Objective:To study the expression and relationship of Pin1 and CyclinD1 in adult papilloma of larynx,and the effect of both in laryngeal papilloma'S canceration.Method:Ninety-two cases of paraffin section with immunoperoxidase(SP)staining method was used to detect the distribution of Pin1 and CyclinD1 in 10 cases of laryngeal normal epithelial tissue,39 cases of laryngeal papilloma,27 cases of laryngeal papilloma with middle,severe atypical hyperplasia and 16 cases of laryngeal carcinoma.Result:The distribution of Pin1 and CyclinD1 increased gradually from laryngeal normal epithelial tissue tO laryngeal carcinoma(P＜0.05);No difference of the expression of CyclinD1(not including Pin1,for Pin1,P=0.009)was found between laryngeal papilloma and laryngeal papilloma with middle,severe atypical hyperplasia(P＞0.0125),but there had significant difference of the expression of Pin1 and CyclinD1 among the rest groups;There was significantly direct correlation between the expression of Pin1 and CyelinD1(P＜0.05).Conclusion:The hyper-expressions of Pin1 and CyclinD1 may play a key role in laryngea1 papilloma's malignant change.Pin1 up-regulating the expressions of cyclinD1 possibly participate in its malignant change.

Objective To explore the related risk factors for diabetic nephropathy(DN) and discuss the value of diabetic dermopathy (DD) screening for DN.Methods A total of 188 patients with type 2 diabetes mellitus (T2DM) were studied,which included 78 patients with DN (DN group) and 110 cases without DN (non-DN group).The sex,age,duration of diabetes mellitus,smoking,DD,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),2hours postpradial glucose(2 h PG),triglyceride (TG),total cholesterol (TC),glycosylated hemoglobin A1c (HbA1c),fasting C-peptide(FC-P) were recorded.Multiple factor Logistic regression was applied in patients with DN and non-DN.Results The incidence of DD and DN in T2DM patients was 47.34％(89/188) and 41.49％ (78/188) respectively.The ratio of DD in DN group was 79.49％(62/78),in non-DN group was 24.55％ (27/110),and the difference was significant (P ＜ 0.05).The age,duration of diabetes mellitus,SBP,FBG,2 h PG,HbA1c in DN group was higher than that in non-DN group [(52.83 ± 6.43) years old vs.(50.35 ±6.48) years old,(10.51 ±4.36) years vs.(6.48 ±3.25) years,(137.42 ± 14.17) mmHg(1mmHg =0.133 kPa) vs.(132.57 ± 15.38) mmHg,(11.95 ±2.83) mmol/L vs.(10.28 ± 1.98) mmol/L,(15.07 ± 3.16) mmol/L vs.(13.51 ± 2.75) mmol/L,(9.62±2.17)％ vs.(8.63 ± 2.08) ％],FC-P was lower than that in non-DN group [(1.76 ± 0.89) μ g/L vs.(2.01 ± 0.72) μ g/L],and the difference was significant (P ＜ 0.05).Multiple factor Logistic regression analysis showed that duration of diabetes mellitus,DD and FPG were still related to DN in T2DM (OR =4.841,3.209,3.368,P ＜0.01).Conclusions DD is correlated with DN in T2DM.DN should be screened in T2DM patients with DD.

Objective To explore the application of body mass index(BMI)and the increased value of postpradial 2h C peptide [2hCP minus fasting C-peptide(FCP), ΔCP]as indexes to adjust the antidiabetic plan after intensive blood glucose control in poorly controlled patients with type 2 diabetes mellitus(T2DM).Methods The insulin intensive therapy with injections of insulin four times a day was applied to 156 type 2 diabetic in-patients with poorly glycemic control.Islet function was evaluated after glucostasis in all patients.According to FCP≥1 ng/ml, addition of basal insulin to oral antidiabetic drugs was applied(as plan A, A group).The insulin intensive therapy was continued if FCP<1ng/ml(as plan B,B group).The treatment plan was adjusted from plan A to B when plasma glucose was poorly controlled after a week(as B group).The baseline data of sex, age, diabetes duration, BMI, fasting plasma glucose(FPG), 2 hours postpradial plasma glucose(2hPG), HbA1C, triglyceride(TG), total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, FCP, 2hCP, 2hCP/FCP, and ΔCP were analyzed.Insulin dose, the incidence of hypoglycemia, and the targeted rate of glucose control were compared between two groups before grouping and one month after treatment.Results The results showed that BMI, TG, FCP, 2hCP, 2hCP/FCP, and ΔCP in A group were higher than those in B group(P<0.01), while FPG, 2hPG and HbA1C were lower(P<0.01).There were no differences in insulin dose, the incidence of hypoglycemia, the targeted rate of FPG and 2hPG between two groups when grouping.After one-month treatment, insulin dose and the incidence of hypoglycemia in group A were lower than those in group B, while the targeted rates of FPG and 2hPG in group A were better than group B(P<0.05 or P<0.01).The results of binary logistic regression analysis showed that BMI and ΔCP were independent factors for choosing antidiabetic plan A(β=0.26, 0.90,P<0.01).The areas under receiver operator characteristic curve of BMI and ΔCP were 0.72 and 0.84, respectively(P<0.01), and their cut-off points to choose antidiabetic plan A were 23.14 kg/m2 and 1.32 ng/ml.Conclusions BMI and ΔCP can be used as the predictive indexes for choosing an antidiabetic plan for poorly controlled type 2 diabetic patients.

