Objective To evaluate the curative effect of insulin glargine plus acarbose in the treatment of elderly type 2 diabetes and cerebral infarction.Methods Totally 84 elderly patients with type 2 diabetes and cerebral infarction were received insulin glargine and acarbose for 16 weeks.The levels of fasting plasma glucose (FPG),hemoglobin A1c (HbA1c),Postprandial glucose values of 2 h (2 hPG),Postprandial C peptide (PCP) and Fasting C peptide (FCP) before and after treatment were detected.Results Compared with pretreatment,the levels of FPG,HbA1c and 2 hPG after treatment were decreased to (6.87 1.46) mmol/L (t =1.658,P＜0.05),(6.48±1.12)％ (t=1.629,P＜0.05) and (8.34±2.15) mmol/L (t=2.037,P＜0.05),respectively,while PCP and FCP were increased to (3.82±0.22) μg/L and (3.52±0.36) μg/L (t=2.698,t=2.087,bothP＜0.05).Conclusions Combined insulin glargine with acarbose in the treatment of elderly type 2 diabetes and cerebral infarction can effectively reduce fasting and postprandial blood glucose,and improve the function of islet β cells.

Objective To summarize the experience of assisted reproductive technology concurrent deep vein thrombosis, improve the level of nursing. Methods The clinical data of 5 cases of assisted reproductive technology concurrent deep vein thrombosis in Reproductive Medical Center of Peking University Third Hospital were retrospectively analyzed and the related literature was retrieved,the nursing experience and preventive measures were summarized. Results Through treatment and careful, all the patient were cured. Conclusions Strengthen the nursing care of patients with assisted reproductive technology concurrent deep vein thrombosis, actively prevent ovarian hyperstimulation syndrome occurred is the key to reduce thrombosis. Those patients with risks factors should be paid more attention, strengthen health education, reduce or alleviate complications.

It is recommended that cyclophosphamide combined with corticosteroids should be used as the first-line treatment of ANCA ( antineutrophil cytoplasmic antibody) associated with systemic vasculitis ( AASV) , however, cyclophosphamide has notable ad-verse reaction of causing pulmonary fibrosis ( PF) . In this paper, whether cyclophosphamide should be used in an AASF patient with PF was analyzed in order to decide whether AASV with PF is one of contraindications of cyclophosphamide in clinical practice.

Objective Artificial atrial septum defect combining pulmonary artery banding to create a model of congenital heart defect with decreased pulmonary blood flow to explore the morphological changes of immature pulmonary vascular. Methods Choose twenty piglets with about one to two-month-old, which are exclusively for experiment used. The piglets were randomly divided into three groups: normal control group (group C, n = 6), Small incisions on the right chest, produced a transient reduction in pulmonary blood; low-medium pulmonary artery stenosis groups ( group T1, n = 7 ) : Did artificial room septostomy creation by self-dilators which were delivered into the surface of the right atrium and controlled Systolic trans pulmonary artery banding pressure (Trans-PABP) at pressure of 20 - 30 mmHg; severe pulmonary artery stenosis groups ( group T2, n = 7): T2 were the same surgical procedures with group T1 ,and controlled Trans-PABP ≥ 30 -50 mmHg. Monitored ultrasound after operation , carried out 64-slice computed tomography scanning after one month, to measure the proximal vessel diameter and TransPABP , after two month surgical exploration on the left chest. When the animals were sacrificed, the heart and lung tissue was cut to measure atrial septal defect, pulmonary artery and the banding diameter. By weihgt elastic fiber and van Cieson staining to observe the morphological pathological changes, three groups took lung tissue with right middle lobe lateral segment about 1.0 cm × 0.8 cm × 0.8cm at the end of surgery and 2-months after operation respectively. Results The models were all successfully in the survival animal of the two test groups. One pig died from tracheal intubation accident in the C group, there was one case died due to bowel obstruction in the T1 group, And there were two cases died result from acute right heart failure and chronic heart failure respectively in T2 group. 64-slice CT angiography showed that BD was significantly lower than the AOD in the two test groups, the proximal pulmonary vascular expansion result from stenosis, distal pulmonary vascular scarce. Histopathology showed that the pulmonary artery inside diameter of T1 and T2 was significantly higher than group C(P ＜0. 05,P ＜ 0.01), and the NAPSC of two experimental groups were significantly lower than group C 2-month after operation( P ＜0.01).Conclusion This type of Piglet model is closer to clinical pathological and physiological ,64-slice spiral CT combined with lung histopathology observed for the evaluation of pulmonary vascular hypoplasia is a reliable method. Tunica media of pulmonary arterioles hypoplasia with the number reducing, with pulmonary artery banding increased,the degree of pulmonary arterioles hypoplasia gradually increased.

ObjectiveTo explore the clinical results of endoscopic resection of the frontal benign tumors.MethodsNineteen cases of benign tumors in the frontal area were rcsected using endo scopic techniques.The tumors were diagnosed as benign according to complaint,history and physical examination.ResultsAll 19 tumors were totally resected.The pathological examination revealed 11cases of lipoma,3 cases of sebaceous cyst,3 cases of sebaceous cyst and 2 cases of dermoid cyst.During 6 months to 2 years of follow-up,no tumor recurred.Local concavity was noticed in all patients but all resolved within 6 months except 2 patients.They received granular fat graft of the concavities 6months late and were satisfied with the results.ConclusionsBenign tumors near eyebrows and in glabella area can be treated by minimally invasive endoscopic technique.Compared with traditional surgery,this technique offers inconspicuous scar and fast recovery.

