Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

Objective:Observing the therapeutic effectiveness of Erhuangwendan Decoction and Yiqiyangyinningxin Decoction treating acute viral myocarditis.Methods: 344 cases were distributed into the therapeutic group(258cases) and the control group (86 cases). The treapeutic group were first given Erhuangwendan Decoction one packet per day, then Yiqiyangyinningxin Decoction one packet per day after acute attack. The control group were only given myocardial nutrient. All were given 3～6 months. We observed the symptoms,signs ang EKG of the two groups. Results: The effective rate of the therapeutic group was 40% after 3 months. And it was 84% after 6 months. The effective rate of the control group was 15% after 3 months. And it was 34.8% after 6 months. The two groups have obvious difference( P

Objective: To determine the efficacy of lobectomy and wedge resection in the management of early stage (T 1N 0M 0) non small cell lung cancer. Methods: We analyzed the results of 109 patients with pathologic stage (T 1N 0M 0) non small cell lung cancer who underwent open wedge resection (n=21), video assisted wedge resection (n=30), and lobectomy (n=58) to assess perioperative morbidity and mortality, recurrence rates, survival difference and late pulmonary function among the three groups. Results: There were no differences among the three groups in regard to histologic tumor type, perioperative morbidity and mortality, late pulmonary function. Analysis demonstrated the wedge resection groups to be significantly older and to have reduced pulmonary function despite a higher incidence of treatment for chronic obstructive pulmonary disease when compared with patients having lobectomy. Statistically, the mean hospital stay was significantly less and locoregional recurrences rate higher in the wedge resection groups. Kaplan Meier survival curves were nearly identical at 1 year (open wedge resection, 94%; video assisted wedge resection, 95%; lobectomy, 91%). 5 year survival was 58%, 65% and 70% respectively. Log rank testing demonstrated significant differences between the survival curves during the 5 year period of study (P=0.02). Conclusion: Wedge resection, done by thoracotomy or video assisted techniques, appears to be a viable surgical treatment of stageⅠ(T 1N 0M 0) non small cell lung cancer for patients with cardiopulmonary physiologic impairment. Because of the increased risk for local recurrence, anatomic lobectomy remains the surgical treatment of choice for patients with stage I non small cell lung cancer who have adequate physiologic reserve.

Radiotherapy is one of the main means of local treatment of breast cancer. Triple negative breast cancer (TNBC) as a molecular subtypes of breast cancer, its biological behavior is special and existing multiple molecular targets, these molecular targets inlfuence the response of ionization radiation through different mechanisms and regulate radiotherapy sensitivity of TNBC This article reviewed the recent advances in radiotherapy and radiosensitivity related molecular targets of TNBC.

Objective:To establish an HPLC method compatible with the mass spectrometry for the determination of the content and related substances in amlodipine besylate tablets. Methods:The sample was separated on a CAPCELL PAK C18 column (250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of methanol and 20 mmol·L-1 ammonium acetate (60∶40) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was set at 237 nm. The column temperature was 35℃ and the injection volume was 20 μl. Be-sides, an HPLC-QTOF MS method was used to identify the molecular structure of the related substances of amlodipine. Results: The related substances were completely separated from amlodipine. The linear range of amlodipine besylate was 10-100 μg · ml-1 ( r =0. 999 8), and the mean recovery was 99. 2%(RSD=1. 0%,n=9). The main related substances could be detected by HPLC-QTOF MS. Conclusion:The established method is accurate, reliable and reproducible, which can be used in the quality control of amlodip-ine besylate tablets.

Objective To investigate the recognition of graded nursing and its influencing factors among nursing assistants in elder homes.Methods A questionnaire survey was conducted on 116 nursing assistants.Results The nursing assistants showed insufficient recognition of graded nursing,there were significant differences in role cognition,operation and practice training,salary,and the nursing workload,there were no significant differences in working years and educational levels.Conclusions The recognition of graded nursing was insufficient.It is suggested to increase the role cognition education,enhance the theory and practice training,provide higher salaries and allocate workload reasonably to ensure the implementation of graded nursing and increase the satisfaction level of the elderly.

Magnetic resonance spectroscopy(MRS)is an advanced medical imaging technique that can provide more accurate physiological and biochemical information than an MRI.MRS has more advantages in displaying abnormal physiological signs than the conventional MRI.A key problem in radiation therapy is the definition of the tumor target volume.MRS can define the tumor margin and range as well as predict the immediate response or side effects to radiotherapy.This paper summarized the role of MRS in tumor volume definition and clinical evaluation in radiation therapy.

Objective To investigate the clinical application of dezocine and remifentanil in elderly patients with painless gastroscopy.Methods According to random number table,180 elderly patients undergoing painless gas-troscopy were randomly divided into dezocine group(group D),remifentanil group(group R)and control group(group C),each group 60 cases.Group D was infusion with dezocine 20μg/kg,Group R was infusion with remifentanil 0.5μg/kg and Group C was infused with normal saline,then three groups patients,respectively,after the interval of 1 minutes were given propofol 1 mg/kg.Objects induced sum of propofol,starting time,awakening time,discharged time,HR,MAP and SpO2 during operation,sedation scores,postoperative side effects such as nausea and vomiting were observed.Results The decrease of MAP was alleviated in group D compared with group C and group S(tDR =2.278,PDR<0.05 and tDC =2.545,PDC <0.05).SpO2 in group C and group R were significantly lower than that in group D(tDR=2.184,PDR<0.05 and tDC =2.206,PDC <0.05).The time for regaining consciousness(tDC =5.401 and tRC =6.674)and propofol dosage(tDC =3.726 and tRC=4.213)in group D and group R were significantly lower than those in group C(P<0.05).The Ramsay of group D was (2.3 ±0.7)points,which was lower than (3.8 ±1.2) points of group C,(3.6 ±0.9)points of group R(tDC =8.938,PDC <0.01;tDR=7.154,PDR<0.01),and there were fewer adverse reactions in group D.Conclusion Dezocine is more suitable for the elderly patients than remifentanil, which has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.

Objective:To investigate the effect of NF-κB p65siRNA of IL-17 inducing the expression of MCP-1 in the primary cultured cardiac myocytes.Methods:The cardiac myocytes were isolated from neonatal mice by different adhesion method.NF-κB P65 siRNA was transfected into cardiac myocytes and the rates of transcription and translation of MCP-1 were detected by RT-PCR and enzyme-linked immunosorbent assay( ELISA) ,the rates of transcription and translation of P-P65 and P65 were detected by RT-PCR and Western blot.Results:Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were increased in negative siRNA +IL-17 group(P<0.05).Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA group( P<0.05).Compared with negative siRNA+IL-17 group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA+IL-17 group(P<0.05).The expression of the NF-κB P65 at mRNA and protein levels in cardiac myocytes were specifically and extensively suppressed by NF-κB P65 siRNA(P<0.05).After stimulated by IL-17,the amount of P-P65 in the cardiac myocytes was significantly increased in time-dependent manner compared with that of black group( P<0.05) , but the levels of P65 changed little ( P>0.05 ) .Conclusion: IL-17 stimulates MCP-1 expression in cardiac myocytes via NF-κB activation,and NF-κB P65 siRNA can effectively inhibit the upregulation of IL-17 on MCP-1.