Objective To explore the effect of family health management on community type 2 diabetes medication compliance.Methods Totally 123 patients with type 2 diabetes who live in Shanghai City Qingpu District Xujing Town An Ju Wei Hao Xiao Qu and met the WHO diagnostic criteria for type 2 diabetes were enrolled into this study.The patients' age was 50-75 years,including 60 male,63 female cases,mean age was (63.9 ± 6.9),(10.0 ± 7.4) years,course of disease,a family health file,making personalized home health management measures of community were analyzed.The effects of the 2 years of intervention on the compliance of the patients before and after the intervention as well as the blood pressure,blood glucose,blood lipid control were evaluated.Results The treatment compliance rate was (77.1％,94/122,intervention 1 cases died) significantly higher after intervention than that before intervention (62.6％,77/123) (x2=6.06,P＜0.05).After the intervention,the rate of target achievement in blood pressure (51.6％,63/122),blood glueose (44.3％,54/122),total cholesterol (72.1％,88/122),triglyceride (61.5％,75/122) low density lipoprotein (75.4％,92/122) were higher than those before intervention [blood pressure standard rate of 36.6％ (45/123),blood glucose standard rate of 28.5％ (35/123),total cholesterol standard rate of 59.3％ (73/123),triglyceride standard rate of 47.9％ (59/123),low density lipoprotein standard rate of 65.0％ (80/123)],the differences were statistically significant (x2=5.63,6.61,4.44,4.51,3.97,P＜0.05).Conclusion Community and family health management can improve the medication compliance in patients with type 2 diabetes.

Objective:To investigate the cognitive status of socialist core value among medical students, and to provide reference for the core value education in medical colleges and universities. Methods: 1024 medical students were selected with random cluster sampling method, and the socialist core value was investigated using self-designed questionnaire. Results:It was shown that 69 percent of medical students recognized the importance of socialist core values, but the contents had not been mastered. Social atmosphere, medical student's own short-coming and school education were all the factors leading to the weakness of socialist core values. Conclusion:It is quite necessary to cultivate medical students′socialist core values. Class, school, and society should play the main role to guide the medical students to establish the correct socialist core value.

Objective To assess the respective value and limitation of cardioangiography and ultrasonography in interventional therapy for congenital heart disease in children,and to discuss the clinical significance of the combined use of both examinations. Methods A total of 162 children with congenital heart disease,screened by ultrasonography,were enrolled in this study.The disorders included VSD(n=50),PDA(n=96)and PS(n=16).Before the interventional therapy all the cases accepted cardioangiography and ultrasonography examinations,and the diameter of the abnormal passage was measured.The difference in the diameter between two examinations was compared and statistically analyzed by using paired t test.All the cases accepted both examinations after the interventional therapy to check the location of the occluder and the result of balloon dilatation.Results Both cardiovascular angiography and ultrasonography could make a definite diagnosis of congenital bean disease in children,and could well display the location and shape of the abnormalities.The diameter of VSD(n=50)measured by cardioangiography and ultrasonography was(4.93±2.73)mm and(5.66±2.77)mm respectively,with no significant statistical difference existing between two methods(P＞0.05).The diameter at the narrowest site of PDA(n=96)measured by cardioangiography and ultrasonography was(3.22±1.45)mm and(3.96±1.42)mm respectively,with a significant difference existing between two methods(P＜0.05).In 16 PS cases,the diameter of valvular ring determined on cardioangiogram and on ultrasonogram wag(16.16±4.26)mm and(17.94±5.50)mm respectively,with no significant difference between two groups(P＞0.05).During the operation of VSD,the monitoring ultrasonography revealed that the valvular opening and closing was interfered by the occluder in 9 cases,so the occluder was re-adjusted till it was fixed to proper position. After the interventional therapy for VSD and PDA,cardioangiography detected a small residual shunt in 7 cases,which completely disappeared 24 hours later on ultrasonography.After balloon dilation in all 16 children with PS the right ventricle-pulmonary artery pressure difference was reduced by more than 50%and the pressure figure reached the standard of clinical Cure.The interventional procedure was successfully completed in all patients except for three cases. Conclusion In treating children of congenital heart disease with interventional procedures,the determination of the lesion's diameter and the selection of the occluder should be based on cardioangiographic measurement,although ultrasonography is more helpful in making preoperative screening and postoperative evaluation.

