Objective CT-guided collagenase injection through posterolateral path into the interior and superficial prominence of the herniated lumbar disc in the treatment of L4-5 lumbar disk herniation.Methods The approach of posterolateral path to the prominence through intervertebral foramen and epidural space of L4-5 was established according to the analysis of anatomical features and vertebral medical images. The accuracy and safety of the approach were evaluated by CT scanning after epidural injection with air. CT-guided injection was operated in 66 cases of prolapse of L4-5 intervertebral disc confirmed by CT. Results Technical success was 100%. Followed up for 3 months to 3 years, 62 cases (93%) were markedly suecessfud with the effective rate of 93%. Twenty-three had CT re-examination three months later showed the prominences becoming smaller or disappeared in 22 patients having a resolved rate of 95%.Conclusions CT-guided injection of collagenase is one of the effective methods for the treatment of prolapse of L4-5 intervertebral disc.

Objective To investigate the relationship among the leptin receptor(lepr) gene exon 20,nucleotide 3057 G→A transition and lipid metabolism,insulin sensitivity index,high blood coagulation in type2 diabetes mellitus.Methods Polymerase chain reaction(PCR) and restriction fragment length polymorphism(RFLP) were used to detect the variation of leptin receptor gene nucleotide 3057 G→A transition;Simultaneusly,we detected some parameters,including blood lipids,height,weight,blood glucose,waistline to hipline ratio(WHR).The body mass index(BMI),fat percent,insulin sensitivity index(ISI) were calculated out in all subjects.Results The variation frequency at 3057 nucleotide G→A transiton was 80% in type 2 diabetic group,though it was 68% in control group(P

Objective To explore the protective effect of a small balloon on bifurcation lesions by applying a single stent treatment of coronary bifurcation lesions strategy. Methods Fifty patients with coronary bifurcation lesions were randomly divided into A group and B group( 25 cases for each group ). Patients in A group were treated with the pre-entry protection branch guide wire to complete the main branch balloon pre-dilation,stenting,while in B group were treated with the set aside the branches of a small balloon. The information of main branch balloon pre-dilation,stenting were recorded. The blood flow slowed down,the incidence of side branch occlusion or stent placement,and the incidence of postoperative 24 h troponin I( cTnI) levels were measured. Results Nine cases(36%)in A group occurred lower branch blood flow,which due to 4 cases(16% )with significantly narrow branch stenting,2 cases(8%)with complete occlusion. There were only 2 cases(8%)with decrease branching blood flow in B group,and the difference was significant(P=0. 041, 0. 022). The cases with higher cTnI after 24 h in A group were 11( 39%),significantly higher in group B (3(12 %);P =0. 027 ). Conclusion Compared with the traditional protection guidewire,the approach of setting aside a small balloon to protect important branch can effectively prevent important branch occlusion, branch involvement due to lower incidence of myocardial infarction.

Objective To explore the changes of vascular endothelial growth factor (VEGF) and high-sensitivity C-reactive protein (hs-CRP) levels in the patients with coronary heart disease (CHD), and its clinical significance.Methods Nighty cases with CHD in our hospital from January 2015 to February 2016 were selected as study group, while 30 cases healthy persons underwent physical examination were selected as control group, and the study group were divided into stable angina pectoris ( SAP) group, acute myocardial infarction ( AMI) group and unstable angina pectoris ( UAP) group.The serum VEGF and hs-CRP levels were detected by ELISA.Results The serum VEGF and hs-CRP levels in study group were higher than those in control group (P<0.05).The serum VEGF and hs-CRP levels in AMI group were higher than those in SAP group and UAP group, the serum VEGF and hs-CRP levels in UAP group were higher than SAP group (P<0.05).There was positive correlation between serum level of VEGF and hs-CRP(r=0.626,P<0.05).The ROC showed a higher diagnostic value of VEGF and hs-CRP on CHD.Conclusion The serum levels of VEGF and hs-CRP has a higher diagnostic value and accuracy on CHD, which could evaluate the patient’s condition and predict the progress of cardiovascular events.

