Objective To investigate the changesof glomerular filtration rate(eGFR)in type 2 diabetic patients with normal serum creatinine(Scr)and serum cystatin C(Cys-C). Methods A total of 166 patients with type 2 diabetes mellitus admitted into our hospital from January 2014 to September 2015 were enrolled in this study and divided into three groups according to the level of Scr and Cys-C:T2DM patients with normal Scr and Cys-C (normal group,n =109),T2DM patients with normal Scr and high level of Cys-C (high Cys-C group,n=40),and T2DM patients with high levels of Scr and Cys-C (high Scr Cys-C group,n=17). Normal group were further divided into two subgroups according to the level of eGFR:eGFR≥90 ml/(min·1.73 m2 )subgroup and eGFR<90 ml/(min·1.73 m2 )subgroup.Clinical characteristics and laboratory datawere collected in all subjects. eGFR were measured by 99mTc-DTPA nephro-dynamic imaging. Results The average value of eGFR were significantly different in normal group(82.68±13.45)ml/(min·1.73 m2 ),high Cys-C group(67.93 ±14.01)ml/(min·1.73 m2 )and high Scr,Cys-C group (50.54±15.10)ml/(min·1.73 m2 ). In normal group,the proportion of patients with eGFR equal or greater than 90 ml/(min·1.73 m2 )was 26.6%,patients with eGFR ranged from 60 to 89 ml/(min·1.73 m2 )was 72.5%,patients with eGFR ranged from 30 to 59 ml/(min·1.73 m2 )was 0.9%. After follow-up for three months,in normal group,the proportion of patients with CKD stage1 was 4.6%,patients with CKD stage 2 was 34.9%,and patients with CKD stage 3 was 0.9%.Multivariate logistic regressionanalysis in normal group showed that female,older age,higher TC,lower LVEF were risk factors for eGFR decline (P <0.05). Conclusion In T2DM patients with normal Scr and Cys-C, 73.4% of them had mild to moderate eGFR decline,and 40.4%entered CKD stage in this study.eGFR should be evaluated especially in T2DM patients with risk factors including female,older age,higher TC and lower LVEF.

BACKGROUND: Microarc oxidation (MAO) is a break-through anodyzing technology for forming oxide films on valve metal.Use of this technology allows thick, porous oxide layers to be formed on the surface of pure titanium. Few biocompatibility reports using this treatment have been found.OBJECTIVE: The blood compatibility of a novel surface modified titanium substrata biomaterial using MAO was investigated.DESIGN: Positive and negative control, contrast observation and gold standard control.SETTING: Wuhan Union Hospital.MATERIALS: A healthy male adult New-Zealand rabbit, weighing 2.5 kg and ordinary grade, was selected in this study.Pure titanium sticks TA1 (Baoji Yingnaite Non-ferrous Metal Co., Ltd.), MAO-Ti and 20 g/L potassium oxalate were also selected in this study.METHODS: The study was carried out in the Laboratory of General Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology in May 2006. ① Materials: Titanium substrate of 10 mm in diameter and 2 mm in depth was put in an electrolyte which was quipped with deionized water, dibasic sodium phosphate, and ethanoic acid calcium for MAO treatment for 10 minutes. ② Groups: Three groups were analysed: test group, negative control group and positive control group. Test group: MAO-Ti was dipped in 10 mL saline; Positive control group: 10 mL deionized water was added in each tube; Negative control group: 10 mL saline was added in each tube. ③ Operation: Fresh whole blood was collected from rabbit and then mixed with the liquids in the three groups respectively after anti-coagulation. In addition, UV-Visible Spectrophotometer was used to evaluate the hemolytic ratio. A hemolytic ratio below or equal to 5% indicated that this novel material fitted the requirements. On the contrary, a hemolytic ratio higher than 5% proofed the existence of a hemolyzation.MAIN OUTCOME MEASURES: The hemolytic ratio of materials in three groups.RESULTS: The hemolytic ratio of the test group was 0.90%. The result indicated that this new material had no haemolysis effect.CONCLUSION: The material does not resolve red blood cells and is coincident with the international and governmental standard.

