[Objective] To investigate the clinical characteristics and risk factors of lower-extremity arterial disease in the patients with newly diagnosed type 2 diabetes mellitus combined with nonalcoholic fatty liver disease (NAFLD). [Methods] One hundred fifty-one patients were investigated respectively. The patients were divided into two groups (NAFLD-Group and non-NAFLD group) by liver ultrasonography and disease history, then their clinical data were collected and compared in order to find the differences of biochemical indicators and the morbidity of lower-extremity arterial disease between two groups. [Results] Ninety-two cases (60.93%) were complicated with NAFLD. NAFLD group had higher levels of fast insulin and C peptide level, postprandial insulin and C peptide level, uric acid, body mass index (BMI), homeostasis model assessment (HOMA-IR) and lower level of high-density lipoprotein cholesterol and insulin sensitive index than those of without NAFLD (P<0.05). One hundred and one cases(66.89%) were complicated with lower-extremity arterial disease. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group (75% vs. 54.24%, P<0.01). [Conclusion] Both lower-extremity arterial disease and NAFLD are common complicated with type 2 diabetes. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group.

Objective To understand college students on-site first aid training demand situation in Chongqing ,in order to provide the basis for college students to carry out on-site first aid training .Methods Using stratified random sampling method ,a question-naire survey was conducted on 1 232 students of 6 university in Chongqing .Results 90 .9% of the students hoped that they could master the on-site first-aid knowledge and skills ,students of different genders had significant differences on learning attitude of field first aid knowledge(P<0 .05) .The on-site first-aid knowledge among college students in Chongqing city most wanted to know was thetrauma emergency stop(74 .8% ) ,the most loving way of learning was to the hospital or emergency center study tour(47 .7% ) ,The love of on-site first aid training and learning style were theory teaching+watch video teaching or teacher demon-stration+classroom practice (63 .6% ) ,The operation way of learning the most love was teacher ,all the students into groups of two ,mutual operation practice(65 .9% ) ,and in both gender and specialty had significant differences(P<0 .05) .The survey of col-lege students in Chongqing city training status display results ,43 .5% of the students never received on-site first aid training .In ad-dition ,college students receive on-site first aid training frequencies were low ,48 .6% students in more than 2 years received 1 ses-sions of training .while the rescue confidence survey of college students after the on-site first aid training ,only 13 .1% of the students“completely had the confidence to do” .Conclusion College students in Chongqing have strong desire to learn on-site first aid training ,and there are differences in gender and major on demand ,past state of first aid training is poor ,in urgent need of the relevant departments give attention ,and formulate the on-site first aid training programs to improve college students′competence .

OBJECTIVETo compare the safety and efficiency of pacing at right ventricular outflow versus right ventricular apex.

METHODPatients were divided into two groups: pacing at ventricular cardiac apex (common pacing group, n = 22) and pacing at right ventricular outflow tract (uncommon pacing group, n = 18).

RESULTSImpedance and amplitude of R-wave were similar during implantation between the two groups (all P > 0.05). The pacing threshold and electric current were significant higher in uncommon group than those in common pacing group (all P < 0.05), however, these differences disappeared at 1 month post pacemaker implantation (all P > 0.05). The mean QRS duration tended to be shorter in uncommon pacing group compared to that in common pacing group (P > 0.05). There was no pacemaker associated adverse effect in both groups.

CONCLUSIONThe safety and efficiency of pacing at right ventricular outflow was similar as those of pacing at right ventricular apex.

Adult ; Aged ; Cardiac Output ; Cardiac Pacing, Artificial ; methods ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Ventricles ; physiopathology ; Humans ; Male ; Middle Aged ; Ventricular Function, Right

OBJECTIVETo determine the effects of irrigation fluid absorption on system hemodynamics, fluid-electrolyte and hormone during mini-percutaneous nephrolithotomy.

METHODSIn this study 128 patients with renal calculus or calculus of superior ureter from January 2007 to February 2008 were collected. Hemoglobin (Hb), hematocrit (Hct), plasma osmotic pressure (POP), fluid-electrolyte, serum creatinine (Cre), renin, angiotensin II and aldosterone were determined before and after operation. Heart rate (HR), mean arterial blood pressure (MAP) and oxygen saturation (SPO(2)) were recorded dynamically every 30 min.

RESULTSThe HR speeded up accompanied with the irrigation time. When compared with before operation, POP, Cl(-), renin and Cre were significantly increased after operation; Hb, Hct and K(+) were significantly decreased after operation; MAP, SPO(2), Na(+), aldosterone and angiotensin II did not change significantly after operation. No serious surgery-related complication occurred in all patients.

CONCLUSIONSIrrigation fluid is absorbed during mini-percutaneous nephrolithotomy. The absorption amount is positively correlated with irrigation time. Changes of hemodynamics, fluid-electrolyte balance and renin may be caused by the irrigation fluid absorption.

