Objective To analyze the relation between glycosylated hemoglobin (HbA1c) and coronary heart disease (CHD) among diabetic and non-diabetic individuals.Methods A total of 1190 in patients from January 2009 to September 2009 were selected and divided into two groups:225 patients with diabete mellitus and 965 patients without.We collected the age,sex,triglyceride ( TG),total cholesterol ( CHO),high-density lipoprotein ( HDL-C),low-density lipoprotein ( LDL-C),fasting blood-glucose (FBG),glycosylated hemoglobin (HbA1c),high-sensitivity CRP (hs-CRP) and analyzed the relation between these indexes and CHD in diabetic and non-diabetic individuals respectively,then,analyzed the difference of HbA1c between patients with and without CHD after correcting the differentiating factor with a multivariable-adjusted model.Meanwhile,according the HbA1c level,we divided all participants into four groups:4.0％ -5.4％( Ⅰ),5.5％ -5.9％ ( Ⅱ),6.0％ -6.4％ ( Ⅲ),≥6.5％ ( Ⅳ),and observed the distribution of HbA1c and coronary heart disease in diabetic and non-diabetic individuals respectively.Results ( 1) In non-diabetic individuals,statistically significant difference of male( 80.5％ υs 62.7％),age [ ( 59 ±11) years υs (55 ± 11) years],FBG [(5.62 ± 1.48) mmol/L υs (5.30 ±0.84) mmol/L],HbA1c [(5.98±0.92)％ υs (5.65 ±0.53)％],CHO [(4.48 ±1.01) mmol/L υs (4.77 ±1.04) mmol/L],LDL-C [(2.59±0.87) mmol/L υs (2.79 ±0.86) mmol/L],HDL-C [(1.08 ±0.26) mmol/L υs(1.21 ±0.32) mmol/L] was observed between patients with and without CHD (P ＜0.01),however,in diabetic individuals,only LDL-C [ ( 2.56 ± 0.81) mmol/L υs ( 3.07 ± 0.90) mmol/L],CHO [ (4.44 ±0.95) mmol/L υs ( 5.08 ± 1.16) mmol/L] were observed ( P ＜ 0.0 1).(2) In all participants,the higher of HbA1c,the higher of CHD percent,compared to patients without CHD,the percent of high HbA1c in CHD patients was significantly higher.After adjusting for age,sex,HDL-C,HbA1c was an independent risk marker for CHD in non-diabetic individuals ( OR:1.935,95％ CI:1.356 - 2.762,P ＜ 0.05),however,links between FBG in the non-diabetic range and CHD appeared weaker after controlling indexes listed above( OR:1.507,95％CI:1.082 -2.098,P＜0.05).Conclusion HbA1c is an independent risk factor for CHD in nondiabetic individuals and prior to FBG.

Objective To study the effect of MRCP for operation difficulty assessment before laparoscopic cholecystectomy. Methods 110 patients with gallbladder stone were randomly selected from March 2011 to July 2012 in our hospital,and all the patients were given LC operation after examined by MRCP. Regarded the average operation time 30 min as a criterion,when the operation time was no more than 30 min,the operation was considered as normal operation;when the operation time was more than 30 min, the operation was considered as op-eration of a certain degree of difficulty. Made a correlation analysis between LC operation difficulty and age,gender,location,volume of gall-bladder,angle of ductus cysticus, thickness of gallbladder wall, circumstances surrounding the cystic duct, length of ductus cysticus, and whether there were calculus in the cervical part of gallbladder. Results The difficulty level of LC operation is related to length of ductus cys-ticus and whether there were calculus in the cervical part of gallbladder,and there is no correlation with age,gender,location,volume of gall-bladder,angle of ductus cysticus,thickness of gallbladder wall,circumstances surrounding the cystic duct. Conclusion Routinely MRCP test in preoperative patients is of important significance to the prediction of LC operation difficulty.

Objective To evaluate the utility of MMP9,MPO and sCD40L in detection of the character of coronary artery plaque.Methods From April 2008 to January 2010,118 patients from outpatient of Fu Wai Hospital with chest pain were enrolled.All of them underwent 64 Multiple-detector row spiral computer tomography (64-MDCT),the CT value ＜ 130 Hu patients were enrolled in non-calcified plaque group (71 cases),CT value ≥ 130 Hu patients were enrolled in the calcified plaque group (47 cases).Ninty healthy volunteers were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum markers,including MMP9,MPO and sCD40L.Levels of MMP9,MPO and sCD40L of each group were compared.ROC curve was used to evaluate the sensitivity and specificity of the markers in diagnosis of non-calcified plaque.Results MMP9,MPO and sCD40L levels of non-calcified were ( 762.25 ± 368.71 ),[ 844.10 (582.00 - 1220.70) ],(9.37 ± 3.15) μg/L,higher than the healthy control group (342.70 ± 178.53),[426.35 ( 283.20 - 592.00) ],(6.55 ± 2.96) μg/L and calcified plaque group ( 483.12 ± 219.09 ),[ 469.00 ( 302.45 - 723.55) ],( 7.24 ± 2.86) μg/L The difference was statistically significant ( F =42.47,H =50.28,F =17.94,all P ＜ 0.01 ). Areas of MMP9,MPO and sCD40L under the ROC curve to predict non-calcified plaque were 0.854,0.792,0.751 respectively,when the identification threshold for non-calcified plaque were 510.13,537.82,7.05 μg/L respectively,the diagnostic sensitivity was 80％,80％,80％ respectively,and specificity was 80％,67％ and 55％ respectively.Conclusion The serum MMP9,MPO and sCD40L levels can help to determine the　character of coronary plaque.

