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

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.

Currently, competition in the market of health service of our country is very fierce. In this circumstance, realization of military hospital's development aim-focuse on people, leading position in technology-to provide better service armyman is depend on economic foundation. To increase economic benefit of hospital, it is necessary to intensify management of cost accounting first, in which cost accounting of clinical department is of especial importance. In this article, we probe into the significance, content, method and problems of cost accounting in clinical department of military hospital.

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 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 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.