Weight increasing would happen with the control of glucose in diabetic patients,whether the application of insulin or that of oral medication.Long-term and effective weight control should be done in order to lower the mortality rate.A large number of studies have shown that the mortality rate has increased along with weight gain,especially death caused by cardiovascular disease.The following measures can be used:(1)Rational target should be formulated.It would be the best that weight decrease 0.5~1.0 kg every week.(2)Diet should be controlled.Low-calorie,high protein,low-fat diet can be used.(3)Exercise therapy:Aerobic exercise will be recommended.(4)Drug intervention treatment:Metformin or Thiazolidinediones drugs can be use,Sibutramine or Orlistat can be used in the patients with serious obesity.

25 year).The patients were analyzed for the clinical characteristics.Autoantibodies to glutamic acid decarboxylase 65(GAD65-Ab),insulin(I-Ab)and autoantobodies to protein tyrosine phosphatase-like proteins(IA2-Ab)were assayed.HLA-DRB1,DQA1,DQB1 alleles(HLA-DRB1*03,*04,*09,*15,DQB1*0201,*0302,*0601,DQA1*0301,*0501)were typing by PCR-sequence specific primer(PCR-SSP).Results A little higher proportion of males,a longer duration of disease; a higher BMI and WHR characterized the adult-onset patients.The adults have a higher level of triglycerides and 120 min C-peptides than adolescent.The frequency and level of IA2-Ab of the adolescents were higher than adults(47.1% vs 15.1% and 0.46 U?mL~ -1 vs 0.07 U?mL~ -1 ,respectively,P

Objective To investigate the status of second trimester maternal serum screening for Down's syndrome from 2006 to 2009 to evaluate the screening quality in Beijing.Methods Birth defect data (birth defect register) from 2006 to 2009 and screening data reported by certificated screening hospitals from 2008 to 2009 in Beijing were retrospectively analyzed by descriptive statistic method.Results Three hundred and thirty Down' syndrome babies were delivered from 2006 to 2009 in Beijing,among which 166 mothers accepted Down' syndrome serum screening and 85(51.2％) were diagnosed finally according to the screening results;among the 85 mothers,35 were≥35 years old with the detection rate of 62.5％ (35/56),and 50 cases were ＜35 with the detection rate of 45.5％ (50/110).The prenatal diagnostic rate of Down's syndrome babies increased from 26.8％(11/41) in 2006 to 47.4％(46/97) in 2009.The detection rate of Down's syndrome with serum screening increased from 23.1％(3/13) in 2006 to 62.9％(22/35) in 2009.One hundred and fifty-eight 21-trisomy cases accepted mid-term ultrasound screening,among which 62 cases (39.2％) were found abnormal.Conclusions Quality control for second trimester maternal serum screening for Down's syndrome should be improved in Beijing.Second trimester maternal serum screening for Down's syndrome in elderly primipara is not suggested.More attention should be paid on prenatal ultrasound screening.

Objective: To study the nursing care of patients had stent placement for constriction of pancreatic duct.Methods: 34 patients performed stent placement for constriction of pancreatic duct were given preoperative psychological nurse and preparation, close cooperation in process, careful postoperative observation, and discharge instruction.Therapeutic efficacy was evaluated by symptom remission rate. Results: Symptom remission rate was 100%. Conclusion:Nursing care before, in, and after operation is important for stent placement.

Objective To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE),which is helpful to the differential diagnosis.Methods Outpatients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study.Clinical data were comprehensively collected.Incidence of disease,severity,frequency of esophageal and extraesophageal symptoms,and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.Results Totally 446 subjects were recruited,including 225 patients with NERD and 221patients with RE.The occurrence rates of esophageal symptoms including heartburn [76.0％ (171/225) vs 52.0％ (115/221),P ＜ 0.01] and acid regurgitation [74.7％ (168/225) vs 54.3％ (120/221),P ＜0.05] in NERD group were significantly higher than those in RE patients,with more severe and frequent (P ＜ 0.05).Despite the rates of food regurgitation were similar,NERD patients behaved more severely and frequently (P ＜ 0.05).Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9％ (92/225) vs 27.6％ (61/221),42.2％ (95/225) vs 31.7％ (70/221),all P ＜0.05] were also higher than those in RE group,the degree of which was more severe too (P ＜ 0.05).RE patients claimed a higher proportion of chronic cough.The incidences of overlapping with IBS in two groups were similar.But there were more patients with FD in NERD group [72.0％ (162/225) vs 62.9％ (139/221),P ＜ 0.05] than in RE group.Conclusions The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different,as well as comorbidities such as FD and IBS.These results suggest that NERD and RE are independent diseases.

