ObjectiveTo investigate the correlation between glucose excursions and oxidative stress in the elderly type 2 diabetic patients. MethodsFifty five elderly type 2 diabetic patients (32 males and 23 females) were recruited. All the patients were submitted to continuous glucose monitoring system (CGMS) for three days. According to the result of CGMS monitoring ,the patients were divided into two groups: high glucose excursion group (30 cases) and low glucose excursion group (25 cases). In high glucose excursion group, the therapy was adjusted for 4 weeks based on the CGMS monitoring. After the treatments, the specimens of blood were collected again to detect the related indexes. Results(1) There were no differences in age, blood pressure, fasting blood glucose and glycosylated hemoglobin between the two groups (all P>0.05). The stardard deviation of blood glucose was higher, and the maximun and average amplitude of glycemic excursion were significantly lower in high glucose excursion group than in low glucose excursion group (t= 5. 4620,5. 9416,3. 8281, all P<0.05) ;(2) Compared with low glucose excursion group, plasma concentration of 8-iso-PGF2a was obviously higher in high glucose excursion group[(57.56 ± 3.86)ng/L vs.(34. 21±3. 82) ng/L, t= 18. 221, P=0. 0000)] . (3) Stepwise regression analysis showed that the standard deviation of blood glucose was involved in regression model (β= 1. 959, P= 0. 013).ConclusionsIn elderly patients with type 2 diabetes mellitus, glucose excursion is related with oxidation stress, which suggests that the glucose excursion may be the risk factor for oxidation stress.

Objective To evaluate the mid-term results of arthroscopic anterior cruciate ligament (ACL) reconstruction using Transfix technique.Methods From August 2002 to December 2003,38 patients (24 left knees and 14 right knees) with ACL ruptures underwent arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation.There were 21 males and 17 females,aged from 19 to 48 years (average,28.4 years).The causes of injury included sports injury in 27 cases,traffic injury in 2 cases and fall injury in 2 cases,and 7 patients had no significant injury.There were 6 cases of acute injury and 32 cases of old injury.Anterior drawer test was positive in 35 cases,weak positive in 1 case and negative in 2 cases.Lachman test was positive in 37 cases,and weak positive in 1 case.The Lysholm score was used to evaluate the results.Moreover,X-rays and MRIs were used to observe the conditions of graft and bone tunnel.Results Thirty-six patients were followed up for 6.3 to 7.6 years (average,6.8 years).All patients had normal joint range of motion.The Lysholm score improved from preoperative 64.4±4.52 to postoperative 85.6±4.60,and the difference was statistically significant (P ＜ 0.05).The X-rays and MRIs showed femoral and tibial tunnel enlargement in 3 cases,femoral tunnel enlargement in 5 cases and tibial tunnel enlargement in 3 cases.No joint space narrowing was found in all patients.One patient underwent arthroscopic revision ACL reconstruction with allograft tendon using bioabsorbable interference screws fixation on both tibial and femoral sides for re-rupture of ACL 4 years after operation due to trauma.Conclusion Arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation is an effective method,which can provide satisfactory joint range of motion and stability.

20 % . In both groups CH was induced with infusion of 0.01 % NTP at a rate 0.5-6.0 ?g?kg-1?min-1 to maintain MAP at 55-65 mm Hg. MAP, HR, CVP and CO were continuously monitored. Arterial lactate concentration was measured by enzyme assay. Arterial and mixed venous blood gases were analyzed, and oxygen delivery (DO2 ) and consumption (VO2) were calculated before AHH (T0) after AHH was performed (T1), 30 min after CH was induced (T2) and 30 min after termination of CH (T3) in group Ⅰ and in group Ⅱ before CH (T1), 30 min after induction of CH (T2) and 30 rain after termination of CH (T3 ) .ResultsIn group Ⅰ(AHH + CH) compared with the baseline values (T0 ) HR significantly decreased while CVP significantly increased after AHH (T1 ) ; cardiac output (CO) significantly increased after AHH (T1 ) and during CH (T2) while DO2 was significantly decreased after AHH (T1) and CH (T3 ) but arterial lactate concentration was significantly decreased during and after CH (T2, T3). In group Ⅱ (CH alone) compared with the baseline values (T1) HR significantly increased while CVP significantly decreased during and after CH (T2, T3 ) ; there was no significant change in CO and DO2 at T2 and T3 but arterial lactate concentration significantly increased during and after CH (T2, T3). There was significantly less blood loss during operation in group I than in group Ⅱ . ConclusionThere was tissue deoxygenation during and after deliberate hypotension as shown by increased arterial lactate concentration while AHH combined with CH can improve tissue perfusion and oxygenation. AHH can also maintain hemodynamic stability during CH.

