Objective: To discover and prevent diabetes early in high-risk group. Methods:Chose 323 records of type 2 diabetes or IFG,IGT patients with first course which come from a large hospital in Lanzhou between 2009 January to 2014 March; Use Apriori algorithm and the SPSS Clementine 12 software design;Set up prediction model of type 2 diabetes. Results:A total of 10 strong association rules are formed. The strong association rules contain some associations between factors and type 2 diabetes. Conclusion: Through the association rules, the initial judgment on the high-risk group of diabetes is simple and accurate.

Objective To evaluate the susceptibility of itraconazole-resistant Aspergillus fumigatus isolates to four other antifungal drugs.Methods Six strains of Aspergillus fumigatus were serially isolated from a patient with lung aspergilloma,who was resistant to itraconazole therapy.Clinical Laboratory Stan- dard Institute broth microdilution method M38-A and E-test were applied to test the susceptibility of A.fumi- gatus strains to amphotericin B,itraconazole,voriconazole,caspofungin and micafungin.Results With M38-A method,the minimal inhibitory concentration(MIC)of itraconazole was 0.5?g/mL for 2 strains and more than 16?g/mL for the other 4 strains;the MICs of amphotericin B and voriconazole were 1?g/mL and 0.25-1?g/mL respectively for all the 6 strains;and the minimal effective concentration(MEC)of caspofungin and micafungin were no more than 0.03?g/mL for all the 6 strains.Moreover,E-test results also revealed that caspofungin and voriconazole had a good antifungal activity against all the strains,including the 4 itraconazole-resistant ones.Conclusion The itraconazole-resistant A.fumigatus strains isolated from a patient with lung aspergilloma are susceptible to amphotericin B,voriconazole,caspofungin,and micafungin.

OBJECTIVETo evaluate the effect of nasogastric decompression tube after gastric cancer operation on the postoperative recovery.

METHODSA total of 174 patients with gastric cancer were prospectively enrolled from December 2009 to March 2011 and randomly divided into non-nasogastric tube control group(n=88) and nasogastric tube group(n=86). Postoperative symptoms, complications, recovery time, and quality of life during hospital stay were compared between the two groups.

RESULTSThe incidences of nausea(14.8% vs. 47.7%, P<0.01), sore throat(6.8% vs. 38.4%, P<0.01), bucking and foreign body sensation(3.4% vs. 20.9%, P<0.01), expectoration obstruction(36.4% vs. 55.8%, P<0.05) were significantly lower in nasogastric tube group than those in the control group. The intervals to ambulation and flatus were(1.46±0.58) d and(3.11±0.77) d in the non-nasogastric tube group, significantly shorter those in nasogastric tube group[(1.68±0.61) d and(3.75±1.03) d]. There was no anastomotic leak or bowel obstruction. The difference in bleeding was not statistically significant[3.4%(3/88) vs. 5.8%(5/86), P>0.05] between the two groups. The quality of life differed between the two groups(mean score, 3.36 vs. 2.78, P<0.01).

CONCLUSIONEarly removal of nasogastric decompression tube is safe and reasonable and can improve the quality of life during hospital stay.

Humans ; Intubation, Gastrointestinal ; adverse effects ; methods ; Perioperative Period ; Postoperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Quality of Life ; Stomach Neoplasms ; surgery

Objective To assess the effect of continuous renal replacement therapy (CRRT) on severe acute pancre-atitis (SAP). Methods According to the collaborative search strategy, MEDLINE (1966-2013.9), Embase(1974-2013.9), Chinese Wanfang database(1996-2013.9), CNKI(1979-2013.9) and the clinical control test database of Cochrane Library were searched.Published and unpublished literature and meeting summary were searched manually.Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was performed using RevMan 5.2. Results A total of 15 reports were identified which met the inclusion criteria, in which include data of 652 patients.Com-pared with control group, serum amylase decreased in CRRT group (WMD=-140.76, 95%CI was-212.42 to-69.11, P=0.000 1). Mediators of inflammatory mediators were scavenged effectively and APACHEⅡscore decreased in CRRT group (WMD=-2.97, 95%CI was-4.01 to-1.93, P<0.001). The overall survival rate was significantly higher in CRRT group than that in control group (RR=1.35, 95%CI 1.19-1.52, P<0.001). Conclusion Continuous renal replacement therapy could ef-fectively improve the survival rate of patients with severe acute pancreatitis.

