Objective To study the application effect of insulin aspart alone or in combination with metformin to treat diabetes.Methods 80 patients with diabetes from February 2014 to February 2015 were studied.They were randomly divided into observation group and control group,40 cases in each group.The observation group was given insulin aspart therapy combined with metformin hydrochloride tablets.The control group was treated with insulin aspart.The blood glucose levels,insulin dosage were recorded,the incidence of hypoglycemia was analyzed in the two groups.Results After treatment,the blood glucose levels in the two groups were lower than before treatment,the decrease of the observation group was more significant than the control group,the difference was statistically significant (P <0.05).The two groups showed no significant difference in mean blood glucose and glycemic lowest (P >0.05), the highest blood glucose value of the observation group was lower than the control group [(7.3 ±1.1)mmol/L vs (8.5 ±1.8)mmol/L)],there was statistically significant difference (t =3.597 8,P =0.000 2).The average blood glucose level of the observation group was also shorter than the control group,there was statistically significant differ-ence (t =10.880 3,P =0.000 2).After treatment,NIHSS scores of the two groups were decreased,NIHSS score reduce the magnitude of the observation after treatment was significantly higher than the control group (4.33 ± 0.82)vs.(5.24 ±1.25),there was significant difference(t =3.849 8,P =0.000 2).The effect of improving lipid levels observed were significantly better than the control group,the difference was statistically significant (P <0.05). Conclusion Combination of insulin aspart and metformin hydrochloride tablets in the treatment of patients with dia-betes to control blood sugar levels is better than the effect of single treatment with insulin aspart,insulin aspart therapy combined with metformin hydrochloride tablets in patients with diabetes can reduce postprandial 2h,fasting glucose, reduce the incidence of hypoglycemia,it should be popularized and used in the clinical.

Objective: To discuss the mechanism and clinical effect of quickening the blood and transforming stasis method in treatment of heart syndrom X. Methods:Observing its effects on the endothelium dependent vasodilatation function and the endothelin 1 (ET 1) level when chest pain occurs. Results: Chinese herbs with actions of quickening the blood and transforming stasis can reduce the concentration of endothelin 1 (ET 1) in blood, adjust the function of endothelium dependent vasodilatation. There is a significant difference in the percentages of inside diameter of brachial artery when reactive hyperemia between the therapeutic group (8.4? 4.1)% and the control group (4.2?2.1)% ( P

Objective:To investigate the effect of pulmonary rehabilitation therapy on the exercise capacity and dyspnea of persons with chronic obstructive pulmonary disease (COPD).Methods:One hundred COPD patients were randomly divided into a control group and an observation group, each of 50. Both groups were given routine medication, while the observation group was additionally provided with health guidance, oxygen therapy, respiratory physiological therapy and exercise for 3 months. Before and after the intervention, both groups′ forced expiratory volume in 1 second (FEV1) and the first and second forced expiratory volume as a percentage of FEV (FEV1%) were measured. The subjects′ motor functioning was evaluated using the 6-minute walk test. Enzyme-linked immunosorbent assays and immunoturbidimetry quantified their expression of inflammatory factors. And their ability in the activities of daily living (ADL) was evaluated using the Barthel index. The COPD quality of life questionnaire (CRQ) was also used to assess their life quality.Results:After the intervention, the average clinical efficacy in the observation group was 96%, significantly higher than that of the control group (80%). Moreover, the average FEV1, FEV1%, 6-minute walk test time of the former group were all significantly better than before the intervention and better than the control group′s results after the intervention. Their average CRP, IL-6 and TNF-α levels were all significantly lower as well. After the intervention, the observation group′s average total CRQ score and its average scores on the instrument′s emotion, fatigue, wheezing and disease control components were all better than the control group′s averages. The observation group′s average ADL score was also significantly higher than that of the control group.Conclusions:Supplementing conventional medication with pulmonary rehabilitation therapy can effectively improve the lung function, motor functioning and life quality of COPD patients. It can also lower their level of serum inflammatory factors.

