Objective To analyze the causes of poor compliance of elderly patients with diabetes mellitus , and put forward corresponding countermeasures to control blood glucose level and delay the occurrence of complications .Methods A total of 113 elderly patients with type 2 diabetes mellitus aged 60 years and over were recruited in endocrinology department of our hospital.The self-made questionnaire was used to investigate the compliance and the factors that affected the compliance.Results There were 48 patients (42.48%) with good compliance and 65 patients (57.52%) with poor compliance.Univariate analysis showed that the level of education, monthly income, drug types, understanding of diabetes-related knowledge and whether the elderly living alone affected compliance ( P<0.05 ) .Multivariate Logistic regression analysis showed that patients with low education level, poor monthly income, medication types and living alone were the main factors that influence the compliance of elderly patients with diabetes mellitus (P<0.05).And the level of education, monthly income level and the compliance of diabetic medication was positively correlated, medication types and living alone and diabetes compliance were negatively correlated (P<0.05).Conclusion The low level of education, poor monthly income, medication types and living alone are the main factors that affect the compliance of elderly patients with diabetes.The social and family support can effectively improve the compliance of elder patients with diabetes.

Objective To analyze the effects of different age and gender on the efficacy and pharmacokinetics of the target controlled infusion of atracurium besylate on liver dysfunction.Methods 160 case of patients with liver dysfunction and undergoing elective general anesthesia operation were divided into four groups according to their age and gender, 40 cases in each group:group A (age≥65 years old, male), group B (age≥65 years old, female), group C (age<65 years old, male), group D (age<65 years old, female).The patients received one-time double dose ED95 atracurium besylate, pharmacodynamic indexes and pharmacokinetic parameters were compared.Results The four groups of patients with block onset time, block maintenance time, clinical duration of T25%, in vivo role time T95%, muscle relaxation recovery index were compared, the difference was not statistically significant.The preoperative and postoperative 24h, four groups of patients with liver function ( alanine aminotransferase, aspartate aminotransferase, albumin, bilirubin) and renal function ( creatinine, urea nitrogen) were compared, the difference was not statistically significant.There was no significant difference between the four groups in the plasma concentrations of the substance to be measured, the peak time, the area under the curve and the elimination half lives.Conclusion For the patients with liver dysfunction, the target controlled infusion of atracurium besylate in general anesthesia operation, gender and age were not considered.

Objective To study cervical human papillomavirus (HPV) infection and genotype distribution characteristics in patients with vaginal disease.Methods The PCR dot blot was used to carry out HPV detection of cervical exfoliated cells in 816 women with cervical lesions in the hospital, and 23 kinds of HPV genotypes were identified.Results Among the 816 cases receiving HPV type detection, HPV of 532 cases (65.20%) was positive, including 371 cases (69.74%) with low-risk HPV (HR-HPV) infection, 161 cases (30.26%) with low-risk HPV infection (LR-HPV) (P<0.05).The HPV infection rate below 45 years old was relatively higher.The HPV infection rate in patients with cervical cancer (97.10%) was higher than that in patients with cervical intraepithelial neoplasia (CIN) II -III (80.54%), patients with CIN Ⅰ(41.55%) and patients with cervicitis (17.20%) (P<0.05).The top five types of HPV infection were HPV16, 58, 18, 11 and 56 type, respectively.The single infection rate (79.70%) was higher than multiple infection rate (20.30%) (P<0.05); HR-HPV infection was the main infection in single infection, and double infection was the main infection in multiple infection.Conclusion Below 45 years old women are the high-risk groups of HPV infection.16, 58, 18, 11 and 56 are the main types of HPV infection.The infection rates of patients with cervical cancer and precancerous lesions are relatively higher.Paying attention to the screening of HPV infection has positive significance in the prevention and treatment of cervical cancer.