Objective: To observe the prognosis of continuous renal replacement therapy (CRRT) in patients with multiple organ dysfunction syndrome(MODS). Methods: Thirty patients with MODS were enrolled in this study and were divided into two groups (survival group and death group) by their outcomes. All of these patients underwent CRRT for at least 24 h. The levels of interleukin (IL)-1β, IL-4, IL-6, IL-10 and tumor necrosis factor(TNF)-α were measured at the beginning and 3, 6,12 and 24 h after initiation of CRRT. Results: Among these thirty patients, the level of TNF-α came to peak at 12 h, and there was no significant difference between beginning and the end of CRRT. The level of IL-6 in death group was higher than that in survival group. There were correlations among numbers of complications, abnormalities of co-agulation and acute pathologic and chronic health evaluation Ⅱ(APACHEⅡ) separately. Conclusion: Clinical oxygenation and hemodynamics situation can be improved by CRRT, but there were no significant differences in levels of inflammatory mediators between initiation and the end of CRRT.

Objective To explore the constitute and antimicrobial susceptibility of pathogenic fungi causing candidemia in Nanchang City of Jiangxi Province.Methods Candida spp.isolated from blood specimens of patients at a hospital in Nanchang in March-October 2015 were collected, fungal strains were identified by amplifying the internal transcribed spacer (ITS) and large ribosomal subunit (D1/D2 region of 26rRNA), antifungal susceptibility of fungi was detected.Results A total of 1 332 positive blood culture specimens were collected, including 74 fungal positive specimens, accounting for 5.56％, 52 strains of Candida spp.were obtained, most were Candida tropicalis (n=17,32.69％),followed by Candida albicans(n=16, 30.77％) and Candida parapsilosis complex (n=16, 30.77％).Identification results of ITS and D1/D2 region were identical.52 strains of Candida spp.were sensitive to both micafungin and caspofungin, epidemiological cutoff value(ECV) of amphotericin B showed that 52 strains were all wild type.Resistance rates of Candida tropicalis to fluconazole and voriconazole were 29.41％ and 17.64％ respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 82.35％ and 94.12％ respectively;resistance rates of Candida albicans to fluconazol and voriconazole were 93.75％ and 81.25％ respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 75.00％ and 81.25％ respectively;Candida parapsilosis complex strains were sensitive to both fluconazole and voriconazole, ECV of itraconazole and posaconazole showed that all were wild type;all Candida glabrata strains had intermediate resistance rates to fluconazole, ECV of voriconazole, itraconazole, and posaconazole showed that wild type accounted for 66.67％, 100.00％, and 100.00％ respectively.Conclusion Candida tropicalis is the most common pathogenic fungus causing candidemia in Nanchang of Jiangxi, followed by Candida albicans and Candida parapsilosis complex.Azole, echinocandin, and amphotericin B are still first-line antifungal agents.

