One hundred and thirty-six adult patients with type 2 diabetes ( ≥40 years, body mass index > 24) were assigned to the low-dose Mefformin, high-dose Mefformin, and control groups. Plasma lactic acid level was detected with ultraviolet enzyme kinetics assay. Our data showed that plasma lactic acid of the low-dose or high-dose mefformin group was significantly higher than the control group (2.314 vs. 2.511, P<0.05 ), although there was no significant difference between the low-dose and the high-dose Mefformin group. In all the 3 groups, increased lactic acid ( > 2. 2 mmol/L) was found in some patients ( Mefformin group vs. Control group: X2 = 7.43, P < 0.05 ), and no lactic acid > 5.0 mmol/L was found. Insulin resistance index and hemoglobin Alc were similar between the 3 groups. Thus, mefformin may not increase the risk of lactic acidosis in diabetic patients with normal cardiorespiratory and renal function.

AIM: To observe the effect of intraocular lens ( IOL) implantation on visual acuity and contrast sensitivity in patients with cataract.
METHODS: Fifty - eight cases ( 72 eyes ) cataract patients with regular cornel astigmatism, in our hospital from May 2014 to May 2015 were randomly divided into two groups to undergo phacoemulsification and IOL implantation: the observation group: 29 cases (36 eyes) received multifocal toric IOL implantation; the control group: 29 cases (36 eyes) received monofocal toric IOL implantation. Uncorrected distance visual acuity ( UCDVA), uncorrected near visual acuity ( UCNVA), best corrected distance visual acuity (BCDVA), the best corrected near visual acuity ( BCNVA ), total eye astigmatism, and the dark contrast sensitivity were observed for these patients at 1 and 6mo after cataract surgery.
RESULTS: There were no statistical significant difference between the two groups at postoperative 1, 6mo on UCDVA, BCNVA, BCDVA and total eye astigmatism(P>0. 05). UCNVA of observation group at 1 and 6mo were better than those of control group ( P <0. 05); there were statistically significant difference in high frequency comparison at the sixth postoperative months (P<0. 05).
CONCLUSION: Both monofocal toric IOL implantation, and aspheric multifocal toric IOL implantation for cataract with regular corneal astigmatism are effective to improve visual acuity. But the latter treatment would contribute to the improvement of uncorrected near visual acuity and the dark contrast sensitivity.

Acupuncture Therapy ; methods ; Adult ; Ankle ; Female ; Humans ; Male ; Middle Aged ; Stress Disorders, Traumatic, Acute ; therapy ; Wrist

Objective To study the MRI manitestation of juvemle acute pure cartilage fracture of the knee joint.Methods The MRI changes of cartilage,subcartilage low signal line and subcartilage bone were analysed retrospectively in 26 juvenile patients with acute pure cartilage fracture confirmed by arthroscopy.Sagittal and coronal MRI scanning were performed in 26 patients.Using fast low angle shot fat saturation T_1-weighted image(FLASH-FS-T_1WI)sequences,spin echo T_1-weighted image(SE-T_1WI)and fast imaging with steady-state precession three dimensional fat saturation T_2-weighted image(FISP-3D-FS- T_2WI)sequences in sagittal plane,SE-T_1WI and multi echo data image combination T_2-weighted imaging (MEDIC or ME-T_2WI)in coronal plane.Using ME-T_2WI sequence,axial plane MRI scanning in 5 patients.Results Twenty-seven sites of 26 patients include 8 patella,7 femoral medial condyle, 11 femoral lateral condyle and 1 tibial plateau.Three types pure cartilage fracture were observed,totally defect of the cartilage in 7 sites(include 3 patella,2 femoral medial condyle,1 femoral lateral condyle and 1 tibial plateau),fissuring fracture in 3 sites(include 2 femoral medial and 1 femoral lateral condyles), superficial defect of the cartilage in 17 sites(include 5 patella,3 femoral medial and 9 femoral lateral condyle).Corpus liberum was found in 21 patients'knee joints by arthroscopy,but only 3 cases by MRI. Bone bruise was detected,and subcartilage low signal lines were normal.Conclusion Using FLASH-FS- T_1WI,SE-T_1WI,FISP-3D-FS-T_2WI and ME-T_2WI sequences,sagittal and coronal MRI scanning in femoral and tibial plateau pure cartilage fractures,and using ME-T_2WI sequence axial scanning in patella r cartilage fractures may show the position,extension and types of the acute pure cartilage fracture of the knee joint. MRI is the hest non-invasive method for studying cartilage fracture.

