0.05,respectively).But most inte-restingly,the MMP-9 showed a positive relevance(r=0.686,P

Objective:To study the diagnostic value of combined detection of IAA,ICA and GADA in the classification of diabetes mellitus.Methods:30 cases of patients with type 1 diabetes who were treated in our hospital from June 2015 to June 2016 were selected as A group,60 cases of patients with type 2 diabetes were selected as B group,50 cases of healthy people were selected as C group.The IAA,ICA and GADA of the three groups were detected by ELISA,and the positive rate of the three groups were compared.Results:The fasting glucose of A group was (10.12± 3.68) mmol/L,B group was (11.23± 3.26) mmol/L,A group and B group were significantly higher than that of C group (P＜0.05),but there was no significant difference between A group and B group (P＞0.05);the positive rates of GADA,ICA and IAA in A group and B group were significantly higher than those in C group (P＜0.05),and the positive rates of GADA,ICA and IAA in A group were significantly higher than those in B group (P＜0.05);the sensitivity and specificity of combined detection of IAA,ICA and GADA in type 2 and type 1 diabetes mellitus were significantly higher than that in the single test (P＜0.05).Conclusions:The combined detection of IAA,ICA and GADA has a high diagnostic value in the classification of diabetes mellitus,which is worth clinical application.

Objective To seak a available way of evaluating morphology of filtering blebs after trabeculectomy is very important for forecasting the successful rate of surgery.At the present time,filtering blebs were commonly evaluated by using the slim lamp microscope,but it did not to exactly reflect the filtering passage.This study aimed to evaluate the morphology of filtering blebs after trabeculectomy with anterior segment optical coherence tomography (AS-OCT).MethodsThis was a prospective study.Sixty-nine eyes of 53 patients who had previously undergone trabeculectomy were selected in this study,including 25 eyes with open-angle glaucoma,38 eyes with close-angle glaucoma and 6 eyes with secondary glaucoma.These filtering blebs were classified into functional type (typeⅠandⅡ) and nonfunction type (type Ⅲ and Ⅳ) under the slit lamp microscope based on the van Buskirk grading scales.Intra-bleb morphology and structure were characterized as diffuse-like,cystic-like,encapsulating-like and flatten-like by AS-OCT in reference to the Leung method.The consistency between the two methods was evaluated by the Chi-Square test.Written informed consent was obtained from all the patients before surgery.ResultsThe average follow-up time was 10.78±11.0 months.All the patients finished the examination during the follow-up duration.The average intraocular pressure was(14.9±4.5)mmHg during the observation period.There were 38/69 (55.1%) functioning blebs and 31/69 (44.9%) non-function blebs under the slim lamp microscope.AS-OCT imaging showed diffuse-like blebs in 26 eyes (15.9%),cystic-like blebs in 11 eyes (27.5%),encapsulating-like blebs in 19 eyes (18.8%) and flatten-like in 13 eyes with the intraocular pressure of(13.16±3.77)mmHg,(15.36±2.92)mmHg,(15.77±5.07)mmHg and (16.62±5.33)mmHg,respectively,showing a significant difference among them (F=3.32,P＜0.05).These patterns of different OCT presented a good consistency with the clinical outcome (χ~2=0.03,P=0.86).ConclusionAS-OCT allows the observation of filtering blebs after glaucoma surgery.It is probably to visualize the internal structure of filtering bleb and deep sclerectomy.Functional and dysfunctional filtering blebs delivery gives different OCT patterns.This could be a new way to assess the postoperative healing process.

