Objective To investigate the relationship between thyroid hormone and uric acid (UA) and body mass index (BMI) in patients with type Ⅱ diabetes and normal thyroid function.Methods Total of 313 patients with type Ⅱ diabetes and normal thyroid function were selected.BMI,fasting blood glucose (FBG),the metabolism of blood lipid,thyroid hormones and UA indicators were examined and the correlations of thyroid hormone,BMI and UA were analyzed.Results (1) The patients were divided into two groups according to gender,and FT3,FT4,and UA of male were found to be significantly higher than those in female (P＜0.01).TSH,SBP,HDL-C in female were significantly higher than those in male (P＜0.01);(2) The patients were divided into three groups according to BMI Level.Thyroid-stimulating hormone (TSH),three iodine armour gland original glycine (TT3),free three iodine thyroid glycine (FT3),UA,and FBG in overweight and obesity groups were found to be higher than those in normal weight group (P ＜ 0.05);(3) The patients were divided into two groups according to the TSH level.Serum uric acid,TT3,FT3,fasting insulin in the group with TSH above 2.5 uIU/L were found to be higher than those in the group with TSH under 2.5 uIU/L (P ＜ 0.05);(4) Patients were divided into two groups according to the UA level.TSH,FT3 in male with high uric acid were found to be higher than those in male with normal uric acid (P ＜ 0.05);TSH was in female with high uric acid was found to be higher than that in female with normal uric acid (P ＜ 0.05).Conclusion Thyroid hormone in patients with type Ⅱ diabetes can be used to assess the body weight and uric acid,which is of great clinical importance.

Objective To evaluate carotid intima-media thickness(IMT) and elasticity in patients with pregnancy-induced hypertension(PIH) using ultrasound radio-frequency data(RF-data) technology.Methods Twenty-seven PIH women(mean brachial blood pressure:108 mm Hg,1 mm Hg=0.133 kPa)were included and thirty age- and gestational week-matched normal pregnant women served as controls.Carotid IMT and stiffness were evaluated using quality IMT(QIMT) and quantitative artery stiffness(QAS)techniques with color Doppler.Results Carotid IMT and elasticity parameters,including pulse wave velocity,pressure at T1,arterial augmented pressure(AP) and arterial augmented pressure index(AIx) were significantly higher in PIH group than in the normal group[IMT:(466.84±118.50)μm vs (386.58±125.79)μm;PWV:(7.09±1.97)m/s vs (5.95±1.11) m/s;PT1:(127.50±14.29) mm Hg vs (105.89±11.02)mm Hg;AP:(5.14±3.39) mm Hg vs (1.98±2.19)mm Hg;AIx:(7.58±8.73)% vs (-4.79±7.92)%)], and there were significant differences(t=2.660,2.660,3.460,3.460,3.460,all P＜0.01).Conclusions PIH women have significantly increased carotid IMT and decreased elasticity compared with normal pregnant women.Radio-frequency technique could reliably reflect the changes of the carotid arterial structure and elasticity in patients with pregnancy-induced hypertension.

AIM: To evaluate the safety and efficacy of intravitreal bevacizumab ( avastin ) injection in patients with exudative age related macular degeneration ( AMD) .
METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for AMD were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography and fundus fluorescein and/or indocyanine green angiography. Observation was made on the best corrected visual acuity ( BCVA) , intraocular pressure, and the changes of lens, vitreous, central retinal thickness (CFT) and total macular volume (TMV), at 1d, 3d, 7d, 1mo and 6mo after the treatment and then compared with those of pre - operation. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. And all cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given once every 6wk.
RESULTS:All 50 eyes of 48 patients with the average of 58±20. 46 years old were included. The mean baseline of BCVA and CFT were 0. 82±0. 53, and 364. 97±151. 83μm respectively. Although there was no significant decrease in mean CFT and TMV one week after the injection, the mean BCVA had significant improvement. At the last visit of 9. 7mo follow - up, BCVA, CRT and TMV showed significant improvements over baseline values. BCVA was improved by at least two lines in 32 eyes (64%),remained stabilization in 18 eyes (36%) at the last visit. A total of 98 injections were performed and the average number of injections was 1. 98 for each eye in the group. About 50%of re - injections gained at least two lines of vision improvement one week postoperatively. There were no serious adverse events during the treatment.
CONCLUSION: Intravitreal bevacizumab ( avastin ) injection for managing CNV due to age-related macular degeneration is safe and few side effects. Intravitreal avastin associated with improvement in visual acuity ( VA ) , which can reduce macular edema and choroidal neovascularization leakage. But a prolonged treatment effect needs further observation.

To evaluate the safety and efficacy of intravitreal bevacizumab injection in patients with macular edema (ME) induced by retinal vein occlusion (RVO).
● METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for ME induced by RVO were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography ( OCT) and fundus fluorescein angiography ( FFA ), etc. Best corrected visual acuity (BCVA), intraocular pressure, the change of lens and vitreous, central foveal thickness (CFT) were observed at 1, 2, 3, 6mo after treatment and compared with before treatment. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. All the cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given at 6wk intervals.
●RESULTS: Fifty patients (56 eyes) with the average of (57±18. 56) years old were included. The mean baseline of BCVA, CFT were (logMAR0. 82±0. 63), (626. 5±178. 0)μm respectively. Although there was no significant decrease in mean CFT at 1wk after injection, the mean BCVA had significant improvement. Followed up at mean 10. 26 ± 5. 87mo, BCVA, CFT showed significant improvements over baseline values. The statistics of CFT at 1, 2, 3mo after injection were significant differences compared with before injection in each of the three groups. CFT at 1, 3, 12mo after injection were (365. 11±23. 212) μ m, (333. 42± 35. 526) μ m, (267. 6 ± 116. 8) μ m, which had a significant difference ( P < 0. 001), namely macular retinal thickness was thinner obviously that before treatment, ME was improved obviously. CFT was no significant difference at each time point after injection in the group of BRVO-ME and CRVO- ME (P> 0. 05). OCT image showed that after injection macular retinal thickness was becoming thinner. FFA showed that after injection macular fluorescein leakage decreased. BCVA was improved by at least two lines in 48 eyes (86%),remained stable in 8 eyes (14%) at the last visit. A total of 112 injections were performed and the average number of injections was 1. 96 in the group. About 50% of reinjections gained at least two lines of vision improvement at 1wk following the retreatment. There was no serious complications during the treatment.
●CONCLUSlON: lntravitreal injection of bevacizumab can improve visual acuity (VA) of RVO (CRVO and BRVO) in patients with ME, relieve ME, reduce the leakage of CNV, and repeated treatment is better. But a prolonged treatment effect needs further observation. There are no serious ocular and systemic complications occurred in our study.

OBJECTIVESTo investigate the detection rate of small hepatocellular carcinomas using 3.0T MRI 3D-volumetric interpolated breath-hold examination (VIBE) sequence dynamic contrast-enhanced scan, and to evaluate its application in the diagnosis of small hepatocellular carcinomas.

METHODSImaging data of 61 cases of small hepatocellular carcinomas obtained using a 3.0 T Siemens Magnetom Trio Tim magnetic resonance scanner for plain scan and multi-phase dynamic contrast-enhanced scans of three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) were retrospectively analyzed with reference to their pathological diagnoses. The signal and enhanced features and the detection rates of the tumors in different phases of examination were analyzed.

RESULTSSixty-six lesions were detected in the livers of the 61 patients by pathological examinations, of which 49 had pseudocapsule formation. In their T1WI plain scanning, 43 (65.15%) lesions were found, of which pseudocapsules were found in 19 (38.78%). In their T2WI imaging, 53 (80.30%) lesions were found. In dynamic enhanced 3D-VIBE sequence, 65 (98.48%) lesions were found, of which 35 (71.43%) were found with pseudocapsules. The sizes of the carcinomas ranged from 0.8 to 3.0 cm, 2.1cm on the average. The results of statistical analysis for the detection rates of the cancers of the three different sequences were significantly different (chi2=24.197, P less than 0.05). The differences of qualitative accuracy obtained by plain scan (T1WI + T2WI) and 3D-VIBE sequence were significantly different (chi2=66, P less than 0.05).

