OBJECTIVE:To investigate the effect of insulin use intervention and self management of blood glucose in the treat-ment of cystic fibrosis related diabetes. METHODS:In prospective cohort study,during Apr. 2007-Apr. 2013,1 295 CFRD inpa-tients selected from 14 hospitals of Shanghai were randomly divided into trial group (743 cases) and control group (552 cases). Control group maintained the dose of insulin,and trial group adjusted the dose of insulin every week and received patient education about self management of blood glucose. Blood glucose,blood lipid,quality of life,the ability of self management and other in-dex were detected,recorded and compared between 2 groups 1 year after intervention. RESULTS:1 year after intervention,fasting blood glucose,postprandial 2 h blood glucose and HbA1c of trial group were significantly lower than those of control gorup,with statistical significance(P<0.05). The time of blood glucose reaching the standard,the dose of insulin,the number of hyperglycemia and hypoglycemia in trial group were all significantly shorter or lower than control group,with statistical significance (P<0.05). There was statistically significant difference in the rate of standard blood glucose between trial group [93.5%(695/743)] and control group [59.6%(329/552)]. TG of trial group decreased while HDL increased,there was statistically significant difference between 2 groups (P<0.05). There was statistically significant difference in the quality of life score between trial group (196.24 ± 15.80) and control group(180.33±16.29)(P<0.05). The ability of self management in trial group was significantly higher than control group, with statistical significance(P<0.05). CONCLUSIONS:Insulin use intervention and self management of blood glucose can control the level of blood glucose in CFRD patients,and improve the quality of life,medication compliance and therapeutic effect.

Objective To investigate the effects of ursolic acid (UA) on oxidative stress and apoptosis in focal cerebral ischemia reperfusion in rats. Methods One hundred and twenty SD rats were randomly divided into 6 groups:sham operation group, model group, and groups of 20, 40, 80 120 mg/kg UA, with 20 rats in each group. A model of focal cerebral ischemic reperfusion was induced using the intraluminal thread method. Drugs were administrated immediately via tail vein injection when the suture was inserted. At 6h later, the total antioxidative capacity (T-AOC), malondialdehyde (MDA) level, and the activity of creatine kinase (CK), lactate dehydrogenase (LDH) in the serum, and the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) in the ischemic cortex were measured. Apoptosis in the ischemic cortex was detected by TUNEL staining. Results Compared with the model group, the activity of CK (301.2 ± 86.8 U/L, 258.5 ± 58.4 U/L, 228.7 ± 49.2 U/L vs. 352.6 ± 88.1 U/L), LDH (327.5 ± 87.1 U/L, 288.6 ± 69.5 U/L, 243.7 ± 74.9 U/L vs. 395.4 ± 98.6 U/L) in the serum in the groups of 40, 80 120 mg/kg UA were significantly decreased (P<0.05 or P<0.01), MDA (5.5 ± 1.4 mmol/L, 4.8 ± 1.1 mmol/L, 4.4 ± 1.3 mmol/L vs. 7.8 ± 2.0 mmol/L) and T-AOC (9.4 ± 2.2 U/L, 10.5 ± 2.9 U/L, 11.8 ± 3.1 U/L vs. 8.0 ± 2.1 U/L) were significantly increased (P<0.05 or P<0.01); the activity of SOD (10.1 ± 2.7 U/mg, 11.6 ± 2.5 U/mg vs. 6.9 ± 2.6 U/mg),GSH-Px (12.9 ± 2.9 U/mg, 14.2 ± 3.2 U/mg vs. 9.5 ± 2.3 U/mg), CAT (3.3 ± 1.3 U/mg, 3.9 ± 1.2 U/mg vs. 2.3 ± 0.9 U/mg) in the ischemic cortex in the groups of 80 120 mg/kg UA were significantly increased (P<0.05 or P<0.01). TUNEL staining showed that apoptosis in the ischemic cortex in all the UA groups were significantly decreased compared with the model group. Conclusion UA could effectively enhance the activity of antioxidant enzymes and free radical scavenging capacity, ameliorate oxidative stress and inhibit apoptosis in focal cerebral ischemia reperfusion in rats.

