Objective To investigate the relative risk factors of glucose metabolism disorder in newborn infants.Methods Clinical information of 791 newborns suffered from glucose metabolism disorders who had been hospitalized in NICU from Jan.2004 to May 2007 were analyzed retrospectively.Four hundred and thirty-nine cases presented with hypoglycemia,275 cases presented with hyperglycemia,and 77 cases presented with both hypoglycemia and hyperglycemia.Data of risk factors were processed with both ?2 test and multiple Logistic regression analysis.Results The statistic analysis showed that low birth weight[258 cases(58.77%)],asphyxia[217 cases(49.43%)],acidosis[146 cases(33.26%)],hypothermia[128 cases(29.16%)],maternal gestational hypertension[83 cases(18.91%)],pneumonia[63 cases(14.35%)],anomaly of placenta[35 cases(7.97%)],maternal diabetes[17 cases(3.87%)] and septicaemia[10 cases(2.28%)]were significant hypoglycemia risk factors(according to the level of morbidity).Pneumonia[98 cases(35.64%)],asphyxia[129 cases(27.23%)],hypoxemia[61 cases(22.18%)]and septicaemia[24 cases(8.73%)]were significant hyperglycemia risk factors.Acidosis[33 cases(42.86%)],pneumonia[27 cases(35.06%)]and maternal diabetes[6 cases(7.79%)] were significant risk factors for neonates with both hypoglycemia and hyperglycemia.Conclusion Dynamic monitoring of blood glucose concentration and reasonable adjustment is recommended for neonates with risk factors to lower morbility and mortality.

Objective The paper analyzes the operating patterns of the outpatient process and identifies the links needing reengineering so as to provide scientific basis for the optimal allocation of outpatient resources and process reengineering and prove the rationality and feasibility of using the queuing theory. Methods Using the methods of the queuing theory, the service time and the patients' arrival time at such service links as registration, billing and accounting, internal medicine, and gynecology in the outpatient department of a certain hospital were measured and the operational indexes at various links such as service intensity, average queuing length, average queuing time, average stay, probability of the service desks being idle, and the probability of the patients having to wait were calculated so as to estimate the rational number of service desks and the optimal value of the sum of the cost of waiting and the cost of service. Results Registration, billing and accounting , service intensity in internal medicine, personnel allocation, and queuing time were basically rational in the outpatient department of the hospital surveyed. One more physician should be added to the gynecology department so as to improve efficiency and reduce patients' waiting time and queuing length. There was currently a shortage of medical staff in the hospital. The cost of hospital input was moderate while the cost of waiting was on the high side. Conclusion It is rational and feasible to evaluate the efficiency of the outpatient process with the methods of the queuing theory. The method deserves to be spread.

Objective To evaluate the safety,biocompatibility and efficacy of transcatheter closure of atrial septal defect(ASD)with no stainless-steel-screw occluder in canine model.Methods The device was constructed from superelastic Nitinol wires tightly woven into two flat disks and sewed with polyester fibers inside,with a pliable loop on the right-atrial-disk of the device,connecting to the delivery cable.ASD was created by transcatheter puncture and balloon dilatation and then closed by occluder under fluoroscopy in the catheterization laboratory.The location and the influence of the implanted device on function of tricuspid valve and mitral valve were evaluated by echocardiography.At 1,2,3 and 6 months after the operation,the animals were killed and autopsy was conducted.Results Eight dogs with puncture-produced ASD underwent ASD closing procedure successfully.The occluder showed no influence on the function of MV and AV demonstrated by echocardiogram.The two disks of the implanted device were covered with a smooth intact neogenesis layer in all dogs.Endocardial cells fully covered the surface of the two disk without inflammating reaction 3 months later. There was no evidence of corrosion on the surface of the nitinol wire removed from the dog after 6 months.Light microscopic examination of the liver,kidney,lung and spleen showed no evidence of embolization and inflammation.Conclusion Transcatheter ASD occlusion with new-type occluder is safe,feasible,effective and good biocompatibility with a good prospective clinical application.

OBJECTIVETo observe the influence of Gandou Tablet I (GD I) on neurologic electrophysiology in patients of hepatolenticular degeneration (HLD).

METHODSVigilance-controlled electroencephalogram (VEEG), electromyogram (EMG) and brain-stem auditory evoked potential (BAEP) in 32 cases of HLD were examined before GD I treatment, and reexamined after 4 weeks of treatment in those with abnormal neurologic electrophysiology.

