Objective To investigate the effect of aspirin combined with atorvastatin in the treatment of diabetic atherosclerosis.Methods 120 patients with diabetic atherosclerosis form August 2014 to February 2016 were selected,and randomly divided into treatment group and control group,60 cases in each group.Control group treated with aspirin enteric-coated tablets,the treatment group treated with aspirin enteric-coated tablets combined with atorvastatin,comparing the two groups before and after treatment of fasting blood glucose,blood lipid related index,carotid intima-media thickness and plaque thickness,and the adverse reactions.Results After treatment, the levels of fasting blood glucose and fasting insulin in treatment group were significantly lower than control group(P<0.05),the carotid intima-media thickness and plaque thickness in treatment group was significantly lower than control group(P<0.05).The levels of TG,TC,LDL-C and HDL-C in treatment group were significantly improved(P <0.05).Conclusion Aspirin enteric coated tablets combined with atorvastatin efficacy significantly in the treatment of diabetic atherosclerosis.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which em-bodies the concept of individualized diagnosis and dynamic treatment on a holistic view. RCT was frequently used in TCM clinical study. However, it cannot reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies (ATS) in clinical research can adjust therapy in patients according to the change of disease, so it can reflect personalized medicine and dynamic treatment. From this perspective, the process of treat-ment based on syndrome differentiation was a process of adaptive treatment decision. So the method for developing ATS can effectively evaluate the efficacy of different treatment strategies in TCM clinical study. ATS had been used in some clinical studies from published literatures abroad. However, the use of ATS in domestic clinical research was seldom been reported. This paper gave an outline of the concept of ATS. In addition, this paper focused on three methods which can take the delayed effects of current treatment action into consideration and can compare the over-all effect of different ATS. It was hoped to lay foundation for future scientific research of TCM in the implementation of SMART and provide a new idea.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which is the core technology that can embody the characteristics and advantages of TCM diagnosis and treatment. This is based on holistic view to illustrate individual diagnosis and treatment and dynamic treatment. However, RCT, which is frequently used in TCM clinical studies, can not reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies in clinical researches can adjust therapy in patients according to the changes of diseases, so it can reflect individual diagnosis and treatment and dynamic treatment. From this perspective, the process of treatment based on syndrome differentiation is a process of decision-making of adaptive treatment. So the method for developing adaptive treatment strategies can effectively evaluate the efficacy of different treatment strategies in TCM clinical studies. Adaptive treatment strategies have been used in some clinical studies from some published foreign literatures. However, the use of adaptive treatment strategies in domestic clinical researches is seldom reported. This article discussed the concept of adaptive treatment strategies and their important components in detail. In addition, it presented three methods which can take the delayed effects of the current treatment action into consideration and can compare the overall effect of different adaptive treatment strategies, with a purpose to lay some foundation for future TCM researches in the development of optimal clinical pathway and provide new ideas and methods for researches.

Objective To explore ways of enhancing the therapeutic level of the neurology department and reducing the economic burdens of patients. Methods Relevant materials were collected by means of evidence based medicine to optimize therapeutic schedules, with cerebral infarction being the pitching in point. Results Prior to the adoption of evidence based medicine, the average length of stay, the effective rate of treatment and the expenses for single entity diseases were respectively 17.83?13.44, 89.91% and 4 550.70 yuan, whereas after the adoption of evidence based medicine, they were respectively 15.38?11.37, 94.16% and 3 942.88 yuan. Conclusion Evidence based management is a means of scientific management. Its application in the department of neurology has produced a marked effect and it is worthy to be spread.

Objective:To understand the current situation of hospital violence medical students experienced during the internship period and their professional identity.Method:With the method of cluster sampling,a questionnaire survey was conducted among 500 medical students from a medical college in Ganzhou,to understand the characteristics of hospital violence and compare the difference between the medical students who experienced violence and those not.Results:The effective recovery rate of questionnaire was 90.8％,of which 61.4％ of medical students had witnessed hospital violence,8.1％ of students had experienced hospital violence;the hospital violence that medical students experienced were characterized by low frequency and emotional violence.The overall score of personal identity was (117.05 ± 19.65),was in a medium level.Among the comparison of personal identity between the medical students who had experienced violence and those not,there was a significant difference in occupational cognition dimension (P ＜ 0.01),but there was no significant difference in the total score and other four dimensions (P ＞ 0.05).Conclusion:We should pay attention to the current situation of hospital violence that students experienced and their professional attitude,carry out targeted training and psychological counseling to improve their ability to respond to hospital violence and enhance their professional identity.

