Non-linear association between long-term air pollution exposure and risk of metabolic dysfunction-associated steatotic liver disease

BACKGROUND@#Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD) has become a global epidemic, and air pollution has been identified as a potential risk factor. This study aims to investigate the non-linear relationship between ambient air pollution and MASLD prevalence.@*METHOD@#In this cross-sectional study, participants undergoing health checkups were assessed for three-year average air pollution exposure. MASLD diagnosis required hepatic steatosis with at least 1 out of 5 cardiometabolic criteria. A stepwise approach combining data visualization and regression modeling was used to determine the most appropriate link function between each of the six air pollutants and MASLD. A covariate-adjusted six-pollutant model was constructed accordingly.@*RESULTS@#A total of 131,592 participants were included, with 40.6% met the criteria of MASLD. "Threshold link function," "interaction link function," and "restricted cubic spline (RCS) link functions" best-fitted associations between MASLD and PM2.5, PM10/CO, and O3 /SO2/NO2, respectively. In the six-pollutant model, significant positive associations were observed when pollutant concentrations were over: 34.64 µg/m3 for PM2.5, 57.93 µg/m3 for PM10, 56 µg/m3 for O3, below 643.6 µg/m3 for CO, and within 33 and 48 µg/m3 for NO2. The six-pollutant model using these best-fitted link functions demonstrated superior model fitting compared to exposure-categorized model or linear link function model assuming proportionality of odds.@*CONCLUSION@#Non-linear associations were found between air pollutants and MASLD prevalence. PM2.5, PM10, O3, CO, and NO2 exhibited positive associations with MASLD in specific concentration ranges, highlighting the need to consider non-linear relationships in assessing the impact of air pollution on MASLD.

Investigation of the frequency of kdr mutation of voltage-gated sodium channel in Anopheles sinensis in Yunnan Province / 中国热带医学

@#Abstract: Objective　To understand the kdr (knockdown resistance, kdr) gene mutation of the voltage-gated sodium channel (VGSC) of Anopheles sinensis in Yunnan Province. Methods　From 2018 to 2019, mosquitoes were collected in Luoping County, Suijiang County, Tengchong City, Yingjiang County, Yuanjiang County and Mengla County in Yunnan Province. The collected mosquitoes were morphologically identified as Anopheles sinensis and genomic DNA was extracted by kits. The DNA templates were sequenced after PCR amplification and the sequencing results were identify as Anopheles sinensis by homology alignment in NCBI. After the ⅡS5 and ⅡS6 fragments of the sodium channels in Anopheles sinensis were amplified and sequenced, the sequencing results were multiple aligned by DNAMAN software, and the mutations were analyzed one by one with BioEdit software to determine the kdr allele types and genotypes, and the frequencies were calculated. Results This survey amplified 287 sequences, and the sequence maps showed that 1014 loci had three alleles, including wild type TTG/L (89.20%), mutant type TTT/F (9.76%) and TCG/S (1.04%). Five genotypes: homozygous wildtype L/L (85.02%), homozygous mutant F/F (6.27%) and S/S (0.35%), heterozygous mutant L/F (6.97%) and L/S (1.39%). The wild type allele TTG/L was the main allele in six sampling sites except Suijiang County. The frequency of wild type allele in Tengchong City was the highest (100.00%). That is, no mutation was detected, while the rest of counties occurred different degrees of mutation at 1014 loci. The frequency of mutant allele in Suijiang County was the highest, reaching 55.68%. Luoping County, Mengla County and Suijiang County had two mutant types. Yingjiang County and Yuanjiang County had one heterozygous mutant L/F. Conclusion　Wild type L1014 (TTG/L) is still dominant in most areas of Yunnan Province. The kdr mutation type is mainly L1014F, followed by L1014S, and the mutation frequency is lower than that in central provinces of China.

Serum Ferritin and the Risk of Metabolic Syndrome: A Systematic Review and Dose-Response Meta-Analysis of Cross-sectional Studies / 生物医学与环境科学（英文）

Objective@#This study aims to assess the dose-response relationship between serum ferritin (SF) and metabolic syndrome (MetS) in the two sexes.@*Methods@#We searched for articles on PubMed, the Cochrane Library, EMBASE, and the Web of Science databases that were published from 1950 to 2020. The summary odds ratio ( @*Results@#This study included 14 studies and 74,710 samples. The results of the classical meta-analysis showed that SF was positively associated with MetS ( @*Conclusions@#Our study shows that SF is significantly and positively associated with MetS, and the risk in the male population is higher than that in the female population. This finding also supports the recommendation of using SF as an early warning marker of MetS.

