Objective] To explore the clinical experience of Professor Zhang Juan on Elderly Diabetic Constipation and hope to provide a new perspective for future study about Chinese medicine treatment of Diabetes Mellitus(DM).[Method] Reviewed 103 cases from Sep. 2014 till now who were older than 65,diagnosed with DM and had constipation as primary symptom. Analyzed and summarized the syndrome differentiation and treatment of the cases. [Results] According to the etiology and pathogenesis of Elderly Diabetic Constipation ,Professor Zhang deems that its pathogenesis takes place in two stages:one is spleen deficiency,the other is kidney deficiency and proposes the therapy of“treat the middle-jiao if others are not working”,“nourish the natal qi with post-natal qi”,“combine disease,syndrome and symptom”and“treat in stages”.[Conclusion] The treatment on Elderly Diabetic Constipation raised by Professor Zhang is effective and her clinical experience has important clinical value .

To strengthen the medical students in patient safety education is the first step to effectively prevent medical accidents.But at present patient safety education has not been given enough attention by domestic mnedical colleges.Research group consulted literature at home and abroad related to patient safety courses, according to the Medical colleges patient safety curriculum guide proposed by The World Health Organization (WHO) Alliance for Patient Safety, opened the patient safety course in undergraduate medical education with the goal to improve the medical students to maintain patient safety consciousness, ability and methods and implemented scene simulation teaching and formative assessment.We achieved good teaching effect and appraisal by students.

Objective To explore the absorption properties and kinetics of nicorandil from small intestinal segments. Methods The absorption kinetics and permeability of nicorandil under different conditions were investigated by HPLC via the in situ perfusing method in rats. Results There was no significant difference in Ka of nicorandil under different concentrations and different pH.The absorption rate in rats descended in order of jejunum,duodenum,ileum and colon, as (4.69±0.05)×10-2 ,(3.35 ±0.04) × 10-2 ,(2.66± 0.05) × 10-2 and (0.89± 0.08) × 10-2 .h-1 . Conclusion The absorption of nicorandil in intestine complies with the passive transport mechanism and first order kinetics.Nicorandil is well absorbed in the whole intestine and can be prepared as delayed release and controlled release forms.

Objective To observe and evaluate the effect of ultrasound guided percutaneous ethanol injection for hyperparathyroidism secondary to chronic renal failure. Methods Fifty-three patients with secondary hyperparathyroidism in Nanjing General Hospital Military Command from January 2011 to May 2013 were treated by percutaneous ethanol injection. The echogenicity, size and blood supply of parathyroid glands were observed by color Doppler ultrasound before and after treatment. Parathyroid hormone (PTH) and volumes of parathyroid glands were analyzed and compared with non-paired t test. Results Before treatment, the parathyroid gland volume was (5.28±0.84) cm3. The enlarged parathyroid glands had homogeneous hypoechogenicity and abundant blood supply, and the PTH was (1041.6±37.1) ng/L. After treatment, the size of solitary parathyroid gland was (3.93±0.67) cm3 which did not change significantly compared with that before treatment. The echogenicity of parathyroid glands enhanced and blood supply decreased after injection ethanol into solitary parathyroid. PTH [(509.2±27.6) ng/L] decreased obviously (t=3.792, P < 0.05). Conclusion Color Doppler ultrasound guided percutaneous injection of ethanol has an important role in the treating of secondary hyperparathyroidism and the curative effect can be observed timely.

Adenoma ; metabolism ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Kidney Transplantation ; Living Donors ; Male ; Mucin-1 ; metabolism ; Young Adult

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Cytarabine ; administration & dosage ; Daunorubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Mitoxantrone ; administration & dosage ; adverse effects ; Young Adult