Objective To investigate the factors affecting the susceptibility of tigecycline and assess the testing methods.Methods The 116 isolates of Acinetobacter baumanaii and Klebsiella pneumoniae were collected in 13 hospitals from January to December,2010,to evaluate the effects on the tigecycline susceptibility of the overnight medium,medium brand and lot number,respectively.The 56 isolates of Acinetobacter baumannii and the 47 isolates of Klebsiella pneumoniae were selected randomly according to the MIC distribution proportion in 2010 and 2012.The broth microdilution was taken as the reference method to evaluate the effects of the agar dilution,disk diffusion,MIC Test Strip (MTS) and Vitek2 (GN16) on the susceptibility of tigecycline.Results The essential agreement (EA) of Acinetobacter baumannii and Klebsiella pneumoniae is 89.7％ (52/58)and 87.9％ (51/58) using overnight medium and fresh medium respectively.Both EA and categorical agreement (CA) of the different brands (BBL and Oxoid) and lot numbers are 100％ using agar dilution.According to the FDA break point criteria,the CA/EA is 77.7％ (80/103)/99.0％ (102/103),87.4％ (90/103)/98.1％ (101/103),64.1％ (66/103)/76.7％ (79/103) using agar dilution,MTS,Vitek (GN16) with respect to broth microdilution.The CA is 79.6％ (82/ 103,S≥14 mm,R≤10 mm),69.9％ (72/103,S≥ 16 mm,R≤ 12 mm),34.0％ (35/103,S≥19 mm,R≤14 mm)using disk diffusion method compared with broth microdilution (FDA break point criteria).Conclusions The susceptibility of tigecycline must be tested using fresh medium.The medium brands and lot numbers used in this test have no effects on the tigecycline susceptibility to Acinetobacter baumannii and Klebsiella pneumoniae.There exist the better correlations on MIC using agar dilution and MTS than the disk diffusion and Vitek(GN16) compared with broth microdilution.It is expected that the consistency can be improved by adjusting the break point of disk diffusion.

Objective To finding out the characters of vascular remolding after the establishment of native arteriovenous fistula on the wrist,and exploring the influential factors.Methods Doppler ultrasound was used to monitor the diameter of cephalic vein,brachial artery,radial artery and ulnar artery at the time before the surgery and one day,one week,two weeks,four weeks and eight weeks after the surgery respectively.The tendency of the diameter change was analyzed.Results Twenty eight patients completed the whole monitor session,in which eleven were female.The average age of those patients was (53.68 ± 2.61) years old.Twelve of them were diabetic nephropathy.The diameters of all vessel were increased more rapidly at the first day than any other days after surgery(all P ＜ 0.01).The patients were divided into two groups depending on whether diabetic nephropathy.No significant difference was found between the two groups on the tendency of diameter change in cephalic vein and brachial artery (all P ＞ 0.05).However,the tendency of diameter change in radial artery and ulnar artery was statistically significant difference between the two groups (all P ＜ 0.05).Conclusions Cephalic vein,brachial artery,radial artery and ulnar artery are all apparently dilated on the first day after the surgery.The vascular dilation and diameter increasing become much slower after the period,the diameter tend to be stable.The primary diseases may affect the tendency of the diameter change in radial artery as well as ulnar artery.

Objective To study the clinical efficacy of micro-plasma radiofrequency with joint electron-beam radiation treatment for keloids.Methods A total of 15 patients with keloids over half a year were treated with single time micro-plasma radiofrequency technology by roller tip at 80-100 watts.The hypofractionated electron-beam was used,with 9 Gy dose per time covering the scar with a 1 cm margin,within 24 hours and 1 week after the micro-plasma treatment.The Vancouver Scar Scales (VSS) were assessed before and 6 months after the treatment.Patients' satisfaction and the adverse reactions were evaluated 6 months after the treatment.Results There was astatistically significant difference between the mean VSS of 15 patients pre-and 6 months posttreatment (from 11.73± 1.12 to 3.87±2.53,P＜0.05).The degree of improvement was:excellent in 1 case,good 10 cases,fair 3 cases,and poor 1 case.Patients' assessment was:extremely satisfied in 6 cases,satisfied 6 cases,approximately satisfied 2 cases and dissatisfied 1 case.The adverse reactions included hyperpigmentation within the radiation field on the anterior chest wall in 1 case and delayed healing of 1 patient 's scar wound.Conclusions Micro-plasma radiofrequency combined with electron-beam radiation therapy is highly effective and safe on keloids with good clinical application value.

