[abstract] Objective To study the health education on diabetes nurse diabetes management mode at the core of application in the patients with follow-up effect. Methods Our hospital endocrinology in October 2015,participate in blood sugar management company research project(namely,doctors,nurses and patients ofthree Eonline and offline (O2O) integration management system).The project is the specialist education nurses,doctors and patients of organic whole,to form a closed-loop management.Use of the project with mobile tablet (PAD),SMS platform on the first base into a group of patients with type 2 diabetes insulin for 5 minutes on education and baseline data collection,and in the next 15 weeks of diabetes health education nurses via text message and phone tracking in the form of blood sugar and insulin dose data,at the same time for more than three months of education,guidance and management,to help patients with initial foundation of insulin self management knowledge and skills,promote the blood glucose control is at target. Results In 12 weeks of the completion of this project and follow-up,425 patients of FPG success rate is 82.6%. Conclusion Nurse diabetes health education as the core of diabetes management model is feasible in patients with type 2 diabetes, the effect is good,that greatly arouse the subjective initiative of patients;Improve the patients′self-management ability,improving according to the medical behavior;Improved treatment adherence to standard prompt patients FPG.

Objective To study the clinical characteristics of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese patients. Methods A series of 101 patients with colorectal cancers (CRC) and HNPCC associated tumors from 22 families fulfilling Amsterdam criteria were analyzed. Results Eighty-four patients were found to have CRC. Mean age at diagnosis of first CRC was 45.7 years. 58.3% and 23.8% of the first CRC were located proximal to the spleen flexure and in rectum respectively. 23.8% of patients had synchronous and metachronous CRC. Twenty patients had extracolonic tumors, among which gastric cancer was the most common tumor type in our series. Conclusions The frequency of HNPCC was 2.6% in this series of patients. It is characterized by early onset with a propensity to involve the proximal colon, and high frequency of multiplicity. Gastric cancer seems more frequent in Chinese patients, which is different from American and European reports. So it is necessary to set up criteria for diagnosis of HNPCC in Chinese.

Objective To investigate the changes of monoamine neurotransmitters of the brain in physical dependence induced by morphine in rats.Methods A physical dependent rat model was established with morphine in a gradually in creasing doses and the withdrawal syndrome was scored after naloxone precipitation.The conditioned place preference(CPP)in rats induced by morphine was used to investigate psychic dependence in rats.Contents of norepinephrine(NE0,dopamine(DA)and serotonin(5-HT)in hypothalamus of rats were assayed with a fluorescent method. Results (1)In naloxone-precipitated withdrawal test of morphine-dependent model rats,after morphine had been withdrawn,morphine-abstinent rats presented marked withdrawal symptoms and signs,their withdrawal scores were significantly increased,and the levels of NE and 5-HT in the rat brain were obviously enhanced,but the content of DA was reduced.(2)In CPP test,morphine caused a marked place preference in rats and the levels of DA and 5-HT in the rat brain were obviously enhanced,but the content of NE was reduced.Conclusiion Morphine dependence development and withdrawal are closely connected with monoamine neurotransmitters in CNS.In the physical dependent model induced by morphine in rats,the rising of NE and 5-HT in the rat brain were significant,but in psychic dependent model induced by morphine in rats,the levels of DA in the rat brain were enhanced p-redominately.

ObjectiveTo explore the effect of percutaneous locking compression plate(LCP) internal fixation for distal tibial comminuted fracture.Methods35 patients of distal tibial Comminuted fracture were treated with percutaneous locking compression plate(LCP) internal fixation.ResultsAll patients were followed up for average 1.8 years(ranging from 1 to 2.5 years).All of cases have healed well,and the average bone healing was 14.6 weeks (ranging from 8 to 28 weeks ).All of them have no infection and no loosening or breakage of internal fixation.According to Mazur criterion,excellent effect 17 cases,good effect 16 cases,fair effect 1 case poor effect 1 case,94.3％ was excellent or good.ConclusionThe LCP internal fixation for distal tibial comminuted fracture have the advantage of less invasive,good internal fixation and bone union fastly and little complications.

