Objective To study the effect of different insulin administration methods on glucose control of gestational diabetes mellitus ( GDM) .Methods Sixty-four cases with GDM were randomly divided into observation group and control group.The observation group received continuous subcutaneous insulin infusion insulin pump therapy, the control group received multiple subcutaneous insulin therapy.Then,the glucose control effect,SAS and SDS score were compared between two groups.Results After 4 weeks,the FBG,HbA1c,2h PG of observation group were significantly lower than the control group[(5.89 ±0.66)mmol/L vs (7.13 ±0.74)mmol/L,(7.14 ±0.82)% vs (8.92 ±0.95)%,(8.87 ±0.92)mmol/L vs (10.13 ±1.32)mmol/L](t=7.074,4.430,8.024,all P<0.05). The glucose fluctuations,insulin amount,hypoglycemia incidence of the observation group were significantly lower than the control group,blood sugar standard time was shorter than the control group[(5.64 ±0.65)mmol/L vs (8.44 ± 0.92)mmol/L,(0.52 ±0.06)U· kg-1· d-1 vs (0.73 ±0.09)U· kg-1· d-1,6.25% vs 28.13%,(4.76 ± 0.55)d vs (7.41 ±0.94)d,t/χ2 =14.061,10.983,5.379,13.764,all P<0.05)];SAS score,SDS score of the observation group were significantly lower than the control group[(34.95 ±4.2) points vs (40.23 ±3.98) points, (35.12 ±3.95)points vs (38.36 ±3.88)points,t=5.162,3.310,all P<0.05)].Conclusion Continuous subcu-taneous insulin infusion insulin pump therapy is helpful to control glucose levels,reduce blood sugar fluctuations and mitigate negative sentiment during treatment,it is an ideal insulin administration method for the treatment of GDM.

The paper analyses the function of mutual communication in solving physician-patient conflict. Some feasible suggestions on the mutual communication between doctors and patients are also raised in order to solve the physician-patient conflict effectively.

Objective To discuss the related factors about the rising cesarean section rates, and to propose feasible measures to reduce cesarean section rates. Methods Cesarean section cases in our hospital from January, 2000 to December, 2009 were retrospectively analyzed. Results The cesarean section rate increased year by year,32.0% in 2000,34.5% in 2001,35.0% in 2002,32.3% in 2003,37.1% in 2004,37.9% in 2005,40.2% in 2006,41.7% in 2007,43.6% in 2008,46.1% in 2009. Conclusions Effective measures should be taken to reduce the cesarean section rate.

The basic nature of medical ethics education is the cultivation of morality for medical students,in which humanistic spirit is the fundamental element.Humanistic spirit is in great need for the development of medical ethics,the transformation of medical mode,the harmonious development of physician-patient relationship,and the healthy growth of medical students.Based on present realistic conditions,humanistic spirit should be developed in the fields of classroom training,medical professional education,and other aspects of campus culture.It would be necessary to find multi-path training modes of humanistic spirit.

This paper introduces a new perspective of case choice in medical ethics teaching,which breaks through the limitations of the choice of teaching cases,chooses the hot-case analogy teaching methods out of medical field,and proves to have received good teaching results.

The specialization of medical science determines the objective existence of asymmetric information in medical and health industry.These different understandings in the psychological and behavioral area influenced the development of physician-patient relationship.Medical personnel should look squarely at the professional attributes and dare to play a leading role.Meanwhile,the exchange of the role of patient and medical personnel,understanding patient,clearing of communication channels and enlarging patients′ means of communication will promote harmonious relations between doctors and patients.

