ObjectiveTo study diabetes self-management skills among outpatient diabetics and their influence on glycemic control.MethodsData were collectedfrom 281 diabetes patients recruited in Tianjin Medical University Metabolic Hospital using a questionnaire covering their diet, physical exercise and glycemic self-monitoring during the last three months.Additional HbA1c and blood lipid information were retrieved from medical records.Logistic regression modified by factor analysis was then conducted.ResultsMore than half patients did well in diet control, physical exercise and drug treatment.23% patients exceeded physician-recommended intervals for self-monitoring.Self-monitoring was primarily conducted through hospital testing or family-owned glucometers.Abnormal blood pressure (53%) or lipid (47%) levels were also common.Overall, self-management practices among men and the younger(<60yr)were worse than that among women and elderly people.The significant related factors for good glycemic control included higher socioeconomic status and positive treatment, but Abnormal cholesterol and inadequate self-monitoring were related with poor glycemic control with the adjusted odds ratios equaling to 059, 039, 189 and 183, respectively.ConclusionsMore attention should be taken on men and the younger (<60yr)to improve their skills of self-management.Self-monitoring, physical exercise, diet control, etc. independently influence blood glucose control.

The Qirongrunchang Mixture(QRRCM)is a prescription composed of Radix Astragali,Fructus Cannabis,etc.It is effective for habitual constipa- tion and constipation in the aged and the debilitated,It was shown in this study that oral administration of this mixture could accelerate the intestinal movement in mice with yang-deficiency in a dose-dependent manner,and exerted a cathartic effect on mice with eonstipation.It increased the volume of intestinal content in rabbits,but did not influence the absorption of water in the intestines.

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

Objective To investigate the influence of Yishen granule on the expression of type Ⅳ collagen,laminin (LN)and fibroneetin (FN)in diabetic nephropathy (DN) rats.Methods DN model rats were established by unilateral nephrectomy and intraperltoneal injection of STZ.The experimental rats were divided into six groups:normal group,DN model group,Yishen granule groups in low and high dose (8.1 g/kg、16.2 g/kg) and positive control medicine group with lotensin (0.0015 g/kg).After 16 weeks of treatment,kidney tissues were sampled and pathologically observed through Masson trichrome staining.The proteins of type Ⅳ collagen、LN and FN were determined through immunohistochemical methods.Results The type Ⅳ collagen in normal group,DN model group,Yishen granule groups in low and high dose,and positive control medicine group was (1521.22 ± 415.26),(1579.22 ± 343.26),(3402.00 ± 863.39),(2984.30 ± 674.53),(2959.15 ± 561.22),(2918.04±363.96); LN was (1968.04±522.17),(2004.52±417.19),(3299.04±665.78),(3116.89±540.10),(2932.63 ± 528.38),(2815.89 ± 798.58) ; FN was (2614.67 ± 533.82),(2742.63 ± 562.80),(3311.41 ± 529.29),(2993.44±548.66),(2953.30±535.74),(2897.41 ±505.84) respectively.The level of type Ⅳ collagen、LN and FN expression in Yishen granule group obviously decreased as compared with that in DN model group (P＜0.05).The mesangial cells,basement membrane thickening and endocapillary proliferation in glomerular filtration membrane were significantly alleviated in Yishen granule group.The pathology of kidney was obviously modulated by Yishen granule.Conclusion Yishen granule can significantly inhibits the expression of type Ⅳ collagen、LN and FN in DN rats,which may be the mechanisms for Yishen granule in protecting the DN rat's kidney.

The idea of establishing Shanghai Academy of Medical Sciences was brought forward　in the background of great external changes.It was to meet the demand for resolving all kinds of　conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This　article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical　Sciences.

This study surveyed medical research institutions in Shanghai for the structure set, input and output, development orientation, bottleneck and other aspects. Problems were found with their relationship management, discipline arrangement, research efficacy and else.

Objective To study the expression and clinical significance of Wnt10b gene in tissue samples of Hirschsprung disease (HD).Methods Sixty samples of stenotic intestines and 60 samples of normal intestines were collected from 60 patients with sporadic HD who were admitted to the Shengjing Hospital of China Medical University from 2003 to 2010.Tissue samples were stained by hematoxylin and eosin (HE),and then the expression of Wnt10b gene in the tissues was detected by immunohistochemical staining.The mRNA and protein expressions of Wnt10b in HD were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot.All data were analyzed by two independent sample t test.Results The results of HE staining confirmed HD in the 60 patients,and the samples met the requirement of the study.The expressions of Wnt10b were strong positive in the plasma of intramuscular and submucosal cells in stenotic intestines,while weak positive or negative in normal intestines.The results of immunohistochemical staining showed that the percentages of positive proteins in the stenotic intestines and the normal intestines were 0.061％ ± 0.014％ and 0.006％ ± 0.005％,respectively,with a significant difference (t =2.955,P ＜ 0.05).The results of qRT-PCR showed that the relative quantification of mRNA of Wnt10b was 23.5 ± 1.6 in the stenotic intestines,which was significantly higher than 13.1 ± 1.7 in the normal intestines (t =1.687,P ＜0.05).High mRNA expressions of Wnt10b were observed in 45 patients with HD,and low mRNA expressions of Wnt10b were observed in 15 patients.The results of Western blot showed that the relative protein expression of Wnt10b was 35.2 ± 2.3 in the stenotic intestines,which was significantly higher than 19.1 ± 1.3 in the normal intestines (t =2.046,P ＜ 0.05).High protein expressions of Wnt10b were observed in 43 patients,and low protein expressions of Wnt10b were observed in 17 patients.Conclusion There is a close relationship between the abnormal mRNA and protein expressions of Wnt10b in the intestines,which might play a role in the pathogensis congenital malformation of the alimentary tract.

