Objective:To evaluate the efficacy of insulin aspart 30 combined with metformin in the treatment of type 2 diabetes. Methods:According to the random number table, 68 patients with type 2 diabetes were randomly divided into two groups, the control group (n=34) and the observation group (n=34). The control group was treated with insulin aspart 30 by hypodermic injection, while the observation group was orally treated with metformin additionally. Results:After the treatment, the levels of FPG, HbA1c and 2hPG, plasma viscosity, blood viscosity and platelet adhesion rate in the two groups were lower than those before the treatment, and those in the observation groups were lower than those in the control group, and the differences were statistically significant (P<0. 05). After the treatment, the levels of TC, TG and LDL-C in the two groups were lower than those before the treatment (P<0. 05), and the levels of TC and TG in the observation groups were lower than those in the control group (P<0. 05). Before and after the treatment, HDL-C and BMI showed no significant differences in the two groups (P>0. 05). The reaching standard time of blood glucose of the observation group was shorter than that of the control group (P <0.05). Compared with the untoward reactions between the two groups, no statistical difference was shown (P<0. 05). Conclusion: Insulin aspart 30 combined with metformin can control blood sugar more effectively, and significantly improve the glucose metabolism of patients, shorten the reaching standard time of blood glucose and improve blood lipid and hemorheology indices, which is worthy of clinical promotion and application.

Objective To investigate the effect of probiotics on the blood lipid metabolism of elderly patients with coronary artery disease (CHD).Methods The clinical data of 100 elderly CHD patients who were admitted in our hospital from May 2012 ～November 2015 were collected.The enrolled patients were randomly divided into observation group and control group,50 cases in each group.All patients were routinely given medication for secondary prevention of CHD,patients in the observation group were additionally given oral probiotics.Then we observed the changes in the lipid levels of patients before and after 12 weeks treatment.Results The serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) of patients in the observation group were improved more significantly than the control group,the difference was significant (P＜0.05).The serum total High-density lipoprotein cholesterol (HDL-C) was improved more significantly than the control group.Conclusion Probiotics adjuvant therapy can significantly improve the blood lipid indexes in elderly CHD patients.

Objective To evaluate the influence of Fuzheng Huayu decoction on different pathological stages fibrotic liver tissue and activated hepatic stellate cells (HSCs). Methods Use a carbon tetrachloride (CCl4)-induced liver cirrhosis rat model system. The drug intervention was administered via oral-gastric irrigation in building, the end of week 2 and 4. Rats were batch sacrificed at the end of week 2 , 4, and 6. Liver fibrosis was evaluated by histology, and expression of a-smooth muscle actin (α-SMA) was determined by immunohistochemistry. Between-group comparisons were made by completely random design and ANOVA with Bonferroni correction. Results At the end of weeks 2, 4 and 6, the model group and drug intervention groups had significantly higher area ratio of liver fibrosis and higher expression of α-SMA than the normal group, but the three drug intervention groups had significantly less area ratio of liver fibrosis and less expression of α-SMA than the model group and the drug intervention 1 group showed the most robust decrease (P<0.05). Conclusion The Fuzheng Huayu decoction leads to down-regulated α-SMA expression and reduced degree of liver fibrosis on different pathological stages of fibrotic liver tissue, and the earlier drug intervention, the better the results.

Objective To explore the application effect of ICU checklist of medical cooperation on prevention of ventilator-associated pneumonia. Methods Totally 728 patients with mechanical ventilation from July 2015 to July 2016 in ICU were assigned to the experimental group with using of the checklist; and 685 patients with mechanical ventilation from June 2014 to June 2015 were set as the control group who did not use the checklist. The incidence of ventilator-associated pneumonia and medical cooperation were compared before and after the implementation of the checklist. Results The incidence of ventilator associated pneumonia were 6.72% (46/685) and 3.02% (22/728), the intervention strategy execution rates were 63.36% (434/685) and 84.89% (618/728) before and after the application of checklist, there was significant difference between two groups (χ2=10.51, 86.03, P<0.01). Medical cooperation (doctors and nurses) and satisfaction scored 18.53 ± 2.39, 21.91 ± 2.16, 30.93 ± 2.18 and 26.71 ± 2.21, 28.64 ± 2.55, 45.33 ± 1.74 before and after the application of checklist, there was significant difference between two groups (t=6.14, 14.25, 2.39, P<0.01 or 0.05). Conclusions The application of checklist can improve the medical cooperation on prevention of ventilator-associated pneumonia management, reduce the incidence of ventilator-associated pneumonia, improve medical cooperation, nursing satisfaction and the management efficiency, which is worthy of popularization and application.

