Dose comparison of mammography with two photographic modes / 中华放射医学与防护杂志

Objective:To compare radiation dose between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM), and explore the correlation of average glandular dose(AGD) with breast density and compression thickness.Methods:The mammographic data of patients with breast diseases who underwent digital breast tomosynthesis (DBT) and the population who underwent full-field digital mammography (FFDM) screening in the First Affiliated Hospital of Kunming Medical University from October 2020 to May 2022 were retrospectively collected. The compression thickness, compression force and AGD were recorded. According to the 2013 ACR BI-RADS MAMMOGRAPHY, the breast gland density was classified into 4 types: a(glandular tissue<25%), b(glandular tissue 25%~50%), c(glandular tissue 50%~75%) and d(glandular tissue >75%), by two senior doctors engaged in breast imaging diagnosis. The relationships between different gland densities, different compression thicknesses and AGD under FFDM and DBT mode were analyzed.Results:In both FFDM and DBT modes, the AGD increased significantly with the increase of breast density( F=861.63, 617.83, 330.33, 451.45, 290.47, P<0.001), and AGD a<AGD b<AGD c<AGD d. For type c and d breasts undergoing FFDM, AGD was lowest when the compression thickness was 31~40 mm. Under the same compression thickness, The AGD DBT was significantly higher than the AGD FFDMin all types (Type a: t=-17.88, -42.19, -29.90, -28.14, -24.95, P<0.001; Type b: t=-49.18, -35.94, -27.25, -28.37, -24.10, P<0.001; Type c: t=-11.78, -32.90, -23.13, -20.51, -18.24, P<0.001; Type d: t=-7.94, -26.24, -17.24, -15.44, -13.81, P<0.001). The difference between two AGDs of Type d with compression thickness of 61~70 mm was the largest, which was 1.07 mGy (95% CI: 0.92~1.22). The AGD was positively correlated with breast density and compression thickness, and the relationship of FFDM was stronger than that of DBT. Conclusions:The AGD is positively correlated with breast density and compression thickness in mammography. Compared with FFDM, DBT can increase AGD, The AGD would increase in DBT than FFDM but be safe. DBT would be beneficial to patients with breast diseases in clinical practice.

Correlation between serum zinc and brain injury in infants with mild gastroenteritis complicated with benign infantile convulsion and febrile convulsion / 中华危重病急救医学