Adult ; Aged ; Aldosterone ; blood ; Angiotensin II ; Female ; Hemodynamics ; drug effects ; Humans ; Kidney Calculi ; blood ; physiopathology ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; Renin ; blood ; Therapeutic Irrigation ; Ureteral Calculi ; physiopathology ; surgery ; Water-Electrolyte Balance ; drug effects

BACKGROUND: Bone defects are one of the most important challenges that surgeons have to manage in total knee arthroplasty. The reasonable treatment method can guarantee the effect of the repair operation. OBJECTIVE: To review the relevant literatures concerning bone defects treated by primary total knee arthroplasty and revision total knee arthroplasty, and to analyze the optimal managements for different types of bone defects. METHODS: Relevant literatures were identified in China National Knowledge Infrastructure, Wanfang data, Vip, PubMed, Medline, and Web of Science. The key words were "total knee arthroplasty, total knee replacement, revision total knee arthroplasty, bone loss, bone defect, bone deficiency, management". The included studies were analyzed and summarized. RESULTS AND CONCLUSION: (1) Sixty-two studies regarding total knee arthroplasty for bone defects were included, without recognized standards on the type of bone defects. AORI is the most widely used classification for bone defects. (2) Pre-operated detailed evaluation including laboratory and radiographic examination, and accurate diagnosis are the key to success. (3) Management of bone defect was similar in tibia and femur, but there is still no standard classification and management of patellar bone defect. (4) Using stem fixation whenever a femoral or tibial component is revised can improve clinical outcome. (5) Through detailed evaluation, accurate diagnose and appropriate classification of bone defect, selection, according to the characteristics of different strategies, the age of the patient and the needs of life, can get a good clinical result.

OBJECTIVETo study the prokaryotic expression of extracellular ligand binding domains of chick tie-2, the purification, refolding conditions of the recombinant protein, and its anti-angiogeneic effect.

METHODSA DNA fragment encoding extracellular ligand binding domains of chick tie-2 was obtained by PCR amplification using a previous constructed plasmid as a template. The amplified fragment was then inserted into prokaryotic expression vector pQE30, and was expressed in E.Coli XL-1 blue by adding isopropyl-beta-D-thiogalactoside(IPTG). The recombinant protein in inclusion bodies was purified by nickel-nitrilotriacetic acid (Ni-NTA) affinity chromatography under denatured conditions. Then the refolding of the purified protein was performed with gradient dialysis. The target protein was injected s.c. into mouse, and the antibody was detected by ELISA and Western blot analysis. The antibody was purified from the antiserum and then incubated with human umbilical endothelial vein cell (HUEVC) to find its anti-angiogenesis in vitro by using propidium iodide(PI) dying through FACS. Alginate encapsulated tumor cell assays were performed and micro-vessel density was determined by counting per high power field in the sections stained with an antibody reactive to CD31 to test its inhibition of angiogenesis.

RESULTSThe recombinant protein was highly expressed in E.Coli XL-1 blue, and the antibody produced in mouse could specifically recognize the recombinant protein. The purified antibody could induce apoptosis of HUEVC in vitro. The anti-angiogenic effect of the antibody could also be found in alginate-encapsulate tumor cell assay and by counting micro-vessel density.

CONCLUSIONThe protein of extracellular ligand binding domains of chick tie-2 can be expressed at high level in the prokaryotic expression system, and the expressed protein can induce immune response in mouse. Furthermore, the antibody can induce the anti-angiogenic effect.

Angiogenesis Inhibitors ; pharmacology ; Animals ; Binding Sites ; Blotting, Western ; Chickens ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Platelet Endothelial Cell Adhesion Molecule-1 ; analysis ; Receptor, TIE-2 ; chemistry ; metabolism ; Recombinant Proteins ; pharmacology

OBJECTIVETo investigate the clinical and neurodevelopmental profiles of patients with biotinidase deficiency and to determine the efficacy of current therapy with respect to outcome.

METHODSSix patients aged from 3 months to 14 years with biotinidase deficiency were confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS) and biotinidase assay on dried blood spots. Biotin was supplemented individually (10-40 mg/d). Their clinical features, laboratory findings, and treatment regimen were reviewed.

RESULTSAll the 6 patients presented with some extent of neurological abnormalities and dermatological lesions. Cases 1 - 3 had poor feeding, vomiting, seizures, mental retardation, and lethargy onset from their early infancy, with varied degree of anemia, ketosis, acidosis, and hypoglycemia. Case 2 exhibited eczema and dermatitis from his age of 7 months. Case 4 displayed motor deficit and ataxia after 6 months of age, and generalized pustular psoriasis when he was 8 months old. Cases 5 and 6 gradually showed muscle weakness and paraplegia at the age of 7 years and 5 years, respectively. Inflammatory demyelination changes of cervical cord were evident on magnetic resonance imaging in these two patients. Case 6 had progressive optic atrophy, eczema and alopecia. Remarkable elevations of urinary lactate, pyruvate, 3-OH-propionate, methylcitrate, propionylglycine, 3-OH-isovalerate, 3-methylcrontonylglycine were confirmed in cases 1, 2, 3 and 5. Slight increase of urinary lactate, pyruvate, and 3-methylcrontonylglycine was observed in cases 4 and 6. Biotinidase activities assayed on dried blood spots from all the patients were below 0.1 pmol/(min.3 mm) Biotin supplementation for all the patients, except for case 3 who was not treated, resulted in pronounced and rapid clinical and biochemical improvement. Cases 4 and 6 had residual neurological damage comprising ataxia and motor handicap of legs, due to prolonged disease course.

