Objective To explore the efficacy and safety of metformin therapy on obese nondiabetic children with hyperinsulinemia.Methods Twenty-two obese nondiabetic children with hyperinsulinemia were divided into two groups:control group(dietary counseling and exercise) and treatment group(dietary counseling and exercise combined with metformin).The changes of body mass index(BMI),fasting glucose(FPG),fasting insulin(FINS),insulin resistance(HOMA-IR),2 h PG,2 h INS,total cholesterol(TC) and triglyceride(TG),before and after treatment were determined,and the findings were compared and analyzed.Results After treatment,there were significant differences in BMI,TC,FINS,HOMA-IR levels(P0.05),except the BMI(P

Objective To investigate risk factors related to postoperative death of patients with rectosigmoid junction tumor perforation.Methods The clinical data of 76 cases with rectosigmoid junction tumor perforation confirmed by laparotomy from January 2000 to October 2015 were collected.Results Of the 76 cases,17 patients died postoperatively,the mortality rate was 22％,the single factor analysis showed that age(x2 =4.649,P =0.031),duration of abdominal pain(x2 =8.218,P =0.016),severe heart and lung diseases(x2 =11.996,P =0.007),circulatory and renal function(x2 =10.360,P =0.016),serum albumin(x2 =7.252,P =0.027),white blood cell count(x2 =7.633,P =0.022),Perforation diameter (x2 =9.770,P =0.008),Geroge grade of intraperitoneal contamination (x2 =10.086,P =0.006) were related to postoperative death (P ＜ 0.05).Multivariate analysis showed that complicating severe heart and lung diseases,preexisted circulatory and renal dysfunction,white blood cell count ＜ 4 × 109/L,size ＞ 3 cm,intraperitoneal contamination larger than one quadrant were independent risk factors for postoperative death.Conclusion Risk factors related to postoperative death of rectosigmoid junction tumor perforation were preoperative important organ dysfunction and intraperitoneal infection.

Adolescent ; Brain Neoplasms ; diagnosis ; Child ; Child, Preschool ; Endocrine System Diseases ; etiology ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Infant ; Luteinizing Hormone ; blood ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

ObjectiveTo apply the Schwann cell neurilemma channel(SCNC) in promoting the regeneration of injuried spinal cord.MethodsSpinal cords of rats after laminectomy at T8/9 were divided in 3 groups randomly: 10 rats were transplanted with SCNC(Group A);10 rats only made models(Group B);10 rats were as normal control group(Group C).All rats received behaviour survey and inclined plane test every week 8 weeks after operation.6 weeks after operation,they were measured with cortical somatosensory evoked potential(CSEP).And 8 weeks after operation,all specimens were studied histologically.ResultsCSEP could be recorded in group A and C,but not in group B.There were marked differenties between group A or C and group B in behavior survey,inclined plane test.Amount of nerve fibers regenerated through the injury gap in group A was significantly larger than that in group B.ConclusionSCNC could facilitate axonal regeneration and promote the repairing of injuried spinal cord.

OBJECTIVETo observe the effect of general anaesthesia with combination of acupuncture [conducted with Han's acupoint nerve stimulator (HANS) applied] and enflurane in radical operation of laryngocarcinoma (LC).

METHODSSixty patients with LC of grade I - II , classified according to the standard of American Society of Anesthesiologists (ASA), were assigned by randomizing number table to the control group and the tested group, 30 patients in each group. The control group received anaesthesia with enflurane alone for inducing and maintaining; the tested group was anaesthetized with enflurane like that given to the control group but also received additionally needling stimulation conducted by HANS. The dosage of enflurane used, the minimum effective concentration of enflurane in alveolar air (MACEnf) and the changes of heart rate (HR) as well as blood pressure (BP) in patients at different time points in the operational process were observed.

RESULTSAs compared with those in the control group, in the tested group, both the MACEnf and the dosage of enflurane were reduced, with the difference between the two groups significant (P<0. 01). The changes of HR and BP among different time points in the tested group were slight, and as compared with those in the control group at the corresponding time points, the difference was significant ( P <0. 05 or P<0.01).

CONCLUSIONGeneral anaesthesia with combination of enflurane and needling conducted by HANS applied in radical operation of LC has definite effect with less complication. Needling could be cooperated with narcotics, and so it could be taken as an auxiliary measure of anaesthesia for radical operation of LC.

