BACKGROUND: Most of the literatures only reported that there is a great difference between diabetics who have a high 24-hour urinary albumin excretion rate and those without renal damage, but there is no obvious difference between cases of microalbuminuria and those without renal damage.OBJECTIVE: To probe into the relationship between diabetic nephropathy and osteoporosis.DESIGN: A case-control study.SETTING: Department of Endocrinology, West China Hospital of Sichuan University.PARTICIPANTS: According to the diagnostic standard set by the American Diabetes Association in 1997 (fasting blood glucose ≥ 7 mmol/L,postprandial blood glucose ≥ 11.1 mmol/L), 96 diabetic patients were selected, including 56 males ＜ 60 years old and 40 females who had not entered the menopausal period, excluding the influence of age and osteoporosis caused by menopause. The average age of the subjects was (48.7±10.5)years, their duration were from one month to twenty-one years with the aver age of (7.85±2.56) years, and their general information had no significant differences.METHODS: According to the urine albumine excretion rate and renal function, the patients were divided into four groups: normal albuminuria group (n=48), microalbuminuria group (n=28), macroalbuminuria group (n=15), renal failure group (n=5). The bone mineral densities of lumbar spines (L2-4), femoral neck, Ward's triangle and trochanter were detected with Dual energy X-ray absorptiometry, and then the fasting blood glucose,2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate were compared between the patients with and without osteoporosis.MAIN OUTCOME MEASURES: The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate, as well as the bone mineral density, were observed in all the patients.RESULTS: The L2-3 bone mineral density in the macroalbuminuria group was significantly different from that in the microalbuminuria group (P ＜ 0.05). The proximal femur bone mineral density in the microalbuminuria group was significantly different from that in the normal albuminuria group (P ＜ 0.05). The bone mineral densities of proximal femur and lumbar spine in the renal failure group were significantly decreased as compared with those in the other groups (P ＜ 0.01). The disease course,glycosylated hemoglobin A, alkaline phosphatase and body mass index were significantly different between the patients with and without osteoporosis (P ＜ 0.05).CONCLUSION: The incidence rate of osteoporosis is increased with the aggravation of nephropathy, and diabetic nephropathy may be closely correlated with the decrease of bone mineral density and the occurrence of osteoporosis.

Congenital Abnormalities ; diagnosis ; Ear, Inner ; abnormalities ; Humans ; Vestibular Evoked Myogenic Potentials

Objective:To investigate the relationship of etiology and complications of rhabdomyolysis with its prognosis in the elderly.Methods:Patients with rhabdomyolysis at the emergency department of our hospital from January 1, 2018 to December 31, 2019 were retrospectively analyzed.Based on age, patients were divided into the non-elderly group(<65 years old)and the elderly group(≥65 years old). The frequency distribution of etiological factors, concurrent acute kidney injury, and their association with prognosis were analyzed.Results:The number of patients with rhabdomyolysis caused by 2 or more etiologies was higher in the elderly group than in the non-elderly group(40.3% or 48/119 vs.17.0% or 16/94, χ2=13.582, P=0.000). The frequency distribution of etiological factors was different between the two groups.The top-five etiologies were infection, muscle ischemia/hypoxia, endocrine metabolic abnormalities, trauma and muscle fatigue in the elderly group and muscle fatigue, infection, endocrine metabolic abnormalities, drugs/toxicants and trauma in the non-elderly group.Compared with the non-elderly group, the elderly group had fewer patients with typical clinical manifestations(32.8% or 39/119 vs.48.9% or 46/94, χ2=5.067, P=0.024). In contrast, patients who newly presented with disturbance of consciousness were more likely to be found in the elderly group than in the non-elderly group(40.3% or 48/119 vs.21.3% or 20/94)( χ2=7.923, P=0.005). There were 37 patients with AKI(38.9% or 37/95)in the elderly group and 13 of them died(35.1%), and there were 17 patients with AKI in the non-elderly group(19.3% or 17/88)and 4 died(23.5%), indicating the elderly were prone to AKI( χ2=7.545, P=0.006). There was a significant correlation between AKI and prognosis in the non-elderly group( χ2=7.196, P=0.007). Conclusions:Rhabdomyolysis caused by multiple etiologies is more common in elderly patients than in non-elderly patients.The etiological classification of rhabdomyolysis in the elderly is different from that in the non-elderly.Elderly patients are less likely to have typical clinical manifestations and are more prone to AKI.Elderly patients with rhabdomyolysis combined with AKI have a poor prognosis.