Objective To investigate the effect of low dose low molecular weight heparin (LMWH) on acute pancreatitis (AP). Methods 98 AP patients who were admitted in our hospital from 2002 to 2008 were randomly divided into anticoagulant therapy group (n = 40) and control group (n = 58). Anticoagulant therapy group consisted of 15 cases of severe acute pancreatitis (SAP) and 25 cases of mild acute pancreatitis (MAP) ; while there were 19 cases of SAP and 39 cases of MAP in control group. The patients of control group received conventional treatment, and conventional therapy together with 3 000 U LMWH subcutaneous injection every 12 hours were used in anticoagulant therapy group for two weeks. The changes of APACHE II score, complication rate, mortality and length of hospital stay were observed and the coagulation changes before and after anticoagulant therapy were documented. Results 7 days later, the APACHE II score, complication rate, mortality and length of hospital stay of SAP patients in the anticoagulant therapy group were 9. 9 ±4. 9, 20% , 13.3% , (20.6 ±10.4)d, respectively; while they were 12. 2 ±4.8, 42. 1%, 47.4%, (28. 2 ± 12. 5) d, respectively, in the control group, and the difference was statistically significant (P < 0. 05). The corresponding values were not statistically significantly different among MAP patients in the two groups. The coagulation after treatment in anticoagulant therapy group was not statistically different with that before treatment. Conclusions Low dose LMWH could reduce the rate of complication rate, mortality and decrease the length of hospital stay, without complication of hemorrhage, which should be recommended in the early phase of SAP.

Objective The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as the biomarkers to predict systemic inflammation. However, there is less study to investigate the association between the biomarkers and thyrotoxicosis. Methods A total of 1 012 healthy subjects and 1 599 newly diagnosed thyrotoxicosis patients were enrolled in this study, including 978 in Graves′ disease (GD group), 452 in Hashimoto′s thyroiditis (HT group), and 169 in subacute thyroiditis (SAT group) groups. The clinical characteristics were retrospectively extracted from the medical records. The NLR and PLR at the baseline were calculated, the correlations between the NLR, PLR, and the clinical characteristics were analyzed. Results The NLR and PLR in SAT patients were significantly higher than those in the control, GD, and HT groups (all P<0.01), but were similar among the last three groups. The NLRs were positively correlated with white blood cell counts (r=0.5, P<0.01) and erythrocyte sedimentation rates (r=0.4, P<0.01), while the PLR was positively correlated with FT4 (r=0.16, P<0.05) and erythrocyte sedimentation rate (r=0.47, P<0.01). The SAT patients with abnormal liver function showed higher NLR and PLR compared the patients with normal liver function (all P<0.01). Based on the receiver operating characteristic curve, when to predict SAT patient with autoimmune thyrotoxicosis, the best cutoff value of NLR was 2.0 (sensitivity 80.5%, specificity 76.9%, area under curve 0.833), and the best cutoff value of PLR was 150 (sensitivity 64.3%, specificity 84.2%, area under curve 0.801). Conclusions The NLR and PLR values exhibited a dignostic value in the differentiation of SAT from autoimmune thyrotoxicosis.

OBJECTIVETo evaluate the role of polymorphism in the neurogenic differentiation factor 1(Neuro D) gene in Chinese patients with type 2 diabetes mellitus.

METHODSThe genotypes of codon 45 variant (GCC-->ACC) in the Neuro D gene were determined by mismatch PCR-restriction fragment length polymorphism assay in 448 Chinese, including 124 subjects with normal glucose tolerance and 324 patients with type 2 diabetes mellitus. The diabetic patients were divided into two groups cutting off with the age of 40 at onset.

RESULTSNo homozygote of the Ala45Thr variant was found in these subjects. The frequencies of AT heterozygous type were significantly higher in early-onset type 2 diabetic group than those in the control group and in the late-onset type 2 diabetic group (chi(2)=7.85, P=0.005; chi(2)=8.81, P=0.003). The frequencies of Thr45 allele in the early-onset type 2 diabetic group were significantly different from those of the control group (13.4% vs 5.2%, chi(2)=7.15, P=0.008) and the late-onset type 2 diabetic group (13.4% vs 5.8%, chi(2)=8.13, P=0.004). The presence of Thr45 allele was shown to have an association with early-onset type 2 diabetes (OR=2.52, 95% CI: 1.42-4.49). Furthermore, the subjects carrying the variant appeared to have lower serum concentration of C-peptide in diabetic group. However, the frequencies of polymorphism genotypes of Neuro D gene showed no difference between the late-onset type 2 diabetic group and the control group.

CONCLUSIONThe genetic polymorphism in the Neuro D is associated with the development of early-onset type 2 diabetes. The presence of Thr45 allele may represent a risk factor for early-onset type 2 diabetes among Chinese.

Alleles ; Basic Helix-Loop-Helix Transcription Factors ; DNA ; genetics ; metabolism ; DNA Restriction Enzymes ; metabolism ; DNA-Binding Proteins ; genetics ; Diabetes Mellitus, Type 2 ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Mutation, Missense ; Polymorphism, Genetic ; Trans-Activators ; genetics

OBJECTIVETo evaluate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and plasma homocysteine levels in patients with type 2 diabetes mellitus and diabetic retinopathy (DR).

