The definition of impaired glucose tolerance (IGT) was first introduced by the National Diabetes Data Group at 1979. Recently the morbidity rate of IGT is soaring. About 10%-15% of patients with IGT will progress to type 2 diabetes mellitus (T2DM) which is approximately more than 100 times comparing with normal glucose tolerance people. Angiopathy can be detected in 40% patients with newly diagnosed IGT. Advanced glycation end products (AGEs) are closely related to angiopathy. Meanwhile there is some connection between IGT and AGEs. In this review, the relationship between IGT, agiopathy and AGEs is discussed.

Adult ; Fatigue ; Humans ; Male ; Professional Competence ; Sleep Deprivation

Objective: To analyze the influences of implementing essential medicine system on primary medical institutions and give suggestions. Methods: Using system dynamics method to construct the compensation mechanism model for primary medical institutions. Compare the growth in revenue and expenditure of primary medical institutions before and after essential medicine system implementation. Results: After the implement of essential medicine system, the growth in total expenditure and total income of primary medical institutions is steadier; when the annual growth rate of government financial subsidies invested more than 13%, the growth in total receipts will keep balance. Conclusion: It’s better to guarantee the government financial subsidies invested in time, raise medical service price properly and establish comprehensive compensation mechanism for implementing compensation mechanism of primary medical institutions.

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

Objective:To observe the difference of the therapeutic effect between heat-sensitive moxibustion and warm needling therapy for cervical spondylosis of vertebral artery type (CSA).
Methods:A total of 60 cases with CSA who met the inclusion criteria were randomly divided into a heat-sensitive moxibustion (HSM) group and a warm needling therapy (WNT) group according to the visiting sequences, with 30 cases in each group. Patients in the former group were treated by heat-sensitive moxibustion, while patients in the latter group were treated by warm needling therapy. Both groups were treated once every other day, with 10 times as 1 course of treatment, and the therapeutic effects were evaluated after 1 course of treatment.
Results:After 1 course of treatment, the total effective rate of the HSM group was 93.3%, versus 83.3% in the WNT group. There was a statistically significant difference between the two groups (P<0.05).
Conclusion:Heat-sensitive moxibustion has better therapeutic effect for CSA than warm needling therapy.

Objective To study the protective effect of sodium ferulate (SF) on CPB-induced lung ischemia reperfusion injury (IRI) and discuss its possible mechanism. Methods 40 patients undergoing CPB were randomly divided into contral group(CCG, n=20 ) and SF group(SFG, n=20). In SFG, SF was injected (0.2 g in NS 150 ml) intravenously Bid for one week preoperatively. In CCG, SF was replaced by same volume of NS. The changes of TNF-?、IL-6、IL-8、SOD level in the CCG and SFG would be examined before operation, at 15min、30 min after aortic cross clamp(ACC) and 1 hour after operation. By the time of before ACC、15 min and 30 min after ACC was opened, blood samples were taken from the right and left atrium to examine the amount of neutrophils. Lung tissues were cut for pathological studies in 5 patients in each group randomly. Results At 15 min、30 min after ACC and 1h after operation TNF-?、IL-6、IL-8、SOD levels of 2 groups were significantly higher than that before the operation (P

AIM: To investigate the efficacy of 23G minimally vitrectomy without irrigation in cataract phacoemulsification and trabeculectomy of malignant glaucoma, and to analyze such compound operative procedures for phakic malignant glaucoma.
●METHODS:A total of 21 phakic malignant glaucoma patients (21 eyes) underwent anterior vitrectomy without irrigation by using 23G vitrectomy. During surgical course phacoemulsification with anterior and posterior continuous circular capsulorhexis, trabeculectomy combined with iridectomy would be completed. lntraocular pressure, anterior chamber depth changes and postoperative complications were observed after the operation.
●RESULTS:ln the three-month follow-up, intraocular pressures were reduced from ( 57. 18 ± 6. 18 ) mmHg to (16. 15 ± 2. 43 ) mmHg, there was statistical difference compared with pre - operation ( P < 0. 001 ). The preoperative anterior chamber depth (ACD) was (0. 88± 0. 25) mm, the postoperative ACD was (2. 44±0. 37) mm 3mo later, there were significant difference (P<0. 001). The best corrected visual acuity improved significantly, no serious postoperative complication appeared.
● CONCLUSION: The compound surgical method of anterior vitrectomy combined with phacoemulsifier and trabeculectomy can effectively treat phakic malignant glaucoma. Early diagnosis and early compound surgery may effectively reduce the intraocular pressure of malignant glaucoma.

Objective To explore difficulties and countermeasures of laparoscopic cholecystectomy (LC) for treating huge gallstones. Methods Fifty-six cases of huge gallstones with a diameter of 2.0~5.3 cm (3.4?0.6 cm) were reviewed in respect of their clinical features and operative difficulties and countermeasures during laparoscopic cholecystectomy. Results The laparoscopic cholecystectomy was completed smoothly in 54 cases, with an operation time of 30~130 min (94.3?40.7 min). Conversions to open surgery were required in 2 cases because of acute suppurative cholecystitis. Moderate-to-severe adhesion was found in 41 cases (73%). White bile or absence of bile secretion was found in 23 cases (41%). There were 2 cases (4%) of small bile duct injuries in the gallbladder bed, 15 cases (27%) of liver tissue injures in the gallbladder bed, and 19 cases (34%) of intraoperative gallbladder leakage. No major bile duct injury or massive hemorrhage occurred. The postoperative hospitalization time was 3.6?1.5 days. Follow-up observations for 6~12 months (mean, 11 months) found that the symptoms disappeared and no complications were noted. Conclusions The difficulties during LC for huge gallstones lie in the thickening of the gallbladder wall that causes injuries of the liver tissue and small bile ducts in the gallbladder bed. Careful dissection and reservation of part of the gallbladder wall are effective methods to lower the incidence of complications.

Objective To investigate the value of intraoperative choledochofiberscopy and B-ultrasonography for intrahepatic bile duct calculus. Methods After bile duct stone removal by routine instruments, choledochofiberscopy and B-ultrasonography were conducted for detecting and removing the residual cholelith in intrahepatic bile ducts. Results The incidence of residual cholelith was 29.8% (14 of 47) after stone removal by routine instruments, and it declined to 10.6% (5 of 47) ( ? 2=5.267, P

Objective To analyze drug resistance of pathogenic bacteria from the blood culture and distribution in clinical departments,and to guide the rational clinical drug use.Methods We retrospectively analyzed 11 275 samples of blood cultures in The Central Hospital of Wuhan from 2012 to 2014.The blood specimens were cultured by VersaTREK(USA).The pathogenic bacteria were identified and their drug resistance was analyzed by BD-PHOENIX 100 automicrobiological identification systems(USA).Results Among the 11 275 blood cultures,636 bacterial strains were detected.The top four bacterial strains were Escherichia coli,Staphylococcus aureus,Klebsiella pneumonia and Enterococcus f aecium.A vancomycin-resistant Enterococcus faecium strain and a pandrug-resistant Klebsiella pneumoniae strain were detected.The top three clinical departments with distribution of pathogens were Gastroenterology Department,Nephrology Department and Intensive Care Unit (ICU).Pathogens isolated from ICU were evenly distributed.Conclusion Distributions of pathogenic bacteria in the blood culture are different in clinical departments.Identification of pathogenic bacteria and result of drug susceptibility can reduce use of broadspectrum antimicrobials and enhance antimicrobial de-escalation.