As one of the common endocrine diseases in children, the incidence of type 1 diabetes mellitus(T1DM)is increasing year by year.T1DM is an autoimmune disease.It is generally believed that the pathogenesis of T1DM is that the immune disorder of genetically susceptible individuals under the action of environmental factors causes immune damage, leading to islet inflammation and the production of autoantibodies, and the destruction of β cells of the islet, leading to insufficient insulin secretion to absolute deficiency.Although there is no effective radical cure for T1DM at present, more and more research on stem cell therapy has been conducted.Umbilical cord blood, as an important source of stem cells, is expected to make the radical cure of T1DM possible in the future.In this paper, the mechanism of immune injury in T1DM and the progress of umbilical cord blood stem cell therapy are reviewed.

Objective To investigate clinical effects of arthroscopic synovectomy combined with radiofrequency vaporization for the treatment of rheumatoid synovitis of the knee joint.Methods In 36 cases of rheumatoid gonarthritis with chronic synovitis of the knee joint,with simultaneous administration of regular medication,we had applied arthroscopic synovectomy combined with radiofrequency vaporization to remove the hyperplastic synovium and pannus through standard anteromedial and anterolateral approaches, and superolateral and superomedial approaches.In 21 out of 36 cases,diseased synovium in the posterior compartment was resected via additional posteromedial and posterolateral approaches.A systematic rehabilitation program was practiced 3 days after operation. Results All the 36 cases were followed for 4~26 months(mean,16 months).Clinical effects evaluation showed "excellent" in 21 cases,"good" in 13 cases,and "fair" in 2,with a total excellent-or-good rate of 94.4%(34/36).The knee joint function scores were significantly elevated from 58.6?5.3 preoperatively to 91.6?5.8 postoperatively(t=2.723,P=0.003).The Lysholm scores were significantly elevated from 42.3?3.8 preoperatively to 90.2?4.4 postoperatively(t=2.437,P=0.001).Conclusions Combined use of arthroscopic synovectomy with radiofrequency vaporization for the treatment of rheumatoid gonarthritis has advantages of minimal trauma,little blood loss,and rapid recovery of joint function.The procedure can effectively control the progression of rheumatoid arthritis and restore the knee joint function to the greatest possible extent.

Objective To investigate the role of prokinetic agent itopride in colonic preparation before colonoscopy examination in patients with constipation.Methods A total of 115 outpatients with history of chronic constipation who requested colonoscopy were collected.According to colonic preparation proposal,patients were divided into three groups.Group A (39 cases) took standard dosage of PEG-E solution six hours before colonoscopy examination.Group B (38 cases) took 150 mg itopride 30 minutes before administration of lavage solution.Group C (38 cases) took itopride 150 mg at 7 am,12 am and 8 pm the day before the examination and on the examination day took the same medicine as that of group B.The blood pressure,heart rate and blood electrolytes were monitored before and after taking medicine in the patients of three groups.Quality of colon cleansing of each group was observed and side effects were also observed.One-way analysis of variance (least significant difference,LSD) test was performed for pairwise comparisons among the three groups.Chi-square test was applied for count data.Results Both group A and group B excluded one patient because of malignant carcinoma with colon stricture under colonoscopy,and 113 patients completed the whole colon examination.There was no significant difference in the baseline patients' data of three groups.The colon cleaning score of group C (7.28±1.11) was higher than those of group A and B (6.55±1.18 and 6.51±1.16,LSD test,both P＜0.05).The frequency of bowel movements defecation of group C (8.31± 1.32) was more than those of group A and group B (7.11± 1.41 and 6.94± 1.51,LSD,test,both P＜0.05).There was no significant difference in terms of intestinal bubble scores,blood pressure,heart rate,blood electrolytes the uncomfortable degree of colonic preparation and rate of side effects of the three groups.Conclusion The colonic preparation can be safely and effectively improved by taking high dose of itopride one day before and on the day of colonoscopy examination.

ObjectiveTo compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.MethodsFrom March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.ResultsAll patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.ConclusionThrough compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.

Colorectal cancer (CRC) is a common malignant tumor of digestive system. The incidence and mortality of CRC are increasing consistently in our country. Colorectal adenoma (CRA) is the main precancerous lesion of CRC. Effective prevention and treatment of CRA is an important way to reduce the incidence and mortality of CRC. In recent years, the secondary prevention after CRA resection has become a research hotspot. This article reviewed the research progress of secondary prevention after resection of CRA.

OBJECTIVE: To explore the effect and indications of radiofrequency ablation for the treatment of obstructive sleep apnea-hypopnea syndrome. METHOD: Multilevel temperature-controlled radiofrequency therapy of soft palate, uvula, inferior turbinate, and tonsils were applied to 74 adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). There were 16 mild, 23 moderate, and 35 severe cases respectively in this study. Evaluation of mucosal injury and effect of radiofrequency therapy on pain, speech and swallowing were performed early after operation. The volume of targets and length of soft palate and uvula were measured three months after operation. Polysomnography, Epworth Sleepiness Scale and Snoring Scale Score questionnaires were reevaluated six months after operation and compared with the results of pre-operation. Treatment outcome measurements were mainly based on polysomnography. RESULT: By our definition, 5 of 74 patients (6.76%) have been cured and 42 of 74 (56.76%) had improved totally. Mean Apnea-Hypopnea Index (AHI) decreased significantly and mean lowest oxygen saturation value increased significantly postoperatively (P < 0.01). The total effective rate of the patients, whose obstructive sites were all treated by radiofrequency, was remarkably higher than that of the ones, whose obstructive sites were only partly treated by radiofrequency (P < 0.01). The total effective rate of the former was 72.92%. Patients showed a significant decrease in mean score on ESS and SSS postoperatively (P < 0.01). No significant complications were observed in most patients. There were little influence on pain, speech and swallowing. The volume or length of targets decreased obviously three months after operation. CONCLUSION Radiofrequency can reduce the volume of tissue. The short-term outcomes of radiofrequency were satisfying if obstructive sites had been all treated. This study demonstrates that the characters of radiofrequency are as follows: minimally invasive, safe, efficient, repeatable and multilevel applicable. Temperature-controlled radiofrequency therapy is a safe and effective procedure for hypertrophic infraturbinal when used separately, or as a part of a the combined approach for complex syndromes.
Adult ; Catheter Ablation ; methods ; Contraindications ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome

Biofilms are complex three-dimensional bacterial assemblages that attach to biotic or abiotic solid surfaces, and frequently embed within a self-produced matrix of extracellular polymeric substances. Biofilm formation is a microbial defense response to biotic and abiotic stresses, and a key factor for survival in adverse environments. A wide variety of microorganisms can colonize distant tissues of higher plants, such as leaves, vascular network and roots, and adhere to the surface of the tissues to form biofilms. The dynamic processes in forming biofilms in response to plant internal environment are key steps required for full virulence of phytopathogenic bacteria. Exploring the mechanisms involved in regulation of bacterial biofilms is important for understanding the plant-pathogens interactions. In this review, we summarized the research progresses related to the biofilms of bacterial phytopathogens, including biofilm characteristics, essential regulatory mechanisms and key signals affecting the transition between a planktonic lifestyle and multicellular behavior.