Objective The prevalence rate of type 2 diabetes mellitus in schizophrenia patients were significantly higher than normal people.The study examined the glucose metabolism in first-episode, drug-naive patients with schizophrenia. Methods Case-control study was employed.According to the 4th edition of American Diagnostic and Statistical Manual of Mental Disorders, 58 first-episode, drug-naive patients with schizophrenia hospitalized in our hospital were collected for the study.Brief psychiatric rating scale, Hamilton depressive scale and assessment of abnormal involuntary movement were used to assess the mental state and the degree of illness.Meanwhile, 60 hospitalized Han patients in the Second Hospital of Lanzhou University were selected as the control group. Fast plasma glucose (FPG) were detected in the morning on each patient along with oral glucose tolerance test (OGTT).Measure-ments were also made on height, body weight, waist circumference, hip circumference, as well as WHR and body mass index (BMI). Results No significant difference was found in gender, age, diet habit, activity, BMI and the number of education years between the groups(P>0.05).The average FPG of the patient group was higher than that of the control group(5.29 ±0.83 mmol/L vs 4.37 ±0.54 mmol/L);postprandial 2 hour glucose of the patient group was significantly higher than that of the control group ( 6.89 ±0.98 ) mmol/L vs 5.97 ±0.82 mmol/L, P<0.05).Statistical difference in the incidence of impaired glucose tolerance( IGT) was found between the two groups, 8 paitents in patient group(13.8%), 2 in control group(3.3%) (χ2 =4.25,P<0.05).Patients with normal and ab-normal glucose tolerance showed no difference in mental state and illness degree(P>0.05). Conclusions First-episode, drug-na-ive patients with schizophrenia have more impaired fasting glucose tolerance than normal people.In order to identify and intervene the abnormal glucose metabolism of schizophrenia patients, it is of great importance to measure relation index to glucose metabolism, espe-cially the oral glucose tolerance test.

Objective On patients with mechanical ventilation spontaneous breathing trial (SBT) success, out of breath machine smoothly pulled out after endotracheal intubation for active airway moist sequential therapy of clinical new method and new technology. Methods Between January 2013 and May 2014 respiratory endotracheal intubation implementation of mechanical ventilation with intensive medicine successful withdraw machine pulled out of 135 patients with tracheal intubation, they were divided into group A(68 cases) and group B(67 cases) by random digits table method. The patients in group A were treated with buoy type oxygen device, group B with active airway moist heat treatment unit. The breathing rate, PaO2, SpO2, heart rate, Clinical Pulmonary Infection Score(CPIS) were measured after 72 h of pull out endotracheal intubation in two groups. Sputum viscosity was evaluated by Airway Secretions Score before pull out endotracheal intubation and after 24, 48, 72 h of pull out endotracheal intubation in two groups. Results There were no significant differences between two groups in gender, age, clinical diagnosis, mechanical ventilation time, acute physiology and chronic health evaluation systemⅡrating etc (P>0.05). The breathing rate, heart rate and CPIS score respectively (20.94 ± 0.89), (80.79±4.67) times/min and (7.13 ± 2.54) points after 72 h of pull out endotracheal intubation in group B, and (24.12 ± 0.97), (86.32 ± 5.12) times/min and (8.79±3.56) points in group A, and there were significant differences(t=5.113, 7.298, 5.597, all P<0.01). PaO2, SpO2 were (93.24±1.96) mmHg(1 mmHg=0.133 kPa), 0.973 2±0.014 8 in group B, and (87.35±2.32) mmHg, 0.937 8±0.013 2 in group A, and there were significant differences(t=9.279, 4.548, all P<0.01). There was no significant difference in sputum viscosity before pull out endotracheal intubation between two groups (P>0.05). After 24, 48 and 72 h of pull out endotracheal intubation, group B of patients with sputum viscosity was suitable in group A (Z=-2.684,-2.870,-2.771, all P < 0.01). Conclusions Mechanical ventilation in patients with ventilator buoy type oxygen device for the pull out after endotracheal intubation success does not favor the sputum drainage, improve patients with dyspnea and hypoxemia is not obvious. By positive airway plus temperature humidity to sequential therapy is helpful to correct hypoxemia, improve the patients' respiratory function, reduce the breathing difficulties, reduce sputum viscosity, promote the airway drainage unblocked, shortening the time of lung infection.