Objective:To investigate the efficacy of single locked-plate internal fixation combined with autologous iliac bone graft in the treatment of Rorabeck type II periprosthetic distal femural fracture (PDFF) after total knee arthroplasty (TKA).Methods:A retrospective case series study was made on 13 patients suffering from Rorabeck type II PDFF after primary TKA together with severe osteoporosis (T value≤ -2.5 SD) admitted to 940th Hospital of Joint Logistics Support Force of PLA from January 2016 to December 2020, including 4 males and 9 females, aged 65-85 years [(75.2±6.5)years]. All patients were treated with single locked-plate internal fixation combined with autologous iliac bone graft. Anti-osteoporosis and early standardized joint function rehabilitation were undertaken postoperatively. The operation time and intraoperative blood loss were recorded. The range of motion of knee joint was compared before operation, at postoperative 3, 6 and 12 months and at the last follow-up. The Hospital for Special Surgery (HSS) knee score was assessed at postoperative 3, 6 and 12 months and at the last follow-up to evaluate the recovery of knee joint function. The bone mineral density was reexamined at postoperative 6 months and 12 months to evaluate the therapeutic effect of anti-osteoporosis. Complications were detected as well.Results:All patients were followed up for 12-72 months [(43.2±19.9)months]. The operation time was 90-135 minutes [(103.8±12.6)minutes], with the intraoperative blood loss of 100-250 ml [(150.0±45.6)ml]. The range of motion of knee joint was (114.6±7.8)°, (90.4±8.0)°, (97.3±4.8)° and (98.1±6.3)° before operation and at postoperative 3, 6 and 12 months (all P<0.05). The HSS knee score was (80.2±2.2)points, (84.6±2.9)points and (87.3±3.3)points at postoperative 3, 6 and 12 months (all P<0.05). The knee joint function was excellent in 10 patients and good in 3 at postoperative12 months, and the excellent and good rate was 100%. The T value of bone mineral density was (-3.8±0.6)SD, (-3.4±0.6)SD and (-2.9±0.6)SD preoperatively and at postoperative 6 months and 12 months (all P<0.05). One patient experienced nonunion and was cured after secondary autologous iliac bone grafting combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) bone grafting. Three patients developed venous thrombosis of lower limbs and were cured with oral administration of rivaroxaban. One patient had mild knee flexion and extension limitation and was improved after manual release under femoral nerve block anesthesia and subsequent functional rehabilitation. Conclusion:For patients with Rorabeck type II PDFF after TKA, single locked-plate internal fixation combined with autologous iliac bone graft has advantages of short operation time, few intraoperative bleeding, satisfactory knee range of motion and functional recovery as well as significant improvement of bone mineral density.

Background There are a variety of microorganisms in ambient air, and susceptible people can be infected once contact with pathogenic microorganisms in the environment. In order to avoid the spread of pathogenic bacteria, disinfection is the simplest and most effective way of killing pathogenic bacteria in the environment to block the contact between pathogenic bacteria and humans. Sodium hypochlorite (NaClO) is the most widely used disinfectant, but its safety in ambient air disinfection is not clear yet. Objective To establish a model of bronchial epithelial cell (BEAS-2B) injury induced by NaClO, and to explore the mechanism of the toxic effect of NaClO disinfectants on BEAS-2B. Methods Cells were treated with concentration gradients of 0, 25, 50,100, 200, and 400 μmol·L⁻¹ of the diluted NaClO (100 mmol·L⁻¹) standard solution, respectively, and cell activity was measured by cell counting kit-8 (CCK-8) assay after 15 and 30 min. Cells treated with 0, 25, and 50 μmol·L⁻¹ NaClO were selected to observe the cell morphology under an inverted microscope, apoptosis was determined by flow cytometry Annexin V FITC / PI double staining to determine the final experimental concentration. The morphology of organelles such as mitochondria was observed under a transmission electron microscope. Mitochondrial membrane potential of the cells was detected by JC-1 staining. Intracellular Ca²⁺ concentration was measured with a Fluo-4 AM fluorescent probe. Total cellular reactive oxygen species (ROS) was detected with a 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe, cell mitochondrial ROS with a dihydroethidium (DHE) fluorescent probe, and lipid peroxidation intermediate malondialdehyde (MDA) with a commercial kit. Results Compared with 0 μmol·L⁻¹, NaClO treatment group, cell morphology did not change a lot after 25 μmol·L⁻¹ NaClO treatment for 30 min, and the cells began to wrinkle and become round after 30 min treatment with 50 μmol·L⁻¹ NaClO, showing about 70% of normal cell viability (P<0.01). So 30 min 50 μmol·L⁻¹ NaClO treatment was selected for the subsequent experiment. The experimental results found that compared with the 0 μmol·L⁻¹ NaClO treatment group, the number of apoptotic cells increased (P<0.05), the mitochondrial membrane potential decreased (P<0.01), the intracellular Ca²⁺ concentration increased (P<0.05), the cellular ROS level increased (P<0.05), the mitochondrial ROS level increased (P<0.01), and the MDA content increased (P<0.01) in the NaClO treatment group.. Conclusion The study has successfully established a model of BEAS-2B injury induced by NaClO, and found that NaClO can lead to cell damage by inducing apoptosis and oxidative stress in BEAS-2B cells. According to the results, there are two possible reasons. First, NaClO solves in water to form hypochlorous acid (HClO) which is oxidative and increases the intracellular ROS level after entering cells, leading to cellular oxidative stress. Second, HClO enters cells to directly attack the mitochondrial membrane, resulting in the imbalance of potential inside and outside the mitochondrial membrane, and apoptosis caused by Ca²⁺ efflux.