[Summary] A total of 165 type 2 diabetic patients were divided into two groups with pigmented pretibial pathes(PPP group) and no PPP( NPPP group). 50 subjects with normal glucose regulation were used as a control group(NGR group). The records of sex, age, diabetes duration, body mass index( BMI), systolic blood pressure (SBP), diastolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting blood glucose(FBG), 2 h postpradial plasma glucose(2hPG), triglyceride(TG), total cholesterol, HbA1C , retinol binding protein 4(RBP4), cystatin C(Cys C)were analyzed. The results showed that BMI,FBG, 2hPG, TG, and Cys C levels in NPPP group were higher than those in NGR group(all P<0. 01). The levels of BMI, SBP, FBG, 2hPG, TG, Cys C, and RBP4 in PPP group were higher than those in NGR group(P<0. 01 or P<0. 05), while diabetes duration, FBG, 2hPG, HbA1C , Cys C, and RBP4 in PPP group were higher than those in NPPP group ( P <0. 01). Pearson correlation analysis revealed that serum RBP4 and Cys C were in linear positive correlation(r=0. 77, P< 0. 01). The areas under receiver operating characteristic curve of RBP4 and Cys C were 0. 81 and 0. 78, respectively(P<0. 01). The results of binary logistic regression analysis showed that diabetes duration, HbA1C , RBP4 were related to PPP(r=0. 37, 0. 26, 0. 22, P<0. 05 or P<0. 01).

Objective:to investigate the clinical feature and dynamic changes of the cervical dural sac and spinal cord during neck flexion in Hirayama disease(juvenile muscular atrophy of distal upper extremity).Methods:Clinical data were taken and MRI in neutral neck position and a fully flexed neck position were performed on 27 cases of Hirayama disease.Results:(1)All patients were consistent with the diagnostic criteria of Hirayama disease who had asymmetric muscular atrophy and weakness of the hand and forearm.All patients were young males and right handed of whom 77.8% had initial symptoms before they were 19 years old.More patients(20 cases,74%)had muscular atrophy in the right hand than in the left at onset.The duration after disease onset was from 2-72 months[(26.48?15.57)months].(2)In neutral neck position by MIR examination,16 patients showed abnormal cervical curvature,14 showed atrophy of the lower cervical cord and 2 patients had intramedullary abnormal high signal.(3)In a fully flexed position of the neck,all patients showed forward displacement and flattening of the lower cervical cord,and a crescent-shaped high signal area behind the cord.(4)The crescent-shaped area was enhanced on T1-weighed imaging and disappeared after the patient returned to a neural position in one case.Conclusion:Hirayama disease occurs mainly in young males.There are obviously dynamic changes of the cervical cord during neck flexion in Hirayama disease by MRI examination,which can help the doctor make diagnosis in the early stage.

OBJECTIVE: To study the expression and relationship of Pin1 and CyclinD1 in adult papilloma of larynx, and the effect of both in laryngeal papilloma's canceration. METHOD: Ninety-two cases of paraffin section with immunoperoxidase (SP) staining method was used to detect the distribution of Pin1 and CyclinD1 in 10 cases of laryngeal normal epithelial tissue, 39 cases of laryngeal papilloma, 27 cases of laryngeal papilloma with middle, severe atypical hyperplasia and 16 cases of laryngeal carcinoma. RESULT: The distribution of Pin1 and CyclinD1 increased gradually from laryngeal normal epithelial tissue to laryngeal carcinoma (P<0.05); No difference of the expression of CyclinD1 (not including Pin1, for Pin1, P=0.009) was found between laryngeal papilloma and laryngeal papilloma with middle, severe atypical hyperplasia (P>0.0125), but there had significant difference of the expression of Pin1 and CyclinD1 among the rest groups; There was significantly direct correlation between the expression of Pin1 and CyclinD1 (P<0.05). CONCLUSION The hyper-expressions of Pin1 and CyclinD1 may play a key role in laryngeal papilloma's malignant change. Pin1 up-regulating the expressions of cyclinD1 possibly participate in its malignant change.
Adult ; Aged ; Cyclin D1 ; metabolism ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; NIMA-Interacting Peptidylprolyl Isomerase ; Papilloma ; metabolism ; pathology ; Peptidylprolyl Isomerase ; metabolism ; Young Adult

Posttraumatic ankle arthritis caused by trauma, a common articular disease, mainly destroys the biomechanical balance of the ankle joint and results in degeneration of the joint.It often occurs in young people, leading to articular pain and stiffness and other symptoms which may deteriorate to end-stage posttrau-matic ankle arthritis with no intervention.At present, a variety of therapies are available for the disease. However, no domestic literature has addressed the choice and application of its treatment methods.To be useful in clinic, this review deals with the etiology, diagnosis and treatment (including choice, efficacy, indications and contraindications) of the disease.