Objective:To investigate the association between serum zinc levels and convulsive brain injury in infants with mild gastroenteritis complicated with benign infantile seizures (BICE) and febrile seizures (FC).Methods:A case-control study method was conducted. 120 children with mild gastroenteritis and convulsion admitted to the First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were enrolled as the research subjects. They were divided into BICE group and FC group according to the type of convulsion. The serum zinc level, the frequency and duration of convulsion, and the occurrence of convulsive brain injury in the two groups were recorded. Multivariate Logistic regression analysis was used to screen the risk factors for convulsive brain injury. The Spearman correlation method was used to analyze the association between serum zinc levels, clinical characteristics of convulsion and convulsive brain injury.Results:A total of 120 children were enrolled, of which 81 developed to BICE and 39 developed to FC during hospitalization. The serum zinc level of children in the FC group was significantly lower than that in the BICE group (μmol/L: 39.24±6.50 vs. 48.65±7.21, P < 0.01). In the BICE group and FC group, the serum zinc level in children with more than 2 convulsions was significantly lower than that in the children with one convulsion (μmol/L: 37.65±6.50 vs. 53.17±7.55 in the BICE group, and 30.27±5.58 vs. 44.16±7.57 in the FC group, both P < 0.01). Serum zinc level in children with convulsion duration ≥5 minutes was significantly lower than that in the children with convulsion duration < 5 minutes (μmol/L: 38.75±6.74 vs. 51.21±7.58 in the BICE group, and 31.08±5.46 vs. 45.19±7.25 in the FC group, both P < 0.01). Moreover, the serum zinc level of children with different convulsion frequency and duration in the FC group was significantly lower than that in the BICE group (all P < 0.01). Among the 120 children, 9 cases of convulsive brain injury occurred, and the incidence rate was 7.50%. The incidence of convulsive brain injury in the BICE group was 1.23% (1/81), which was significantly lower than 20.51% in the FC group (8/39, P < 0.01). The serum zinc level of children with convulsive brain injury was significantly lower than that of children with non-brain injury (μmol/L: 28.50±5.00 vs. 60.22±7.31, P < 0.01), and the number of convulsion was significantly higher than that of non-cerebral injury (≥ 2 convulsions: 100.00% vs. 1.80%, P < 0.01), and the duration of convulsion in children with brain injury was significantly longer than that of non-brain-injured children (convulsion duration ≥5 minutes: 100.00% vs. 11.71%, P < 0.01). Multivariate Logistic regression analysis showed that decreased serum zinc level [odds ratio ( OR) = 2.147, 95% confidence interval (95% CI) was 1.354-3.403], increased number of convulsion ( OR = 3.452, 95% CI was 1.266-9.417), and prolonged convulsion duration ( OR = 3.117, 95% CI was 1.326-7.327) were independent risk factor for convulsive brain injury in children with mild gastroenteritis and convulsion (all P < 0.05). Spearman correlation analysis showed that serum zinc level, convulsion ≥2 times, duration of convulsion ≥5 minutes and convulsion ≥2 times + convulsion duration ≥5 minutes were significantly negatively correlated with the occurrence of convulsive brain injury in FC children ( r values were -0.546, -0.517, -0.522, and -0.528, all P < 0.01). There was no significant correlation between serum zinc level, convulsion ≥2 times, convulsion duration ≥5 minutes and convulsion ≥2 times+convulsion duration ≥5 minutes and convulsive brain injury in BICE children ( r values were -0.281, -0.129, -0.201, -0.243, all P > 0.05). Conclusions:Serum zinc level is related to the characteristics of convulsive symptoms in children with mild gastroenteritis complicated with FC, and has a strong negative correlation with the occurrence of convulsive brain injury. Active targeted intervention and treatment may help reduce the incidence of brain injury in children.

Research Progress on Sensory Feedback Technology in Prostheses / 中国医疗器械杂志

As an important auxiliary tool for amputees to gain abled limb functions, prosthetic limbs with decoration or feedforward control channel could not meet the needs. In order to enable the prosthesis to deliver the information, includes temperature, pressure, position, shape and so on, a variety of sensory feedback methods have been integrated into the prosthesis. According to the position of the feedback terminal on the human body, the perceptual feedback systems include invasive and noninvasive sensory feedback. This review presents the research progress of these perceptual feedback techniques, and summarizes the problems in the application in artificial limbs. Finally, the development trend of sensory feedback technology in prostheses is prospected.

Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis

Background/Aims@#Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues. @*Methods@#A total of 1,815 adults aged ≥ 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses. @*Results@#During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all pnonlinearity ≥ 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p ≤ 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively. @*Conclusions@#Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults.

Nested case-control study on paediatric early warning score and ventilator-associated complications in children with acute respiratory distress syndrome / 中南大学学报(医学版)

To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS).
 Methods: A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University, who underwent mechanical ventilation, were selected. The baseline data, blood gas analysis index, laboratory test index, ventilator parameters, pediatric critical illness score (PCIS) and PEWS in the children were recorded. With reference to ventilatory treatment results, the children with ventilator-associated complications were included in the trial group (n=20), while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study. Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment.
 Results: There were statistically significant differences in multiple organ dysfunction syndrome (MODS), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2), serum creatinine (SCr), albumin (ALB), blood urea nitrogen (BUN), mechanical ventilation time, mean article pressure (MAP), tidal volume (VT), positive end-expiratory pressure (PEEP), PCIS, PEWS between the control group and the experimental group (all P<0.05). Multivariate logistic regression analysis showed that MODS, PaO2/FiO2, PaCO2, VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05).
 Conclusion: The MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS exert effects on complications after mechanical ventilation in children with ARDS. PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.

