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 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 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 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.

BACKGROUND:In high-intensity exhaustive exercise process, the body must bear the exercise intensity decreasing splanchnic blood flow“ischemia”, at the same time, along with the movement of energy and material consumption, metabolite accumulation and oxidative stress in the body cause pathological damage, leading to a decline in exercise capacity. Thus, what is the impact on kidney filtration barrier? How to adapt to the change of renal tissue? Houttuynia cordata has the functions of heat clearing and detoxifying, dieresis for treating strangurtia, hemostatic, expel ing phlegm to arrest coughing and analgesia, if it has a protective effect on the renal injury caused by acute exhaustive exercise and its mechanism has not been reported in the literature. OBJECTIVE:To explore the effect of acute exhaustive exercise on kidney filtration barrier in rats and the intervention effect of Houttuynia cordata.METHODS:After resting and watching for 3 days, Sprague-Dawley rats received adaptive running for 15 minutes at a speed of 10 m/min on a 0° treadmil . A total of 24 rats, which can finish the running, were selected. They were divided into normal control group, exhaustive exercise group and dosed exhaustive exercise group according to the weight of layer (n=8). Rats in the exhaustive exercise group and dosed exhaustive exercise group on the 10° treadmil received once exhaustive exercise. Dosed exhaustive exercise group received intraperitoneal injection of sodium houttuyfonate 10 mL/kg at 30 minutes before exercises. The normal control group did not do any exercise. RESULTS AND CONCLUSION:Compared with the normal control group, serum urea nitrogen, serum creatinine, urine protein content, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly increased, but nitric oxide content and nitric oxide synthase activity in the renal tissue were significantly deceased in the exhaustive exercise group (P<0.05 or 0.01). Glomerular filtration epithelial cells, the kidney filtration barrier of basement membrane and podocyte damage were obvious, showing abundant cellapoptosis, occasional y necrosis. Compared with the exhaustive exercise group, urine protein content, serum creatinine, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly reduced, but nitric oxide content and nitric oxide synthase activity were significantly increased in the dosed exhaustive exercise group (P<0.05). No obvious pathological changes were detected, but apoptosis was visible. These findings confirmed that houttuynine made a reduction in renal cellinjury induced by exhaustive exercise and possibly significantly reduced apoptosis, increased nitric oxide synthase content, decreased malonaldehyde, and apparently increased superoxide dismutase activity, and final y protected injured renal tissue induced by exhaustive exercise.

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.

OBJECTIVE: To explore the effect of different pressure on microcirculation of scar proliferation. METHODS: A total of 60 patients with scar proliferation after burning were collected, including 49 males and 11 females, with averagely aged 37 years. The patients were divided into low pressure (0.67-1.33 kPa), normal pressure (1.33-3.33 kPa) and high pressure (3.33-6.67 kPa) groups by envelope method. Pressure tension bandage was used at 1 week after wound healing and gradually increased, reached expected pressure at days 5-7 and sustained for 6 months. Then the changes of blood perfusion at the scar tissue were measured by laser Doppler perfusion imaging (LDPI). RESULTS: According to the intended processing analysis, all the 60 patients enter the result analysis. There were no significant differences of the scar tissue perfusion of the 3 groups before the therapy. After the therapy, the perfusion was decreased in the low pressure group, but there are no statistical changes compared to before the therapy (P > 0.05), while the perfusion was decreased in the normal pressure and high pressure groups (P < 0.05), which was lower in the high pressure group than the normal pressure group (P < 0.05). When the pressure increased to 3.33-6.67 kPa, the patients feel much more uncomfortable and the swelled signs appear, and 2 patients quit the experiment. CONCLUSIONS: The scar tissue perfusion is decreased obviously when adding the pressure to 3.33 kPa by using tension bandage. Using this method, the pressure should gradually increase to the maximum if patients can bear.

Objective To assess the influence of timing of tracheostomy performed on ICU patientswith mechanical ventilation support for long-term.Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation.The differences in lengths of mechanical ventilation support (MVS),ICU stay,and hospital stay,incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics.Results Compared with group B,there were statistically significant reduction in duration of mechanical ventilation (7d vs.17 d;P ＜ 0.05),shorter length of ICU stay (10 d vs.19 d;P ＜ 0.05),and lower incidence of VAP (21.05％ vs.36.84％;P ＜ 0.05) in group A.There were no significant differences in hospital stay and mortality between two groups (P ＞0.05).There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2 =0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2 =0.662) was found.Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU.These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy.