Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

The essence of twirling reinforcing-reducing method is discussed to provide theoretical guidance for clinical application of reinforcing-reducing method. Through retrospection on historical literature of twirling reinforcing-reducing method, records and explanatory notes are thoroughly explored. Several existing opinions are analyzed and explained for instance twirling method has connection with circulation direction of channels; twirling method is subdivided into right and left, male and female, hand and foot; twriling method is related to quantity of stimulus and operation time; twriling method belongs to spiral motion and so on. As a result, it is found that the key of twirling reinforcing-reducing method is the posture of needle-holding hand that defines three-dimensional motion. If twirling method is subdivided into right and left, male and female, hand and foot and so on, steric effects of lifting-thrusting movement that come along with twirling method could be ignored at the same time. It is that the essence of twirling reinforcing-reducing method is close to the principle of lifting-thrusting reinforcing-reducing method, enriching effect with slow insertion and fast withdrawal of needle while reducing effect with fast insertion and slow withdrawal, which is recorded in Miraculous Pivot: Nine needle and Twelve Yuan. With this principle as guide, manipulation could be avoided to become a mere formality and illusory metaphysics during clinical application of twirling reinforcing-reducing method.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

Objective To realize the characteristics of clinical distribution of multidrug-resistant organisms (MDRO)in a hospital,and take specific measures for the prevention and control of infection.Methods Surveillance data of 891 MDR isolates detected in a hospital between January 1 and December 31,2012 were analyzed retrospec-tively.Results Of 891 MDR isolates,extended-spectrumβ-lactamase (ESBL)-producing Escherichiacoli ranked first(342,38.39% ),followed by ESBL-producing Klebsiellapneumoniae(195,21.89% ),MDRAcinetobacterbau-mannii(185,20.76% ),methicillin-resistantStaphylococcusaureus(138,15.49% ),MDRPseudomonasaeruginosa (27,3.03% ),ESBL-producingProteusmirabilis(2,0.22% ),and ESBL-producing Klebsiellaoxytoca(2,0.22% );Bacteria mainly concentrated on general intensive care unit(ICU)(163,18.29% ),department of neurology(136, 15.26% ),general surgery(103,11.56% ),neurosurgery(85,9.54% ),and respiratory diseases department(71, 7.97% ).The most common bacteria isolated from sputum was MDR Acinetobacterbaumannii(242,50.63% ),and mainly concentrated on general ICU;the most common bacteria isolated from urine was ESBL-producing Escherich-iacoli(141 ,80.57% ),mainly concentrated on the departments of neurology and urology. Conclusion MDRO infec-tion in this hospital mainly concentrate on lower respiratory tract and urinary system. Monitor on high-risk depart-ments and vulnerable patients should be intensified,targeted preventive measures should be stressed to curb MDRO infection and spread.

Objective To assess the diagnostic value of cytokeratin 18 fragment M30 (CK18-M30) and Fas in patients with nonalcoholic fatty liver disease (NAFLD),especially nonalcoholic steatohepatitis (NASH).Methods Among 58 patients with NAFLD,36 patients with NAFLD received liver biopsy.According to NAFLD activity score (NAS) and liver fibrosis score,patients were divided into NASH group (24 cases) and non-NASH group (12 cases).And at the same period,15 healthy individuals were set as healthy control group.The serum level of CK18 M30 and Fas were measured with enzyme-linked immunosorbant assay (ELISA).Rank sum test was performed to analyze the differences in the level of CK18-M30 and Fas between groups.The diagnostic value of CK18 M30 and Fas were assessed by the receiver operating characteristic (ROC) curves.Results The level of serum CK18-M30 of NAFLD group was significantly higher than that of healthy control group (97.24 U/L (86.06 to 113.12 U/L) vs 78.41 U/L (74.29 to 80.76 U/L),Z=-4.206,P＜0.01)).The level of serum CK18-M30 of NASH group was higher than that of non-NASH group (111.06 U/L (94.30 to 142.68 U/L) vs 89.00 U/L (83.56 to 106.50 U/L),Z=-2.233,P＜0.05)).The area under the ROC curve (AUC) of CK18-M30 in the diagnosis of NASH was 0.73 (0.56,0.90),and the sensitivity and specificity of CK18-M30 in diagnosis of NASH was 79.2％ and 58.3％,respectively.The AUC of Fas in diagnosis of NASH was 0.58 (0.38,0.77),while the sensitivity and specificity of Fas in diagnosis of NASH was 54.2％ and 66.7 ％.The serum level of Fas increased in FAFLD group compared with healthy control group,and in NASH group compared with non-NASH group,however the differences were not signifincant (both P＞ 0.05).Conclusions The level of CK18-M30 has certain value in the diagnosis of NASH.The diagnostic value of Fas in NASH needs more samples in further study.

Colorectal cancer(CRC) is kind of the common malignant tumor worldwide.Bad prognosis is always due to distal metastasis.In recent years,the research on chemokines targeted on cancer metastasis and directing on the movement of the tumor cells have been more and more deeply taken into consideration.Chemokine CXCL12 and its specific chemokine receptor CXCR4 play important roles in CRC cell's targeted cancer metastasis and directing movement by signal transduction mechanism.Researches showed that it can inhibit the migration and invasion of the tumor through interception chemokine receptor CXCR4 by many ways.The studies of this signal may be a potential target sit for gene therapy.The aim of this review was to summarize the current knowledge of these researches.

Objective To investigate the acaroid mite pollution in houses in Huaibei area,Anhui province and to prevent allergic diseases caused by acaroid mites. Methods The samples of acaroid mites were collected from the houses,hotels and undergraduate dormitories,then the acaroid mites were separated,classed and counted. Results Fifteen kinds of acaroid mites were detected from the samples,belonging to 5 families,11 genera. The analysis showed that average density of acaroid mites in the common houses ranked the first,32.5. The values of the species richness index R was 1.36,the species diversity index was 2.16,the species evenness index was 0.9. Conclution The density of acaroid mites in the common houses is higher in Huaibei area and the effective measure should be taken to control the acaroid mites.

Objective To investigate the correlation between social support and psychological health status of paid blood donors infected with HIV to implement psychological intervention in these people.Methods Sixty individuals responded to questionnaires using self-designed questionnaire,SCL-90 and questionnaires on quantity social support.Results Compared with the national norm,the scores of somatization,obsessive compulsion,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety and psychoticism of the paid blood donors infected with HIV were significantly higher(P

Multiple modality treatment has been adapted for the treatment of various cancers,the outcome has been dramatically improved,but some of unique side effects due to the modalities like chemotherapy combined with radiotherapy have been observed in the clinic. Radiation recall dermatitis(RRD) is one of the side effects. In this paper,the etiology,clinical features,diagnosis,treatment and related factors of the radiation recall dermatitis are discussed.

OBJECTIVE:To discuss on how to make use of the space resource of open-shelf retail drugstore to get more benefits. METHODS:Magnet theory was applied to analyze commodity display location in drugstore included in cases and improvement program was put forward. RESULTS & CONCLUSIONS:It is meaningful to make schedules for commodity display location in open-shelf retail drugstore,which can guide customens to consume appropriately by means of psychological method and form psychological induction to conduct customers’consumption and contribute to utilization ratio of display facilites and commodity sales in drugstore.