This study was aimed to discuss traditional Chinese medicine (TCM) factors of bone mineral density (BMD) in order to figure out the relation of BMD T-Score to the TCM syndrome of kidney-deficiency, qi-deficiency , and blood-stasis . It may provide the scientific basis for TCM treatment of osteoporosis . Patients were collected from August 2010 to April 2011 at the Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine . The assay of BMD was performed with the U . S . HOLOGIC dual-energy radia-tion . The BMD was measured and recorded in the form . All data were collected into the computer using Epi-Data3 . 02 software . Then , the data was analyzed by the SPSS15 . 0 statistical software . The results showed that through the Mann-Whitney U test , the BMD of patients with kidney-deficiency syndrome was worse compared to patients without kidney-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with q i-deficiency syndrome was worse compared to patients without q i-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with blood-stasis syndrome was worse compared to patients without blood-stasis syndrome ( P < 0 . 01 ) . It showed that the BMD of patients with kidney-deficiency , q i-deficiency and blood-stasis was worse compared to patients with-out syndrome of kidney-deficiency , q i-deficiency and blood-stasis . Under a variety of evidence-based BMD distribution , the chi-square test showed that there was significant difference ( P < 0 . 01 ) . It showed that differ-ent BMD had different TCM syndrome distributions . Among normal BMD cases , distributions of syndrome with-out kidney-deficiency, qi-deficiency and blood-stasis occupied the largest proportion. Among osteoporosis cas-es , the distribution of syndrome of kidney-deficiency , q i-deficiency and blood-stasis occupied the largest pro-portion . It was concluded that the syndrome of kidney-deficiency , q i-deficiency and blood-stasis maybe impor-tant factors to influence BMD . It may also be the risk factor of osteoporosis complication . The BMD are relat-ed to the syndrome of kidney-deficiency , q i-deficiency and blood-stasis and their combinations . Among bone mass reduction and osteoporosis cases , the proportion of combination of two or three types of syndromes was more than single one syndrome . It suggested that the combination of kidney-deficiency , q i-deficiency and blood-stasis had more influence on BMD .

ObjectiveTo study the efficacy of fluoxetine on improving depressive symptoms and activities of daily living(ADL) in early poststroke depressive patients.Methods42 early poststroke depressive patients (within 14 days after first stroke) were randomly divited into fluoxetine treatment group and control group (without antidepressive drugs).Evaluation was conducted before the treatment and at 4 and 6 weeks after treatment,using the Hamilton Depression scale(HAMD)and Barthel Index(BI).ResultsThere was no significant difference in HAMD and BI scores between the two groups before the treatment(P>0.05).At 4 and 6 weeks after the treatment, compared with the control group, the fluoxetine treated group demonstrated significant reduced in HAMD scores (P<0.001) and significant improvement in BI scores (P<0.01).ConclusionsFluoxetine is an effictive drug in improving depressive symptoms and ADL in early postsroke depressive patients.

ObjectiveTo explore the role of parameters of organ function during heat stroke (HS) on the prognosis, and to form the treatment strategy through an analysis of parameters of organ function during HS. Methods A retrospective study was conducted. Thirty-seven patients with HS (HS group) and 54 patients with mild-to-moderate stroke (stroke group) admitted to Zhejiang Xiaoshan Hospital from 2011 to 2014 were enrolled. The experimental results of organs function indicators for patients were recorded including:① cardiac markers:troponin I (TnI);② myocardium zymogram: creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST);③ renal function indexes: blood urea nitrogen (BUN), uric acid (UA), and serum creatinine (SCr);④ electrolyte: serum K+, Na+, and Cl-;⑤coagulation function: prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and D-dimer;⑥ blood gas analysis: pH value, arterial partial pressure of carbon dioxide (PaCO2), base excess (BE), standard bicarbonate (SB), and actual bicarbonate (AB);⑦ routine blood test: blood platelet count (PLT);⑧ hepatic function: alanine aminotransferase (ALT). Abnormal rates of laboratory parameters of 37 HS patients were statistically analyzed. Various laboratory parameters of organs function as well as the initial value and extreme value (maximum or minimum value) during treatment of CK and PLT in HS patients were compared between two groups.Results The abnormal rates of 37 HS patients were more than 70%, including incipient value of TnI, CK, LDH, AST, serum Na+, ALT, D-dimer, PaCO2, AB, maximum value of CK, and minimum value of PLT, the abnormal rates being 73.0%, 70.3%, 81.1%, 78.4%, 78.4%, 70.3%, 70.3%, 70.3%, 75.7%, 81.1%, 75.7%, respectively. The abnormal rates of other parameters were less than 70%. There were significant differences in incipient value of TnI, CK, LDH, AST, serum K+, serum Na+, D-dimer, and PLT between HS group and mild-to-moderate stroke group [TnI (μg/L): 0.087 (0.026, 0.306) vs. 0.007 (0.004, 0.110),Z = -7.017,P = 0.000;CK (U/L): 392.30 (287.60, 524.10) vs. 137.10 (106.33, 607.80),Z = -7.930,P = 0.000; LDH (U/L): 317.98±122.74 vs. 207.85±57.71, t = 1.678,P = 0.000; AST (U/L): 94.90 (52.80, 155.80) vs. 26.10 (18.13, 317.40),Z = -6.157, P = 0.000; serum K+ (mmol/L): 3.46±0.65 vs. 3.86±0.57,t = 1.662,P = 0.001; serum Na+ (mmol/L): 129.75±7.34 vs. 138.79±4.26,t = 1.674,P = 0.000; D-dimer (mg/L): 2.53 (0.63, 6.00) vs. 0.30 (0.21, 9.71),Z = -5.084, P = 0.000; PLT (×109/L): 144.62±86.14 vs. 219.48±64.76,t = 1.669,P = 0.000]. There were also statistically significant differences in the initial value and extreme value of CK and PLT between HS group and mild-to-moderate stroke group [CK (U/L): 392.30 (287.60, 524.10) vs. 721.50 (546.30, 964.10),Z = -6.351,P = 0.000; PLT (×109/L):132.40±82.55 vs. 68.24±44.62,t = 1.688,P = 0.000].Conclusions HS can impair several organs and systems, having complications, and it is a heavy insult for body. Increasing of CK and decreasing of PLT has some value to assess illness changes. It is helpful of laboratory results for doctors to estimate complications on time.