Objective The aims of this study were to investigate the prognostic value of CEA and CA19-9 expression in advanced gastric cancer and the prognostic factors of advanced gastric cancer.Methods A total of 255 patients with advanced gastric cancer who underwent radical R0 radical surgery were enrolled in the Department of Gastrointestinal Surgery,Harbin Medical University Cancer Hospital from January 2010 to December 2010,and were divided into group A(CEA<2.19ng/mL and CA19-9<10.78U/mL),group B(CEA≥2.19ng/mL or CA19-9≥10.78U/mL)and group C(CEA≥2.19ng/mL and CA19-9≥10.78U/mL).These groups were analyzed the differences in gastric cancer patients with clinical pathology and survival,and prognostic factors of patients with advanced gastric cancer factors.Results There were statistically significant differences in clinical N staging,clinical TNM staging and pathological TNM staging in three groups of patients with advanced gastric cancer(P<0.05).There was no significant difference in the median survival time in three groups of patients with advanced gastric cancer(P>0.05).The 1-year,3-year and 5-year survival rates of group A were higher than those of group B and group C(P>0.05).The factors affecting the prognosis of gastric cancer included the degree of tumor differentiation,pathological T staging,pathological TNM staging,the total number of lymph nodes,the number of positive lymph nodes and lymph node metastasis.Conclusion Combined detection of CEA and CA19-9 expression indicates a certain reference value for prognosis of gastric cancer.

Objective To investigate the effectiveness of arthroscopic reduction and percutaneous fixation (ARPF) for the treatment of tibial plateau fractures. Methods Seventeen cases of tibial plateau fractures from April 1999 to June 2002 were reviewed. The fractured tibial plateau was reconstructed by “drag-and-draw” reduction and iliac crest bone graft under arthroscope. And percutaneous cancellous bone screw fixation was conducted. Results Clinical bone union was achieved in all the patients at the third postoperative month. No infection or severe osteoarthritis occurred. Conclusions ARPF for tibial plateau fractures has advantages of reduction under direct view, reliable fixation and facilitation for early activities.

Objective To approach the effect of prosthetic valve at preventing reflux esophagitis.Methods After the total gastrectomy and esophagojejunostomy,interrupted suture was apphed to form a prosthetic valve at output and input beyond Braun's stoma.Results Only one got light reflux esophagitis in 15 patients.Conclusion Prosthetic valve can prevent reflux esophagitis,and the operation is convenient and safe,which is deserved to be in generalization and approach the latest method.

Objective To evaluate the efficacy of non-Hodgkin's lymphoma(NHL)treated by high does MTX,autologous peripheral stem cell transplantation and biotherapy for 67 cases.Methods Sixty-seven NHL patients from June,2003 to March,2007 were treated by three times HD-MTX,APBSCT and biotherapy of IL-2.Results There were 36 cases(87.8%)in complete relase(CR)period;5 cases(12.2%)in relapse(RE)period and 1 patient(2.4%)died in CR group;in PR group,there were 15 cases(57.7%)in CR period;11 cases(42.3%)in RE period and 5 patients(19.2%)died.Conclusion These preliminary results suggest that the therapy can be performed safely.It is an efficacious therapeutic measure for the patients with non-Hodgkin's lymphoma.

Objective To evaluate clinical effect of autologous peripheral blood stem cell transplantation(APBSCT)on the treatment of hematologic malignancies.Methods Totally 231 patients(ALL in 45 cases,AML in 34 cases,NHL in 100 cases,HD in 31 cases,MM in 21 cases)with hematologic malignancies received APBSCT from March 2001 to February 2007.Therapeutic effect and complication were oberserved.Results Totally 230 patients obtained hematopoietic reconstitution quickly,one case failed.ALL CR1(first time CR):13 in DFS,4 alive with disease(LWD),11 in death;ALL CR2(second time CR):3 in DFS,4 in LWD,10 in death;AML CR1:12 in DFS,3 in LWD,6 in death;AML CR2:6 in DFS,2 in LWD,6 in death;NHL CR:43 in DFS,7 in LWD,9 in death;NHL CR2:18 in DFS,5 in LWD,7 in death;NHL NR:2 in DFS,4 in LWD,5 in death;HD CR1:10 in DFS;HD PR:12 in DFS,3 in LWD;HD RE:3 in DFS,2 in LWD,1 in death;MM:7 in DFS,6 in LWD,8 in death.Conclusion APBSCT is a safe and effective therapy method for treating hematologic malignancies.

