OBJECTIVE:To investigate the effects of fluvastatin combined with aspirin on the related indicators of patients with diabetic lower extremity arteriosclerosis occlusive desease(LEAOD). METHODS:80 patients with diabetic LEAOD were ran-domly divided into control group(40 cases)and observation group(40 cases). Based on convertional treatment,control group was given Rosuvastatin calcium tablet 5 mg+Aspirin enteric-coated tablet 100 mg every evening;observation group was given Fluvas-tatin sodium capsule 40 mg+Aspirin enteric-coated tablet 100 mg. They were treated for 3 months. Fibrinogen,plasma D-dimer, blood viscosity, cholesterol (TC), triglyceride (TG), glycosylated hemoglobin (HbAlc), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), carotid intima-media thickness, compliance situation of TC, TG, HbAlc,LDL-C and HDL-C,cases of carotid intima thickening,plaque formation,stenosis and occlusion before and after treat-ment were observed,and the incidence of adverse reactions was recorded. RESULTS:After treatment,fibrinogen,plasma D-di-mer,blood viscosity,TC,TG,HbAlc,LDL-C and carotid intima-media thickness in 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group;HDL-C in 2 groups was significantly higher than be-fore,and observation group was significantly higher than control group,with statistical significance (P<0.05). Compliance rates of TC,TG,LDL-C and HDL-C in observation group were significantly higher than control group,proportion of carotid intima thickening and carotid plaque formation were significantly less than control group,with statistical significance (P<0.05),there were no significant differences in the compliance rate of HbA1c,proportion of carotid stenosis and occlusion and the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Fluvastatin combined with aspirin can significantly improve the pa-tients 'blood viscosity,blood lipid,vascular endothelial function in the treatment of diabetic LEAOD,it can reduce the thrombotic disease risk,and does not increase the incidence of adverse reactions.

Objective To investigate the influencing factors involved in the long-term effect after interventional treatment of diabetic lower extremity vascular disease.Methods The data of 358 diabetic patients with lower extremity vascular disease were collected retrospectively.The ankle-brachial index (ABI) values at the 6th, 12th and 24th month after interventional treatment were documented and the factors may influence ABI value werc analyzed.Results Single factor analysis showed that after 24 months treatment, the proportion of ABI＜0.5 (severe ischemia) in the patients combined with obesity, smoking, older age were 15.0％ (31/206), 18.4％ (25/136) , 12.1％(19/157) ,7.5％(15/200) ,while non obesity,younger age,no smoking,no hypertension were 6.6％ (10/152), 14.8％ (33/222), 6.5％ (13/201), 1.9％ (3/158), and the differences were significant (P ＜0.05).Logistic regression analysis showed that old age (OR =1.341,95％ CI: 1.281-1.496, P =0.045), smoking(OR=2.301,95％ CI: 1.903-4.844,P=0.028) and obesity(OR=1.299,95％ CI: 1.270-1.588,P =0.038) were the independent factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.Conclusion Obesity, smoking, old age are the main factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.

Objective To explore changes of anti-HCV antibody and HCV-RNA in patients with HCV infection and its clinical significance in diagnosis and treatment of hepatitis C .Methods Serum samples from patients with HCV infection were collected . HCV antibodies were analyzed with a chemiluminescence micro-particle immunoassay method ,while a PCR-fluorescent probe meth-od was used to detect HCV-RNA .Concentrations of ALT and AST were also determined .Based on the concentrations of ALT , AST and HCV-RNA ,samples were divided into two groups respectively and the changes of different indicators were analyzed and compared .Meanwhile samples from 37 HCV-infected patients were collected continuously .Different indicators after treatment were compared with those before treatment .Results HCV-Ab and logarithm values of RNA load in the group with abnormal concentra-tions of ALT and AST were significantly higher than those in the normal group (P<0 .05) .HCV-Ab ,ALT and AST concentrations in HCV-RNA positive group were significantly higher than those in HCV-RNA negtive group(P<0 .05) .The areas under receiver operating characteristic curve of HCV-Ab and logarithm values of RNA load were 0 .990 and 0 .838 respectively .Concentrations of ALT ,AST and logarithm values of RNA load after treatment were significantly lower than those before treatment (P<0 .05) while there was no significance between HCV-Ab level after treatment and that before treatment (P>0 .05) .Conclusion The diagnostic performance of HCV-Ab is better than that of logarithm values of RNA load .Determination of ALT ,AST and HCV-RNA is of clinical importance in monitoring the effect of hepatitis C treatment .