Objective To study the protein expression profiles in stegnotic and normal segment of Hirschspning disease (HD) and find the differentially expressed proteins. Methods Immobilized pH gradient two-dimensional polyacrylamide gel electrophoresis (2-DE) was used to isolate the proteins from stegnotic and normal segment of HD. After the samples were treated with silver staining,ImageMaster 2D Platinum analysis software was used to analyze the differentially expressed proteins. Results Repeatable 2-DE profiles were obtained. The mean matching rates of the stegnotic and normal mucosa were 78.1% and 86.7%,respectively. Totally, 103 spots of differentially expressed proteins were screened out between the stegnotic and the normal segment of HD. Conclusion Good reproduuibility and resolution could be obtained in the tissues of HD by applying immobilized pH gradient two-dimensional polyacrylamide gel electrophoresis.Screened differentially expressed proteins may provide the candidates of the markers for early detection of HD.

Objective Non-traumatic and posteromedial subchondral osteonecrosis of trochlea tali (NTPSOTT) is a special type of necrosis of the talus , for which early diagnosis and treatment are particularly important .This study investigated the clinical ef-fectiveness of autogeneic cancellous bone transplantation in the treatment of NTPSOTT . Methods We retrospectively analyzed 21 cases of NTPSOTT treated by autogeneic cancellous bone transplantation and evaluated using the Clinical Rating System of the American Orthopedic Foot and Ankle Society ( AOFAS) , Visual Analogue Scale ( VAS) , and X-ray and CT examinations . Results The pa-tients were followed up for 12-26 months and all healed desirably , with the graft well integrated into the surrounding tissue , but no as-similation, collapse of the articular surface , or narrowing of the joint space .The last follow-up visit revealed significantly improved AOFAS score (90.55 ±6.73 vs 50.87 ±11.42, P=0.009) and VAS score (1.32 ±0.81 vs 6.43 ±1.66, P=0.027) as compared with the baseline . Conclusion Autogeneic cancellous bone transplantation is preferable for the treatment of NTPSOTT , which can effectively reduce the pain in the ankle , maintain the joint space , and protect the function of the ankle .

Objective To evaluate the clinical advantages of transradiai approach for percutaneous coronary intervention in elderly patients with acute myocardial infarction.Methods From January 2008 to October 2011,150 elderly patients (average age of 70.4±7.2 yrs) diagnosed with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary invention (PCI).They were divided into transfemoral intervention group (TFI group,n=91) and transradial intervention group (TRI group,n=59).The arrival time at the first balloon inflation,the success rate of reperfusion,the X ray exposure time,the total procedural time,contrast volume,the average in-hospital days,the mean hospital expenses and postoperative complications were compared between two groups.Results The average in-hospital days was shorter in TRI group than in TFI group [(9.3±0.5) days vs.(12.8±0.7) days,P＜0.01].The mean in-hospital expenses was less in TRIgroup than in TFI group [(44707.3±1009.3) RMB vs.(54047.8±1971.6) RMB,P＜0.05].There were no significant differences in the arrival time at the first balloon inflation,the success rate of reperfusion,the X-ray exposure time,the contrast volume between the two groups [(26.7±0.8)minutes vs.(27.7±1.2) minutes,98.3％ (58/59) vs.96.7％ (88/91),(10.8±0.9) minutes vs.(9.6±0.6) minutes,(223.9±9.2) ml vs.(229.8±7.5) ml,respectively,all P＞0.05].The postoperative complications including major bleeding,pseudoaneurysm,radial occlusion without ischemia and the incidence of major adverse cardiovascular events had no statistical differences between the two groups (P＞0.05).The cases of urethral catheterization caused by urinary retention were less in TRI group than in TFI (0 vs.11 cases,P＜0.01).Conclusions Compared with transfemoral approach,the transradial approach is feasible and safe for primary PCI in elderly patients with acute myocardial infarction,and has better clinical advantage and socioeconomic benefit.