Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

Objective:To develop the intelligent management system for diabetes medication knowledge base with the help of community hospital information platform.Methods:Based on the China Type 2 Diabetes Prevention Guide (2013 edition),National Essential Drugs (2012 edition) and the relevant package inserts,the knowledge base of diabetes medication was established.Results:The information platform could make interception beforehand,warning in the process of medication and provide attentions for physicians after treatment to determine rational medication.Conclusion:The intelligent management system for diabetes medication knowledge base can promote physicians to firmly grasp the principles of drug treatment,simplify treatment regimen,select effective drugs with reasonable prices and provide individualized treatment.

BACKGROUND:Percutaneous kyphoplasty for the treatment of vertebral compression fractures has gained good clinical results and it is characterized as smal trauma, less bleeding and very low rate of complications. The vast majority of elderly patients can tolerate it, but this method cannot prevent fracture replase in the elderly. OBJECTIVE:To evaluate clinical outcomes of percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures METHODS:According to strict inclusion and exclusion criteria, 137 patients, including 26 males and 111 females, mean age of (75.55±6.96) years, with a total of 198 acute osteoporotic vertebral compression fractures treated by kyphoplasty that involves injection of polymethyl methacrylate cement under radiologic control into a treated vertebral body were conducted in this study. Al patients were asked to take anti-osteoporosis drugs for 3 post-treatment months. The primary outcomes were visual analogue scale, ertebral restoring rate, Oswestry disability index, Cobb angle at different time (pre-operation, 1 week and 3 months after operation). In addition, the rate of complications and the replase rate of vertebral compression fractures after operation were recorded. RESULTS AND CONCLUSION:There were significant differences in the mean visual analog scale scores, vertebral restoring rate, Oswestry disability index, Cobb angle at pre-procedure and post-procedure (at 1 week and 3 months) (P<0.001). In addition, the rate of postoperative complications was 0.7%and there were no vertebral compression fractures during 3-month fol ow-up period. Our study suggests that percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures can gain good clinical results.

Objective To investigate the neuroprotection of delayed treatment of thoracic acute spinal cord injury with recombinant human erythropoietin (rhEPO) in rat model of compressive injury. Methods Sixteen adult male Sprague-Dawley rats were randomly divided into two groups: control group (compressive injury group) and experimental group (rhEPO group), In the compressive injury group,the animals recived 0.9% saline treatment at 2 h, day 1 and day 3 after the injury, while in the rhEPO group, rhEPO (3 000 U/kg) was given to rats at 2 h, day 1 and day 3 after the injury. All the rats were observed in 4 days after the injury. The primary outcomes were evaluated by BBB scale, apoptotic index, inflammatory index and electron microscopy. Results Delayed treatment of thoracic acute spinal cord injury with rhEPO could reduce apoptosis, regulate inflammation, improve motor function and promote regeneration of the spinal cord. Conclusion Our study suggests that delayed treatment of thoracic spinal cord compressive injury with rhEPO could exert neuroprotection.

Objective To evaluate the clinical diagnostic contribution of 18 F-FDG PET/CT in giant cell arteritis with initial presentation as fever of unknown origin (FUO).Methods Eight cases with initial presentation as FUO diagnosed with the contribution of PET/CT were retrospectively studied in Peking Union Medical College Hospital.The radiologic manifestations of PET/CT were analyzed.Results Eight patients (4 men and 4 women) with average (63 ± 7) years (range from 55-75 years) were included in our study based on the criteria.Non-specific clinical symptoms were common in these patients,including fatigue,night sweat and weight loss.They all suffered from anemia of chronic disease.Not surprisingly,the inflammatory parameters were elevated significantly in all patients.The medical history,physical examination and routine lab and radiologic examinations couldn't reveal the causes of fever.PET/CT was performed in all of them,which demonstrated intense 18F-FDG uptake in the area of aorta and its major branches with maximal standard uptake value (SUVmax) 2.1-4.6 (3.6 ± 0.9).Immunosuppressive agents were effective to control the inflammation activity.The SUV decreased significantly after treatment in the follow-up PET/CT.Conclusions PET/CT has demonstrated high yield of diagnostic contribution in giant cell arteritis with initial presentation as fever of unknown origin.As to elderly FUO patients presenting with prominent inflammatory reaction,PET/CT may provide potential value to differentiate diagnosis from maligancies.

Objective To compare the field molluscicidal effects of 25%suspension concentrate of nielosamide ethanolamine salt(SCNE),50% wettable powder of niclosamide ethanolamine salt(WPN),40% META-Li and 50% Rongbao powder,so as to provide scientific basis for choosing the safe and highly effective molluscicide in field.Methods Four snail habitats with the similar snail status were selected and sprayed with the four molluscicides mentioned above,respectively.Then the snail status in the four fields was surveyed 3,7 and 17 d after the spraying and the moiluscicidal effects of difierent molluscieides were cornpared.Results The corrected mortalities of snails in the field sprayed with SCNE 3,7 and 17 d afterthe spraying were the hiishest among the four fields,with the rates of 93.13%,91.85% and 85.28%,respectively.Conclusion SCNE has a high molluseieidal effect in the field and can be further used in snail-infested areas.