Objective: To investigate mechanism on the restenosis after percutaneous transluminal coronary angioplasty (PTCA) with FSZ (Hirudo, Rhizoma Coptidis, Radix et Rhizoma Rhei, Radix Curcumae, Rhizoma Polygonati Odoroti, etc) by studying the protective effects of FSZ on arrhythmia and injury induced by ischemia and reperfusion.Methods:Rats were randomly divided into four groups and administered orally with FSZ. Left coronary artery ligature was used to form ischemia and reperfusion model. Lipid peroxidation (LPO), superoxide dismutase (SOD), cyclic adenosine monophosphate (cAMP), area of myocardial infarction, myocyte ultrastructural injury and occurrence of arrhymia were investigated.Results: FSZ could improve the changes in ST segment. In rats treated with FSZ, the levels of SOD were elevated while cAMP, LPO, and the specific viscosity of whole blood or plasma and the aggregation of the platelet were lowered, keep to improving the hemorheological changes. It also could antagonize the myocardial damage by myocardial ischemia or reperfusion reduced the area of myocardial infarction. Especially, Fufangshuizhijing Capsule reduced the area of left ventricular (LV) compared with the control group remarkably.Conclusion: FSZ could obviously antagonize arrhythmia and the injury induced by the ischemia and reperfusion, FSZ may scavenge oxygen free radical, regulate the second messenger, remarkably improve the local circulation to reduce the specific viscosity of whole blood of plasma and the aggregation of the platelet in rats, protect mitochondria safeguard the cardiac myocyte to treat PTCA.

Objective To explore the application effect of amelioration of pterygium combined with free autogenous conjunctival flap transplantation in patients with primary pterygium.Methods 90 cases (90 eyes) of primary pterygium treated in our hospital were grouped according to random number table.45 cases in control group were treated with traditional pterygium excision,and 45 cases in observation group were treated with pterygium combined with free autogenous conjunctival flap transplantation.The operative condition (length of operation,incision size,blood loss during operation,healing time of corneal epithelium),the effect of operation and corneal astigmatism [corneal dispersion (CAD)],naked eye [uncorrected visual acuity (UCVA)] and tear film rupture time [break up time (BUT)] before and after operation were observed and compared.The incidence of complications,recurrence rate and quality of life (SF-36) before and after operation were compared between the two groups.Results The incision size,operative time,intraoperative blood loss and corneal epithelial healing time in the observation group were smaller than those in the control group (P ＜0.05).The total effective rate of the observation group was 93.33％ (42/45),which was higher than that of the control group 75.56％ (34/45) (P ＜0.05).3 months after operation,the UCVA of the observation group was larger than that of the control group,while CAD was less than that of the control group (P ＜ 0.05).The BUT 3 months after the operation was greater than that before operation (P ＜0.05),but the difference was insignificant (P ＞ 0.05).The complication rate in the observation group was 2.22％ (1/45),which was lower than that in the control group 17.78％ (8/45) (P ＜ 0.05).The recurrence rate of the observation group was 2.22％ (1/45),which was lower than that of the control group 17.78％ (8/45) (P ＜0.05).3 months after operation,the SF-36 scores of the two groups were all higher than those before operation,and the SF-36 score of the observation group was higher than that of the control group 3 months after operation (P ＜ 0.05).Conclusions Free autogenous conjunctival flap transplantation combined with amelioration of pterygium can improve corneal astigmatism and visual function of the patients with primary pterygium,and promote corneal epithelial healing,with small incision,less bleeding and longer operation,which can reduce the incidence of postoperative complications and the recurrence rate,and help to improve the quality of life of the patients.

Objective: The metaanalysis aims to estimate the prevalence of suicide plan among college students in mainland China, and to provide more clues and reference for control and prevention of suicide. Methods: The relevant studies were systematically searched via electronic databases (PubMed，Embase，CNKI，Wan Fang Data，VIP). We only selected original articles that either reported on Chinese retrieval words of "college students" "undergraduate" "university" "college" "colleges and universities" "suicide plans" "detection rate" "prevalence" "report rate", and the English retrieval words of "undergraduate" "college" "university" "suicide" "suicidality" "suicide plans" "suicidal plans suicide intending" "prevalence" "report rate" "detection rate" "China" "Chinese". And Stata 12.0 software was used to make a metaanalysis of the data. Results: A total of 18 eligible studies, with 47 071 college students, were finally included. The maximum and minimum reported prevalence of suicidal plan among college students in China mainland was 4.4%(95%CI: 3.4%-5.4%).Subgroup analyses showed that the pooled estimate of suicidal plan of boys(5.4%) was higher than girls’(4.2%); The prevalence among college students from earth, middle and west areas were 5.1%，2.7%，4.5%, respectively; The prevalence among college students in 2010 and after (4.4%)was higher than that before 2010(4.3%), The prevalence among college students of life time suicide plan (4.9%)was higher than that during the past 12 months(4.0%), but there was no statistical significance in the subgroup(P>0.05) . Sensitivity analysis suggested that the results of metaanalysis were relatively stable, while funnel plot analysis suggested that publication bias might exist. Conclusion Prevalence of suicidal plans among college students in mainland China is respectively low, and there was no statistical significance in gender, region, the period of time and simple size.