Adult ; Career Mobility ; Factor Analysis, Statistical ; Female ; Humans ; Intention ; Job Satisfaction ; Male ; Personnel Turnover ; Surveys and Questionnaires

Objective To investigate the accuracy of real-time continuous glucose monitoring(RT-CGM)system in the type 2 diabetes mellitus(T2DM). Methods A total of 318 subjects hospitalized between 2013 May to 2014 August were recruited. Each subject received a RT-CGM system. In order to calibrate the interstitial glucose level, finger-stick blood glucose were measured at least four times every day. Patients were divided into three groups according to their finger-stick blood glucose level:≤6.99 mmol/L, 7.0-10.0 mmol/L and≥10.01 mmol/L. Pearson correlation was used to analyze the relationship between the finger-stick glucose and interstitial glucose gained from RT-CGM. Clarke error grid analysis was used to analyze the accuracy of RT-CGM. Results (1)A total of 2, 815 glucose meter values from finger-stick were com?paired with glucose from RT-CGM. A positive relationship(r=0.847)were found between CGM and finger-stick blood glu?cose. The correlation was closer with higher finger-stick blood glucose levels(r=0.457, 0.648 and 0.852 respectively in≤6.99 mmol/L group, 7.0-10.0 mmol/L group and≥10.01 mmol/L group. P<0.001).(2)The Clarke error grid analysis re?vealed that 76.69%of the readings from RT-CGM were clinical perfect (zone A), 20.28%were acceptable (zone B), 3.03%were unacceptable (zone C-E). Clinical perfect rate was lower when the finger-stick glucose≤6.99 mmol/L , compared with that when it is between 7.0-10.0 or≥10.01 mmol/L group(73.12%vs 78.63%&79.28%,P<0.05), there was no significant difference between group of 7.0-10.0 mmol/L with group≥10.01 mmol/L (P>0.05). Conclusion RT-CGM provides accu?rate blood glucose values to guide the treatment of diabetes, and the accuracy is more reliable in high glucose environment.

Objective To investigate the clinical effect of Ultrasound-guided minimal invasion technique used in the diagnosis and treatment of benign breast tumor .Methods 60 cases of benign breast tumors , including single or multiple breast lumps ,were treated using minimally invasive technology under the guidance of ultrasound . The average operation time was 25min.Through 3-6months after operations ,any residue and recurrence at local lesion were not found by clinical and ultrasonic examination , and incision scar formation was not clear .Minimally invasive operation can completely amputate breast tumors .Results Under real time ultrasound monitoring ,all the 60 cases of operation had 100%of display rate.The tumor pathologic classification is as follows:25cases of fibroadenomas ,2 ca-ses of cyst ,3 cases breast cystic hyperplasia ,12 cases of adenosis of mammary glands ,3 cases of lipoma of the breast and one case of phyllodes tumor .The other 14 cases have both two kinds of pathological types .Conclusion The system of ultrasound-guided minimally invasive technology can accurately puncture benign breast tumor with high re -section rate,small trauma and is operated safely .It is a therapeutic method and consistent with the opinion of cosme-tology.

Objective To investigate the significance of the Children's Rehabilitation Management System (ICR 2.0) for occupational therapy (OT) for cerebral palsy (CP). Methods 60 children with CP were divided into group A (n=30) and group B (n=30). The group A accepted OT program assisted with ICR 2.0, and the group B accepted OT program drawn by therapists experientially. They were assessed with Enjoji infant development scale and Fine Motor Function Measure (FMFM) before and 3 months after treatment. Results There was no significant difference in development months and the fine motor between 2 groups before treatment (P>0.05). Both the development and fine motor improved after treatment (P<0.001), and improved more in the group A than in the group B (P<0.05). Conclusion ICR 2.0 assisted OT program can further improve the recovery of children with CP.

Humans ; Accidents, Traffic ; Colon, Sigmoid ; Forensic Medicine ; Autopsy ; Abdominal Injuries ; Thoracic Injuries ; Rupture

AIM: To evaluate the clinical outcomes of management in younger patients with primary chronic angle-closure glaucoma (PCACG).METHODS: Thirty-eight patients (50 eyes) aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from January 2000 to December 2005were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6±7.5 months.Full ophthalmic examinations were performed. The clinical outcomes including clinical presentations, surgical results and complications were evaluated.RESULTS: The mean age of patients was 33.5±6.1 years old. There was a female preponderance (60.5%). The mean axial length was 22.4±3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60.0% fiat anterior chamber depth (＜1.9mm). Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology (80.6%). There was a statistically significant difference in intraocular pressure (IOP) reduction postoperativelyvs preoperatively (P＜0.001). Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber (20.0%) and malignant glaucoma (12.0%).CONCLUSION: The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy.They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma. Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients.

