Objective To investigate the value and limitations of ultrasound determination-evaluated brachial artery endothelial function in elderly diabetic patients. Methods High-resolution two-dimensional ultrasound was used to determine brachial artery(BA) flow-mediated vasodilation(FMD) during reactive hyperemia. Endothelial function was evaluated by FMD in 67 elderly patients with type 2 diabetes. Results In diabetes versus normal control group,the BA diameter and flow velocity showed no significant difference (P＞0.05) at basal state,but showed significant decreases (P＜0.05) after reactive hyperemia. Single-factor correlation analysis showed that FMD was in negative correlation with disease course, TG, ISI and age (r=-0.2357,-0.2215 and -0.3256, -0.2415,(all P＜0.05～0.01),and showed no correlation of FMD with BMI, TC, FBG, HbA1c, FIns. Conclusions FMD has a value in evaluating the flow-mediated endothelial dysfunction in older T2DM patients, while our analysis of the results should consider the patient's age, gender, race, disease course, blood lipids and other factors.

OBJECTIVE:To discuss the practice of voluntary principle on the community pharmacy so as to provide some good suggestions for the smooth implementation of the GPP.METHODS:The voluntary principle of GPP was analyzed from several aspects,including the purpose of GPP,the integrated pharmaceutical service level,justice,law and policy and etc.RE_ SULTS:The feasibility of the implementation of voluntary GPP principle in China is expected to be verified,meanwhile,the concerned law and policy should be established in no time and the knowledge of medicine administration should also be publi?cized widely among the public.

Objective To investigate the expression and clinical value of platelet membrane glycoproteins CD 62p ,CD 63 in patients with type 2 diabetes mellitus (DM).Methods The levels of CD 62p ,CD 63 were measured by FCM in 64 cases of type 2 DM (31 cases with microangiopathy,33 cases without microangiopathy) and 30 normal individuals.Serial measurements were carried out in 16 patients before and after treatment.Results The levels of CD 62p ,CD 63 in type 2 DM were significantly higher than those in controls (P

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4 )and related factors in type 2 diabetic patients. Methods Eighty type 2 diabetic and patients 30 non-diabetic subjects were recruited into obese-diabetic group [body mass index (BMI) 1525 kg/m~2],normal-weighted diabetic group(BMI < 25 kg/m~2)and control group(BMI < 25 kg/m~2). Serum adiponectin(APN), RBP4 and hemoglobin A_1c (HbA_1c)triacylglycerol (TG),total cholesterol (TC).high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and were measured on fasting samples. BMI, waist/hips girth ratio (WHR) and insulin resistance index (HOMA-IR) were calculated. The correlation between RBP4 and other factors was analyzed. Results The concentration of RBP4 was significantly increased in obese-diabetic group and normal-weighted diabetic group compared with that in control group [ (30.02 ± 5.32), (20.10 ± 5.45), (12.02 ± 3.45) mg/L] (P < 0.01). The concentration of RBP4 was higher in obese-diabetic group than that in normalweighted diabetic group (P < 0.01). Univariate analysis showed serum RBP4 was positively associated with TG,BMI,FBG, WHR,FINS,HOMA-IR and negatively associated with APN (r = 0.225, 0.697, 0.323,0.557, 0.272, 0.461, -0.398). Conclusions The concentration of RBP4 is significantly higher in type 2 diabetic patients compared with that in normal subjects. RBP4 possibly plays an important role in the insulin resistance and the occurrence and development of type 2 diabetes.

A total of 100 patients with subacute thyroiditis hospitalized from January 2011 to October 2012 were recruited.Each received glucocorticoid treatment for 8 weeks and there was a 2-month follow-up period after drug withdrawal.After treatment,the short-term recurrence rate was 34％ (34/100).If thyroid ultrasound was abnormal,the recurrence rate was 52％ (30/58).And it was significantly higher than 10％ recurrence rate for those with normal thyroid ultrasound (4/42,x2 =9.67,P ＜ 0.01).The recurrence rate of different erythrocyte sedimentation rate groups of 40-100 mm/1 h and ＞ 100 mm/1 h was 37％ (22/60) and 30％ (12/40) respectively (P ＞ 0.05).