Objective To study the MR imaging technology and 3D reconstruction of the articular cartilage of knee.MethodsConventional,2D,3D and multiparameter MR imaging scans of knee were performed in ninety patients with trauma(n=34)andosteoarthritis(n=56) of knee and 10 healthy volunteers.The articular cartilages on 3D images were reconstructed using maximum intensity projection(MIP).The mean thickness of articular cartilage was measured and analysed statistically.Results Articular cartilages of knee were clearly depicted by MR imaging technique and 3D.On 2D FSE sequence,about 50% of articular cartilage appeared as three laminar apearance.On 3D imaging,the three-dimensional morphology of articular cartilage was showed clearly.Conclusion MR imaging and 3D reconstruction of the articular cartilages of knee is helpful in early diagnosis and treatment of disordered cartilages.

Objective On the basis of internet of things technology,to initially establish a management model of chronic obstructive pulmonary disease (COPD) patients in Gumei community,so as to provide experience for the comprehensive management of community COPD patients.Methods According to the characteristics of the Internet of things technology,we formulated a scheme as a technical route to manage the COPD patients.A homogenous COPD management team of doctors was established under the training of experts from the Department of Respiration of Zhongshan Hospital,Fudan University.Results We drew a COPD patient management model chart,and initially formed a qualified and homogeneous COPD management team of general practitioner.Conclusions Through the Internet of things technology management,we initially formed a set of manual quality control model in the process of data automatic transmission,and initially formed a management model of community COPD patients,based on the internet of things.

Objective To investigate the clinical value of transanal endoscopic microsurgery (TEM) for the treatment of elderly patients with colorectal adenoma.Methods Totally 21 patients with colorectal villous adenoma underwent TEM from Dec.2007 to Sep.2010.The distance of adenoma from the anal verge was 4-20 cm (average 8.9 cm) and tumor size was 1.1-3.5 cm (average 1.9 cm).There were 12 cases with tubular adenoma and 9 cases with villous adenoma according to pre-operative diagnosis by colonoscopy and endoanal ultrasonography (EUS).Appropriate position and posture were dictated by the location of the tumor under general anesthesia.A special rectoscopy was inserted into the anus with CO2 insufflation to keep the rectum open.Under the stereoscopy and lapaoscopy-type instruments,the tumor was completely resected (submucosal or full-thickness excision) using a 5 mm ultrasonic dissector.The operative wound was closed with intra-lumen continuous sutures.Results The tumor was completely removed with negative resection margins in all the 21 patients (submucosal excision in 12 cases and full-thickness excision in 9 cases).The operating time was 40-100 min (average 76 min) and the intraoperative blood loss was 10-80 ml (average 50 ml).The post-operative stay was 2-10 d (average 4.5 d).The postoperative pathological stages were pT0 in 16 cases and pTia in 5 cases.The postoperative pathological diagnosis were tubular adenoma in 12 cases,villous adenoma in 9 cases,low-grade intraepithelial neoplasia (IN) in 5 cases and high-grade IN in 5 cases.Follow-up checkups in the 20 patients for 2-20 months (average 11 months) revealed no local recurrence.Conclusions TEM is safe and effective with little complication for the treatment of elderly patients with colorectal adenoma.Pre-operative EUS is very important for TEM.

Objective To evaluate the effects of carbohydrate-electrolyte solution(CES)on serum glucose,pancreas islet function,and safety in elderly patients after abdominal operation.Methods In this prospective,double-blinded,randomized,and controlled study,40 elderly patients who met the defined criteria were enrolled.Subjects in CES group were intravenously administered with 1 000 ml CES for consecutive three days beginning from the 1st and 2nd post-operative day,while subjects in the control group were administered with 10% glucose of the same volume under the same arrangement.The changes of serum glucose,insulin and insulin C-peptide,as well as lactic acid and uric acid and uric acid were determined before and after injection.Adverse events were recorded.Results All patients completed the study.The increase rate of serum glucose was significantly lower on the 2nd and 3rd day after injection in CES group than in control group(P=0.008,P:0.001).Blood insulin and insulin C-peptide levels showed increasing trends in both two groups,but were not significantly different between two groups(P=0.612,P=0.213).In the CES group,6 patients experienced systemic inflammatory response syndrome and 4 patients had infective complications after surgeries ;on the contrary,these two numerals were 8 and 6 in the control group(P=0.639,P=0.606).No increase in serum lactic acid or uric acid was detected.Conclusion Appropriate application of CES has minimal effect on the blood gluocse and pancreas islet function in elderly patients after abdominal surgery and may be helpful to improve clinical outcomes.