Objective To evaluate the relationship between serum C‐P levels and microvascular complications in patients with T 2DM. Methods The clinical data of 434 patients with T2DM were retrospectively analyzed. All subjects were divided into three groups based on ΔC‐P (2 hC‐P - FC‐P) tertiles :ΔC‐P1(≤2.2 ng/ml) ,ΔC‐P2(2.3~4.0 ng/ml) and ΔC‐P3(≥4.1 ng/ml). Results The levels of BMI ,TG ,FC‐P were lower ,and the course and HbAl c were higher in ΔC‐P1 group. ΔC‐P level was positively associated with BMI and TG (P< 0.05) ,and negatively associated with prevalence of DR and chronic kidney disease (CKD)in diabetes ,course and HbA1 c.ΔC‐P levels decreased gradually with the progression of DR and CKD. Logistic regression analysis showed that lower ΔC‐P level was the independent risk factor for microvascular complications after adjustment for related risk factors. Conclusion Serum ΔC‐P level is an independent factor for the development of diabetic microvasculr complications in T 2DM.

Adult ; Aged ; Colon ; physiopathology ; Constipation ; drug therapy ; physiopathology ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Transit ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective To observe the role of the health education model in pain self- efficacy for patients with cancer pain. Methods Sixty- four patients suffering from cancer pain were enrolled into the study and self- contrast experiment was made on each patient. The health education model was set up and health education for each patient with cancer pain was implemented. The pain, self- efficacy, cancer pain knowledge before and after the intervention were observed by Numerical Rating Scale (NRS),Chronic Pain Self- efficacy Scale(CPSS) and Cancer Pain Knowledge Questionnaire. Results NRS score were (5.38 ±0.19) points and (1.05 ± 0.11) points before and after the intervention, and there was significant difference (t =25.288, P = 0.000). Before intervention, pain management self- efficacy, physical function self- efficacy, symptom coping self- efficacy of CPSS scores were (10.38 ±0.37) , (20.97±0.81) , (16.86 ± 0.49) points, while after the intervention, the scores were (19.31± 0.30) , (33.25 ± 0.60) , (29.75 ±0.51) points, there were significant differences ( t = -33.225, -18.236, -18.235, all P = 0.000). Before and after the intervention, the answer rate of Cancer Pain Knowledge Questionnaire was 50.00%(32/64) and 87.50%(56/64), there was significant difference( χ2=20.51, P < 0.01). Conclusions To set up the health education model and implement health education for each patient with cancer pain can improve the patient′s pain management and enhance self-efficacy.

Objective To evaluate the effect of pretreatment with botulinum toxin A injected intrath?ecally or locally at the incision site on the neurokinin?1 ( NK?1) receptor internalization in the spinal dorsal horn in a rat model of incisional pain. Methods Male Sprague?Dawley rats, weighing 280-300 g, aged 6-8 weeks, were used in the study. The experiment was performed in two parts. ExperimentⅠ Twenty?seven rats with no sign of nerve injury at day 7 after successful catheterization were selected and divided into 3 groups (n=9 each) using a random number table: control group (C1 group), incisional pain group (IP1 group) and intrathecal botulinum toxin A group (BoNT∕A1 group). At 24 h before operation, botulinum tox?in A 0.5 U ( in 10μl of normal saline) was injected intrathecally in group BoNT∕A1, and normal saline 10μl was injected intrathecally in group IP1. ExperimentⅡ Twenty?seven rats were selected and divided into 3 groups (n=9 each) using a random number table: control group (group C2), incisional pain group (IP2 group) and locally injected botulinum toxin A at the incision site group (BoNT∕A2 group). At 24 h before op?eration, botulinum toxin A 2 U ( in 0.4 ml of normal saline) was injected subcutaneously at the incision site and into the plantar surface, and normal saline 0.4 ml was injected subcutaneously at the incision site and into the plantar surface in group IP2. Six rats in each group were selected, and the cumulative pain score (CPS) was recorded, and the mechanical paw withdrawal threshold ( MWT) in the right hindpaw was measured be?fore administration, before operation, and at 3 h and 1, 3, 5 and 7 days after operation. At 3 h after opera?tion, 3 rats in each group were selected and sacrificed, and the lumbar segment ( L4,5 ) of the spinal cord was removed for determination of the expression of NK?1 receptors in the spinal dorsal horn by immunofluores?cence. Results ExperimentⅠ Compared with group C1, the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h and 1 and 3 days after opera?tion, and the expression of NK?1 receptors in the spinal dorsal horn was significantly up?regulated in group IP1, and the CPS was significantly increased at 3 h and 1, 3 and 5 days after operation, the MWT was sig?nificantly decreased at 3 h after operation ( P<0.05) , and no significant change was found in the expression of NK?1 receptors in the spinal dorsal horn in group BoNT∕A1 (P>0.05). Compared with group IP1, the CPS was significantly decreased, and the MWT was significantly increased at 3 h and 1, 3, and 5 days after oper?ation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A1 (P<0.05). ExperimentⅡ Compared with group C2, the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h and 1, 3, 5 and 7 days after operation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly up?regu?lated in group IP2, and the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h after operation ( P<0.05) , and no significant change was found in the expression of NK?1 receptors in the spinal dorsal horn in group BoNT∕A2 ( P>0.05) . Compared with group IP2, the CPS was significantly decreased at 3 h and 1, 3, and 5 days after operation, the MWT was signifi?cantly increased at 3 h and 1 and 3 days after operation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A2 (P<0.05). Conclusion Pretreatment with botulinum toxin A injected intrathecally or locally at the incision site can inhibit the internalization of NK?1 re?ceptors in the spinal dorsal horn in a rat model of incisional pain.

