OBJECTIVE:To observe the efficacy and safety of metformin combined with rosiglitazone in the treatment of incipi-ent type 2 diabetes. METHODS:160 patients with incipient type 2 diabetes were randomly divided into observation group and con-trol group. Based on the diet control and exercise therapy,control group was orally given 0.5 g Metformin hydrochloride tablet,3 times a day;observation group was additionally given 4 mg Rosiglitazone maleate tablet,once a day. They were treated for 24 weeks. Clinical efficacy,body mass index (BMI),fasting plasma glucose (FPG),total cholesterol (TC),triglyceride (TG),2 h postprandial glucose(2 h PG),glycated hemoglobin(HbA1c),fasting plasma insulin(FINS)level,insulin resistance index(HOMA-IR)and insulin sensitivity index(HOMA-IAI)before and after treatment,and incidence of adverse reactions in 2 groups were ob-served. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statis-tically significant(P<0.05). Before treatment,there were no significant differences in the above-mentioned indexes(P>0.05). Af-ter treatment,BMI、FPG、TC、TG、2 h PG、HbA1c、FINS、HOMA-IR in 2 groups were significantly lower than before,FPG,2 h PG, FINS,BMI and HOMA-IR in observation group was lower than control group,HOMA-IAI was significantly higher than before, and observation group was higher than control group,the differences were statistically significant(P<0.05). There was no signifi-cant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:The efficacy and improvement of glucose metabolism,insulin resistance and insulin sensitivity of rosiglitazone combined with metformin are superior to metformin alone in the treatment of incipient type 2 diabetes,with similar safety.

Objective To explore the value of angiographic diagnosis and interventional therapy of severe gastrointestinal bleeding.Methods 33 patients in a critically ill state(1000ml of bleeding greater than alimentary canal),who could not or were not willing to go fibre gastroscope/intestines ytterbium checks,were diagnosed by selectivie or surpass-selectivie stomach-bowel angiography,and embolismed or poured into by the surpass-selection artery art after the bleeding artery definiting at the same time.Results The selective stomach-bowel artery radiography group identified 27 patients site of bleeding,the masculine rate was 82%.The surpass-selectivie stomach-bowel artery radiography group identified 31 patients site of bleeding,the masculine rate was 94%.2 patients had no abnormality,26 patients were cured by the embolism,7 patients were treated successfully by pouring into the pharmaceuticals.Among them 8 patients were bleeding again,4 patients were cured through the surgical operation without complication.Conclusions DSA surpass-selectivie stomach-bowel artery radiography can define the site of severe gastrointestinal bleeding and raise the hemorrhage kitchen range recall rate,the embolism can successfully control the bleeding.Throughout the pouring into the pharmaceuticals,those who can't be treated by embolism can save time for the surgical operation,make part of patient cure further gaining time for the surgical operation.

This paper introduces a solution to the development of next-generation telemedicine system based on Ipv6 with the analyses of present situation and related problems of telemedicine system.The devices,advantage of new system and a successful program based on Ipv6 are also mentioned.

OBJECTIVE:To observe clinical efficacy and safety of Zishen jianpi huoxue decoction combined with Xiaoxintong capsule in the treatment of type 2 diabetes complicating with silent myocardial ischemia (SMI). METHODS:126 patients with type 2 diabetes complicating with SMI were selected and randomly divided into control group(62 case)and observation group(64 cases). Both group were given diet guidance and hypoglycemic drugs as sulfonylureas,biguanides. Control group was given Xiaox-intong capsule 10 mg,tid;observation group was additionally given Zishen jianpi huoxue decoction 400-500 ml,bid. Both groups received treatment for 7 d. Therapeutic efficacy of thoracic obstruction,improvement of coronary artery branch stenosis and times and duration of electrocardiogram ST segment low voltage outlet were observed in 2 groups. ADR was compared between 2 groups. RESULTS:Therapeutic efficacy of thoracic obstruction and improvement of coronary artery branch stenosis in observation group were significantly better than in control group,with statistical significance(P<0.05);the times and duration of electrocardiogram ST segment low voltage outlet in observation group were significantly lesser shorter than in control group,with statistical signifi-cance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Zishen jianpi huoxue decoction complicating with Xiaoxintong capsule shows significantly therapeutic efficacy in the treatment of type 2 diabetes complicating with SMI with good safety.

