Objective To explore the effect of responsibility system of family doctors( RSFD) for community management of the patients with diabetic retinopathy ( DR ) .Methods Fifty -two cases with non -proliferative diabetic retinopathy( NPDR) found in annual health examination in community health care centers were selected and randomly divided into intervention group(30 cases) and control group(22 cases).The intervention group received RSFD service mode and the control group received conventional management mode for 1 year.Patients'visual acuity, fundus,fasting blood-glucose(FBG),glycosylated haemoglobin(HbA1c) were observed and compared before and after intervention.Results In this study,the efficacy in improving patients'visual acuity and retinopathy was 73.3%in the intervention group and 45.5%in the control group,there was statistically significant difference between the two groups(χ2 =4.168,P=0.041).Before intervention,the control rates of patients'FBG were 36.4% and 30.0%respectively,and HbA1c was 27.3%and 33.3%.There were no statistically significant differences between the two groups(P>0.05).After intervention,the control rates of patients'FBG and HbA1c were 86.6% and 80.0% in intervention group,and 59.1%and 54.5%in the control group,there were statistically significant differences between the two groups (χ2 =5.147,P=0.023;χ2 =3.861,P=0.049).Conclusion RSFD service mode was conductive to control patients'blood sugar and improve visual acuity and retinopathy,we could disseminate and apply it to manage-ment of DR in community.

H2S,considered as the third gas transmitter besides NO and CO,has extensive biological activities.It shows great potential therapeutic use among several diseases.This review focuses on the recent research achievements on H2S and its potential therapeutic use.

0.05) but quite different from European and African's(P

Objective]Through judging the constitutional types of traditional Chinese medicine(TCM) of acute mastitis patients, do statistics and analysis of the distribution of the acute mastitis patients’constitutional types of TCM, and study their laws, in order to provide guiding basis of constitutional theory of TCM for preventing and early treating mastitis. [Method] By means of questionnaire method, judge the constitutional types of TCM of 77 acute mastitis patients according to the classification and judgment of constitution of TCM ,and analyze the results by statistical methods. [Results] The number of the constitutional types of TCM of 77 acute mastitis patients from high to low is as follows: dampness-heat constitution is 65 cases, energy-stagnant constitution is 52 cases, yang-deficiency constitution is 51 cases, qi-deficiency constitution is 37 cases, yin-deficiency constitution is 34 cases, phlegm-dampness constitution is 32 cases, blood-stasis constitution is 29 cases, normal constitution is 12 cases, and special-natural constitution is 7 cases. Individuality constitution has 9 cases, two and three mixed constitution each has 12 cases, four and five mixed constitution each has 9 cases, six mixed constitution has 14 cases, seven mixed constitution has 11 cases, eight mixed constitution has 1 case. In the main constitutional types of TCM of 77 acute mastitis patients, dampness-heat constitution(54 cases, 70.13%) is most, followed by normal constitution(12 cases, 15.58%) and yang-deficiency constitution(5 cases, 6.49%). In the individuality constitution and two mixed constitution, the proportion of dampness-heat constitution(60 cases, 39.47%) is highest, and that of yang-deficiency constitution(34 cases, 22.37%) is also higher. This shows that: 1. Dampness-heat constitution is the most common constitutional type related with the occurrence of acute mastitis, and yang-deficiency constitution is the second. 2. The acute mastitis patients have a variety of constitutional types such as dampness-heat constitution, energy-stagnant constitution etc. Mixed constitution is common and complex. May be it is associated with the particular period of postpartum lactation period. [Conclusion] Constitution as internal factors of disease has an important influence on occurrence and development of acute mastitis. It has great meaning to adjust prejudiced constitutional types of TCM as dampness-heat constitution and yang-deficiency constitution for preventing and early treating acute mastitis. This reflects the TCM thought of“treat unoccurred disease”.

Objective To investigate the clinical application of magnetic resonance cholangiopancreatography(MRCP) in diagnosis of obstructive jaundice.Methods Thirty-three patients with obstructive jaundice were examined by MRCP and the accurate rate of MRCP was evaluated according to the result of operation and pathology examination.Results The positive rate of the orientation diagnosis of MRCP in obstruction was 100%(33/33).The accurate rates of qualitative diagnosis for benign disease and malignant obstructive jaundice were 87.5%(21/24) and 90%(9/10) respectively.The general qualitative diagnose accordance rate was 87.9%(29/33).Conclusion MRCP is simple,hurtless and safe for the diagnosis of obstructive jaundice and it deserves generalization in the clinical application.

Objective: To investigate the association between three single nucleotide polymorphisms-2562G＞A,-416C＞G and-232G＞A in Tim-3(T cell immunoglobulin domain and mucin domain protein 3)gene promoter region and child allergic asthma in Chinese Han population by using family-based association study.Methods: Genotypes of 3 SNPs(-2562G＞A,-416C＞G and-232G＞A)in 118 allergic asthma nuclear pedigrees were analyzed by restriction fragment length polymorphism.The genotype data were analyzed by using the family-based transmission disequilibrium test(TDT).Haplotypes and their frequencies were established and analyzed by TRANSMIT software.Results: ①No transmission disequilibrium was found at the-2562G＞A and-232G＞A sites from heterozygous parents onto patients in 118 trios analyzed by TDT(P＞0.05);However,at the-416 C＞G locus,the observed values of G allele from heterozygous parents to offspring were significantly higher than the expected values(P＜0.05)②The haplotype TDT analysis by TRANSMIT showed the observed and the expected value in GCA and GGA haplotype from parents to the affected offsprings had significant difference respectively(P＜0.05).The Global X~2 test results also showed that Tim-1 haplotype were associated with child allergic asthma(X~2 = 17.26, P＜0.01).Conclusion: Tim-1 gene promoter-416C＞G locus are associated with allergic asthma susceptibility in Hubei Chinese Han population and the haplotypes constructed by-416C＞G are also associated with asthma.Tim-1 genetic polymorphism may play an important role in the pathogenesis of asthma.