A survey of correlation between serum 25-hydroxyvitamin D levels and dyslipidemia rlsk among middle-aged individuals in Beijing / 中华内科杂志

Objective To evaluate vitamin D status in middle-aged subjects in Beijing and explore the correlation between serum 25-hydroxyvitamin D[25(OH)D] levels and dyslipidemia.Methods A total of 448 individuals over 40 years old were enrolled in the cross-sectional survey.The general information,blood biochemical and lipid profiles and serum 25 (OH) D levels were collected.The subjects were either divided into two groups (the dyslipidemia group and the non-dyslipidemia group) based on the lipid levels,or four groups according to quartiles of 25 (OH) D levels.The association between 25 (OH) D levels and dyslipidemia risk was analyzed by a logistic regression analysis.Results A total of 234 cases were in dyslipidemia group,which accounted for 52.23％ of the subjects.The serum 25 (OH) D levels were significantly lower in the dyslipidemia group than in the non-dyslipidemia group both in men and in women (all P ＜ 0.05).The median serum 25 (OH) D level in the total subjects was 15.7 (12.2,20.1) μg/L with 91.1％ subjects of serum 25 (OH) D level ＜ 30 μg/L.The proportion of subjects with dyslipidemia (high TC,high TG,high LDL-C,or low HDL-C) increased with the decrease of 25 (OH) D level quartiles (P ＜0.05).After adjustment of confounding factors,the logistic regression analysis showed that subjects in the lowest 25 (OH) D quartile group had 143％ higher risks for dyslipidemia than those in the highest quartile group.Conclusion These findings indicate that 25 (OH) D insufficiency is highly prevalent among middleaged individuals and it may be associated with the risk of dyslipidemia.

Auxiliary reference significance of Blumensaat line for knee joint disease / 中国组织工程研究

BACKGROUND:With the development of sports medicine and research of radiologic imaging techniques, Blumensaat line (the radio-opaque line at the roof of the intercondylar notch) has been paid increasing attention. Blumensaat line is considered as measurement indexes of knee diseases. Taking advantage of the Blumensaat line, many surgeons and radiography physicians are trying to diagnose some knee diseases. OBJECTIVE:According to the knowledge about Blumensaat line in auxiliary diagnosis of knee disease, we hoped that it wil have a wide application in clinic. METHODS:A computer-based online search of CBM, CNKI, Wangfang Database and PubMed between 2000 and 2015 was performed for articles addressing Blumensaat line. We summarized its application as different diagnostic indicators. The key words were patel a alta, Blumensaat line, anterior cruciate ligament (ACL) injuries and ACL reconstruction. Thirty-nine studies were accorded with the inclusion criteria. RESULTS AND CONCLUSION:Blumensaat line represents the tangential y hit part of the roof in the intercondylar fossa. The line can be used for diagnosing ACL injuries and directing ACL restruction. (1) Blumensaat line and patel a alta:Patel a heights can be measured with the use of Blumensaat method, modified Blumensaat method and modified Blumensaat ratio. Modified Blumensaat ratio was found by Japanese researchers in 2014 and it is efficient. (2) Blumensaat line and ACL injuries:Blumensaat angle is formed by Blumensaat line and ACL. If this angle is negative or it is greater than 15°, we can draw a conclusion that the ACL was hurt. (3) Harner’s method can be used for choosing an accurate isometric point and a perfect bone tunnel’s angel in ACL reconstruction.

Analysis of bone minimal density and bone quantitative ultrasound in men with osteoporotic risks / 中华老年医学杂志

