Objective To observe the characteristics of electro-neurophysiology in diabetic patients with early peripheral neuropathy. Method The nerve conduction velocity ( NCV ) and quantitative sensory test (QST) were examined in 175 diabetic patients without clinical peripheral neuropathy and in 50 normal subjects, and their results were compared. Results In 175 diabetic patients, the abnormal ratio of NCV was 7% (13/175).While using QST,the abnormal ratio was 45% (79/175). There was significant difference between two methods (P< 0.01). Compared diabetic patients with normal subjects,there was no significant difference between motor conduction velocity and sensory conduction velocity (P > 0.05 ).While using QST, the threshold values of cold sensation, warm sensation, and thermalgesia showed significant difference between diabetic patients and normal subjects (P< 0.01). Conclusion QST is more sensitive than NCV in diagnosing diabetic peripheral neuropathy, which suggests that small nerve fibers are more likely to be damaged than large fibers in early stage.

OBJECTIVE To study and find reasonable methods of nursing care of incision through analyzing the risk factors in liver transplant patients.METHODS A total of 416 liver transplantation operations in our hospital from Sep 2004 to May 2006 were evaluated.The risk factors that resulted in the incision infection were considered.RESULTS The incision infection rate was decreased from 13.9% to 4.3% after improvement.CONCLUSIONS Nursing care is of great significance in preventing the incision infection in liver transplant patients.

Objective To evaluate the prognostic value of RAS association domain family 1A gene (RASSF1A) methylation in patients after hepatocellular carcinoma (HCC) hepatectomy.Methods A total of 260 patients with HCC who underwent hepatectomy were enrolled.HCC tissues and tumor adjacent tissues which were 2 cm away from the tumor edge of the patients were obtained.The clinicopathological data of patients were collected.The methylation of RASSF1A in HCC tissues and corresponding tumor adjacent tissues was determined by methylation specific polymerase chain reaction (PCR).The correlation between the expression rate of RASSF1A methylation and clinicopathological characteristics was analyzed by chi-square test.Log-rank test was performed to analyze the relation between RASSF1A methylation and overall survival rate.Univariate and multivariate Cox statistical techniques were used to identify the influence factors in the prognosis of HCC.Results Among 260 HCC tissues and corresponding tumor adjacent tissues,RASSF1A promoter hypermethylation was detected in 214 HCC tissues (82.3 ％) and 101 corresponding tumor adjacent tissues (38.8％),and the difference was statistically significant (x2 =102.824,P ＜ 0.01).There was no correlation between RASSF1A methylation and age,gender,liver cirrhosis,α-fetoprotein level,maximum diameter of tumor,Barcelona Clinic Liver Cancer (BCLC) stage,hepatitis B virus (HBV) infection,smoking and alcohol drinking (all P＞0.05).The 5-year overall survival rate of patients with negative RASSF1A methylation was 93％,while that of patients with positive RASSF1A methylation was 51 ％,and the difference in overall survival rate between the two groups was statistically significant (x2 =26.556,P ＜ 0.01).Univariate and multivariate Cox regression analysis indicated that liver cirrhosis,BCLC stage and RASSF1A methylation were the main influence factors in the death of patients with HCC after surgery (Wald=16.767,8.791,16.286; all P＜0.01).Conclusion RASSF1A methylation is not only one of the predictive factors of survival rate in patients with HCC after hepatectomy,but also an independent prognostic factor of HCC.

Objective To compare the impact of the sirolimus and tacrolimus on the tumor recurrence after liver transplantation due to HCC beyond Milan criteria.Method Sixty-one liver transplantation recipients due to HCC beyond Milan criteria,between Jan.2008 and Apri.2012,were randomized,with the informed consent,into two different immunosuppression groups: sirolimus group (n=30) and tacrolimus group (n=31).In tacrolimus group,tacrolimus was used as the basic immunosuppressant,methylprednisolone was discontinued within one month postoperatively,and mycophenolate mofetil was used within the dosage of 1.5 g/d accordingly.In sirolimus group,the immunosuppresive scheme was the same as that of the tacrolimus group within postoperative one month,and from that,tacrolimus was transferred to sirolimus.No antineoplastic agents were given before tumor recurrence.The tumor recurrence rate and the survival rate of the recipients were compared between the two groups.Result The median follow-up duration was 35.2 months (10.3～ 60.2).The tumor recurrence rate at postoperative year 1,2,3 and 4 in the sirolimus group (13.3％,36.7％,43.3％ and 53.3％) was significantly lower than that in the tacrolimus group (38.7％,67.7％,74.2％ and 77.4％),P ＜ 0.05 for all.The one-year survival rate in the recipients postoperation had no significant difference between sirolimus group and tacrolimus group (90.0％ vs.87.1％,P=0.438).The 2-,3-and 4-year survival rate in the recipients was significantly higher in the sirolimus group (53.3％,33.3％ and 20.0％) than that in the tacrolimus group (41.9％,22.6％ and 9.7％),P ＜ 0.05 for all.The liver function and renal function of the recipients at the postoperative year 1,2,3 and 4 showed no significant difference between the two groups,P＞0.05.Conclusion In comparison with tacrolimus,sirolimus could significantly reduce the tumor recurrence rate and increase the survival rate for the liver transplant recipients due to HCC beyond Milan criteria.

