Objective To investigate the relationship of plasma homocysteine and the polymorphism of MTHFR gene with ischemic stroke in type 2 diabetes. Methods Serum Hcy ,folic acid and the polymorphism of MTHFR gene were compared among 81 T2DM patients with brain infarction (T2DM+BI) and 325 T2DM patients without brain infarction (T2DM ). Results All the genotypes of T2DM group and T2DM+BI group followed the hardy‐weinberg law. There was no significant difference in the frequency of mutant alleles (T) in site 677 of MTHFR gene and in frequency of TT genotype between the groups of T2DM and T2DM + BI (64.15% vs 60.15% and 42.5% vs 34.5% ,P > 0.05 ). The concentration of Hcy was significantly higher in patients with TT genotype than with CC genotype (14.4 ± 7.86) vs (10.58 ± 3.37)mmol/L(P<0.01). Conclusion There is no correlation between polymorphism of MTHFR gene and stroke in T2DM patients. The mutation of MTHFR C677T is associated with hyperhomocysteinemia.

Lung ultrasound(LUS)has gained increasing popularity among intensivists in recent dec-ades.Although limited by the presence of air,LUS has proved to be useful in the evaluation of a number of different acute and chronic conditions,such as pneumonia,pneumothorax,acute lung injury,alveolar-intersti-tial syndrome,pleural effusion,etc,and showed a relatively higher sensitivity,specificity and diagnostic accu-racy compared to routine radiographic imaging.It is also critical in improving the safety of pleural interven-tional procedures.The most common signs for diagnosing and differential diagnosing include the pleural line, lung sliding,the A-line,the quad sign,the sinusoid sign,the fractal,and tissue-like sign,the B-line,lung rock-ets,abolished lung sliding with the barcode sign,the lung point,the dynamic air bronchogram,etc.The BLUE-protocol allows differential diagnosis of acute respiratory failure.LUS is a feasible technique that can be used routinely and integrated into clinical practice in the fields of intensive care,emergency care,respirato-ry and general medicine.

Objective To explore influence of comfort care on life quality of breast cancer patients undergoing chemotherapy. Methods Hospitalized breast cancer patients(80 eases) after modified radical mastectomy were selected by convenience sampling method.They were randomly divided into the intervention group and the control group.The control group received conventional care.The intervention group was given comfort care based upon conventional care.The quality of life questionnaire-core 30 (QLQ-C30) by European organization for research and treatment of eancer(EORTC),hospital anxiety and depression scale (HADS) and self-designed questionnaire of satisfaction degree with nursing job were adopted for evaluation of the two groups. Results There was no significant difference in the life quality of patients between two groups before intervention (P＞0.05),but statistical difference was seen after intervention (P＜0.05).The incidence rate of depression and anxiety after the intervention in the intervention group was significantly lower than that of the control group (P＜0.05) and the satisfaction degree with nursing job was significantly higher (P＜0.05). Conclusions Comfort nursing intervention can improve the quality of nursing service,reduce anxiety and depression,improve the life quality of patients.

Objective To observe the biomechanics of the anterior and posterior interosseous talo-calcaneal ligaments (ITCLs) . Methods Load-displacement characteristics of the subtalar joint were studied in 12 cadaver specimens whose ankle joints were mutilated. The ankle articular surfaces of the talus and the post-calcaneus were exposed. Bone blocks were then embedded in polymethylmethacrylate. The an-terior ITCLs were abscised in 6 of them, and the posterior ITCLs in the other 6. A multi-functional biome-chanical machine was used to perform the biomechanical tests on the specimens. Results When the anterior ITCLs were cut, the tali moved to the anterior-lateral side. When the posterior ITCLs were cut, the tali mostly moved to the anterior-interior side. Conclusions The anterior and posterior ITCLs have dif-ferent roles in maintaining stability of the subtalar joint. Since the posterior ITCLs seem more important than the anterior ones, they should have priority in ITCL reconstruction.

OBJECTIVE:To summarize the key issues such as the drug waste and the phone calls affecting the working efficiency in pharmacy intravenous admixture service(PIVAS)and to put forward countermeasures so as to improve the working quality there.METHODS:The records about the drug waste in PIVAS and the phone calls that affected the working efficiency from clinical departments were analyzed statistically.RESULTS:Dispensing error and drug return were the main factors accountable for the drug waste in PIVAS.The proportion of phone calls from clinical departments demanding drug bills and drug dispensing was the highest,which greatly affected the working efficiency in PIVAS.CONCLUSIONS:The clinical staff should be informed not to make the unnecessary calls to PIVAS so as to improve the working quality in PIVAS.

