Objective:To investigate the efficacy and safety of metformin in the treatment of elderly patients with diabetes. Meth-ods:Totally 72 cases of elderly patients with diabetes in our hospital from January 2012 to December 2012 were randomly divided into the observation group and the control group. The observation group was received metformin, and the control group was given repaglin-ide. The efficacy and safety of the two groups were compared. Results:After the treatment, blood sugar of fasting, 2h after meals and 10:00 p. m. in the observation group and the control group was significantly decreased (P<0. 05), and blood sugar of fasting in the observation group was significantly lower than that in the control (P<0. 05), while that of the other time points was without significant difference (P>0. 05). The HbA1c levels before and after the treatment in the observation group was with statistically significant differ-ence (P<0. 05), and those in the control group was without significant difference (P>0. 05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0. 05). Conclusion:Effect of metformin in the treatment of elderly patients with diabetes is remarkable and safe, which is worthy of further promotion and application.

Objective To analyze the change of the shear stress in atherosclerotic carotid artery of rabbits and its effect on the plaque and intimia-media pathological morphology. Methods Totally 36 male Japanese White rabbits were randomly divided into blank control group (n=6), sham operation control group (n=6) and the surgery group (n=24). The blank control group was fed by normal diet. The sham operation control group was fed by the high-cholesterol diet. The surgery group was fed by high-cholesterol diet and treated by air-drying. In the 2nd, 4th, 8th and 12th week after operation, the hemodynamic parameters were measured using Color Doppler Flow Imaging. Blood viscosity was determined and the degree of artery stenosis was showed by digital subtraction angiography (DSA). The stenosis rate, mean shear stress, intimia-media ratio and mean integrated optical densities (IOD) of media smooth muscle cells (SMC) were calculated respectively. Results The typical atherosclerotic plaque was presented in surgery group. The thickness of media and mean IOD of SMC were increased at the 2nd week after operation. However, following the increase of the stenosis rate and shear stress, the flow field was changed on the stenotic artery. The pathological morphology showed the character of vulnerable plaque such a large lipid core, thin fibrous cap, and plaque rupture at 4th, 8th week after operation. The media showed atrophy and became thin, mean IOD of SMC was decreased. Statistic analysis showed significant difference in the 2 week group compared with other group. Conclusion Following the increase in the degree of stenosis, the flow shear stress is increased, turbulent flow presents, and flow field changes on the stenotic artery. Thus the plaque become unstable , and the vessel occurs remodeling.

Objective:Elaborated the system cloud platform based on wireless coverage of automatic temperature measuring system, complete the body temperature measurement, collection, transmission and processing, discusses the intelligent temperature monitoring in the medical role in the process of practical application.Methods: through the establishment of information system cloud and accurate and the design of the portable detector, by constantly monitor the temperature; put forward the study of the importance of the temperature in the clinical diagnosis and treatment. Results: based on the information platform, the real temperature of the intelligent detection, which changes the traditional temperature measurement model.Conclusion: the clinical information and make full use of the equipment and software resources of integration, further perfecting the existing function of hospital information system, reduce the work intensity of medical staff, improve the utilization of medical resources.

OBJECTIVE: To reduce the incidence of the disputes between pharmacists and patients. METHODS: The reasons for the disputes between pharmacists and patients as well as the countermeasures were analyzed. RESULTS & CONCLUSIONS: The disputes between pharmacists and patients were mainly resulted form pharmacists' dispensing error, improper service attitude or skills, or lack of the ability in dealing with the problems. The quality of pharmaceutical care can be enhanced and the incidence of disputes can be reduced or evaded through institutionalized management, standardized operation and humane concern showed to patients etc.

Objective To explore how to apply SWOT analysis method for analysis in nursing management in special wards,to develop individualized measures,and to evaluate the clinical quality of care. Methods Using SWOT analysis method to investigate the internal strengths factors,internal weaknesses factors,external opportunities factors,and external threats factors and arranged as a matrix in accordance with a certain order,and used systems analysis methods to analyze the factors matching each other,to dr aw the appropriate conclusions,and to develop appropriate countermeasures.30 patients before and 40 patients after the application of SWOT analysis method were selected for effect comparison. Results After the implementation of SWOT analysis method primary care,I-level care,health education quality,satisfaction degree of patients and ward management score were better than those before the implementation. Conclusions SWOT analysis method was intuitive and simple to use.It possesses balance and systematieness,which is suitable for clinical care management.

Objective To evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P ＜0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P ＜0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P ＜0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P ＜0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.

OBJECTIVE:To establish the method for the residues determination of 5 organic solvents in teicoplanin raw materi-al and injection. METHODS:Headspace GC was performed on the column with 6% cyanopropylphenyl-94% dimethyl polysiloxane (DB-624)as the stationary phase capillary column,the carrier gas was nitrogen,using the temperature program. The temperature of inlet was 200 ℃,detector was hydrogen flame ionization detector with the flow rate of 1 ml/min,split ratio was 40 ∶ 1 and the vol-ume was 1 ml. RESULTS:Good linearity of ethanol,acetone,ethyl acetate,tetrahydrofuran and triethylamine were obtained(r were 0.999 0-0.999 3);the average recoveries were respectively 95.6%,97.0%,103.2%,94.3%and 98.2%(RSD were 2.1%-4.9%, n=9);RSDs of precision and repeatability tests ≤2.6%;and the minimum detectable concentration were respectively 2,2,2,0.7 and 0.3 μg/ml. CONCLUSIONS:The established method is rapid,sensitive and accurate,and can be used for the residues determi-nation of organic solvents in teicoplanin raw materials and injection.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

Objective:To discuss the effect of amlodipine combined with atorvastatin in the treatment of elderly patients with acute cerebral infarction hypertension. Methods:Totally 86 cases with acute cerebral infarction hypertension were randomly divided into the treatment group (43 cases) and the control group (43 cases). The control group received amlodipine 5mg, po, qd, and the treatment group was given atorvastatin 20mg additionally, po, qd. After the one-month treatment, the efficacy of the two groups was studied and compared, and the changes in neural function defect scale, blood pressure, blood lipids and CRP were also investigated. Results:Af-ter the treatment, the total effective rate and the total effective rate of antihypertensive effect in the treatment group were both signifi-cantly higher than those in the control group (P<0. 05). The neurological deficit scores of the two groups were significantly higher than those before the treatment (P<0. 05), and those of the observation group was significantly higher than those of the control group (P<0. 05). The blood pressure of the two groups was both decreased after the treatment(P<0. 05), and the decrease in the treat-ment group was more significant (P<0. 05). TC, TG, LDL-C and CRP levels of the two groups had significant decrease after the treatment (P>0. 05), and those in the treatment group was significant lower than those in the control group (P<0. 05). Conclu-sion:Amlodipine combined atorvastatin in the treatment of elderly patients with acute cerebral infarction hypertension shows significant effect with low incidence of adverse drug reaction, which is worthy of wider application.

Breast cancer and thyroid diseases are common diseases in women.It is reported that breast cancer and thyroid diseases have some relevance.Breast cancer patients have relatively high incidence of thyroid dysfunction,thyroid node and thyroid cancer,which are easily misdiagnosed for lacking of obvious clinical manifestations and will affect the treatment and prognosis of breast cancer.In breast cancer patients,screening and diagnosis of thyroid function and disease through thyroid function detection and ultrasound examination should be strengthened.