Objective To compare the significance of two blood glucose monitoring methods of eight-point and five-point after liver transplantation. Methods 160 patients after liver transplantation selected eight-point or five-point blood glucose monitoring methods randomly,each method had 80 patients.Blood glucose value one month after operation,incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection were compared. Results Eight-point and five-point blood glucose monitoring methods showed no difference in incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection.Rate of blood glucose to reach standard level 4 days,1,2,3,4 weeks after operation also showed no difference. Conclusions Comparison of eight-point and five-point blood glucose monitoring methods supply the information needed in clinic,reduce the burden of patients,strengthen the compliance of patients,it has important practical significance for clinical work.

OBJECTIVEIn order to prove a basis for rational exploitation and utilization of the herb, the charaeteristic feature for Acanthus iliciflius was studied.

METHODThe botanical and pharmacognostic features of the collected original plant were stadied.

RESULTA. ilicifolius showed obvious pharmacognostic characters. The aerate cells of the root were upgrowth. and four vascular bundles were found in leaf venation.

CONCLUSIONThe distinct characteristic features revealed in this studies can serve as evidence for the identification of A. ilicifolius.

Acanthaceae ; anatomy & histology ; chemistry ; Chromatography, Thin Layer ; Pharmacognosy ; Plant Leaves ; anatomy & histology ; chemistry ; Plant Roots ; anatomy & histology ; chemistry ; Plant Stems ; anatomy & histology ; chemistry ; Plants, Medicinal ; anatomy & histology ; chemistry

OBJECTIVETo evaluate the clinical effect of one stage anterior and posterior fusion and posterior fixation for the treatment of thoracic and lumbar spinal tuberculosis.

METHODSFrom March 2003 to December 2006, one stage anterior and posterior fusion and posterior fixation were performed to treat 23 patients who suffered thoracic and lumbar spinal tuberculosis. There were 15 males and 8 females with an average of 37.6 years (17-61 years). 4 cases' tuberculose focus were in thoracic vertebra, 8 cases in thoracolumbar, 11 cases in lumbar.

RESULTSThe average follow up period was 28.7 months (9-40 months). The symptoms of all patients had primarily relieved and the patients can ambulate at 2-3 weeks after treatment. At the 6th after operation, the X-ray showed interbody fusion. Frankel grading of 16 patients with incomplete paraplegia were improved averagely 1.62 grades. The major complications including 2 cases of temporary sinus formation, 1 case of fixtor breaking and 1 case of recurring (owing to an inadequate postoperative chemotherapy).

CONCLUSIONOne stage anterior and posterior fusion and posterior fixation can effectually resect focus, rebuild stability of spine, promote interbody fusion and recovery of incomplete paraplegia in treating thoracic and lumbar spinal tuberculosis.

Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Spinal Fusion ; Thoracic Vertebrae ; surgery ; Treatment Outcome ; Tuberculosis, Spinal ; surgery ; Young Adult

Colorectal cancer (CRC) is a common malignancy burdening people globally, with increasing morbidity and mortality nowadays, due to the alternation in the diet type and lifestyle in modern society. Berberine, a type of benzylisoquinoline alkaloid, is widely present in numerous medicinal plants, particularly including Coptidis Rhizoma. Mounting evidence reveals that berberine possesses an array of pharmacological effects, such as anti-inflammation, anti-bacterium, anti-cancer, anti-diabetes mellitus and so on. In particular, berberine exhibits substantial inhibition on various types of cancers including CRC. Hereby, we sought to systematically review the suppressive effect of berberine on CRC through the diminishment of the proliferation and metastasis, induction of apoptosis, arrest of cell cycle, regulation of inflammatory reaction, the reverse of chemotherapeutic resistance and restoration of gut microbiota in CRC, so as to shed light on the in-depth mechanisms underlying the treatment of CRC with berberine in the clinical setting.

Medical professionalism is the perfect combination of medical science spirit, medical humanities spirit and professional spirit. As a special group in medical colleges and universities, medical interns should attract teachers' attention due to the occupational confusion caused by the epidemic. Taking the brave "countermarching people" as examples, establishing the correct value orientation, strengthening the study of professional expertise, building a trinity teaching system of medical professionalism, and exploring ESPCS (explain-simulate-practice-communication-support) practice teaching are effective measures to reshape the professionalism of medical interns.

Brown adipose tissue (BAT) increases energy consumption by directly dissipating stored energy in the form of heat through the role of uncoupling protein (UCP1). Recent studies have found that brown adipocytes may also regulate metabolism through autocrine, paracrine, and endocrine mechanisms. A growing body of evidences have shown that the BAT has a close relationship with bone metabolism, in which BAT secretes a variety of factors to regulate bone metabolism, while bone also secretes a variety of bioactive substances to control BAT function. In addition, BAT may indirectly participate in bone metabolism through muscle-mediated regulation or SNS activity and improvement of body metabolism, thus forming a BAT-skeletal axis. In this paper, we try to explain the relationship between brown adipose tissue and bone, and to discuss their interactive mechanisms.