RESULTSAt the same time of clinical symptom improvement after treatment, the abnormal VEEG, EMG and BAEP also improved with the effective rate of 71.43%, 70% and 66.67% respectively, their constitutional ratio were different insignificantly, P > 0.05. The peak latency (PL) of III, V waves and interpeak latency (IPL) of I-III, III-V and I-V waves in patients before treatment were all greatly prolonged, compared with those in the healthy control group (P < 0.05 or 0.01), the IPL of III-V and I-V waves were markedly improved after treatment.

CONCLUSIONNeurologic electrophysiologic examination was valuable for complementary diagnosis and therapeutic effect evaluation of HLD. GD I could improve the abnormal neurologic electrophysiologic parameters.

Adolescent ; Adult ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Electroencephalography ; drug effects ; Electromyography ; drug effects ; Electrophysiology ; Evoked Potentials, Auditory, Brain Stem ; drug effects ; Hepatolenticular Degeneration ; drug therapy ; physiopathology ; Humans ; Male ; Phytotherapy ; Tablets

OBJECTIVEThe present study was undertaken to design antisense oligodeoxynucleotides (AS-ODNs) of glial glutamate transporter-la (GLT-1a) and to evaluate the effectiveness of the designed AS-ODNs on the expression of GLT-1a.

METHODSFive sequences of GLT-1a AS-ODNs were designed according to the C terminus specific sequences of GLT-1a mRNA using antisense design software of IDT Com- pany. Western blot analysis was used to evaluate the inhibition effects of the five GLT-1a AS-ODNs on the expression of GLT-la.

RESULTSThe sequence of GLT-1a AS-ODNs with sequence of 5'-GGTTCTTCCTCAACACTGCA-3' could specifically inhibit the expression of GLT-1a in the hippocampal CA1 subfield of rats, while it had no effect on the expression of GLT-1b. This sequence showed similar inhibition on the expression of GLT-la in sham and ceftriaxone (Cef)-treated rats. It could also significantly inhibit the cerebral ischemic preconditioning (CIP)-induced up-regulation in the expression of GLT-1a. The magnitude of the inhibition in sham, Cef- or CIP-treated rats was similar by more than 60%.

CONCLUSIONFrom the designed five sequences of GLT-1a AS-ODNs, we obtained an effective sequence which can specifically inhibit the expression of GLT-1a.

Animals ; CA1 Region, Hippocampal ; metabolism ; Excitatory Amino Acid Transporter 2 ; antagonists & inhibitors ; metabolism ; Ischemic Preconditioning ; Oligonucleotides, Antisense ; genetics ; RNA, Messenger ; Rats ; Up-Regulation

OBJECTIVETo study on the reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in total knee arthroplasty (TKA) the rotational alignment reference bony landmarks of the proximal tibial component on magnetic resonance image (MRI) were measured.

METHODSFrom January 2010 to December 2013, 80 normal knees of Chinese volunteers including 35 males and 45 females with an average age of (35.4±6.1) years were reviewed. The images of the knees were obtained by MRI. The surgical epicondylar axis (STEA) was identified in the femoral transverse sections and then was projected to the side of tibia, forming the SETA'. A line connecting the medial border of the patellar tendon and the middle of the posterior cruciate ligament insertion (Akagi line) and its vertical line (AK), as well as a line connecting the medial 1/3 of the patellar tendon and the middle of the posterior cruciate ligament insertion and its vertical line (AP), were identified in the tibial transverse sections. The angles were measured between the AK, AP and STEA'.

RESULTSThe angle between AK and STEA' was (0.59±2.07)°, and there was no significant difference between the two lines (t=-2.54, P=0.13). The mean angle between AP and STEA' was (3.21±2.04)°, and there was a significant difference between the two lines (t=14.05, P<0.05). There was a significant difference between the AK and AP (t=-11.68, P<0.05).

