Objective To evaluate and compare two definitions for metabolic syndrome(MS)issued by International Diabetes Federation(IDF)and by Chinese Medical Association Diabetes Branch(CDS).Methods An epidemic survey and physical examination were conducted among 481 subjects randomly selected from 3 354 subjects(above 40 years old)by cluster sampling.Results The prevalence rate of MS by IDF or by CDS definition were 40.96% and 38.05%,respectively.Kappa value was 0.51,P0.01).Metabolic disorder ratio for above 3 items by IDF was higher than that of CDS criterion.Conclusion The IDF diagnostic criterion for MS and CDS are in good accordance and applicability.The MS diagnostic criterion of IDF is better at diagnosing centricity obesity than that of CDS.

Objective To investigate the value of magnetic resonance (MR) diffusion weighted imaging(DWI) in the diagnosis of prostate cancer(PCa). Methods Fifty-seven patients with suspected prostate cancer underwent DWI and T_2-weighted imaging (T_2W). These images and apparent diffusion coefficient (ADC) maps results were compared with histopathologic findings. Receiver operating characteristic(ROC) analysis was used to compare the cancer detection performance of them. The results were rated on a scale of scores Ⅰ (benign) to Ⅴ (malignant) on the basis of ADC maps. Abnormal voxels were overlaid on the corresponding transverse TRUS images and used to perform voxel-guided biopsy. Results DWI had a sensitivity of 85%, specificity of 82%, positive predictive value of 80%, negative predictive value of 86% , and accuracy of 83%. T2WI had a sensitivity of 77%, specificity of 71%, positive predictive value of 69%, negative predictive value of 79%, and accuracy of 74%. The areas under the ROC curves for DWI and T_2WI were 0. 830 and 0. 742, respectively. The performance of DWI in PCa detection was significantly better than of T_2WI (P<0. 05). 6 of 30 patients with negative DWI results also had negative biopsy findings. PCa was detected in 17(85%) of 24 men findings with voxel score Ⅳ , with a sensitivity of 100%, specificity of 46%, positive predictive value of 71 %, negative predictive value of 100% , and accuracy of 77%. Conclusions The performance of DWI in PCa detection was better than of T_2 WI. ADC maps can be transferred to TRUS images and used to sample regions of cancer in men with rising PSA levels and negative findings at prior biopsy with good accuracy. DWI appears to be a robust and reliable method to examine the whole prostate within an acceptable scan time in clinical settings.

Objective To investigate current status and problems of coagulation factor Ⅷ and Ⅸ assay in domestic laboratories so as to provide the reference for implementing the standardization and quality improvement.Methods A questionnaire survey was carried out in 76 laboratories,and quality control materials were distributed to 54 laboratories for activity assay.The questionnaire information was analyzed statistically.Test results of quality control materials were classified into three groups according to the reagents and the ranked grading analysis were used to evaluate the performance.Results This research was investigative study.The amount of sample was less than 30 per month in 72％ (52/72)of laboratories.The frequencies of calibration were different,and 33％ (24/72) of laboratories did not perform calibration in a different assay batch.39％ (28/72)of laboratories did not run internal quality control,and about 21％ (15/ 72) of laboratories just performed the normal level quality control.Individual laboratories showed a high cumulative CV (＞ 30％) of intemal quality control.For normal FⅧ and FⅨ control materials,the CV of results were 11.3％-18.2％ and 11.3％-17.9％ respectively as well as 15.3％-20.3％ and 19.5％-21％ for abnormal.Of the three groups,the proportions of laboratories which the FⅧ test results out with consensus were18％,24％ and 22％ as well as 20％,24％ and 28％ for FⅨ.Conclusions The key requirements for quality control of coagulation factors active assay remain to be addressed and implemented.The repeatability and comparability in some laboratories are not satisfactory to meet the clinical needs.With the purpose of promoting quality improvement,we need to develop guidelines,organize related training and establish a national external quality assessment scheme.

0.05). The bone graft rate was 13% in senile group and 9% in non-senile group( P

GEP (Gene expression programming) is a new genetic algorithm, and it has been proved to be excellent in function finding. In this paper, for the purpose of setting up a diagnostic model, GEP is used to deal with the data of heart disease. Eight variables, Sex, Chest pain, Blood pressure, Angina, Peak, Slope, Colored vessels and Thal, are picked out of thirteen variables to form a classified function. This function is used to predict a forecasting set of 100 samples, and the accuracy is 87%. Other algorithms such as SVM (Support vector machine) are applied to the same data and the forecasting results show that GEP is better than other algorithms.
Algorithms ; Artificial Intelligence ; Computational Biology ; methods ; Data Mining ; Diagnosis, Computer-Assisted ; instrumentation ; methods ; Gene Expression Profiling ; methods ; Gene Regulatory Networks ; genetics ; Heart Diseases ; diagnosis ; Humans ; Models, Cardiovascular

