Objective To investigate the carotid plaque conditions and clinical commonly used test events in patients with type 2 diabetes mellitus (T2DM) and to explore the risk factors affecting the stability of plaques in carotid artery.Methods According to the results of cervical vascular color Doppler ultrasound examination, 125 patients with type 2 diabetes mellitus were divided into unstable plaque group (n=21), stable plaque group (n =54), and non-plaque group (n =50).Analysis related results including age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), intima-media thickness (IMT), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), uric acid (UA), fibrinogen (Fbg), D-dimer (D-D), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were analyzed.Results Age, gender, SBP, DBP, TG, HDL, D-D, and TSH were without significant differences among groups.Glucose and Fbg were significant different (P ＜ 0.05) between unstable plague group and stable plaque group/no plaque group.No significance difference was found between stable and no plaque groups.IMT, TC, LDL, and FT4 were significant different (P ＜ 0.05) between unstable and stable plaque groups, and between stable and no plaque groups.Logistic multiple regression analysis suggested that IMT and TC might be independent risk factors for the stability of plaques in carotid artery of patients with type 2 diabetes mellitus (P ＜ 0.05).Conclusions The factors affecting formation of plaques in carotid artery include glucose level, TC, and LDL in patients with type 2 diabetes mellitus.The factors affecting its stability include thickness of IMT, TC, LDL, and FT4.IMT and TC were the independent risk factors for the stability of plaques in carotid artery.

OBJECTIVETo investigate the application of combining mastopexy and triple-plane breast augmentation in correction of breast ptosis and atrophy.

METHODSPeri-areolar incision was performed to finish the fascia and dermal suspension to correct the breast ptosis. The implant was inserted under the pectoralis major muscle through lateral lower border of the gland and a "X" shape full thickness incision was made on the pectoralis major muscle according to the new position of nipple-areolar complex.

RESULTS14 patients received combined mastopexy and triple-plane breast augmentation to correct breast atrophy and mastopexy simultaneously. All the patients were regularly followed for 6-12 months. No patients suffered severe complication and the results were satisfied.

CONCLUSIONS"Triple-plane" breast augmentation could be safely performed with peri-areolar mastopexy with minor injury. The technique could help to ensure the balance between the gland, nipple-areolar complex and the implant.

Atrophy ; surgery ; Breast ; pathology ; surgery ; Breast Implantation ; methods ; Female ; Humans ; Mammaplasty ; methods ; Nipples ; pathology ; surgery ; Pectoralis Muscles ; surgery

Objective To investigate the level and value of serum uric acid (UA) in patients with multiple system atrophy (MSA).Methods One hundred and one MSA patients were selected as the MSA group and 101 age and sex-matched healthy controls as control group.The UA concentrations and other biochemical indexes were measured by an enzymatic method and carefully analyzed.By comparing the UA concentrations for different genders, subtypes, and different levels of certainty of the MSA group with their counterparts in the control group, we obtained the differences between these two groups and also discussed possible reasons and factors.Results The serum UA levels of MSA patients ((283.74 ± 87.76) μmol/L) were significantly lower than the controls ((317.86 ± 76.95) μmol/L;t =-2.94, P ＜ 0.05).In addition, when the male and female groups were investigated separately, the decrease of serum UA was more significant in the male group compared to the female group (t =-3.88, P ＜ 0.01).Furthermore, by comparing different subtypes of the MSA patients with the control group, we found that the serum UA levels in both P-type or C-type MSA patients were significantly lower than in controls (t =2.92, 2.02;all P ＜ 0.05).By comparing different levels of MSA with the control group, we obtained that UA levels in both probable MSA patients and possible MSA patients were significantly lower than in controls (t =3.13, 2.09;all P ＜ 0.05).By adjusting for the confounding factors, such as age, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatinine, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol, the multiple Logistic regression analysis showed that the numbers of MSA patients in the lowest level UA group (UA ＜ 263.0 μmol/L) were higher than the high level UA group (UA ＞ 370.5 μmol/L), though the difference did not reach statistical significance (P ＞ 0.05).Nevertheless, the numbers of male MSA patients in the lowest level and the lower level UA groups (UA =263.0-309.0 μmol/L) were 11.5 and 10.8 times that in the high level UA group (P =0.001, P =0.003).No obviously linear relation between the level of UA and disease progression was found.Conclusions The level of serum UA is significantly decreased in MSA patients, especially in the male patients.The UA, as an antioxidant, may be beneficial to the neurodegenerative diseases.

