Objective To explore the influence of thyroid status on serum level of leptin and expression of leptin mRNA in rats with hypothyroidism or hyperthyroidism.Methods Fifty rats were artificially rendered hyperthyroidism and hypothyroidism by L-thyroxine or methimazole and divided into 5 groups.The serum of T 3,T 4,TSH,leptin concentration and expression of leptin mRNA were measured in 5 groups.Results Serum leptin concentration was significantly correlated with weight of rats in 5 groups(P

Objective To investigate the characteristic of type 2 diabetes (T2DM) patients with coronary heart disease (CHD),and provide methods for prevention and treatment for patients who suffered from CHD.Methods The hospitalized patients were divided into three groups.The treatment group contains 46 cases who were T2D with CHD;The control group Ⅰ contains 30 cases who were T2DM without CHD;The control group Ⅱ contains 50 cases who were CHD without T2DM.Their ordinary circumstances were compared;the blood sugar,BP,TC,TG,HDL,LDL,HbA1c,C-P,Ins were measured.Insulin sensitive index(ISI) was calculated.Results Three groups had obvious statistical differences in BP,TC,LDL-C,ISI,HbA1 c.Diabetic patients with CHD have more common with three lesions.Conclusion In the clinical job,the composite observation should be strengthened and treatment because the factors of atherosclerosis in T2DM patients were numerous and complex.

Objective To investigate the effect of recent blood glucose control level of diabetes on prognosis in the patients with general surgery. Methods To analyze the clinical data of 126 diabetic patients with general surgery and the relatiouship among the average hospitalized length,medical cost and the complications of sugery due to glycosylated hemoglobin. Results Comparing with controls, diabetic patients HbA1c＞7.5% had more days longer than those HbA1c＜6.5 % at the time of average in-hospital duration, stitch removing, food-taking and using antibiotics after the operation,Diabetics HbA1c＜6.5 % with cholecystolithiasis, thyroid adenoma had lower surgery cost than those HbA1c＞7.5 %. Conclusion To intensify the control of blood glucose of the patients of limited or selective general surgery as to lower glycosylated hemoglobin＜6.5 % is very important for improving prognosis, and decreasing the complications and medical cost of the operation.

Aged ; Anthracosis ; genetics ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Transforming Growth Factor beta ; genetics ; Tumor Necrosis Factor-alpha ; genetics

Objective To investigate and analyze the effect and insulin dosage of insulin pump in type 2 diabetes. Methods 63 hospital patients with type 2 diabetes(FPG≥12mmol/L), who had poorly controlled blood glucose, were treated by insulin pump for 14 days, without hypoglycemic agents. The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed. FPG, CBG, HbA1c, FINS/FPG, ISI, Homa-B and Homa-IR were measured before and after insulin pump. Results When blood glucose were well controlled, the mean time was (5.4+1.6) days, the insulin was (0.6+0.2)U/kg, the basal insulin was 38%. The dosage of insulin was decreased after blood glucose were controlled. Reaction of hypoglycemia was (0.6+0.2). After 2 weeks insulin pump intensive treatment, the result of FPG, CBG, HOMA-IR and HbA1c were significantly decreased (all P<0.01); FINS/FPG, HOMA-B and ISI were incleased (all P<0.01). Conclusion The excellent glycemic control and improvement of beta-cell function can be induced by short-term insulin pump intensive therapy in diagnosed type 2 diabetic patients with severe hypoglycemia.

OBJECTIVETo analyze the imaging features of osteopoikilosis and its diagnosis knowledge.

METHODSThe imaging data of 9 patients with osteopoikilosis were analyzed retrospectively, including 6 familial cases and 3 sporadic cases. In 6 familial cases,there were 4 males and 2 females with an average age of 28 years old ranging from 10 to 63 years. Clinical manifestations of 1 familial case were left knee pain and limitation of activity for 3 years, and other 5 cases without clinical manifestation. In 3 sporadic cases, there were 2 males and 1 female with an average age of 33.7 years old ranging from 25 to 44 years. Three sporadic cases had obvious injury history with following up from 6 to 12 months. All imaging results of 9 cases were observed.

RESULTSThe imaging data of 6 familial osteopoikilosis showed the multiple round or oval nodes within bone with clear margins, uniform density, different size. The occurrence of the hyperostotic spots preferentially localized in the epiphyses and metaphyses of the long bones, and carpus and tarus. X-ray features of 3 sporadic osteopoikilosis were similar to that of 6 familial cases and for 6 to 12 months follow-up X-ray features were unchanged.