Molluscicidal effect of immersion with 50% wettable powder of niclosamide ethanolamine salt against Oncomelania hupensis on the soil surface and inside the soil layer in winter / 中国血吸虫病防治杂志

Objective To evaluate the molluscicidal effect of 50% wettable powder of niclosamide ethanolamine salt (WPNES) against Oncomelania hupensis on the soil surface and inside the soil layer by immersion method in winter. Methods O. hupensis snails were placed on the soil surface and 2, 5 cm and 10 cm under the soil layer outdoors in winter, and then immersed in 50% WPNES at concentrations of 1 mg/L and 2 mg/L for 1, 3 d and 7 d, while dechlorinated water served as controls. Snail mortality was observed following immersion with 50% WPNES on the soil surface and inside the soil layer. Results Following immersion with 50% WPNES at concentrations of 2 mg/L and 1 mg/L outdoors in winter, the 3-day corrected snail mortality rates were 98.0% and 76.0% on the soil surface, and the 7-day corrected snail mortality rate was both 100.0%. Following immersion with 50% WPNES at concentrations of 2 mg/L and 1 mg/L outdoors in winter, the 7-day corrected snail mortality rates were 95.5% and 85.6% 2 cm below the soil layer, 66.0% and 6.4% 5 cm below the soil layer. However, the 7-day snail mortality rate swere comparable between the 50% WPNES treatment group (at 2 mg/L and 1 mg/L) and controls 10 cm below the soil layer (both P > 0.05). Conclusion Immersion of 50% WPNES at a concentration of 2 mg/L for 7 days presents a high molluscicidal efficacy against O. hupensis on the soil surface and 5 cm within the soil layers in winter.

An Experimental Study Observing the Transient Expansion of Right Heart During Contrast-enhanced Echocardiography Post Bolus Injection of SonoVueTM / 中国循环杂志

Objectives: To observe the phenomenon of transient expansion of right heart during contrast-enhanced ultrasound (CEUS) by SonoVue?ultrasound contrast agent (UCA) in Chinese experimental mini-pig , and to explore the possible causes of this phenomenon. Methods: 24 healthy Chinese experimental mini-pigs were randomly divided into 3 groups according to the dose of injected contrast agent: 2 ml group (n=8), 1 ml group (n=8) and 0.5 ml group (n=8). Cardiac structure and function at baseline and during contrast procedure were determined by contrast-enhanced echocardiography. Pigs in each group received bolus contrast agent injection followed by 5ml saline flush with baseline concentration, 2, 4 and 6-fold serial dilutions, respectively. When the right heart enlargement appeared, stop the injection and next injection followed after the right heart returned its original size. The study protocols discontinued at the time when the right heart enlargement did not appear post injection. Results: In 2 ml group, the number of right heart enlargement with different injection concentrations was 7, 6, 4, 3, respectively; in 1 ml group, the number of right heart enlargement with different injection concentrations was 6, 5, 3, 1; in 0.5 ml group, the number of right heart enlargement with different injection concentrations was 5, 5, 2, and 0, respectively. Incidence of right heart enlargement decreased in proportion with lower contrast agent amount, and lower contrast concentration(P<0.001). The right heart enlargement phenomenon occurred at about (26±15) s after the injection and lasted for about (47±21) s. Conclusions:Transient expansion of right heart phenomenon is common by bolus injection of contrast agent during CEUS in the Chinese mini-pigs, which may be related to the injected concentration and dosage of the contrast agent, as well as the injection mode and animal species.

Effects of Tongmai Decoction on PLT, PAgR, D-D and TEG in elderly patients with intertrochanteric fracture in perioperative period / 中成药