Objective Explore the sodium citrate anticoagulation in the continuity of plasma adsorption closed-circuit circulation of anticoagulation therapy method and effect. Methods Line into the continuity of plasma adsorption treatment of 156 cases of acute drug poisoning patients were randomly(random number) divided into two groups, 78 cases in each group, respectively adopt low molecular heparin (group A), sodium citrate anticoagulation (group B). Contrast analysis of two groups after the therapy began 30 min, 3 h, 6 h before the filter in patients with pressure, transmembrane pressure, pressure drop, at the same time to compare two groups of 10 min before the start of treatment, after treatment began to 3 h, 6 h platelet, coagulation time live enzymes, vein in the body of free Ca2+, Na+and HCO3- 24 h and internal bleeding. Results Two groups in gender, age, clinical diagnosis, blood purification time comparative differences had no statistical significance (P>0.05);Two groups of 30 min after the start of treatment, 3 h, 6 h patients before pressure, transmembrane pressure, filter pressure drop compared differences were no statistical significance (P>0.05); Part of coagulation treatment after low molecular heparin group live enzymes the sodium citrate group significantly prolonged (P<0.01);Platelets, HCO3- the two groups after treatment, intravenous free Ca2+ and Na+ differences had no statistical significance (P>0.05). Conclusions In the continuous plasma adsorption treatment process using sodium citrate anticoagulation with clinical feasibility, safety.

Objective:To explore the clinical effect of antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap in the treatment of diabetic foot(DF).Methods:From April 2020 to July 2021, a total of 6 patients with DF were treated with antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap. The patients were 5 males and 1 female, aged from 45 to 67 years old with an average of 56.2 years old. The wounds were all located in dorsal foot, 4 in right foot and 2 in the left. The wound area was 2.4 cm×5.0 cm-6.5 cm×10.0 cm. The depth of wound were: 3 cases up to tendon layer, and 3 cases up to metatarsal bone. Two of the wound were complicated with metatarsal osteomyelitis. The wounds at Wagner grade 3 in 4 patients and grade 4 in 2 patients. The flap size was 3.0 cm×6.0 cm-8.0 cm×11.0 cm. All of the wounds were repaired with delayed supramolleolar perforator fascia flap after debridement, application of antibiotic bone cement and fumigation with Sanhuang decoction(a traditional Chinese medicine). The affected limbs were externally fixed with plaster and raised after surgery, and the colour, temperature, tension and capillary reaction of the flaps were closely observed. Stitches were removed 2 weeks after surgery and rehabilitation of the affected limb was performed. Regular follow-up was made postoperatively. The appearance of flaps and the scar of donor and recipient sites were observed. The foot and ankle function were evaluated by the American Orthopaedic Association foot and Ankle Surgery(AOFAS) score scale.Results:Six cases of DF had no recurrence of wound infection. All flaps survived well. The average follow-up time was 6(3-14) months. The postoperative follow-up revealed satisfactory appearance of the flap, only linear scars remained in the donor and recipient sites. The function of foot and ankle recovered well with full weight-bearing and normal walk. AOFAS scores ranged from 81 to 95.Conclusion:It is an effective method to treat DF by applying antibiotic bone cement combined with delayed superior lateral malleolus perforator fascial flap. The operation is simple, safe and can cut down the time of treatment, quickly control the wound infection. It deserves further trials.

BACKGROUND: Although newly formed constructs of feasible pressure-preadjusted bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) showed biomechanical flexibility and superior capacity for cartilage regeneration, it is still not very clear how BMSCs and seed cells feel mechanical stimuli and convert them into biological signals, and the difference in signal transduction underlying mechanical and chemical cues is also unclear. METHODS: To determine whether mechanical stimulation (hydrostatic pressure) and chemical cues (platelet-rich fibrin, PRF) activate canonical or noncanonical Wnt signaling in BMSCs, BMSCs cocultured with PRF were subjected to hydrostatic pressure loading, and the activation of the Wnt signaling molecules and expression of cartilage-associated proteins and genes were determined by western blotting and polymerase chain reaction (PCR). Inhibitors of canonical or noncanonical Wnt signaling, XVX-939 or L690,330, were adopted to investigate the role of Wnt signaling molecules in mechanically promoted chondrogenic differentiation of BMSCs. RESULTS: Hydrostatic pressure of 120 kPa activated both Wnt/b-catenin signaling and Wnt/Ca2+ signaling, with the the maximum promotion effect at 60 min. PRF exerted no synergistic effect on Wnt/b-catenin signaling activation. However, the growth factors released by PRF might reverse the promotion effects of pressure on Wnt/Ca2+ signaling. Real-time PCR and Western blotting results showed that pressure could activate the expression of Col-II, Sox9, and aggrecan in BMSCs cocultured with PRF. Blocking experiment found a positive role of Wnt/b-catenin signaling, and a negative role of Wnt/ Ca2+ signaling in chondrogenic differentiation of the BMSCs. Mutual inhibition exists between canonical and noncanonical Wnt signaling in BMSCs under pressure. CONCLUSION Wnt signaling participates in the pressure-promoted chondrogenesis of the BMSCs co-cultured with PRF, with canonical and noncanonical pathways playing distinct roles during the process.