We detected Zika virus (ZIKV) in a febrile case returning from Suriname and entry China from Guangzhou Baiyun International Airport Port.Serum and saliva samples were collected from a suspected case returning from Suriname.We detected ZIKV RNA using real-time fluorescence RT-PCR methods by both in-house reagent and commercial detection kits.RT-PCR detection was carried out with saliva sample and sequence analysis was performed.Phylogenetic tree was constructed to analyze the source of imported cases.Real-time fluorescent RT-PCR result showed that saliva was detected ZIKV RNA positive while for serum was weakly positive.A specific 1 500 bp fragment in size was amplified with saliva sample by RT-PCR.Sequence analysis showed 99％ homologous to the corresponding sequence of Brazil ZIKV (GenBank No.KX197250).Phylogenetic tree indicated it was located on African lineage.According to the epidemiological investigation results,clinical manifestations and nucleic acid detection of case,the suspected case was confirmed to infect Zika virus,being the first case from Suriname into Guangdong Province.

Objective:To investigate the clinical characteristics and the risk of major adverse cardiac events within 1 year of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure(HF)in the medical alliance setting.Methods:A retrospective cohort study was conducted among a total of 180 in-patients with acute decompensated heart failure in Cardiovascular Hexi Hospital Consulting Area of Tianjin Chest Hospital.According to ejection fraction measured by echocardiogram, the in-patients were classified into three groups: heart failure with reduced ejection fraction(HFrEF)group(n=70, 38.9%), HFmEF group(n=50, 27.8%), and heart failure with preserved ejection fraction(HFpEF)group(n=60, 33.3%). Clinical feature and 1-year prognosis between different groups were compared.Results:Univariate Cox regression analysis of 1-year all-cause death and cardiovascular death showed that there was no significant difference between HFrEF group and HFmEF group, HFpEF group and HFmEF group(all P>0.05); 1-year readmission analysis of heart failure showed that 47.1%(33 cases)of HFrEF group was higher than 24.0%(12 cases)of HFmEF group, 48.3%(29 cases)of HFpEF group was higher than HFmEF group( HR=2.307, 2.368, 95% CI: 0.187-4.480, 1.207-4.644, respectively, all P<0.05); The major 1-year cardiovascular events were 57.1%(40 cases)higher in the HFrEF group than 34.0%(17 cases)in the HFmEF group( HR=2.053, 95% CI: 0.187-4.408, P< 0.05). Multivariate analysis showed that the 1-year risk of major cardiovascular events was significantly different between HFmEF group and HFpEF group( HR=0.477, 95% CI: 0.241-0.941, P< 0.05). Pulmonary heart disease( P< 0.05), atrial flutter and/or atrial fibrillation( P< 0.01), New York Cardiology class Ⅳ( P< 0.01)were risk factors for death.Hypertension and cor pulmonale were the risk factors for readmission in patients with heart failure(all P< 0.01). Conclusions:The clinical characteristics of inpatients with HFmEF in the medical alliance setting tended to be consistent with those with HFrEF, while the feature of ischemic heart disease was more prominent in HFmEF.The 1-year risk of heart failure readmission in HFmEF group was significantly lower than that in HFpEF and HFrEF group, and the risk of all-cause mortality and cardiovascular mortality at 1 year was not significantly different among the three groups.

Objective To investigate the status of depression in female infertility patients and its influencing factors in reproductive medicine center. Methods Totally 147 cases of female infertility patients from the reproductive medicine center of a tertiary hospital in Beijing were collected as the research object by convenient sampling method from July to September 2015. The questionnaire survey was used to investigate the patients′general information, disease related data and depression mood. Results In the study, the average depression score of 147 participants was (0.45±0.12). Among them, there were 32 cases (21.8%) of mild depression, 15 cases ( 10. 2%) of moderate depression and 4 cases ( 2. 7%) of severe depression. Multiple regression analysis showed that patients with depression were affected by academic qualifications, age and whether there was a history of transplantation. Conclusions The outpatients of the reproductive medicine center have a more severe depression mood and will be affected by the patient′s education background, age, and whether there is a history of transplantation. It is recommended to consider the patient′s education background, age, and whether there is a history of transplantation in patients′health education.

Objective To investigate the status of anxiety and depression in patients with recurrent miscarriage and analyze the influence factor so as to provide the basis for taking corresponding measures . Methods One hundred and fourteen patients with recurrent miscarriage were surveyed by the questionnaire , and the relevant factors were analyzed by the ANOVA and Pearson correlation analysis .Results One hundred and twenty-four questionnaires were issued and 114 questionnaires were responsive with an effective response rate of 91.94%.The scores of SAS and SDS were respectively (37.07 ±7.54 ),(37.61 ±8.71 ) in the patients, and were higher than ( 29.78 ±10.07 ) , ( 33.46 ±8.55 ) in the Chinese norms , and the differences were statistically significant ( t=10.318 ,5.094 , respectively;P<0.01 ) .The cases of anxiety and depression were respectively 36 ( 31.6%) and 35 ( 30.7%) cases in patients , and the cases of patients with anxiety and depression together were 25 (21.9%) cases.The score of body mass index was negatively related to the score of anxiety ( r=-0.279 ,P<0.01 ) .The degree of depression is relatively serious in the lower level of education of patients and their spouse and lack of physical exercise patients (P<0.05).Conclusions The levels of anxiety and depression in patients with recurrent miscarriage are high .According to the different characteristics of recurrent abortion , the professional guidance should be given so as to alleviate their anxiety and depression .

The role and function of nurses in the application of assisted reproductive technology were sorted out.Addressing potential ethical dilemmas,this paper analyzed the restrictive factors in dealing with difficulties in nursing practice and proposed the construction of a nursing ethics literacy system.It is suggested to improve ethical rules and education systems,strengthen case education,enhance risk prevention capabilities,and cultivate a healthy ethical culture,so as to effectively enhance nurses'ethical literacy.