Objective To discuss the relationship between hyperhomocysteinemia(HCY) and chronic complications in type 2 diabetes.Methods 206 cases with type 2 diabetes were divided into no microvascular complications(NDC) group,diabetic retinopathy(DR) group and diabetic nephropathy(DN) group according to the occurrence of microvascular complications,98 healthy persons were selected as control group.The levels of plasma HCY,folic acid(FA) and vitamin B12(Vit B12) were detected by chemiluminescence method.Results Plasma HCY in diabetic group was significantly higher than the control group (P ＜ 0.05 ),DMAP group (DR group and the DN group) was higher than the NDC group ( P ＜ 0.05 ),FA,Vit B12 levels were significantly decreased compared with control group(P ＜0.05 ).Statistical analysis showed that HCY level was negatively correlated with FA,Vit B12 levels in patients with diabetes( P ＜ 0.01 ).Condusion HCY is an important risk factor for DMAP,the determination of plasma HCY level in patients with diabetes will help to monitor,determine the occurrence and development of DMAP.

Objective To investigate the clinical efifcacy of Chinese and western medicine on toxic diffuse goiter (Graves disease) diabetes mellitus. Methods 50 cases of Graves' disease and diabetes mellitus collected in Xianhe hospitol of Dongying city,Shandong Province from June 2010 to June 2011 were randomly divided into observation group(n=25) and control group(n=25). Control group was adopted conventional western medicine treatment. Based on western medicine treatment, observation group was, conducted dialectical types according to TCM theory, and used appropriate Chinese medicine to treatment. Efficacy of two groups after 8 weeks treatment were evaluated. Results The total effective rate in observation group was 90%, higher than 80% in control group(P<0.05). Compared with before treatment, insulin resistance index (HOMA-IR), TT 3, TT 4 levels were signiifcantly decreased, and TSH was signiifcantly increased in both two groups(P<0.01). The improvement of TT 3, TT 4, TSH in treatment group were more obvious than control group, and the difference was signiifcant (P<0.01). Conclusion The combination therapy was effective on patients with Graves' disease and diabetes.

Objective To explore the types, clinical pathologic and immunohistochemical features of spindle cell tumors of the uterine and broad ligament. Methods Clinical pathological files of spindle cell tumors in the uterine and broad ligament from 2007.12 to 2015.12 were reviewed. Results The primary sites of the 145 cases was cervical in 11 cases (7.58%), uterine body in 119 cases (82.07%), the broad ligament in 12 cases (8.28%), and uterine or cervix and the abdominal wall in 3 case (2.07%). Histopathological types of the 145 cases was smooth muscle origin in 126 cases (86.90%), of which 120 cases had benign leiomyoma, 3 cases had uncertain malignant potential and 3 cases had leiomyosarcoma;endometrial stromal origin in 15 cases (10.34%), including endometrial stromal nodule (5 cases), endometrial stromal sarcoma (10 cases); endometrial stromal- variant (3 cases, 2.07%), including endometrial stromal nodule associated with smooth muscle differentiation (2 cases), endometrial stromal sarcoma associated with smooth muscle differentiation (1 case); gastrointestinal stromal tumor (1 case, 0.68%). Conclusions Origin of spindle cell tumors of the uterine and broad ligament is mainly smooth muscle, endometrial stromal origin, and endometrial stromal tumor variants, and gastrointestinal stromal tumors in rare cases. We need to combine the clinical site, pathological morphology and immunohistochemistry for diagnosis and differential diagnosis.

According to many years,clinical experience,professor GUO Zhi-yuan proposed four methods of treating chronic hepatitis B: pay attention to nourishing yin,removing blood stasis,expelling phlegm and treatment based on fi ve zang viscera differentiation.The four methods have achieved satisfactory curative effects in clinics.

Objective To explore the relationship between quality of life and coping style of nurse. Methods 203 nurses were surveyedwith the World Health Organization Quality of Life-100 (WHOQOL-100) and simplified coping style questionnaire through conveniencesampling in rehabilitation hospital. Results and Conclusion Self-evaluations of nurses were significantly higher than ordinary people (P<0.01) in domains of psychological, independent, social relationship, spiritual pillar and personal beliefs, but lower in physical domain (P<0.01). Positive coping style was adopted by most of nurses. The coping style related with their physical status.