OBJECTIVE To investigate the immunoregulatory role of tolerogenic dendritic cells(TolDC) in allergic airway inflammation in mouse model of allergic rhinitis(AR).METHODS A total of 24 Balb/c mice were equally and randomly divided into 4 groups with 6 mice in each group. AR group was established with oval bumin(OVA) sensitization and challenge, meanwhile the physiological saline(PBS) sensitization and challenge as the control group. AR group were treated by adoptive transfer of TolDC as treatment group. And treatment group were injected intraperitoneally with TGF-β/IL-10R neutralizing antibody as blockade group. In each group, allergic nasal symptoms score, inflammatory cell infiltration in lung, the expression of Th1/Th2-derived cytokines in the bronchoalveolar lavage fluid(BALF) and nasal lavage fluid(NALF), the expression of OVA-specific serum IgE and the expression of Treg in lung were measured.RESULTS The mouse model of OVA-induced AR was successfully developed. Compared with AR group, treatment group exhibited lower allergic nasal symptoms score, a decrease in inflammatory cell infiltration in lung, lower expression of Th1/Th2-derived cytokines in BALF and NALF and OVA-specific serum IgE, as well as up-regulation of Treg in lung, which were abolished by TGF-β/IL-10 neutralizing antibody shown in blockade group.CONCLUSION TolDC suppress airway inflammation in AR by inducing regulatory T cells through TGF-β/IL-10-dependent mechanisms.

Objective To investigate the change of peripheral blood lymphocyte immunophenotype in the patients with malignant carcinoma and its clinical significance .Methods The flow cytometry was adopted to detect the expression levels of peripheral blood T lymphocyte subpopulations ,CD19+ cells ,CD3-CD56+ cells ,CD3+CD56+ cells in 167 patients with malignant carcinoma (inclu‐ding respiratory tract cancers ,gastrointestinal cancers and reproductive system cancer) and 170 normal controls as the healthy con‐trol group .The contrastive analysis was performed .Furthermore the analysis was conducted according to whether having tumor me‐tastasis and chemotherapeutic cycles .Results The total absolute value of the lymphocytes and the proportion of CD3+CD4+ cells in the patients with malignant carcinoma were significantly lower than those in the healthy control group (P<0 .05) ,but the propor‐tions of CD3+CD8+ ,CD3+CD56+ and CD3-CD56+ cells were significantly higher than those in the healthy control group (P<0 .05) .The proportion of CD3+CD4+ cells in the patients with tumor metastasis were significantly lower than those in the ones without tumor metastasis ;but the proportions of CD3+ CD8+ ,CD3-CD56+ and CD3+ CD56+ cells were significantly higher than those in the ones without tumor metastasis ,the differences were statistically significant(P<0 .05) .In the chemotherapy treatment , the proportions of CD3+CD4+ ,CD3+CD56+ and CD3-CD56+ cells were gradually increased with the increase of chemotherapeutic cycles ,but the proportion of CD3+CD8+ cells was gradually reduced .Conclusion In the process of development ,progression and treatment of tumor ,the cellular immunity function plays a dominant role ,which could be used as one of indexes for clinically moni‐toring the cellular immune function in the patients with tumor .

Objective To evaluate the efficacy of disinfection and isolation measures in a hospital that received and treated the first case of imported Middle East respiratory syndrome(MERS)in China.Methods The first MERS case in China was admitted in the negative pressure room of the intensive care unit in a hospital on May 28,2015,a series of disinfection and isolation measures were taken for controlling and preventing MERS coronavirus (MERS-CoV)infection.Results One case of MERS confirmed by Guangdong Provincial Center for Disease Control and Pre-vention (CDC)and Chinese CDC were admitted in a hospital at 2:30 of May 28,2015,throat swabs and blood specimens of patients were detected as positive for MERS-CoV by real-time polymerase chain reaction.On the 3rd day,8th day,2 week after admission,and on June 21 ,throat swabs,blood,stool,and sputum specimen culture were negative respectively;before patient’s discharge,throat swabs,sputum,blood,and stool specimen culture were all negative for consecutive two times,there was no fever for 10 consecutive days,clinical symptoms were im-proved,patient finally recovered and was discharged on June 26.Detection of MERS-CoV were all negative for nasal swabs,throat swabs,and blood specimens from all health care workers (HCWs)participated in the treatment for MERS;all HCWs were performed physical examination from June 26 to July 10,none of them felt discomfort, there was no infection occurred among them.On the 7th,13th day of admission,and following terminal disinfec-tion,specimens of environment and object surface were taken and performed detection of MERS-CoV,all were negative.Conclusion Strict implementation of disinfection and isolation measures can effectively cut off the routes of MERS-CoV transmission and protect the safety of HCWs.

