Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER200 ?g/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P

ObjectiveTo investigate the role of vascular endotheliar growth factor(VEGF),chemokine receptor 4(CXCR4) and stromal cell-derived factor-1(SDF-1) in Wilms tumor as well as their relationship with clinical features by examining the expressions of VEGF,CXCR4 and SDF-1.MethodsThirty cases of Wilms tumor samples and 12 cases of adjacent kidney tissue were collected from the First and the Third Affiliated Hospital of Zhengzhou University from May 2003 to May 2008.Thirteen boys and 17 girls aging from 4 months to 7 years old of whom were 22 favorable histologic types and 8 unfavorable histologic types.By means of cytoplasm to dye buffy for masculine cell,staining intensity and percentage of positive tumor cells serve as the judgment criteria for being positive or negative.All tissues would be tested by hematoxylin and eosin stain at the same time.ResultsThe positive expression rate of VEGF,CXCR4 and SDF-1 in Wilms tumor were 63.33%,70.0% and 53.33%.Those in adjacent normal kidney tissue were 25.0%,8.3% and 16.7%.The 2 groups were statistically significant(Pa

Objective To investigate the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for impacted upper ureteric calculi.Methods Retro-urethral catheterization was conducted in the diseased ureter under cyctoscope.After a channel from the skin surface into the middle calyx was established under the guidance of X-ray or B ultrasonography,pneumatic lithotripsy was conducted to break up stones under ureteroscopy.Results The success rate of pneumatic lithotripsy was 100%.The rate of postoperative macroscopic hematuria was 55.1%(27/49).The symptom lasted one to three days in 26 cases,and 1 case had apparent hematuria with blood clot flowing out from nephrostomy tube,which lasted 8 days.10.2%(5/49) of cases was complicated with postoperative pyrexia.The stone-free rate in one week and one month postoperatively was 93.9%(46/49) 98.0%(48/49),respectively.Follow-up observations in 49 cases for 1-12 months(mean,5 months) showed no major complications.Conclusions MPCNL for impacted upper ureteral calculi has the advantages of simple performance,less complications and satisfactory efficacy.

Objective: To analyze the influencing factors for anterior tibial artery atherosclerosis among patients with hyperuricemia, so as to provide insights into the prevention of anterior tibial artery atherosclerosis. Methods: Patients aged 18 years and older with hyperuricemia in Dazhou Integrated TCM & Western Medicine Hospital were enrolled as research subjects from 2020 to 2023. Demographic information and blood biochemistry indicators were collected through electronic medical records. Anterior tibial artery atherosclerosis was evaluated by color Doppler ultrasound. Factors affecting anterior tibial artery atherosclerosis among patients with hyperuricemia were analyzed by a multivariable logistic regression model. Results: A total of 1 105 patients with hyperuricemia were surveyed, including 862 males (78.01%) and 243 females (21.99%). There were 918 cases (83.08%) at the ages of 60 years and older, and 457 cases (41.36%) with a course of disease at 10 years and longer. The median level of blood uric acid was 480.79 (interquartile range, 98.28) μmol/L. There were 314 cases (28.42%) with anterior tibial artery atherosclerosis. Multivariable logistic regression analysis showed that body mass index (≥24.0 kg/m2, OR=1.597, 95%CI: 1.185-2.151), long-term smoking history (yes, OR=1.709, 95%CI: 1.153-2.534), diabetes mellitus (yes, OR=1.517, 95%CI: 1.162-1.981), serum uric acid (≥480.79 μmol/L, OR=1.667, 95%CI: 1.131-2.457), serum creatinine (≥97 μmol/L, OR=1.685, 95%CI: 1.155-2.460), fasting blood glucose (≥6.1 mmol/L, OR=1.528, 95%CI: 1.106-2.112), fibrinogen (>4 g/L, OR=1.589, 95%CI: 1.091-2.315) and triglycerides (≥1.7 mmol/L, OR=1.879, 95%CI: 1.226-2.881) were influencing factors for anterior tibial artery atherosclerosis among patients with hyperuricemia. Conclusion Anterior tibial artery atherosclerosis among patients with hyperuricemia is associated with long-term smoking, diabetes mellitus, serum uric acid, serum creatinine, fasting blood glucose, fibrinogen and triglycerides high level.

Objective: To discuss the rational drug application of Kawasaki disease in children with upper respiratory tract infection in order to provide reference for the therapy of Kawasaki disease suspected of bacterial meningitis.Methods: The medical record of a 2-year-old boy with Kawasaki disease was retrospectively analyzed, and the anti-infection treatment was analyzed and evaluated.Meanwhile, the mechanism of elevated leukocyte count in cerebrospinal fluid (CSF)of children with incomplete Kawasaki disease was discussed.The pharmaceutical care and treatment results in the diagnosis and treatment process were analyzed as well.Results: The anti-infective therapy in early stage was reasonable as the early symptoms of respiratory tract infection in the child were obvious, however, the choice of aztreonam was defective.On the premise of the clinical diagnosis of Kawasaki disease and excluding bacterial meningitis, the medication was timely adjusted.Finally, the symptoms of the child were improved.Conclusion: The application of anti-infection drugs should be reasonable in clinics, and the abnormality in cerebrospinal fluid should be paid more attention in children with Kawasaki disease.It is necessary to strengthen clinical observation and pharmaceutical care in order to guarantee the safety of medication for patients.

