Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; methods ; Shoulder Dislocation ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective:To optimize the formula of Junduqing dispersible tablets .Methods:Using appearance , disintegration time and dispersing uniformity as the indices ,the types of filler, disintegrating agent and adhesive were optimized by single factor tests;the amount of filler and disintegrating agent was optimized by orthogonal experiments with the disintegration time as the index ; using ap-pearance and sticking as the indices , the single factor tests were also used to optimize the lubricant , and the adding method of disinte-grating agent was optimized using disintegration time as the index .Results: For 500 tablets, the amount of Junduqing extract was 61.25 g, microcrystalline cellulose (52.5 g) and dextrin (17.5 g) were used as the fillers, crospolyvinylpyrrolidone (8.75 g) and croscarmellose sodium (26.25 g) were applied as the disintegrating agents , 70% ethanol was the binder , magnesiumstearate (3 g) and talcum powder (2.25 g) were used as the lubricants , and stevioside (3.5 g) was the flavoring agent .Conclusion:The formula is reasonable and feasible ,which provides reference for the preparation of Junduqing dispersible tablets .

Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.

Objective To study the clinical significances of serum lipoprotein (LP),high sensitivity C- reactive protein (hs CRP),cystatin (Cys-C),apolipoprotein (Apo) in type 2 diabetic mellitus (T2DM) patients with early renal impairment.Methods Totally 96 patients were divided into two groups:50 cases in simple diabetic group (DM) aged 60-73 years,46 cases in diabetic nephropathy group (DN) aged 61-72 years,and 50 healthy persons as normal control group aged 61-68 years.Serum levels of LP(a),hs-CRP,Cys-C,ApoA1 and ApoB were detected.Results Serum levels of LP (a) [(214.8±182.3) mg/L vs.(113.1±76.2) mg/L],Cys-C[(0.95±0.16)mg/L vs.(0.46±0.17) mg/L],hs-CRP (2.57± 1.84) mg/L vs.(1.07±0.38)mg/L] and ApoB [(1.12±0.18) g/L vs.(0.81 ±0.15) g/L ]were higher in T2DM patients than in normal control group(all P＜0.01),while ApoA1 level was lower than in control[(1.02±0.17)g/L vs.(1.27±0.14)g/L,P＜ 0.01].The levels of LP (a) (455.6 ± 263.5 ) mg/L,Cys-C (2.14 ± 0.68 ) mg/L,hs-CRP (7.24±4.55)mg/L and ApoB(1.22±0.17)g/L in DN group were increased compared with DM group (all P＜0.01).Serum levels of ApoA1 were decreased in DN group compared with DM group [(0.88±0.17) g/L vs.(1.02±0.17) g/L,P＜0.01].The serum levels of LP (a) (r=0.487,P＜0.05),Cys-C(r=0.55,P＜0.05),hs-CRP(r=0.478,P＜0.01) and ApoB(r=0.505,P＜0.05) were positively correlated with urinary mAlb in T2DM patients,while ApoA1 was negtively related with mAIb(r=-0.52,P＜0.05).Conclusions The serum LP (a),Cys C,Apo and hsCRP could be sensitive markers of early renal impairment,and their combinatorial measurement offers more value in patients with T2DM.

Objective To understand the current circumstance of the surgical resident training bases in Beijing Methods The reassessment data of the 11 surgical resident training bases in Beijing were collected and analyzed. Results 73%(8/11)surgical resident training bases have passed the assessment; and 27%(3/11)have not completely reached the requirements The most prominent problems found in the reassessment were that the numbers of clinic and emergency patients in some departments;the qualification and teaching level of the instructors;the administration in the training process;the test after finishing the rotation and the training results, Conclusion Surical resident training bases criterion,instructor for resident training and administration in the training process are the most important factors which influence the surgical resident training results

