Objective To explore the change of 25 hydroxyvitamin D level and its correlation with glucose metabolism and bone mineral density in elderly men with type 2 diabetes mellitus(T2DM).Methods Hospitalized 53 elderly male patients with T2DM (T2DM group) and 51 patients without T2DM (NDM group) were chosen.Blood.biochemical indexes and 25 hydroxyvitamin D level were measured.Bone mineral density of lumbar (L2_4),left proximal femur was measured by dual energy X-ray.Results The serum 25 hydroxyvitamin D level in T2DM group was lower than that in NDM group [(12.38 ±5.12)μg/L vs.(17.35 ± 5.52) μ g/L],and there was significant difference(P＜ 0.05).The serum 25 hydroxyvitamin D level was negatively associated with fasting blood glucose level and glycosylated hemoglobin (r =-0.225,-0.499,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with fasting insulin and homeostasis model insulin resistance index (r =-0.050,-0.082,P ＞ 0.05).The incidence of osteoporosis in T2DM group was higher than that in NDM group [30.19％(16/53) vs.11.76％(6/51)],and there was significant difference (P ＜0.05).The serum 25 hydroxyvitamin D level was positively associated with bone mineral density of femur neck,greater trochanter of femur and Ward triangle(r =0.773,0.762,0.812,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with bone mineral density of lumbar (L2_4)(r =0.116,P ＞ 0.05).Conclusions The prevalence of vitamin D deficiency is found in elderly men with T2DM.Vitamin D level can affect blood glucose control and increase the risk of the occurrence of osteoporosis.Therefore,T2DM patients,especially elderly patients,should be routine vitamin D testing.Vitamin D supplementation to the patients of vitamin D insufficiency in time may be beneficial to glucose metabohsm and the prevention and treatment of osteoporosis.

Objective To study the feasibility of preoperative acute hypervolemic hemodilution for decreasing perioperative blood use. Methods Thirty two patients(ASAI-II) undergoing spinal surgery were randomized into AHH group and control group. After anesthesia 6% HES(200/0.5) was given through internal jugular vein for AHH. The blood volume was increased by about 25%. During the operation, blood loss was replaced by HES in equal volume. Blood was transfused when the Hct dropped below 25%. The HR, MAP, CVP, SPO2, Hb, Hct., Plt, FIB, APTT, PT, amount of blood loss, blood transfused and urine output, volume of drainage 24h after operation and VAS score (0 means no effect, 10 means maximal effect) were observed before AHH, at the end of AHH, at the end of operation, and 24h after the operation. Blood volume expansion was calculated. Results (1) HR increased significantly in both groups(P

Objective To explore the hemodynamics changes of patent foramen ovale (PFO) ofnewborn and early infant.Methods Two groups of cases were analyzed in the study.One group was 60 cases of left-to-right(L-R)shunt in fossa ovalis(FO),the other group was 31 cases of PFO that were foundduring corrective heart surgery but no shunts in FO detected by echocardiography.ACUSON 128 was used.The main indexes were mobility of FO valve,phase,direction,velocity of shunt in FO,jet width.Results ①Valve of FO moved from left to right and right to left with the change of cardiac-period;②44 cages appeared that the jet with<5 mm,Doppler spectrum was two-peaks, positive continuity,peak flow velocity <0.5 m/s;③1 6 cases appeared that the jet width>6 mm,postive wide spectrum,continued from latesystole to diastole,peak flow velocity>0.6 cm/s;④Inside diameter in surgery group was 2～6 mm,meanvalue was 3.4 mm.Conelusions FO valves appears two-directional shunt,the PFO of newborn and early infant mostly appears left-to-right shunt.Atrial septal defect could be diagnosed when the jet width>6 mmand peak flow velocity>0.6 m/s.