AIM To investigate the effects of Tongmai Decoction on PLT,PAgR,D-D and TEG in elderly patients with intertrochanteric fracture in perioperative period.METHODS One hundred and fifteen recruited patient subjects were randomly divided into two groups.Fifty-seven cases in the control group were treated with Low Molecular Weight Heparins Calcium Injection,and 58 cases in the treatment group were intervened with both Low Molecular Weight Heparins Calcium Injection and Tongmai Decoction.The preoperative and postoperative dynamic changes of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA),and adverse drug reactions in the two groups were detected 1,3,7 d prior to,and after the treatments,respectively.RESULTS No statistically significant difference between the two groups' PLT,PAgR and D-D contents were observed before the operation (P ＞ 0.05).The levels of PLT,PAgR and D-D in both groups increased one day after the operation with similar change degree (P ＞ 0.05).On the 3rd and 7th days after the surgery,the PLT,PAgR and D-D contents in the two groups began to drop,and the decline in the treatment group was more significant (P ＜ 0.05).No significantly different TEG (R value,K value,alpha angle,MA) between the two groups was noticed before the operation (P ＞ 0.05).Patients of both groups displayed their R value,K value decrease,and alpha Angle,MA increase (P ＞ 0.05) one day after the operation with similar change degree.Their R value,K value increased,and alpha angle,MA decreased,and as well as the statistically significant change between the two groups were discovered on the 3rd and 7th postoperative days (P ＜ 0.05).CONCLUSION Tongmai Decoction can effectively reduce blood hypercoagulability and prevent deep venous thrombosis in terms of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA) improvement in elderly patients with intertrochanteric fracture in perioperative period.

Risk factors in progression from endometriosis to ovarian cancer: a cohort study based on medical insurance data / 부인종양

OBJECTIVE: The objective was to identify risk factors that were associated with the progression from endometriosis to ovarian cancer based on medical insurance data. METHODS: The study was performed on a dataset obtained from the National Health Insurance Research Database, which covered all the inpatient claim data from 2000 to 2013 in Taiwan. The International Classification of Diseases (ICD) code 617 was used to screen the dataset for the patients who were admitted to hospital due to endometriosis. They were then tracked for subsequent diagnosis of ovarian cancer, and available biological, socioeconomic and clinical information was also collected. Univariate and multivariate analyses were then performed based on the Cox regression model to identify risk factors. C-index was calculated and cross validated. RESULTS: A total of 229,617 patients who were admitted to hospital due to endometriosis from 2000 to 2013 were included in the study, out of whom 1,473 developed ovarian cancer by the end of 2013. A variety of factors, including age, residence, hospital stratification, premium range, and various comorbidities had significant impact on the progression (p < 0.05). Among them, age, urbanization of residence, hospital stratification, premium range, post-endometriosis childbearing, pelvic inflammation, and depression all had independent, significant impact (p < 0.05). The validated C-index was 0.69. CONCLUSION: For a woman diagnosed with endometriosis, increased age, residing in a highly urbanized area, low or high income, depression, pelvic inflammation, and absence of childbearing post-endometriosis all put her at high-risk to develop ovarian cancer. The findings may be of help to gynecologists to identify high-risk patients.

The effect of preoperative body composition and nutritional status measurements on clinical outcomes for patients with gastrointestinal cancer / 肠外与肠内营养

Malnutrition is a common complication in patients with gastrointestinal tract cancer and has adverse impact on clinical outcomes Thus preoperative comprehensive evaluation is needed to ensure perioperative safety.There are many tools to evaluate nutritional status.However,validated methods for identification of nutritional status in this group of patients is still absent,as well as the pathway for detecting cancer related to malnutrition.This review focuses on the studies related to evaluating the prognostic implications of nutrition related indicators in patients with gastrointestinal tract cancer to provide clinician reference of making preoperative nutritional status assessment.

Coronary Stent Infection Presented as Recurrent Stent Thrombosis

Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis.

Iatrogenic Subclavian Artery Perforation Rescued by Operator-Modified Graft Stent

Subclavian artery (SCA) perforation is a rare complication while performing SCA intervention. In our present report, a 73-year-old female, with stenosis of the left SCA and situs inversus, presented with exercise-induced left arm weakness. The SCA stenosis was treated with direct stenting with a balloon-expansible Express LD 10×25 mm stent. However, it caused iatrogenic SCA perforation and hemothorax. The perforation was sealed by endovascular repair with operator-modified Endurant II graft stent, which complicated with occlusion of left common carotid artery. And, the carotid artery was rescued by another stent. The graft stent, which was originally designed for abdominal aortic aneurysm, can be modified to suitable length and take as a rescue stent of large vessel with iatrogenic perforation. Due to strong radial force of graft stent, preservation of large side branches should been watched out.

Do people from Taiwan have higher heavy metal levels than those from Western countries?