Cerebellum ; surgery ; Cystadenoma, Papillary ; complications ; pathology ; surgery ; Epididymis ; pathology ; surgery ; Follow-Up Studies ; Genital Neoplasms, Male ; complications ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Kidney ; surgery ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Vimentin ; metabolism ; von Hippel-Lindau Disease ; complications ; metabolism ; pathology ; surgery

Objective To investigate the current status of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass and analyze its influential factor,and provide reference for effective intervention.Methods A total of 208 cardiac valvular surgery patients with cardiopulmonary bypass were recruited from 4 cardiovascular surgery in Guangdong and were investigated with the self-designed questionnaire,Mishel Uncertainty in Illness Scale (MUIS),Connor-Davidson Resilience Scale (CD-RISC),Medical Coping Modes Questionnaire (MCMQ),in the preoperative day and the day before discharge.The data were analyzed by single-factor and multiple-factor analysis.Results The average score of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass was 99.09±11.41,and 92.3％ of patients got a moderate uncertainty in illness level in the preoperative day.The average score of uncertainty in illness in the patients was 90.33± 10.32,and 91.8％ of patients got a moderate uncertainty in illness level in the day before discharge.Multiple linear regression indicated that,age,cardiac valvular disease types,number of cardiac valvular surgery,optimism and yield were the protective factors of uncertainty in illness level.Average monthly household income,self-improvement,scores of resilience and confront coping were the risk factors of uncertainty in illness level.Conclusion The level of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass is moderate.Age,average monthly household income,cardiac valvular disease types,number of cardiac valvular surgery,resilience and coping style are factors influencing uncertainty in illness level of patients.

Objective To investigate the value of the intraoperative real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) in therapeutic application of surgery for the mitral valve prolapse.Methods Thirty-five patients underwent surgical treatment were diagnosed as mitral valve prolapse by 2-dimensional transthoracic echocardiography (2D-TTE),with or without ruptured chordae tendineae.RT 3D-TEE was performed for assessing the segment of prolapse and its complications before cardiopulmonary bypass and after heart resuscitation respectively.The echocardiographic results were compared with the surgical findings.Results The accuracy of RT 3D-TEE to identify segments with prolapse was significantly higher than that of 2D-TTE (91.4％ vs 82.9％,P =0.003).RT 3D-TEE was more accurate than 2D-TTE for identifying ruptured chordae tendineae,vegetation and thrombus since higher sensitivity,specificity and Youden index.Among all 35 patients,valvuloplasty was performed in 28 cases,whereas,only 7 cases underwent replacement of prosthetic valves.Three patients were benefited by accurate evaluation of therapeutic effect using RT 3D-TEE in time.ConclusionsIntraoperative RT 3D-TEE can be used to provide “ surgical view”,acquired adequate valuable information of mitral valve,and more reliable functional and anatomical assessment of the mitral valve components and its geometry.Suitable surgical intervention can be designed for improving outcomes of patients.

Objective To explore the relationship between resilience and coping style of cardiac valvular postoperative patients with cardiopulmonary bypass.Methods A total of 208 cardiac valvular postoperative patients with cardiopulmonary bypass were recruited from 4 cardiovascular surgery in Guangdong and were investigated with the self-designed questionnaire,Connor-Davidson Resilience Scale (CD-RISC),Medical Coping Modes Questionnaire (MCMQ).Results The average score of resilience in cardiac valvular postoperative patients with cardiopulmonary bypass was (55.38±10.63)points.The average score of tenacity,strength and optimism were (28.21 ±5.87)points,(18.21 ±4.02)and (8.96± 1.85)points respectively.The average score of coping style of confrontation,avoidance and acceptance-resignation were(18.13±3.38),(16.95±1.75)and (9.24±2.47)points respectively.All the sub-scores of the resilience were positively correlated with confrontation,and all the sub-scores of the resilience were negatively correlated with avoidance and acceptance-resignation.Conclusions There is a certain degree of correlation between resilience and copping style of cardiac valvular postoperative patients with cardiopulmonary bypass.Nurses should enhance resilience of the patients,guide the patients to adopt effective coping styles,to promote disease rehabilitation and improve the quality of life.