Objective To discuss the methods and effects of arthroscopic treatment of posterior and anterior ankle impingement syndrome through anterior approach,tarsal sinus approach plus posterolateral approach.Methods The study enrolled 12 patients with posterior and anterior ankle impingement syndrome treated from January 2012 to March 2014.There were 8 males and 4 females,agedl7-65 years (mean,45 years).Left ankle injury was noted in 9 patients and right ankle injury in 3 patients.Eight patients had a history of obvious ankle injury (5 acute and 3 chronic sprains).Arthroscopic surgery was performed to manage the posterior and anterior ankle impingement syndrome through the combined anterior,tarsal sinus and posterolateral approaches,and prone position and posteromedial incision were not used during operation.Postoperative outcome was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score.Results Operation time was 45-80 min (mean,62 min).Arthroscopy confirmed anterior bone impingement in all patients.Three patients suffered from posterior bony impingement of the talus,while nine patients os trigonum injury.Duration of follow-up was 10-18 months (mean,14 months).AOFAS score was (91.4-± 6.5) points after operation,significantly higher (34.4 ± 12.6) points before operation (t =14.607,P ＜0.01).All patients had normal ankle range of motion after operation.There were no complications such as neurovascular injury.All the surgical incisions achieved primary healing.Conclusion The procedure avoids body position shift and posteromedial incision during operation,and attains a good vision to the anterior and posterior portions and satisfactory short-term outcome.

Objective To investigate the role of perioperative antiviral therapy with Entecavir for patients with hepatitis B virus related hepatocellular carcinoma (HBV-HCC) with low serum HBV DNA levels.Methods The HVB-HCC patients were randomly divided into 2 groups.Patients in the antiviral group received Entecavir 4 days before hepatic resection while patients in the control group received no antiviral treatment.The serum HBV DNA,liver function,morbidity and length of hospital stay were compared between the two groups.Results Sixteen patients in the control group (n =44) developed HBV reactivation.On the other hand,only 1 patient in the antiviral group (n =44) developed HBV reactivation.Recovery in liver function in the antiviral group was much faster than the control group,especially for glutamic-pyruvic transaminase level.The antiviral group had significantly lower morbidity and shorter total or postoperative hospitalization (all P ＜ 0.05).Conclusions Patients with HBV-HCC with low levels of HBV DNA have a high risk of developing HBV reactivation in the perioperative period.Perioperative antiviral therapy was safe and efficacious in preventing HBV reactivation,improved liver function,reduced postoperative complications and shortened hospitalization.

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.

Objective To study the pathogens and drug resistance profiles of pulmonary infection in patients with AIDS. Methods The pathogens and their drug susceptibility of pulmonary infection diagnosed by fibrobronchescopy-induced brunchoalveolar lavage fluid (BAI.F) culture and/or transbronchial biopsy in 116 AIDS cases were analyzed. Results Monopathogenic infection in lungs were detected in 18 cases(15.5%) and mixed infection in 98 cases ( 84.5%). Of the 116 cases, bacteria were present in 91 patients, fungi in 62, tubercle bacillus in 49, pneumocystis jiroveci in 29, and cytomegalovirus in 11.Ninety-five bacterial strains were isolated from BALF, mainly including Streptococci (34), coagulase negative Staphylococcus (20), Klebsiella pneumoniae (10) and Escherichia (7). The isolated bacteria were resistant to β-lactam, macrolides, quinolones and aminoglycosides, of which were 14 methicillin-resistant Streptococci (MRS) strains and 12 extended spectrum β-lactamases (ESBL) strains. Sixty-eight fungal strains were isolated, including 36 Candida mycodermas, 19 Penicilliums, 6 Aspergilli and 5 Mold fungi;they were sensitive to amphotericin B but resistant to fluconazol (5.6% -50. 0% ) and itraconazole( 10. 5%-60. 0% ). Conclusion Pneumonia in AIDS patients are usually caused by multiple pathogens,predominantly consisting of multiresistant bacteria and fungi. Therefore, antibiotics should be rationally chosen according to drug susceptibility test.