Objective To use thrombelastography (TEG) and conventional coagulation tests (CCTs) to diagnose disseminated intravascular coagulation (DIC) and find a better diagnostic method.Methods Patients with potential DIC factors,DIC clinical manifestation or DIC patients suspected by laboratory tests were included after their admission into our hospital.TEGs and CCTs were detected,respectively.DIC score was evaluated.The single factor logistic regression was used to evaluate the correlation between TEG and CCTs as well as the diagnostic accuracy.Results The international normalized ratio (INR) in CCTs of the DIC patients were significantly higher,the reaction rime (R),clot formation time (K),angle rate of clot formation (α),maximum amplitude (MA),and composite index (CI) figures in TEG were significantly increased (P ＜ 0.05).The sensitivity and specificity of TEG were 82.4％,and 62.2％,which were significantly higher than 21.6％ and 47.2％ in CCTs (P ＜ 0.05).Single factor logistic regression results show that odd ratio (OR) in prothrombin time (PT) and INR of CCTs was 1.23 and 1.27,respectively.The OR in R,K,α,MA,and CI of TEG was 5.13,6.14,1.37,1.25,and 3.02,respectively.Conclusions Compared to CCTs,TEG is more indicative of the conditions of DIC patients and it might be a better way to predict the DIC risks,which is of greater value in clinical diagnosis.

OBJECTIVETo assess the efficacy of prophylactic treatment with recombinant human thrombopoietin (rhTPO) on chemotherapy-induced thrombocytopenia in tumor patients.

METHODSIn this randomized cross-over self-controlled clinical trial, 24 patients with malignant neoplasms were randomized group A (12 cases) and group B (12 cases). All the patients underwent two identical cycles of chemotherapy. In group A, RhTPO (1.0 µg/kg) was administered subcutaneously on a daily basis 3 days before the second chemotherapy cycle for 7 consecutive days, and in group B, RhTPO was administered daily 6-24 h after the second chemotherapy cycle for 7 days. In both groups, RhTPO was not administered in the first chemotherapy cycle, which served as the control cycle.

RESULTSIn both the groups, platelet count was significantly higher in the second cycle than in the control cycle, and the duration of thrombocytopenia was significantly shortened in the second cycle. Compared with group B, the patients in group A showed a significantly higher platelet count in the second cycle and a significantly shorter duration of thrombocytopenia in the second cycle.

CONCLUSIONProphylactic administration of rhTPO can significantly reduce the severity and duration of thrombocytopenia and promote platelet recovery in patients undergoing chemotherapy for malignant tumors.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Cross-Over Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; drug therapy ; Platelet Count ; Recombinant Proteins ; therapeutic use ; Thrombocytopenia ; chemically induced ; prevention & control ; Thrombopoietin ; therapeutic use ; Young Adult

Under the general requirements of China's national health reform, the basic framework of Shanghai's health reform was constructed at five different aspects the long term vision, goal, strategies, measures, supportive reform activities. The general thought of Shanghai's health reform can be concluded into two aspects: first, establishing a basic healthcare system of covering both urban and rural residents universally; second, enhancing the foundation of enabling sustainable health development.

