Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

Objective To set up care service quality evaluation indicators and establish weight coefficient for assessment of elderly institution in Chongqing.Methods SEVQUAL Model was used as the theoretical guidance,through Delphi expert inquiry,analytic hierarchy process (AHP),the weight of each indicator in five grades and consistency check was calculated.Results The care serv ice quality evaluation indicators contained five first-grade indexes and twenty second-grade indexes.The first-grade indexes included tangibles,reliability,responsiveness,assurance,empathy,respectively.The results of the consisten-cy check of the single grade sorts had a satisfying consistency(CR＜0.10).Conclusions The scientific meth-ods and comprehensive indicators were applied to the construction of care service quality e-valuation indicators for elderly institution in Chongqing.In some degree,this construction of indicators may improve quality of care service and provide useful reference evidence for quality assessment in elderly in-stitution.

Objective To investigate the efficacy and mechanism of Sanxuemingmu tablets and compound Xueshuantong capsule in treatment of RVO patients with qi stagnation and blood stasis syndrome.Methods 1200 cases of RVO patients with qi stagnation and blood stasis syndrome from April 2014 to April 2016 months in our hospital were selected,and randomly divided into two groups,600 cases in each group.The observation group was treated with Sanxuemingmu tablets,the control group were treated with compound Xueshuantong capsule,the curative effect and relative score of the two groups were compared.Results After treatment,the visual acuity of the two groups was significantly higher than that before treatment,the visual acuity of the observation group was higher than control group (P<0.05);The absorption of fundus hemorrhage in the observation group was significantly better than that in the control group(P<0.05);The total effective rate of FFA in observation group was significantly higher than that in control group (P<0.05);Compared with before treatment,the whole blood viscosity and plasma viscosity of the two groups were decreased,and the whole blood viscosity and plasma viscosity of the observation group were lower than those of the control group(P<0.05);The TCM syndrome scores of both groups were lower than those before treatment,and the observation group was significantly lower than the control group( P <0.05);The total effective rate and the total effective rate of the treatment group were significantly higher in the observation group than in the control group(P<0.05).Conclusion Sanxuemingmu tablets has significant clinical effect in treatment of RVO patients with qi stagnation and blood stasis syndrome,can accelerate the absorption of retinal hemorrhage,treatment of retinal vein obstruction qi stagnation of blood stasis,promote vision recovery and improve treatment efficiency.

Objective:To study the correllation of genetic polymorphisms of IL-10 polymorphic loci with ulcerative colitis sus-ceptibility and its influence on clinical outcomes.Methods:A total of 80 patients with ulcerative colitis were selected as case group and the others by sex and age matched healthy subjects as control group according to the case-control study design.Peripheral venous blood samples were drawn and DNA was extracted from all subjects prior to treatment.PCR primers of -819T/C(rs1800871),-592A/C (rs1800872),-1082G/A(rs1800896) were designed for PCR amplification.The fragments produced from human genomic DNA were performed by restriction enzyme digestion of amplified PCR products,and further separated using agarose gel electrophoresis.Relative risk(OR) and 95%confidence interval(95%CI) were calculated by the Logistic regression,in order to evaluate the correlation of IL-10 gene polymorphism with susceptibility of ulcerative colitis and clinical outcomes.Results:(1)The distribution frequency of genotype AA,GG and AG of polymorphic loci rs1800896 in cases patients were significantly different from that in control group(P<0.01).(2) Compared to rs1800896 genotype AA,genotype GG were significantly associated with increased risk for ulcerative colitis(P<0.01)and the decreased clinical remission rate ( P<0.01 ).( 3 ) The distribution frequency of genotype CC, CT and TT of polymorphic loci rs1800871 were not significantly different between groups(P>0.05).(4)The distribution frequency of genotype AA,AC and CC of polymorphic loci rs1800872 were not significantly different between groups(P>0.05).Conclusion:IL-10 polymorphic loci rs1800896 genotype GG would be associated with increased susceptibility to ulcerative colitis,and poor prognosis of patients.

