ObjectiveTo investigate the effect of repaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes.Methods110 patients with type 2 diabetes were randomly divided into the control group and observation group,each group 55 cases,The control group was given novolin 30R,initial dose of 0.4U ·kg-1 · d-1.The observation group was given subcutaneous injection of insulin glargine at bedtime,the initial dose of 0.2U · kg- 1 · d - 1,preprandial oral repaglinide,3 of 6mg/d,divided into three doses,two groups were observed for 3 months,the difference of fasting plasma glucose (FPG),2h postprandial glucose (2hPG),glycated hemoglobin (HbAlc),Homa-IR,Homa-β,hypoglycemia,blood glucose time were compared before and after treatment.ResultsAfter treatment,FPG,2hPG,HbA1c,Homa-IR were significantly lower than before treatment,and Homa-β was significantly higher than that before treatment ( all P ＜ 0.01 ) ; After treatment,HbA 1 c,Homa-IR were lower than the control group significantly( t =2.786,3.449,all P ＜ 0.01 ),and Homa-β was significantly higher than the control group( t =-4.833,P ＜ 0.01 ); The blood glucose compliance time of the observation group was significantly shorter than the control group(t =2.126,P ＜0.01 ) ;The observation group had 0 case of low blood sugar,and the control group had 4 cases of low blood sugar,the difference was statistically significant( x2 =4.151,P ＜ 0.05 ).ConclusionRepaglinide combined with insulin glargine in the treatment of patients with type 2 diabetes could quickly reduce blood sugar,reduce blood glucose to normal levels,keep blood sugar stable,restore [β-cell function,reduce insulin resistance,reduce insulin dosage,reduce adverse events,and it was worthy of clinical use.

Objective To explore the effect of aerosol inhalation with pulmicort and terbutaline on children with asthma. Methods Sixty children infants with asthma were divided randomly into the treatment and control groups:the latter received routine treatment and nursing and the former were intervened with aerosol inhalation with pulmicort and terbutaline besides the regular nursing. The curative effect was compared between the groups.Result The total effectiveness rate(93.8%)in the treatment group was significantly higher than that(75.0%)in the control(χ2=4.273,P=0.044)group.Conclusions Aerosol inhalation with pulmicort and terbutaline may be effective in the treatment of asthma in infants.The nursing points like keeping a comfortable position,right dosage of the medicine and close observation of the diseases are critical for the effectiveness and safety during aerosol inhalation.

Objective To observe the clinical efficacy of electroacupuncture plus ginger-partitioned moxibustion in treating sudden hearing loss. Method Sixty patients with sudden hearing loss were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by electroacupuncture plus ginger-partitioned moxibustion, while the control group was by electroacupuncture alone. The audiometry was conducted before and after intervention, and the therapeutic efficacy was also evaluated.Result Respectively after the first and second treatment course, the threshold of audibility was significantly changed in both groups (P<0.05); there were significant differences in comparing the threshold of audibility between the two groups (P<0.05). The total effective rate was 80.0% and 90.0% respectively after the first and second treatment course in the treatment group, versus 53.3% and 63.3% in the control group, and the differences were statistically significant (P<0.05).Conclusion Electroacupuncture plus ginger-partitioned moxibustion is an effective approach in treating sudden hearing loss.

OBJECTIVE: To detect whether there is mixing of norfloxacin in loperamide hydrochloride capsules by UPLC-MS. METHODS: The separation of norfloxacin was performed on C18 column with column temperature set at 35 ℃, and the mobile phase was composed of acetronitrile and 0.1% formic acid (gradient elution) with a flow rate of 0.3 mL?min-1. The sample size was 10 ?L. ESI source was applied with capillary tube tension at 3.0 kV and ion source temperature at 110 ℃, and scan mode was multiple reaction monitor. RESULTS: It has been proved that there was norfloxacin in 2 of the total 5 batches of samples based on the data of retention time of RP-HPLC including ultraviolet spectra, the quasi-molecular ion and the second order mass spectra split fragments. CONCLUSION: The method is highly selective and sensitive, and can be used to detect whether norfloxacin has been illegally added into loperamide hydrochloride capsules.

Objective:To study the relationship among brachial ankle pulse wave velocity (baPWV ) ,level of high sensitive C reactive protein (hsCRP ) and blood glucose level in patients with type 2 diabetes mellitus (T2DM ) . Methods :A total of 102 T2DM patients and 60 healthy people undergoing physical examination (normal control group) were selected .According to level of glycosylated hemoglobin (HbA1c) ,T2DM patients were divided into normal HbA1c group (n=44 ,HbA1c≤6. 5% ) and HbA1c elevating group (n=58 ,HbA1c>6. 5% ) .BaPWV ,lev‐els of blood lipids ,blood glucose and hsCRP were measured and compared among above groups .Results:Compared with normal control group ,there were significant rise in hsCRP level [(1.82 ± 0.2) mg/L vs . (2.7 ± 0.1) mg/L vs . (3.5 ± 0.1) mg/L] and baPWV [ (1412 ± 95) cm/s vs . (1755 ± 72) cm/s vs . (2040 ± 105) cm/s] in normal HbA1c group and HbA1c elevating group (P<0.01 all) ,and hsCRP level and baPWV of HbA1c elevating group were sig‐nificantly higher than those of normal HbA1c group ,P<0.05 both .Conclusion:Brachial ankle pulse wave velocity and level of hsCRP of patients with type 2 diabetes mellitus are significantly higher than those of normal subjects , and those of patients with poor blood glucose control are significantly higher than those of patients with good blood glucose control .Active blood glucose control can delay atherosclerosis progress .

