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.

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

Accidents, Occupational ; Acetic Anhydrides ; Adult ; Blast Injuries ; complications ; therapy ; Burns, Inhalation ; etiology ; therapy ; Humans ; Lung Injury ; etiology ; therapy ; Male ; Middle Aged

The morbidity and mortality of heart failure (HF) were gradually incrcased,around 2％-3％ of the population suffered from HF.As a biomarker,NT-proBNP has been shown to be widely used in the diagnosis of HF patients.NT-proBNP lever is affected by many factors,especially the age,age-specific NT-proBNP lever is very important in diagnosis of elderly HF patients.

Objective To investigate the effect of dichloroacetate on the expression of Kv1.5 in a rat model of pulmonary arterial hypertension (PAH) .Methods Thirty-two male SD rats weighing 200-250 g were randomly divided into 4 groups ( n = 8 each): normal control group (group C), dichloroacetate control group (group D),PAH group, and PAH + dichloroacetate group (group PD). PAH was induced by left lung resection combined with subcutaneous injection of monocrotaline 60 mg/kg in PAH and PD groups. In group PD, dichloroacetate 80 mg/kg was given through a gastric tube into stomach once a day for 28 consecutive days after monocrotaline injection,while the equal volume of normal saline was given instead of dichloroacetate in group PAH. Group D only received dichloroacetate 80 mg/kg through a gastric tube into stomach once a day for 28 consecutive days. Pulmonary arterial pressure (PAP) was measured at day 28 after monocrotaline injection. The rats were then sacrificed and lung tissues were removed to calculate the percentage of thickness of the tunica media of pulmonary artery and right venicular hypertrophy index and to determine the proliferating cell nuclear antigen (PCNA) and Kv1.5 protein expression (by Western blot) and Kv1.5 mRNA expression (by RT-PCR).Results Compared with group C, the PAP,percentage of thickness of the tunica media, right ventricular hypertrophy index were significantly increased, Kv1.5 mRNA and protein expression was down-regulated and PCNA expression was up-regulated in groups PAH and PD ( P ＜ 0.05). Compared with group PAH, the PAP, percentage of thickness of the tunica media, right ventricular hypertrophy index were significantly decreased, Kv1.5 mRNA and protein expression was up-regulated and PCNA expression was down-regulated in group PD (P ＜ 0.05). There was no significant difference in the indexes mentioned above between group C and group D ( P ＞ 0.05). Conclusion Dichloroacetat alleviates PAH through upregulating Kv1.5 expression in lung tissues and inhibiting pulmonary vascular remodeling in rats.

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.

Objective:To study the correllation of genetic polymorphisms of IL-10 polymorphic loci with ulcerative colitis sus-ceptibility and its influence on clinical outcomes.Methods:A total of 80 patients with ulcerative colitis were selected as case group and the others by sex and age matched healthy subjects as control group according to the case-control study design.Peripheral venous blood samples were drawn and DNA was extracted from all subjects prior to treatment.PCR primers of -819T/C(rs1800871),-592A/C (rs1800872),-1082G/A(rs1800896) were designed for PCR amplification.The fragments produced from human genomic DNA were performed by restriction enzyme digestion of amplified PCR products,and further separated using agarose gel electrophoresis.Relative risk(OR) and 95%confidence interval(95%CI) were calculated by the Logistic regression,in order to evaluate the correlation of IL-10 gene polymorphism with susceptibility of ulcerative colitis and clinical outcomes.Results:(1)The distribution frequency of genotype AA,GG and AG of polymorphic loci rs1800896 in cases patients were significantly different from that in control group(P<0.01).(2) Compared to rs1800896 genotype AA,genotype GG were significantly associated with increased risk for ulcerative colitis(P<0.01)and the decreased clinical remission rate ( P<0.01 ).( 3 ) The distribution frequency of genotype CC, CT and TT of polymorphic loci rs1800871 were not significantly different between groups(P>0.05).(4)The distribution frequency of genotype AA,AC and CC of polymorphic loci rs1800872 were not significantly different between groups(P>0.05).Conclusion:IL-10 polymorphic loci rs1800896 genotype GG would be associated with increased susceptibility to ulcerative colitis,and poor prognosis of patients.

Objective:To establish a nomogram model for predicting the risk of intracranial hemorrhage in patients with acute cerebral infarction after mechanical thrombectomy.Methods:The clinical data of 251 patients with acute cerebral infarction who underwent mechanical thrombectomy in Shengjing Hospital Affiliated to China Medical University from January 2017 to December 2019 were retrospectively analyzed. Logistic regression model was used to analyze the independent risk factors of intracranial hemorrhage after mechanical thrombectomy. A nomogram prediction model based on independent risk factors was established to verify the prediction and accuracy of the model.Results:The analysis results of logistic regression model were as follows: age ( OR=1.303, 95% CI:1.184-1.433), the time from infarction to re-canalization ( OR=4.306, 95% CI:2.497-7.425), preoperative NISS score ( OR=7.584, 95% CI:2.221-25.900), preoperative computer tomography (CT) low-density lesions ( OR=7.954, 95% CI:1.176-53.792) were independent risk factors for intracranial hemorrhage after mechanical thrombectomy in patients with acute cerebral infarction ( P<0.05). Based on the above 4 independent risk factors, a nomogram predictive model of intracranial hemorrhage risk after mechanical thrombectomy was established. The Bootstrap internal verification method proved that the model had good prediction accuracy, and the receiver operating characteristic (ROC) curve analysis testified that area under curve (AUC) area was 0.966. Conclusions:The risk nomogram prediction model has good accuracy, discrimination and good prediction ability, which can improve the diagnostic efficacy of intracranial hemorrhage after mechanical thrombectomy in patients with acute cerebral infarction.