Objective: To investigate the therapeutic effect of intensive glycemic control on patients with early diabetic nephropathy. Methods: A total of 41 type 2 diabetes patients who developed microalbuminuria were divided into two groups randomly. Patients in Group A received intensive glycemic control and the blood glucose in Group B was regularly controlled. Glycemic monitoring and control were followed for 12 weeks to observe the changes of microalbuminuria in both groups; meanwhile the levels of serum lipids and coagulation indices were also recorded. Results: The urine albumin excretion rate (UAER) in Group A decreased significantly from (47.91±13.86)mg/24 h to (35.31±14.56)mg/24 h after 12 weeks (P<0.05), and this decrease was significantly greater than that in Group B. However, Group B had no significant difference in UAER decrease [(48.93 ± 13.32)mg/24 h to (40.48 ± 19.62)mg/24 h, P>0.05]. The decrease of triglyceride (TG) and low-density lipoprotein cholesterol (LDL cholesterol), and the increase of high-density lipoprotein cholesterol (HDL cholesterol) showed no significant differences (P>0.05). And the level of plasma fibrinogen (FIB) showed no significant decrease after 12 weeks, either (P>0.05). Conclusion: Intensive glycemic control reduces the level of microalbuminuria and may ameliorate the progression of early diabetic nephropathy.

Objective: To investigate the therapeutic effect of intensive glycemic control on patients with early diabetic nephropathy. Methods: A total of 41 type 2 diabetes patients who developed microalbuminuria were divided into two groups randomly. Patients in Group A received intensive glycemic control and the blood glucose in Group B was regularly controlled. Glycemic monitoring and control were followed for 12 weeks to observe the changes of microalbuminuria in both groups; meanwhile the levels of serum lipids and coagulation indices were also recorded. Results: The urine albumin excretion rate (UAER) in Group A decreased significantly from (47.91±13.86)mg/24 h to (35.31±14.56)mg/24 h after 12 weeks (P<0.05), and this decrease was significantly greater than that in Group B. However, Group B had no significant difference in UAER decrease [(48.93 ± 13.32)mg/24 h to (40.48 ± 19.62)mg/24 h, P>0.05]. The decrease of triglyceride (TG) and low-density lipoprotein cholesterol (LDL cholesterol), and the increase of high-density lipoprotein cholesterol (HDL cholesterol) showed no significant differences (P>0.05). And the level of plasma fibrinogen (FIB) showed no significant decrease after 12 weeks, either (P>0.05). Conclusion: Intensive glycemic control reduces the level of microalbuminuria and may ameliorate the progression of early diabetic nephropathy.

ObjectiveTo observe the changes of artery diameters, cerebral blood flow and glutamate level in the early stage (2 h after the stimulus finished) of acute mechanical middle cerebral artery (MCA) vasospasm in cats. MethodsThe right MCA was persistently mechanically stimulated using a small smooth stainless steel nail in the field across the olfactory tract for 30 min. The diameter of MCA was recorded with metrical ocular of microscope. The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull. The level of glutamate were investigated through high performance liquid chromatography. ResultsThe diameter of MCA decreased to 68.8% of normal. 2 h later, the diameter of MCA recovered. The perfusion index of the cortex surface decreased to 42.6% of normal and up to 63.8% 2 h later. The level of glutamate raised about 40 times of normal and maintained a high level 2 h after the mechanical stimulus. ConclusionThe persistent mechanical stimulus can cause acute cerebral vasospasm. Reduce of cerebral blood flow and raise of excitatory amino acids were observed in the early stage of acute mechanical vasospasm.

Objective To investigate the relationship between the steroid-sensitive nephrotic syndrome(SSNS) and interleukin-18(IL-18) and to approach the inhibitive role of dexamethasone(DEX) on expression of IL-18 of peripheral blood mononuclear cells(PBMC) in children with SSNS in vitro.Methods IL-18 levels of serum, urine and supernatants of PBMC cultured in vitro were measured by enzyme linked immunosorbent assay(ELISA) in 23 children with SSNS who were either before or after treatment. Fifteen age-matched healthy children served as normal control group, and another 18 children with respiratory infections as infectious control group.Results There were signi-ficant differences of IL-18 in serum and urine before and after treatment in children with SSNS (t=15.072,16.149 Pa

OBJECTIVETo study the in vitro antibacterial activity of cefdinir against clinical isolates of respiratory tract pathogens in Children.

METHODSMIC values of cefdinir against 380 strains were determined with E-test method and compared with those of cefaclor.

RESULTSAll penicillin-susceptible Streptococcus pneumoniae (PSSP) strains were also susceptible to cefdinir and cefaclor. Both cefdinir and cefaclor were not active against penicillin-resistant SP (PRSP). Against penicillin-intermediate SP (PISP) the susceptibility rates of cefdinir and cefaclor were 70.1% and 57.4%, respectively. The activity of cefdinir and cefaclor against beta-lactamases negative Hemophilus influenzae (HI) was excellent, but the susceptibility rates of cefdinir and cefaclor against beta-lactamases positive HI were 85.0% and 70.0%, respectively with MIC(90) of 1.5 mg/L vs. 256.0 mg/L. Cefdinir presented higher activities and lower MIC values than cefaclor against Moraxella catarrhalis (MC), Group A streptococcus (GAS), methicillin susceptible staphylococcus aureus (MSSA), and extended spectrum beta-lactamases (ESBLs) negative Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pn). Both cefdinir and cefaclor were not susceptible to ESBLs positive E. coli and K. pn.