OBJECTIVE: Mitochondrial deoxyribonucleic acid (mtDNA) 8344 A>G (m.8344A>G) mutation is the common mutation associated with mitochondrial myoclonus epilepsy with ragged-red fibers (MERRF) syndrome. Herein we report a rare case with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes/MERRF/Leigh (MELAS/MERRF/Leigh) overlap syndrome caused by m.8344A>G mutation. METHODS: The clinical and imaging data of the patient were collected and an open muscle biopsy was carried out. We further employed molecular genetic analyses to detect mtDNA mutation in the proband and his mother. And then a clinical and neuroimaging follow-up was performed. RESULTS: This patient was a 25-year-old male, who developed exercise intolerance since the age of 6. At age 10, he suffered from acute episodes of hemianopia, and cranial magnetic resonance imaging (MRI) showed occipital stroke-like lesions and cranial magnetic resonance spectroscopy (MRS) revealed a lactate peak corresponding to the lesion. After that the patient presented slowly progressive psychomotor decline. He had myoclonic seizures and cerebellar ataxia since the age of 12. At age 21, he was admitted to our hospital because of confusion and cranial MRI revealed symmetrical lesions in bilateral posterior putamen, thalami and midbrain. Then repeated MRI showed progression of original lesions and new frontal multiple stroke-like lesions. Symptomatic and rehabilitation treatment relieved his condition. Follow-up cranial MRI at age 24 showed the lesions in basal ganglia and thalami diminished, and the midbrain lesions even completely vanished. Muscle pathology indicated the presence of numerous scattered ragged-red fibers (RRF), suggestive of a mitochondrial disorder. Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) detected the m.8344A>G mutation of the MT-TK gene encoding mitochondrial transfer RNA for lysine in the patient's blood. Next generation sequencing (NGS) of the whole mitochondrial genome identified that the proportion of m.8344A>G was 90%, and no other mtDNA mutation was detected. Sanger sequencing further identified this mutation both in the proband and his mother's blood, although the mutation load was much lower in his mother's blood with approximately 10% heteroplasmy. CONCLUSION The present study is the first to describe a patient with m.8344A>G mutation in association with the MELAS/MERRF/Leigh overlap syndrome, which expands the phenotypic spectrum of the m.8344A>G mutation.
Acidosis, Lactic ; Adult ; Child ; DNA, Mitochondrial/genetics* ; Humans ; Male ; Mitochondrial Encephalomyopathies ; Mutation ; Stroke ; Young Adult