Objective To investigate the effect of coenzyme Q10 combined with Shenmai injection on serum enzyme in the treatment of brain hypoxic injury after asphyxia by meconium in newborn.Methods 64 cases with brain hypoxic injury after asphyxia by meconium from Medical University of Tianjin Jinghai Clinical College were selected and randomly divided into 2 groups, 32 cases in each group.The control group received maintained ventilation and circulation function and routine drug therapy adequate, and the experiment group received more with coenzyme Q10 combined with Shenmai injection for 7 days.Serum enzymes and myocardial injury markers, oxidative stress and inflammation related factors and the clinical effect and complications were compared after the treatment.Results Compared with before treatment, levels of CK-MB, AST, LDH, CK and α-HBDH decreased in two groups after the treatment, levels of CT-1, CTnI and Mb decreased, levels of SOD and MDA decreased, contents of GSH-Px, APN, IGF-1 increased, contents of Leptin decreased (P<0.05).Compared with the control group, the levels of CK-MB, AST, LDH, CK and α-HBDH in the experiment group were lower, levels of CT-1, CTnI and Mb were lower, levels of SOD and MDA were lower, contents of GSH-Px, APN, IGF-1 were higher, contents of Leptin were lower(P<0.05).The clinical curative effect rate of control group(65.63%) was lower than the experiment group (87.50%)(P<0.05).Conclusion Coenzyme Q10 combined with Shenmai injection in the treatment of brain hypoxic injury after asphyxia by meconium in newborn is curative effective with high safety, and it can reduce serum enzyme and myocardial injury.

Objective To study the curative effect and prognosis of malignant pleural effusion treated by staphylotoxoid injection and its effect on immune system.Methods A total of 65 patients with malignant pleural effusion from August 2012 to 2014 November in Lishui City Central Hospital were selected,and divided into observation group(n=33) and control group (n=32) in terms of different treating methods,two groups were implemented with thoracic closed drainage to drain pleural effusion up.The observation group was completely drained after 2 500 U intrapleural injection of staphylotoxoid injection,the control group to the traditonal method of bleomycin 1 mg/kg injection.The efficacy,prognosis and immune system were compared.Results The effective of rate of the observation group was significantly higher(72.7%) than the control group(43.8%);the adverse reaction rate of observation group was lower and its median survival time was longer;white blood cells counts of observation group was significantly more than control group ( P<0.05).Conclusion Compared with the traditional method of bleomycin intrapleural injection treatment of malignant pleural effusion, staphylotoxoid injection can be more effective control of the disease , reduce adverse reactions, and can improve their immunity and improve the body tolerance .

Objective To explore the Efficacy and safety of intravenous thrombolysis with different doses of rt-PA in the treatment of acute anterior circulation cerebral infarction with atrial fibrillation.Methods Retrospective analysis of 61 cases of patients with anterior circulation of cerebral infarction with atrial fibrillation from October 2009 to October 2014 in the First Affiliated Hospital of Xiamen University, the incidence within 4.5 hours of intravenous thrombolysis,and divided into two groups by rt-PA usage,19 cases in adequate group,received 0.9 mg/kg rt-PA intravenous thrombolytic therapy,42 cases in low dose group, received 0.6 mg/kg rt-PA intravenous thrombolysis.Before and after thrombolysis 1,7 and 30 days,NIHSS score was measured, the indexes of coagulation were observed at before thrombolysis and 1,7 days after thrombolysis,,CT scans were performed at 1, 7, and 14 days after thrombolysis,and Rankin (MRS) scores were compared at 90 days after thrombolysis.Results NIHSS 1,7,30 days scores of 2 groups were significantly decreased after thrombolysis(P<0.05),there was no statistically significant at at each time point after thrombolysis.Plasma prothrombin time increased significantly at 1 day and 7 days after thrombolysis,fibrinogen was significantly lower,compared with the low dose group, the difference was significant (P<0.05).There was no significant difference between the two groups in clinical outcome and mortality.The rate of mucosal bleeding in low dose group was lower than that in adequate group (P<0.05).Conclusion Low-dose rt-PA group intravenous thrombolysis with anterior circulation of atrial fibrillation is more safe,can reduce the risk of bleeding, reduce neurological deficits and improve the quality of life of patients.

Objective To explore the effect of Buyanghuanwu decoction on blood glucose control and renal function protection in patients with early diabetic nephropathy.Methods 170 cases of patients with early diabetic nephropathy from May 2012 to June 2013 in wenzhou hospital of integrated traditional chinese and western medicine were selected,all patients were divided into observation group and control group,the control group was given routine treatment,the observation group treatment with Buyanghuanwu decoction based on control group .The clinical effective rate was compared between the two groups after treatment,the levels of blood lipids, 24 h urine microalbumin and hemorheology were compared between the two groups before and after treatment.Results After treatment, the total effective rate of the observation group was 90.59%,which was significantly higher than the control group 76.47% (P<0.05).Compared with before treatment,the levels of triglycerides and cholesterol decreased in two groups,high-density lipoprotein levels increased,24 h urine microalbumin decreased,whole blood viscosity,whole blood viscosity trimming and fibrinogen decreased,the difference was statistically significant(P<0.05).Compared with the control group,the levels of triglycerides and cholesterol in observation group was lower,high-density lipoprotein was higher,24 h urine microalbumin was lower,whole blood viscosity,whole blood viscosity trimming and fibrinogen were lower,the difference was statistically significant(P<0.05).Conclusion Buyanghuanwu decoction in the treatment of diabetic nephropathy is effective in treating diabetic nephropathy,it can effectively reduce blood lipids and blood viscosity,significantly reduce urinary protein excretion and protect the kidneys.