CONCLUSIONThe imaging features of osteopoikilosis are relatively specific such as the multiple mottling dense focal within bone with clear border and bilateral symmetry, and the focus located on cancellous bone and the diaphyses usually is unaffected. The imaging is a valuable examination for the accurate diagnosis of osteopoikilosis.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Osteopoikilosis ; diagnosis ; diagnostic imaging ; Pedigree ; Radiography ; Young Adult

Objective To systematically evaluate the safety and effectiveness of combined portal vein resection and reconstruction in the resection of hilar cholangiocarcinoma.Methods Literatures were researched using Cochrane Library,PubMed,Embase,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang database,VIP database from January 31,2006 to January 31,2016 with the key words including “hilar cholangiocarcinoma”“Klatskin tumor”“Bile duct neoplasm”“Vascular resection”“portal vein resection”“肝门部胆管癌”“血管切除”“门静脉切除”.The clinical studies of resection of hilar cholangiocarcinoma with portal vein resection and construction and without vascular resection and construction were received and enrolled.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Patients who underwent resection of hilar cholangiocarcinoma combined with portal vein resection and reconstruction were allocated into the portal vein resection group and patients who didn't undergo vascular resection were allocated into the no vascular resection group.Analysis indicators included (1) results of literature retrieval;(2) results of Meta-analysis:① incidence of postoperative complications (hepatic failure,biliary fistula,intra-abdominal hemorrhage),② postoperative mortality,③ patients' prognosis,④ related indicators of postoperative pathology (lymph node metastasis rate,moderate-and low-differentiated rate,nerve invasion rate,negative rate of resection margin).The heterogeneity of the studies was analyzed using the I2 test.The hazard ratio (HR) and 95％ confidence interval (CI) were used for assessing the prognostic indicators.The incidence of complications,mortality and pathological indicators were evaluated by the odds ratio (OR) and 95％ CI.Results (1) Results of literature retrieval:13 retrospective studies were eurolled in the meta-analysis,and the total sample size was 1 668 cases including 437 in the portal vein resection group and 1 231 in the no vascular resection group.(2) Results of Meta-analysis:① incidence of postoperative complications was respectively 39.86％ in the portal vein resection group and 35.27％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.12,95％ CI:0.82-1.53,P ＞0.05).The results of subgroup analysis showed that hepatic failure,biliary fistula and intra-abdominal hemorrhage were postoperative main complications,and the incidences were 17.09％,8.79％,6.25％ in the portal vein resection group and 10.62％,9.69％,2.51％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =0.48,1.13,0.82,95％ CI:0.23-1.02,0.45-2.83,0.21-3.12,P ＞ 0.05).② Postoperative mortality was respectively 5.38％ in the portal vein resection group and 3.88％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.16,95％ CI:0.62-2.14,P ＞ 0.05).③ There was statistically significant difference in patients' prognosis between the 2 groups (HR =1.81,95％ CI:1.52-2.16,P ＜ 0.05).④ The related indicators of postoperative pathology:lymph node metastasis rate,moderate-and low-differentiated rate and negative rate of resection margin were 41.55％,76.42％,63.74％ in the portal vein resection group and 33.42％,66.75％,64.29％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =1.45,1.59,0.67,95％ CI:0.95-2.21,0.97-2.61,0.37-1.20,P ＞ 0.05).The nerve invasion rate was 83.47％ in the portal vein resection group and 64.90％ in the no vascular resection group,with a statistically significant difference between the 2 groups (OR =2.61,95 ％ CI:1.45-4.70,P ＜ 0.05).Conclusion Combined portal vein resection and reconstruction is safe and feasible in the treatment of hilar cholangiocarcinoma,and the prognosis of patients with portal vein invasion is worse than that without portal vein invasion.

Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.

OBJECTIVE:To systematically review the efficacy and safety of insulin glargine versus premixed insulin in treat-ment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD, Wanfang Database and VIP Database,the randomized controlled trials(RCT)about the efficacy and safety of premixed insulin ver-sus insulin glargine in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.0 statistics software after extracting data and evaluating quality by modified Jadad. RESULTS:A total of 10 RCTs were enrolled,involving 1 655 patients. Results of Meta-analysis showed that insulin glargine was better than premixed insulin on reducing glycated hemoglobin [M=-0.41,95% CI(-0.64,-0.18),P<0.001] and fasting blood glucose [MD=-0.51,95% CI(-0.99,-0.02),P=0.04], there were significantly differences between 2 groups,and there were no significantly differences in reducing 2 h postprandial blood glucose [MD=-0.56,95% CI(-1.21,0.09),P=0.09] and body mass index [MD=-0.52,95% CI(-1.52,0.48),P=0.31];the incidence of hypoglycemia in insulin glargine group was significantly lower than premixed insulin,there were significantly differ-ences between 2 groups [RR=0.65,95%CI(0.46,0.90),P=0.01]. CONCLUSIONS:The efficacy and safety of insulin glargine are better than premixed insulin in the treatment of type 2 diabetes.

To investigate the distribution of virulence associated factors of 5 strains of Streptococcus suis type 2 from slaughtered pigs isolated in Fujian province , 7 virulence genes were detected through PCR amplification. They were the glutamate dehydrogenase gene(gdh), the capsular polysaccharides gene(cps), the extracellular factor gene(ef), the muramidate-released protein gene(mrp), the suilysin gene(sly), the fibronectin-binding protein gene(fbps) and the virulence-associated sequence or f2. Among these 5 strains isolated, the virulence genotypes of 4 strains S.suis type 2 and strain SS2PFJ07 was gdh+/cps2J+/mrp+/ef-/sly-/fbps+/orf2+ and the other one strain isolated from slaughtered pigs was gdh+/cps2J+/mrp+/ef+/sly+/fbps+ /orf2+ respectively. This results showed that there are at least 2 virulence genotypes in Streptococcus suis type 2 from slaughtered pigs isolated in Fujian province.