Biological Clocks ; Genetic Therapy ; Heart Diseases ; therapy ; Humans ; Stem Cell Transplantation

Objective To compare the peri-operative anaesthetic management between emergent and selective operations of(off-pump) coronary artery bypass grafting(OPCAB).Methods A retrospective review was conducted on clinical data of 50 cases of OPCAB from January 2001 to December 2004 in this hospital,including 30 emergent operations(Emergent Group) and 20 elective operations(Selective Group).The preoperative assessment and preparation,hemodynamic changes,vasoactive agent usage,hemostatic functions,and postoperative outcomes were compared between the two groups.Results ①The risk assessment score was greater in the Emergent Group(18.56?5.12) than in the Selective Group(8.98?3.12)(t=-7.479,P=0.000),and the application rate of(intra-aortic) balloon pump assist device(IABP) before the operation was higher in the Emergent Group(93%) than in the Selective Group(50%)(?~2=12.354,P

Objective To assess the efficacy of ropivacaine in combination with different doses of sufentanil for epidural anesthesia in patients undergoing hysterectomy. Methods Eighty ASA Ⅰ or Ⅱ patients aged 30-55 yrs weighing 40-70 kg undergoing elective hysterectomy were randomly divided into 4 groups ( n = 20 each) : ropivacaine group (R) and 3 ropivacaine-sufentanil groups (R-S1-3). The patients were unpremedicated. ECG, BP, HR and SpO2 were monitored during ansthesia. Each patient received an epidural catheter placed at L2,3 interspace. After correct placement of epidural catheter was confirmed 0.75% ropivacaine 13 ml and normal saline (NS) 2 ml were given through epidural catheter in group R whereas in the 3 R-S groups 0.75% ropivacaine 13 ml and sufentanil 10 (R-S1), 20 (R-S2) or 30 (R-S3) ?g in NS 2 ml were injected into epidural space. BP, HR and SpO2 were recorded every 3 min. The onset time, upper spread and duration of sensory block; onset and duration of motor block (Bromage scale); degree of abdominal muscle relaxation; level of sedation (OAA/S scale); anesthetic efficacy and side-effects were recorded. The dose-response curve constructed by probit regression analysis was established to calculate ED50 and ED95. Results The onset time, the time needed to reach the highest sensory level were significantly shorter and the duration of sensory block was significantly longer in the 3 R-S groups than in R group ( P

Objective:To observe the effects of acupuncture at the follicular phase on ovarian blood supply and pregnancy outcomes in patients who received in vitro fertilization/intracytoplasmic sperm injection-embry transfer (IVF/ICSI-ET) of assisted reproductive technology (ART).Methods:A total of 169 IVF/ICSI-ET female recipients from the Reproductive Center of Xiehe Hospital,Tongji Medical College,Huazhong University of Science & Technology were randomized into an observation group (57 cases),a placebo group (54 cases) and a control group (58 cases).The observation group received acupuncture during the follicular phase,meanwhile the placebo group received placebo-acupuncture,and the control group did not receive acupuncture.The hemodynamic index,biochemical pregnancy rate and clinical pregnancy rate of each group were observed,respectively.Results:As to the ovarian arterial hemodynamic index,the pulsatility index (PI),resistance index (RI),and the systolic-to-diastolic peak velocity ratio (S/D) of the observation group were (0.819±0.131),(0.552±0.055) and (2.306±0.512),respectively,obviously lower than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),but there were no statistically significant differences between the placebo group and the control group (all P＞0.05).As to the biochemical pregnancy rate and clinical pregnancy rate,the biochemical pregnancy rate in the observation group was 64.9％ and the clinical pregnancy rate was 52.6％,which were significantly higher than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),while there were no significant differences between the placebo group and the control group (both P＞0.05).Conclusion:Acupuncture treatment during the follicular phase can improve ovarian blood supply and pregnancy rate in those receiving IVF/ICSI-ET.

