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.

[Objective]To discuss the outcome of acetabular protrusion after total hip arthroplasty. [Method]Fifteen patients(M=7,F=9) having painful acetabular protrusion received total hip arthroplasty with reinforcement of the acetabulum with bone grafts(autogenous or allogeneous bone).The results were reported at 1~4 years(mean,3 years) of follow-up.Of the 15 cases,5 were mild protrusion and 10 were moderate protrusion.The Harris hip-rating and radiographs were taken pre-and postoperatively. [Result]The average Harris hip-rating was improved from 45 points(range,39~60 points) preoperatively to 85 points(range,70~100 points) postoperatively.The average preoperative protrusion of the femoral head medial to the Kohler line was 8.8 mm(6~18 mm).The average postoperative placement of the prosthetic femoral head was 10 mm(6~13 mm) lateral to the Kohler line.None acetabulum prothesis failure or bone grafts absorption was seen.The grafts were well incorporated on radiograms in all patients one year after operation by radiographs. [Conclusion]Good results can be obtained in hips with acetabular protrusion after reconstructed with autogeneous or allogeneous bone grafting and total hip arthroplasty.

Objective To investigate the effects of ketamine in relieving postoperative pain after laparoscopic cholecystectomy(LC).Methods Forty patients undergoing selective LC from July to August 2006 were randomly divided into ketamine group and control group,with 20 patients in each group.Incision pain and non-incision pain was assessed at 1,2,4,6,12,24 h and once each day for the first 3 days postoperatively with visual analogue pain scale(VAS)and sedation scale.Adverse effects and analgesic requirements were recorded.Results Patients in ketamine group had significantly lower scores in incision pain and non-incision pain compared with those of control group(F=22.805,P =0.000;F=18.109,P=0.000).Incidence of postoperative nausea and vomiting was not significantly different(P=1.000)between ketamine(55%)and control group(60%).No significant difference was noticed in analgesic requirements between ketamine group(3 cases)and control group(9 cases)(P=0.082).Conclusions Preoperative administration of ketamine significantly improves postoperative analgesia after laparoscopic cholecystectomy,but does not reduce the incidence of postoperative nausea and vomiting.

Objective: To evaluate the pharmacokinetics of palonosetron hydrochloride in healthy volunteers. Methods: Thir-ty-one healthy volunteers were grouped into three palonosetron hydrochloride dosage regimens of 0.125, 0.25, and 0.5 mg. The plasma concentrations of palonosetron were determined by ultra high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). DAS 2.1 software was applied to assess the plasma concentration-time data. Results:After intravenous injection of 0.125, 0.25, and 0.5 mg palonosetron to the subjects, the AUC0-168h values of palonosetron were (7.5±2.5), (15.2±4.0), and (34.8±9.7) μg· h·mL-1. The t1/2 values were (27.2±9.5), ( 27.2±6.5), and (31.4±5.6) h. Palonosetron exposure increased proportionally with the dose range of 0.125 mg to 0.5 mg. The correlation coefficient was 0.998. No grade 3 or grade 4 toxicity was observed during the study. Con-clusion:A rapid, sensitive, and selective UPLC-MS/MS method for palonosetron quantification in human plasma was developed and validated. All the participants indicated high tolerance throughout the study. Our data showed that palonosetron exhibits linear pharma-cokinetics over the the dose range of 0.125 mg to 0.5 mg.

The O_2 collision cell technology was accepted to move the analyte to new oxide line position in stead of attenuating the double charge ions directly. A minus kinetic energy discrimination configuration was used to promote the oxide ions passing. An isobaric interference on new oxide line was corrected by a mathematic equation. It was found the enhancing effect of organic reagent benefit to As and Se oxide ion signal also. The 1% methanol sample solution was applied to improve the analyte sensitivity. The detection limits were 4.5 ng/L for As and 6.2 ng/L for Se. The background equivalent concentration was 0.022 μg/L for As and 0.025 μg/L for Se. The analysis errors enter into the allowed range of the standard material, which greatly improve the analytical accuracy of the actual sample.

