was easy to use with reliable results (the accept rate of 103 patients were 87.3％ and 93.2％).Conclusion The established models can timely and accurately predict the awakening probability of coma patients with traumatic brain injury; the software named sober probabilistic prediction for coma patients with traumatic brain injury can help in decision-making in clinics.

Objective To investigate the potential clinical prognostic factors of severe traumatic brain injury.Methods Two hundred and thirteen severe traumatic brain injury patients,admitted to our hospital from May 2013 to July 2015,were chosen in our study.Their clinical data were retrospectively analyzed;prognostic factors,including age,gender,mGCS scores (movement GCS scores),improved CT scores,brain hernia,volume of intracranial hematoma,range of cerebral contusion and laceration,and location of intracranial hematoma,were estimated using Chi square test,and after the Chi square test,the factors enjoying statistical significance were analyzed by COX proportional hazards regression model.Results The mortality rate was 15.9％ (34/213).Death occurred within 30 days of admission,and death mostly occurred within 10 days of admission (1-10 d:23 patients;11-20 d:9 patients;20-30 d:2 patients).Cox proportional hazards regression analysis indicated that age,GCS scores (movement GCS scores),improved CT scores,and brain hernia were the prognostic risk factors in patients with severe traumatic brain injury,while gender,volume of intracranial hematoma,range of cerebral contusion and laceration,and location of intracranial hematoma were not.Conclusion Age,mGCS scores (movement GCS scores),improved CT scores,and brain hernia dare important factors affecting the prognosis of patients with severe traumatic brain injury.