Logistics supplies are essential for normal operations of hospitals,while effective management of hospital suppliers is key to optimizing the materials supplies.An evaluation system is built for both key suppliers and standby suppliers respectively.Based on such a system,a dynamic management mechanism is built to provide long-lasting supplier incentives,for competitive selection and elimination of the suppliers.These efforts enable the hospitals to pick the best suppliers by means of systems and regulations.

OBJECTIVETo masess the role of hypertension and family history of hypertension in the development of nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM).

METHODSA retrospective analysis was done on 2 groups of NIDDM patients, one group without proteinuria (urine protein < 300mg/24h, n = 106) and the other group with proteinuria (urine protein > or = 500mg/24h, n = 106). The 2 groups were matched by age (< or = +/- 3yrs), sex, ethnic and resident place. Some information of these subjects including demographic; history of disease, family history of diseases, lifestyle and behavior style variables was obtained by questionnaire; some variables were measured, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), quantity of protein in 24h urine. Then conditional logistic regression analysis was performed.

RESULTSSome factors, including history of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP, were independently associated with the occurrence risk of diabetic nephropathy (DN). Their corresponding odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17 approximately 3.43), 1.25(1.08 approximately 1.46), 1.38(1.15 approximately 1.66), and 1.33(1.09 approximately 1.62) respectively, but family history of hypertension was not significantly associated with the development of DN. When/the above-mentioned relations were respectively adjusted by some possible confounding factors, they still existed.

CONCLUSIONSHistory of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP are independent risk factors for DN in Chinese NIDDM patients.

Adult ; Aged ; Blood Pressure ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; etiology ; Female ; Humans ; Hypertension ; complications ; genetics ; Male ; Middle Aged ; Proteinuria ; complications ; Retrospective Studies ; Risk Factors

Objective To study the relationship between plasma creatinine and lactic acid levels in type 2 diabetic patients with normal renal function, and the effect of mefformiu administration on plasma lactic acid. Methods Blood samples were collected from 723 type 2 diabetic inpatients(275 cases treated with mefformin as treatment group and 448 without mefformin as control group). Plasma lactic acid was measured with enzyme-electrode assay. The fasting plasma glucose, fasting insulin, creatinine (Cr) , alanine aminotransferase (ALT), and HbA1C levels were also determined. Results (1) The lactic acid level in treatment group was significantly higher than that in control group [(1.33±0.57 vs 1.17±0.47) mmol/L, P<0.01] and so was the incidence of hyperlactacidemia (9.45% vs 4.91%, P<0.01). No lactic acidosis was found in all patients. (2) The correlation analysis showed that Cr, blood urea nitrogen, ALT and body mass index (BMI) were positively correlated with lactic acid in control group, and the positive correlation between Cr and lactic acid still existed (r= 0.345, P<0.01) after adjustment for ALT and BMI. (3) After being divided by 20 μmol/L Cr in control group, lactic acid levels in subgroup increased with the Cr levels, especially when Cr was over 90 μmol/L. The Cr cutpoint for predicting lactatemia was 95.35 μmol/L. Conclusion It is safe to administrate metformin in type 2 diabetic patients with normal renal function, along with low risk of lactic acidemia. The incidence of lactic acidemia may increase when plasma Cr level reaches 95.35 μmol/L,

Objective To investigate the prevalence of thyroid nodules and thyroid dysfunction in southern mountainouss areas of Ningxia.Methods A cross-sectional study was conducted among a representative sample of 10 639 adults in Jingyuan county with a population proportionate sampling method.High-resolution ultrasound was used to examine the thyroid and fasting blood specimens were collected in the morning for measurement of TSH,FT4,FT3.Chi-square test and spearman rank correlation analysis were used for statistical analysis.Results The prevalence of thyroid nodules was 29.08％,the sex-and age-adjusted rate was 27.17％.The prevalence of thyroid nodules was higher in women than in men (32.68％ vs.24.88％,x2=76.029 2,P＜0.001) and age was positively associated with thyroid nodules (r=0.272,P＜0.001).The rate of thyroid dysfunetion,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism were 17.39％,13.00％,0.42％,0.96％,3.01％,respectively.The prevalence of thyroid nodules was higher in abnormal TSH group than in normal TSH group (39.44％ vs.27.24％,x2=95.624 0,P＜0.001).The level of THS,FT3,FT4 in thyroid nodules group differed fromn control group (Z=-9.144,P＜0.001;Z=-6.140,P＜0.001;Z=-1.997,P=0.046).Conclusion The prevalence of thyroid nodules and thyroid dysfunction were higher in southern mountainous areas of Ningxia.The relationship between thyroid nodules and thyroid function needs further research.We should pay attention to the early screening and diagnosis of thyroid nodules in mountainous areas.

This study was to assess the chronic morbidity and metabolic disordelters in 262 patients with type 2 diabetes.Of all participants,64(24.4%)coexisted with peripheral neuropathy,34(13.0%)combined with peripheral vascular disease.41(15.6%)were diagnosed as diabetic retinopathy,and 46 (17.6%)had concurrent diabetic nephropathy.In comparison with diabetic patients without these complications,those with the chronic conditions generally had higher plasma glucose,blood pressure or body mass index.

Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.

OBJECTIVETo determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.

METHODSA total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.

RESULTSAfter adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.

CONCLUSIONSmoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cholesterol, HDL ; blood ; Diabetes Mellitus ; blood ; epidemiology ; Follow-Up Studies ; Humans ; Hypertriglyceridemia ; blood ; epidemiology ; Male ; Metabolic Syndrome ; blood ; epidemiology ; etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Smoking ; adverse effects ; blood ; epidemiology ; Waist Circumference

Objective To investigate the prevalences of the obesity and hypertension in southern mountain regions of Ningxia. Methods A cross-sectional study was conducted among a representative sample of 10 639 adults using questionnaires, physical examinations, and blood pressure measurement in southern mountain areas with a population proportionate sampling method. Results The prevalences of overweight,obesity,central obesity,high percentage of body fat,and hypertension were 33.53%,10.71%,19.50%,27.69%,and 31.57% respectively, which were 30.31%,9.62%,16.70%,24.90%,and 27.61% after age-adjustment in rural areas of Ningxia,and increased with aging(Ptrend<0.05). The prevalences of overweight,obesity,and hypertension were higher in males than those in females(P<0.05),and that of central obesity was higher in females than in males(P=0.003).The prevalences of hypertension in subjects with overweight, obesity, central obesity, high percentage of body fat were 38. 14%, 53.75%,52.69%,and 48.90%,respectively. Body mass index,waist circumference,and percentage of body fat were positively correlated with systolic and diastolic blood pressure(P<0.05). The multivariable logistic model revealed that the risk of hypertension in different types of obesity increased about 1.5 times. Conclusion There is high prevalence of obesity and hypertension among the adults in southern mountain areas of Ningxia. The prevalence of hypertension in obesity,central obesity,and high percentage of body fat is closed to or more than half of the population investigated.

Abundant clinical and basic studies in recent years reported the high association of Wnt/β-catenin signaling pathway with the incidence and development of multiple neurological disorders. In order to improve the attention about the relationship between Wnt/β-catenin signaling pathway and neurological disorders, and to provide new therapy target, this article reviews the research progress on the relationship between wnt/β-catenin signaling pathway and Parkinson′s disease, Alzheimer′s disease, epilepsy, multiple sclerosis and myasthenia gravis.

Objective To explore the role of visual oculomotor-vestibular eye balance function in the diagnosis of central and peripheral vertigo. Methods From January 2015 to June 2016,one hundred and sixty-two patients with central vertigo who were treated at Kailuan General Hospital were enrolled in the study, including 124 males and 38 females, aged ( 64. 09 ± 10. 98 ) years old; there were 166 cases of peripheral vertigo,75 males and 91 females,aged (52. 13±12. 20) years old. Spontaneous nystagmus test,gaze test,position test, saccade test, smooth visual tracking test, visual single-speed test, visual sinus test, swivel chair rotation- emergency stop test using infrared video nystagmus and static balance posture instrument,open-closed eye hard plate erect test, open-closed eye sponge soft bottom erect test balance function electrophysiological test were conducted. Results The detection rate of pathological spontaneous nystagmus and pathological gaze nystagmus was higher in the central vertigo group than that in the peripheral vertigo group (χ2=5. 674,16. 458,P<0. 05) . The occurrence rate of positional nystagmus was higher in peripheral vertigo group than that in central vertigo group (χ2=48. 896,P<0. 001). The abnormal rate of scanning test,stable visual tracking test,visual movement single speed and sinusoidal test,and static balance posture test were higher in the central vertigo group than those in the peripheral vertigo group (χ2 =137. 169, 166. 972, 150. 877, 150. 877, 27. 273, P<0. 001 ) , while the abnormal rate of rotating chair sudden stop test was higher in the central vertigo group than that in the peripheral vertigo group (χ2=51. 000,P<0. 001) . The abnormal results were mainly scanned underflush and slow scan in central vertigo group (χ2=103. 846,4. 296,P<0. 05),stable visual tracking curve (χ2=147. 389,4. 296,P<0. 05) in type III-IV,and the gain of nystagmus decreased unilaterally and bilaterally (χ2=47. 531,44. 477, 52. 529,53. 255,P<0. 001) . Anomalies of proprioception in reverse and vertical nystagmus and static balance posture were induced by rotating chair sudden stop test (χ2=11. 847, 23. 778, P<0. 001 ) , while peripheral vertigo group showed unilateral decrease of nystagmus gain induced by rotating chair sudden stop test. (χ2=79. 771, P < 0. 001 ) . Conclusion The patients with peripheral vertigo have obvious body position spontaneous vestibular response and vestibular oculomotor system dysfunction, while the patients with central vertigo mainly have visual and oculomotor system dysfunction,and may be accompanied by vestibular oculomotor system and vestibular spinal reflex dysfunction.