Objective To investigate the role of DWI in differentiating autoimmune pancreatitis ( AIP) from pancreatic cancer ( PC) , and in the therapeutic effect evaluation of AIP.Methods DWI data of 26 cases with AIP , 29 cases with PC and 30 cases with normal pancreas ( NP ) were analyzed retrospectively.The distribution type and signal feature of lesions in cases with AIP or PC were evaluated by Chi-squared test.ADC values were measured and compared among 3 groups by Kruskal-Wallis test.ADC values of AIP and PC were analyzed by using ROC curve to determine the optimal threshold and diagnostic efficiency.ADC values were compared in AIP ( n=15 ) before and after steroid therapy by paired t test.Results Diffuse lesions were detected in 21 cases with AIP and 3 cases with PC, while focal lesions in 5 cases with AIP and 26 cases with PC (χ2 =27.64, P<0.01).On DWI, most of AIP (n=19) and PC (n=24) showed hyper-intense signal, while a few of AIP (n=7) and PC (n =5) showed iso-intense signal (χ2 =0.75, P>0.05).The median ADC values of AIP, PC and NP were 1.15 ×10 -3,1.35 × 10 -3 ,1.59 ×10-3 mm2/s, respectively; and the difference was statistically significant ( H=45.60, P <0.01).ROC analysis yielded an optimal ADC cutoff value of 1.255 ×10 -3 mm2/s (80.8% sensitivity, 79.3%specificity and 0.871 area under curve for the diagnosis of AIP ).ADC values of AIP ( n=15) were markedly increased from the baseline (1.10 ±0.19) ×10 -3 to (1.57 ±0.12) ×10 -3 mm2/s after steroid therapy (t=-10.14, P<0.01).Conclusions DWI may be useful for diagnosing and evaluating the effect of steroid therapy in AIP.ADC values of AIP were significantly lower than those of pancreatic cancer and normal pancreas.After steroid therapy , ADC values were markedly increased in AIP.

Objective To explore the application of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE ) in two-stage hepatectomy of hepatocellular carcinoma (HCC).Methods From September 2010 to September 2013,a total of 107 patients with HCC in the right liver lobe who were not suitable for one stage hepatectomy received TACE or TACE combined with SPVE treatment were enrolled.Among them,55 received TACE therapy and 52 accepted TACE combined with SPVE treatment.The technique success rate,complication,adverse reactions,the volume change of each liver lobe and the rate of hepatectomy of HCC were observed.Chi-square test was used for numerical data comparison and Student′s t test for measurement data.Results TACE or TACE combined with SPVE therapy was successfully applied in all the 107 patients,the technique success rate was 100%.During treatment period,no complications such as ectopic embolization, liver function failure,puncture tract bleeding,gastrointestinal bleeding,bile leakage and hepatic abscess were observed.After treatment,the adverse reactions included liver function impairment,pain in hepatic region,fever,nausea and vomiting.Four weeks after the treatment,the volumes of tumor and right liver lobe decreased to certain degree in patients with HCC of both TACE group and TACE combined with SPVE group.The volume of left liver lobe in TACE group had no obvious change,while remarkably increased in TACE combined with SPVE group.The pre-treatment residual liver volume (RLV)of TACE group and TACE combined with SPVE group was (404.0 ± 46.3 )cm3 and (393.9 ± 65 .7 )cm3 , respectively,and the difference was not statistically significant (t=0.927,P =0.356).Four weeks after the treatment,RLV was (415.4 ±45.7 )cm3 and (567.3 ±88.7 )cm3 ,respectively,and the difference was statistically significant (t= -11 .219,P <0.05).Patients were followed up for three to six months,the rates of hepatectomy were 38.2%(21/55)and 86.5 %(45/52)in TACE group and TACE combined with SPVE group,and the difference was statistically significant (χ2 =26.440,P <0.01 ).Conclusion For patients with HCC not suitable for one stage hepatectomy,the treatment of TACE combined with SPVE before operation could effectively control the growth of the tumor,decrease the volume of tumor,increase RLV,and then increase the rate of two-stage hepatectomy.