Objective To study the effects of environmental exposure to rare earth elements REEs on intelligence of children. Methods Intelligence quotient IQ were examined with Drawing a Man Test in 464 children aged 7-10 years living in RE ore containing area and the control area in Xunwu country Jiangxi province China. Fifteen kinds of REEs in 112 blood samples 69 samples from RE ore area and 43 samples from the control area  were detected by inductively coupled plasma source mass spectrometry ICP-MS. Results All 15 kinds of REEs were detected in each sample the content of blood REEs of the children in the rare earth area 2.18?1.08 ng/g was 1.73 times of that of the children in the control area 1.26?0.35 ng/g the difference was significant P

Epstein-Barr virus (EBV) is a human herpesvirus associated with important human diseases, including infectious mononucleosis syndrome, malignant lymphoma, and nasopharyngeal carcinoma. The mechanism of EBV entry into host cells remains a subject of intensive research. After decades of study, researchers have identified several key proteins and different patterns of EBV intrusion into host cells. The viral surface glycoproteins, gp350/220, gp42, gB, gH, and gL, are involved in interactions with the CR2 receptor on the surface of B lymphocytes during viral entry. However, the majority of epithelial cells lack CR2 receptor expression, which makes viral invasion much more complex than in B lymphocytes. Three different models have been proposed to explain how EBV enters epithelial cells: (1) "transfer of infection", mediated by B lymphocytes or Langerhans cells; (2) EBV utilizes its own proteins during the process of fusion with the cell membrane; and (3) progeny virions arising from EBV-infected epithelial cells cross lateral membranes into adjacent epithelial cells. This review will discuss the relevant mechanism of viral entry into B lymphocytes and epithelial cells during EBV infection.
Animals ; B-Lymphocytes ; virology ; Epithelial Cells ; virology ; Epstein-Barr Virus Infections ; virology ; Herpesvirus 4, Human ; genetics ; physiology ; Humans ; Viral Proteins ; genetics ; metabolism ; Virus Internalization

OBJECTIVETo discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.

METHODSFrom July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.

RESULTSNo severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.

CONCLUSIONSMost of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandible ; abnormalities ; surgery ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; prevention & control ; Young Adult

OBJECTIVETo study the technical refinements of intraoral reduction malarplasty to prevent postoperative drooping of the cheek.

METHODSTwenty-four patients with prominent zygomatic complex underwent reduction malarplasty from January 2005 to January 2006. In all these cases, the osteotomized malar complex was repositioned superioposteriorly, and the perioral muscles and periosteum were redraped accordingly and fixed on deep temporal fascia.

RESULTSSymmetry between the left and right complexer were achieved, with a decreased midfacial width of 10.22-/+1.97 mm. During postoperative follow-up of 4 to 6 months, all the patients had satisfactory operative results, and reported no postoperative drooping of cheek.

CONCLUSIONThis method of superioposterior reduction of the perioral muscles and periosteum is simple and effective, but the long-term result needs to be observed.

Adolescent ; Adult ; Female ; Humans ; Mandible ; surgery ; Osteotomy ; methods ; Postoperative Complications ; prevention & control ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome ; Zygoma ; surgery

OBJECTIVETo establish a rabbit model of orbital hypertelorism for plastic and reconstructive surgery and evaluate the surgical effects.

METHODSOrbital osteotomies and medial translocation was performed in 16 New Zealand rabbits (4 to 6 months old) by combined intracranial-extracranial approach. The interorbital distance (IOD) and bone healing between the orbits were evaluated with gross measurement. X-ray and histological examinations were performed immediately and 12 weeks after the operation.

RESULTSThe average IOD of the rabbits was 0.74 cm after completion of the operation, but increased to 0.96 cm 12 weeks after the operation, showing significant relapse of orbital hypertelorism (P<0.01).

CONCLUSIONThe IOD can be decreased successfully in this rabbit model.

Animals ; Disease Models, Animal ; Female ; Hypertelorism ; etiology ; surgery ; Male ; Rabbits ; Reconstructive Surgical Procedures ; methods ; Surgery, Plastic ; methods

OBJECTIVETo introduce a method to reduce the volume of medial gastrocnemius for calf reduction.