Objective:To investigate the medical students' cognition of ethical issues in assisted reproductive technology (ART) and discuss the importance of ethical education in medical colleges and universities.Methods:A questionnaire survey about the ethical cognition of assisted reproductive technology was conducted among 632 medical students.The questionnaire included the donation and management of gametes and embryos,and offspring problems.Results:Medical students agreed with most of the current ART-related laws and regulations.however,44.8％ of medical students considered that criteria of donating eggs should be relaxed,such as allowing women who do not receive ART treatment be paid for eggs.In addition,a total of 39.0％ of medical students supported the legalization of surrogacy technology in china.Conclusion:Medical students exists a certain misunderstanding in egg donation and surrogacy technology.We should give more training to medical students in ethical knowledge.In addition,our country can supplement and perfect the current laws and regulations to a certain extent.

Objective To explore the clinical effect and safety of using recombinant tissue type plasminogen activator (rt-PA) in early lower extremity deep venous thrombosis (DVT) after gynecological surgeries. Methods Twenty-five cases with early DVT after gynecological operation were enrolled and randomly divided into two groups,contorl group (n = 13) and the rt-PA therapy group (n = 12). The patients from contorl group were treated with Low-Molecular-Weight Heparins Calcium 0. 4 ml/d alone, and the rt-PA group accepted rt-PA 100 mg i. v in addition to the Low-Molecular-Weight Heparins Calcium. The recanalization rates of lamb veins,prothrombin time (PT) ,bleeding event and other adverse complications were observed and evaluated at day seven. Results The recanalization rates of lamb veins were 91. 7% (11/12) and 53. 8 % (7/13) in rtPA and the control group respectively,which showed significant difference between each other (x2 = 15. 68, P <0. 01). One case had vaginal stump bleeding in each group but no other hemorrhage in both group,the difference of bleeding rates between two groups didn't reach statistically significance (x2 = 1. 48 ,P> 0. 05). Two patients with vaginal stump bleeding were healed by local hemostasis. Conclusion The usage of rt-PA could improve the recanalization rate of DVT after gynecological surgery. The rates of adverse complications, including vaginal stump bleeding,were extremly low.

Purpose To explore the clinicopathological features, differential diagnosis of solitary bronchial papilloma, and its relation with and human papilloma virus infection.Methods Four cases of SBP were studied by routine histologic,immunohistochemical staining and in situ hybridization, together with review of the literature.Results One of four lesions was squamous cell papilloma, with focal malignant change of squamous cell carcinoma with microinvasion. The case was an old woman and the cancer located in central bronchus. Others were mixed squamous cell and glandular papilloma, and two cases with features of moderate cytologic atypia. The age ranged from 25 to 73 years (average 54), and tumors were located in the bronchi and segmental bronchi. Papillary arborizing connective tissue stalks were lined by both squamous and glandular epithelium. Four papillomas were exophytic, with one case inverted partly. Four cases were examined for HPV DNA and all were negative.Conclusions SBP in adults is a rare lung neoplasm. Based on uncommon cases association with malignant change, all endobronchial papillomas should be completely excised.

Objective To investigate CT findings of hepatic necrosis and regeneration after liver failure.Methods Five patients with liver failure underwent CT scan before orthotopic liver transplantation.These findings were retrospectively reviewed and correlated with gross specimen and pathologic findings obtained after transplantation.Results Among 5 cases,the CT appearances of liver failure can be divided into 3 types.(1)Massive confluent aggregate foci in 2 patients demonstrated low attenuation and high attenuation as geographical patlerns on CT scans before contrast enhancement.respectively.The histopathological liver changes showed massive necrosis and regencratinn. Regions of necrosis enhanced to attenuation greater than that of normal liver parenchyma in portal-venous phase,the regions of regeneration enhanced to attenuation greater than that of normal liver parenchyma in arterial phase on postcontrast CT images.(2)In 2 patients,diffuse nodules of liver demonstrated high attenuation on plain CT scans,which was nodular necrosis and nodular regeneration pathologically.All enhanced to attenuation greater than that of normal liver parenchyma in arterial phase.The former showed hypointensity in portal-venous phase and equilibrium phase.The latter enhanced to attenuation equal to that of normal liver parenchyma in portalvenous phase and equilibrium phase on postcontrast CT images.(3)Multiple small foci in 1 case demonstrated low attenuatiun on precontrast CT images and enhanced to hyperintensity in portal-venous phase and isointensity in arterial phase and equilibrium phase on postcontrast CT images.The histopathological liver changes showed multiple necrosis.Conclusion Liver failure may reveal characteristic imaging patterns at CT.