Acupuncture Analgesia ; Adult ; Aged ; Anesthesia, General ; Anesthetics, Inhalation ; pharmacology ; Blood Pressure ; drug effects ; Enflurane ; pharmacology ; Female ; Heart Rate ; drug effects ; Humans ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Vecuronium Bromide ; pharmacology

Adenocarcinoma ; pathology ; surgery ; Aged ; Carcinoma, Signet Ring Cell ; pathology ; surgery ; Cell Differentiation ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Paneth Cells ; pathology ; Stomach Neoplasms ; pathology ; surgery

Heart transplantation is considered the best treatment modality for advanced heart disease.While old age has conventionally been considered a contraindication for heart transplantation due to the reported adverse effect of advanced age,however donor hearts' shortage continues to stimulate the discussion about the recipient's upper age limit.Our study was based on a retrospective analysis for the results of 52 (18％) patients aged 60 years and older undergoing heart transplantation between May 2008 and December 2015,and these patients were compared with 236 (82％) adult recipients who were younger than 60 years at the time of transplantation and during the same period.In older group,71％ were males with the mean age of 63.38+3.55 years,and in younger group,83.4％ were males with a mean age of43.72±11.41 years (P=0.27).Dilated cardiomyopathy was the most common indication for transplantation among patients in both groups (P=0.147).In older group,the 3-month survival rate was higher than that in younger group (P=0.587),however the 6-month survival rate showed no significant difference (P=0.225).Although the 1-year survival rate was higher in older group (P=0.56),yet the 3-year survival rate between the two groups showed no statistically significant difference (P=0.48).According to our experience among older heart transplant candidates who were 60 years and older,we believe that advanced age should not be an excluding criterion to cardiac transplantation.

Objective:To observe the clinical efficacy of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation (LIDH).Methods:A total of 70 patients with LIDH were randomized into an observation group and a control group,with 35 cases in each group.The observation group was treated with acupuncture at abdomen acupoints plus tuina,while the control group was treated only with tuina treatment.The clinical efficacy was observed after one course of treatment.Results:The cure rate and the total effective rate of the observation group were 83.3％ and 96.7％,respectively.The cure rate and the total effective rate of the control group were 39.4％ and 78.8％,respectively.There were significant differences in the cured rate and the total effective rate between the two groups (both P＜0.05).There was no significant difference in Japanese Orthopedic Association (JOA) score between the two groups before treatment (P＞0.05).After treatment,the JOA scores of both groups increased significantly,and the intra-group differences were statistically significant (both P＜0.05);the JOA score of the observation group was significantly higher than that of the control group (P＜0.05).Conclusion:Acupuncture at abdomen acupoints plus tuina has a better therapeutic effect than tuina alone in the treatment of LIDH.

Objective To investigate the effects of basal and early phase insulin secretion on plasma glucose level in type 2 diabetes. Methods Plasma glucose and true insulin levels were measured at 0, 30, 60, 120 min during standard meal test in 81 patients with type 2 diabetes. Insulin sensitivity index (ISI) and insulin secretion index (?I 30 /?G 30 ) were calculated for evaluating the insulin sensitivity. Contributions of basal and early insulin secretion to plasma glucose level were evaluated by multivariate regression analysis with SAS software. Results ISI and ?I 30 /?G 30 showed nearly equal effects on plasma glucose levels by multivariate regression analysis. Among insulin levels of different time points during standard meal test, basal and postprandial 60 min insulin levels played important roles in changes of plasma glucose levels. The effect of fasting insulin on the area under plasma glucose curve was stronger than that of ?I 30 /?G 30 . Conclusion Both basal and early insulin secretions greatly contribute to glycemic control.

OBJECTIVETo investigate the selection of operative methods,timing of operation and the effect of hige-energy distal tibia Pilon fracture.

METHODSFrom July 2006 to December 2009, 29 patients with hige-energy distal tibia Pilon fractures were treated, including 23 males and 6 females with an average age of 36.8 years old ranging from 21 to 54 years. According to Ruedi-Allgower classification on Pilon fractures, there were 3 cases of type I, 16 of type II and 10 of type III. The type I patients were fixed by screws and Kirschner wires and the cases of type II and III were fixed by filmy clover steel plates closed up tibia medial border or tibia lateral anatomical steel plates. All patients were evaluated by the tumid algesic level of ankle joint, gait,the activity of ankle joint according to Mazur score.

RESULTSNone of patients occurred complications such as deep infection, fractured internal fixation and prolapsed internal fixation. All patients were followed up from 6 to 42 months (averaged 28 months). The time of fracture healing was from 10 to 32 weeks (means 15 weeks). According to the ankle score of Mazur, the results were excellent in 15 cases,good in 10 cases,fair in 3 cases, poor in 1 case.

CONCLUSIONThe step-by-step delayed open reduction and internal fixation for hige-energy distal tibia Pilon fracture is an effective method with fewer complications and good function after the recovery of soft tissue injury. The method can not only mitigate the level of soft tissue injury, but also is beneficial to the early joint motion with rigid fixation.

Adult ; Female ; Follow-Up Studies ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Tibia ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Time Factors ; Tomography, X-Ray Computed ; Young Adult