Objective To investigate the changes and clinical significance of platelet parameters and the hemorheological parameters in patients with diabetic kidney disease(DKD). Methods One hundred and eight patients with diabetics were divided into simplicity diabetes mellitus ( SDM ) group with 41 cases, early diabetic nephropathy( EDN) group with 36 cases and clinical diabetic nephropathy( CDN) group with 31 cases according to 24 hours urine albumin excretion rate( UAER) ,and 26 healthy persons were included into this study as control group. The platelet parameters(including mean platelet volume(MPV),platelet volume distribution width(PDW),platelet volume(PCT),and PLT) and hemorrheology were measured in all groups. Results Levels of MPV,PDW,PCT and PLT in diabetics group were (9.80±1.14) fl,(18.00±0.99) fl,(0.21 ±0. 05)% and (186±47)×109/L respectively,in control group were(7. 70±1. 11) fl,(13. 90±1. 02) fl,(0. 16 ±0.05)% and (234±51)×109/L respectively,the differences were significant(P=0.043,0.039,0.040, 0. 035). Levels of MPV,PDW,PCT and PLT in SDM group were (8. 40±1. 07) fl,(16. 40±0. 79) fl,(0. 19 ±0. 04)% and (195±49)×109/L respectively,in EDN group were (10. 20±1. 23) fl,(18. 30±1. 02) fl,(0. 20 ±0. 06) % and (188±52)×109/L respectively,in CDN group were (11. 40±1. 14) fl,(19. 60±1. 21) fl,(0. 25 ±0. 05)% and (172±40)×109/L respectively,the differences were significant between the groups( P=0. 032,
0. 039,0. 041,0. 008). The levels of erythrocyte aggregation index,capillary plasma viscosity,low/medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index in diabetics group were 1. 86±0. 13,1. 40±0. 14,(13. 83±1. 62) mPa·s,(7. 79±0. 84) mPa·s,(6. 46±0. 77) mPa·s,7. 54±1. 03,4. 73±0. 74,4. 16±0. 69 and 0. 55±0. 03 respectively,in control group were 1. 38±0. 05,1. 21±0. 08,(9. 35±1. 22) mPa·s,(5. 88±0. 87) mPa·s,(5. 02±0. 86) mPa·s, 4. 00 ±0. 75,3. 12±0. 65,2. 76±0. 56 and 0. 68±0. 06 respectively,the differences were significant between the two groups( P=0. 034,0. 020,0. 018,0. 044,0. 016,0. 014) . Furthermore,the results of erythrocyte aggregation index, capillary plasma viscosity, low /medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index were significantly different in sub group of diabetes( P=0. 004,0. 002,0. 001,0. 004,0. 003,0. 041,0. 025,0. 009,0. 042) . Conclusion It is important to measure the platelet parameters and hemorrheology in diabetes kidney disease patients. The platelet parameters and hemorrheology may be the early indicators to diagnosis the diabetic nephropathy.

Objective To study the association of carotid atherosclerosis with high-sensitivity creative protein(hs-CRP),lipoprotein-a(Lp-a) and superoxide dismutase(SOD) in patients with chronic renal failure (CRF).Methods Seventy-one CRF patients were divided into Group A of 45 patients under maintenance hemodialysis and Group B of 26 patients without hemodialysis,and 20 healthy donor was Group C in this study.And 71 CRF patients were divided into carotid atherosclerosis group (43 cases) and non carotid atherpsclerosis group(28 cases) according to whether the carotid atherosclerosis plaque was detected out.Fortythree CRF patients presented carotid atherosclerosis including 17 patients with soft plaque,10 patients with hard plaque and the other 16 with mixed plaque.Color ultra-sound was used to measure the carotid intimal medial thickness(IMT) and define the type of plaque.Levels of hs-CRP,Lp (a) and SOD were detected and analyzed in this study.Results (1) Levels of hs-CRP,Lp-a,SOD and IMT were significantly different in group A ((7.39±2.25) ag/L,(428.43±102.25) mmol/L,(71.35±21.52) KU/L and (1.23±0.31) mm,respectively),group B((7.41±1.67) mg/L,(432.12±96.43) mmol/L,(68.14±15.25) KU/L and (1.18±0.26) mm,respectively),and group C ((2.11 ± 0.86) mg/L,(193.32 ± 62.31) mmol/L,(94.23 ± 21.13)KU/L and (0.61 ±0.22) mm,respectively),the differences were significant (F =2.998,2.783,2.032,2.802;P＜0.05).Plaque incidence was increased in group A(68.9％) and group B(69.2％) compared with group C (12.5％) with statistical significance (x2=17.863,17.989;P＜0.001).(2) Furthermore,for CRF patients,hsCRP and Lp-a were positively related to IMT in group A (r =O.436,0.279;P＜0.05) and group B (r =0.652,0322;P ＜ 0.05),SOD presenting negative relationship with IMT (r =-0.283,P ＜ 0.01 for group A,and r =-0.164,P＜0.05 for group B).(3) Level of hs-CRP and Lp-a in carotid atherosclerosis group were higher than those in non carotid atherosclerosis group((7.58±2.47) mg/L vs.(3.41±1.26) mg/L,(437.31±115.38) mmol/L vs.(256.24± 101.22) mmol/L),the differences were significant (t =2.917,2.583;P ＜0.05).Level of SOD in carotid atherosclerosis group was lower than that in non carotid atherosclerosis group ((68.43±13.36) KU/L vs.(76.22±17.12) KU/L),the difference was signifiant(t=2.156,P＜0.05).(4)Level of hs-CRP and SOD in patients with soft plaque and mixed plaque were statistically different from those in patients with hard plaque(F=4.210,2.056;P＜0.05).Conclusion The micro-inflammatory status,oxidative stress and disturbance of Lp-a metabolism are extensively existed in CRF patients and closely connect to each other.Therefore,they might correlate with the formation of plaques in carotidartery.

