During the past year of 2011,International Diabetes Federation ( IDF),American Association of Clinical Endocrinologists ( AACE),Chinese Diabetes Society,and Chinese Society of Endocrinology,etc had published some guidelines and consensuses on clinical diagnosis,treatment,laboratory test,and complication therapy of diabetes.Characters of diabetic angiopathy in Chinese and death cause of diabetes were also announced by several new studies.Meanwhile,Food and Drug Administration ( FDA ) and The European Agency for the Evaluation of Medicinal Products(EMEA) declared their statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles on standard clinical diagnosis,treatment,and medication.

Objective To study the factors associated with post-operattve renal function injury after laparoscopic nephron-sparing surgery(LNSS)for tumors. Methods Fifty consecutive patients were enroned in a prospective protocol and underwent LNSS.Preoperative and postoperative renal scintigraphic scan was performed in all patients. 99 Tcm-diethylenetetraminepentacetic acid scan was performed in all patients.Linear correlation and multivariate regression model were used to analysis the factors associated with postoperative renal damage.Twenty consecutive patients associated with risk factors were followed-up.These data in GFR were monitored at the preoperative,1 week and 3 months after operation.The duration Warm ischemia was recorded. Results In selected patients,assessed by renal scintigraphy,the function of the operated kidney was reduced by a mean of 24%.Linar correlation analysis showed that there was positive correlation between the age,tumor size,duration of warm ischemia and postoperative renal function injury.Furthermore,multivariate Legression analysis revealed that the duration of warm ischemia was the independent risk factor of postoperative renal damage.Twenty consecutive patients were included in this protocol.There was a significant difference between vessel clamp time≤30 min and vessel clamp time＞30 min.Renal scan data did not reveal any significant decrease in GFR in the affected kidney at 3 months after surgery for the patients whose yesscl clamp time less than 30 min.Renal function damage could not recover in the patients over 70 years with longer than 30 min warm ischemia or with longer than 60 min warm ischemia. Conclusions This paper evaluated renal function on the affected side before and after surgery by measuring renal function with renal scintigraphy using99 Tcm-DTPA.Risk factors for renal dysfunction in the affected kidney after LPN are age over 70 years with more than 30min warm ischemia time,and a warm ischemia time longer than 60 min.

Objective To evaluate the clinical effect of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for refractory ulcerative colitis (UC).Methods In this study 60 refractory UC patients received IPAA operation during the period of 1990 to 2010.Data were collected regarding early and late postoperation complications,anal continence function,and characteristics of feces.The patients' quality of life was objectively accessed using the Clevend Global Quality of Life (CGQL)index.0ne-way analysis of variance was used.Results Mean follow-up period was 2 years.Early postoperative complication rate developed in 15％ (9/60),including abdominal or pelvic infection,anastomotic leak,pouch bleeding,pouch-vaginal fistula,and intestinal obstruction.Late postoperative complication rate was 12％ (7/60),including pouchitis,intestinal obstruction,and male sexual dysfunction.Stool frequency per 24 hours and that at night was 3.5 ± 1.3 and 1.4 ±0.6.93％ (56/60)patients differentiated gas and feces well and 3％ (2/60) needed daily pads.According to Kirwan Grading Scale,anal function outcomes were Grade Ⅰ:54 (90％),Grade Ⅱ:4 (7％),and Grade Ⅲ:2 (3％).According to Bristol Stool Form Scale,characteristics of feces were Grade Ⅳ:31 (52％),Grade Ⅴ:25(42％),and Grade Ⅵ:4 (6％).Postoperative CGQL result showed a much better quality of life than preoperative CGQL (F =12.368,P ＜ 0.05).Conclusions Refractory UC is surgically indicated and IPAA is the operation of choice with safety,satisfactory long-term outcome and improved quality of life.

