The fatty acid components and microviscosity of erythrocyte membrane in 39 type 2 diabetic patients with and without coronary heart disease(CHD) were examined by high-performance liquid chromatography (HPLC) and fluorescence polarization teachnique,and their relationship with insulin sensitivity index (ISI) and CHD were analyzed.The results showed that contents and composition of erythrocyte membrane arachidonic acid (AA,C20:4)were significantly lower in type 2 diabetic patients with or without CHD than those in control subjects (P＜0.01 and P＜0.05).The total fatty acids contents were also significantly lower in patients with CHD than those in normal subjects (P＜0.05).In patients with or without CHD,erythrocyte membrane microviscosity was significantly increased as compared with the controls (P＜0.01 and P＜0.05),and it was higher in diabetics with CHD than those without CHD (P＜0.05).AA contents of erythrocyte membrane was negatively correlated with microviscosity and positively correlated with insulin sensitivity index (ISI),while the microviscosities were negatively correlated with ISI in diabetics.AA,linoleic acid contents,microviscosity of erythrocyte membrane and ISI were all correlated with the incidence of CHD in diabetics.In diabetic patients,the fatty acid metabolic abnormality could cause the alterations of functions,structures and fluidity of erythrocyte membrane,thus may contributing to increased IRS and might be related to the incidence of CHD.

Objective To compare the therapeutic effect of routine dose of calcitriol and large dose impulsion therapy on hemodialysis patients with secondary hyperparathyroidism(SHPT). Methods 48 uremic hemodialysis patients were divided into group A(routine group, n = 22) and group B(control group, n = 21 ). In group A,22 pa-tients were administered with calcitriol for 6 months at the dosage of 0.25～0.5μg/d,adding calcium agents simul-taneously;the patients in group B were not given calcitriol for economic reason. In group C,21 patients were given calcitriol twice a week at the dosage of 2μg/time after hemodialysis for 3 months. Results Comparing to group B,serum PTH,AKP in group A had no significant difference,but serum hypocalcium and hyperphasphate were partly corrected,symptoms of bone pain, muscular convulsion and akin pruriter were improved. Comparing to group A,serum hypocalcium and hyperphasphate in group C were corrected, serum PTH, AKP were significantly decreased( t=2.031,P<0.05;t =3.317,P<0.001),and no hypercalcium oecurred. Conelosion Routine dose of calcitriol can not control uremic-SHirr,while impulsion therapy with lower dose oral calcitriol is effective and safe.

Objective To explore the determination of elements selenium content in Se Semen Cassiae. Method Selenium content in Se Semen Cassiae was measured by graphite atomic absorption spectrophotometer. Result and Conclusion An appropriate extraction method and digesting condition were screened out. The determined results were accurate when the digested sample was dissolved and metered volume with 1% HNO3 which containing 0.1% Tween 80.

Objective To inquire into the value of Liechtenstein Hernioplasty in the therapy of oblique or direct hernia.Method Liechtenstein was used in the therapy of 163 cases of oblique hernia (154 cases) and direct hernia (9 cases) from Feb.1998 to Jun.2001 and the clinical data was retrospectively studied.Most of them are of onset hernia except 8 cases of recurrent hernia.In 148 cases,the diameter of hernia ring is less than 2.5 cm and 30.1% of patients are elder than 65.The emergent operation was adopted in 12 cases.Results Off-bed exercises can be admitted at early stage of postoperation with slight pain and no local tension.Total recovery was obtained in 5-10 days after operation.After 6-36 months' follow-up,no mortality and less recurrence was detected.Conclusions There are so many advantages to treat oblique or direct hernia with Liechtenstein, such as minimized trauma, accelerated recovery,low recurrence rate and low cost. The indication of this operation involved all kinds of hernia (onset or recurrence of oblique or direct hernia,emergent operation of incarcerated oblique hernia, etc).

Breast Neoplasms ; metabolism ; pathology ; Cell Polarity ; Epithelial Cells ; metabolism ; pathology ; Epithelial-Mesenchymal Transition ; Eye Proteins ; metabolism ; Female ; Humans ; Membrane Proteins ; metabolism ; Nerve Tissue Proteins ; metabolism ; Receptors, Proteinase-Activated ; metabolism ; Tumor Suppressor Proteins ; metabolism

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2010 to June 2013 clinical data of 37 pairs of MCDA twins (74 fetuses)with sIUGR and 40 pairs of normal MCDA twins (80 fetuses) in the same period were analyzed retrospectively.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 20 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,twins discordance of birth weight,neonatal death and survival rate at 6 months.Results The gestational age of sIUGR group at delivery was significantly earlier than that of control group [(33.1 ± 3.0),(36.9 ± 3.2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR group was significantly higher [5.4％ (4/74),0,respectively],there was significant difference(P ＜ 0.05).In sIUGR group,the average birth weight of large or small twins [(2 030.8 ± 353.4),(1 529.0 ± 432.9) g] was smaller than those in control group [(2 471.5 ± 500.9),(2 346.0 ± 460.3) g],there was significant difference (P ＜ 0.05).The twins discordance of birth weight in sIUGR group was significantly larger [(27.2 ± 2.6)％] than that in control group [(8.0 ± 1.6)％] (P ＜0.05).The gestational age at delivery in type Ⅱ and type Ⅲ [(33.1 ± 5.0),(34.3 ± 2.8) weeks] was significantly earlier than that in control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18.2％,4/22) was significantly higher than that in type Ⅰ (0) and control group (0) (P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1 646.0 ± 433.5),(1 332.8 ± 310.5),(1 504.5 ± 382.2) g respectively,all of which was significantly smaller than that in control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the twins discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅲ was (26.3 ±5.1)％,(31.0 ±1.6)％,(31.4 ±3.3)％ respectively,all of which was significantly larger than that in control group (P ＜0.05).There were no significant difference of the twins discordance of birth weight among the three types of sIUGR (P ＞ 0.05).Survival rate at 6 months in type Ⅱ (63.6％,14/22) was significantly lower than type Ⅰ (95.0％,38/40) and control group (92.5 ％,74/80) (P ＜ 0.05).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅱ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.