Objective To evaluate the effects of gender on the median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion in patients.Methods Fiftyfive ASA physical status Ⅰ or Ⅱ patients,aged 20-60 yr,with body mass index 18-25 kg/m2,requiring LAM insertion,undergoing elective surgery,were divided into 2 groups according to the gender:male group (group M,n =27) and female group (group F,n =28).Propofol was given by target-controlled infusion.Anesthesia was induced with target-controlled infusion of propofol.The concentration of propofol was determined by using modified Dixon's up-and-down method.The initial target plasma concentration of propofol was 3.0 μg/ml (group M) or 2.7μg/ml (group F) and the ratio between the 2 successive concentrations was 1.1.Fentanyl 1 μg/kg was injected intravenously at about 10 min of propofol target-controlled infusion.LMA was inserted after the effect-site and plasma concentrations were balanced.The positive response to LMA insertion was defined as development of swallowing,coughing,biting LMA,body movement and laryngospasm during insertion.When the response to LMA insertion was positive,the concentration of propofol was increased in the next patient and when the response was negative,the concentration was decreased in the next patient.The EC50 and 95 ％ confidence interval of propofol inhibiting responses to LMA insertion were calculated.Results The EC50 (95 ％ confidence interval) of propofol was 3.11 (2.92-3.30) μg/ml in group F and 2.70 (2.55-2.85) μg/ml in group M (/ ＜ 0.05).Conclusion The EC50 of propofol inhibiting responses to LMA insertion is higher in female patients than in male patients.

Objective To test the hypothesis that if oxidized low density lipoprotein (ox-LDL) were associated with target organ damage(TOD) in patients with essential hypertension.Methods A total of 182 patients with primary hypertension[102 males and 80 females,age (52.8?18.4) years] were enrolled in this study in our department between October 2006 and June 2009.Patients were classified as with TOD(n=85) or without TOD (n=97).Left ventricular mass index (LVMI) and intima-media thickness(IMT) was determined using echocardiography;24 hours urine microalbumin and retinal changes were measured.Cerebral hemorrhage,ischemic infarction,transient ischemic attack (TIA) were evaluated by CT or MRI.Serum ox-LDL was measured by sandwich ELISA.Results Mean ox-LDL level were (114.6?24.3)U/L in without target organ damage patients which was significantly lower than that in target organ damage group[(164.2?27.6)U/L,P

5-Fluorouracil(5-FU)has been widely used to treat gastrointestinal,head,neck,chest and ovarian malignant tu-mors since 1957. As an analogue of pyrimidine,5-FU plays anti-cancer roles by inhibiting thymioylate synthase and integrating its me-tabolites into DNA and RNA. Although 5-FU is one of the first-line therapeutic compounds for gastrointestinal malignant tumor as a sin-gle drug or in combination with other drugs,its effectiveness is hindered by its low efficiency,which may be due to chemotherapy re-sistance. 5-FU chemotherapy resistance may stem from enzyme abnormality,genetic abnormality and tumor microenvironment. In this paper,we make a review about 5-FU actions and the mechanisms underlying chemotherapy resistance.

Objective To survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use.Methods A retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded.Results A total of 727 cases were included , 471 (64.79%) of which were infected cases.Respiratory tract infection was the main site of both healthcare-associated infection and community-associated infection (39.17% and 45.98%, respectively).The average days of glycopeptide antibiotic use were 6.06 day (4 403/727).Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively.Glycopeptide was used in 338 patients(46.49%),the average types of combined use was 4.43, triple and above was used in 99 patients(13.62%),combination of the second generation cephalosporins was the highest(20.48%).450(61.90%) patients used vancomycin, 260(35.76%)used teicoplanin,17(2.34%)used both vancomycin and teicoplanin.A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillin-resistant Staphylococcus aureus was 50 strains.490 (67.40%) patients treated with glycopeptide antibiotics were effective.Of 727 patients, 86 (11.83%) used antibiotics rationally, 315(43.33%) basically rational,and 326 (44.84%) irrationally.Conclusion Application of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

