BACKGROUND:Diabetes mel itus can give rise to bone metabolic disorders in patients, resulting in the occurrence of osteoporosis and low traumatic fractures. However, the pathogenesis mechanism remains unclear. OBJECTIVE:To review the current research progress in the bone metabolic disorders resulting from diabetes mel itus, and to provide theoretical basis of the prevention and treatment of diabetic osteopathy. METHODS:A computer-based online search was conducted in Pubmed database (http://www.ncbi.nlm.nih.gov/pubmed/) from January 2000 to December 2013. Articles focusing on diabetes mel itus regulating bone metabolism were col ected using the key words of“diabetes mel itus;bone”in English. High-quality relevant studies were included, while repetitions and unidirectional studies were excluded.
RESULTS AND CONCLUSION:A total of 6 979 articles were obtained initial y, and after screening procedures 58 literatures were selectively included in this review. Although type 1 and type 2 diabetes mel itus exert different effects on the bone mineral density, they ultimately result in osteoporosis and low traumatic fractures. It is widely believed that the pathogenesis may be that high glucose breaks the balance between bone formation and bone absorption, so that bone absorption is greater than bone formation. The number of the osteoclasts is increased, while the cytokines of promoting osteogenesis are restrained. As a consequence, those result in low bone mineral density, brittle bone and high incidence of fracture.

Objective To investigate the prevalence of nutritional risk,undemutrition,overweight/obesi-ty,and apphcation of nutrition support in departments of neurology in 3 metropolitan hospitals in Beijing. Methods Adult patients in the departments of neurology from 3 metropolitan hospitals in Beijing were consecutively en-rolled from March 2005 to March 2006.Nutritional Risk Screening 2002(NRS2002)score≥3 was defined a8 nu-tritian risk,while body mass index(BMI)<18.5 ks/m2 as undemutrition.NRS2002 was performed on the next morning of admission and nutritional support evaluation was performed on the 14th day of admission or discharge day.The relationship between nutrition risk and nutrition support was analyzed.Results A total of 753 patients were enrolled.NRS2002 scoring results were obtained in 461 patients.The prevalence of undemutrition was 4.2%and nutritional risk Was 21.2%.Among them 292 cases in undemutrition category were estimated by semm albu-min<30g/L without accurate BML If the cases without accurate BMl were excluded,the prevalence of undemutri-tion was 5.4%and nutritional risk Was 10.8%.Twenty-three patients(14.4%)with NRS2002≥3 received nutrition support.Thirteen patients(2.2%)with NRS2002<3 received nutrition support.The average PN:EN ratio Wag 1:2.Conclusions A large proportion of inpatients were at nutritional risk or undemutrition in the de-partments of neurology in metropolitan hospitals in Beijing.The application of nutrition support Wag somehow inap-propriate in these patients.Evidence-based guidelines are required to improve this situation

Objective To explore the incidence rate and related factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy(DRP). Methods The 986 patients(1 326 eyes) with DRP arranged vitro-retinal surgery were studied. The inci-dence rate of intraocular pressure was analyzed between different types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation and crystalline lens excision. Results The incidence rate of high intraocular pressure was 27. 8%(368/1 326). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher than non-pro-liferative DRP (17. 2%)(χ2 =30. 648,P=0. 000),and higher in DRP D grade than B grade(34. 1%,20. 8%)(χ2=8. 834,P=0. 003). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher in patients complicated with macular de-tachment(30. 4%,22. 7%)(χ2 =8. 834,P=0. 0030). The incidence rate of patients filled with silicone oil/C3F8(39. 1%,24. 0%) (χ2 =28. 088,P=0. 000),total/supplementary retina photo-coagulation(32. 8%,16. 8%) (χ2 =21. 159,P=0. 000),with/without crystal-line lens excision (40. 5%,25. 9%)(χ2=15. 532,P=0. 0001)was different obviously. Conclusion There is a high incidence rate and re-lated factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy,and it is related to different DRP types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation,crystalline lens excision.

Objective Human bone marrow mesenchymal stem cells were transfected by Smad7 and labeled with green fluores-cent mark.BMMSCs were implanted into rabbit glaucoma operational model and observed surviving condition.Methods Through BP and LR reaction,Smad7 with green fluorescent mark was inserted into human bone marrow mesenchymal stem cells by bacterio-phage,filtered positive colony and picked out cell line.15 New Zealand white rabbits were enforced trabeculectomy with BMMSC, then following up cell survival condition.Results Smad7 expressed stable in human bone marrow mesenchymal stem cells with sat-isfactory green fluorescent mark.BMMSC survived in rabbit trabecula with stable green fluorescent and effective ocular press.Con-clusion Smad7 with green fluorescent mark could be inserted into human bone marrow mesenchymal stem cells stably,and has ef-fective results in rabbit model.

