Objective To develop a diabetes risk score (DRS)to predict the risk of development of incident diabetes in male senile people in Beijing. Methods DRS was developed basing on a test group including a cohort of 1 370 individuals aged 48-87 years without diabetes at baseline, followed for 10 years by Logistic regression and validated on a value group including a cohort of 340 individuals aged 43-88 years without diabetes at baseline. Results The model with the highest area under the ROC curve ( AUC ) included age, hypertension,history of hyperglycemia, body mass index, fasting plasma glucose, triglycerides, and high-density lipoproteincholesterol (HDL-C). DRS was developed basing on this model with a range from 0 to 12 and an optimal cut-off of 4. AUC were respectively 0. 726 ( 95% CI0. 692-0. 759 ) and 0. 765 ( 95% CI0. 691-0. 839 ) in test group and validation group. The sum score value ≥4 had sensitivity of 65.3% and 68. 1%, specificity of 70. 0% and 64.8%, positive predictive value of 37.0% and 23.2%, negative predictive value of 88.2% and 94. 1%.Conclusion The DRS, derived from clinical information combined with plasma glucose and lipids, is an effective tool to predict incident diabetes.

Objective To evaluate the technical feasibility and safety of transvaginal appendectomy by endoscopy in canine models.Methods Six female dogs weighing between 12-15 kg underwent transvaginal appendectomy by endoscopy.A small incision at posterior fornix of the vagina was made endoscopically by a needle knife and then dilated by a balloon dilator.After the endoscope entered the peritoneal cavity,the appendicular artery was clipped and the appendix was dissociated,and then the free appendix was ligated by an endoloop near root and removed by snare cutting.The appendix was then removed through the vaginal port.Finally,the vaginal incision was closed by clipping and endolooping.Two weeks after the procedure,the animals were sacrificed for anatomic investigation.Results Endoscopic transvaginal appendectomy was successfully performed in all animals with a mean operating time of (94.2±41.8) min.Complicated bleeding occurred in 1 dog and rectal burn in another during the operation.All the experimental animals survived the post operative period for 2 weeks without any complications.Post mortem examination revealed that the wound and vaginal incision healed well.Conclusion Transvaginal appendectomy by endoscopy is safe and feasible in a canine model,while further study and progression of appropriate accessories are needed for future clinical use.

Objective To understand the status of Toxoplasma gondii(TOX)infection in pregnant women in Qingdao area. Methods Antibody capture ELISA was used to detect the TOX-IgM,IgG and TOX-DNA in 1 341 pregnant women and 201 infer-tility,miscarriage,stillbirth pregnant women from June 2011 to July 2013. Results Among 201 abnormal pregnant women,43 cases were TOX antibody positive,accounting for 22.39%,and among the normal pregnant women,84 cases were TOX antibody positive,accounting for 6.26%,and there was a significant difference(χ2 =10.60,P<0.05). The TOX positive rate of 20-29 years old women was higher than that of the women aged over 30 years(χ2=21.9,P<0.05). The TOX antibody positive rates of families with pets and families without pets were 26.63%and 8.77%respectively(χ2=10.93,P<0.05). The TOX antibody posi-tive rates were 10.94%(22/201)in unemployed women,3.98%(8/201)in farmers,3.98%(8/201)in staff,and 3.48%(7/201)in workers. Conclusions The TOX infection rate in abnormal pregnant women is significantly higher than that in normal pregnancy women;therefore,the health education should be strengthened. In addition,in young women,especially 20-29 years old women, and some special occupation women,the control measures should be enhanced.

Objective To assess the feasibility and safety of adjustable loop-based purse-string technique in gastrotomy closure of natural orifice translumenal endoscopic surgery (NOTES).Methods Ten healthy female dogs were used in this study.Transgastric NOTES peritoneal exploration was performed in 5 groups (2 dogs in each) via various sites of the stomach ( greater curvature of the antrum; greater and lesser curvature of the body; anterior and posterior wall of the body).The gastric incision was then closed by using loop-based purse-string technique.Healing of the incision and intra-peritoneal infection were checked by endoscopy,necropsy,bacterial culture and histological examination 2 weeks later.Results The performance of NOTES peritoneal exploration and closure with purse-string technique was successful in ten dogs without significant complications.The mean operation time of closure was 7.3 ± 1.8 min.Minor bleeding occurred in 2 dogs (20％) during the incision of greater curvature of the antrum and body,which was controlled by electrocoagulation.Culture of the ascitic fluid and necropsy revealed no sign of abdominal infection or other complications except for adhesion in 1 dog ( 10％ ).The intact incision was confirmed by endoscopic,postmortem and histological examination,which suggested complete healing of the incision.Conclusion It is easy and safe to use loop-based purse-string technique for closure of multi-regional NOTES gastrotomy.This technology may be used for the repair of gastric ulcer perforation theoretically.