Objective To study the expression of CD4+, CD25+ regulatory T cells and its significance in carcinoma of stomach. Methods Flow cytometry was used to quantify and analyze the results of CD4+, CD25 + regulatory T cells and CD8+ T cells in 76 patients with gastric cancer. Results CD4+, CD25+ regulatory T cells expression in gastric cancer tissue, adjacent tissues and control group are (1.2±0.9) %, (6.4±1.1) % and (4.1±0.8) %. The results have statistical significance (P<0.05). CD8+ T cells markedly de-creased in gastric cancer tissue, while CD4+ , CD25+ regulatory T cells increased. But this manifest did not happen in adjacent tissues.Conclusion CD4+, CD25+ regulatory T cells suppress gastric cancer though inhibiting CD8+ T cells.

objective To investigate the association between two single nucleotide polymorphisma (SNP)rsl0053538 and r810515746 in Tim-3(T cell immunoglobulin domain and mucin domain protein 3) gene promoter region and child allergic asthma in Chinese Han population from Hubei province by using faro-ily-based association study．Methods Cenotypes of 2 SNPs(rs10053538 and rs10515746)within Tim-3 gene in 118 allergic flsthma nuclear pedigrees were analyzed by restriction fragment length polymorphism and DNA sequencing．Two family-based designs，transmission disequilibrium test(TDT)and haplotype-based haplotype relaive risk(HRR)were employed for the data analysis．Haplotypes and their frequencies in 118 nuclear pedigrees were established and analyzed by Transmit software．Results The HRR analysis showed no increased risks of contracting the disease owing to rs10053538 and rs10515746 polymorphisma of Tim-3 promoter in our 118 tries(X2=2．430，P>0．05；x2=1．368，P>O．05)．N0 transmission disequilibrium was found from heterozygous parents onto patients in our 118 tries analyzed by TDT(x2=2．042，P>0．05；X2=0．750，P>0．05)．The haplotype analysis also showed no biased transmission of rs10053538 and rs10515746 haplotypes from parents to the affected offsprings(P>0．05)．Condusion The two SNPs rs10053538 and rs10515746 in Tim-3 gene promoter region are not associated with susceptibility to child allergic asthma in Chinese Han population from Hubei province．

Objective Our research aimed to investigate the efficacy and the nursing characteristics of allogenic bone marrow mesenchymal stem cell (BM-MSCs) transplantation in HBV related acute-on-chronic liver failure (ACLF) patients.Methods A total of 91 HBV related ACLF patients were enrolled,among whom 45 patients received allogenic BM-MSCs transplantation via peripheral vein and other 46 patients received medical treatment only.We assessed the 12-week survival rates and the variation of model for end liver disease (MELD) score.Besides,we administrated comprehensive nursing for these patients in different stages of the transplantation.Results The cumulated survival of patients received BM-MSC transplantation was 75.6％,which was higher than the control group (54.5％).The level of total bilirubin and International Normalized Ratio (INR) had greatly improved.41 of 45 patients passed through perioperative period safely,without any severe adverse events.11 patients died due to exacerbation of liver failure,among whom 3 happened in perioperative period.But none was related with the operation.Conclusions Allogenic BM-MSCs transplantation can improve the survival rate of HBV related ACLF patients.The psychological nursing pre-operation,skilled operation,intensive care and observation post operation were beneficial to the patients' recovery after transplantation.

Objective To assess the clinical value of dobutamine 201Tl stress-redistribution/nitroglycerin augmented ~(99m)Tc-metho~(99m)Tc-xyisobutylisonitrile (MIBI) gated myocardial perfusion imaging (MPI) in patients with coronary artery disease (CAD). Methods A total of 132 patients with suspected CAD underwent dobutamine 201Tl stress-redistribution/nitroglycerin augmented MIBI gated MPI and coronary arteriography (CAG) within two weeks after MPI. Percutaneous coronary interventions (PCI) were performed in 23 patients with myocardial infraction. The regional wall movement was assessed with echocardiography before and within three months after PCI. Results Taking stenosis ≥50% as standard of CAD, the sensitivity, specificity and accuracy of dual-isotopic SPECT imaging in diagnosing CAD was 93.41%, 87.80% and 91.67%, respectively. The sensitivity, specificity and accuracy in diagnosing left anterior descending artery (LAD) stenosis was 93.85%, 91.04% and 92.42%, for left circumflex artery (LCX) was 86.79%, 89.87% and 88.64%, while for right coronary artery (RCA) was 81.25%, 82.14% and 81.82%, respectively. Of all 207 myocardium segments in 23 patients with myocardial infarction, radioactivity defect was found in 113 segments on the redistributed ~(201)Tl images, and radiofilling was found in 52 (52/113) segments on the nitroglycerin augmented ~(99m)Tc-MIBI images, whereas 61 segments had no radiofilling. Taking regional wall movement improvement as the criterion of viable myocardium, the sensitivity, specificity and accuracy of identifying viable myocardium with nitroglycerin augmented ~(99m)Tc-MIBI imaging was 87.23%, 83.33% and 84.96%. Conclusion Dobutamine ~(201)Tl stress-redistribution/nitroglycerin augmented ~(99m)Tc-MIBI gated MPI is able to effectively detect CAD and viable myocardium and helpful in diagnosis and treatment of CAD.