ObjectiveTo investigate the change of serum vitamin D level in type 2 diabetes mellitus(T2DM) patients,and explore the role of vitamin D in the metabolic disturbance of T2DM and relationship with other metabolic indexes.MethodsBased on the diagnostic criteria of diabetes mellitus of the WHO (1999) and Asian adult obesity criterion established by International Obesity Special Work Group in 2002,32 patients were selected as T2DM group A[body mass index (BMI)≥25.00 kg/m2],and 38 patients were selected as T2DM group B(BMI ＜ 25.00 kg/m2).Thirty-three healthy subjects were selected as control group.The biochemical parameters of human were measured and serum 25-hydroxyvitamin D3 [ 25 (OH)D3] was measured by enzyme-linked immunoassay.The statistic data were compared among three groups.ResultsThe levels of serum 25 (OH)D3 in T2DM group A,T2DM group B and control group were (20.59 ± 4.82 ),( 27.07 ± 5.73 ) and ( 32.27 ±: 8.49 ) μ g/L,and there were significant differences among three groups (P ＜ 0.05 ).The level of serum 25 (OH)D3 was (25.51 ± 6.12) μ g/L in T2DM patients with normal blood pressure (43 cases),(21.87 ± 5.78) μ g/L in T2DM patients with hypertension (27 cases),there was significant difference between the two patients ( P ＜ 0.05 ).The level of serum 25 ( OH ) D3 was (28.42 ± 5.20) pg/L in T2DM patients with normal blood lipids (8 cases),(23.55 ±6.15)μg/L in T2DM patients with dyslipidemia (62 cases),there was significant difference between the two patients (P＜ 0.05).The level of serum 25 (OH)D3 was negatively associated with weight,waistline,BMI,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,fasting insulin,insulin resistance index,total cholesterol,triaeylglycerol and low density lipoprotein cholesterol(P ＜ 0.01 or ＜ 0.05 ),and had no significant association with parathyroid hormone,calcium,phosphorus,high density lipoprotein cholesterol and age (P ＞ 0.05).ConclusionThe level of serum vitamin D decrease in T2DM patients,especially remarkably in patients combined with obesity,hypertension and dyslipidemia.

The effects of amrinone on the contraction and action potential of isolated guinca pig papillary muscles were studied with intracellular microelectrodes. When the preparations were exposed to 25 ?mol/L amrinone, their pcak developed tension(DT) was inereased by 65.4%, the maximum rate of force development (dT/dt_(max)) was increased by 50.8% the time to peak developed tension (tPT) was shortened by 15.9%. By raising the concentration of amrinone to 250 ?mol/L, DT and dT/dt_(max) were increased by 98.5% and 91.3%, respectively, and tPT was shortened by 24.7%. Concomitantly, amrinone can prolong the durations of action potential (APD50, APD90)and the effective refractory period (ERP) of the ventricular cells.These results suggest that amrinone (made in China) possesses the obvious positive inotropic effect.

Objectives To investigate the incidence of the heparin-induced thrombocytopenia (HIT) and positivity of anti-heparin/platelet factor 4 complex antibody (HIT-antibody) in inpatients treated with heparin preparations.Methods A total of 197 consecutive patients,including 120 men and 77 women,who were treated with unfractioned heparin (UFH) or low molecular weight heparin (LMWH),were enrolled in this study.HIT-antibody was detected by enzyme-linked immunosorbent assay (ELISA).All patients were classified into subgroups based on 4Ts (Pretest Clinical Scoring System) and types of underlying disorders.The incidence of HIT and positivity of HIT-antibody among different groups were analyzed.Results The overall incidence of HIT was 3.0％ (6/197),and the positivity of HIT antibody was 12.2％ (24/197).The positivity of HIT-antibody was 10.1％ (18/178),7.7％ (1/13) and 83.3％(5/6) in low,moderate and high HIT probability group respectively.There were significant differences of HIT positivity and mean level of HIT-antibody between the high HIT probability group and the low or moderate HIT probability group (P =0.000).Both the incidence of HIT and positivity of HIT-antibody were higher in surgical patients than in medical patients (5.8％ vs 0.9％,P =0.047 and 19.8％ vs 6.3％,P =0.004).Conclusions The incidence of HIT and positivity of HIT-antibody were 3.0％ and 12.2％ respectively,both of which were related with the types of disorders.Detection of HIT-antibody has a better applicable value in patients with high HIT probability.

