Objective To assess the effects of management by diabetes specialist nurse (DSN) on blood glucose control.Methods A comprehensive search of databases was carried out including PubMed,the Cochrane Library,Web of Science,China National Knowledge Infrastructure (CNKI),Chinese Biomedical Literature Database (CBM),China Scientific Journal Database (VIP) and Wanfang Database from their inception to November 2013 in any language to identify trials.Searching of relevant publications was undertaken to identify additional trials.Randomized controlled trials and quasi-randomized controlled trials dealing with the effects of management by DSN on glycosylated hemoglobin (HbA lc) were included in the review.Two investigators performed data extraction and quality assessment independently.Statistic analysis were carried out using RevMan5.2 software.Results Eighteen trials were included finally.Meta-analysis showed that management by DSN can better control the blood glucose of patients(WMD=-0.63,95％CI-0.88--0.38),but the effect was influenced by intervention time,location and type of the diabetes mellitus.Conclusions The presence of a DSN can improve patients' blood glucose control,especially in the long-term control of blood glucose.

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

Animal medicines mainly contain protein which was organic molecule with quaternary structure and had the property of thermal denaturation. When suffering from heat for a consistent time, the native conformation of protein would be destroyed. After denaturation the biological activity of protein will lose and some physicochemical and biochemical properties will be changed. Leech was a classical animal medicine in the views of traditional Chinese medicine (TCM) which had the functions of breaking stagnant and eliminating blood stasis. In the usage history, it was processed for a long time. No matter stir-frying leech with talc powder embodied in Chinese Pharmacopoeia or stir-baking with wine as a distinctive method in Beijing district, the process procedure was basically performed under high temperature. The purposes and intentions of process are mostly limited to technology conditions at specific historical period. In this article, based on existing processing procedure and its character of Leech, the changes of active components and pharmacological activities before and after processing under high temperature were summarized. The results demonstrate that the protein of leech would be denaturated; some active peptide such as hirudin were partly or totally destroyed; some toxic mineral elements, such as Pb, Hg, Cd, were decreased; at the same time, heating can promote some chemical components transforming into hypoxanthine which had the function of antihypertensive, antiasthmatic and antalgic. Consequently, after processed under high temperature, the purpose of decreasing toxicity and alleviating the strong property was achieved. Pharmacological changes of leech processed under high temperature were mainly manifested in the anticoagulant and antithrombotic activity, etc. Based on current processing research status about animal medicine leech, future research methods and directions on scientific connotation of leech processed under high temperature were put forward in this article.
Animals ; Biological Factors ; chemistry ; isolation & purification ; pharmacology ; Chemistry, Pharmaceutical ; methods ; Hot Temperature ; Humans ; Leeches ; chemistry

Objective To assess the feasibility and clinical value of high-resolution magnetic resonance imaging (HRMRI) in patients with symptomatic severe intracranial stenosis (SSIS).Methods HRMRl wasperformed with a 3.0 T MR scanner on 5 patients with symptomatic middle cerebral(n=3) or basilar (n=2) arterial stenosis of≥70% confirmed bv DSA.Image diagnosis Was made on the basis of HRMRI findings of vessel wall at the stenotic segment by 2 neuroradiologists blinded t0 patient's status.Results Three of the five patients were diagnosed to have advanced intracranial atherosclerosis based on the presence of a complex eccentric atherosclerotic plaque containing a large lipid-rich necrotic core with a heterogeneous post-contrast enhancement and with signs of ruptured fibrous cap.Two other patients were likely to suffer from non-atherosclerotic lesion.HRMRI revealed an iso-signal septum in the arterial lumen attaching to the slighfly thickened arterial wall that was iso-signal with a homogeneous post-contrast enhancement in one patient and an obviously concentrically thickened arterial wall with hypo-intense signal on T1 WI and slightly high signal on T2 WI and PDWI and without any post-contrast enhancement in the remaining patient.Conclusions In vivo HRMRI in patients with SSIS is technically feasible.It provides detailed information of intracranial arterial wall at the stenotic segment.