BACKGROUND:Posterior lumbar interbody fusion can thoroughly decompress the central canal, which is the common surgical technique for the central type of lumbar disc herniation with intervertebral instability at low lumbar segment. However, due to the regular traction on dural sac and nerve root in the operation, lower limb radicular pain in the early stage is inevitable. OBJECTIVE:To evaluate the effect of local use of gelatin sponge containing prednisolone acetate around the nerve roots after posterior lumbar interbody fusion on lower limb radicular pain. METHED:Sixty-three cases of lumbar disc herniation with degenerative instability were devided into treatment group (n=21) and control group (n=42) based on the type of implants. Gelatin sponge containing prednisolone acetate was implanted into patients in the treatment group after posterior lumbar interbody fusion, while pure gelatin sponge was implanted into patients in the control group. RESULTS AND CONCLUSION:Compared with the control group, radicular pain in the treatment group was significantly relieved within 1 week after surgery. The visual analog scale score and Oswestry disability index score were similar between the two groups. There were three cases of radicular pain recurrence in the control group, but no incision infection and epidural hematoma after surgery in both two groups. In conclusion, local use of gelatin sponge containing prednisolone acetate around the nerve roots can significantly relieve lower limb radicular pain in the early stage after posterior lumbar interbody fusion in lumbar disc herniation, contributing to early rehabilitation exercise and patient satisfaction outcomes.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

Objective To compare the effect of one-site and two-site incision in glaucoma with cataract combined surgery.Methods Forty-two cases (58 eyes) of patients of glaucoma with cataract combined surgery were selected.One-site incision were 22 cases with 30 eyes (one-site incision group),and two-site incision were 20 cases with 28 eyes (two-site incision group).The postoperative intraocular pressure,ultrasound biomicroscope (UBM),filtering bleb and complications were compared in two groups.Results The postoperative visual acuity and intraocular pressure in two groups were better than preoperative [one-site incision group:0.82±0.11 vs.0.18±0.09,(17.32±4.52) mm Hg (1 mm Hg=0.133 kPa) vs.(31.98± 5.18) mm Hg,two-site incision group:0.79 ±0.20 vs.0.20 ±0.03,(16.98 ±4.65) mm Hg vs.(33.16 ±4.61) mm Hg],there were statistically significant differences (P ＜ 0.05),but there was no significant difference between two groups on postoperative (P＞ 0.05).There was no statistically significant difference in visibility of filtering routes under the scleral flap and reflectivity inside the blebs in two groups (P ＞ 0.05).Conclusions Ohe-site and two-site incision in glaucoma with cataract combined surgery has good intraoeular pressure control,can maintain a good filtering bleb function at the same time.The effects are similar between the two operative methods.

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

In this study, a novel tetrapeptide hydrophilic interaction chromatography (HILIC) material was synthesized, and corresponding enrichment method for glycopeptides was developed.The tetrapeptide modified silica gel materials (denoted as Poly-DAPD) were synthesized by atom-transfer radical-polymerization (ATRP) and characterized by N2 adsorption desorption and thermometer, thermal gravimetric analyzer (TGA) and X-ray photoelectron spectrometer (XPS).The characterization results indicated that tetrapeptide had been successfully synthesized on silica gel.Poly-DAPD materials showed high enrichment selectivity toward fetuin glycopeptides under solid-phase extraction (SPE) mode.Comparing with commercialized ZIC-HILIC in glycopeptides enrichment of fetuin digest which mixed with 5 mole ratio of albumin bovine (BSA), the as-prepared materials showed higher selectivity in both aspects of the identified number of glycopeptides and anti-interference property.The SPE results demonstrated that the tetrapeptide-based HILIC materials could be a potential tool in large-scale glycosylation analysis.

Objective Self-made docetaxel-carrying microbubbles were developed and evaluated as a new ultrasound contrast agent for diagnosis and targeted-chemotherapeutic drug delivery.Methods Docetaxel was mixed with an aqueous suspension of phospholipids in vials,which were put into 40℃ water for 30 minutes,after cooling,gas in vials was replaced with perfluoropropane gas,then vials were agitated for 45 s on a shaking device.Properties were studied contained concentration,size,zeta potential,drug entrapment efficiency and drug-loading amount.Drug released with ultrasound and imaging for VX2 carcinoma in rabbits were observed.Results Docetaxel-carrying microbubbles had a concentration of approximately 2.2×109～3.2×109/ml,a mean size of 623.1 am and a zeta potential of -(3.1±0.9)mV.Size distribution was 473.4～706.6 nm.Drug entrapment efficiency was more than 70% and drug-loading amount was(17.5±0.8)%.Fixed amount of ultrasound energy ruptured microbubbles and released docetaxel.Liver imaging of rabbits could be enhanced obviously and persistently,"fast in and out"phenomena was typical of VX2 carcinoma.Conclusions Liposome microbubbles represent a new class of acoustically active drug delivery vehicles.Docetaxel-carrying microbubbles can promote the value of ultrasound in tumor diagnosis,and docetaxel-carrying microbubbles combined with ultrasound have a hope to establish a kind of real-time monitoring,targeted system for tumor therapy.