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.

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.

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 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 explore reconstructive methods for defects uf bone and soft tissue in traumatic injury uf medial malleolus.Methods A vascular iliac bone with a piece of faacial strip is used together with a local island flap or a free flap to reconstruct the defects of bone,triangular ligament and skin in medial malleolus al one or two stages.Results Follow-ups of 11 to 24 months proved that the stability and walking and weight loading functions uf ankle joint of the patients were restored satisfactorily and their normal varus range without abnormal articular motion was restored.Slight varus occurred during walking in one case,and pain appeared after fatigue in two cases.The X-grams showed no obvious absorption or areosis in the free iliac bone implanted.Conclusion In repair of defects of medial malleolus,combined transplantation of iliac bone and flap is rceommendable because it can keep the essential integrity of malleolus and achieve good Stability and functional recovery of ankle joint.

Objective To establish a new method using Flaer for detecting abnormal clone in patients with paroxysmal nocturnal hemoglobinuria(PNH).Methods Peripheral WBC and bone marrow mononuclear cells from patients with PNH and normal controls were isolated and stained with flaer,CD55 PE,CD59 FITC and CD34 PE.Results PNH cells can easily be distinguished by flare.Compared with CD55,CD59,Flaer showed advantage in detecting minor clone of PNH,either in peripheral blood or in CD34+ bone marrow cells.Conclusion Flaer can be a new,simple and effective method to detect PNH clone,and especially when the PNH clone is small.

Objective To evaluate the techniques and application of 64-slice helical CT colonography in colonic lesions. Methods Thirty-eight patients (including 12 colonic carcinomas,10 polypi, 9 colon multiple scrobiculus, 2 multiple diverticula, 2 negative, 1 congenital bowel malrotaion,1 ulcerative colitis and tunica mucosa glandular organ hyperplasy,1 colocolic anastomosis of terminal ileum and sigmoid colon) underwent volume scanning using 64-slice helical CT after cleaning colon. Six types of reconstruction including CT virtual colonoscopy(CTVC), volume rendering(VR), multiple planar reconstruction(MPR), 360?sectional view, RaySum,and navigation were gained.CTVC appearances were compared with that of conventional colonoscopy(CC).Results In 12 colonic carcinomas and 10 polypi,the lesions’ morphology,number,size, were satisfactorily shown by CTVC. The lesions’ location,range,and 1 intestinal canal obviously stenosis were also exactly shown by RaySum.The relationship between tumor and environment, 3 liver or retroperitoneal lymph node metastasis were satisfactorily shown by MPR and 2D transection image. On 360?sectional view,the distance between tumor and anus was exactly measured and the result was in conformity to that of CC. Of the CTVC appearances,1 sigmoid carcinoma and 1 transverse colon polyp was in unconformity to that of CC;1 ulcerative colitis and descending colon carcinoma was diagnosed as ulcerative colitis and tunica mucosa glandular organ hyperplasy by pathology.Conclusion 64-slice helical CT is a valuable imaging technique for detecting colon diseases. CTVC can obtain more clinical information than CC combining MPR,RaySum and VR.

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.