CONCLUSION3.0 T MRI 3D-VIBE sequence dynamic contrast-enhanced scan is high-speed and can clearly demonstrate the arterial phase, the portal venous phase and the parenchymal phase images. It not only can find small lesions which can not be found with a plain scan, but also can assist diagnosis through a time-intensity curve. It is of great value for detection and differential diagnosis of small hepatocellular carcinomas.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; Female ; Humans ; Imaging, Three-Dimensional ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the osteoblast-like characteristics of human periodontal ligament cells affected by elastic stress in vitro, and the role of corebinding factor a 1 (cbfa1) in alveolar bone formation during orthodontic tooth movement.

METHODSRat dig-labeled cbfa1 cDNA probe was prepared from SD rat osteoblasts cultured in vitro. Human periodontal ligament cells were cultured on the elastic bottom plate and stimulated by elastic stress using mechanical loading system for cultured cells in vitro. The expression of cbfa1 mRNA was detected by in situ hybridization method.

RESULTSCbfa1 mRNA express in human periodontal ligament cells stimulated by elastic stress and did not express in normal human periodontal ligament cells.

CONCLUSIONIt is suggested that elastic stress plays a role in the differentiation process from human periodontal ligament cells to osteoblast-like cells. Cbfa1 is a transcription factor in alveolar bone remodeling during orthodontic tooth movement.

Adolescent ; Animals ; Cells, Cultured ; Child ; Core Binding Factor alpha Subunits ; DNA-Binding Proteins ; genetics ; Elasticity ; Humans ; Periodontal Ligament ; cytology ; metabolism ; RNA, Messenger ; analysis ; Rats ; Transcription Factors ; genetics

OBJECTIVETo evaluate the value of T2WI, DWI and 3D-VBIE at 3.0 T MR in the differentiation of recurrent rectal cancer and benign pelvic lesions after curative rectal operation.

METHODSA total of 28 patients with abnormal pelvic lesions confirmed by CT or MR from April 2007 to October 2010 were evaluated with MR imaging. All the patients received examinations of both T2WI and DWI, and 24 of them received additional examination of 3D-VIBE. Thirteen patients with MR imaging in the same period who were confirmed to have no diseases of the rectum were used as control group. The mean apparent diffusion coefficient(ADC) value and the ratio of the signal intensity(SI) of the lesions to the gluteus maximus in T2WI(SI(L)/SI(M)) and the ratio of the net added signal intensity of the lesions to the net added signal intensity of the iliac artery(SI(L)/SI(A)) at the time of 35 seconds after the iliac artery achieved its highest intensity were measured and calculated. The type of the time-intensity curve(TIC) was over viewed and classified as the benign type when the TIC was rising slowly or constantly and lasted for more than 90 s; however the malignant type when the TIC was rising significantly but lasted less than 90 s kept as a horizontal line for a period or was descending slowly or rising slowly.

RESULTSThere were 29 lesions of different final diagnosis, including 17 recurrence rectal cancers, 4 fibrous masses, 6 stoma inflammations, 1 sinus and 1 abscess. Fourteen of them were confirmed by pathological examination. The ratio of SI(L)/SI(M) was 2.84±1.52 in the benign group, 2.58±0.80 in the malignant group, and 2.13±0.58 in the control group, the differences between the 3 groups were not statistically significant(F=1.620, P=0.211). When the ADC value of 1.21×10(-3) mm(2)/s was set as a diagnostic threshold, the sensitivity, specificity, accuracy and coherence for the diagnosis of the malignant lesions were 100%(17/17), 91.7%(11/12), 96.6%(28/29) and 0.928, respectively. When the SI(L)/SI(A) value of 0.28 was set as a diagnostic threshold, the sensitivity, specificity, accuracy and coherence for the diagnosis of the malignant lesions were 100%(13/13), 66.7%(8/12), 84.0%(21/25) and 0.675. When considering the TIC as the diagnostic standard, the sensitivity, specificity and accuracy for the diagnosis of the malignant lesions were 100%(13/13), 83.3%(10/12) and 92.0%(23/25), respectively.

CONCLUSIONThe signal intensity of T2WI has no specificity in the differentiation of malignant lesions and benign lesions while the DWI and the 3D-VIBE have high values in it.

