?AlM:To analyze the related risk factors of retinopathy in pregnancy induced hypertension syndrome ( PlHS) .
?METHODS:Two hundred and sixty-two cases with the PlHS retinal lesions were selected, and the correlation between PlHS stage, age, body mass, albuminuria, mean arterial blood pressure, hematocrit value and retinopathy in PlHS were observed.
?RESULTS: Retinal stage increased with the increase of the grade of PlHS (χ2regression=52. 13, P<0. 05);there was no statistical significance between age and retinopathy (χ2regression=6. 52, P>0. 05);the greater body mass was, the higher the degree of retinopathy was (χ2regression=22. 97, P<0. 05 ); albuminuria was associated with retinopathy (χ2regression = 40. 16, P<0. 05 ); the degree of retinopathy increased with the increase of mean arterial blood pressure (χ2regression = 44. 38, P < 0. 05 ); the degree of retinopathy increased with the increase of hematocrit value (χ2regression=52. 73, P<0. 05).
?CONCLUSlON: PlHS stage, body mass, albuminuria, mean arterial blood pressure, hematocrit value are the related risk factors of retinopathy in PlHS.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.

Objective To investigate the effect of hypertriglyceridemic waist(HTWC)phenotype on cognitive function in patients with type 2 diabetes.Methods According to the standard of plasma triglycerides concentration≥1.7 mmoL/L,waist circumference(WC)≥ 90 cm in men or ≥80 cm in women,304 patients with type 2 diabetes were divided into four groups:normal triglycerides and waist circumference group(group A,n =65),normal waist circumference and hypertriglyceridemia group (group B,n=53),abdominal obesity and normal triglycerides group(group C,n=114),and HTWC group(group D,n =72)for prospective studies.Patients in four groups were surveyed with Mini-mental state examination (MMSE)and Montreal cognitive assessment (MOCA).And changes of cognitive function among the four groups were compared.Results Total score for the MMSE was significantly lower in group D than in group A(27.1±1.9 vs.29.0±1.3,F=2.869,P=0.019).The subscales of attention and calculation(4.0± 1.4 vs.4.6±0.9,F=1.605,P=0.047)and recall(2.2± 0.9 vs.2.6±0.6,F=1.959,P=0.043) were significantly lower in group D than in group A.Total score for the MOCA was significantly lower in group D than in group A(23.4±3.9 vs.25.9±3.6,F =1.975,P=0.031).The subscales of visuospatial and executive(3.5 ± 1.4 vs.4.1 ± 0.9,F=1.537,P =0.048),attention(5.1±1.4 vs.5.7±0.9,F=1.660,P=0.048)and orientation(5.6±1.0 vs.6.0± 0.0,F=2.362,P=0.030)were significantly lower in group D than in group A.Conclusions There is a statistically more significant decline in cognitive function in patients with HTWC phenotype and the effective intervention and treatment are needed.

Animals ; Blood Gas Analysis ; Endothelin-1 ; blood ; Hypertension, Pulmonary ; pathology ; Hypoxia ; blood ; physiopathology ; therapy ; Male ; Oxygen ; administration & dosage ; therapeutic use ; Oxygen Inhalation Therapy ; Swine

Adult ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Respiration, Artificial ; Young Adult

Objective To evaluate anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol in patients undergoing short surgery. Methods Fifty ASA Ⅰ or Ⅱ patients who scheduled for elective surgery under general anesthesia were enrolled in study. The anesthesia was induced with intravenous injection of midazolam 0.03 mg/kg and sevoflurane inhalation. Induction of anesthesia was started with 6% sevoflurane and fresh gas flow rate of 6 L/min. The inspired concentration of sevoflurane was reduced to 2% as soon as eyelash reflexes of these patients were abolished. At the same time, remifentanil 2 μg/kg was injected slowly over 1 min,and 30 s later,patients were mechanically ventilated after tracheal intubation. 2% sevoflurane was kept inhaling, and remifentanil and propofol were kept pumping for anesthesia maintenance. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO_2) and bispectral index (BIS)were recorded before administration,at the time of the disappearance of eyelash reflex, immediately before tracheal intubation,and immediately after tracheal intubation. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was also recorded. And conscious recovery, spontaneous breathing recovery,the endotracheal extubafion time and OAAS score were recorded. Results All patients were successfully intubated at the first attempt. The satisfactory intubation conditions were found in 82% (41/50) of cases. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was (73 ± 12) s. MAP,heart rate and SpO_2 remained stable and BIS was maintained at 45-55 before and after tracheal intubation, and all patients were quick recovery. Conclusion The anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol without muscle relaxant in patients undergoing short surgery is smooth, safe and reliable.