The paper introduces the common methods for automatic de-identification of clinical texts,including the method based on rules,machine learning method,comprehensive method,etc.,states the challenges for clinical texts practicability,system universality and scalability of clinical texts de-identification research,analyzes the further research direction,and provides reference for researchers of this field.

Objective To study the effect of abnormal left ventricular diastolic function(LVDF)on the onset and severity of atrial or ventricular arrhythmia in elderly essential hypertensive patients.Methods The 210 elderly essential hypertensive patients were enrolled in this study. Their arrhythmias were monitored by 24-hour ambulatory electrocardiogram. The essential hypertensive patients were referred for Doppler echocardiography to evaluate left ventricular function, while patients with abnormal systolic function were excluded, and then the patients were classified as normal LVDF and abnormal LVDF including, impaired relaxation, pseudonormal, and restrictivelike filling patterns. Results In 210 elderly essential hypertensive patients, 147 (70%) cases were diagnosed as atrial arrhythmia and 102 (49%) cases as ventricular arrhythmia (χ2 = 19. 975, P ＜ 0.05 ).Morbidities of atrial (89%) or complex atrial arrhythmia (49%) as well as ventricular (63%) orcomplex ventricular arrhythmia (30%) were significantly higher in abnormal LVDN group than in normal LVDN group (40%, 13%, 26% and 7%, χ2 = 56. 723 、 28. 359 、 28. 076、15. 9102 , all P＜0. 05). The morbidities of arrhythmias were higher in hypertensive patients with pseudonormal and restrictiveike filling patterns than in other groups 93.6% and 96. 4%. Conclusions Abnormal left ventricular diastolic function affects on the onset and severity of atrial or ventricular arrhythmia in elderly essential hypertensive patients, and complex atrial or ventricular arrhythmia is easier found in hypertensive patients with pseudonormal and restrictivelike filling patterns.

In order to summarize and perfect the basic skill practicing method in acupuncture teaching and form a characteristic teaching, the research on skill training and technique improving of acupuncture and tuina major was carried out. The undergraduate students in acupuncture and tuina major from College of Acupuncture-Moxibustion and Tuina were randomly divided into an experimental group and a control group. Students from both groups received the basic courses of acupuncture-moxibustion and tuina as requested in the syllabus and the special teaching was added to the experimental group, namely "three practice" (strength practice, coordination practice, targeted practice of acupuncture basic skills) and "three enlightenment" (technique enlightenment, mind and qi enlightenment, efficacy enlightenment). During and after the courses, the teaching effectiveness was evaluated on the basis of needling manipulation. The peacetime score in the experimental group was superior to that in the control group (38.03 +/- 1.14 vs 33.25 +/- 1.31, P < 0.05), the total score in the experimental group was superior to that in the control group (84.03 +/- 6.30 vs 78.05 +/- 6.55, P < 0.05). The special teaching method of "three practice" and "three enlightenment" can improve the effect of skill training teaching method. It highlights the unique feature of central plains by integrating the essence of Shaolin internal qigong and Chen-style Taiji, it can also provide new ideas for the practical teaching of TCM professional courses and the construction of characteristic professionals.
Acupuncture ; education ; manpower ; Acupuncture Therapy ; methods ; Humans ; Students ; Teaching

Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.

For medical student, diagnostic practice is the first step of clinical study. To penetrate the humanities education in diagnostic teaching,the combination with practice from the following steps as physical examination, laboratory examination and interrogation, would cultivate medical students' humane quality imperceptibly and play an important role in creating noble medical ethics of them.

Objective To optimize preparation process of Zushima Gel Cream. Methods The comprehensive evaluation set sensory evaluation, initial adhesive force, viscous force, and peeling strength score as indexes. The mixing time, refining temperature, mixing speed, and powder adding sequence were investigation factors. Orthogonal experiment was used to optimize forming process. Results Conditions of optimized preparation process were as following: add Zushima powder in Viscomate NP-700 and glycerol; mixing time was 5 min; refining temperature was 40 ℃; mixing speed was 100 r/min. Conclusion The preparation process is good and optimized Zushima Gel Cream has a good adhesive force, good glossiness and excipients. The preparation process is good.