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 expression of glucocorticoid receptor ( GR) ? and ? in cultured human keratinocytes ( HaCaT cells) with treatment of dexamethasone ( Dex) and after withdrawal. Methods The mRNA and protein expressions of GR? and GR? in HaCaT cells after the treatment of Dex ( 10 -6mol/L) for 24 and 48 h and in 24,48 and 72 h after withdrawal of Dex were detected by real-time PCR and Western blot analysis respectively. The intracellular distribution of GR? and ? was examined by immunofluorescence. Results In 24 or 48 h after Dex treatment,the expressions of GR? at mRNA and protein levels were reduced in a time-dependent manner ( P

Purpose The aim of this study was to reveal the role of SGT,the small glutamine-rich tetratricopeptide repeat (TPR)-containing protein,in the developing mouse brain through examining the expression profile of SGT during the development stage. Methods In this study, quantitative RT-RCR and Western blot were applied to investigate the expression of SGT mRNA and protein in the mouse whole brain. Western bolt was also used to detect the expression of SGT in the hippocampus, cerebral cortex, striatum and cerebellum. Immunohistochemical analysis on postnatal and adult mouse brain was performed to examine the subcellular localization of SGT. Results Our data showed that the levels of SGT mRNA and protein in the mouse whole brain were both high during the postnatal stage and declined in the adult. Regional expression of SGT protein in the hippocampus, cerebral cortex, striatum and cerebellum showed a similar expression profile.Immunohistochemical analysis found that in the P14 mouse brain, SGT was abundant in all the CA regions of hippocampus as well as most regions of cerebral cortex and striatum. In the cerebellum, SGT was mainly distributed in Purkinje cells. In the sections of the adult mouse brain, faint expression was observed in the regions mentioned above. Conclusions Our findings firstly exhibit the expression pattern of SGT in the mouse brain development,which might shed new light on further functional analysis of SGT in the central nervous system.

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.

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.