Objective To screen college students contacts of tuberculosis index cases among colleges located in Haidian District,Beijing,so as to provide evidence for the modification of screening strategies for college students.Method The purified protein derivative test (PPD) and chest X-ray examination were carried out in colleges,located in Haidian District from March 2015 to March 2016.The basic demographic characteristics,tuberculosis infection and detection of patients,etc were analyzed.Results A total of 88 cases of tuberculosis index cases were diagnosed,and 3 604 college students contacts were detected 16 pulmonary tuberculosis cases were detected among close contacts,and all patients were negative,the detection rate was 443.95/100 000.Among the 3 604 close contacts,the positive rate of PPD was 8.32％.With the increase of the diameter of the PPD reaction,the detection rate of tuberculosis patients increased significantly (xtrend =8.06,P ＜0.001).During the period of outbreak,the PPD positive rate and the detection rate of patients were significantly higher than that of non-outbreak period,and the difference was statistically significant(all P ＜0.05).Conclusions It is necessary to strengthen the screening of tuberculosis among college students,and to find out the infected persons and patients as early as possible,so as to prevent the outbreak of tuberculosis.

Objective To evaluate the early and midterm effect by retrospective analysis of the cone reconstruction in Ebstein′s anomaly. Methods From January 2012 through June 2016,16 patients with Ebstein′s anomaly underwent the cone reconstruction in our hospital. There were 7 males and 9 females at mean age(28.21 ± 11.88)years,including 12 patients of Carpentier B type,4 patients of Carpentier C type. There were 9 patients in New York Heart Association(NYHA)functional class Ⅲ,5 patients in NYHA functional class Ⅳand the others in NYHA functional class Ⅱ. All patients had Tricuspid insufficiency ,including 2 patients with Grade 2 ,10 patients with Grade 3 and 4 patients with Grade 4. All patients were followed up over a period of 6 to 51 months (mean:24.36 ± 10.71). By comparing the details of pre-operation with post-operation and post-operation with current stage,we analyze the outcomes of early and midterm effects. Results All patients are well survived. There were one patient recovering from the low cardiac output syndrome with adding the strength of the positive inotropic drug in the first day after operation ,and one patient recovering from bigeminy of ventricular prematurebeat with the aid of amiodarone and lidocaine the third day after operation. The remaining patients recovered smoothly. Early post-operative echocardiograms showed good right ventricular morphology and reduction in tricuspid regurgitation grade from(3.13 ± 0.62)to(1.75 ± 0.45)(P<0.001)with the functional class improved from(3.19 ± 0.66)to(2.00 ± 0.52)(P<0.001). After mean follow-up of(24.36 ± 10.71)months,the situation is improving furtherly with the tricuspid regurgitation grade reducing to(1.31 ± 0.48)(P=0.016)and the functional class rising to(1.50 ± 0.52) (P = 0.031). Conclusions This surgical technique for Ebstein′s anomaly can improve the function of tricuspid valve and the right ventricular morphology. It showed a satisfactory performance in the early and midterm results by enhancing the Cardiac function and life quality. But indications should be strictly grasped and more experiences need to be accumulated. Long-term effect need to be furtherly explored.

Objective To study the relationship between stress rise of blood glucose and the PEEL prognostic index of the patients with acute myocardial infarction, and provide the basis for a quick judgement and evaluation of prognosis to nurses. Methods Taking the 6.8,7.8 and 8.8 mmol/L as demarcation point to study the PEEL prognostic index in 59 patients with acute myocardial infarction, and compare the PEEL score value on two sides of each demarcation point. Results No significant difference in PEEL evaluation score when taking 6.8 mmol/L as the demarcation point, there was significant difference when taking 7.8 mmol/L as the demarcation point, PEEL score in blood glucose > 7.8 mmol/L group was higher than that of ≤7.8mmol/L group, so was when taking 8.8 mmol/L as the demarcation point. Conclusions There was instructive signifi-cance for nurses to observe a stress rise of blood glucose timely in evaluating the prognosis of patients with a-cute myocardial infarction. Nurses should strengthen disease observation and preventive nursing of admission patients whose fasting blood glucose are above 7.8 mmol/L as well their blood glucose monitoring.