BACKGROUND: There are no effective methods to cure Alzheimer disease (AD). Now, researches have shown that panax notoginseng saponins (PNS) play an important role in improving AD, but its mechanism is unclear.OBJECTIVE: To observe the protective effect of PNS characterized by removing blood stasis to stop bleeding and promoting blood circulation to relieve pain on pathological lesion of cholinergic neuron in rat with AD.DESIGN: Completely randomized grouping design and controlled study.SETTING: Neuroscience Institute of Guangxi Traditional Chinese Medical University.MATERIALS: This experiment was completed in the Chinese Herb Pharmacodynamic Laboratory of Guangxi Traditional Chinese Medical University between June 2003 and April 2005. A total of 90 health Wistar rats of clean grade and half gender were selected in this study. Among them, there were 75 old rats with 15 months old and 15 young rats with 3 months old. METHODS: This experiment was completed in the Chinese herb Pharmacodynamic Laboratory (Key Laboratory) of Guangxi Traditional Chinese Medical University between June 2003 and April 2005. ① A total of 90 healthy Wistar rats of clean grade and half gender were selected in this study. Among them, there were 75 old rats with 15 months old and 15 young rats with 3 months old. Fifteen young rats with 3 months old were regarded as young control group, and other 15 selected from 75 rats with 15 months old were regarded as old control group. The rest 60 rats were modeled on the basis of subacute injury induced by intravenous injection of D-galactose and bilateral cerebral Meynert basal nuclei injured by ibotenic acid. Parallel control was performed with saline on rats in young control group and old control group under the same condition. ② Two weeks later,survival modeling rats were divided randomly into 4 groups: model group,high-dosage PNS group, low-dosage PNS group and huperzine A group with 12 in each group. Rats in high-and low-dosage PNS groups were perfused with 200 and 100 mg/kg PNS (provided by Yunnan Yuxi Weihe Pharmaceutical Factory), respectively, once a day; rats in huperzine A group were perfused with 0.3 mg/kg huperzine A once a day for 4 weeks; rats in model group, young control group and old control group were perfused with the same volume of saline for 4 weeks. ③ After administration, pathological sections of brain tissue were cut, and immunologic-reaction activity of choline acetyltransferase (ChAT), morphological changes and numbers of positive neuron in cerebral sections were determined by immunohistochemistry analysis. ChAT immuno-positive neurons were analyzed with IBAS imaging analysis system to assay average area of section and average absorbance (A), and amount of ChAT immuno-positive neurons was calculated with microscope micrometer. ④ Measurement data were compared with single-factor analysis of variance.MAIN OUTCOME MEASURES: Effect of PNS on distribution of cholinergic neuron and ChAT content in cerebral tissue of AD rat models.RESULTS: A total of 75 old rats and 15 young rats entered the final analysis. ① Amount of ChAT immuno-positive neurons was the most, and the color was the deepest in young control group; amount of ChAT immuno-positive neurons was higher in high-dosage PNS group than that in huperzine A group and model group; ChAT immuno-positive neurons were smaller in model group than those in other goups, and the amount was decreased obviously. Axis-cylinder and dendrite of soma were shortened remarkably. ② Amounts of ChAT immuno-positive neurons in basal forebrain were less in model group than those in other groups (P ＜ 0.05), less in lowdosage PNS group, huperzine A group and model group than those in old control group (P ＜ 0.05), less in huperzine A group and model group than those in high- and low-dosage PNS group (P ＜ 0.05), and less in young control group than those in other groups (P ＜ 0.05). The mean A value of ChAT immuno-positive neurons in basal forebrain was similar to amounts in each group. Average area of section of ChAT immuno-positive neurons in basal forebrain was smaller in low-dosage PNS group and model group than that in young control group (P ＜ 0.05), and differences in other groups were not significant (P ＞ 0.05).CONCLUSION: PNS plays a protective role in pathological lesion of cholinergic neuron in AD rat models. PNS can also increase survival amount and quality of cell and increase content and activity of ChAT so as to protect and improve central cholinergic system, and inhibit aging and dementia through improving and repairing injured cholinergic neurons.

Objective To investigate the association of the Cx37 polymorphism of connexin gene with essential hyper?tension (EHT) in Xinjiang Han and Kazak population. Methods In Xinjiang region, 500 EHT patients (EHT group) were in?cluded in this study including Kazak 250 cases and Han 250 cases. Five hundred healthy volunteers (NT) were used as NT group including Kazak 250 cases and Han 250 cases. The values of age, body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), and other general clinical features were compared between two groups. The poly?morphism of Cx37 gene rs1630310, rs697372 and rs705193 SNP were compared between EHT and NT groups in the two eth?nic groups. Hardy-Weinberg equilibrium was used to detect the representation, and differences of genotype frequencies and gene frequency were calculated in two groups of Kazak and Han groups. Results There were significant differences in BMI, SBP, DBP, apolipoprotein ratios and homocysteine between EHT group and NT group in Kazak and Han groups (P<0.05). There were no significant differences in genotype frequencies and gene frequencies of rs705193 between EHT and NT groups (P>0.05). The differences of Kazak rs1630310 genotype and gene frequency were statistically significant (P<0.01). The frequency of Kazak rs697372 locus genotype was not significantly different (P>0.05), but the difference of gene frequen?cy was statistically significant (P<0.05). There were no significant differences in rs1630310 and rs697372 locus genotype and gene frequency in two groups of Han group. Conclusion Cx37 gene polymorphism is associated with the occurrence of EHT in Xinjiang Kazak population, which may be related with the rs1630310 and rs697372 polymorphism.