Contraindications ; Humans ; Infant ; Infant, Newborn ; Promethazine ; adverse effects

Objective To investigate the clinical efficacy of ultrasound-guided and nerve stimu-lator-guided modified fascia iliaca compartment block combined with popliteal fossa sciatic nerve block in patients undergoing unilateral great saphenous varicose veins surgery.Methods Sixty patients, male 32 and female 28,aged 42-76 years,ASA Ⅰor Ⅱ,scheduled for unilateral great saphenous var-icose veins surgery were randomly divided into two groups (n =30 each):modified fascia iliaca com-partment block with popliteal fossa sciatic nerve block group(group N)and epidural anesthesia(group E).Firstly,popliteal fossa sciatic nerve block was performed in group N.Then confirmed iliac fascia and femoral nerve position on the ultrasonic image and the femoral nerve was blocked.The 1% lido-caine 10 milliliters and 0.5% ropivacaine 10 milliliters were injected in the fascia iliaca compartment block from medial border of sartorius to upward site of femoral artery.Meanwhile,the ultrasonic probe was moving inside in the level of inguinal ligament.The SBP,DBP and HR were recorded be-fore block(T0 ),10(T1 ),30(T2 )and 60 minutes(T3 )after block.The block working time and onset time of sensory block,use of ephedrine after anesthesia,anesthesia efficacy and the postoperative ad-verse reactions in the last 48 hours ,including nausea,vomiting,headache and urinary retention, were also recorded.Results Compared with T0 ,the SBP and DBP was significantly decreased at T2 in group E(P <0.05).Compared with group E at the same time,the SBP and DBP was significantly higher at T2 in group N(P <0.05).The onset time of sensory block was significantly shortened and the use of ephedrine after anesthesia was also less in group N(P <0.05 ).Group E was better than group N in the whole anesthesia efficacy (P <0.05),but there was no significant difference in the ex-cellent rate of anesthesia efficacy between the two groups.The incidence of postoperative urinary re-tention was significantly decreased in group N(P <0.05)and there was no significant difference of the rate of nausea,vomiting and headache.Conclusion Modified fascia iliaca compartment block with popliteal fossa sciatic nerve block has excellent anesthetic quality in patients undergoing unilateral great saphenous varicose veins surgery,which ensures more stable hemodynamics less side effects and more indications when compared with epidural anesthesia.

Objective:To analyze and evaluate the quality control of Radix Aucklandiae in Xianglian preparation and develop a new quality control method for the preparation through standard testing and exploration study on 127 batches of samples .Methods:Ac-cording to the mandatory method , Radix Aucklandiae was identified by TLC .In the exploratory research , the volatile compounds in Xianglian preparation was analyzed by SPME/GC-MS, and the GC-MS fingerprints of volatile compounds in Xianglian preparation with different dosage forms were established .The contents of costunolide and dehydrocostuslactone in Xianglian preparation were determined by UPLC.Results:According to the current quality standard , all the batches of samples met the standard with the qualified rate of 100%.The composition of volatile compounds in different dosage forms was similar , while the relative contents were quite different . The contents of costunolide and dehydrocostuslactone in Xianglian preparation were different .Conclusion: The exploratory research provides reference for the further revision of drug standard and monitoring quality of the preparation .

Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.

Objective To investigate the effect of Bunao capsule on learning,memory and antioxidative abilities of rats with Alzhheimer’s disease(AD)induced by D-galactose combined with amyloid β-protein(Aβ25-35 ),and provide experimental basis for the prevention and treatemtn of AD. Methods A total of 90 SD male rats were randomly divided into model control group,piracetam group,sham operated group,Bunao capsule(0.79,1.58,3.15 g·kg-1 )groups(n= 15 each).The rat models were established by intraperitoneal injection of D-galactose and injection of Aβ25-35 into the bilateral lateral cerebral ventricle.Then rats were given corresponding drugs by gavage in different groups for 8 weeks.The learning and memory abilities were meseured by Morris water maze test.The morphology of brain cells was observed by HE staining.The activities of glutathione peroxidase(GSH-Px)and superoxide dismutase( SOD),and the malondialdehyde( MDA)contents in the brain tissues were measured by spectrophotometry. Results The target quadrant residence time was(20.39±7.75)s and(20.82±5.09)s in Bunao capsule (1.58,3.15 g·kg-1 )groups,which were significantly increased as compared with that in model control group[(12. 35 ± 6.95)s](P<0.01).Brain nerve cell morphology in Bunao capsule(1.58,3.15 g·kg-1 )groups was obviously improved as compared with that in model control group,and was close to that in sham operated group.The activities of GSH-Px and SOD were significantly increased,and MDA contents decreased in Bunao capsule groups as compared with those in model control group (P<0.01). Conclusion Bunao capsule can dose-dependently improve the learning,memory and antioxidative abilities of AD rats.The mechanism may involve upregulation of antioxidative enzyme activities and removal of oxidative products.

Objective To investigate the clinical and electrophysiology features of infantile spinal muscular atrophy,and explore the clinical significance of genetic diagnosis. Methods The clinical data of 13 infants suffering from infantile spinal muscular atrophy were analysed.The serum creatine phosphokinase was examined,and nerve conduction velocity was tested in median nerve,ulnar nerve,tibial nerve and peroneal nerve.The parameters such as distal motor latency,motor nerve conduction velocity and amplitude of compound motor active potential were analysed.Electromyography was performed in no less than four muscles,and the insertion potential,spontaneous potential and motor unit action potential were observed.Deletion of exon 7 in SMN1 gene was detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results All these infants were characterized by progressive flaccid paralysis in limbs.In all cases,amplitude of muscle response was significantly decreased,with prolonged distal latency and slowed conduction velocity.Electromyography demonstrated motoneuron degeneration.Deletion of exon 7 in SMN1 gene was detected in all 13 infants. Conclusion There are unique clinical and electrophysiology features for infantile spinal muscular atrophy,and electromyography may play an important role in the diagnosis.Prenatal genetic diagnosis may help to avoid the birth of this kind of infants.