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.

Based on the taxonomic system of Nelson et al. (1993) ,a preliminary computerized identification system with groupaverage method of hierachical cluster analysis for the genus Fusarium was established. Three unidentified isolates, Fusarium sp. 1 F. sp. 2 and F. sp. 3 from Zea mays L. , were identified by use of this analysis. The results clearly showed that F. sp. 1 was identified as F. graminearum, F. sp. 2 as F. moniliforme and F. sp. 3 as F. subflutinans or F. proliferatum. The facts proved its applicability to comparison and identification of Fusarium.

Objective:Observing the therapeutic effectiveness of Erhuangwendan Decoction and Yiqiyangyinningxin Decoction treating acute viral myocarditis.Methods: 344 cases were distributed into the therapeutic group(258cases) and the control group (86 cases). The treapeutic group were first given Erhuangwendan Decoction one packet per day, then Yiqiyangyinningxin Decoction one packet per day after acute attack. The control group were only given myocardial nutrient. All were given 3～6 months. We observed the symptoms,signs ang EKG of the two groups. Results: The effective rate of the therapeutic group was 40% after 3 months. And it was 84% after 6 months. The effective rate of the control group was 15% after 3 months. And it was 34.8% after 6 months. The two groups have obvious difference( P

Objective: To determine the efficacy of lobectomy and wedge resection in the management of early stage (T 1N 0M 0) non small cell lung cancer. Methods: We analyzed the results of 109 patients with pathologic stage (T 1N 0M 0) non small cell lung cancer who underwent open wedge resection (n=21), video assisted wedge resection (n=30), and lobectomy (n=58) to assess perioperative morbidity and mortality, recurrence rates, survival difference and late pulmonary function among the three groups. Results: There were no differences among the three groups in regard to histologic tumor type, perioperative morbidity and mortality, late pulmonary function. Analysis demonstrated the wedge resection groups to be significantly older and to have reduced pulmonary function despite a higher incidence of treatment for chronic obstructive pulmonary disease when compared with patients having lobectomy. Statistically, the mean hospital stay was significantly less and locoregional recurrences rate higher in the wedge resection groups. Kaplan Meier survival curves were nearly identical at 1 year (open wedge resection, 94%; video assisted wedge resection, 95%; lobectomy, 91%). 5 year survival was 58%, 65% and 70% respectively. Log rank testing demonstrated significant differences between the survival curves during the 5 year period of study (P=0.02). Conclusion: Wedge resection, done by thoracotomy or video assisted techniques, appears to be a viable surgical treatment of stageⅠ(T 1N 0M 0) non small cell lung cancer for patients with cardiopulmonary physiologic impairment. Because of the increased risk for local recurrence, anatomic lobectomy remains the surgical treatment of choice for patients with stage I non small cell lung cancer who have adequate physiologic reserve.

It is well known that the tumor mainly transfers through the lymphatic vessels of the tumor .The current studies main-ly focus on the mechanism of metastasis , hoping to uncover the lymph node metastasis through investigating generation of lymphatic ves -sels and remodeling of tumor lymphatic vessels .Lymph node metastasis is directly related to and prognosis and the quality of life of cancer patients , and how to block the corresponding signaling pathways to prevent tumor lymphangiogenesis becomes the research fo -cus.This paper reviews the lymphangiogenesis and lymphatic vessel remodeling .

Objective To set up care service quality evaluation indicators and establish weight coefficient for assessment of elderly institution in Chongqing.Methods SEVQUAL Model was used as the theoretical guidance,through Delphi expert inquiry,analytic hierarchy process (AHP),the weight of each indicator in five grades and consistency check was calculated.Results The care serv ice quality evaluation indicators contained five first-grade indexes and twenty second-grade indexes.The first-grade indexes included tangibles,reliability,responsiveness,assurance,empathy,respectively.The results of the consisten-cy check of the single grade sorts had a satisfying consistency(CR＜0.10).Conclusions The scientific meth-ods and comprehensive indicators were applied to the construction of care service quality e-valuation indicators for elderly institution in Chongqing.In some degree,this construction of indicators may improve quality of care service and provide useful reference evidence for quality assessment in elderly in-stitution.

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.

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 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.