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Objective To discuss the clinical features and treatment strategy of patients with fulminant type 1 diabetes mellitus (FT1 DM).Methods Clinical and laboratory data of 4 patients diagnosed as FT1 DM in our hospital from January 2008 to February 2016 were retrospectively analyzed.Results 2 females and 2 males aged from 22 to 68 years old were included.They were developed to ketoacidosis rapidly after the appearance of diabetic symptoms in 2-6 days.Some cases complicated with shock,acute renal insufficiency and rhabdomyolysis.One case with late pregnancy had a stillbirth.The plasma glucose level was ranged from 35.6 to 67.8 mmol/L,HbA1c ranged from 5.8 % to 6.7%,fasting C peptide ranged from lower than 0.01 to 0.11 ng/mL and 2 -hour postprandial C peptide ranged from lower than 0.01 to 0.12 ng/mL.No improvement in C peptide levels were followed up for 9 -43 months.After acute phase,intensive insulin therapy was used to control blood glucose.The patients had a great glycaemia excursion and were subjected to hypoglycaemia.Conclusion FTlDM is a special type of diabetes developed rapidly with dangerous prognosis.It is often shown as ketoacidosis and the HbA1 c level is normal or mildly elevated.Serious cases are associated with other organ damage,pregnancy fetal death rate is very high.Because the serious impaired islet B -cell function,FTlDM patients has a great glycaemia excursion,continuous subcutaneous insulin infusion is the first choice to control plasma glycemia.
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ObjectiveTo explore the effect of single glucocorticoid treatment and glucocorticoid joint cyclophosphamide treatment on thyroid-associated ophthalmopathy.MethodsRetrospective analysis of clinical data of 35patients used single glucocorticoid( single medicine group) and 16 patients used glucocorticoids joint cyclophosphamide(joint group) was carried out.ResultsThe effective rate of joint group(93.8％ ) was significantly higher than single drug group (68.6％) ( x2 =3.87,P ＜ 0.05).Simple using glucocorticoid had significant treatment effect at CAS score,prominent eyes degrees,soft tissue inflammation score,but the curative effect was significantly lower than the joint group ( P ＜ 0.05 ).The adverse reaction rate had no significant difference between two groups.ConclusionCompared to single glucocorticoid treatment,the glucocorticoid joint cyclophosphamide treatment had better effect and lower adverse reaction rate,especially suitable for patients who had no effect or low effect on hormone therapy.
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Objective To establish an experimental retinal artery occlusion (RAO) model by means of photochemistry therapy with 532 nm frequency-doubled laser, and to evaluate the feasibility of this method. Methods Ten eyes from ten healthy adult New Zealand rabbits were intravenously injected 5% rose bengal solution, then their monocular retinal artery was irradiated by 532 nm frequency-doubled laser. Both eyes of these rabbits were examined by direct ophthalmoscope and fundus photographic camera on the 1st hour, 24th hour and 3rd day. Meanwhile, the experimental eyes were examined by fundus fluorescein angiography (FFA). These rabbits were killed on the 3rd day, experimental eyes were enucleated, the retina was observed under light microscope. Results There were 9 eyes approved having RAO by direct ophthalmoscope and FFA. Thrombi in retinal arterials could be found by light microscope in all these 9 experimental eyes, and the walls of blood vessel were intact without any obvious necrosis or attenuation. Conclusions RAO animal model can be induced by photochemistry therapy with 532 nm frequency-doubled laser. There are thrombi in the retinal artery without trauma of the artery wall. Photochemistry therapy is an efficient, secure and reproducible method to induce animal model of RAO.
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Different from fasting blood glucose reflecting the basal glucose level of the body, the post-prandial blood glucose gives us the information about the highest glucose level during a day. It has been proved that post-prandial hyperglycemia (PPG) is associated with cardiovascular diseases more closely, which may be caused by oxidative stress, hence the management of PPG is of great meanings. But what is the effect of PPG control on the treat-to-target blood glucose management? This is a question worth discussing.
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<p><b>OBJECTIVE</b>To develop chromosome abnormal karyotype quality control cell and to explore the external quality assessment (EQA) method for chromosome karyotype analysis.</p><p><b>METHODS</b>The chromosome abnormal karyotype quality control cells were prepared by EB virus (EBV) transfection of human B lymphocyte strain establishment and were distributed to participating labs for EQA test of chromosome karyotype analysis project at appointed time. The evaluation results were obtained through 4 grades scoring.</p><p><b>RESULTS</b>Six kinds of chromosome abnormal karyotype quality control cells were initially developed, the karyotypes of which were 46,X, t(Y;5)(q12;q21), 46, XY, 15p +, 46, XX, t(13;18)(q12;q21), 46, X, r(Xp), 46,X,t(Y;Y), 46,XX,t(9;20)(p13;p13) respectively. In the external quality assessment, feedbacks from the participating labs on the sequencing results of the six kinds of quality control cells showed that the wholly overlapping rate were 82.1%, 92.0%, 84.6%, 80.8%, 86.2%, 74.1% and the wholly deviation rate were 10.7%, 8.0%, 11.5%, 19.2%, 13.8%, 18.5%. The overall wholly overlapping rate, partial overlapping rate, partial deviation rate and wholly deviation rate turned out to be 83.2%, 0.6%, 2.5% and 13.7% respectively.</p><p><b>CONCLUSION</b>The misdiagnose rate of chromosome karyotype analysis is rather high and regular external quality assessment is necessary to achieve dynamic information and improve diagnosis quality.</p>