The PET tracer 5-([11C]methyloxy)-L-tryptophan (5-(11)CMTP) was prepared by nucleophilic fluorination and alkylation reaction via a two-step procedure in order to develop specific tumor probe. The biodistribution and microPET imaging of 5-(11)CMTP were executed. The results unveiled that the overall radiochemical yield with no decay correction was (14.6 ±7.2) %, the radiochemical purity was more than 95% and high uptake and long retention time of 5-(11)CMTP in liver, kidney and blood were observed but low uptake in brain and muscle were found, furthermore, high uptake of 5-(11)CMTP in tumor tissue was observed. It seems that 5-(11)CMTP will be a potential amino acid tracer for tumors imaging with PET.
Amino Acids ; Animals ; Neoplasms ; diagnostic imaging ; Positron-Emission Tomography ; Radioactive Tracers ; Tissue Distribution ; Tryptophan ; analogs & derivatives

Objective To investigate the risk factors of standard selectivity biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) for patints with choledocholithiasis,and the effect and safety of assistant cannulation methods.Methods The clinical data were retrospectively analyzed in 372 patients,who received ERCP for choledocholithiasis in the Yijishan Hospital of Wannan Medical College from January 2014 to December 2014.The risk factors of standard biliary cannulation were assessed by univariate and multivariate logistic regression analysis.The success rate of assistant biliary cannulation and the incidence of post-ERCP pancreatitis (PEP) of standard biliary cannulation were compared with doubleguide wire technique (DGT) and precut sphincterotomy (PS),which were used when standard biliary cannulation failed.Results The univariate analysis showed that floppy and long duodenal papilla (P=0.000),angulated common bile duct(P=0.013) were related to failure of standard biliary cannulation.Multivariate analysis showed that floppy and long papilla (P=0.000,OR=0.131,95％CI:0.056-0.307),angulated common bile duct (P =0.003,OR =0.378,95 ％ CI:0.197-0.726) were independent risk factors for standard biliary cannulation.The success rate of standard biliary cannulation was 83.3％ (310/372),62 cases undergone DGT or PS after standard biliary cannulation failure,and the total success rate of cannulation was 99.7％ (371/372).There were 29 cases suffered from PEP in 371 successful cases of biliary cannulation,including 18 cases (5.8％,18/310) of standard biliary cannulation,8 cases (16.3％,8/49) of DGT,and 3 cases (25.0％,3/12) of PS.The incidence of PEP by DGT (x2 =5.532,P =0.019) and PS (x2 =6.994,P=0.008) was significantly higher than that of standard biliary cannulation,but there was no statistical difference on the incidence of PEP between DGT and PS (x2 =0.079,P =0.778).Conclusion Floppy and long duodenal papilla and angulated common bile duct could easily induce the failure of standard biliary cannulation in ERCP for patients with choledocholithiasis.DGT and PS are effective assistant cannulation methods when the standard cannulation fails.

Objective:To study the effects and safety of metformin combined with vildagliptin on the glycemic control for patients with newly diagnosed type 2 diabetes mellitus.Methods:60 patients with type 2 diabetes mellitus who were treated from February 2015 to April 2016 were selected and divided into the control group and the observation group according to different treatment methods.The control group was treated with routine treatment.The observation group was treated with vildagliptin based on the control group.The blood glucose,glycosylated hemoglobin,two-hour postprandial blood glucose and serum as well as urinal amylase were measured before and after treatment,and the clinical curative effect of the two groups and the levels of interleukin-6,tumor necrosis factor and C-reactive protein were compared.Results:After treatment,the total effective rate of observation group was 90％,which was significantly higher than that of the control group(66.7％,P＜0.05).After treatment,the serum interleukin-6,tumor necrosis factor,C-reactive protein and fasting blood glucose,glycosylated hemoglobin and postprandial blood glucose levels were significantly lower than those of the control group[(7.63± 1.12)dvs(8.68± 1.30)d;(7.23± 0.95)d vs(7.89± 1.20)d;(11.14± 1.56)d vs(12.12± 1.89)d];[(12.12± 1.89)d vs(ll.20± 1.34)d;(6.89± 0.96)d vs(8.23± 1.10)d;(1.65± 0.23)d vs(3.65± 0.48)d] (P＜0.05).After treatment,the INS level of observation group was significantly lower than that of the control group (P＜0.05) and the GLP-1 level was significantly higher than that of the control group (P＜0.05).Conclusion:Metformin combined with vildagliptin could effectively control the blood glucose of patients with newly diagnosed type 2 diabetes and enhance the safety.