Objective To explore the intervention in patients with advanced lung cancer in chemotherapy effect in psychology. Methods According to the routine nursing care of 40 cases of patients with advanced lung cancer chemotherapy, and classified as the control group, the other 40 patients in the control group based on the nursing for patients with psychological intervention, and classified as the observation group, two groups of patients in our hospital from January 2015 to January 2017. Results The intervention of patients before, there were no significant difference between the two groups of patients' quality of life and life ability score, after grouping after intervention in observation group were significantly better than the control group patients were compared between the two groups; for the intervention of the satisfaction rate of visible, The proportion of patients in the observation group 97.5% was significantly higher than the control group of 72.5% patients, showed significant differences between the two groups (P<0.05). Conclusion The psychological intervention analysis find application in patients with advanced lung cancer in chemotherapy, the chemotherapy effect can help to reflect, consolidate the therapeutic effect, improve the quality of life of patients, improve the patients for nursing recognition, therefore it is worthy of reference.

With continued ozone deletion and increased ultraviolet application,ultraviolet (UV) induced eye injury receives more attention,especially for astronauts,residents on high elevation plateaus and other people exposed to intense beams of UV.Continuous exposure to UV can lead to damage of conjunctiva,cornea,crystalline lens and retina,which are correlated with conjunctivitis,keratitis,ocular tumor,climatic droplet keratopathy,and pterygium.This paper focuses on the effect of UV on eyes,with a systematic elaboration of UV-induced eye injury.

BACKGROUND:For patients with lumbar spondylolisthesis combined with osteoporosis, appropriate fixation system for effective reset and good fixation stability is currently a hot issue of clinical concern. Pedicle screw screw-rod system after bone cement perfusion can achieve the effective fixation between pedicle screw system and the vertebral bone. OBJECTIVE:To observe the therapeutic effect of bone cement-augmented pedicle screw on patients with lumbar spondylolisthesis combined with osteoporosis. METHODS:17 cases of lumbar spondylolisthesis combined with osteoporosis were identified by bone density test. They received the posterior open reduction and internal fixation, and implanted with 68 bone cement-augmented pedicle screws. Their repair effects were observed by short-term fol ow-up. Patients were evaluated using low back pain Visual Analog Scale and lower limb Oswestry Disability Index before treatment, 1 week, 3 months and 1 year after treatment. Vertebral height, intervertebral height, screw loosening and bone cement leakage were observed using imaging.
RESULTS AND CONCLUSION:Compared with pre-treatment, low back pain Visual Analog Scale score and lower limb Oswestry Disability Index were significantly improved at 1 week, 3 months and 1 year after treatment (P<0.05). No significant difference was detected between post-treatment and fol ow-up (P>0.05), which indicated that clinical repair effect could be effectively maintained. At 3 months of fol ow-up, one screw loosening occurred in two patients. During fixation, mild bone cement leakage appeared in seven vertebral bodies with screw fixation, no symptoms or subsequent complications were observed. There were no significant differences in vertebral height and intervertebral height before and after treatment and during fol ow-up (P>0.05). These results suggest that bone cement-augmented pedicle screw for patients with lumbar spondylolisthesis combined with osteoporosis can effectively reset vertebral slippage, effectively provide good anti-pul-out force for a long term, and the effect was stable. Bone cement augmentation can perfectly strengthen fixation, shows good biocompatibility, and avoids osteoporosis around the screw-induced failure fixation.

Objective:To explore the clinical efficacy of Paishi granules on promoting stone expulsion after extracorporeal shock wave lithotripsy ( ESWL) . Methods:A retrospective study method was adopted. Totally 510 cases of lithangiuria patients were divided into the treatment group and the control group with 255 cases in each. The control group was treated by ESWL, and the treatment group was treated by Paishi granules after ESWL. The stone expulsion rate,clinical efficacy and adverse reactions in the two groups were stud-ied and compared. Results:The stone expulsion rate of the observation group was 78. 8%,which was significantly higher than that of the control group (51. 0%, P<0. 05). The curative rate of the observation group was 72. 9% with the total effective rate of 92. 5%, that of the control group was 43. 9% with the total efficiency of 82. 4%,and the differences between the two groups were statistically significant (P<0. 05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0. 05). Conclusion:Using Paishi granules after ESWL can promote stone expulsion with high efficacy and slight adverse reactions.