OBJECTIVE:To introduce the experience of application and report for accreditation of drug clinical trial institution qualification of our hospital,to provide a reference for other hospitals. METHODS:From the building of institution,drug clinical trial ethics committee,clinical trials of listed drugs,simulated qualification accreditation,and other aspects,the experience and key points of application and report for accreditation of drug clinical trial qualification of our hospital were summed up. RESULTS& CONCLUSIONS:Priority should be given to staffing(particularly the leaders of the institution),the installation of software and hardware (for system development,training,institution office and specialized department),and the building of ethics committee. Departments should share work experience of clinical trials of listed drugs and set up a self-inspection group to simulate qualifica-tion accreditation. Work procedures and methods of qualification accreditation should be clearly understood,the requirements of Good Clinical Practice,the standards for qualification accreditation,should be known well;Good Clinical Practice should be seri-ously implemented and the subjects’rights and interests should be protected,which will contribute to the successful completion of application and report for qualification accreditation.

To observe the time-dependent course of potentiation of vecuronium produced by 1MAC of end-tidal sevoflurane and isoflurane. Method: At the beginning, a steady infusion rate of vecuronium to maintain 90 of neuromuscular block was established in 40 patient undergoing neurosurgical procedures under propofol fentanyl nitrous oxide oxygen anesthesia. The patients were randomly assigned to receiving IMAC end-tidal concentration of either sevoflurane (Group Sev) or isoflurane(Group Iso). Vecuronium infusion rate was adjusted to maintain 90%, neuromuscular block. The change of infusion rate of vecuronium with time was observed after inhalation of Sev or Iso. Result: Sev and Iso decreased the infusion dosage of vecuronium in an exponential manner, maximal potentiation occurred 90 min after inhalation. Maximal reduction in infusion rate was 67.87% in group Sev and 69.87% in group Iso without the significant difference between them. Conclusion: Sev and Iso can potentate the muscular relaxation of vecuronium at similar degree in strong time-dependent way.

Objective To assess the effects of hyperventilation on the balance of cerebral oxygen supply and consumption during craniotomy Methods Twenty ASA Ⅰ Ⅱ patients with supratentorial tumor undergoing elective craniotomy were studied Anesthesia was induced with fentanyl 2 4 ?g/kg and propofol 1 2mg/kg I V and tracheal intubation was facilitated with succinylcholine 1 5 2 0mg/kg I V After tracheal intubation the patients were mechanically ventilated Anesthesia was maintained with isoflurane with or without nitrous oxide and intermittent intravenous bolus of vecuroinum The patients were randomly divided into two groups : in group Ⅰ anesthesia was maintained with 1 5% isoflurane alone (ISO group, n=10); in group Ⅱ with 0 8% isoflurane and 60% 65% N 2O(ISO N 2O group, n=10) Demographic data including age, sex and weight were not significantly different between the two groups In group Ⅰ there were 6 male and 4 female, the mean age was (40 1?9 7) years and weight (64 5?7 3)kg whereas in group Ⅱ there were 5 male and 5 female, mean age was(43 6?8 4)years and mean body weight (62 7?6 5)kg After the opening of dura mechanical ventilation was regulated to maintain PaCO 2 at 4 7 6 0kPa(normal ventilation), 0 9) Arterial and venous blood lactate was within normal range but had a tendency to increase Conclusions Severe hyperventilation influences the balance of cerebral oxygen supply and consumption significantly during either isoflurane or isoflurane N 2O anesthesia at equal MAC, particularly in ISO N 2O group Severe hyperventilation should not be used during anesthesia for brain surgery

OBJECTIVE: To study the bacterial endotoxin test for detecting pyrogen in fructose sodium diphosphate injection . METHODS: The interference of fructose sodium diphosphate injection to the process of bacterial endotoxin test was studied .RESULTS: Fructose sodium diphosphate injection in 10- fold dilution had no interference to the bacterial endotoxin lest .CONCLUSION:Bacterial endotoxin test could be used for pyrogen test of fructose sodium diphosphate injection.

Objective To assess the efficiency of central urban and rural hospitals in the 7 cities, counties and districts under the jurisdiction of Hangzhou City and the status of the medical markets so as to provide theoretical basis for the promotion of decentralized medical markets. Methods On the basis of defining the scope of a medical market, the HHI values of the medical markets in places where 37 hospitals in Hangzhou were located was calculated, the average efficiency of the various hospitals was measured by means of DEA, and an analysis was made on the correlation between the average efficiency and the HHI values. Results The central urban and rural medical markets in the various places surveyed, whose HHI values were all greater than 1 800, belonged to markets of monopolistic competition. Of the 37 hospitals, there were 11 whose relative efficiency reached 100% and another 11 whose relative efficiency was less than 60%. The greater the monopoly of a medical market, the lower the average efficiency of its hospitals. Conclusion Establishing competitive markets with low market concentration is an effective way of enhancing overall hospital efficiency.