Objective To understand Severe Acute Respiratory Syndrome(SARS)better and accumulate more experience of preventing and treating this disease. Methods 63 cases of SARS patients diagnosed during March and May of 2003 were studied by retrospective. Results The average age of patients was(35.1?14.4) years old. Among them, 36 patients had the histories of closing contact with diagonosed patients and 22 patients showed infectious links. There were 3 medical staff patients infected. The average incubations period was (6.2?3.1) days and the SARS epidemic pick in Taiyuan is on April of 2003. People between 20～40 years old had the highest incidence. The most common symptom is fever. The second is dry cough. Most of the patients with SARS had normal or lower white blood counts than normal. The chest radiographs showed infiltration signs such as ground-glass opacities, focal consolidation or pathy consolidation within one week after being ill. The Average period of beginning absorption of the infiltration on chest radiograph is (11.6?5.9) days and the average period of completely resolution is (22.9?6.7) days after being admitted in hospital. There were 14 cases of severe type and 6 patients died of ARDS among 63 patients. Conclusions SARS patients showed obvious infectious link. Therefore it supports the view that SARS is mainly conmmunicated by close air droplets. The main characteristics of SARS are fever, normal or lower white blood cells counts and abnormal chest radiographs.

Objective To investigate the characteristics and related risk factors of patients with lymphoma complicated with tuberculosis (TB), the possible pathogenesis and effective therapy. Methods Twenty-one cases of lymphoma combined with TB were retrospectively analyzed by clinical manifestations,pathological features,diagnostic methods,treatments and prognosis.Results Six cases were diagnosed as TB after the diagnosis of lymphoma,5 cases of which were undergoing chemotherapy for lymphoma; 13 cases were diagnosed as lymphoma after TB,including 6 of 10 obsolete pulmonary TB were reactivated during undergoing chemotherapy. Two cases were diagnosed lymphoma and TB simultaneously. Six cases of 21 cases were Hodgkin lymphoma, whereas the other 15 cases were non-Hodgkin lymphoma. Conclusion TB and lymphoma may exist in the same patient in areas where TB is endemic; among this population,the proportion of Hodgkin lymphoma was higher than in the general population.Therefore,the possibility of TB reactivation when undergoing chemotherapy must be focused on.

OBJECTIVE:To observe clinical efficacy and safety of Bifidobacterium triple viable capsules in the adjunctive treatment of Helicobacter pylori(Hp)positive chronic atrophic gastritis(CAG)complicated with anxiety-depression. METHODS:A total of 100 Hp positive CAG patients with anxiety-depression were divided into control group and observation group according to random number table,with 50 cases in each group. Control group was given standard triple therapy (rabeprazole+amoxicillin and clavulanate+levofloxacin). Observation group was additionally given Bifidobacterium triple viable capsules 0.42 g,tid. The treatment lasted for 14 d in both groups. Clinical efficacies,Hp eradication rates as well as HAMA and HAMD scores before and after treatment were all observed in 2 group. The occurrence of ADR was compared. RESULTS:Total response rate of observation group was 94.0%,and Hp eradication rate was 92.0%,which were significantly higher than 76.0% and 78.0% of control group, with statistical significance (P<0.05). Before treatment,there was no statistical significance in HAMA and HAMD scores in 2 groups(P>0.05). After treatment,HAMA and HAMD scores of 2 groups were decreased significantly,the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of ADR in observation group (4.0%)was significantly lower than control group(20.0%),with statistical significance(P<0.05). CONCLUSIONS:Adjunctive use of Bifidobacterium triple viable capsules can significantly improve Hp eradication rate,clinical symptom,anxiety and depres-sion,while reduce the incidence of ADR.

Objective To discuss the feasibility of using serum complement C5a and C5b-9 as predictive indicators of liver injury severity in traumatic rats with hemorrhagic shock.Method Fifry healthy male Wistar rats were randomly(random number)divided into normal group,model 1 hour group,model 3 hours group,model 6 hours group,and model 24 hours group.Plasma CH50,C5a and C5b-9 were detected by using enzyme-linked immunosorbent assay,and rate method was used for determination of plasma aspartate aminotransferase.Paraffin sections of hepatic tissues were used to observe the damage of liver.Results In the model l h group,the CH50 increased significantly and reached the highest value,it began to decline in 3 hours group,and it reached the lowest point in 24 hours group.Compared with the model 3 hours group,6 hours group,and 24 hours group,the level of CH50 in model 1 hour group increased more significantly(respectively P<0.05).A small amount of C5b-9 in the normal group was detected.In the model 1 h group,C5b-9 increased significantly and reach the peak compared with 3hours group,6hours group and 24 hours group,respectively(P<0.05),but in the model 3hours,it began to decline,and in 24 hours group,it reduced to minimum.C5a increased insignificantly in the model 3 hours group,6 hours group and 24 hours group,and peaked in 24 hours group compared with normal group(P<0.05).Aspartate aminotransferase in the model 1 hour group increased significantly and peaked in 24 hours group compared with other groups(P<0.05).Conclusions A large number of complements are activated in the seRing of hemorrhagie shock.C5b-9 and CH50 increase significantly in the early stage,and C5a.increases significantly in the later stage.C5b-9 can be considered as,an initiative factor of liver injury.The low levels of C5a in the early stage may be a mechanism of self-protection of the body.The high levels of CSa in the later stage may be a kind of decompensation,and C5a can be used as a late predictor of disease severity.