Objective To report the therapeutic results of Hybrid external fixator in treatment of open metaphyseal fractures of the tibia.Methods From March 2000 to July 2004,19 cases of proximal tibial meta- physeal fractures and six cases of Pilon fractures were treated with Hybrid external fixators.By Gustilo classification, eight cases were of typeⅡ,10 typeⅢA,five typeⅢB and two typeⅢC.The wounds were closed directly after thorough debridement in 21 cases,and closed by pedicled flap transposition or free flap transplantation in four. Fasciotomy was performed in three.Closed indirect reduction of the fractures was done in 11 cases,while open reduction was carried out through an extended wound or a limited incision in 14.Anatomical reduction was done for the articular fractures,if any,and Hybrid external fixators were employed to stabilize fractures in all the cases in this series.Results All the patients had a mean follow-up of 15.7 months (ranging from 9 to 26 months) which re- vealed bone union of the fracture in all cases with a mean healing time of 8.8 months.Two patients had their external fixators replaced with plates and iliac bone graft to get fracture union.The fixators were removed 2.9 to 21 months (mean,9.4 months) after operation.Except for two cases of secondary healing,all the wounds healed primarily without serious complication,such as infection.The final follow-up revealed a knee motion range of more than 90?in 15 cases,less than 70?in four,whose knee motion range was improved to more than 90?after knee release performed one year later.In all the six cases of Pilon fractures,the ankle joint recovered normal range of motion.Traumatic arthritis occurred in two cases of Piion fracture 11 months after operation.Evaluation by Rasmussen's functional and radiological scoring system demonstrated excellent knee function in 13 cases,good in three,fair in two and poor in one,with a good to excellent rate of 84.2%.The ankle function was excellent in three cases,good in two and poor in one,with a good to excellent rate of 83.3%.Conclusions In treatment of open tibial metaphyseal fractures, the Hybrid external fixator can well maintain the stability of the fragments with a low incidence of soft tissue com- plications and insignificant interference with the knee motion.However the bone healing time can be prolonged with a definite rate of nonunion.

Epiretinal membrane (ERM) is a relatively common macular disease that forms along the surface of the internal limiting membrane (ILM) of the retina to some reason.The pathogenesis is not clear.Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment.Deciding when to perform a vitrectomy can be difficult.There are many factors which can affect the postoperative visual acuity,such as age,the thickness of macular,integrity of photoreceptor inner segment/outer segment (IS/OS) junction.

Objective To study the prevalence of metabolic syndrome (MS) in patients with type 2 diabetes according to three different diagnostic criteria and the effects of accumulation of MS components on blood lipid profile and to explore possible causes of their increased morbidity of cardiovascular diseases. Methods Components of MS and blood lipid profile were observed cross-sectionally in 157 patients with type 2 diabetes and analyzed using recommended diagnostic criteria by the World Health Organization (WHO, 1999), the National Cholesterol Education Program-Adult Treatment PanelⅢ( NCEP-ATPⅢ, 2001) and the Chinese Diabetes Society under Chinese Medical Association (CDS, 2004). Results Prevalence of MS was 73. 9% , 49. 7% and 52. 9% , and that of dyslipidemia was 54. 8% , 61. 2% and 54. 8% , with the criteria by WHO, NCEP-ATPⅢand CDS, respectively. Dyslipidemia was included in the most common combinations of MS. Blood level of triglycerides increased significantly, that of high density lipoprotein cholesterol ( HDL-C) decreased significantly, and size of low density lipoprotein cholesterol (LDL-C) particles decreased with the increase of the number of MS components, with a more significant coefficient of correlation by the criteria of CDS than that by the other two criteria. Conclusions In patients with type 2 diabetes, prevalence of MS could be more than 50% , most of them complicated with dyslipidemia, one of the most common components of MS, including elevated triglycerides, decreased HDL-C and decreased size of LDL-C particles, which could easily cause cardiovascular disease. The criteria by CDS could reflect the change in blood lipid profile in Chinese population more objectively.