Objective To analyze the features of bone minimal density and bone quantitative ultrasound in men with different osteoporotic risk graded by osteoporosis self-assessment tool for Asian (OSTA).Methods After exclude the secondary osteoporosis,724 subjects over 50 years old were involved.The parameters of hight,weight,quantitative ultrasound index (QUI),QUS-T score were examined.The bone density (BMD) were measured by dual-energy X-ray absorptiometry (DXA)in 120 elderly men.All subjects were grouped into low (osteoporotic) risk group,moderate risk group and high risk group by OSTA index.120 subjects measured BMD were grouped into normal bone mass group,osteopenia group and osteoporosis group by WHO standard.The differences and correlation analysis in BMD,QUST,and QUI between these groups were analysed.Results The percents of low risk people,moderate risk people and high risk people were 56.4％ (408 cases),28.2％ (204cases),15.5％ (112 cases),respectively.There were 30.0％ (36 cases) normal bone mass people,58.3％ (70 cases) osteopenia people and 11.7％ (14 cases) osteoporosis people in groups measured BMD.QUS-T score,QUI were gradually decreased in groups of low risk,moderate risk and high risk (-0.56±1.09,-0.88±-1.28,-1.21±1.40; 98.47±19.04,92.62±22.49,87.68±24.43; all P ＜0.05) and had statistical significant differences between low risk and moderate risk,high risk groups,while had no differences between moderate risk and high risk groups.The femoral neck BMD and total BMD were gradually decreased in all the three groups (0.89±0.12,0.85±0.10,0.77± 0.10; 1.0±0.15,0.93 ± 0.11,0.83±0.1; all P＜0.01).Osteoporosis in the three groups were 3.4％ (2 cases),13.0％ (6 cases),37.5％ (6 cases),respectively and osteoporosis percents in moderate risk group and high risk group were higher compared with low risk group (x2=11.77,P＜0.01).QUS-T score and QUI decreased gradually in groups of normal mass,osteopenia and osteoporosis (0.99±0.08,-0.70±1.07,-1.96±0.73; 109.26±17.05,96.15±18.20,72.54±10.00; F=10.47,11.73,all P＜ 0.01).Except for lumbar BMD,a positive linear correlation emerged between OSTA and QUS-T score,QUI,hip BMD(all P＜0.01).The values of R with femoral neck BMD,torch BMD and total hip BMD were 0.45,0.38,0.39,respectively.And the same value with QUS-T score and QUI was 0.23.Conclusions With the decreasing of OSTA index,risk of osteoporosis is increased and QUS-T score,QUI and BMD are decreased gradually.There are positive linear correlation between OSTA index and QUS-T score,QUI,hip BMD.

The interventional study of family cohesion and adaptability by systemic health education in patients with internet addiction disorder / 中国实用护理杂志

Objective A intervention study was conducted with systemic health education in patients with internet addiction disorder (IAD),and evaluate the intervention effect of systemic health education.Methods 120 patients with IAD were collected,and then divided into the observation group andthe control group with 60 cases in each group.On the base of conventional treatment,the observation groupwas given systemic health education,and the control group was given general health education.The differences between the two groups were analyzed.Results The self-evaluated addiction scores,family cohesion scores,ideal adaptability scores,reality adaptability scores in the observation group before the intervention were significantly different from those after the intervention.The addiction scores,family cohesion scores,ideal adaptability scores,reality adaptability scores in the observation group were significantly different from those of the control group after the intervention.The scores of addiction ranged between 86～90,systemic health education had protection effect on IAD,the higher family cohesion scores,the better effect of IAD with systemic health education.When the ideal adaptability scores ＞46,the observation group has approximately two times the positive effect of the control group.When the reality adaptability scores ＞46,the effect of systemic health education in the observation group was better than the control group.Concl~ons Systemic health education has a positive effect on treatment of IAD,and it can improve family cohesion and family adaptability,so that the parent-kid relationship will improve.

Safety and efficacy of the thrombolytic therapy in submissive pulmonary thromboembolism / 中华急诊医学杂志

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P ＞ 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P ＞ 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P ＜0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0％ and 96.2％ respectively,and those of CTPA and lung perfusion scan were 66.7％ and 98％ respectively.The efficiency of TT was significantly superior over AT in this respect (P ＜ 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P ＜ 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

The influencing factors of hepatic steatosis in patients with chronic hepatitis B / 中华传染病杂志