Objective To study how design and harvest perforating artery free flaps in posterior region of thigh based on research of the anatomical features and distribution regularities of those perforating artery.Methods Using 8 fresh bodies specimen with latex leaded perfusion of inferior gluteal area to study perforator artery anatomy structure and distribution of rear thigh.Screen the fitting perforator arteries for perforator free flap both in caliber and length.Total 7 cases were performed with perforator free flap in posterior thigh,the flap size:from 3 cm × 8 cm-8 cm × 16 cm,and the first perforating artery flap carried out in 4 cases,the second perforating artery flap in 2 cases,the third perforating artery flap in Ⅰ case.Results Anatomic study showed that perforating artery suitable for free flap in this area were in teams of 4 to 5,the average diameter were in range of 0.4 to 2.8 mm,the average length was 2.2-9.0 cm.Seven cases had been applied with perforator flap and all survived.Followed-up from 5 to 11 months,the wounds repaired by the perforator flap of posterior thigh presented fine elasticity,thin flap,beautiful appearance.Conclusion The distribution,length and diameter of perforating artery in posterior region of thigh are suitable for perforator free flap.Being hidden,direct close the posterior region of thigh expected to acchive satisfactory clinical effects.

Objective To analyze the clinical features,diagnosis and treatment of thrombotic thrombocytopenic purpura (TTP) in patients with systemic lupus erythematosus (SLE).Methods Clinical manifestations,laboratory findings,diagnosis,treatment and prognosis of 14 SLE patients with TTP were retrospectively analyzed.Results Of the 14 patients diagnosed with SLE and TTP,4 were men and 10 were women.The median age at diagnosis was 23 (17-69) years old.In five patients,the onset of SLE preceded TTP,and in nine patients SLE and TTP occurred simultaneouslv.All the 14 patients had thrombocytopenia and hemolytic anemia,12 had fever,11 had neurologic abnormalities,and 11 had renal dysfunction.Eight patients presented with the classic pentad of symptoms.Six patients were given steroids (alone or in combination with intravenous immunoglobulin and cyclophosphamide),and eight patients were treated with steroids in combination with plasmapheresis,with response rates of 2/6 and 6/8,respectively.Six patients died,with overall mortality rate of 6/14.No patients relapsed during the follow-up period.Conclusions SLE and TTP share some similar clinical symptoms.As a result,repeated examinations of peripheral blood smears are very important for early diagnosis.The renal damage in patients of co-existing diseases is more serious than those with TTP alone or SLE alone.Early diagnosis and prompt treatment with plasma exchange and steroids may improve the prognosis in SLE patients with TTP.

Objective To evaluate a combination therapy for huge tumors in the buttocks.Methods A total of 11 patients from our hospital were collected,among them 5 cases were of hemangioma,4 cases of neurofibroma,2 cases of soft tissue sarcoma.Before definite surgical resection all cases received tumor embolization with silk thread and gelatin-sponge article using Seldinger's technic.Subsequently,all patients underwent a successful tumor resection. Results Superselective embolization for all the cases'feeding arteries resulted in recession of the tumors and relatively well-demarcated margins,and all the lumps became softer.and the local pain was alleviated.Surgical resection could be radical with avoidance of fatal intraoperative hemorrhage.The 5 cases of hemangioma had a average operative bleeding of 450 ml,4 cases of neurofibroma had 420 ml,2 cases of soft tissue sarcoma had 150 ml.No patients needed intraoperative and postoperative blood transfusion.The operation time was about 2-3 hours,the normal tissues were preserved and the contour and function of the diseased limbs were very good.One case had a delayed incision healing,and the others had a healing by the first intention.There was no recurrence and other complications (like deep venous thrombosis)during a follow-up period of 4-8 months. Conclusions Surgical resection combined with interventional embolism for the treatment of huge tumors in the buttocks can reduce the risk of bleeding effectively during operation.It can improve the success rate of operation leading to satisfactory results.