Objective To summarize the computed tomography (CT) features of small intestinal obstruction caused by primary abdominal cocoon and investigate the essentials of diagnosis and differential diagnosis.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with small intestinal obstruction caused by primary abdominal cocoon who was admitted to the Second Affiliated Hospital of Jiaxing University on October 6,2014 were collected.The patient underwent abdominal CT on admission and at 10 hours after admission.The patient received emergency exploratory laparotomy after preoperative preparation,and then postoperative regular symptomatic treatment and pathological examination.Results of abdominal CT were observed,including imaging features of abdominal masses,extent of small intestinal obstruction,situation of intestinal tube within the masses,vessel distribution in the mesentery and fibrous capsules around the mesentery.Situation of operation,routine blood test,biochemical indicator,blood coagulation indexes,postoperative recovery,complications,results of pathological examination and situation of patient during follow-up were recorded.The follow-up by telephone interview and outpatient examination was applied to the patient till October 31,2015,including detecting the dietary,with or without symptoms of abdominal pain and distension,haematemesis and hematochezia,routine blood retest,liver function,renal function and CT.Results Results of abdominal CT on admission:(1) coronal plain scan of abdominal CT showed that there were signs of incomplete intestinal obstruction,and local small intestinal dilatation and gas accumulation in left abdominal region without specific sign.(2) Plain scan of abdominal CT showed that there were the coated sign with thickened fibrous capsules around the intestinal tube, banana shape ' with agglomerate and expanding-distortion intestinal tube and aggregative,stretching and twisting mesentery with abnormal vessel distribution.(3) Sagittal reconstruction images of abdominal CT showed that a huge mass consisted of fibrous capsules as cocoon and agglomerate and expanding-distortion intestinal tube was petal-like and fixed on posterior abdominal wall.(4) Coronal reconstruction images of abdominal CT showed that agglomerate and expanding-distortion intestinal tube was annularly surrounded by uneven thickness fibrous capsules with abnormal vessel distribution in the mesentery.Results of abdominal CT at 10 hours after admission:(1) coronal plain scan of abdominal CT showed that small intestinal obstruction was obviously exacerbated and expanding intestinal tubes were increased and aggravated.(2) Plain scan of abdominal CT showed that a typical sign of small intestinal obstruction was exacerbated and there were multiple air-fluid levels in the agglomerate and expanding-distortion intestinal tube with fluid and gas accumulation.Patient underwent successful enterodialysis + resection of fibrous capsules.During operation,a huge mass in the intestine from suspensory ligament of duodenum to ileocecum was fixed on posterior abdominal wall and surrounded by dense,smooth and white fibrous capsules,partial colon was also surrounded by fibrous capsules and greater omentum was missing.Patient received the postoperative supporting treatments of fasting,anti-infection and inhibition of acid.Number of white blood cells,absolute value and percentage of neutrophils,levels of high-sensitivity C-reactive protein and procalcitonin were 17.10 × 109/L,15.70 × 109/L,91.5％,127.49 mg/L and 1.370 μg/L by blood routine retest at postoperative day 1,respectively.Patient had normal liver,renal and coagulation functions.Fluid diet intake at postoperative week 1 was gradually replaced by normal diet intake.Patient had normal liver and renal functions by blood routine retest at postoperative day 10 and a good recovery without intestinal fistula,abdominal and pulmonary infections and other complications.Postoperative pathological examination showed that gross specimen was mainly composed of cocoon-shaped,grayish white and tough fibrous capsules.Fibrous capsules were consisted of proliferative fibrofatty tissues by microscope observation,with small vascular hyperplasia and large numbers of the inflammatory cell infiltration.Patient was diagnosed with small intestinal obstruction caused by primary abdominal cocoon after operation,and followed up for 1 year with normal diet intake and without abdominal pain and distension,nausea and vomiting,melena and discomfort.There was normal blood routine retest,liver and renal functions and distribution of the intestine in abdomen by CT examination.No dilatation of the intestinal tube was found and strip-like high density shadow in ileocecum was detected and considered as remnant fibrous capsules.Conclusion Imaging features of small intestinal obstruction caused by primary abdominal cocoon include agglomerate and expanding-distortion intestinal tube fixed on abdomen,partial intestinal tubes dilatation,intestinal fluid accumulation and air-fluid level,aggregative,stretching and twisting mesentery with abnormal vessel distribution,thickened fibrous capsules around intestinal loops and among intestinal tubes.