Objective To study the clinical characteristics, diagnosis, treatment and its effectiveness of vulvar intraepithelial neoplasm Ⅲ(VIN Ⅲ).Methods Clinical data, including age of the patients, mode of surgical operation, pathological features, results of post-operation follow-up, of 12 cases of VIN Ⅲ admitted to the Peking Union Medical College Hospital(PUMCH)during January 1984 to December2006 were retrospectively analyzed.Results Mean age of the 12 cases was 40.3(ranging from 23 to 56)years.All the patients had symptoms of vulvar itching, three with VUlVar ulcer and one with vulvar pain.There was single neoplasm focus in two cases and multiple focuses in 10 cases, five cases with neoplasm in other sites and five with human papilloma virus(HPV)infection.All the 12 patients received surgical operation, three with simple vulvectomy(one with some residue at perianal incisal edge)and other nine with lumpectomy(four with some residue at incisal edge).Eight cases were followed-up for 9.0 months in average(ranging 1～22 months)after surgical operation, including three with some residue at incisal edge.Relapse was found in two cases three and 11 months after operation, respectively, who received re-operation, including one with residue at incisal edge and one without residue.Conclusions It is necessary to attach more importance to biopsy for the cases of suspected VIN Ⅲ, as well as colposcopic diagnosis for those with vaginal or vulvar neoplasm and testing for HPV infection.Surgical operation, including simple vulvectomy and lumpectomy with or without adjunctive measures, are main treatment for patients of VIN Ⅲ and follow-up is also important for all those with VIN Ⅲ.

Objective To establish HPLC characteristic spectrum of Polygonum Capitatum from GAP planting base, and provide reference for the overall quality control of Polygonum Capitatum. Methods HPLC analysis was performed on a DiamonsiL C18 chromatographic column (250 mm× 4.6 mm, 5μm) with the eluting system of gradient consisted of methanol and 0.2% H3PO4. The flow rate was 1.0 mL/min. The column temperature was maintained at 25℃ and the detection wavelength was at 254 nm.Results HPLC characteristic spectrum of Polygonum Capitatum samples from 10 different areas was established, which contained 11 common peaks, and the similarities of comparative results were over 90%.Conclusion The established method can be used to determine the characteristic spectrum of Polygonum Capitatum and can provide a basis for the overall quality control and quality standards of Polygonum Capitatum.

Objective To evaluate the feasibility and accuracy of full volume three-dimensional echocardiography(FV3DE) for quantifying the left ventricular volume in healthy fetuses. Methods Two hundred and twenty-two normal fetuses with gestational ages between 20 and 40 weeks were investigated. Full volume three-dimensional, two-dimensional (2D) and M-mode images were acquired by Philips iE33 system and data was processed offline using QLAB analysis software. Left ventricular end-systolic volume(ESV) and end-diastolic volume ( EDV) were measured using semiautomated border detection echocardiographic techniques, and compared with 2D biplane Simpson's method and M-mode Teichholz formula. Results Thirty-six fetuses with poor three-dimensional images and 5 twin pregnancies were excluded,the study subjects consisted of 181 singleton fetuses. The highest concordance correlation ( r =0.987 for EDV, r =0.988 for ESV) P <0. 001) was noted between 2D biplane Simpson's and FV3DE-derived values with a small bias (0. 332 ml for EDV,0. 135 ml for ESV). The Bland-Altman analysis showed that FV3DE had the best reproducibility than M-mode Teichholz formula and 2D biplane Simpson's method. Intra- and interobserver error of EDV were 2.85% and 4.22% for FV3DE,8.37% and 8.98% for 2D biplane Simpson's rule,30. 63% and 54. 70% for M-mode Teichholz formula. Intra- and interobserver error of ESV were 2.34% and 6. 14% for FV3DE,6. 26% and 11.7% for 2D biplane Simpson's rule,43.06% and 66.03% for M-mode Teichholz formula. Conclusions FV3DE is a novel technique that can be more accurate than conventional methods in quantification of fetal left ventricular volumes, it may provide new insight into evolving fetal cardiac structure and function.