Objective To explore the influencing factors of hepatic steatosis in patients with chronic hepatitis B (CHB),and to provide a theoretical basis of hepatic steatosis prevention and control.Methods A total of 291 hospitalized CHB patients in affiliated Southeast Hospital of Xiamen University were enrolled and divided into two groups:132 CHB patients with hepatic steatosis as the case group and 159 CHB patients without hepatic steatosis as the control group.Conducted a case control study and compared the two groups in terms of body mass index (BMI),waist-to-hip ratio (WHR),fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST),gamma-glutamyl transpeptidase (γ-GT),hepatitis B e antigen (HBeAg),hepatitis B virus DNA (HBV DNA) by descriptive analysis and inferential statistics to analyze the association of these factors with hepatic steatosis in CHB patients.The histological characteristics of the liver were observed.The date analysis used rank sum test and t test.Results FBG,TG,TC,γ-GT,AST of the case group and the control group were (5.11±0.62) mmol/L,(1.81±0.89) mmol/L,(5.29±1.05) mmol/L,(65.04±53.89) U/L,(65.60±71.52) U/L and (4.94±1.89) mmol/L,(1.21±0.79) mmol/L,(4.25±1.58) mmol/L,(146.48±200.39) U/L,(165.35±180.57) U/L,respectively.The case group had significantly higher FBG,TG and TC than the control group (Z=3.607,4.039 and 4.197,respectively,all P＜0.01),while the control group had significantly higher γ-GT and AST (Z=2.672 and 3.020,respectively,both P＜0.01).BMI of the two groups were (26.89±2.78) kg/m2 and (21.17±2.96) kg/m2,respectively,higher in the case group (t=9.711,P＜0.01).WHR in male patients of two groups were 0.93±0.05 and 0.87 ± 0.06,respectively,higher in male patients of the case group (t=4.469,P＜0.01).Positive rate of HBeAg,HBV DNA between the case group and the control group hadn't significantly difference (x2 =0.334,2.960; both P＞0.05).The case group had more severe degree of hepatic steatosis than the control group (Z=-16.145,P＜0.01),while the inflammatory activity and fibrosis were more advanced in the control group (Z=-12.639,P＜0.01; Z=-11.242,P＜0.01,respectively).Conclusions BMI,WHR,FBG,TG and TC appear to be the influencing factors of CHB with hepatic steatosis.The hepatic steatosis in CHB patients is mainly caused by the changes of anthropometric indexes and metabolic factors rather than the effect of HBV.If effective measures are taken,hepatic steatosis in CHB patients can be effectively prevented.

The influence of Satir family therapy on family cohesion and family adaptability in internet addictive disorder / 中华行为医学与脑科学杂志

Objective To investigate the influence of internet addictive disorder(IAD) patient' s family cohesion and adaptability effect with Satir family therapy.Methods According with table of random number,the patients (n =120) with IAD were divided into two groups,test group with the 60 patients and the control group with 60.All of subjects were given Linyi mental health center conventional interventions,test group with satir family therapy and the control group without the therapy.Measurements with the addiction self-test scale and the family cohesion and adaptability scale for five months before and after the intervention.The differences of the two groups were analyzed,and then the correlation analysis were used.Results After the intervention of the test group with Satir family therapy,compared to control group,the IAD score (54.28 ± 4.69) and family ideal cohesion (74.64 ±3.22),real cohension (70.42 ± 3.66),ideal adaptability (54.08 ± 5.78),cohesion dissatisfaction degree (5.07 ±1.64) and adaptability dissatisfaction degree (2.23 ± 0.85) score were all had statistically significant (P ＜ 0.05 or 0.01).IAD score,ideal cohesion,real cohension,ideal adaptability and real adaptability score,before and after the intervention between the control group and the test group had statistically significant (P ＜ 0.05 or 0.01).Conclusion The Satir family therapy can improve family cohesion and the adaptability,and also effectively improve the parent-child relationship.