Objective:To investigate the inhibitory effects of different concentrations of chlorhexidine in the development of peri-odontitis models in rats.Methods:periodontitis models were established by the ligation of bilateral first molars and orally challenge with P.gingivalis W83.0.05%,0.1%,0.2% and 0.5% chlorhexidine were used to wash the periodontal pocket and oral mucosa of the rats.4 weeks later,absolute real time quantitative PCR was used to count the copy of P.gingivalis W83 in rat periodontal pockets.Scanning electron microscopy was used to observe the distribution of P.gingivalis W83 on rat teeth surface.Immunohisto-chemical technique was used to detect the expression of TNF-αin gingival tissue of the rats.Results:0.2% and 0.5% chlorhexi-dine reduced the copy of P.gingivalis W83 on teeth surface and in periodontal pockets (P <0.05);0.1% -0.5% chlorhexidine reduced the expression of TNF-αin gingival tissue (P <0.05).Conclusion:0.1% -0.2% chlorhexidine can inhibit the develop-ment of chronic periodontitis in rats.

The aim of this study was to evaluate the effect and relative factors of hypnosis combing medication on resistant phantom limb pain (PLP).This study presented one case report involving of the use of visualization,hypnotic imagery,suggestions procedures combing venlafaxine in the alleviation of PLP and depression.Visual analogue score (VAS) and Hamilton Rating Scale for Depression-17 items (HAMD17) were used to assess the severity of PLP and depression,which were evaluated at baseline and the end.Existing literature were reviewed.After hypnosis combing medication,PLP and depression were consistently alleviated.Hypnosis may be a useful adjunct to established strategies for the treatment of PLP.

OBJECTIVE: To explore the application of biological patches in tension-free inguinal hernia repair. METHODS: Totally 29 Chinese references and 1 English article regarding tension-free repair for inguinal hernia with biological patches were retrieved from 1999 to 2008. Then the retrieved information was summarized from clinical data, surgical results, complication, and recurrence rate to report the biological patches in tension-free inguinal hernia repair. RESULTS: The biological patch in tension-free inguinal hernia repair was characterized by little trauma, simple operation, rapid recovery and less complication with lower recurrence rate, especially obtained an excellent result in treating recurrent hernia. CONCLUSION: Tension-free repair for inguinal hernia with biological patches is an ideal operative method.

Objective:To investigate the effects of serum from smoking individuals with periodontitis in the process of Fusobocterium.Nucleatum(Fn)invading KB cells and the expression of matrixmetalloproteinase1(MMP1)of KB cells.Methods:Serum was prepared from 10 smokers with periodontitis(group Y),10 nonsmokers with periodontitis(group N)and 5 periodontal healthy nonsmokers(group H).Serum of 200,400 and 800 μl from the subjects was added to the model of Fn invading KB cells respectively and cultured for 24 hours,the cfu of cellinvaded bacteria was estimated by colony counting.MMP1 protein level in culture supernatant wasmeasured by ELISA.Results:In the 800 μl serum groups,the percentage of invaded cfu was 12.59 ±1.27,8.03 ±0.075 and 7.99±0.14 in group Y,N and H(P ＜0.05)respectively,the concentration(μg/L)of MMP1 in the cultrue supernatant of group Y,Nand H was 400.04 ±21.02,252.57 ±18.89 and 262.47 ±35.29(P ＜0.05)respectively.In the 200 μl and 400 μl serum groups,no significant difference was detected in invasion cfu of Fn in KB cells and MMP1 secrition of KB cells among Y,N and H groups(P>0.05).Conclusion:Higher doses of smokingserum might play a role in the course of Fn invading KB cells and promote the expression of MMP1 secretion from KB cells.

Objective To understand the Shanghai City General Hospital in two non Department of Endocrinology nurses′ comprehensive intervention of diabetes care ability and its influencing factors. Methods To investigation and analysis of the result of comprehensive nursing intervention in diabetic ability questionnaire to two hospitals in Shanghai city of Pudong New Area in a non Department of Endocrinology nurses. Results The comprehensive nursing intervention of non Department of Endocrinology nurses diabetes score was (46.75 ± 7.91) points, diabetic blood glucose monitoring knowledge score was (14.76 ± 2.96) points, insulin injection knowledge score was (20.28 ± 4.83) points, diabetes knowledge score was (11.71±1.55) points. Multivariate analysis showed that the number of years of work and attention to diabetes were the main factors affecting their scores. Conclusions The comprehensive nursing intervention ability of non Endocrinology Department of diabetes care at a moderate level, the ability to provide comprehensive nursing intervention for the patients need to be further improved, the need to strengthen the skills training and diabetes specialist.