There are several special advantages of the application of standardized patients ( SPs) in the assessments of clinical skills examination of medical practitioners .However , this application in China is restricted by some limit factors, such as the shortage of SP trainers and SPs , the huge funds needed and the imbalance of regional develop-ment.The suggestion to overcome those limitation and to promote SPs be applied to the clinical skills examination of medical practitioners are as follow: the preparatory of regional university union of SPs , the introduction of social capital to participate in and the adoption of the mode of scale operation .

AIMTo study the enhancing effect of electroporation and iontophoresis on the permeation of insulin through human cadaver skin in vitro.

METHODSUsing side by side two-chamber diffusion cells, the flux of insulin achieved with iontophoresis and electrophoration were compared.

RESULTSThe application of high-voltage pulse combined with iontophoresis resulted in higher flux transdermal permeation of insulin than either one technique alone (P < 0.05). Pulsing at a higher voltage increased the flux of insulin more dramatically than pulsing at a lower voltage (P < 0.01). The transdermal transport of insulin by 90 pulse of 500 V (exponential pulse generater, pulse time: 20-24 ms, pulse frequency: 3 pulse.min-1) followed by iontophoresis led to a quick input and a high steady flux.

CONCLUSIONElectroporation combined with iontophoresis can enhance the permeation of insulin significantly.

Electroporation ; methods ; Humans ; In Vitro Techniques ; Insulin ; administration & dosage ; pharmacokinetics ; Iontophoresis ; methods ; Permeability ; Skin ; metabolism ; Skin Absorption

Objective To observe the all-cause and cardiocerebrovascular disease(CCVD)-related mortalities in the senile male population and the relationship of them with fasting plasma glucose (FPG) level.Methods A survey was performed among 1 572 male subjects aged 60-90.All the subjects were groups were calculated by Kaplan-Meier method and the log-rank test was used to compare the survival rates of the 4 groups.Logistic regression model was used to analyze the correlation factors of all-cause mortality and CCVD-related regression model analysis showed that age was related with the all-cause mortality.Among all these factors, age, body mass index, FPG and the history of CCVD had the relationships with the mortality of CCVD.Conclusion In the older male population, CCVD are considered as one of the main causes of death.With the increased levels of FPG, the all-cause mortality and CCVD mortality of senile male population are increased.

In order to improve the sharing of DICOM, a proposal is offered to introduce XML into DICOM on the SPIE 2005 and in this way, better readability and expansibility of DICOM files have been achieved. On this basis, the DICOM data structure is improved further by replacing the one-dimension linear data structure with multilayer tree-shaped data structure. And thus the nesting and dependence relationships between information object and data elements are much clearer and it is more convenient and easy to browse DICOM image files.
Database Management Systems ; Information Storage and Retrieval ; methods ; standards ; Medical Informatics ; methods ; Medical Records Systems, Computerized ; Programming Languages ; Radiology Information Systems ; Software ; User-Computer Interface

Actins ; metabolism ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Hemangioma ; metabolism ; pathology ; surgery ; Hemangiosarcoma ; pathology ; Humans ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; pathology ; Skin Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To determine the frequency of depression in patients with Parkinson' s disease(PD) and healthy controls over 50 years of age and to analyze the characteristics and influencing factors of PD with depression(PDD) in Nanjing.Methods One hundred and twenty-six PD patients were diagnosed and assessed using Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD).The frequency,characteristics and influencing factors of depression were statistically analyzed,and the factor analysis of HAMD was carried out.Also,one hundred and twenty-four healthy subjects over the age of 50 were selected as the control group.Ressults The incidence of depression in PD group was 48.4％ ( 61/126):15.1％ (19/126) for mild depression,27.8％ (35/126) for moderate depression,5.6％ (7/126) for severe depression.The incidence of depression in the control group was 9.7％ (12/124):5.7％ (7/124) for mild depression,2.4％ (3/124) for moderate depression,1.6％ (2/124) for severe depression.There was a significant difference between these two groups( x2 =45.36,P ＜ 0.01 ).Univariate and Logistic regression analysis revealed that a high frequency of depression occurred in patients with long PD duration,high H-Y stage and UPDRS Ⅲ.According to each factor analysis of HAMD,the scores of cognitive impairment,tardiness,anxiety and sleep disturbances of the PD patients with depressive syndromes were higher than that of the control group.Conclusion Depression is a relatively common complication of PD in Nanjing which is associated with long PD duration,severity of motor disturbances and increasing H-Y stage.