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.

[Objective] The paper tries to demonstrate the reasonableness and legality of Doctors ’Right of Intervention. [Methods]By comparing life divine principle and patient autonomy principle to analyze the value ranking. By data col ection, study the relevant provisions of Doctors ’Right of Intervention at home and abroad. [Results] Life divine principle demonstrates the reasonableness of the Doctors ’Right of Intervention, and the right to life and health in Constitution demonstrates the legality of the Doctors’Right of Intervention. [Conclusions] Doctors’Right of Intervention is reasonable and legal, so when patients or their family members make wrong or harmful choice in treatment, doctors should exercise the Doctors ’Right of Intervention without hesitation to help them to choose the right way or make decisions for them.

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.

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.

Objective To investigate the clinical application of dezocine and remifentanil in elderly patients with painless gastroscopy.Methods According to random number table,180 elderly patients undergoing painless gas-troscopy were randomly divided into dezocine group(group D),remifentanil group(group R)and control group(group C),each group 60 cases.Group D was infusion with dezocine 20μg/kg,Group R was infusion with remifentanil 0.5μg/kg and Group C was infused with normal saline,then three groups patients,respectively,after the interval of 1 minutes were given propofol 1 mg/kg.Objects induced sum of propofol,starting time,awakening time,discharged time,HR,MAP and SpO2 during operation,sedation scores,postoperative side effects such as nausea and vomiting were observed.Results The decrease of MAP was alleviated in group D compared with group C and group S(tDR =2.278,PDR<0.05 and tDC =2.545,PDC <0.05).SpO2 in group C and group R were significantly lower than that in group D(tDR=2.184,PDR<0.05 and tDC =2.206,PDC <0.05).The time for regaining consciousness(tDC =5.401 and tRC =6.674)and propofol dosage(tDC =3.726 and tRC=4.213)in group D and group R were significantly lower than those in group C(P<0.05).The Ramsay of group D was (2.3 ±0.7)points,which was lower than (3.8 ±1.2) points of group C,(3.6 ±0.9)points of group R(tDC =8.938,PDC <0.01;tDR=7.154,PDR<0.01),and there were fewer adverse reactions in group D.Conclusion Dezocine is more suitable for the elderly patients than remifentanil, which has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.

Objective:To investigate the effect of NF-κB p65siRNA of IL-17 inducing the expression of MCP-1 in the primary cultured cardiac myocytes.Methods:The cardiac myocytes were isolated from neonatal mice by different adhesion method.NF-κB P65 siRNA was transfected into cardiac myocytes and the rates of transcription and translation of MCP-1 were detected by RT-PCR and enzyme-linked immunosorbent assay( ELISA) ,the rates of transcription and translation of P-P65 and P65 were detected by RT-PCR and Western blot.Results:Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were increased in negative siRNA +IL-17 group(P<0.05).Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA group( P<0.05).Compared with negative siRNA+IL-17 group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA+IL-17 group(P<0.05).The expression of the NF-κB P65 at mRNA and protein levels in cardiac myocytes were specifically and extensively suppressed by NF-κB P65 siRNA(P<0.05).After stimulated by IL-17,the amount of P-P65 in the cardiac myocytes was significantly increased in time-dependent manner compared with that of black group( P<0.05) , but the levels of P65 changed little ( P>0.05 ) .Conclusion: IL-17 stimulates MCP-1 expression in cardiac myocytes via NF-κB activation,and NF-κB P65 siRNA can effectively inhibit the upregulation of IL-17 on MCP-1.

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.

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.

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.

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.