METHODSTotal of 208 patients with type 2 diabetes mellitus and 57 controls were recruited into the study. MTHFR genetic C677T polymorphisms were determined by PCR-RFLP. Plasma total homocysteine levels were measured using high-performance liquid chromatography (HPLC) with fluorescence detection.

RESULTSThe frequencies of MTHFR TT homogeneous type, CT heterogeneous type and allele T (28.18%, 41.82%, 49.09%) were significantly higher in the type 2 diabetes mellitus with diabetic retinopathy group than those without retinopathy (18.37%, 29.59%, 33.16%) and those of controls (17.54%, 28.07%, 31.58%). The presence of the T allele appeared to have a strong association with the development of diabetic retinopathy. The odds ratio was 1.94 with a 95% confidence interval of 1.31 - 2.88. Moreover, plasma homocysteine levels were remarkably higher in patients with TT or CT genotype than in patients with the CC genotype.

CONCLUSIONMTHFR gene C677T mutation associated with a predisposition to increased plasma homocysteine levels may be considered as a genetic risk factor for diabetic microangiopathy (such as DR) in Chinese patients with type 2 diabetes mellitus.

Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; etiology ; Female ; Genotype ; Homocysteine ; blood ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; Middle Aged ; Mutation ; Oxidoreductases Acting on CH-NH Group Donors ; genetics ; Polymorphism, Genetic

Objective: To study the current status, hotspots and frontiers in the field of occupational health and safety (OHS) research among medical staff. Methods: A comprehensive search on OHS of domestic and international literature on medical staff was conducted using the China National Knowledge Infrastructure and Web of Science databases from 2002 to 2022. The collected literature was subjected to bibliometric analysis and visualized using CiteSpace 6.1.R6 software. Results: A total of 5 858 articles related to medical personnel OHS comprising 2 144 Chinese articles and 3 714 English articles, were included. The publication of Chinese articles showed an initial increase followed by a decline, while English articles exhibited a sustained increase followed by a sudden decline. Domestic research mainly focused on hospitals and academic institutions, with few collaboration between institutions and regions in China. Research abroad demonstrated strong collaboration and exchange between countries and institutions. The OHS related research hotspots were occupational exposure, occupational health, and occupational safety of medical personnel at home and abroad. The key department of interest was operating rooms, and the key group personnel was nurses. Advanced research in foreign countries has extended to fields such as personal protective equipment and medical personnel sleep issues. Conclusion: There is still a gap on OHS research among medical staff between China and foreign countries. Domestic scholars need to grasp the academic frontiers, strengthen collaboration and exchange among domestic institutions, regions, and international counterparts, enlarge the research scope and content to ensure the OHS of medical personnel.

OBJECTIVETo evaluate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and plasma homocysteine levels in Chinese patients with type 2 diabetes mellitus and diabetic retinopathy (DR).

METHODSMTHFR genetic C677T polymorphisms were determined by PCR-restriction fragment length polymorphism. Total plasma homocysteine levels were measured using high-performance liquid chromatography (HPLC) with fluorescence detection.

RESULTSThe frequencies of MTHFR T homogenetic type and CT heterogenetic type and allele T (28.18%, 41.82%, 49.09%) in type 2 diabetic patients with diabetic retinopathy were significantly higher than those in diabetic patients without retinopathy (18.37%,29.59%,33.16%) or the normal controls (17.54%, 28.07%, 31.58%). Howerver, there were no significant differences in the frequency of MTHFR genotype and allele between the type 2 diabetic patients without retinopathy and the normal controls. The presence of T allele appeared to have a strong association with the development of diabetic retinopathy. The odds ratio was 1.94 and the 95% confidence interval was 1.31-2.88. Moreover, the plasma homocysteine levels in patients with TT or CT genotype were markedly higher than those in patients with CC genotype.

CONCLUSIONMTHFR gene C677T mutation associated with a predisposition to increase of plasma homocysteine may represent a genetic risk factor for diabetic retinopathy in Chinese type 2 diabetes mellitus.

Adult ; Alleles ; DNA ; genetics ; metabolism ; Deoxyribonucleases, Type II Site-Specific ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; complications ; genetics ; Diabetic Retinopathy ; blood ; etiology ; genetics ; Female ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; Middle Aged ; Oxidoreductases Acting on CH-NH Group Donors ; genetics ; Point Mutation ; Polymorphism, Genetic