CONCLUSIONSBiotinidase deficiency intensively impairs nervous system and skin in the affected patients. Urinary organic acid analysis and blood biotinidase assay are crucial to the diagnosis. Early diagnosis and biotin supplementation can contribute significantly to the improvement of prognosis.

Adolescent ; Biotin ; administration & dosage ; therapeutic use ; Biotinidase Deficiency ; diagnosis ; drug therapy ; urine ; Child ; Child, Preschool ; Gas Chromatography-Mass Spectrometry ; Humans ; Infant ; Male ; Treatment Outcome

BACKGROUNDThere are limited data on longer-term outcomes (>5 years) for patients with unprotected left main coronary artery (ULMCA) disease who underwent percutaneous coronary intervention (PCI) in the drug-eluting stents (DES) era. This study aimed at comparing the long-term (>5 years) outcomes of patients with ULMCA disease underwent PCI with DES and coronary artery bypass grafting (CABG) and the predictors of adverse events.

METHODSAll consecutive patients with ULMCA disease treated with DES implantation versus CABG in our center, between January 2003 and July 2009, were screened for analyzing. A propensity score analysis was carried out to adjust for potential confounding between the two groups.

RESULTSNine hundred and twenty-two patients with ULMCA disease were enrolled for the analyses (DES = 465 vs. CABG = 457). During the median follow-up of 7.1 years (interquartile range 5.3-8.2 years), no difference was found between PCI and CABG in the occurrence of death (P = 0.282) and the composite endpoint of cardiac death, myocardial infarction (MI) and stroke (P = 0.294). Rates of major adverse cardiac and cerebrovascular events were significantly higher in the PCI group (P = 0.014) in large part because of the significantly higher rate of repeat revascularization (P < 0.001). PCI was correlated with the lower occurrence of stroke (P = 0.004). Multivariate analysis showed ejection fraction (EF) (P = 0.012), creatinine (P = 0.016), and prior stroke (P = 0.031) were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age (P = 0.026) and EF (P = 0.002) were independent predictors in the CABG group.

CONCLUSIONSDuring a median follow-up of 7.1 years, there was no difference in the rate of death between PCI with DES implantation and CABG in ULMCA lesions in the patient cohort. CABG group was observed to have significantly lower rates of repeat revascularization but higher stroke rates compared with PCI. EF, creatinine, and prior stroke were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age and EF were independent predictors in the CABG group.

Aged ; Coronary Artery Bypass ; Coronary Artery Disease ; physiopathology ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Stroke Volume

The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis (50.70%), 19 cases of alcoholic chronic pancreatitis (13.38%), 14 cases of autoimmune pancreatitis (9.86%) and 37 cases of undetermined etiology (26.06%). Pathologically, the average inflammatory mass diameter was 3.8 ± 3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head (n=97), neck (n=16), body (n=12), tail (n=15) and whole pancreas (n=2) influenced the choice of surgical procedures. Ninety-four patients (66.20%) received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer (QLQ-C30) a decrease from 76 ± 22 to 14 ± 18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.
Adolescent ; Adult ; Aged ; Autoimmune Diseases ; epidemiology ; therapy ; China ; epidemiology ; Cholestasis ; epidemiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis, Alcoholic ; epidemiology ; therapy ; Pancreatitis, Chronic ; etiology ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

AIM: To study the correlation between the selection of surgical methods for children with basic exotropia and the incidence of lateral incomitance and correction effect.METHODS: Retrospective study. Clinical data of 180 children with basic exotropia who received treatment in the ophthalmology department of our hospital from June 2018 to December 2020 were selected. The patients were divided into 104 cases in monocular recess-resection group(R & R group)and 76 cases in binocular lateral rectus recession group(BLR-rec group)according to the surgical method. The general information, correction effect, the degree of surgical strabismus and the lateral incomitance were compared between the two groups.RESULTS: There were no differences in the degree of near and far strabismus between 2 groups at 3d, 1 and 6mo after surgery(all P>0.05). The correction rate of the R& R group at different time after surgery was higher than that of the BLR-rec group(P<0.05). R & R group had lower risk of lateral incomitance than that of BLR-rec group(OR=0.524, Wald χ2=4.260, P=0.039). After 6mo of operation, the patients in two groups mainly showed eye abduction fixation in the horizontal rectus muscle operation, but there was no difference in the incidence of near and distant lateral incomitance between the two groups(all P>0.05).CONCLUSION: R & R is better than BLR-rec in correcting children's basic exotropia, and it can reduce the incidence of lateral incomitance.