Objective To discuss the influence of psychological nursing on the therapeutic effect of patients with newly diagnosed type 2 diabetes. Methods Patients (60 cases) who received psychological nursing were set as the nursing group. Patients (65 cases) who did not received psychological nursing were set as the control group. The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment was observed. Results The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment in the nursing group was higher than that of the control group (P<0.01). Conclusions Psychological nursing of patients with newly diagnosed type 2 diabetes could make patients obey doctors' advice and accept early insulin treatment to control plasma glucose and delete the toxicity of high concentration of plasma glucose as soon as possible.

Objective To investigate the usage of antibacterial drug in the department of operation in our hospital for improving the management and proper clinical utilization.Methods 1366 operational cases from our hospital were randomly collected from June 2004 to June 2005 and a comprehensive analysis of the usage of antibacterial drugs was conducted.Results All of the cases were given antibacterial drugs.The rate of preventive usage was 89.0%,among which those given in the period in 1h before operating was only 30.6%,and the other's was given after operating.The therapy time of antibacterial drugs were ranged from 1 to 63 days in different case and the preventive usage were 1 to 16 days.The therapy time of surpass 3 days was 94.7% and surpass 7 days was 53.5% in preventive usage.Prescriptions of more than one kind drug was widespread very much and 2～3 kinds were 87.5%.The wide-table,new-style and high-efficiency antibacterial drugs were the most frequently used in prescription.Conclusions The use of the antibacterial drugs in operational case in our hospital has some problem,especially in scope,opportunity moment,therapy time and union of usage.The management and education about rational usage of antibacterial drugs must be strengthened in order to improve the level of rationality in the clinical application.

OBJECTIVE:To investigate the influence of cephalosporins antibiotics on cost and length of hospital stay in pa-tients underwent gallbladder calculus resection,and to provide reference for drug use in clinic. METHODS:A total of 1866 patients underwent gallbladder calculus resection were collected from 9 third grade class A hospitals in Guangxi during 2013-2014. SPSS 22.0 software was adopted to analyze cost and length of hospital stay in patients underwent gallbladder calculus resection. RESULTS:Multi-factor analysis showed that the factors which significantly affected the cost and length of hospital stay were antibiotics,hospi-tals,age,surgery types and disease species (all P<0.01). The antibiotics were divided into the subset 1-4 according to the cost of hospital stay:the subset 1 only contained cefuroxime(9454 yuan);the subset 2 contained noncephalosporins(16199 yuan)and ce-fazolin pentahydrate(17241 yuan);the subset 3 contained ceftazidime(20716 yuan),other cephalosporins(21046 yuan)and cefo-taxime sulbactam(22724 yuan);subset 4 contained cefotaxime sulbactam(22724 yuan),cefoperazone sulbactam(23688 yuan), cefoxitin(24685 yuan)and cefodizime(24698 yuan). The antibiotics were also divided into the subset 1-4 according to the length of hospital stay:the subset 1 only contained noncephalosporins (7.61 d);the subset 2 contained cefuroxime (8.94 d) and cefazolin pentahydrate(9.78 d);the subset 3 contained cefoxitin(13.39 d),cefodizime(13.44 d),other cephalosporins(14.32 d)and ceftazi-dime(14.60 d);the subset 4 included cefoperazone sulbactam(16.03 d)and cefotaxime sulbactam(16.91 d). The higher the subset numbers,the higher the cost of hospital stay or the longer the length of hospital stay;there were statistical differences among differ-ent subsets (P<0.05),while there was no statistical difference among the same subsets (P>0.05). CONCLUSIONS:Cephalospo-rins antibiotics can significantly influence the cost and length of hospital stay in patients underwent gallbladder calculus resec-tion. Antibiotics selection canbe considered comprehensively ac-cording to local medical resources and the patients'demands.