Objective To explore the efficacy and safety of minimal invasive adrenal sparing surgery for the treatment of Cushing syndrome caused by adrenocortical adenoma.Methods Patients who underwent minimal invasive adrenal surgery for adrenocortical adenoma in our institution from January 2010 to December 2015 were retrospectively analyzed.Preoperative, intraoperative, and postoperative variables were reviewed from the database.The mean patient age at diagnosis was 39 years and male:female ratio was 10:111.Of the 121 adenomas, 50 were located in the right adrenal and 71 in the left.The mean tumor size was 2.6 cm.84 cases had hypertension (69.4％), 36 cases had diabetes mellitus (29.8％), and 45 cases had obesity (37.2％).Postoperative follow-up was performed by evaluating adrenal gland function and imaging.Results Mininal invasive partial adrenalectomy was performed in 121 cases and the success rate of operation was 99.2％ (120/121).Sixty-two cases received operation through retroperitoneal approach,and 59 cases were through transperitoneal approach.The median operative time was 50 min with a median blood loss of 50 ml.The mean postoperative hospital stay were (5.0 ± 3.2) days.The vascular injury occurred in 2 cases (1 case in each surgical approach), while the abdominal organ injury occurred in 2 cases with 1 case of spleen injury and 1 case of liver injury (both in transperitoneal approach).Postoperative complications were observed in 6 cases:1 case of deep venous thrombosis, 1 case of wound hematoma, 4 cases of wound infection.Cortisol substitution was given in 2 to 12 months (mean 6.2 months)postoperatively.One year after operation, the remission rate of hypertension, diabetes and obesity was 58.3％ (49/84), 30.6％ (11/36) and 60.0％ (30/45), respectively.Conclusions Minimal invasive adrenal surgery using retroperitoneal and transperitoneal laparoscopic technique can be performed with low morbidity and achieve an excellent outcome.The perioperative hormone therapy may also play an important role.

OBJECTIVETo analyze the phenotype and genotype of a family with inherited dysfibrinogenemia.

METHODSLaboratory tests including activated particle thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and the activity of protein C (PC), protein S(PS) and antithrombin (AT) were conducted in the proband and 4 family members. The activity and antigen of fibrinogen in plasma were measured by functional and immunoturbidimetry assay, respectively. All the exons and exon-intron boundaries of the three fibrinogen genes were analyzed by direct sequencing.

RESULTSThe proband had normal APTT and PT, but prolonged TT. Her plasma fibrinogen levels were extremely reduced, which was also found in her mother. The sequencing results of the proband revealed heterozygous g.5678 G>A in the exon 8 of FGG gene originating from her mother, which caused Arg275His missense mutation.

CONCLUSIONDysfibrinogenemia in the family is caused by Arg275His in the beta chain of fibrinogen and it is the first report on a Chinese family with inherited dysfibrinogenemia.

Adult ; Afibrinogenemia ; blood ; genetics ; Amino Acid Substitution ; Arginine ; genetics ; DNA Mutational Analysis ; Female ; Fibrinogen ; genetics ; metabolism ; Histidine ; genetics ; Humans ; Male ; Pedigree ; Phenotype

Objective To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care,number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW). Methods Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high,senior high,junior college)of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles,according to the distribution of the original variables on pregnant women with newborns of normal birth weight. Results Whether the pregnant women were stratified by educational level,with the increasing number of prenatal care visits,LBW risk was shown a U-type tendency in different strata of educational levels,when comparing with the reference group,respectively. Compared to the baseline group,the OR and 95%CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64),0.55(0.32-0.95),0.50(0.32-0.80),0.36(0.20-0.66)in all subjects who had received educational levels as junior middle school,senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk(χ2=4.650 2,P=0.031 1). However,no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk(χ2=0.929 7,P=0.334 9). Conclusion Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits,but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.