Objective] To investigate the relationship between pain from malnutrition and MM, looking for a cure for MM.[Methods]To analyze the relationship between pain from malnutrition and MM in clinical TCM based on the study of Neijing and the textual works of famous Chinese physicians. According to the etiology and pathogenesis to find the treatment method, and validation from clinical cases. [Result]We find that the pain from malnutrition caused by deficiency of kidney and spleen is a major cause of MM by summarizing of the ancient physicians. And we tally up the invigorating kidney is an important method for the treatment of MM.[Conclusion]Pain from malnutrition is an important pathogenesis of MM. To a method of treating MM, invigorating kidney and spleen is obvious and this method for the treatment of MM will bring more help.

Objective To assess the diagnostic value of cytokeratin 18 fragment M30 (CK18-M30) and Fas in patients with nonalcoholic fatty liver disease (NAFLD),especially nonalcoholic steatohepatitis (NASH).Methods Among 58 patients with NAFLD,36 patients with NAFLD received liver biopsy.According to NAFLD activity score (NAS) and liver fibrosis score,patients were divided into NASH group (24 cases) and non-NASH group (12 cases).And at the same period,15 healthy individuals were set as healthy control group.The serum level of CK18 M30 and Fas were measured with enzyme-linked immunosorbant assay (ELISA).Rank sum test was performed to analyze the differences in the level of CK18-M30 and Fas between groups.The diagnostic value of CK18 M30 and Fas were assessed by the receiver operating characteristic (ROC) curves.Results The level of serum CK18-M30 of NAFLD group was significantly higher than that of healthy control group (97.24 U/L (86.06 to 113.12 U/L) vs 78.41 U/L (74.29 to 80.76 U/L),Z=-4.206,P＜0.01)).The level of serum CK18-M30 of NASH group was higher than that of non-NASH group (111.06 U/L (94.30 to 142.68 U/L) vs 89.00 U/L (83.56 to 106.50 U/L),Z=-2.233,P＜0.05)).The area under the ROC curve (AUC) of CK18-M30 in the diagnosis of NASH was 0.73 (0.56,0.90),and the sensitivity and specificity of CK18-M30 in diagnosis of NASH was 79.2％ and 58.3％,respectively.The AUC of Fas in diagnosis of NASH was 0.58 (0.38,0.77),while the sensitivity and specificity of Fas in diagnosis of NASH was 54.2％ and 66.7 ％.The serum level of Fas increased in FAFLD group compared with healthy control group,and in NASH group compared with non-NASH group,however the differences were not signifincant (both P＞ 0.05).Conclusions The level of CK18-M30 has certain value in the diagnosis of NASH.The diagnostic value of Fas in NASH needs more samples in further study.

Elf-1 (E74-like factor 1) is a member of Ets transcription factor family,which participated in physiological and pathological process of cells proliferation,differentiation and tumorigenesis. In this review,we summarize that Elf-1 is related to T cell differentiation and development,tumor and autoimmune disease.

This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

Objective:To investigate the effect of Sec-O-Glucosylhamaudol on inflammatory mediator and cytokine( NO and IL-6)production in Lipopolysaccharide(LPS) stimulated murine macrophage(RAW264.7).Methods: Macrophages were induced with LPS,and incubated with different concentrations of Sec-O-Glucosylhamaudol(20,40,80 μg/ml),the quantity of NO production was measured by Griess reagent;the IL-6 production were measured by enzyme linked immunosorbent assay(ELISA),the expression of nitric oxide synthase( iNOS) in cells were detected by Western blot;the expression of iNOS and IL-6 mRNA were analyzed by real-time PCR.Results:Each concentrations of Sec-O-Glucosylhamaudol(20,40,80 μg/ml) inhibited the production of NO and IL-6 in LPS-stimulated RAW264.7 cells(P<0.01).This compound also reduced the mRNA expression of iNOS and IL-6.Conclusion:Sec-O-Glu-cosylhamaudol exhibited anti-inflammatory activity by inhibited the NO and IL-6 production in LPS stimulated RAW264.7 cells.