Objective To investigate the pathogenic bacterial distribution and drug resistance situation of multi‐drug resistant bacterial strain mixed infection among postoperative traumatic patients in Zaoyang area to provide a reference for clinical treatment . Methods A total of 71 traumatic cases of multi‐drug resistant bacterial strain mixed nosocomial infection were selected and per‐formed the bacterial culture and drug resistance analysis according to the samples taking from different infection sites .The the re‐sults were statistically analyzed .Results Among 71 cases of multi‐drug resistant strains mixed infection ,205 multi‐drug resistant strains of bacteria were isolated .Among them ,119 (58 .05% ) strains were Gram‐negative bacteria ,Gram‐positive bacteria was in 83 strians(40 .49% ) and fungus was in 3 strains(1 .46% ) .The resistance of Escherichia coli ,Klebsiella pneumoniae ,Enterobacter and Serratia to more than 10 kinds of antibacterial drugs was more than 50% ,which to ampicillin ,cephalothin ,cefuroxime ,azlocillin ,ce‐fotaxime cefuroxime ,azlocillin ,cefotaxime and cefoperazone was more than 80% ,while which to imipenem and amikacin was only 5 .88% and 28 .57% respectively .The resistance rates of Gram‐positive bacteria represented by Staphylococcus aureus ,Staphylococ‐cus epidermidis ,Staphylococcus haemolyticus and Streptococcus pneumoniae to penicillin G ,oxacillin and ampicillin generally reached 98 .80% ,97 .59% ,and 95 .18% respectively .No Gram‐positive bacteria was resistant to vancomycin ,in addition the resist‐ance to rifampin and chloramphenicol also was only 32 .53% and 34 .94% respectively .Conclusion In early stage of infection ,it is unable to determine the types of pathogenic bacteria and difficult to select sensitive antibacterial drugs ,under this occasion ,the com‐bination of imipenem and vancomycin is a good choice .

OBJECTIVE:To discuss the pharmaceutical care trustworthiness imperfection from the perspective of eco?nomics and to put forward some suggestions for the reduction of trustworthiness imperfection behavior in the pharmaceutical care.METHODS:The behavior of the pharmaceutical care trustworthiness imperfection was analyzed from the perspective of profits maximum,information dissymmetry,and trade cost etc.in the economics theory.RESULT&CONCLUSION:It is of positive meaning to reduce pharmaceutical care trustworthiness imperfection behavior by establishing and improving related laws and rules,popularizing the medicine knowledge,strengthening monitoring,reforming the salary mode of the pharmaceuti?cal technical personnel.

Objective To apply the theory and model of International Classification of Functioning, Disability and Health (Children and Youth Version) (ICF-CY) in rehabilitation for children with cerebral palsy. Methods A case accepted rehabilitation in the framework of ICF-CY was reported. Results and Conclusion The framework of ICF-CY can be used in rehabilitation for children with cerebral palsy.

Objective To evaluate the applied value of multislice CT (MSCT) in the selection of living donor kidneys and excision methods.Methods Ninety living renal donors underwent MSCT assessment.The nonenhanced,arterial,venous and excretory phase examinations were performed.Using maximum intensity projection and volume rendering techniques for vascular imaging,two blinded radiologists independently analyzed and evaluated all MSCT images.According to the CT reconstructive images,radiologists and physicians selected the left renal or the right renal donors,and chose laparoscopic or open live donor nephrectomy.Results On the 90 cases of donors,78 donors underwent nephrectomy in the left kidney.Seventy-one left kidney donors having no significant variation received the routine laparoscopic live donor nephrectomy.Seven left kidney donors on both sides had relatively obvious anatomical variations such as accessory renal artery,multi-branch renal vein and renal vein in the back of the abdominal aorta,and they were subjected to the left kidney open donor nephre.ctomy.Other 12 donors having significant variation in the left kidney were given nephrectomy in the right kidney,and all of them received hand-assisted laparoscopic live donor nephrectomy.All intraoperative records of urine collection system and renal vascular anatomy were consistent with the preoperative evaluation of MSCT,and the accuracy was 100 ％.Two imaging experts in the evaluation of renal artery,renal vein and urine collection system showed good consistency.Nephrectomy was successfully performed on 90 cases of donors,and.postoperative recipients had no renal vein thrombosis and other vascular complications.Conclusion MSCT can provide accurate and valuable information for the selection of living donor kidneys and excision methods as a “one-stop” technique for the preoperative evaluation of living renal donors.