<p><b>INTRODUCTION</b>This study investigated whether heavy metal levels were higher in people from Taiwan as compared to those from Western countries.</p><p><b>METHODS</b>We measured the level of heavy metals (lead, mercury, arsenic and cadmium) in the blood of 40 apparently healthy adults. Since mercury does not respond to ethylenediaminetetraacetic acid (EDTA) infusion, only urine lead, arsenic and cadmium levels were determined by applying the body burden concept after calcium disodium EDTA infusion. These three heavy metals were extracted from daily urine samples for three consecutive days.</p><p><b>RESULTS</b>The mean blood lead, mercury and cadmium levels of the Taiwanese individuals (24.46 ± 9.69 µg/L, 9.64 ± 6.98 µg/L and 0.73 ± 0.27 µg/L, respectively) were greater than those of the Americans. The Taiwanese also had greater blood mercury and cadmium levels than the Germans. The first-day urine lead, arsenic and cadmium levels were 77.9%, 33.1% and 62.4%, respectively, of the total lead, arsenic and cadmium excretion during the three days. This indicates that the first-day urine lead and cadmium excretion represented most (> 60%) of the lead and cadmium excretion in those three days.</p><p><b>CONCLUSION</b>This study demonstrated that the Taiwanese population has higher blood mercury and cadmium levels than Western populations. To study the urine lead and cadmium body burden of patients, detection of first-day, rather than three-day, urine lead and cadmium levels can be done, as the former yields results that are fairly representative, and is more time- and cost-effective.</p>

Bupropion for Interferon-Alpha-Induced Depression in Patients with Hepatitis C Viral Infection: An Open-Label Study

Interferon (IFN)-alpha therapy for chronic hepatitis C virus (HCV) infection is frequently associated with major depressive episodes. Bupropion, a commonly used antidepressant agent, has recently found to have strong anti-inflammatory effects in animal models. Despite of the theoretical relevancy, the antidepressant effect of bupropion in IFN-alpha-induced depression has never been studied. Ten HCV patients with IFN-alpha-induced depression were recruited to receive 8-week bupropion treatment and were assessed every 2 weeks for depressive symptoms by the Hamilton rating scale for depression (HAMD) and somatic symptoms by the Neurotoxicity Rating Scale (NRS). Four of the 10 patients met the criteria for remission (total HAMD scores< or =7), and 5 patients met the criteria for response (at least 50% reduction in total HAMD scores). In addition, 5 patients had 50% decreases in NRS for neuropsychiatric symptoms. This preliminary open-label study suggests that bupropion is effective in treating IFN-alpha-induced depressive and somatic symptoms.

Heat-related illness in Jinshan District of Shanghai:A retrospective analysis of 70 patients / 世界急诊医学杂志（英文）

@#BACKGROUND: This study aimed to investigate the epidemiological and clinical characteristics of patients with heat-related il ness, and guide the prevention, diagnosis and treatment of heat-related il ness. METHODS: From June 2013 to August 2013, seventy patients with heat-related illness were treated at Jinshan Hospital of Fudan University, and their epidemiological characteristics, laboratory results, treatment and prognosis were retrospectively analyzed. RESULTS: In the 70 patients, 18 patients suffered from heat stroke and 52 patients from non-heat stroke. When the environmnent temperature was above 35 °C, the body temperature of the patients began to increase markedly. The patients with heat stroke were significantly older than those with non-heat stroke (P<0.05). The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in the patients with heat stroke were higher than those in the patients with non-heat stroke (P<0.05). Blood lactate dehydrogenase and blood creatine kinase were positively correlated with body temperature (r=0.801). CONCLUSION: When the environmental temperature goes above 35 °C, heat-related illness should be prevented, especially in the elderly. The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in patients with heat stroke are higher than those in patients with non-heat stroke. Blood lactate dehydrogenase and blood creatine kinase are positively correlated with body temperature, but their relationship with heat-related illness awaits further study.