Objective To observe the efficacy and untoward reactions of FOLFOX4 regimen and XELOX regimen in the treatment of patients with advanced colorectal cancer.Methods Fifty four advanced colorectal cancer patients were randomly divided into two groups.Group A (FOLFOX4):28 patients were treated with oxaliplatin 85 mg/m2 on day 1,LV 200 mg/m2 as a 2h infusion followed by bolus 5 -FU 400 mg/m2 and a 24h infusion of 5 -Fu 600 mg/m2 ,repeated for consecutive days every 2 weeks.One cycle was 14 days and efficacy was evaluated after 4 cycles.Group B(XELOX):26 patients were treated with oxaliplation 130mg/m2 on day 1,capecitabine 1 000 mg/m2 orally daily for 14 days.One cycle was 21 or 28 days and efficacy was evaluated after 2 cycles.Efficacy of the two groups was evaluated at 2 cycles.Results All 54 patients were available for evaluating objective response.In A group,the overall response rate was 46.4%,and the overall response rate was 42.3% in B group.The overall response rate of A group was slightly higher than B group,but there was no statistically significant difference(χ2 =0.093,P =0.791 ).Adverse reactions:thrombocytopenia incidence rate and the peripheral nerve toxicity had no significant differences between the two groups(χ2 =0.552,0.108,P =0.550,0.787).The incidence rates of nausea, vomit,diarrhea and leucocytopenia in B group were lower than those in A group(χ2 =9.495,4.862,6.273,P =0.003,0.033,0.108).The incidence rate of hand -foot syndrome was higher in B group than in A group(χ2 =13.389,P =0.000),but the severity was less(grade Ⅰ ~Ⅱ).Conclusion The response rate in the treatment of advanced colorectal cancer was similar between XELOX and FOLFOX4 regiments,but XELOX regiment has the advantages of more convenience,better safety.Thus,XELOX regiment is worth recommending as a first -line therapy for the treatment of patients with advanced colorectal cancer.

Objective To observe the clinical effects of pemetrexed alone or pemetrexed combined with platinum in the treatment of advanced non -squamous non -small cell lung cancer who failed first line therapy. Methods 34 patients with advanced NSCLC who had failed to previous chemotherapy and all of these patients had been confirmed with pathology or cytology.Pemetrexed monotherapy group included 14 cases and pemetrexed plus platinum group included 20 cases.21 days as one cycle.All patients who received 2 or more cycles could be evaluated. Results No complete response (CR)occurred.There were 3 cases of partial response (PR),15 cases of stable disease(SD)and 16 cases of progressive disease(PD)in the 34 patients.The disease control rate was 52.9%(18 /34).The median progressive free survival was 2.7 months.The major toxic reaction included leucopenia,anemia and gastrointestinal response.Conclusion Pemetrexed or pemetrexed combined with platinum can prolong the survival time of some patients of non -squamous non -small cell lung cancer who failed first line therapy.The toxic effects can be tolerated.

Objective Normal estimation is the key step for volume visualization. Commonly used methods for normal estimation are based on interpolation and derivative. A novel normal estimation algorithm based on approximation for visualization of medical images was presented in this paper. Method It approximated the density function in local neighborhood with a second-degree polynomial function. The coefficients of the polynomial function were solved by minimizing the error of the approximation and the gradient vector at arbitrary point was obtained directly from the analytical derivative of the density function without interpolation. Because of symmetry, the solution of this equation was simplified.This method was tested in several volume data sets. The results and the generation time by different methods were obtained and compared. Result The results showed that this algorithm produced satisfactory quality images while the computational complexity was not increased. Conclusion This approach is preferable for most applications, especially for medical images reconstruction.

AIM:To investigate the timing and efficacy of vitrectomy for patients with vitreous hemorrhage(VH) due to proliferative diabetic retinopathy(PDR).METHODS:Retrospective analysis.Patients who presented to our hospital between Feburary 2012 and May 2014 with VH secondary to PDR treated with vitrectomy were included.All patients were divided into three groups according to the duration of VH.A group was less than 1mo for 22 eyes, B group was 1-3mo for 23 eyes, C group was more than 3mo for 25 eyes.All patients underwent intravitreal injection of ranibizumab 1-2wk before vitrectomy, and supplemented or finished panretinal photocoagulation (PRP) intraoperatively or postoperatively.Patients with cataract accepted phacoemulsification and intraocular lens implantation.Eyes filling silicone oil were implanted intraocular lens in the second phase.All patients were followed up 24 to 42mo (mean:28.7mo).We assessed the intraoperative complications such as hemorrhage, iatrogenic retinal hole, and postoperative complications such as vitreous hemorrhage, neovascular glaucoma.Macular edema and best corrected visual acuity were observed at every follow-up.RESULTS:There was no significant difference for other baseline data (P>0.05) but DR stage between three groups (P=0.033).There was significant difference of last follow up visual acuity between three groups (P<0.001).The significant difference can be seen between group A and B (P=0.03).The same outcome showed between Group A and C(P<0.001).There was no significant difference between Group B and C (P>0.05).The percentage of visual acuity was 0.5 and above in the three groups were:41%, 23%, 0 respectively.The patients with visual acuity of less than 0.1 were 5%, 26% and 40% respectively.Silicone oil filling rate of three groups were:9%, 26%, 40% respectively and there was no significantly difference between three groups on postoperative complications (P>0.05).CONCLUSION:Patients with VH due to proliferative diabetic retinopathy undergoing early vitrectomy may get better visual acuity than who accepting delayed vitrectomy.