Objective To build new management model for diabetic foot disease,and to observe the therapeutic effect of diabetic foot ulcers under the new model.Methods 52 patients with newly diagnosed diabetic foot disease were recruited and randomly divided into the experimental group (n=26) and the control group (n=26).While the experimental group adopted the interdisciplinary collaboration model (nurse-doctor jointed diabetes care management model),the control group were treated by the single department pattern.The foot ulcer healing rate,average length of stay (ALOS),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c),and the patient awareness of the knowledge about diabetes self-management were respectively compared at 3 and 6 months.Results After receiving a multidisciplinary joint diagnosis and treatment,FPG and 2 h PBG of the patients from the experimental group [(6.44±2.93)mmol/L,(8.52± 2.09)mmol/L] were significantly decreased than those of the patients from the control group [(8.17±3.19)mmol/L,(10.77±3.27)mmol/L].HbA1c at 3 and 6 months (7.2％,7.7％) and ulcer recurrence rate (3.8％) after 6 months of patients of the experimental group were significantly reduced than those of the control group(8.9％,9.1％ and 15.4％).When compared with patients of the control group,patients of varying severity in the experimental group showed significantly shortened ulcer healing time and hospital stay.Moreover,patients from the experimental group showed statistically higher knowledge level and self management ability (P＜0.05).Conclusion Through interdisciplinary collaboration,podiatric medical joint management model can significantly improve cure rate,shorten ALOS,improve blood sugar control and patient satisfaction.

Atherosclerosis ; prevention & control ; Humans ; Vaccination

Objective The purpose of this study was to investigate the clinical significance of pre-operative combined detection of metastasis-relative genes in non-small cell lung cancer. Methods Peripheral blood lymphocyte specimens from 46 patients before operation and fresh tissue specimens after operation were examined by RT-PCR analysis of CD44v6 and nm23H1 mRNA. The results were compared to the pathological diagnosis of lymph node metastases. ROC curve was used to determine the cut-off value of pre-operative metastases prediction. Results The relative amount of CD44v6 mRNA was higher (P

Coronary Restenosis ; etiology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Stents ; Thrombosis ; etiology

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of malignant fibrous histiocytoma (MFH) of thyroid. Methods The clinical case and follow-up data (n=3) of MFH of thyroid from our hospital between 2000 and 2007 was analyzed, with the correlating references reviewed. Results MFH of thyroid accounted for 0.574% (3/523) of malignant tumor of thyroid. MFH of thyroid progressed so fast as to invase recurrent laryngeal nerve (RLN) and /or cervical lymph nodes. Conclusions The diagnosis of MFH of thyroid is difficult, for it is easy to be misdiagnosed as thyroid carcinoma. Immunohistochemistry pathology can provide a good differential diagnostic value, with CK negative, Tg negative, and Vimentin positive to support the diagnosis of MFH. Extensive and thorough excision should be the main choice to treat MFH of thyroid. Patients of MFH of thyroid often died of recurrence or metastasis in 2 years after operation. MFH of thyroid is a kind of rare thyroid primary tumor, with malignancy of high grade and poor prognosis. The disgnosis of MFH of thyroid depends on immunohistochemistry staining, while excision should be the main choice for treatment.

Objective To learn the status quo of core competency of registered nurses in tertiary level first-class hospitals in Liaoning Province and compare the level and characteristics of core competency of registered nurses in different working years in order to supply evidence to establish contrapuntal training protocol.Methods "The Competency Inventory for Registered Nurse scale"(CIRN,by LIU Ming)was distributed to investigate the core competency of registered nurses,the data underwent analysis.Results The overall score of core competency level was (174.11±31.89),the score of the nurses with 16～20 years of working experience was the highest,while the score of nurses working for 1～5 years was the lowest.The core competency varied with working years,evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for registered nurses from five tertiary level first-class hospitals in Liaoning Province.They are competent enough to provide health care.With the increasing length of working time,nurses' core competency level will strengthen gradually.

Aged ; Angioplasty, Balloon ; Coronary Vessel Anomalies ; complications ; therapy ; Humans ; Male ; Middle Aged ; Mobility Limitation ; Stents

Objective To assess whether the plaque volume of carotid artery evaluated by three-dimensional ultrasound can predict the risk of cardiovascular events earlier in patients with coronary heart disease, in comparison with plaque thickness.Methods A total of 99 patients were enrolled, including 66 patients with asymptomatic carotid plaque and 33 patients with coronary heart disease (CHD) and carotid plaque.Three-dimensional ultrasound was performed in all the patients.Coronary angiography was performed in all the patients in CHD group.Coronary artery Gensini score was calculated.Plaque thickness, plaque area and plaque volume were compared between the two groups.We analyzed the relationship of plaque volume with Gensini score and other cardiovascular risk factors.Results Plaque volume was significantly higher in CHD group [(1312.38±513.70)mm3] than in asymptomatic group [(947.54±321.41)mm3] (P=0.023).However, plaque thickness and plaque area were not significantly different between the two groups (P>0.05).Plaque volume was positively correlated with Gensini score (r=0.519, P=0.002), homocysteine (r=0.569, P=0.002), and cardiovascular risk factors such as diabetes, blood glucose and glycosylated hemoglobin.There was a negative correlation between plaque volume and high-density lipoprotein (HDL), a factor protecting against cardiovascular events (r=-0.387, P=0.038).Conclusion Compared with plaque thickness, the volume of carotid plaques assessed by three-dimensional imaging technique may be a better predictor of the risk of cardiovascular events in patients with coronary heart disease.

Objective:To explore the effects of scout scanning parameters (projection angle and tube potential) on image quality and radiation dose in chest CT and to provide guidance for the selection of scanning parameters in clinical practice.Methods:Different parameter combinations were selected to acquire the scout view of the anthropomorphic adult chest phantom. Fifteen scout views were obtained under parameter combinations of the projection angle (0/90/180 degrees), tube potential (70/80/100/120/140 kV) and tube current (25 mA). And then, chest spiral scans were performed according to the scout views. The other parameters were Assist kV, smart mA (maximum range), 80 mm detector width, 0.992∶1 pitch, 0.5 s rotation time, 330 mm scanning length, 5 mm thickness, NI (noise index) 10. The radiation dose modulation index (ASiR-V) was 30%, and the iterative level was 50%. Volume CT dose index (CTDI vol) and tube current at 4 body levels (pulmonary apex, trachea bifurcation, mammary level and diaphragmatic dome) were recorded. The thermoluminescent dosimeters (TLDs) were used to measure the organ dose of the breast glandular. Regions of interest (ROIs)were selected at the trachea bifurcation and diaphragmatic dome to calculate the contrast noise ratio (CNR). Results:The tube potential of the spiral scanning was automatically selected as 80 kV when the projection angle was 0 degree. The changing of the tube potential for the scout had little influence on the tube current at the four body levels, and the variation range was 0-2% (5/230). The tube potential in the spiral scanning was automatically selected as 100 kV when the projection angles were 90 and 180 degrees. The changing of the tube potential for the scout had a great influence on the tube current at the slice of trachea bifurcation and the variation range was from 14%(29/210)to 44%(93/210). According to the angle projection, there were statistical differences in CTDI vol( P< 0.017), organ dose of the breast glandular, and CNR at the slices of trachea bifurcation and at diaphragmatic dome ( F=13.027, 24.727, 10.630, P< 0.05). According to the tube potential in the scout scanning, there were no significant differences in CTDI vol, organ dose of the breast glandular and CNR at both levels ( P> 0.05). Conclusions:In chest CT, the influence of the projection angle in scout scanning on the image quality and radiation dose was more significant than that of the tube potential.