Expression of RUNX3 mRNA in primary liver cancer and its clinical significance / 中华肝胆外科杂志

Objective To study the expression of RUNX3 mRNA in primary liver cancer (PHC) tissue and its surrounding normal tissue,and its clinical significance.MethodsReverse transcription polymerase chain reaction (RT-PCR) was performed to detect the expression of RUNX3 mRNA in tumor and peritumor tissues in 51 patients with PHC.The relationship between RUNX3 mRNA expression and some clinical pathological parameters was analyzed.ResultsThe relative expression values of RUNX3 mRNA in the tumor tissue and the surrounding normal tissue were 0.4509±0.0963 and 0.9147± 0.0222,respectively.The difference was significant (t=33.6087,P＜0.001).The RUNX3 mRNA expression in tumor tissue correlated with some clinical pathological parameters including low tumor differentiation,positive cancer embolus and intrahepatic invasion and metastasis.The RUNX3 mRNA expression was not correlated with other clinicopathological parameters including gender,cancer diameter,cancer location,hemorrhage and necrosis of cancer,and histotype.ConclusionRUNX3 may be a new tumor suppressor gene for PHC.

Retrospective analysis of heart failure in medical intensive care unit / 中华急诊医学杂志

ObjectiveTo investigate the prevalence and the characteristics of heart failure (HF) in medical intensive care unit (ICU) so as to explore the factors contributing to HF.Methods A retrospective analysis of the data of HF was carried out in 887 HF patients (54. 2％ ) males; age (69.83± 13.57) years oldadmitted to the medical ICU from October 2006 through June 2010. Clinical variables were systematically reviewed for all enrolled patients. HF as either major or additional diagnosis was recorded and the potential risk factors for HF were explored. Left ventricular systolic function was evaluated in HF patients by using ejection fraction (EF) measured by echocardiography. Multivariate Logistic regression analysis was used to identify the independent factors contributing to HF in medical ICU patients. Results Of the 887 patients, 74. 1％ aged 65 years or over, and 53％ had organ dysfunction. The prevalence of HF in medical ICU patients was 22. 8％. Echocardiography measurement revealed that left ventricular systolic function was preserved in 62. 5％ of HF patients with an EF ＞ 50％. Underlying heart diseases were identified in 72. 8％ of the HF patients, and coronary artery disease accounted for the vast majority (52. 5％ ), followed by valvular heart disease ( 17. 8％ ). Structural heart diseases were not identified in 27. 2％ of the HF patients. 4) After the adjustment of age and gender, multivariate regression analysis showed that coronary artery disease ( OR =7. 364, 95％ CI: 4. 979 ～ 10. 890, P ＜0. 01 ), valvular heart disease ( OR =18. 023, 95％ CI: 9. 280 ～ 35. 002, P ＜ 0. 01 ), diabetes mellitus ( OR =2. 154, 95％ CI: 1. 227 ～ 3. 784, P =0. 0076), respiratory failure ( ( OR =1. 527, 95％ CI: 1. 045 ～ 2. 229, P =0. 0285 ), and renal dysfunction ( OR =2. 638, 95％ CI: 1. 621 ～ 4. 294, P =0. 0001 ) were associated with risk increased for HF in medical ICU. ConclusionsHF is highly prevalent in medical ICU and its etiology is multi-factorial. The high rate of HF with preserved EF highlights the importance of enhanced alertness for HF with preserved systolic function in ICU.