The measurement of pressure between tongue and the hard palate during swallowing is an evaluation method which is noninvasive and accurately quantitative. This article reviewed the measurement of tongue pressure, the changes of pressure in different poses,bolus types and people, as well as the prediction of dysphagia according to tongue pressure.

ObjectiveTo explore the effect of left move and twists of I/t curve on predicting prognosis of facial paralysis.Methods181 cases with 171 Bell's palsy and 10 Hunt's syndrome were examined with I/t curve of frontal muscle and upper orbicularis. The assessing criterion of diseases course was determined according to the recovery time of frontal muscle evaluated by raising eyebrow, the recovery time of orbicularis ascertained by House-Brackmann Ⅰ, Ⅱ grades and stable phase in partial moderate and severe facial paralysis.ResultsThe recovery time of frontal muscle and orbicularis between twist and non-twist in I/t curve and in sex was not significant. The left move of I/t curve was confined to slight, moderate and severe arranges; the recovery time was not significant also. Twist rate in I/t curve was highest in moderate facial paralysis and then second in orbicularis of slight paralysis. The left move of I/t curve had a very significant relationship with recovery time of frontal muscle and orbicualris.ConclusionThe left move of I/t curve plays a very important role in determining nerve injury degrees and predicting prognosis of facial paralysis.

Objective To investigate the acquaintance of secondary spinal cord injury (sSCI) of patients and medical workers. Methods 260 patients with sSCI, 145 nurses and 45 doctors were surveyed by questionnaire on the principle of convenience sampling. Results 20% patients knew about sSCI before injured, 41.5% patients took site protection; 90% nurses and 100% doctors knew about sSCI. Conclusion Related knowledge should be publicized to decrease the rate of sSCI and raise people' consciousness, and medical workers should be strengthened health education.

ObjectiveTo investigate the control rate and influence factors of glycolated hemoglobin A1C(HbA1c) of type 2 diabetes in Baoding city community.MethodsA cluster-randomized study was conducted and three communities were selected randomly.The study involved all of people aged 45 years old and above in the three communities.The type 2 diabetic patients diagnosed before,were recorded through the cross section study.Then the questionnaire was finished.All diabetic plasma HbA1c was determined by HPLC method.ResultsEighty-seven patients with HbA1c≤7％ were only 18.6％ in all diabetic patients.As the plasma level of HbA1c increased,occurrences of macroangiopathy and microangiopathy were both increased,by the trend test.Logistic regression analysis showed that therapeutic measures and knowledge about diabetes were main influence factors of achieving the hemoglobin Alc target of ＜7％ in type 2 diabetes.ConclusionThere were low HbA1c control in diabetic patients of Baoding community,and knowing diabetes well and receiving insulin treatment might decrease HbA1c level apparently.

Objective To improve the usage of foam dressing at the sacrococcygeal region and observe its application effect. Methods A total of 80 hospitalized patients with high risk of pressure ulcer were chosen during May to December 2015 as study objects. Patients were drawn into the observation group and the control group, each group contained 40 members. Proper-cutting foam dressings and normal foam dressing were applied in patients by the observation group and the control group individually. Researchers made records by comparing and analyzing the usage time of dressing and the skin intact of two groups. Results The observation group used foam dressing (1.88±0.12) blocks per person, foam dressing use time was (3.87±0.34) d per block, and in the control group, they were (2.60±0.38) blocks per person, (2.13±0.89) d per block, there was significant difference between two groups (t=11.427, 11.551, P<0.05). The skin integrity rate of the observation group and the control group were 95.0%(38/40) and 75.0%(30/40), the difference was statistically significant (χ2=6.275, P<0.05). Conclusions This study shows that the foam dressing need to be cut appropriately before pasting so that the clinical nurses can observe patient's skin conveniently. Once the skin has pressure red, the nurse can take timely measures to deal with it, which can decrease the incidence of pressure sores. The cutting dressing prolongs the period of using without removing the viscose part, which also can reduce the medical expenses.