[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.

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 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.

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 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 investigate the best time interval for replacement of urine collection bags for patients with indwelling catheter. Methods90 patients in brain surgery department with indwelling catheter were randomly divided into group A,B,C,group A replaced urine collection bags every 3 days,group B replaced urine collection bags every 7 days,group C replaced urine collection bags every 14 days.Urine samples were gathered in three groups of patients for bacterial culture on the admission day,the 5th,the 8th,the 11th and the 14th day respectively,and the positive rates of bacterial culture were compared.ResultsThe positive rates of urinary bacterial culture in three groups were not significantly different by statistical analysis. ConclusionsReplacement time of urine collection bags for patients with indwelling catheter may be extended to 14 days,and may be synchronization with the replacement time of urine catheters.This can reduce bacterial ascending infection,decrease nosocomial infection rate,save health care costs,reduce the labor intensity of the nursing staff,improve the social and economic benefits.

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 effects of hippocampal?sparing intensity?modulated radiotherapy ( IMRT) on dose distribution of target volume and organs at risk ( OARs) in locally advanced nasopharyngeal carcinoma. Methods A retrospective dosimetric analysis was performed among 11 patients with locally advanced nasopharyngeal carcinoma. The MONACO ? v5. 10 Treatment Planning System was used to design three treatment plans:routine volumetric modulated arc therapy ( VMAT ) , hippocampal?sparing VMAT, and nine fixed?fields IMRT. The D98%, D50%, D2%, Dmean , conformity index ( CI ) , and homogeneity index (HI) of planning target volume (PTV) and PTVnx as well as dose distribution of the hippocampus and OARs were evaluated. Using single factor analysis of variance,two group comparative was LSD or paired t?test. Results For the above three plans,the D2% values of PTVnx were ,7 513,and 7 462 cGy,respectively (P=0. 016);the D98% values of PTV were 5837,5812,and 5914 cGy,respectively (P=0. 029);the average D2% values of PTV were 7 399,7 380,and 7 333 cGy,respectively ( P=0. 047);the HI values of PTV were 0. 239,0. 241,and 0. 220,respectively (P=0. 016);the V10 values of the brain stem were 97. 2%,88. 1%,and 90. 3%,respectively ( P=0. 001);the V20 values of the brain stem were 74. 2%, 62. 3%,and 67. 1%,respectively ( P=0. 032);the V30 values of the brain stem were 50. 9%,35. 8%,and 45. 5%, respectively ( P= 0. 020 );the V40 values of brain stem were 24. 4%, 14. 4%, and 23. 3%, respectively ( P=0. 018);the Dmean values of hippocampus were 1 518,899,and 896 cGy,respectively ( P=0. 000);the D40% values of hippocampus were 1 379,642,and 639 cGy,respectively ( P=0. 000);the V10 values of the hippocampus were 54. 1%,25. 1%,and 3. 8%,respectively ( P=0. 000);the V20 values of the hippocampus were 26. 2%, 12. 6%, and 12. 0%, respectively ( P=0. 001 ) . Conclusions Hippocampal?sparing VMAT and nine fixed?fields IMRT can significantly reduce the dose to the hippocampus without affecting dose distribution of target volume and OARs. VMAT may be superior to IMRT because VMAT can simultaneously reduce the dose to the brain stem.

Objective To study effect of TCM-based syndrome differentiation combined with diet nursing and point massage on insomnia.Methods Five hundred and twelve patients with insomnia were randomized into control group(n=85)and intervention group (n=67).The patients in both groups received treatment by TCM-based syndrome differentiation.Besides,the control group was given conventional nursing while those in the intervention group received diet nursing and point massage.The two groups were compared in three months in terms of sleep quality and curative effect.Results In comparisons of sleep quality index,the two groups both had statistically significant improvements respectively(both P<0.05).In terms of time to sleep, duration of sleep an sleep efficacy and Pittsburg sleep quality index,the intervention group scored significantly lower than the control group(all P<0.05).In terms of curative effect,the intervention group was significantly higher than the control group(P<0.05).Conclusion The method of TCM-based syndrome differentiation combined with diet nursing and point massage is effective in improving the sleep quality of those with insomnia.