Purpose: Previous studies have demonstrated the usefulness of the controlling nutritional status (CONUT) score in nutritional assessment and survival prediction of patients with various malignancies. However, its value in advanced gastric cancer (GC) treated with neoadjuvant chemotherapy and curative gastrectomy remains unclear. Materials and Methods: The CONUT score at different time points (pretreatment, preoperative, and postoperative) of 272 patients with advanced GC were retrospectively calculated from August 2004 to October 2015. The χ2 test or Mann-Whitney U test was used to estimate the relationships between the CONUT score and clinical characteristics as well as short-term outcomes, while the Cox proportional hazard model was used to estimate long-term outcomes. Survival curves were estimated by using the Kaplan-Meier method and log-rank test. Results: The proportion of moderate or severe malnutrition among all patients was not significantly changed from pretreatment (13.5%) to pre-operation (11.7%) but increased dramatically postoperatively (47.5%). The pretreatment CONUT-high score (≥4) was significantly associated with older age (P=0.010), deeper tumor invasion (P=0.025), and lower pathological complete response rate (CONUT-high vs. CONUT-low: 1.2% vs. 6.6%, P=0.107). Pretreatment CONUT-high score patients had worse progression-free survival (P=0.032) and overall survival (OS) (P=0.026). Adjusted for pathologic node status, the pretreatment CONUT-high score was strongly associated with worse OS in pathologic nodepositive patients (P=0.039). Conclusions The pretreatment CONUT score might be a straightforward index for immunenutritional status assessment, while being a reliable prognostic indicator in patients with advanced GC receiving neoadjuvant chemotherapy and curative gastrectomy. Moreover, lower pretreatment CONUT scores might indicate better chemotherapy responses.

Objective To evaluate the safety and clinical short-term efficacy of interventional emboliz-ation with hepasphere-loaded microspheres in treating inoperable hepatocellular carcinomas. Methods A total of 15 patients with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization ( TACE ) using hepasphere-loaded microspheres as embolic agent . The clinical data , imaging follow-up materials, complications of interventional treatment, prognosis, etc. were summarized and analyzed. The results were evaluated with modified response evaluation criteria in solid tumors (mRECIST); monthly follow-up was made for all patients. A total of 23 TACE procedures were performed in 15 patients. Results The following-up period ranged from 6 months to 15 months , the median follow-up time being 10 months . According to mRECIST, the 3-month objective response rate (CR+PR) was 73.3% and disease control rate (CR+PR+SD) was 93.3%;the 6-month objective response rate (CR+PR) was 73.3%and the disease control rate (CR+PR+SD) was 86.7%. No severe complications, such as bile leak complicated by infection, liver abscess, abdominal hemorrhage, bleeding due to tumor rupture, gastrointestinal bleeding, etc. occurred in all patients . Conclusion In treating unresectable hepatocellular carcinomas , TACE using newly-developed hepasphere microspheres carries satisfactory clinical short-term efficacy and safety, although thelog-term results need to be further investigated with larger sample trial.

Objective To explore the overall situation and development trend of the hierarchical diagnosis,to provide reference for further research direction.Methods Following databases,such as CBM,CNKI,Wanfang Database and VIP,were used to search for publications on this topic from the establishment of database to September 30th,2016.Bibliometric method was used to analyze these literatures,for instance periodical distribution,years,authors and regions;key words were taken into consideration.Results 243 literatures in total were included,the a number of publication is keep increasing every year.These papers were published in 91 kinds of journals,43.2 ％ of which were statis tical source journals.There were 221 first authors from 149 institutions distributed in 26 provinces and municipalities.There were only 18 core authors.The active regions of research were Beijing,Hubei,Sichuan and Shanghai.The research content mainly focused on two-way referral,utilization of medical service and medical insurance.Conclusions The quality of papers is low,research authors are widely distributed,the research strength is not strong enough.The research should be strengthened in extent and depth to transform the research outcomes to guide the actual practice.