Purpose: Elevated plasma D-dimer level is a poor prognostic factor for many solid tumors. However, limited research has been conducted on D-dimer in children with neuroblastoma (NB), and its clinical significance remains unclear. The present study investigated the clinical and prognostic significance of D-dimer in pediatric NB patients. Methods: A retrospective analysis of all newly admitted NB patients was conducted from January 2014 to December 2020.Baseline clinicopathological features, preoperative laboratory parameters, and follow-up information were collected. Univariate and multivariate analyses were performed to determine the relationship between D-dimer level, clinical features, and the prognostic value. Results: Among 266 patients, the median value of D-dimer was 2.98 ng/mL, of which 132 patients showed elevated D-dimer levels before surgery (>2.98 ng/mL). Univariate analysis revealed that elevated D-dimer was significantly associated with age, hemoglobin, neutrophil-to-lymphocyte ratio, neuron-specific enolase, 24-hour vanillylmandelic acid, overall survival, and so on (P < 0.05). Patients with elevated D-dimer levels had shorter median overall survival time when compared with normal D-dimer levels (P = 0.01). The prognosis was better in patients with normal D-dimer levels when combined with lower age, ganglioneuroblastoma tumor type, lower stage on International Neuroblastoma Staging System, low-risk group, and without bone metastasis or bone marrow metastasis. The continuous increase of D-dimer level after treatment indicated tumor recurrence or progression. Conclusion A high D-dimer level is associated with low overall survival, and an elevated D-dimer level after treatment indicates tumor recurrence and progression. D-dimer can be used as one of the evaluation factors for NB treatment or prognosis.

OBJECTIVETo explore the clinical effect of the lobulated medial sural artery perforator flap in repairing soft tissue defect in hand or foot.

METHODSSince March 2012 to September 2014, 6 cases with soft tissue defects in hands or feet were treated by lobulated medial sural artery flaps pedicled with 1st musculo-cutaneous perforator and 2st musculo-cutaneous perforator of the medial sural artery. The size of the flaps ranged from 4.5 cm x 10.0 cm to 6.0 cm x 17.0 cm.

RESULTS5 cases of lobulated flap survived smoothly, only 1 lobulated flap had venous articulo, but this flap also survived after the articulo was removed by vascular exploration. All flaps had desirable appearance and sensation and the two-point discrimination was 6 mm in mean with 4 to 12 months follow-up (average, 7 months). Linear scar was left in donor sites in 3 cases and skin scar in 3 cases. There was no malfunction in donor sites.

CONCLUSIONSLobulated medial sural artery perforator flap is feasible and ideal method for the treatment of soft tissue defect in hand or foot with satisfactory effect.

Arteries ; Cicatrix ; Follow-Up Studies ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Time Factors ; Wound Healing

Objective To investigate the effect of monosialoganglioside GM1 on cardiopulmonary bypass (CPB)-induced inflammatory response in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 350-450 g,were randomly divided into 3 groups (n =8 each):sham operation group (group S),group CPB and CPB + GMi group (group G).GM1 20 mg/kg was added to the priming solution in group G.While the equal volume of normal saline was given in group CPB.Blood samples were collected from the jugular vein at 3 h after termination of CPB for determination of plasma concentrations of neuron-specific enolase (NSE) and S-100β protein (by ELISA) and tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (by radioimmunoassay).The hippocampi were isolated to detect the expression of hippocampal matrix metalloproteinase-9 (MMP-9) and IL-10 and NF-κB activity in hippocampal tissues by Western blot.Results Compared with group S,the plasma concentrations of NSE,S-100β protein,TNF-α and IL-6 and NF-κB activity were significantly increased,the expression of MMP-9 was up-regulated,and the expression of IL-10 was down-regulated in groups CPB and G (P ＜ 0.05).Compared with group CPB,the plasma concentrations of NSE,S-100β protein,TNF-α and IL-6 and NF-κB activity were significantly decreased,the expression of MMP-9 was down-regulated,and the expression of IL-10 was upregulated in group G (P ＜ 0.05).Conclusion The mechanism by which GM1 reduces the CPB-induced brain damage may be related to reduction of the central and systemic inflammatory response in rats.

Objective To identify the prevalence of different amyloid types in renal biopsies.Methods The renal biopsies of 205 patients diagnosed as renal amyloidosis from January 1990 to December 2011 were reassessed.Immunohistochemistry was performed with a penal of antibodies directed against λ-light chain,κ-light chain,amyloid A,fibrinogen,transthyretin,apolipoprotein A1,and lysozyme.Immune electron microscopy and gene analysis were performed when the results of immunohistochemistry were indeterminate.Results Among 205 patients,190 cases (92.7％) were classified as immunoglobulin light chain amyloidosis (AL),1 (0.5％) case as amyloid A amyloidosis and 1 (0.5％) case as fibrinogen A α-chain amyloidosis.The amyloid types of remaining 13 (6.3％) cases were undetermined.In the AL patients,the distribution of λ and κ was 6.6∶1.Conclusion AL is the most common form of renal amyloidosis in China,with a predominant light chain type of λ.