Objective To evaluate the relationship between serum C‐P levels and microvascular complications in patients with T 2DM. Methods The clinical data of 434 patients with T2DM were retrospectively analyzed. All subjects were divided into three groups based on ΔC‐P (2 hC‐P - FC‐P) tertiles :ΔC‐P1(≤2.2 ng/ml) ,ΔC‐P2(2.3~4.0 ng/ml) and ΔC‐P3(≥4.1 ng/ml). Results The levels of BMI ,TG ,FC‐P were lower ,and the course and HbAl c were higher in ΔC‐P1 group. ΔC‐P level was positively associated with BMI and TG (P< 0.05) ,and negatively associated with prevalence of DR and chronic kidney disease (CKD)in diabetes ,course and HbA1 c.ΔC‐P levels decreased gradually with the progression of DR and CKD. Logistic regression analysis showed that lower ΔC‐P level was the independent risk factor for microvascular complications after adjustment for related risk factors. Conclusion Serum ΔC‐P level is an independent factor for the development of diabetic microvasculr complications in T 2DM.

Objective To compare the T-lymphocyte subpopulations,complement C3,C4 and HBV-DNA in the peripheral blood of patients with chronic hepatitis B under different liver function.Methods A total of 136 patients with chronic hepatitis B were selected,the patients were divided into improved group and deteriorated group according to the changes of hepatic function.T-lymphocyte subpopulations,complement C3,complement C4 and HBV-DNA in two groups were determined.Results A total of 72 patients were included in improved group,64 patients were included in deteriorated group.CD4+ in deteriorated group was significantly decreased,and CD8+ was significantly increased compared with those in improved group(P<0.05),CD3+ had no statistical difference between the two groups(P>0.05).Complement C3 and complement C4 in deteriorated group decreased compared with those in the improved group(t=12.124,P=0.003;t=4.041,P=0.010).However,HBV-DNA had no statistical difference between two groups(t=-2.598,P=0.793 ).Conclusion Compared with T-lymphocyte subpopulations,complement C4 and HBV-DNA,complement C3 has a better sensitivity to reflect the damage of the hepatic function in patients with chronic hepatitis B.

BACKGROUND:Diabetic lower limb ischemia is prone to involve distal lower limb arteries, and a conventional treatment is often unable to obtain the ideal effect. OBJECTIVE:To investigate the effect and safety of umbilical cord blood stem cel transplantation in the treatment of diabetic lower limb ischemia. METHODS: A diabetic rat model of lower limb ischemia was established, and along the femoral artery, five points
were selected for injection of human umbilical cord mesenchymal stem cel suspension, 20 μL per point. At 1, 2, 4 weeks after transplantation, transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region, and incidence of adverse reactions were recorded. RESULTS AND CONCLUSION:At 1, 2 and 4 weeks after transplantation, the transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region were found increasing, which were significantly different from those before transplantation (P < 0.05). At different time after transplantation, al animals had no inflammatory reactions such as skin bleeding and dermatitis, and local red, sweling, hot, pain, and had no tumor-like growth in organs. These findings indicate that umbilical cord blood stem cel transplantation can safely and significantly improve symptoms of diabetic lower limb ischemia, which has certain application feasibility. Cite this article:Xie LH, Xing L, Zheng H. Feasibility of umbilical cord blood stem cel transplantation for the treatment of diabetic lower limb ischemia. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):78-82.

OBJECTIVE:To provide a simple and reliable method to estimate confidence intervals of incremental cost-effectiveness ratios for pharmacoeconomics evaluation in China. METHODS:Through retrieving relevant foreign literature,the idea and mathematical properties of non-parametric Bootstrap method were described and the method for calculating confidence intervals were explained by giving an example. RESULTS&CONCLUSION:Non-parametric Bootstrap method is simple and reliable for the calculation of confidence intervals of pharmacoeconomics. When the distribution of samples is skewed significantly or the sample size is not plenty enough,we still need to be cautious to adopt non-parametric Bootstrap method.

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.

Objective To investigate clinical effect of 5-aminolevulinic acid photodynamic therapy(ALA-PDT)in the treatment of perianal condyloma acuminatum.Method ALA-PDT was used to treat 56 cases of perianal condyloma acuminatum and the curative effect was observed.Result The effectiveness rate of ALA-PDT was 94.6%.The recurrence rate was 5.4%.Conclusion The following nursing measures including care observation,adequate expansion of skin during treatment and performance of postoperative health education are all important for the enhanced curative effects of ALA-PDT in treating perianal condyloma acuminatum.