Objective:To investigate the effect of different imaging classifications of prostate cancer seminal vesicle invasion on positive surgical margins (PSM) after laparoscopic radical prostatectomy(LRP).Methods:114 patients with pT 3b stage prostate cancer admitted to Peking University Third Hospital from August 2009 to December 2020 were retrospectively analyzed. The age of the patients was (68.2±7.7) years old, the median pre-biopsy PSA was 20.20 (3.45-186.30) ng/ml, and the patients with biopsy Gleason score of ≤7, and ≥8 was 33 and 81 cases, respectively. The median prostate volume was 33.2 (12.1-155.4) ml. According to the imaging of the seminal vesicle invasion of prostate cancer, the patients were divided into the following types: type Ⅰ, the tumor directly invades the seminal vesicle along the vas deferens; type Ⅱa, the tumor invades the basal capsule of the prostate and invades the seminal vesicle; type Ⅱb, the tumor invades the periprostatic fat and retrogradely invades the seminal vesicles; type Ⅲ, solitary lesions in the seminal vesicles that do not continue with the prostate cancer. All patients underwent LRP, and the PSM were recorded as the base, bilateral, posterior, anterior and apical parts of the prostate. The differences in clinicopathological data of patients with different seminal vesicle invasion imaging types were compared, and the independent risk factors of PSM in pT 3b prostate cancer were evaluated by multivariate analysis. Results:The operative time of 114 cases in this group was (229.4±62.2) min, and the blood loss was 100(20-1 800)ml. The postoperative gross pathological Gleason score was ≤7 in 17 cases and ≥8 in 97 cases. In the imaging classification of prostate cancer with seminal vesicle invasion, there were 28 cases (24.6%) of type Ⅰ, 39 cases (34.2%) of type Ⅱa, 47 cases (41.2%) of type Ⅱb, and no type Ⅲ patients. There was no significant difference in age, body mass index, pre-biopsy PSA, prostate volume, and operation time among patients with type Ⅰ, Ⅱa, and Ⅱb seminal vesicle invasion ( P>0.05). There was a statistically significant difference in blood loss among the three types ( P = 0.001), and the difference in the proportion of lymph node metastasis was statistically significant ( P = 0.013). In the classification of prostate cancer seminal vesicle invasion, the PSM rates of type Ⅰ, Ⅱa and Ⅱb were 28.6% (8/28), 38.5% (15/39) and 70.2% (33/39), and the difference was statistically significant ( P=0.001). The PSM rates of type Ⅰ, Ⅱa, and Ⅱb were 21.4% (6/28), 23.1% (9/39), and 34.0% (16/47), respectively. The results of univariate analysis showed that the biopsy Gleason score ( P = 0.063) and the type of seminal vesicle invasion ( P<0.001) entered into multivariate analysis, and the results of multivariate logistic regression analysis showed that the type of seminal vesicle invasion ( P=0.001) was independent risk factor for PSM after LRP. Conclusions:The PSM rate in patients with type Ⅱb seminal vesicle invasion is significantly higher. The higher imaging type of seminal vesicle invasion is the independent risk factor of PSM after LRP.

The sources of common knee valgus deformities were classified in order to better plan the orthopedic methods, matching prostheses and soft tissue repair of knee valgus deformities.Based on the analysis of typical clinical cases and the operability of classification standards in practical clinical practice, it is of great significance to establish a reasonable morphological classification of knee valgus deformity, in order to grasp the characteristics and patterns of the onset of valgus deformity. According to the origin of the deformity and the tension of the medial and lateral collateral ligaments, the classification of the genu valgus deformity can be divided into the classification of the traditional Genu valgum deformity origin and the classification of the new Genu valgum deformity origin. Although both of them highlight the skeletal characteristics and soft tissue conditions of the valgus deformity, they are quite different. Traditional classification is based on femoral tibial angle, valgus angle, etc; The new classification is divided into mechanical angle, anatomical angle, distal condylar angle, etc. The origin of Genu valgum deformity is generally complex. The traditional classification cannot fully reflect the origin of valgus deformity and the tension state of soft tissue. The new classification, especially based on the classification of anatomical angle valgus deformity, can not only reflect the morphological and anatomical details of knee valgus deformity, but also reflect the tension state of the medial and lateral collateral ligaments and local soft tissue stress state that determine the stability of the knee joint. At present, the commonly used surgical methods for valgus deformity of the knee include periarticular osteotomy of the knee and total knee Joint replacement. The former focuses on correcting extraarticular deformity without over repairing ligaments, and the latter focuses on force line correction, which is the final treatment for terminal valgus deformity. The application of digital technology in clinical orthopedics can improve the accuracy of implant placement. Implant placement needs to be based on the patient's bone characteristics and degree of deformity. For patients with severe deformity, the application of digital technology can improve the accuracy of implant placement and assist in the treatment of knee valgus deformity.

Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.