AIM: To observe the effects of sapindoside on blood pressure,AngⅡ,Ald,ET in the blood plasma and NO in the serum in primary hypertension rat. METHODS: The primary hypertension rats were divided into 5 groups(high,middle and low sapindoside group,control group and captopril group,10 each) in a random fashion and drugs had been given by ig.for 32 days.The blood pressure was messured in the 1,3,7,32 day after administration.At the end of the 32 nd days,AngⅡ,Ald,ET in the blood plasma and NO in the serum were measured. RESULTS: Sapindoside could significantly lower the blood pressure,increase the levels of NO in serum,reduce the concentration of AngⅡ,Ald,ET in the blood plasma. CONCLUSION: Sapindoside plays an important role in decreasing the blood pressure of primary hypertension rat.

Objective To investigate the diagnosis and treatment of pulmonary tuberculosis in renal transplantation recipients.Method The clinical data of 8 renal transplantation recipients suffering from pulmonary tuberculosis infection were retrospectively analyzed.Result Fever,cough and expectoration were the most common symptoms,however,lacking typicality.Images of chest Xray and CT scan were various and couldn't verify TB infection from pneumonia.Seven of 8 cases were diagnosed through invasive methods,either bronchofibroscope or fiberthoracoscopy.Immunosuppressants were decreased in all cases.Three-drug regimens,including isoniazide,rifampicin and ethambutol or pyrazinarnide,were administrated as anti-tuberculosis chemotherapy.All the cases were cured,without episodes like acute rejection and liver function impairment.Conclusion Routine examinations are not sufficient to diagnose pulmonary tuberculosis in kidney transplantation recipients.While,invasive methods like bronchofibroscope and fiberthoracoscope are helpful.When diagnosed,patients should receive normative anti-tuberculosis treatment and immunosuppressive agents adjustment,which can benefit the prognosis of pulmonary tuberculosis in renal transplantation recipients.

Background: Creatine transporter (CRTR) deficiency is the most common creatine deficiency syndrome, of which the final diagnosis relies on mutation in the X-linked CRTR gene. To date, more than 90 mutations in the SLC6A8 gene have been reported. This paper discusses a novel mutation detected via the thorough sequencing of all the X-chromosome-specific exons investigated in a four and a half year old boy with an intellectual disability, speech and language delay and motor disturbance. Methods: A brain magnetic resonance imaging (MRI) and a proton magnetic resonance spectroscopy (MRS) were carried out, the creatine and creatinine concentrations in the urine were checked and all exons were sequenced. Results: A detailed clinical investigation revealed a reduction in the cerebral creatine levels in the brain by the MRS, elevated creatine and creatinine concentrations in the urine and signal abnormalities in the left frontal cortex of the brain by the MRI. A novel change was identified in the heterozygosity of the exon 10: c.1395-c.1401 deletion. Conclusion: The use of a combination of powerful new technologies, such as thorough exome-nextgeneration sequencing and a brain MRS, should be considered, in order to determine any neurometabolic diseases, especially when the signal abnormalities in the brain MRI cannot be explained by any other factors. This mutation results most likely in a dysfunction of the creatine transport and synthesis, hence causing central nervous system symptoms.
Carrier Proteins