BACKGROUND:Poor implant anchorage in osteoporotic bone impacts its stability and requires the new solutions for the treatment. The augmentation technique with bone cements or bone substitutes is one strategy for the solutions. OBJECTIVE:To evaluate the transient stability of pedicle screw augmented using calcium sulfate cement in osteoporotic vertebral body. METHODS:Fresh calf lumbar vertebrae were selected to measure bone density, and then classified into four groups:the group by pedicle screw in normal vertebral body;the group by pedicle screw augmented using calcium sulfate cement in normal vertebral body;the group by pedicle screw in osteoporotic vertebral body;the group by pedicle screw augmented using calcium sulfate cement in osteoporotic vertebral body. Pedicle screw of equal specification was twisted into the tested pedicle of vertebral arch. The maximum axial screw pul-out strength and the maximum energy required to failure were recorded so as to assess the transient stability of pedicle screw augmented using calcium sulfate cement. RESULTS AND CONCLUSION:The maximum screw pul-out strength and the maximum energy required to failure were significantly less in osteoporotic vertebral body compared with normal vertebral body (P<0.05). The maximum screw pul-out strength and the maximum energy required to failure after augmentation using calcium sulfate cement were significantly increased (P<0.05). The maximum screw pul-out strength and the maximum energy required to failure after augmentation using calcium sulfate cement were identical between normal group and osteoporosis group. These results suggested that calcium sulfate cement could effectively increase the transient stability of pedicle screw. Calcium sulfate cement is effective in augmenting fixation in osteoporotic bone, and has potential in clinical application.

Objective To investigate the expression of ADAM8 in patients with hepatocellular carcinoma (HCC) and its clinical significance.Methods The protein expression of ADAM8 in HCC tissues was analyzed using immunohistochemical analysis.Serum levels of ADAM8 were measured by ELISA in 126 patients with HCC,50 patients with liver cirrhosis (LC) and 50 healthy individuals.The relationship between patients' pathological features and serum ADAM8 level was analyzed.Results Immunohistochemical analysis showed that ADAM8 expression was associated closely with serum AFP elevation,tumor size,histological differentiation,and tumor stage.The ELISA assay showed that the serum levels of ADAM8 in the HCC were significantly higher than those in LC and healthy groups.Kaplan-Meier survival analysis showed that high expression of serum ADAM8 exhibited a significant correlation with poor prognosis for HCC patients.Multivariate analysis revealed that serum ADAM8 expression is an independent prognostic parameter for the overall survival rate of HCC patients.Conclusion ADAM8 expression was closely associated with tumor size,serum AFP elevation,tumor differentiation,tumor stage and prognosis in hepatocellular carcinoma.Therefore,ADAM8 expression may serve as a biomarker for predicting the prognosis of patients in hepatocellular carcinoma.

AIM: To establish the experimental acute pulmonary embolism(APE) model and observe the left and right ventricular pressure-volume relationship in different overload situations. METHODS: The present study consisted of seven anesthetized mongrel dogs that were divided into the control group, moderate APE group and severe APE group according to the various phase and different pressure load during the experiment. APE model was induced by suture piece injection through right cardiac catheterization. The hemodynamic indexes were measured by the simultaneous cardiac catheterization and echocardiography.RESULTS: (1) In the group with moderate APE, the pressure-volume relationship of right ventricle tended to right-upward shift, the area of chart increased, the shape of chart transformed form triangle to rectangle. The mild parallel leftward shift, the area of chart decreased mildly and no change of chart shape was observed in the pressure-volume relationship of left ventricle. (2) In the group with severe APE, the chart of right ventricular pressure-volume relationship tended to right-upward shift continuously, the area of chart decreased. The chart of the left ventricle tended to left-downward shift and no change of chart shape was observed in the pressure-volume relationship of left ventricle, the area of chart decreased. The erose shape of charts was also found.CONCLUSION: The chart of ventricular pressure-volume relationships is a practical and reliable method to evaluate left and right ventricular hemodynamic in APE.

Objective To investigate the independent echocardiographic pathogenesis associated with left atrial spontaneous echo contrast(SEC) formation in patients with atrial fibrillation(AF).Methods Twenty-one patients with valvular AF and twenty-three patients with nonvalvular AF undergoing transthoracic and transesophageal echocardiography(TTE/TEE) were studied.Morphological and functional parameters of the heart in patients with AF were detected by TTE,while the sizes of the left atrial appendage(LAA),its Doppler flow patterns,Doppler flow patterns of the left upper pulmonary vein and integrated backscatter(IBS) values of left atrial SEC relative to those of the left ventricle were measured by TEE.Results There were the following 10 variables significantly associated with the left atrial SEC,some of which associated positively with SEC were left atrial diameter(r=(0.40252),P=(0.0061)),diameter of the open mouth of LAA to the left atrium(r=(0.37816),P=(0.0161)),while the others of which associated negatively with SEC were antegrade/retrograde blood flow velocity peak,integrate(RVi) and retrograde blood flow velocity mean(RVm) values,and S/D wave peak,S wave integrate(Is) and D wave mean(Md) values,their r values ranged from(-0.40379) to(-0.32832),their P values between(0.0018) and(0.0386).Collinearity analyses suggested that RVi,RVm,Is,Md represented completely all the blood flow velocity parameters of LAA and the left upper pulmonary vein,respectively.Multivariate analyses demonstrated that RVm and Md were the independent predictors of the left atrial SEC in patients with AF(both P