0.05), but there were significant differences after the operation (P

Objective To evaluate the endothelial function in diabetic patients by high resolution sonography. Methods The intima-media thicknesses (IMT) of the bilateral carotid artery, femoral artery and the iliac artery of 22 elderly patients and 142 non-elderly patients with diabetes mellitus (DM) and 20 elderly and 20 non-elderly healthy persons were measured. The changes of the diameter of brachial artery were determined by measuring the diameter of brachial artery during reactive hyperemia and after sublingual nitroglycerin. Results The increased percentage of the brachial artery diameter under reactive hyperemia was significantly lower in elderly patients with DM (10. 03?6. 39)% than that in the elderly healthy control (15. 87?4. 79)% (P 0. 05). The IMT in elderly patients with early-stage DM incrassated significantly(P

OBJECTIVE To investigate the distribution and the drug resistance changes of the pathogenic bacteria isolated from the blood culture specimens collected during the period of 2006-2008.METHODS Blood culture of patients in our hospital was performed by BacT/Alert 240 and the isolated bacteria were identified by API and Microscan and tested for drug resistance against antimicrobial agent by K-B method.A retrospective analysis was made to the blood culture results during the period of 2006-2008 with WHONET 5.4 software.RESULTS Gram-negative rods were the predominant bacteria which caused sepsicemia.The isolated rates of Escherichia coli took the first place during the period of 2006-2008.Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus(SAU) were also the most important pathogens which caused blood infection.The infection rate of coagulase negative staphylococcus(CNS) and P.aeruginosa had increasing tendency.Imipenem and meropenem were the most effective antibiotics(100%) to E.coli and K.pneumoniae.Then amikacin and cefoxitin also had high susceptibility to E.coli and K.pneumoniae.Furthermore,drug susceptibility in 2008 was higher than that of two years before.All antibacterials had low drug susceptibility to P.aeruginosa,and its drug resistance rate rised obviously.The drug resistance situation of Acinetobacter baumannii was serious.Except imipenem and meropenem had relatively higher susceptibility(20-69.2%),the susceptibility to other antibacterials was lower than 41.7%.Vancomycin,teicoplanin and quinupristin/dalfopristin were the most effective antibiotics to(SAU).CONCLUSIONS The species and drug resistance of the bacteria isolated from blood specimens have changed.More attention should be paid to the detection and surveillance of bacterial resistance in blood culture to promote the rational use of antibiotics.

Objective To explore the incidence rate and the risk factors of deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT.Methods All of 534 Patients with fresh four extremities or pelvic fracture between January 2010 and December 2013 were involved in this study.The incidence of DVT under 5 risk factors including general state, injury type, fracture condition, operation and laboratory examination were analyzed.Each patient underwent three Doppler ultrasound exams in actions as the epidemiology diagnostic criterion for DVT.Results The total incidence rate of DVT in 534 patients was 11.99％.The univariate analysis showed that male patients with age≥60 years, BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension and coronary artery disease had higher incidence rate of DVT.In different injury types, the fall injury caused the highest incidence rate of DVT (45.71％).There were different DVT rates for different fracture sites, with the highest incidence rate of DVT for femur shaft fracture (20.69％).The incidence rate of DVT was 50.00％ for fractures of more than three parts, 15.29％ for fractures of two parts and only 3.98％ for sole part.The incidence rate of DVT for comminuted fractures was higher than others.The operation duration, massive transfusion during operation and general anesthesia were related with the increase of incidence of DVT.Positive ACA and enhancement of D-dimer, Fib and CRP were related with the increase of incidence of DVT.Conclusion The incidence of DVT in patients with traumatic fractures approaches a considerable level.It has relationships with age≥60 years, BMI≥25 kg/m2, history of smoking, fall injury, fracture of femoral shaft and hip, more than three parts of fractures, comminuted fractures, operation duration≥2 hours, largely blood transfused, massive transfusion during operation, general anesthesia, positive ACA, enhancement of D-dimer, Fib and CRP.The surgeons should recognize the importance to prevent DVT and PE in the traumatic patients.

OBJECTIVE To investigate the different methods to calculate the rate of missing report on nosocomial infections.METHODS We had two methods to define the case of nosocomial infections,one was that the cases(infected) during the month we investigated,the other was that patients infected during the in hospital time.Then we got two different rates and "actually" nosocomial infection cases and compare the difference of the two results.(RESULTS) It was significant difference between these two results(P