Objective:To explore the feasibility and clinical effect of emergency lateral thigh muscle transfer in functional reconstruction of major traumatic muscle defects.Methods:Emergency surgeries for 8 patients(7 males and 1 female) with muscle defects were carried out subject to emergently reconstruct the power of lateral femoral muscle superficial region, between March 2020 and December 2021, in the Department of Hand and Foot Microsurgery Hospital, Xi'an Fengcheng Hospital. The 8 patients were 23 to 52 years old with an average of 37.6 years old. Five patients injured by machine crush, 2 by heavy object crush and 1 by traffic accident. Five patients were in Gustilo III B injury in forearm, including 2 with flexor muscle group defects, 2 with extensor muscle group defects and 1 with defect of dorsal metacarpal flexor muscle and extensor muscle. Among the 5 patients, 2 patients had the defects in left forearm and 3 in right forearm. One patient had defect of right 1st metacarpal bone and skin and thenar muscle. One patient suffered a complete right upper arm detachment with musculocutaneous nerve being drawn out from the bicipital muscle. One patient had Gustilo III C injury in the right calf with defects of extensor hallucis longus and extensor digitorum. The areas of soft tissue defect were 10.0 cm×8.0 cm-36.0 cm×11.0 cm and the size of flaps was 12.0 cm×6.0 cm-38.0 cm×12.0 cm with the volumes of excised muscle at 18.0 cm×9.0 cm×1.5 cm-10.0 cm×2.0 cm×1.0 cm. The anatomical cross-section and length of the corresponding muscle on the healthy side were measured by musculoskeletal ultrasound. The chimeric tissue flap was designed on the anterolateral side of the thigh. The flap was designed according to the size of the wound and the corresponding flap. Then 1 or 2 muscle tissue blocks were designed and cut from the superficial region of the lateral femoral muscle according to the condition of the muscle defect, to cover the wound and reconstruct the muscle power. Postoperative follow-ups were conducted by scheduled hospital visit. The contents of follow-up included dynamic observation, evaluation and record through musculoskeletal ultrasound, electromyography and strength of muscle.Results:For the 8 patients who were subject to a muscle reconstruction, the transferred muscles and flaps survived in stage-one without vascular event. Postoperative follow-ups lasted for 10 to 32 months with an average of 19.6 months. The strength of muscle was evaluated according to the M 4 strength of muscle. Strength of muscle restored to M 4 or above in 7 patients who could lift, hook or push a heavy object in 5-30 kg of weight, with free joint movement. One patient restored the strength of muscle to M 3+. Muscle contraction was detected 2-4 months after surgery by musculoskeletal B ultrasound. The average ratio of contraction to resting cross sectional area in 5 cases was 1.45±0.42. The shape of limb was bilaterally symmetrical. There was no discomfort in the donor site and knee joint. The flaps were soft and glossy, with protective sensation restored. Conclusion:Muscle transfer from the lateral femoral muscle superficial region in emergency surgery for functional reconstruction of traumatic muscle defects is feasible and effective with a good clinical effect.

Objective:To explore the feasibility of functional reconstruction of muscle power in treatment of traumatic muscle defects by transferring part of superficial vastus of lateral thigh.Methods:From March 2020 to March 2023, reconstruction of muscle power with transfer of superficial lateral thigh muscle was performed on 9 patients in the Department of Hand and Foot Microsurgery of Xi'an Fengcheng Hospital. Nine patients were assigned in a study group. A total of 48 patients who previously had the surgery of chimerically grafted superficial vastus of lateral thigh were recruited as the "previous surgery group" and another group of 71 staff volunteers from our hospital were recruited as the "healthy control group". Of the study group, 5 patients had Gustilo type ⅢB injury in forearm (two with defects of flexor muscle group and 3 with extensor muscle group, 2 with the defects in the left and 3 in the right), one had defect of both flexor and extensor muscle groups in dorsal hand, one had defect of right 1st metacarpal with defects of soft tissue and thenar muscle, one had a completely severed right upper arm with a withdrawn musculocutaneous nerve from the biceps brachii and one had Gustilo ⅢC injury in right calf with defects of tibialis anterior, extensor longus and extensor phalangeal muscle. In the emergency surgery, part of the superficial muscles of lateral thigh were taken to reconstruct the muscular power for the defected traumatic muscles. During the surgery, the excessed nerve with a length of 3.0 cm proximally was removed at 3.0 cm from the point where the nerve entered the muscle. In the transfer of superficial chimeric muscle of lateral thigh, a 3.0 cm of sample nerve tissue was taken for HE staining to find out the number of nerve fibers. Musculoskeletal ultrasonography, electromyography and muscle strength test were performed in the postoperative follow-up for observations and evaluations of the effects of surgery. Average length and thickness of muscle were taken from the 48 patients in the "previous surgery group". The measurement was compared with the length of muscle fibers and the number of nerve fibers in the gracilis muscle of the 9 patients in study group. The cross-sectional areas (SCA) at contraction state (C) and resting state (R) of the superficial vastus of lateral thigh were taken from the 71 volunteers in the healthy control group, and the C/R ratio was calculated (CR value). All the 9 patients were included in the postoperative follow up by outpatient visits and via telephone or internet reviews to observe the recovery of muscle strength of the reconstruction of muscle dynamics.Results:In the study group, the number of nerve fibers shown by immunohistochemical HE staining was 1 088±213, with the CR value of graft muscle measured by musculoskeletal ultrasonography at 1.44±0.17. The wound healed smoothly without complication. The average time of postoperative follow-up for the 9 patients was 22.6 (10-38) months. Recovery of muscle strength was found at M5 in 6 patients and M4 in 3 patients. The appearance of the joints was normal. In the previous surgery group, the average muscle thickness of the superficial vastus lateralis muscle was 1.74 cm±0.35 cm and the length of muscle fiber was 8.86 cm±1.59 cm. In the healthy control group, the CR value of the superficial muscle vastus of lateral thigh was found at 1.17±0.12.Conclusion:Reconstruction of muscular power with partial muscle transfer of the superficial vastus of lateral thigh is proposed in this study.