Objective To investigate the association between vascular risk factors and the location of intracranial artery stenosis (anterior versus posterior).Methods Magnetic resonance angiography(MRA) were examined in 374 acute stroke patients.It was divided into two groups (anterior and posterior intracranial artery stenosis group).Analyzed possible risk factors.Results Univariate analysis showed there were differences between anterior and posterior intracranial artery stenosis in systolic blood pressure,history of smoking,drinking and stroke status,and national institutes of health stroke scale (NIHSS) score at discharge,short-term prognosis,serum creatinine,triglyceride,low density lipoprotein cholesterol (LDL-C) (P ＜ 0.05).In multivariate logistic regression analysis,high blood sugar (OR =1.135,95％ CI:1.003-1.284),history of stroke(OR =1.133,95％ CI:1.007-1.276),good short-term prognosis (OR =5.987,95％ CI:1.441-24.873) were preferentially related to anterior intracranial artery stenosis,whereas history of smoking (OR =0.003,95 ％ CI:0.000-0.376),high serum creatinine values (OR =0.509,95 ％ CI:0.328-0.790),high triglyceride values (OR =0.054,95％ CI:0.004-0.645) and high LDL-C values (OR =0.096,95％ CI:0.015-0.608) were preferentially related to posterior intracranial artery stenosis.Conclusion Vascular risk factors appeared to exert different effects of risk for anterior and posterior intracranial artery stenosis.

Objective To investigate the effect of repeated hyperbaric oxygen preconditioning (HOP) on the expression of hypoxia-inducible factor-1 alpha (HIF-1a) and erythropoietin (EPO) following spinal ischemiareperfusion (I/R) in rats. Methods Forty-eight male SD rats weighing 250-300 g were randomly divided into 3 groups (n = 16 each): sham operation group (S group); I/R group and repeated HOP group (HOP group). The animals in HOP group were pretreated with O2 ( ＞ 98 % ) at 2.5 ATA I h/d for 5 consecutive days at 24 h before spinal cord I/R. The animals were anesthetized with intraperitoneal pentobarbital sodium 35 mg/kg. Spinal cord ischemia was produced by cross-clamping of abdominal aorta distal to renal artery for 20 min in I/R and HOP groups. Hind-limb motor function was assessed and scored st 48 h of reperfusion. The animals were then sacrificed and the L5-7 segment of the spinal cord was removed for determination of the expression of HIF-1 α and EPO mRNA and protein and microscopic examination. Results Compared with group S, the hind-limb motor function scores and the number of normal motor neurons in the anterior horn of the spinal cord were significantly decreased, and the expression of HIF-1α and EPO mRNA and protein was up-regulated in I/R and HOP groups ( P ＜ 0.05). Compared with group I/R, the hind-limb motor function scores and the number of normal motor neurons in the anterior horn of the spinal cord were significantly increased, and the expression of HIF-1α and EPO mRNA and protein was up-regulated in group HOP ( P ＜ 0.05). The spinal cord injury was attenuated in group HOP compared with group I/R. Conclusion Repeated HOP can reduce the spinal cord I/R injury though up-regulating the expression of HIF1α and EPO in rats.

Objective To compare the time-course of relaxant effect of rocuronium between patients of Uygur and Han nationalities.Methods Thirty ASA Ⅰ or Ⅱ patients (15 Uygur nationality,15 Han nationality) of both sexes,aged 20-55 yr weighing 45-73 kg were divided into 2 groups (n=15 each):group U Uygur nationality and group H Han nationality.Anesthesia was induced with midazolam,propofol,fentanyl and suxamethonium chloride.Tracheal intubation was performed and the patients were mechanically ventilated.Recuronium 0.6mg/kg was then given iv.Neuromuscular function was monitored with acceleromyograph using single stimulation of the ulna nerve.The onset time (time from injection of recuronium to maximal paralysis),nonresponse time (duration of maximal twitch depression),clinical duration (time required for the twitch to return to 25% of control height after injection of initial dose),75%recovery time (time for twitch to return to 75%of control height after injection of initial dose) and recovery index (time for twitch height to return from 25% to 75% of control height) were recorded.Results There was no significant difference in the onset time between the two nationalities.The time of nonresponse period,clinical duration and 75% recovery time were significantly shorter in Uygur patients than in Han patients.Recovery index was significantly shorter in Uygur patients.Conclusion There is a significant difference in the time-course of muscle relaxant effect of recuronium between Uygur and Han nationalities.The influence of nationality on recommended dosage of recuronimn should be considered.