Objective To investigate the effect of compound Shuanghua tablets combined with western medicine on serum secretions TNF-α,IL-6 and IL-10 of patients with secretory otitis media.Methods A total of 200 cases(244 ears) with acute secretory otitis media in Zhejiang Xinchang People’s Hospital from August 2014 to June 2016 were randomly divided into two groups.The control group with 100 case (120ears) were only given conventional western medicine therapy,and the treatment group with 100 case (124ears) were given compound Shuanghua tablets on the basis of the control group.Peripheral venous blood and middle ear effusion of each patient was collected before and after treatment ,and to detect the level of TNF-α, IL-6 and IL-10 by cytometric bead array,meanwhile the curative effect of the two groups were compared.Results The curative effect of the treatment group( 97.58%) was higher than the control group(85.00%),the difference were statistically significant(P<0.05).There were no significant difference on serum TNF-α,IL-6 and IL-10 between the two groups before and after treatment.The secretions TNF-α,IL-6 and IL-10 of the two groups after treatment were significantly reducing,and the treatment group were lower than the control group,the difference were statistically significant (P<0.05).Conclusion Compound Shuanghua tablets combined with western medicine in traetment SOM is effective distinctly,and can reduce secretions TNF-α,IL-6 and IL-10 effectly.

Objective To investigate the effects of serum isoenzyme and inflammatory factors by large doses of methyl prednisolone shocktherapy in the treatment of patients with acute hundred withered grass poisoned.Methods 46 cases of patients with acute hundred withered grass poisoned from June 2014 to October 2015 in ningbo medical center lihuili hospital were collected and randomly divided into two groups,23 cases in each group.On the base of the conventional treatment,patients in the control group were treated by blood perfusion therapy,patients in the experiment group were treated with large dose of methyl prednisolone shock therapy on the base of the control group,tested and compared the levels of serum enzyme and inflammatory factors before and after treatment,observed the clinical symptoms,clinical efficacy and adverse reactions.Results Compared with before treatment,the levels of IL-1,IL-10,TNF-αand CRP in two groups were decreased (P<0.05),levels of CK, CK-MB, TGF-β1 and HIF-1αdecreased (P<0.05);Compared with the control group,the levels of IL-1,IL-10, TNF-αand CRP in the experiment group were lower (P<0.05);CK,CK-MB,TGF-β1 and HIF-1αlevels were lower (P<0.05),after treatment from the last row of green time,the plasma PQ clearance time and length of hospital stay were shorter (P<0.05),total effective rate was higher (P<0.05).Conclusion Large doses of methyl prednisolone shock therapy in the treatment of patients with acute hundred withered grass poisone has definite clinical efficacy , can reduce the patients’serum CK,CK-MB,TGF-β1,HIF-1αand inflammatory factors levels, with higher security.

Objective To investigate the effects of lidocaine throat surface anesthesia on hemodynamics in patients with surgical operation. Methods From January 2013 to April 2016, 118 cases of patients with upper abdominal surgery in our hospital, were randomly divided into observation group (n=68) and control group (n=50), the observation group were given lidocaine throat surface anesthesia, the control group did not give the throat surface anesthesia, observed two groups before induction of anesthesia (T0), before intubation (T1) and after 1 min (T2), 5min (T3) and 10min (T4) intubation, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) and other indicators.Results The observation group T1 and T2 SBP, DBP, MAP were significantly lower than control group (P<0.05);observation group SBP at T4 was lower than control group (P<0.05);HR of observation group and control group was not statistically significant at each period;The incidence of cough and cough classification in observation group were 22.06% and (1.20 ±0.73), which were significantly lower than that of control group 58.00%and (3.18 ±0.57)(P<0.05).The observation group and the control group breathing recovery time and the time of opening eyes difference had no statistically significant.Conclusion The surface of lidocaine anesthesia can reduce the cardiovascular response to tracheal intubation in patients with surgery and postoperative cough.