Objective To investigate the effects of thrombopoietin (TPO) on the proliferation of megakaryocytic line-HEL cells co-cultured with human umbilical cord blood-derived stromal cells (hUCBDSCs), which is supposed to further elucidate the mechanism of TPO-mediated functions. Methods HEL cells were co-cultured with hUCBDSCs, and with human bone marrow stromal cells (hBMSCs), and suspended HEL was used as control. HEL The concentration of TPO in supernatant of hUCBDSCs and hBMSCs was detected by ELISA assay. The expression of c-Mpl membrane-bound protein of HEL cells was detected by laser scanning confocal microscopy and flow cytometry, and the expression of c-Mpl mRNA was detected by RT-PCR. Results It was revealed by ELISA assay that the concentration of TPO secreted by hUCBDSCs was higher than that by hBMSCs, even though the passage was done. The secretion peak in hUCBDSCs group appeared at the 8th day of culturing, somewhat delayed to that in hBMSCs group which the peak appeared at the 6th day. The expression of C-mpl protein displayed uniform green fluorescence on the surface of HEL cell line as determined by laser confocal microscopy, and mean fluorescence intensity detected by flow cytometry was 22.19?2.15, 29.65?0.82 and 37.43?1.69 in HEL suspended culture group, HEL/hBMSCs co-culture group and HEL/ hUCBDSCs co-culture group, respectively. The expression of C-mpl protein in HEL/ hUCBDSCs co-culture group was higher than that in the two other groups (P0.05). Conclusion TPO-pathway might be the important intermediate process for hUCBDSCs to promote megakaryocyte proliferation. The promotion as such may be realized by up-regulating the c-Mpl expression in translation or post-translational modification phase.

OBJECTIVE:To study the protective effect of tanshinoneⅡA(TSⅡA)sulfonate injection against vancomycin(VAN)-induced renal injury model rats and its mechanism. METHODS:72 rats were randomly divided into blank group,model group, positive control group(amifostine,1 mg/kg)and TSⅡA sulfonate injection low-dose,medium-dose and high-dose groups(15,30, 60 μg/kg),with 12 rats in each group. Except for blank group,those groups were given VAN(200 mg/kg)intravenously via tail vein to induce renal injury rat model;after modeling,each drug group was given relevant medicine intraperitoneally once a day, and blank group and model group were given normal saline intragastrically for consecutive 10 days. The levels of 24 h protein, NAG and KIM-1 in urine were determined,and those of Cys C,Scr and BUN in serum and those of SOD,MDA,GSH-Px and NO in renal homogenate were also determined;the pathological change of renal tissue was observed. RESULTS:Compared with blank group,the levels of Cys C,Scr and BUN in serum,those of 24 h protein,NAG and KIM-1 in urine and those of MDA and NO in renal tissue increased significantly in model group,while the levels of SOD and GSH-Px decreased significantly(P<0.01);the pathological slice indicated that model group suffered from renal injury such as kidney tubules albuminoid degeneration,brush border abscission,renal tubular epithelial cell disintegration and abscission. Compared with model group,the levels of Cys C,Scr and BUN in serum,those of 24 h protein,NAG and KIM-1 in urine and those of MDA and NO in renal tissue decreased signifi-cantly in treatment groups,while the levels of SOD and GSH-Px in renal tissue increased significantly(P<0.05 or P<0.01);path-ological changes of renal tissue were relieved significantly. CONCLUSIONS:TSⅡ A sulfonate injection can effectively relieve VAN-induced renal injury in rats,and its mechanism may be associated with inhibiting the oxidative reaction of rats in vivo.