Objective To explore the pathogenesis of juvenile disorders of spine facet joints and to clarify the diagnosis by concluding the clinical and imaging manifestations.Methods Retrospectively analyzed imaging data of 250 patients from 10～30 years with disorders of spine facet joints including X-ray and CT and MRI.Results Reasons of juvenile disorders of spine facet joints has unique imaging manifestations of asymmetric of small joints and joint surface hyperplasia like pen,of nonspecial inflammation in surrounding soft tissue.Conclusions Imaging can diagnose and differentiate diagnosis juvenile disorder of spine facet joints.X-ray is also the primary method.Not only.CT or MRI image can more clearly display the changes of spine facet joints and surrounding soft tissue,but also differentiate diagnosis disc henaiation and other diseases.

Objective To explore the effect of alpha lipoic acid and Shuxuetong on oxidative stress and insulin resistance in patient with type 2 diabetes mellitus(T2DM)and to guide the clinical therapy for T2DM.Methods Totally 90 cases of T2DM pa-tients were sellected from Hainan Province Nongken Hospital.The patients were divided into Shuxuetong group(group A,n=30), alpha lipoic acid group(group B,n=30)and alpha lipoic acid and Shuxuetong group(group C,n =30).HOMA-IR,HOMA-β,and HOMA-ISI was calculated.SOD was determined by xanthine oxidase method.MDA was detected by Thiobarbituric acid method. The expression of IL-6 and TNF-αwas determined by ELISA analysis.Results Before treatment,SOD,MDA,IL-6,TNF-α,HO-MA-IR,HOMA-ISI,and HOMA-βwas no significant difference among the three groups(P >0.05).After treatment,all of which was significantly changed(P <0.05 and P <0.01).SOD,HOMA-ISI and HOMA-βin group C was significantly higher than that in group B(P <0.05),and which was significantly higher in group B than that in group A (P <0.05).MDA and HOMA-IR in group C was significantly lower than that in group B(P <0.05),and which was significantly lower in group B than that in group A (P <0.05).IL-6 and TNF-αin group C was lower than that in group A and group B(P <0.01),and which was no significant difference between group A and group B(P >0.05).Conclusion Alpha lipoic acid combined with Shuxuetong injection can significantly im-prove the oxidative stress state of T2DM patients,inhibit the inflammatory reaction,improve insulin resistance and patient′s sensi-tivity to insulin.Which was contribute to clinical treatment for T2DM.

ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.