CONCLUSIONThe reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in TKA is good.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Rotation ; Tibia ; surgery

Objective To understand treatment outcomes of patients diagnosed with type 2 diabetes aged over 30 years in Jiangninglu Neighborhood of downtown Shanghai. Methods Total 642 patients diagnosed as type 2 diabetes aged over 30 were investigated by cluster sampling in Jiangninglu Neighborhood of downtown Shanghai. Status of optimal control of diabetes in them was analyzed based on the recommendations proposed by International Diabetes Federation (IDF) for Western Pacific Region. Results and serum level of glycosylated hemoglobin Alc (HbAlc) of less than 6.5% was achieved in 37.5% (241/were achieved in 23.8% (153/642) and 18.1% (116/642) of them, respectively, and beth systolic and mmol/L was achieved in 21.7% (139/642) of all the participants investigated, triglyceride of less than 1.5 mmol/L in 46.6% (299/642), low-deusity lipoprotein-cholesterol (LDL-C) of less than 2.5 mmol/L in 23.7% (152/642) and high-density lipoprotein-cholesterol of greater than 1.1 mmol/L in 62.1% (399/of their blood glucose, blood pressure and serum LDL-C (defined as HbAlc less than 6.5%, blood pressure less than 130/80 mm Hg and LDL-C less than 2.5 retool/L). Conclusions Only 2.6% of all the patients diagnosed with diabetes aged over 30 in downtown Shanghai get optimal control of their blood glucose, blood pressure and serum lipid, so comprehensive prevention and control for diabetes shall be strengthened for them at community-level of urban areas.

Objective To investigate the clinical characteristics in chronic severe hepatitis B patients with HbeAg-positive and HbeAs-negative.Methods A total of 95 chronic severe hepatitis B cases were retrospectively analyzed.The clinical information,hepatic function,hepatic fibrosis and HBV DNA in HBeAg-negative and HBeAgpositive groups were analyzed.Results of the 95 cases,54(57% ) were HBeAg-negative and 41(43% ) were HBeAg-positive.No significant differences were found on age,ALB,TB,CHE,indexes of hepatic fibrosis and the ratio of complications between HBeAg-negative group and HBeAg-positive group.Compared with HBeAg-positive group,there were significantly higher levels of ALT(198.25±215.37)U/L vs(400.37±413.59)U/L],AST[(254.78±269.16)U/L vs(578.14±600.23)U/L] and lower level of HBV DNA[(6.17×10~6±8.24×10~1)copies/ml vs (2.39×10~5±6.75×10~1) copies/ml] in HBeAg-negative group(P<0.05).The anteroposterior diameter of the left liver and the thickness of right liver were(65.12±12.43)mm and(95.37.±12.69)mm in the HBeAg positive fatal chronic severe hepatitis B before the terminal phase,vs(56.78±11.04)mm and(89.34.±9.23)mm in the HBeAg negative group,and the former is longer than the later(P<0.05).Conclusion Tissue injury is more serious and the level of HBV DNA is lower in HBeAg-negative patients than HBeAg-positive patients.Liver size of HBeAg negative group reduces more significantly than HBeAg positive group before terminal phase.

Objective To better characterize the clinical and histopathological manifestations, diagnosis and differential diagnosis of epithelioid sarcoma (ES).Methods Clinical data were collected from nine patients with ES diagnosed and treated at the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from 2000 to 2014.The clinical and histopathological manifestations, immunophenotype, treatment and prognosis of ES were reviewed retrospectively.Results The median age at onset of ES was 34.5 years in these patients, and the average disease duration was 8.3 years.Lesions began on the extremities in 8 patients, and manifested as nodules,ulceration and lymphedema.Histopathological examination showed that tumor cells mainly consisted of spindle cells and epithelioid cells, some of which were in a palisade arrangement with central necrosis.Cytokeratin, epithelial membrane antigen (EMA) and vimentin were coexpressed by tumor cells.Recurrence was observed at the original site in 6 patients after lesion resection, and pulmonary metastasis occurred in 4 patients.Five patients were followed up and two of them died of pulmonary metastasis.Conclusions Local recurrence is frequent in patients with ES after lesion removal.Lymph node and pulmonary metastases of ES are common, and pulmonary metastasis is usually associated with a poor prognosis.

Objective The aim of this study was to explore the clinical value of dual-source CT(DSCT)in the diagnosis of coronary artery fistula(CAF)before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF,11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases,with the latter including 3 cases of ramus nodi sinuatrialis fistula,2 cases of anterior descending branch fistula,and 2 cases of left circumflex fistula. CAF entered into right atrium(6 cases),right ventricle(5 cases),left ventricle(4 cases)and left atrium(1 case). There were dilatation of coronary artery in 8 cases,localized aneurysm in 4 cases,normal coronary artery in 3 cases,single fistula orifice in 11 cases,and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass(CPB).The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula,including fistula vascular ligation in 3 cases,the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case,and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.