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

Objective To explore the arterial function of the Miao nationality people who live in natural circumstance.Methods 244 Miaos were mcmited in our studv.Right blood pressure and biochemistry examination were measured.PWV and CAVI were measured using validated automatic devices and used as indexes of arterial stiffness.Ultrasonic indexes such as carotid diameter,carotid plaque,IMT、flow-mediated dilation(FMD) were measured as well.Results Body mass index,waist-to-hip ratio,heart rates,blood lipid level and glucose had no significant difierence between male and female groups.Arterial function indexes such as C-F PWV(9.50±2.14 vs.8.81±1.69,t=2.074,P=0.006),C-R PWV(11.39±1.74 vs.10.54±1.77,t=3.506,P<0.001),R-CAVI(8.25±1.35 vs.7.41±1.20,t=4.768,P<0.001),L-CAVI(8.21±1.30 vs.7.41±1.15,t=4.616,P<0.001),R-IMT(0.67±O.12 vs.0.63±0.13,t=2.503,P=0.012) and L-IMT(0.67±0.11 vs.0.63±0.14,t=2.337,P=O.018) had significant difference between the two groups.Conclusions The medical condition of the Mians needs to be impmved.It is useful to diagnose patients and hish risk people by systemic arterial function examination.

BACKGROUND:Negative pressure wound therapy has been extensively used, but most people only knew the superiority of negative pressure wound therapy based on clinical experiences or subjective judgment.
OBJECTIVE:To observe the effects of negative pressure wound therapy on the wound on the body surface, and to compare with contemporaneous conventional method.
METHODS:A total of 45 patients with wound on the body surface treated in the Peking Union Medical Col ege Hospital from January 2006 to December 2011 were enrol ed in this study, including 25 patients undergoing negative pressure wound therapy and 20 patients undergoing conventional change dressing method. Al clinical data were recorded.
RESULTS AND CONCLUSION:Negative pressure wound therapy was better than conventional method (P<0.05), on terms of preoperative preparation period, wound granulation, bacterial scavenging, labor intensity of working staff and incidence of postoperative complications. However, no significant difference in therapy cost was detectable (P>0.05). These results suggested that compared with conventional method, negative pressure wound therapy positively contributed to the healing, obviously shortened preoperative preparation, accelerated the diminution of wound, decreased the incidence of complications of reconstruction, lessened patient’s distress, reduced their economic cost, and diminished labor intensity of working staff. Negative pressure wound therapy has been proven an excellent tool of to promote wound healing.

BACKGROUND:Negative pressure wound therapy has been widely recognized, the currently published papers are limited in academic value and lack of scientific, objective, qualified index to confirm the therapy effectiveness. OBJECTIVE:To systemical y evaluate the clinical effect of negative pressure wound therapy, provide more evidence for its clinical application, and guide clinical research.
METHODS:Fifteen articles were screened out of peer-reviewed publications (Cochran library, Embase, PubMed-Medline and Chinese BioMedical Literature Database). Scientific data were col ected and evaluated by two researchers. The data were statistical y analyzed with RevMan software.
RESULTS AND CONCLUSION:Only 15 random-control ed trials were final y preserved, including 10 as B-grade moderate bias risk and focused on the effect of negative pressure wound therapy on chronic wounds, and 5 as C-grade high bias risk and focused on the effect of negative pressure wound therapy on acute wounds. There were significant differences in the main outcome measures between negative pressure wound therapy and conventional wound therapy. As for chronic wound patients, no significant difference was observed in the operation-preparing period, reducing wound area, promoting wound granulation, and amputation rate between two therapies. As for acute wound patients, the differences were significant in the operation-preparing period, promoting wound granulation, wound infection rate, and cost materials between two therapies. However, no difference was significant in the healing of wound and hospitalization time. Our findings indicate that, negative pressure wound therapy is an effective means for both acute and chronic wounds, it can shorten operation-preparing period, promote wound granulation, and reduce amputation rate and infection rate, thus providing evidence for clinical application. The wel-designed study is needed to develop high-quality random control ed trails.