The aim of informed consent is to regard patients as the centre of medical service.Physician-patient communication is an effective way to improve the construction of a harmonious physician-patient in medical practice,so more attention should be paid to the communication.

BACKGROUND:Computer-assisted navigation technique has been widely applied in total knee arthroplasty. However, whether computer-assisted navigation total knee arthroplasty is better than traditional total knee arthroplasty remains unclear. OBJECTIVE:To systemical y evaluate and compare the limb and prosthesis alignment restoration post computer-assisted navigation and traditional total knee arthroplasty. METHODS:The PubMed/Medline, EMBASE, Cochrane CENTRAL, ScienceDirect database were searched from established to June 2013 and the randomized control ed trials about computer-assisted navigation and traditional total knee arthroplasty were selected. Meta analysis was performed with Rev Man 5.2 software. The evaluating data included the hip-knee-ankle mechanical axis or tibiofemoral angle, femoral prosthesis coronal angle, femoral prosthesis sagittal angle, tibial prosthesis coronal angle, and tibial prosthesis sagittal angle. The malalignment was defined as a deviation 2° or 3° from the natural line. RESULTS AND CONCLUSION:19 randomized control ed trials involving 2 654 cases (3 392 knees) were included in this study. Meta-analysis showed that, the limb alignment restoration post computer-assisted navigation was significantly better than traditional total knee arthroplasty (3°, P<0.000 01 and 2°, P=0.000 8). The 3° of femoral prosthesis coronal angle deviation post computer-assisted navigation was significantly superior to traditional total knee arthroplasty (P=0.002), while the 2° deviation had no significant difference between the two surgeries (P=0.290). The 3° deviation of femoral prosthesis sagittal angle post computer-assisted navigation was significantly better than traditional total knee arthroplasty (P=0.040);however, the 2° deviation had no significant difference between the two surgeries (P=0.950). 3° and 2°tibial prosthesis coronal angle deviation post computer-assisted navigation was significantly superior to traditional total knee arthroplasty (3°, P=0.030);the 2° deviation had no significant difference between the two surgeries (P=0.260). Computer-assisted navigation has better limb alignment, femoral and tibial prosthesis alignment 3° deviation than the traditional total knee arthroplasty, but the 2° deviation of femoral prosthesis coronal angle, femoral prosthesis sagittal angle, and tibial prosthesis sagittal angle had no significant difference between the two surgeries.

Animal models of pancreatic cancer are important for the experiments of pancreatic cancer research.An ideal an- imal model of pancreatic cancer provides effective tool for exploring the tumorigenesis of pancreatic cancer.This paper summari- zes the methods for establishing mouse model of pancreatic ductal adenocarcinoma and discusses interpretd the advantages and disadvantages of different models.

Adult ; Aged ; Female ; Heart Neoplasms ; pathology ; Heart Valves ; pathology ; Humans ; Lymphangioma ; pathology ; Middle Aged

Objective To explore the feasibility, safety and advantage of thoracoscopes pulmonary bulla resection without thoracic closed drainage tube according to the fast track surgery (FTS) theory. Methods The clinical data of 53 patients with pulmonary bulla were retrospectively analyzed. Among them, 29 patients underwent the thoracoscopes pulmonary bulla resection without thoracic closed drainage tube (FTS group), and 24 patients underwent the thoracoscopes pulmonary bulla resection with thoracic closed drainage tube (tradition group). The oxygenation index at 24 h after operation, visual analogue score (VAS) at 24, 48 and 72 h after operation, postoperative complications, postoperative hospital stay and hospital costs were compared between 2 groups. Results There was no statistical difference in oxygenation index at 24 h after operation between FTS group and tradition group:(312.4 ± 16.4) mmHg (1 mmHg=0.133 kPa) vs. (330.6 ± 13.2) mmHg, P>0.05. The VAS at 24, 48 and 72 h after operation in FTS group was significantly lower than that in tradition group:(2.6 ± 1.1) scores vs. (4.3 ± 1.6) scores, (1.6 ± 0.9) scores vs. (3.8 ± 1.4) scores and (0.8 ± 1.0) scores vs. (2.9 ± 1.4) scores, and there was statistical difference (P<0.05). The incidence of postoperative complications, postoperative hospital stay and hospital costs in FTS group were significantly lower than those in tradition group:13.8%(4/29) vs. 37.5% (9/24), (3.2 ± 0.9) d vs. (6.2 ± 1.2) d and (1.3 ± 0.3) × 104 yuan vs. (1.5 ± 0.4) × 104 yuan, and there were statistical differences (P<0.05). Conclusions FTS used in thoracoscopes pulmonary bulla resection is feasible and safe, and has certain advantages.