METHODSTibial nerve and nerve branches were dissected and explored at popliteal region for morphometry in 20 cadaver-legs. The length, width and the origination position of the nerve to the medial gastrocnemius were measured and recorded. During surgery, the nerve to the medial gastrocnemius muscle were explored and cut off. The circumference and the shape of the leg were measured and recorded.

RESULTSThe nerve innervating the medial gastrocnemius originates from the tibial nerve which lies in the fat tissue of popliteal space. In 8 cases (40%) there is only 1 branch to the medial gastrocnemius, and in 4 cases (30%) there are 2 branches. In other 4 cases (30%) the medial sural cutaneous nerve originate from the nerve to the medial gastrocnemius. The nerve to the medial gastrocnemius muscle branch off at (- 6.6 +/- 13.7) mm; the width is (2.3 +/- 0.4) mm; the length is (42 +/- 12) mm. Neurectomy of the nerve to the medial gastrocnemius was performed in 16 cases. After operation, the circumference of the leg was reduced (3.5 +/- 1.1) cm averagely and the curve of the medial line of the calf was reduced. There is no obvious swelling in these cases and the patients were able to walk immediately after operation. The function of the leg was not obviously influenced.

CONCLUSIONSNeurectomy of the nerve to the medial gastrocnemius muscle was a safe and effective method for calf reduction.

Adult ; Bariatric Surgery ; Female ; Humans ; Leg ; surgery ; Male ; Muscle Denervation ; Muscle, Skeletal ; innervation ; Sural Nerve ; surgery ; Young Adult

OBJECTIVETo investigate the association of single nucleotide polymorphisms (SNPs) of the peptidylarginine deiminase IV (PADI4) and HLA-DRB1 shared epitope (SE) alleles with rheumatoid arthritis(RA) in a Chinese population.

METHODSFour exonic SNPs of the PADI4 gene (PADI 4_89*A/G, PADI 4_90*C/T, PADI 4_92*C/G and PADI 4_104*C/T) were genotyped in 67 unrelated patients with RA and 81 healthy controls, using cDNA sequencing and T vector cloning. HLA-DRB 1*01, *04 and *10 subtypes were determined by polymerase chain reaction with sequence specific primers (PCR-SSP).

RESULTSThe distributions of the 4 SNPs were different in the two groups, and increased RA susceptibility was significantly associated with the minor alleles of PADI 4_89*G (P was 0.023), PADI 4_90*T (P was 0.004), PADI 4_104*T (P was 0.003), and the haplotypes carrying the 4 minor alleles (P was 0.008). HLA-DRB1 SE alleles are composed of HLA-DRB 1*0101, *0102, *0401, *0404, *0405, *0408, *0409, *0410 and *1001. Individuals carrying the SE alleles were associated with increased RA susceptibility (P was 0.002). Individuals carrying both the SE alleles and minor alleles of the 4 SNPs were more susceptible to RA than individuals carrying neither the minor SNP alleles nor the SE alleles.

CONCLUSIONThe PADI4 SNPs and haplotypes are associated with RA susceptibility in Chinese. HLA-DRB1 shared epitope is also an important risky factor for RA. There may exist certain synergistic effect between the PADI4 minor alleles and the HLA-DRB1 shared epitope.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Arthritis, Rheumatoid ; genetics ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Epitopes ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Hydrolases ; genetics ; Male ; Middle Aged ; Phenotype ; Polymorphism, Single Nucleotide ; Protein-Arginine Deiminases

OBJECTIVETo evaluate a modified Mitchell's technique for epispadias repair.

METHODSThree patients with epispadias were undergoing the treatment. It was performed to form a penile pedicled flap or scrotal mediastinum flap for the repair of the urethra and the urine was drained through a perined "U" shaped stent.

RESULTSAll of the patients were successfully treated in one-stage with a good appearance and a matching opening of the urethra.

CONCLUSIONThe above mentioned technique could be a good method for epispadias repair.

Drainage ; Epispadias ; surgery ; Humans ; Male ; Penis ; surgery ; Stents ; Surgical Flaps ; Urethra ; surgery ; Urologic Surgical Procedures, Male ; methods