Adult ; Aged ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; Rectal Neoplasms ; diagnosis ; Retrospective Studies

AlM: To measure the retinal electrical activities in patients with diabetic retinopathy ( DR ) by applying multifocal electroretinogram ( mf-ERG) and evaluate the degree of visual damage at different stages of DR
METHODS:Thirty cases ( 30 eyes ) aged 50 ~70 years old, excluding other diseases, were as normal group, and 99 cases ( 99 eyes ) diagnosed with type 2 diabetes were as experiment group. The cases received mf-ERG examination in the standard state, respectively. The results were statistically analyzed
RESULTS: For DR patients with early and background stage, the reaction density of mf - ERG P1 wave decreased as the disease worsened, significantly reduced in non - proliferating stage and decreased more significantly in the background of the stage Ⅲ. This showed that in the macula, electrical activity had weakened before the retina without visual or morphological changes, and with the development of the disease, the electrical activity decreased more obviously.
CONCLUSlON:mf-ERG can evaluate the severity of DR, especially suit in the early and background period of DR.

OBJECTIVETo evaluate the reliability and application of GeneSearch(TM) breast lymph node assay (Genesearch), a real-time fluorescence quatitative PCR method, in intraoperative assay of metastasis in sentinel lymph nodes (SLNs) from breast cancer patients.

METHODSTotally 140 SLNs from 80 patients with breast carcinoma were prospectively studied from May 2010 to August 2010. The 80 patients included 78 women and 2 men who ranged in age from 29 to 85 years, and the median age is 49 years. The expression of CK19 and mammaglobulin in all 140 SLNs were detected by Genesearch, and the results were compared with that of histological evaluation of both frozen and paraffin-embedded sections.

RESULTSAmong SLNs, by histological analyses, there were 121 without metastasis, 17 with macrometastasis, 2 with micrometastasis, and none of isolated tumor cell. By Genesearch, there were 119 without metastasis and 21 with metastasis. Genesearch showed sensitivity of 89.4%, positive predictive value of 81.0%, negative predictive value of 98.3% and specificity of 96.7% by comparing to histological analyses. The concordance between Genesearch and histological analysis was 95.7%. The sensitivity of Genesearch was 15/17 for macrometastasis and 2/2 for micrometastasis.

CONCLUSIONSGenesearch detection presents high sensitivity and specificity in evaluating metastasis of sentinel lymph nodes in breast cancer, but strict performance technically is necessary to avoid false positive and false negative results. Inability of further subtyping for the positive cases might be the key limitations for wide application of this method.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; pathology ; surgery ; Breast Neoplasms, Male ; pathology ; surgery ; Female ; Humans ; Intraoperative Period ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Neoplasm Micrometastasis ; diagnosis ; Predictive Value of Tests ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy

OBJECTIVETo discuss the cost, cost-effectiveness, and cost-utility of the extension methadone maintenance treatment (MMT) clinics and provide the evidences of the strategy of scaling up the extension MMT clinics.

METHODSA study was conducted in Dehong prefecture, Yunnan province, including Mang, Ruili city, Longchuan, Yingjiang, Lianghe county. 117 newly enrolling heroin addict patients in 17 extension MMT clinics were recruited as subjects from December 2010 to February 2011. An interview was conducted by the trained interviewers for the quality of life score of patients, and the cost of drug use was calculated. Table of outpatient costs of methadone maintenance treatment clinic of Dehong prefecture in Yunnan was used for collecting and calculating the fixed cost, operating cost of the clinics, and the unit cost and incremental cost of the patients from 2008 to 2010. Cost-effectiveness and cost-utility of the extension clinics were analyzed by using the Markov model.

RESULTSThe total spending of extension clinics for 2008, 2009, and 2010 on average was ¥57 294, ¥80 752 and ¥74 739 respectively, or about ¥4379 annually per patient. The cost of averting one HIV infection was ¥316 509; the cost of averting one acquired immune deficiency syndrome (AIDS) patients was ¥508 676; and the cost of averting one death was ¥152 330. The cost of obtaining one life year (LY) was ¥3696 and the cost of obtaining one quality adjusted life year (QALY) was ¥9014. Comparing with drug users, the incremental cost utility ratio (ICUR) of the patients of the extension MMT clinics were -7074 yuan/QALY and -7162 yuan/LY.

CONCLUSIONThe extension MMT clinic service is lower in cost, and better in cost-effectiveness and cost-utility.

Ambulatory Care Facilities ; economics ; China ; Cost-Benefit Analysis ; Health Expenditures ; Heroin Dependence ; therapy ; Humans ; Methadone ; economics ; therapeutic use ; Opiate Substitution Treatment ; economics