Research and application of absorbable screw in orthopedics: a clinical review comparing PDLLA screw with metal screw in patients with simple medial malleolus fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To observe the therapeutic effect of absorbable screw in medial malleolus fracture and discuss its clinical application in orthopedics.</p><p><b>METHODS</b>A total of 129 patients with simple medial malleolus fracture were studied. Among them, 64 patients were treated with poly-D, L-lactic acid (PDLLA) absorbable screws, while the others were treated with metal screws. All the patients were followed up for 12-20 months (averaged 18.4 months) and the therapeutic effect was evaluated according to the American Orthopaedic Foot and Ankle Society clinical rating systems.</p><p><b>RESULTS</b>In absorbable screw group, we obtained excellent and good results in 62 cases (96.88%); in steel screw group, 61 cases (93.85%) achieved excellent and good results. There was no significant difference between the two groups.</p><p><b>CONCLUSION</b>In the treatment of malleolus fracture, absorbable screw can achieve the same result compared with metal screw fixation. Absorbable screw is preferred due to its advantages of safety, cleanliness and avoiding the removal procedure associated with metallic implants.</p>

Left atrial minimum volume by real-time three-dimensional echocardiography as an indicator of diastolic dysfunction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Left atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).</p><p><b>METHODS</b>Sixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.</p><p><b>RESULTS</b>Significant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.</p><p><b>CONCLUSIONS</b>RT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.</p>

Assessment of the morphology and mechanical function of the left atrial appendage by real-time three-dimensional transesophageal echocardiography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The left atrial appendage (LAA) is an important source of thrombus formation. We investigated the feasibility of the recently developed real-time three-dimensional transesophageal echocardiography (RT3D-TEE) method in assessment of the morphology and function of the LAA.</p><p><b>METHODS</b>Ninety-six consecutive patients (58 males with a mean age of (43.4 ± 12.5) years) who were referred for 2-dimensional (2D) transesophageal echocardiography (TEE) underwent additional RT3D-TEE. LAA morphology was visualized in multiple views. Orifice size, depth, volumes and ejection fraction (EF) of the LAA, were measured.</p><p><b>RESULTS</b>All the patients underwent RT3D-TEE examination without complications. Ninety-two patients (95.8%) had adequate images for visualization and quantitative analysis of the LAA. The LAA exhibited great variability with respect to relative dimensions and morphology. LAA orifice area was (3.8 ± 1.2) cm(2) with a diameter of (2.4 ± 0.9) cm × (1.4 ± 0.6) cm. The mean depth of the LAA was (2.9 ± 0.7) cm. End-diastolic volume (EDV-LAA), end-systolic volume (ESV-LAA) and EF of the LAA were (6.2 ± 3.7) ml, (4.1 ± 2.8) ml, and 0.35 ± 0.16, respectively. EDV-LAA, ESV-LAA and the orifice area of the LAA in patients with atrial fibrillation (AF) were larger than those without AF, whereas the EF was smaller in the AF patients.</p><p><b>CONCLUSIONS</b>Defining LAA morphology and quantitative analysis of the size and function of the LAA with superior quality and resolution of images using RT3D-TEE is feasible. This technique may be an ideal tool for guidance of the LAA occlusion procedure. Determination of LAA volumes and volume-derived EF by RT3D-TEE provides new insights into the analysis of LAA function.</p>

Antiulcer effects and mechanism study of Veronicastrum axillare on ethanol induced gastric ulcer rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the antiulcer effects and the mechanism of Veronicastrum axillare (Sieb. et Zucc) Yamazaki (VAY) on ethanol induced gastric ulcer rats.</p><p><b>METHODS</b>Totally 48 healthy SD rats were randomly divided into 6 groups, i.e., the normal group, the model group, the ranitidine group, the high dose VAY group, the medium dose VAY group, and the low dose VAY group, 8 in each group. Rats in the normal group and the model group were administered with normal saline respectively. Rats in the ranitidine group were administered with 0.18% ranitidine suspension (at the daily dose of 0.027 g/kg) by gastrogavage. Those in the high dose VAY group, the medium dose VAY group, and the low dose VAY group were administered with VAY at the daily dose of 2.8 g/kg, 1.4 g/kg, and 0.7 g/kg by gastrogavage, once daily for 14 consecutive days. The gastric ulcer model was established using absolute ethanol after the last gastrogavage. The ulcer index and the ulcer inhibitory rate were compared. The concentrations of malonyldialdehyde (MDA), nitric oxide (NO), epidermal growth factor (EGF), and the activity of superoxide dismutase (SOD) in the serum and the homogenate of the gastric mucosa tissue were detected.</p><p><b>RESULTS</b>Compared with the model group, the gastric ulcer index in the rest groups obviously decreased (P < 0.01). The ulcer index was dose-dependent with VAY (P < 0.01), with the highest gastric ulcer index shown in the high dose VAY group (P < 0.01). Compared with the normal group, the concentrations of MDA and NO significantly increased in the serum and the gastric mucosa tissue, the activity of SOD and the EGF content in the gastric mucosa tissue of rats in the model group significantly decreased (P < 0.01). Compared with the model group, the MDA concentrations in the serum and the gastric mucosa tissue decreased, the serum NO content increased, the NO content in the gastric mucosa tissue decreased, the serum SOD activity increased, the EGF content in the gastric mucosa tissue increased in the rest groups, all showing statistical difference (P < 0.05, P < 0.01).</p><p><b>CONCLUSIONS</b>The water extract of VAY had significant effects on ethanol induced gastric ulcer. Its mechanisms might lie in reducing the generation of free radicals, promoting the oxygen free radical clearance, restraining lipid peroxidation, regulating and controlling the in vivo contents of NO and EGF.</p>

Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease

OBJECTIVE: To determine whether there is an association between serum ischemia-modified albumin and the risk factor profile in type 2 diabetic patients with peripheral arterial disease and to identify the risk markers for peripheral arterial disease. METHODS: Participants included 290 patients (35.2 percent women) with type 2 diabetes. The ankle-brachial pressure index was measured using a standard protocol, and peripheral arterial disease was defined as an ankle-brachial index <0.90 or >1.3. The basal ischemia-modified albumin levels and clinical parameters were measured and analyzed. The risk factors for peripheral arterial disease were examined by multiple logistic analyses. RESULTS: Age, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, urine albumin, homocysteine, and ischemia-modified albumin were significantly higher in patients with peripheral arterial disease than in disease-free patients (p<0.05), while ankle-brachial index was lower in the former group (p<0.05). Ischemia-modified albumin was positively associated with HbA1c and homocysteine levels (r = 0.220, p = 0.030; r = 0.446, p = 0.044, respectively), while no correlation was found with ankle-brachial index. Multiple logistic analyses indicated that HbA1c, systolic blood pressure, homocysteine and ischemia-modified albumin were independent risk factors for peripheral arterial disease in the diabetic subjects. CONCLUSION: The baseline ischemia-modified albumin levels were significantly higher and positively associated with HbA1c and homocysteine levels in type 2 diabetic patients with peripheral arterial disease. Ischemia-modified albumin was a risk marker for peripheral arterial disease. Taken together, these results might be helpful for monitoring diabetic peripheral arterial disease.

Immediate effects of acupuncture on gait patterns in patients with knee osteoarthritis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acupuncture has been shown to be effective in pain relief and anesthesia, and has been suggested for treating various kinds of functional disabilities in traditional Chinese medicine, including knee osteoarthritis (OA). The study aimed to investigate the immediate effects of acupuncture on gait patterns in patients with knee OA.</p><p><b>METHODS</b>Twenty patients with bilateral medial knee OA were assigned evenly and randomly to a sham group and an experimental group. During the experiment, the experimental group underwent a 30-minute formula electro-acupuncture treatment while the sham group received a sham treatment. Before and after treatment, each subject was evaluated for their knee pain using visual analog scales (VAS) and then their performance of level walking using gait analysis. For all the obtained variables, the independent t-test was used for between-group comparisons, while paired t-test was used to investigate the before and after changes.</p><p><b>RESULTS</b>All the measured data before acupuncture treatment between the groups were not significantly different. The VAS scores were decreased significantly after acupuncture in both groups, and the mean change of the VAS values of the experiment group was 2 times greater than that of the sham group. After formula acupuncture stimulation, while no significant changes were found in all the gait variables in the sham group, the experimental group had significant increases in the gait speed, step length, as well as in several components of the joint angles and moments.</p><p><b>CONCLUSIONS</b>The results of the study suggest that significantly improved gait performance in the experimental group may be associated with pain relief after treatment, but the relatively small decrease of pain in the sham group was not enough to induce significant improvements in gait patterns. Gait analysis combined with the VAS can be useful for the evaluation of the effect of acupuncture treatment for patients with neuromusculoskeletal diseases and movement disorder.</p>

Clinical efficacy of artificial skin combined with vacuum sealing drainage in treating large-area skin defects / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects.</p><p><b>METHODS</b>Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents (7 with open fractures), 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers.</p><p><b>RESULTS</b>All skin grafts in 16 cases survived after being controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply.</p><p><b>CONCLUSION</b>Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dressing treatment and worth wide application in clinic.</p>