Objective: To learn the epidemiological characteristics of family clusters of COVID-19 in Henan Province from January 23 to February 22, 2020, so as to provide reference for the prevention and control. Methods: The data of family clusters of COVID-19 in Henan Province from January 23 to February 22 was retrieved from Public Health Emergency Management System, the epidemiological characteristics of time, space, population distribution and clinical feasures were analyzed. Results: By February 22, there were 202 family clusters of COVID-19, with 546 cases reported in Henan Province, including 493 ( 90.29% ) confirmed cases and 53 ( 9.71% ) asymptomatic cases. There were 247 ( 45.24% ) imported cases and 299 ( 54.76% ) local cases. Most of the clusters were reported from January 25 to February 7, with 129 clusters accounting for 63.86% . The cases reported before February 5 were mainly imported ( 153 cases, 57.09% ) , after that local cases were predominant ( 168 cases, 68.29% ) . Eighteen cities in Henan Province all reported family clusters of COVID-19, with Xinyang, Zhengzhou, Nanyang, Zhumadian and Shangqiu as the top five. Most of the confirmed cases ( 430, 87.22% ) were mild. The median and longest incubation period was 8 and 17 days, respectively. The intergenerational distribution was dominated by first-generation and second-generation cases ( 537 cases, 98.35% ) . A total of 5 635 close contacts were tracked down, of whom 262 were secondary cases, with an incidence rate of 4.65%. The first cases of the family clusters were mainly imported from other provinces ( 149 cases, 73.76% ) . Conclusions The family clusters of COVID-19 in Henan Province were concentrated from January 25 to February 7. The source of infection mainly comes from other provinces. Most of the cases are first-and second-generation cases, with longer incubation period. Close contacts have higher incidence rate.

Objective:To study the methods of hormone-related teaching in standardized residency training of endocrinology.Methods:From February 2022 to June 2022, 25 residents in the Department of Endocrinology, Peking University Third Hospital were given a standardized residency training. The teaching mode combined with a hundred years of insulin development was adopted to practice insulin teaching, and questionnaires were evaluated before and after the teaching. Chi-square test was performed by SPSS 20.0.Results:A total of 31 physicians participated in the training, and 25 residents who were included in the first-stage standardized training were analyzed. Before the training, only 3 people (12%) knew the development history of insulin, and 10 people (40%) answered all the questions about clinical use of insulin correctly. After the training, 23 residents (92%) said they knew or were familiar with the history of insulin development, and 20 residents (80%) answered the questions about the clinical use of insulin correctly, all of which were higher than those before the training, and the difference was statistically significant.Conclusion:The integration of medical history in standardized residency training in endocrinology department can effectively improve the teaching effect, and enhance the humanity quality of young doctors, which can become an effective vehicle in standardized residency training.

OBJECTIVETo investigate the metabolic profile of hydrocortisone-induced 'Kidney-yang deficiency syndrome'in rats and the intervention effects of Morinda officinalis.

METHODProton nuclear magnetic resonance (1H-NMR) technique was used to analyze the rat metabonome in serum. Orthogonal partial least squares discriminant analysis (OPLS-DA) were processed to analyze the metabonome difference between the control and hydrocortisone treated samples. Twelve potential biomarkers were selected, via the parameter of variable importance in the projection (VIP). Principal components analysis (PCA) was employed to process the data from the M. officinalis. treatment group and the intervention effects of M. officinalis, was investigated through the selected potential biomarkers.

RESULTAfter hydrocortisone treatment, the energy metabolism, amino acids metabolism and gut microflora environment were seriously disturbed and transmethylation was surpressed. M. officinalis could effectively alleviate the disturbance of energy and amino acids metabolism and enhance transmethylation, but could not modulate the gut microflora environment.

CONCLUSIONThe results obtained suggested that metabonomic studies could better reflect the whole status of metabolism in bio-systems, and could be treated as a potential powerful approach in pharmacological studies and investigation of the essence of 'syndrome' in traditional Chinese medicine.

Animals ; Biomarkers ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Kidney ; drug effects ; metabolism ; Male ; Metabolomics ; Morinda ; chemistry ; Rats ; Rats, Sprague-Dawley ; Yang Deficiency ; drug therapy ; metabolism