Objective To investigate the clinical effect of gastric bypass operation on treating type 2diabetes,and analyze the management status.Methods Fifty-seven patients wiith type 2 diabetes treated by gastric bypass operation were divided by different body mass index(BMI) into 4 groups:group A( BMI ＜ 20kg/m2) with 8 cases,group B (20 kg/m2≤BMI ＜24 kg/m2) with 21 cases,group C (24 kg/m2≤BMI ＜27kg/m2) with 17 cases and group D (BMI ≥27 kg/m2) with 11 cases.The control of blood glucose and glycosylated hemoglobin,changes of diets and body weight,diabetes complications,adverse reactions after operation and postoperative management were followed up or reviewed.The clinical data were analyzed comprehensively.Results The cure rate of group C was the highest [ 70.6％( 12/17 ) ],while the cure rate of group A was the lowest (0).The overall cure rate was 43.9％(25/57) and the overall improvement rate was 28.1％(16/57).The overall efficient rate was 71.9％(41/57) and the overall inefficient rate was 28.1％(16/57).Apart from a few patients had malnutrition,amenorrhea,bad stomach,diarrhea and poor diet after leaving the hospital,other patients had no surgery complications and no patients died.There was no clinician to follow up and did education to these patients after operation.Conchusions Gastric bypass operation is safe and effective for obese and non-obese patients with type 2 diabetes.It is a new method to weat type 2diabetes at present,but the indications should be grasped and operation enlargement must he prevented.The management of teams of physicians,surgeons,dietitians,nurses should be established afler operation.

Objective To investigate the incidence and the possible risk factors of hepatic dysfunction in patients with Graves' disease (GD). Methods Totally 280 outpatients with hyperthyroidism (caused by GD) were divided in two groups: untreated group (131 patients) and treated group (149 patients). The hepatic function, serum thyroid hormone, TGAb and TMAb were detected for analysis of the incidence, clinical characteristics and correlative factors of the hepatic dysfunction. Results Patients who had at least one abnormal result of liver function test accounted for 70.99% in untreated group and 61.07% in treated group. The most common abnormal hepatic function parameter in patients with thyrotoxic hepatic lesion was increased alkaline phosphate enzyme (ALP), which was 57.3% in untreated group and 51.0% in treated group. Abnormalities of alanine transaminase (ALT), aspartate transaminase(AST), gamma-glutamyl tyanspeptidase (GGT) and total bilirubin (TBIL) were 28.2% (37/131), 18.3% (24/131), 10.7% (14/131) and 21.4% (28/131) in untreated group and 21.5%(32/149), 15.4%(23/148), 4.7% (7/149) and 20.1% (30/149) in treated group, respectively. The possibility of thyrotoxic hepatic dysfunction was correlated with the patients' age and FT3 and FT4 levels, but not with the genesis and course of disease, sex, family history of hyperthyroidism, or levels of TGAb and TMAb. Conclusion Abnormal results of liver function test are commom in patients with hyperthyroidism. Increased alkaline phosphate enzyme and alanine transaminase are the most common abnormal hepatic function parameters; the possibility of thyrotoxic hepatic dysfunction is correlated with patients' age and the level of thyroid hormones.

BACKGROUND:Studies on the proteomics contribute not only to exploring the laws governing life activities, but also to elucidating the pathogenesis of a variety of diseases to find the treatment strategies. OBJECTIVE:To summarize the application of proteomics in the plateau medical research. METHODS:A computer-based online search was conducted in PubMed and Wanfang databases from 1995 to 2015 to screen the relevant literatures using the key words“proteomics, medical research, plateau medicine”in English and Chinese, respectively. A total of approximately 200 English and 60 Chinese relevant literatures were selected and the 59 eligible literatures were included after screening final y. RESULTS AND CONCLUSION:Currently, the human genome has been decoded through the studies on exploring the proteomics changes under the pathological conditions and the underlying mechanisms. Construction of physiological and pathological mapping based on the human proteome contributes to revealing the novel treatment targets, diagnostic markers, and drugs for the prevention and treatment of diseases. Proteomics has become the frontier and hot research field both at home and abroad, including al the proteins expressed in the tissue, cel or organism, and becomes a bridge between the genome and clinical application.