Objective To observe the transformation features of children with complete atrioventricular block(CAVB), and to improve the diagnosis and treatment of this disease.Methods Seventeen children with primary diagnosis of CAVB were reviewed by retrospective and follow-up study and the clinical characteristics, treatment schemes and prognosis were evaluated.Results Four cases of congenital CAVB lived normally without obvious symptoms in the tracing period from 6 months to 9 years;1 case had the onset of Adams-Stokes syndrome induced by diarrhea;3 cases of the CAVB caused by virus myocarditis turned into sinus rhythm after comprehensive therapy;2 cases persistently presented with the CAVB Complicated with enlarged heart;1 case gave up treatment after deterioration, and one case died.Three cases of temporary CAVB after the open heart operation turned to sinus rhythm in transitory time, while other two cases presented with permanent CAVB and treated with epicardium pacemaker,among whom one had the pacemaker replaced for one time in the 8-year follow-up,and the follow-up of other cases were intermitted.Conclusions The congenital CAVB in the study group with normal QRS interphase and no obvious symptom might not require treatment but follow-up is needed. While infants with heart malformation and wide QRS wave could not endure the low ventricular rhythm are in high risk. Virus myocarditis induced CAVB children tend to present the Adams-Stokes syndrome, and require effective treatments. Partial cases of the CAVB caused by open heart operation may turn to normal sinus rhythm in 2-4 weeks after surgery. cases has persistent CAVB for over 4 weeks, or Adams-Stokes syndrome onset after the surgery demand epicardium pacemaker treatment.

Objective To evaluate the significance of standardized ultrasound examination of fetal structures in the ifrst trimester (11-13+6 weeks). Methods The ultrasound data of 29 858 fetuses who underwent the ifrst trimester screening were analyzed retrospectively in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2010 to December 2012 and followed up the cases with structural abnormalities and increased nuchal translucency (NT). Results Among 29 858 fetuses, 328 structural defects were detected in 284 fetuses (0.95%) by ultrasound in the first trimester, including fetal hydrops (124 cases), choroid plexus cysts (36 cases), exencephaly (32 cases), gastroschisis (24 cases), exomphalos (22 cases), cardiac defects (19 cases), megacystis (14 cases), spine abnormalities (10 cases), meningoceles/encephaloceles (9 cases), alobar holoprosencephaly (8 cases), hydrocephaly (7 cases), abnormalities of extremities (7 cases), acrania (6 cases), amniotic band syndrome (4 cases), abdominal cyst (3 cases) and conjoined twins (3 cases). Pregnancy was terminated in all cases (115) with exencephaly, gastroschisis, exomphalos, meningoceles/encephaloceles, alobar holoprosencephaly, hydrocephaly,abnormalities of extremities, acrania, amniotic band syndrome and conjoined twins, and the defects were verified by the gross appearance of fetuses. Two cases of megacystis were turned out to be normal during follow-up while 1 case was proved to be aneuploid and 1 other case progressed to multiple abnormalities during the second trimester. Most choroid plexus cysts, except 1 case of aneuploid, were normal during the second and the third trimester follow-ups by ultrasound. Thirteen cases of fetal hydrops were found to be aneuploids and 4 hydrops cases were proved to be complicated with other structural defects during the second and the third trimester. NT was increased in 422 cases (1.41%), among which 122 cases (28.91%) were complicated with structural defects and/or fetal hydrops. Ninty-nine cases with increased NT underwent chromosomal examination and 38 cases were found to be aneuploides. During the follow-up of 298 cases with increased NT who continued pregnancy, 21 structural abnormalities were found, including cardiac defects (14 cases), neural abnormalities (4 cases) and diaphragmatic hernia (3 cases). Conclusion The standardized fetal ultrasound in the first trimester is a effective tool for the screening of aneupolides and major structural abnormalities.

ObjectiveTo evaluate the efficacy of preoperative oral pregabalin for attenuating postoperative pain after laparoscopic cholecystectomy.MethodsIn this prospective,randomized controlled double-blind study,sixty ASA Ⅰ or Ⅱ patients aged 19-72 yr weighing 46-86 kg undergoing laparoscopic cholecystectomy were randomly divided into 2 groups ( n =30 each):control group (group C) received placebo,and pregabalin group (group P) received oral pregabalin 150 mg 1 h before surgery.Anesthesia was induced with propofol,fentanyl and rocuronium and maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and rocuronium.The patients were intubated and mechanically ventilated.BIS value was maintained at 40-50 during operation.Static and dynamic VAS score,Ramsay score and consumption of morphine were recorded at 6,12,and 24 h after surgery.Side-effects including nausea,vomiting,headache and dizziness were also recorded.ResultsStatic and dynamic VAS scores and morphine consumption were significantly lower during the first 24 h after surgery while Ramsay scores were higher at 6 h after operation in group P than in group C.There was no significant difference in the incidence of side-effects between the 2 groups.No over-sedation occurred in group P.ConclusionPreoperative oral pregabalin 150 mg is safe and effective in reducing postoperative pain after laparoscopic cholecystectomy.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Pain Management