Clinical analysis of 165 cases of pancreaticoduodenectomy / 中华胰腺病杂志

Objective To investigate the evolution of pancreaticoduodenectomy and its significance in different time periods. Methods The clinical data of 165 patients from 1988 to 2008 in the department of general surgery, Zhangzhou Municipal Hospital with pancreaticoduodenectomy were retrospectively analyzed.Among 165 cases, simple pancreatoduodenectomy (PD) were performed in 138 cases, pylorus preserving pancreatoduodenectomy (PPPD) were performed in 14 cases, and extended pancreaticoduodenectomy were performed in 13 cases. The methods of pancreato-enteric reconstruction in pancreaticoduodenectomy included 68 cases with binding pancreaticojejunostomy (Peng's type Ⅰ ); 61 cases with pancreaticogastrostomy; 30 cases with traditional pancreaticojejunostomy; and 6 cases with duct-to-mucous pancreaticojejunostomy.Results From 1988 to 1998 (the first 10 years), 50 patients underwent pancreaticoduodenectomy, including 42 cases of PD and 8 cases of PPPD, and no case of extended pancreaticoduodenectomy. The mean amount of blood loss was (620 ± 180)ml, mean amount of blood transfusion was (530 ± 120)ml, the mean operation time was (6.5 ±3.5)h. Anastomotic fistula occurred in 7 cases, the incidence of anastomotic fistula was 14.0%(7/50); and 2 cases died during perioperative period with a mortality rate of 4.0% (2/50). From 1999 to 2008 (the latter 10 years), 115 patients underwent pancreaticoduodenectomy, including 96 cases of PD, 6 cases of PPPD, and 13 cases of extended PD. The mean amount of blood loss was (360 ± 110)ml, mean amount of blood transfusion was (400 ± 6 ) ml, the mean operation time was ( 3.0 ± 2.5 ) h, Anastomotic fistula occurred in 4 cases with an incidence of 3.5% ( 4/115 ); and one case during perioperative period with a mortality rate of 0.61%. The postoperative follow up time was ranging from 6 months to 5 years in 109 patients, the 1, 3,5 year survival rate was 87.2%, 54.1% and 39.5%. Conclusions In the latter 10 years, the amount of blood loss, the operation time, the mortality, and the incidence of pancreatic fistula have decreased significantly compared to the first 10 years.

Outcome and influencing factors of integrated intensive intervention in participants with impaired glucose regulation for two years / 中华内分泌代谢杂志

Objective To investigate the outcome and related risk factors of integrated intensive intervention in participants with impaired glucose regulation (IGR) after two years by the criteria of American Diabetes Association 2003. Methods The subjects who remained to be IGR at the end of first year following 75 g oral glucose tolerance test were randomly assigned to either a routine care control group or to an intensive integrated intervention group. The control group received general dietary and exercise advice at baseline and was followed up. In addition to dietary control and exercise advice, mefformin or acarbose were administrated in the intervention group. The latter group was also advised to take antihypertensive agents, lipid-regulating agents if necessary, as well as aspirin. Results The proportion of patients who fulfilled the assigned goals of blood glucose, blood pressure, body mass index or triglycerides was significantly higher in the intensive group than those in the control group. None in the intensive group developed overt diabetes mellitus, while 8 (9.3%) in the control group did. The proportion of patients who reverted to normal glucose tolerance (NGT) was slightly higher in the intensive group than in the control group (29.5% vs 22.1%, P>0.05). Logistic analysis showed that increase of waist circumference and systolic blood pressure was positively while the improvement of islet β-cell function was negatively correlated with the development of diabetes mellitus. Conclusions The intensive integrated intervention could significantly decrease the conversion rate of IGR to diabetes mellitus, and increase the chance of reversion to NGT. The increase of waist circumference or systolic blood pressure, the deterioration of islet β-ccll function were the influencing factors of the conversion of IGR to diabetes mellitus.

Study on the islet ? cell function and insulin resistance of prediabetic population / 中国糖尿病杂志

Objective To analyze the islet ? cell function and the insulin resistance of different components of impaired glucose regulation(IGR).Methods A total of 463 adults diagnosed as IGR and 200 adults diagnosed as NGT by 75g OGTT,were included for the analysis of the islet beta cell function and insulin resistance.Results In the IFG group,HOMA-IR was significantly higher than in NGT and IGT group(P

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation / 老年心脏病学杂志（英文版）

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P＜0.05). 2)The prevalence of elevated TG,reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P＜0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.

Analysis of sex specific criteria of microalbuminuria in non-diabetic population / 解放军医学杂志

Objective To analyze the sex specific characters of albumin/creatinine ratio(ACR)in non-diabetes population,and to provide reference data for determining the sex-specific criteria of microalbuminuria.Methods A total of 1580 non-diabetes adults who passed the 75g oral glucose tolerance test,were included in present study.All of them answered questionnaire and undertook physical examination.All data were analyzed for the sex difference in ACR,and its causes were looked for.Results In the non-diabetes population,the concentration of urine creatinine was significantly higher in males than that in females(8.1 vs 5.5mmol/L,P