Objective To study the application value of direct digital X‐ray radiography system in the degenerative lumbar insta‐bility .Methods 100 patients with degenerative lumbar instability disease were collected in our hospital ,in which there were L4 ,L5 (80 cases) and L5 ,S1 (20 cases) with degenerative lumbar instability disease .Carestream DRX‐Evolution system was used ,which included conventional horizontal lumbar function photography (control group) and physiological load of lumbar function photography (observation group) .Changes of the displacement or the angle of the lumbar segment on two groups were measured ,and the statisti‐cal software was used to carry on the comparative analysis .Results In 100 patients ,the position and the physiological load position were showed on the sagittal position which were as following :For the lumbar segment of L4 and L5 ,flexion [position (4 .50 ± 0 .25) mm , load position (4 .78 ± 0 .30) mm] ,extension [position (4 .87 ± 0 .22) mm ,load position (5 .18 ± 0 .30) mm] ,and for the lumbar segment of L5 and S1 ,flexion [position (4 .64 ± 0 .24) mm ,load position (4 .91 ± 0 .24) mm] ,extension [position (4 .95 ± 0 .30) mm , load position (5 .30 ± 0 .29) mm];For the intervertebral angle degree of L4 and L5 ,flexion (position 10 .64° ± 0 .29° ,load position 12 .12°± 0 .57°) ,extension (position 11 .57°± 0 .24° ,load position 12 .61°± 0 .28°);For the intervertebral angle degree of L5 and S1 , flexion (position 11 .63° ± 0 .26° ,load position 12 .72° ± 0 .27°) ,extension (position 13 .55° ± 0 .30° ,load position 14 .58° ± 0 .33°) , respectively .The difference between two groups was statistically significant (P< 0 .05) .Conclusion Compared with traditional method ,DR lumbar physiological weight‐bearing functional can more accurately understand the lumbar instability degree ,grading and lumbar positive rate ,which provides the basis for clinical diagnosis and treatment plan .

BACKGROUND:Twin block appliance has been shown to effectively promote mandibular bone growth of Class Ⅱ malocclusion patients and improve lateral appearance of mandibular retrusion.The other improvement of Twin block appliance on hard-soft tissues remains unclear.OBJECTIVE:To assess the hard-soft tissue changes following Twinblock appliance treatment.METHODS:Atotal of 48 adolescent patients,30 males and 18 females,aged 11.6 years (range 9.58-12.37) with Class Ⅱ malocclusion were selected from Department of Orthodontics,Affiliated Stomatology Hospital of Hebei Medical University.Of them,27 were treated with Twinblock appliance as the treatment group,and 21 adolescent patients without treatments were selected as the control group.Cephalonetric analysis was used to compare the changes before and after treatment.RESULTS AND CONCLUSLON:Comparative analysis showed that Twinblock could effectively adjust or improve the effect of the natural growth,reduced upper lip convexity and mentolabial furrow angle.Moreover,Twinblock inhibited facial vertical distance reduction and facial convexity increase to decrease the potential differences between maxillary and mandibular bones in sagittal plance.Results show that Twinblock could effectively improve the profile of soft-tissues of Class Ⅱ malocclusion cases,

Objective To evaluate the relationship between echocardiographic epicardial adipose tissue thickness(EAT) and the presence and severity of coronary artery disease(CAD). Methods One hundredand forty-seven patients (101 patients with CAD and 46 patients with normal coronary arteries by diagnostic coronary angiography) were enrolled. EAT thickness was measured using 2-D echocardiographic parasternal long-and short-axis views. EAT thickness measurements were compared with angiographic findings. Results EAT was significantly higher in CAD group comparison to control group [(7.41 ± 1.63)mm vs (4.41±1.60) mm, P ＜0.01 ]. Furthermore, EAT increased with the severity of CAD [(8.53 ± 1.00)mm vs (6.36 ±1.73)mm, P ＜0.01]. Gensini's score significantly correlated with EAT (r = 0.71, P ＜0.01 ). EAT thickness ≥5.35 mm had 87.13% sensitivity and 80.42% specificity (ROC area 0. 89, P = 0.01,95% CI [0.84 - 0.9;]) for predicting CAD. Conclusions EAT thickness, which is easily and non-invasively evaluated by transthoracic echocardiography, can be an adjunctive marker to classical risk factors for the prediction of CAD, it was significantly correlated with the severity of coronary artery disease.

