Serum adiponectin concentration in diabetic nephropathy (DN) group was significantly higher than that of simple diabetes mellitus (SDM) group.In clinical diabetic nephropathy group with massive albuminuria it was remarkably higher than those of normal control,SDM,and early DN.Furthermore,serum adiponectin concentration was positively correlated with urinary albumin excretion rate and negatively correlated with waist hip ratio.Why it is markedly increased in patients with overt DN merits further investigation.

Ischemic stroke causes varying degrees of cognitive impairment, and its incidence is very high. Early diagnosis of cognitive impairment may provide the best intervention treatment opportunity, and slow disease progression. Therefore, it has attracted more and more attention. This article reviews the advances in etiology, pathogenesis, risk factors, diagnosis, prevention and treatment of cognitive impairment after ischemic stroke.

Humans ; Occupational Diseases ; prevention & control ; Risk Assessment ; Safety

Carcinoma, Papillary ; genetics ; Humans ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Neoplasms ; genetics

Objective To evaluate the relationship between serum bilirubin and carotid atberosclerosis in aged patients with hypertension.Methods 141 aged patients with hypertension were detected by ultrasound were divided into in- creased IMT group,atberoma group and narrow luminal diameter group.Their serum bilirubin levels were measured and compared.Results Those with lower serum total bilirubin,Serum direct bilirubin and serum indirect bilirubin showed more severe carotid atherosclerosis.There was significant statistical difference between threeg roups (P

Objective To determine the predictive factors for lateral lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Methods From January 2002 to December 2009,77 patients with PTMC were treated by modified radical neck dissection. We analyzed the association between lateral LNM and clinical factors, US features, hematological parameters and pathologic features of PTMC. Results The rate of lateral LNM was 39% in 77 PTMCs (30/77). We found a statistically significant association between lateral LNM and age, pathologic features ( extrathyroid invasion and central LNM), higher platelet counts and US features of PTMC (upper pole location,contacting area of the tumor with the capsule of throid gland > 25% of the perimeter of the tumor) in univariate analysis (statistic values were 2.425,6. 392,12. 584,2. 143,8.755 and 6.89,respectively,Ps< 0.05). Age,pathologic features (central LNM) and US features of PTMC (upper pole location) were found to be independent predictive factors for lateral LNM in multivariate analysis ( OR and 95%C/ was 0.942(0.889 -0.998) ,4. 396( 1. 241 - 15. 573) and 4.436( 1. 194 - 16. 482) ,P was 0. 042, 0.022 and 0.026,respectively). Conclusion In patients with PTMC,independent factors in predicting lateral LNM were age, US features of PTMC ( upper pole location) and pathologic features (central LNM ). These patients should receive relatively aggressive initial treatments and vigilant follow-up.

Objective To study the clinical effect of Shenkang injection combined with valsartan in the treat-ment of patients with early stage diabetic nephropathy,and its influence on the expression changes of homocysteine ( Hcy) ,transforming growth factor β1 ( TGF -β1 ) , the inflammatory cytokines high sensitive C -reactive protein (hs-CRP),and interleukin-6 (IL-6).Methods 138 cases of early stage diabetic nephropathy were randomly divided into control group ( conventional treatment, valsartan act as antihypertensive drug ) and treatment group ( treated with Shenkang injection combined with valsartan) by digital table.The total effective rate,glycemic index, renal function,levels of Hcy and TGF-β1,expression levels of inflammatory cytokines of two groups were compared. Results The total effective rate of the treatment group (91.30%) was significantly higher than the control group (76.81%) (χ2 =5.004,P<0.05).The values of FPG,2h PG,HbAlc,UAER,CysC and Scr were lower in the treat-ment group compared with the control group (t=4.514,3.743,4.754,6.214,3.925,3.777,all P<0.05).Com-pared with the control group,the concentrations of Hcy,TGF-β1,hs-CRP and IL-6 decreased significantly[ (11. 78 ±1.95)μmol/L vs (9.21 ±1.64)μmol/L,(71.32 ±14.88) mg/L vs (60.04 ±11.75) mg/L,(7.07 ±1.25) mg/L vs (5.81 ±1.14)mg/L,(50.24 ±21.86)pg/mL vs (32.55 ±17.01)pg/mL],the differences were statistical-ly significant (t=8.378,4.942,6.187,5.305,all P<0.05).Conclusion Shenkang injection combined with val-sartan for the treatment of early stage diabetic nephropathy has significant clinical efficacy.It can improve patients're-nal function and reduce blood sugar levels.The effects may be related with inflammatory response inhibition and Hcy, TGF-β1 levels reduction.

Objective To investigate the clinical and imaging features of Foot-Yangming meridian-muscle syndrome of knee osteoarthritis(KOA) so as to promote the normalization and standardization of the meridian-muscle therapies. Methods A total of 31 KOA cases (involving 31 knees) of Foot-Yangming meridian-muscle syndrome were included into the study group , and 31 healthy volunteers (involving 31 knees) served as the control group. A retrospective research of patellofemoral relationship was carried out based on the clinical and imaging features. Results The differences of Insall index and patella index between the study group and control group were insignificant(P> 0 . 05), but the differences of patellofemoral index , patellofemoral congruence angle, and external patellar angle between the study group and control group were significant(P<0.01). Conclusion The patellofemoral relationship disorder is one of main lesions in Foot-Yangming meridian-muscle syndrome of KOA.

Objective To investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing laparoscopic surgery with prospective cohort study.Methods Study subjects were patients,＞ 65 years of age,undergoing laparoscopic surgery,who were enrolled in an ongoing prospective observational study of the pathophysiology of postoperative delirium.Intraoperative blood pressure was measured,and predefined criteria were used to define hypotension.Delirium was measured by the Confusion Assessment Method on the first two postoperative days.Data were analyzed with t-test,two-sample proportion test,and ordered logistic regression muhivariable model,including correction for multiple comparison.Results Data from 213 patients with a mean age of 73.6 years (SD 6.1) were studied.Of these 63 (29.6％) developed delirium on day 1 and 61 (28.6％) on day 2.Relative hypotension (decreases by 20％,30％,or 40％) or absolute hypotension [mean arterial pressure (MAP) ＜ 50mmHg] were not significantly associated with postoperative delirium,nor was the duration of hypotension (MAP ＜ 50 mmHg).Conversely,intraoperative blood pressure variance was significantly associated with postoperative delirium.Conclusions These results showed that increased blood pressure fluctuation,not absolute or relative hypotension,was predictive of postoperative delirium.

OBJECTIVE:To determine aminophenazone,phenazone and barbital in antodine injection.METHODS:Taking 0.1mol/L NaOH as solvent,the detection data was caculated with partial least square method.RESULTS:The average recoveries were 99.7% for aminophenazone(RSD=0.67%),99.1% for phenazone(RSD=0.76%) and 99.5% for barbital(RSD=0.72%).CONCLUSION:The method is simple,rapid and good in repeatability.