CONCLUSIONSCefdinir exhibits excellent activity against PSSP, PISP, HI, as well as MC, GAS, MSSA and ESBLs negative E. coli or K. pn.

Anti-Bacterial Agents ; pharmacology ; Bacteria ; drug effects ; Cephalosporins ; pharmacology ; Child ; Humans ; Microbial Sensitivity Tests ; Respiratory System ; microbiology

Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.

Objective To evaluate the clinical outcome of external bracket fixation in the treat- ment of complex tibia diaphysis fracture involving intra-articular fractures.Methods Forty-two cases of complex tibia diaphysis fracture with proximal and distal intra-articular fractures treated surgically in our hospital from January 1999 to January 2004 were analyzed.The complex tibia diaphysis fractures were categorized according to the AO classification as type C2 (multiple segments fracture) and type C3 (ir- regular fracture),proximal and distal intra-articular fractures in 23 and 19 cases,respectively.Definite operation was done within one week.Twenty-two cases were treated with simple external fixator,and 20 cases treated with screws and external fixator.Results All the 42 cases were followed-up regularly. According to AO evaluation of the knee and ankle joint movement,83% (35/42 cases) of the cases gained satisfactory functional outcome,14% (6/42 cases) had quite satisfactory results and 2% (1/42 case) had unsatisfactory functional outcome.Conclusion External bracket fixation can obtain outcome of relative length of the tibia and fibula,tube structure reconstruction,smoothness of the articular surface and the parallel and symmetric relation of knees and ankles for complex tibia diaphysis fracture with proxi- mal and distal intra-articular fracture.The arthritis resulting in pain in movement and restriction of func- tion is considered to be the most important factor affecting the joint function.Early functional exercise is important for best recovery of knee and ankle function.

Objective To investigate the feasibility and clinical effect of the tubeless minipercutaneous nephrolithotomy (PCNL) in treatment of upper ureteral calculi.Methods From March 2014 to March 2015,all the patients with upper ureteral calculi except for those with severe infection,pyonephrosis or renal cortex less than 5 mm were randomized into two groups,the standard PCNL group (24 F nephrostomy tube) and the mini-PCNL group (18 F nephrostomy tube).After PCNL,all the patients received ultrasound examination to check residual stones,perforation and urine leakage.DJ tube was placed and the channel of PCNL was packed with hemostatic sponge without nephrostomy tube.There were 26 patients in standard group and 28 in mini-group.The operation time,postoperative hemoglobin change,postoperative visual analogue pain score (VAS),the time when urine turned clean,postoperative urinary extravasation,hydrothorax,fever and the stone-free rate were compared between two groups.Particularly,these data were compared in those aged＞65 years.Results The operation time in the standard PCNL and the mini-PCNL group was (58.3 ±21.8) and (86.4±23.3) minutes respectively,and had a significant difference (t=10.836,P＜0.05).The decrease in hemoglobin level was (8.3±5.8) g/L and (7.7±0.5.4) g/L,the VAS scores was (3.8±0.8) and (3.6±1.1),the time when urine turned clean was (11.9±4.7) h and (9.6±5.6) h,the postoperative hospital stay was (5.1±0.8) d and (4.8±1.2) d,and the stone free rate was 92.3％ and 89.2％ in standard PCNL and mini-PCNL group respectively(P＞ 0.05).No significant difference were found between two groups (all P＞0.05).There was one patient who got fever more than 38.5℃ in the standard group and 2 cases in the mini-group.Each group had 1 slight hydrothorax,and no blood infusion and perinephric urinary extravasation were found.The application of packing hemostatic sponge in the nephrostomy channel was feasible and suitable for both the standard and tubeless mini-PCNL groups.Conclusions The application of packing hemostatic sponge in the nephrostomy channel is feasible and suitable in both the standard and tubeless miniPCNL.It is safe for the treatment of renal and ureteral calculi,and it can decrease the hemorrhage and urine leakage,which works for the elderly patients too.

Objective To evaluate diagnostic value of diffusion tensor imaging(DTI)in ringlike- enhanced lesions.Methods Nine abscesses,12 glioblastomas,10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI.Average diffusion coefficient(ADC)value,fractional anisotropy(FA)value and maps were calculated in the central portion and peripheral edema of the lesions. Results On DTI,the abscesses displayed as hyperintense signal with hypointense or isointense signal of edema;but glioblastomas and metastases all showed as hypointense signal with isointense or hypointense signal of edema.On ADC map,the abscesses showed as hypointense signal,the mean ADC value was (0.66?0.07)x10~(-3)mm~2/s,The mean ADC value were(2.50?0.11)x10~(-3)mm~2/s and(2.37?0.52)x10~(-3)mm~2/s for the glioblastomas and metastases,respectively,all demonstrated as hyperintense signal with slightly hyperintense signal of edema.The difference between abscess and necrotic tumors was statistically significant(F=108.80,P