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.

This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

Objective] To investigate the relationship between pain from malnutrition and MM, looking for a cure for MM.[Methods]To analyze the relationship between pain from malnutrition and MM in clinical TCM based on the study of Neijing and the textual works of famous Chinese physicians. According to the etiology and pathogenesis to find the treatment method, and validation from clinical cases. [Result]We find that the pain from malnutrition caused by deficiency of kidney and spleen is a major cause of MM by summarizing of the ancient physicians. And we tally up the invigorating kidney is an important method for the treatment of MM.[Conclusion]Pain from malnutrition is an important pathogenesis of MM. To a method of treating MM, invigorating kidney and spleen is obvious and this method for the treatment of MM will bring more help.

BACKGROUND:Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion.Therefore,a novel kind of drug stent,which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis,needs to be developed.OBJECTIVE:To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments.RETRIEVE STRATEGY:The retrieve staffs were the research personnel for this paper.A computer-based online search was conducted in PUBMED for English language publications containing the key words of "drug eluting stents,percutaneous coronary intervention,coronary disease" from January 2002 to April 2007.Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007.The number of total retrieved Iiteratures was 15.Inclusion criteria:①reports about drug stents;②reports on research progress in the field of drug stents;③reports on the clinical application of drug stents.Exclusion criteria:low relevance and duplicated articles.LITERATURE EVALUATION:There were 264 articles about research and clinical applications of DES.Of those,42 literatures and 5 conference reports with high relevance and timeliness were included in this report.DATA SYNTHESIS:An ideal DES is comprised of a platform,a drug carrier vehicle and a pharmaceutical compound in harmony with each other.Given the ongoing development of DES materials and drugs,more effective DESs are introduced in the clinical practice.Recently,clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions,such as chronic total occlusions,complex lesions and multivessel lesions.However,concern that DES may be associated with a risk of late thrombotic events arose,suggesting an imbalance between safety and efficacy of DES.Therefore,novel strategies including bioabsorbable stents,and stents coated with pro-healing agents are promising.CONCLUSION:The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease,especially for restenosis and revascularization.Nevertheless,more endeavour will be necessary to create DES with high efficacy as well as low risk.

The essence of twirling reinforcing-reducing method is discussed to provide theoretical guidance for clinical application of reinforcing-reducing method. Through retrospection on historical literature of twirling reinforcing-reducing method, records and explanatory notes are thoroughly explored. Several existing opinions are analyzed and explained for instance twirling method has connection with circulation direction of channels; twirling method is subdivided into right and left, male and female, hand and foot; twriling method is related to quantity of stimulus and operation time; twriling method belongs to spiral motion and so on. As a result, it is found that the key of twirling reinforcing-reducing method is the posture of needle-holding hand that defines three-dimensional motion. If twirling method is subdivided into right and left, male and female, hand and foot and so on, steric effects of lifting-thrusting movement that come along with twirling method could be ignored at the same time. It is that the essence of twirling reinforcing-reducing method is close to the principle of lifting-thrusting reinforcing-reducing method, enriching effect with slow insertion and fast withdrawal of needle while reducing effect with fast insertion and slow withdrawal, which is recorded in Miraculous Pivot: Nine needle and Twelve Yuan. With this principle as guide, manipulation could be avoided to become a mere formality and illusory metaphysics during clinical application of twirling reinforcing-reducing method.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Oblective To define the median effective dose (ED50) and 95%effective dose of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanil anesthesia in children.Methods Twenty six ASA ⅠorⅡchildren aged 5-8 yr weighing 15-30 kg undergoing adenoidectomy under general anesthesia were studied.The patients were unpremedicated.Anesthesia was induced with inhalation of 8%sevoflurane (fresh gas flow=6 L/min)and iv remifentanil 1μg/kg.The patients were mechanically ventilated after tracheal intubation.Fentanyl was injected iv to inhibit emergence agitation.The dose of fentanyl was determined by using modified Dixon's upand-down method (increment or decrement of 0.5μg/kg).The initial dose of fentanyl was 4 μg/kg.Anesthesia Sevoflurane inhalation and remifentanil infusion were terminated at the end of operation.The patients were transferred to the PACU.No alteration in the ventilatory settings was made.Stimulation of the patients was avoided during emergence.The emergence time and the occurrence of agitation,nausea and vomiting and respiratory depression within 4h after operation were recorded.ED50,ED95 and 95%confidence interval (CI) of fentanyl for inhibition of emergence agitation were calculated.Results ED50 was 3.01μg/kg (95%CI 2.52-3.40μg/kg) and ED95 3.81μg/kg(95%CI 3.41-6.22μg/kg).No nsusea and vomiting and respiratory depression occurred within 4h after operation.The emergence time was (11.3±2.6) min.Conclusion The ED50 and ED95 of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanyl anesthesia were 3.01 and 3.81μg/kg respectively in children.

Telomerase can inhibit the shortening of telomere and stimulate continuous cell proliferation to form tumor.The activity of telomerase can be prohibited by G-quadruplex formed by the single chain in G-rich field of telomere 3' end, resulting in tumor cell apoptosis.Ligands which can induce the formation or stabilize the structure of G-quadruplex in G-rich field of oncogene exhibit antitumor function. Nowadays it becomes the core concern of chemists and biologists to screen and structurally design the compounds targeting G-quadruplex.This paper summarized the discoveries in the G-quadruplex-targeted telomerase inhibitors in recent years.

Objective To investigate the nutrition support during stress response period after tumor ex-tirpation in middle-aged and elderly patients with oral and maxillofacial tumors. Methods Sixty patients who had undergone maxillofacial tumor extirpation were randomly divided into nutrition therapy group (n = 35) and control group ( n = 25 ). Patients in nutrition therapy group received enteral nutritional treatment, while patients in control group fed themselves. The nutritional status of the two groups before operations were evaluated with Concise Nutritional Assessment Indicators of human body measurement and biochemistry were used to evaluate the nutritional conditions. The incidence of post-operational complications and recovery time ( from the operation to discharge) were analyzed. Results The weight and arm muscle circumference in the nutrition therapy group significantly decreased after operations (P <0. 05). However, in the control group, all the nutritional indica-tors except the total lymphocyte count were significantly lower than the baseline levels after operations (P < 0. 05 ) ; particularly, of the average body weight decreased by about 6 kg. The incidence of complications in the nutrition therapy group was significantly lower than that in control group (5. 7% vs. 12. 0% , P <0. 05). The recovery time was significantly longer in the control group than that in the nutrition therapy group [ (28. 62± 2.38) vs. (22. 76± 3. 24) d, P < 0. 01 ]. Conclusion The nutritional support during the stress response period can satisfy the demands of high catabolism after maxillofacial tumor extirpation operation in middle-aged and elderly patients.

When semiconductor chilling plate is used in parallel connection mode,a DC power supply with a low voltage and high current has to be available.A power supply of 1.8V,14A is designed to meet above demand.

Iliac vein compression syndrome is one of the most common lower extremity venous backflow obstruction disorders,which often causes lower limb swelling,venous stasis dermatitis,lower extremity deep venous thrombosis,lower extremity venous valvular insufficiency,etc.At present the commonly used imaging diagnostic means include ultrasonography,multi-slice computed tomography,magnetic resonance and digital subtraction angiography.This paper aims to review the recent progresses in the imaging diagnosis of iliac vein compression syndrome.