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Short-Wave Therapy ; Spinal Diseases ; therapy ; Thoracic Vertebrae

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in diagnosing ischemic-type biliary lesion (ITBL) and analyze the relation between the enhancement patterns of bile duct wall of ITBL and its outcome.Methods 36 patients confirmed with ITBL (24 cases),anastomotic biliary stricture (3 cases),cholangitis (4 cases),biliarysludge (1 cases),and acute rejection (4 cases),who underwent CEUS examination,were enrolled in this study.The images were retrospectively analyzed in consensus by 2 readers.After reviewing the images,the readers were asked to make a diagnosis of ITBL.The diagnostic standard was hypo-or non-enhancement of hilar bile duct wall in arterial phase on CEUS.Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 66.7％,83.3％,72.2％,88.9％,and 55.6％ for reader 1;62.5％,83.3％,69.4％,88.2％,and 52.6 ％ for reader 2,respectively.The interobserver agreement was good (κ =0.83).In 24 ITBL patients,the ratio of mortality or retransplantation with non enhancing hilar bile duct wall in arterial phase was much higher than that with enhancing hilar bile duct wall (non-enhancement 54.5％,hypo-enhancement 20％,hyper-or iso-enhancement 12.5％).Conclusions CEUS had diagnostic value of ITBL.Non-enhancing hilar bile duct wall in arterial phase on CEUS predicated the poor outcome.

Objective • To explore the clinical characteristics of the obsessive-compulsive disorder (OCD) patients with hoarding symptoms and analyze the risk factors related to hoarding symptoms. Methods • A total of 247 OCD patients and 137 healthy controls (HC) were enrolled. The OCD patients were divided into hoarding group and non-hoarding group according to hoarding symptoms. Yale-Brown Obsessive-Compulsive Scale, Hamilton Depression Scale, Hamilton Anxiety Scale, Neuroticism Extraversion Openness Five-Factor Inventory and Obsessive Belief Questionnaire-44 were used to measure the severity of OCD, levels of depression and anxiety, personality characteristics and obsessive-compulsive beliefs of the three groups. The differences among the groups were compared, and Logistic regression was used to analyze the related factors of hoarding symptoms. Results • Regardless of hoarding symptoms, the scores of depression, anxiety, neuroticism and obsessive beliefs in the patients with OCD were significantly higher than those in the healthy controls (all P=0.000). Compared with OCD/non-hoarding group, OCD/hoarding group had a significantly lower level of extroversion (P=0.000), a significantly higher level of perfectionism/certainty (P=0.037), and higher scores in indecisiveness (P=0.003), pathological responsibility (P=0.006) and pathological slowness (P=0.000). There was statistical significance in age (OR=0.94), extraversion score (OR=0.89) and pathological retardation score (OR=2.50) in Logistic regression model (all P<0.05). Conclusion • The risk of hoarding symptoms in the OCD patients decreases with the increase of age and extroversion level, and increases with the increase of pathological retardation level.

Objective • To screen for a bacteriophage of a drug-resistant Klebsiella pneumoniae strain and assess its eligibility to be incorporated into the Klebsiella bacteriophage library. Methods • A drug-resistant Klebsiella pneumoniae strain isolated from a patient with urinary infection was used as the host strain. Phage screening was carried out in environmental sewage, and the bacteriophage was isolated, purified, characterized and sequenced. Safety evaluation was also conducted based on the genome sequence. Results • A drug-resistant Klebsiella pneumoniae bacteriophage was isolated and designated as JD902, which belonged to Caudovirales. The burst size was 88 pfu/cell, and it could maintain good activity in pH range 4.0-11.0. Genomic analysis demonstrated that it did not carry any antibiotic resistance genes and virulence factor genes. Conclusion • JD902 is a virulent phage with high stability and safety in vitro. It can be incorporated into bacteriophage library for clinical treatment.