Objective To explore the related risk factors for diabetic retinopathy (DR) in type 2 diabetes. Methods The clinical data of 412 type 2 diabetes patients, diagnosed between 2003 and 2010, were analyzed retrospectively. The diagnosis of DR and proliferative diabetic retinopathy (PDR) was confirmed by ophthalmoloscopy and fundus fluorescein angiography. Glycated hemoglobin A1c, glucose, insulin, and Cpeptide of fasting plasma, and 1, 2 and 3 hours postprandial plasma were measured. According to the abovementioned data, get the fluctuation of glucose, insulin and C-peptide of 1, 2 and 3 hour postprandial plasma. Results The morbidity of DR and PDR increased following the longer disease duration. Age, diabetic duration，body mass index (BMI), hypertension grade, HbA1C, fasting plasma insulin and C-peptide, 2 and 3 hours postprandial plasma glucose, 1 and 2 hours postprandial plasma insulin, 1, 2 and 3 hour postprandial plasma C-peptide, 1, 2 and 3 hours postprandial plasma glucose, insulin and C-peptide fluctuation are different statistically among non-DR group, non-PDR group and PDR group (P＜0.05). 3 hours postprandial plasma glucose and fasting plasma insulin were risk factors of DR (P＜0.05). Conclusions Postprandial plasma glucose and fasting plasma insulin were risk factors of DR. Nevertheless, postprandial insulin, fasting and postprandial C-peptide, postprandial plasma glucose, insulin and C-peptide fluctuation were useful for DR diagnosis.
ObjectiveTo compare the clinical efficacy between moisture healing therapy and multi-source therapeutic apparatus in the management of skin damage. MethodsFrom January 2012 to May 2014, 48 patients with 66 skin damages were divided into observation group (26 patients with 35 damages) and control group (22 patients with 31 damages) based on their informed consent and their own willing to choose the treatment methods. Patients in the observation group were treated with moisture dressings, while those in the control group received exposed treatment through multi-source therapeutic apparatus. Then, we compared the groups in terms of secondary infection rate, pain score, and healing time. ResultsThe secondary infection rate of the observation group was 2.9%, significantly lower than that of the control group (19.4%) (P<0.05). Grade Ⅱ and Ⅲ pain rate of the observation group was significantly lower than that of the control group (P<0.05). The damage healing time of the face, body and limbs was (10.0±1.3), (13.0±1.4), and (15±1.67) days, respectively, in the observation group, which was significantly shorter those in the control group [(16.0±2.6), (21.0±2.5), and (24.0±2.4) days] (P<0.05). ConclusionMoisture healing therapy can improve the eradication of necrotic tissue and dry gangrene, reduce the risk of infection and relieve pain of the patients as well as promote healing process and reduce the formation of scar by promoting regeneration of granulation and epithelium, which is worth clinical popularizing.
ObjectiveTo explore the application of different digestive system management strategies in the perioperative period of thoracolumbar fracture.MethodsThe clinical data of the patients with thoracolumbar fractures and pedicle screw fixation in Affiliated Hospital of Southwest Medical University from January 2016 to January 2018 were retrospectively analyzed. According to different perioperative management strategies of the digestive system, they were divided into two groups. Patients with careful management strategy were included in the observation group, and patients with routine management were included in the control group. The baseline conditions, the abnormalities of digestive tract function at admission and before and after surgery, the postoperative first feeding time, exhaust time, defecation time, the incidence of other postoperative complications except digestive tract complication, length of stay and patient satisfaction were compared between the two groups. At 6 months after surgery, the fracture healing, loosening or fracture of internal plants were compared between the two groups.ResultA total of 121 patients were included in the study, including 67 cases in the observation group and 54 cases in the control group. There was no significant differences in the baseline conditions between the two groups (P>0.05). There were no significant differences between the two groups in the incidences of digestive system dysfunction at admission (P>0.05). The incidences of digestive system dysfunction in the observation group before and after surgery were lower than those in the control group (29.9% vs. 53.7%, P<0.05; 35.8% vs. 61.1%, P<0.05). The first eating time [(3.7±1.1) vs. (6.7±2.6) h], exhaust time [(7.8±2.3) vs. (13.6±4.2) h], defecation time [(26.7±8.1) vs. (40.9±11.2) h] and length of stay [(6.5±2.4) vs. (9.0±2.7) d] in the observation group were shorter than those in the control group (P<0.005), and the patients’ satisfaction was better than that of the control group (8.3±1.1 vs. 7.6±1.3; t=−3.208, P=0.002). There was no statistically significant difference in the incidence of postoperative complications except digestive tract complication, and the fracture healing rate, the incidence of nail-rod breakage at6 months after surgery between the two groups (P>0.05). No internal plant loosening was found in the two groups of patients within 6 months after surgery.ConclusionThe application of the careful digestive system management strategy in patients with thoracolumbar fractures can help reduce the incidence of perioperative gastrointestinal dysfunction, promote the recovery of perioperative gastrointestinal function, shorten the length of hospital stay, and improve patient satisfaction.
ObjectiveTo report a case of port-site metastasis (PSM) after laparoscopic treatment for borderline ovarian tumor (BOT), and to discuss the safety and efficacy of laparoscopic treatment for BOT as well as whether chemotherapy is beneficial for BOT patients. MethodsWe retrospectively studied a case of PSM after laparoscopic treatment of a micropapillary borderline ovarian tumor in August 2013, and reviewed the related literatures in PubMed and Cochrane databases from 1929 to 2014 using "port-site metastasis", "borderline ovarian tumor" , "laparoscopy" , "chemotherapy" as the subject words. ResultsAfter conservative operation and chemotherapy of "carboplatin and taxol" for 8 times, the subcutaneous nodes didn't shrink and the level of CA125 didn't reduce. Though some studies supported that laparoscopy was safe and effective for early-stage ovarian cancer and BOT, there was no high-quality evidence to help quantify the risks and benefits of laparoscopy for the management of early-stage ovarian cancer as routine clinical practice. While early researches suggested adjunctive chemotherapy benefited BOT patients, the subsequent studies indicated opposite results. Therefore, it was still controversial and a lack of high quality evidence existed. However, chemotherapy was recommended for those with high risks. ConclusionLaparotomy is still the standard treatment for ovarian tumor. For patients with low risks and requiring minimally invasive therapy, laparoscopy is an alternative choice, but it should be staged completely. For those with high risks or laparoscopy is difficult to perform, it should be converted to laparotomy as soon as possible. All these procedures should be completed by experienced and skillful gynecologic oncologists. For those with high risks, it is recommended that they should receive chemotherapy and be followed up for a long time.