Objective To explore the safety of unilateral percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral burst fracture.Methods All 25 osteoporotic vertebral burst fracture cases (25 fracture segments) treated from April 2014 to July 2015 were analyzed retrospectively.In 25 cases,there were 17 males and 16 females,aged from 58.0 to 88.0 years with a mean age of 76.6 years.All patients included in the study had preoperative thoracic or lumbar X-rays,CT reconstruction and MR fatsuppression sequence scan in order to definite fracture sites and the integrality of the posterior wall of fracture vertebral.The unilateral PKP were performed by the same operator.All patients included in the study had postoperative thoracic or lumbar X-rays,and CT reconstruction to observe the bone cement leakage.After patients were out of hospital,X-rays were done regularly.The types of bone leakage were recorded.The pre-and post-operational anterior and posterior wall and the kyphotic angle were measured by one doctor.Results The scores of VAS at the first day after operation and the end of follow up decreased compared with the pre-operative scores:(2.8 ± 1.2),(2.4 ± 1.6) scores vs.(6.4 ± 2.6) scores,and there were significant differences (P ＜ 0.05).The kyphotic angle at the first day after operation and the end of follow up decreased compared with the pre-operative,but there were no significant differences (P ＞ 0.05).The post-operative height of vertebral anterior wall increased at the first day after operation and the end of follow up compared with the pre-operative:(21.7 ± 5.0),(21.4 ± 4.1) mm vs.(20.3 ± 3.8)mm,and there were significant differences (P ＜ 0.05).The post-operative height of vertebral posterior wall increased at the first day after operation and the end of follow up compared with the pre-operative,but there were no significant differences (P ＞ 0.05).The above index at the first day after operation and the end of follow up had no significant differences (P ＞ 0.05).Conclusions The unilateral PKP in treating osteoporotic vertebral burst fracture is safe and reliable.Clear image display,skillful puncture techniques and suitable injection timing are necessary factors for a successful operation.

The efficacy of vertebroplasty and percutaneous kyphoplasty in treatment of osteoporotic compression fracture was widely recognized recently.But the complication of bone cement pulmonary embolism was severe and it can threaten life.In this article,the incidence,pathogenesy,risk factors,symptom,auxiliary examination,treatment and prevention of bone cement pulmonary embolism were reviewed.

Objective HLA-G widely participates in immune tolerance by its combination with immunoglobulin-like tran-scripts IL-2 and IL-4 on the surface of dendritic cells (DCs).The aim of the article was to explore the effects of recombinant adnovirus-mediated HLA-G transfection in macaca mulatta immature dendritic cells on T cell proliferation . Methods Marrow blood was collected from macaca mulattas by the puncture needle after anesthesia .Density gradient centrifugation method was applied in separating mononuclear from the extracted blood on which CD 34+cells were collected and pu-rified by means of immunomagnetic separation .Small doses of cyto-kines were added to get the immature dendritic cells after induced dif-ferentiation of CD34+cells.After the recombinant adnovirus-mediated HLA-G transfection in macaca mulatta immature dendritic cells , observation was done on the viral infection efficiency and western blot was used in detecting the expression of HLA -G in immature den-dritic cells.Taking T cells in macaca mulatta as responders and DCs transfected by recombinant adnovirus -mediated HLA-G as stimu-lators, mixed lymphocyte test was conducted .T cells were divided into 5 groups: mDC group ( mature DCs ) , imDC group ( immature DCs), imDC(L) group(addition of 100 ng/mL lipopolysaccharide after getting imDC at 7th day) , imDC(V) group (imDCs infected by recombinant adnovirus-mediated HLA-G) , imDC( L+V) group ( imDCs infected by recombinant adnovirus-mediated HLA-G along with the addition of 100 ng/mL lipopolysaccharide in culture process ) . Results We obtained the immature dendritic cells and recom-binant adenovirus of HLA-G expressed in these cells .Flow cytometry showed DC purity was up to 92.3 %, imDC purity was up to 72.39%and positive percentage of CD 4+T was greater than 80%.In comparison with imDC group ,the proliferation of stimulated T cells in mDC and imDC(L) groups was obviously intensified (P<0.01).In comparison with imDC(V) group, the proliferation of stim-ulated T cells in imDC, mDC, imDC(L), and imDC(L+V) groups was obviously intensified (P <0.01).In comparison with imDC(L+V) group, the proliferation of stimulated T cells in mDC and imDC(L) groups was obviously intensified(P<0.01). Conclu sion Im-mature DCs infected by recombinant adnovirus can inhibit the proliferation of T cells effectively .