Aims To observe the influences of met-formin ( MET ) on the expression of renal tissue ad-vanced glyclation end-products( AGEs) protein and its receptor mRNA ( RAGE mRNA ) in type 2 diabetes mellitus (T2DM) model rats, and to discuss the mech-anism of the MET in the treatment of diabetic nephrop-athy ( DN ) . Methods The rat model of T2 DM was established by fed with high-fat diet and intraperitoneal injection of low-dose of streptozotocin ( STZ ) . All rats were randomly divided into metformin group( MET,300 mg·kg-1 ·d-1 ) , glyburide group( GLY,5 mg·kg-1 ·d-1),T2DM model group(T2DM) and normal con-trol group ( NC ) . After 8 weeks ’ observation, blood glucose ( BG ) , glycated hemoglobin ( HbA1 c ) , blood urea nitrogen(BUN), urinary albumin,urinary AGEs and urine creatinine were detected. The expression of renal tissue AGEs was detected by immunohistochemis-try assay, and the expression of RAGE mRNA was measured by real-time PCR. Results The levels of BG, HbA1c , urinary albumin/urine creatinine ( UACR ) , glomerular basement membrane thickness ( GBMT ) in MET group and GLY group were signifi-cantly lower than those of T2DM group, while higher than those of NC group(P<0. 05), the levels of BG, FINS and HbA1 c were not statistically significant be-tween MET and GLY group ( P >0. 05 ) . The urinary AGEs/urine creatinine( UGCR) , the expressions of re-nal tissue AGEs and RAGE mRNA in MET group and GLY group were significantly decreased compared with those of T2 DM group ( P < 0. 05 ) , but higher than those of NC group ( P <0. 05 ) . The UGCR, the ex-pressions of AGEs and RAGE mRNA in MET group were lower than those of GLY group(P<0. 05). Con-clusion MET can reduce the accumulation of AGEs in the renal tissue,and down-regulate the over-expres-sion of RAGE mRNA in T2DM rats.

OBJECTIVE:To simultaneously determine the contents of paracetamol and caffeine in999Ganmaoling granules with TLC.METHODS:Chloroform-ethylacetate-methanol-annmonia water(15∶4∶3∶0.3)was taken as developing a?gent.The spots were scanned with CS-930TLC scanner at? S =245nm,? R =315nm for paracetamol and at? S =270nm,? R =350nm for caffeine.RESULTS:Average recovery of paracetamol was99.33%,RSD=1.28%;Average recovery of caffeine was100.1%,RSD=1.71%;The labelling contents of paracetamol and caffeine in three batches of samples were99.02%,98.48%,99.23%and99.74%,98.57%,99.24%respectively.CONCLUSION:The method is simple,quick and accurate.It can be used for the quality control of999Ganmaoling.

Objective:To induce the specific cytotoxicity of T lymphocytes to the breast cancer cells overexpressing HER 2 by bispecific monoclonal antibodies anti HER 2?anti CD3 and to stimulate natural immunoreactions. Methods:Using SK BR 3 cell line overexpressing HER 2 as target cells, MCF 7 cell line as control cells, and T lymphocytes as effector cells, the biological function of BsAb anti HER 2?anti CD3 was studied, including growth inhibition of target cells, proliferation of effect cells, and cytotoxicity of lymphocytes mediated to SK BR 3. The measuring methods included MTT(measurement of tetrazplium), 3H thymidine incorporation assay system.Results:BsAb anti HER 2?anti CD3 had the function of MAbHER 2 and MAbCD3, which inhibited growth of SK BR 3 and accelerated proliferation of T lymphocytes from normal donors. BsAb anti HER 2?anti CD3 mediated more significant cytotoxicity of T lymphocytes to SK BR 3 than MAb HER 2.The best ratio of effector cells to target cells was 20∶1. Conclusion:BsAb anti HER 2?anti CD3 bound to the breast cancer cells overexpressing HER 2 and T lymphocytes and mediated significant cytotoxicity of T lymphocytes to the breast cancer cells overexpressing HER 2, indicating BsAb anti HER 2?anti CD3 had significant antitumor function.

Objective To investigate the risk factors of cerebral infarction in elderly patients with type 2 diabetes mellitus.Methods Elderly patients with type 2 diabetes complicated with cerebral infarction from August 2014 to March 2016 in our hospital were selected as observation group of 70 cases, elderly patients with type 2 diabetes alone of 70 cases as control group.The related indicators were compared between two groups, then the indicators with statistical difference were included into the multiple Logistic aggression analysis.Results There were significant difference between two groups of waist to hip ratio (WHR), body mass index (BMI), fasting blood glucose (FBG), 2h postprandial blood glucose (2h PBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1C), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C).The multiple Logistic aggression analysis showed BMI,TG,LDL-C,FINS,2hPBG and WHR were risk factors in elderly type 2 diabetes mellitus complicated with cerebral infarction. Conclusion There are many risk factors in elderly patients with type 2 diabetes complicated with cerebral infarction, higher blood sugar, higher blood lipid and higher body mass index as the independent risk factors, which should be payed attention to and prevent the occurrence of cerebral infarction.

Objective To investigate the therapeutic effect of different wavelength krypton lasers on diabetic retinopathy. Methods A total of 55 eyes (35 cases) with diabetic retinopathy underwent different wavelength krypton lasers photocoagulation treatment, according to the different manifestation of the affected eyes. The visual acuity, intraocular pressure,visual field,visual evoked potential were examined, and slit lamp, ophthalmoscopy, B ultrasonography, and fundus fluorescein angiography were performed preoperatively. The patients were followed up for at least 12 months after krypton laser treatment. Results The resulting effect on visual acuity after 12 months of photocoagulation in this series revealed that, 20 eyes (36.4%) improved, 34 eyes (61.8%) remained no change, and one eye (1.8%) decreased. Conclusions Different wavelength krypton lasers photocoagulation can be used in treatment of diabetic retinopathy and can improve the visual acuity at certain extent.