Objective To analyze the dynamic evolution of brain MRI in patients with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods A retrospective study was performed on 58 MELAS cases with pathologically and (or) molecularly confirmed diagnosis.MRI were repeated within 60 days after the onset of stroke-like episodes (SLE) and the evolution changes of cerebral lesions were accessed.Brain atrophy index (BAI) was calculated in the remission stage from 31 patients with MELAS,and the correlation between BAI,age and disease duration was analyzed.Results The proportion of lesions expansion,migration and shrink within 30 days after the onset of SLE was 64.1％ (25/39),10.2％ (4/39),17.9％ (7/39),respectively,and 13％ (3/23),21.7％ (5/23),56.5％ (13/23),between 30-60 days after the onset of SLE respectively.In the recovery stage of SLE,the BAI in 31 patients with MELAS was 15.2％ ±2.8％.The correlation coefficient between BAI and the age,total disease course and duration of encephalopathy was 0.329 (P =0.043),0.405 (P =0.012) and 0.649 (P =0.000).Conclusions Brain atrophy in the studied MELAS patients gradually develops and strokelike lesions shrink with progression of the disease.However,the migration of lesions is persistent.

Based on the investigation of a hospital's grants during 2004-2005 and the authorized during 2002-2005 (385 in total), we tried to find the trends and bias of clinical sciences at present. We analysed on the types of grants (clinical or basic), research objects, experimental methods, discipline involved, modes of cooperation, and background of applicants. A close connection between research and clinical trial, interdisciplinary study, patient-centered practice and international competitions are becoming more and more important. To meet the needs of clinical research, policies and devotions such as technical platforms are needed.

14 strains were isolated from pits sludge by anaerobic cultivation,two Clostridium butyricum strains were identified by physiological and biochemical experiments and the sequence analysis of 16S rDNA.The physiological characteristics and security of Clostridium butyricum B1 were studied,in vitro research indicated it was tolerant against low pH,bile concentration and antibiotics and has antagonism effects against pathogens.

Objective:To investigate the relationship between tumor necrosis factor-α (TNF-α)-308A/G gene polymorphism and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM),and their correlative risk factors thereof.Methods:Forty cases of T2DM with MCI and 80 cases of T2DM without MCI were selected for this study.The polymorphism of the TNF-α-308A/G was detected by PCR-restriction fragment length polymorphism (PCR-RFLP).According to the clinical data,such as course of disease,plasma glucose,plasma fat and body mass index(BMI),the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression.Results:The frequency of TNF-α2 allele was significantly higher in the group of T2DM with MCI than that without MCI (P＜0.01).The indexes of the statistical significant difference between the two groups were the age,course of disease,postprandial blood glucose(P2BG),glycosylated hemoglobin,body mass index,family history of T2DM,hypertension,diabetic retinopathy,diabetic peripheral neuropathy and TNF-α.The independent risk factors included TNF-α,diabetic peripheral neuropathy,diabetic retinopathy,age and P2BG.Conclusion:There is a significant relationship between TNF-α2 allele and T2DM with MCI.There is a significant relationship between the age,control of plasma glucose and microvaseular complication of T2DM with the cognitive funotion.

?AlM:To explore the influence factors of orthokeratology controlling development of juvenile myopia.
?Methods: A retrospective analysis of 86 cases ( 169 eyes ) who performed orthokeratology from November 2012 to November 2013 in our hospital was carried out. Ater 2a treatment, diopter increased > -0. 25D as invalid control group (54 eyes), diopter increased ≤ -0. 25D as effective control group ( 115 eyes ) . The difference of various factors between two groups were compared.
?RESULTS: Univariate comparison showed that the two groups had no statistical significance (P>0. 05) in terms of gender, whether wear glasses in the past, anterior corneal diameter before treatment, central corneal thickness, intraocular pressure and anterior chamber depth. However, the two groups had statistical significance (P<0. 05) in the terms of age, dioptre before trement, corneal curvature, and axial length basis. Logistic regression analysis showed that foundation axial length, age and corneal curvature were in line with regression model ( P<0. 05 ), these were independent factors that orthokeratology lens control juvenile myopia development.
? CONCLUSlON: lndependent factors affecting orthokeratology control juvenile myopia development is foundation axial length, age and corneal curvature. For juvenile patients, the longer of foundation axial length, the longer the age, the greater the curvature of cornea, orthokeratology can better control the myopia’s development.