Objective To evaluate the curative effect of integrated traditional Chinese and western medicine in treating diabetic nephropathy. Methods 114 cases of type 2 diabetes were randomly separated into experiment group and control group. Members in the experiment group were treated by integrated traditional Chinese and western medicine and Members in the control group were treated with western medicine alone for 8 weeks' course separately. At the end of therapeutic courses, levels of 24 h total proteinuria, serum creatinine, blood-fasting sugar were evaluated. Results In the experiment group, 8 cases got outstanding effects(11.1%), 50 cases got improvement(69.4%), and 14 cases got no effect (19.4%), with a total effective rate of 80.6%. In the control group, 0 cases got significant effect, 24 cases got improvement(33.3%), and 48 cases got no effect(66.7%), with a total effective rate of 33.3%. There was significant difference in total effective rate between the two groups (P＜0.05), that the total effective rate of the experiment group was significantly higher than that of the control group. Conclusion Integrated traditional Chinese and western medicine therapy can be more effective in treating diabetic nephropathy.

Objective To evaluate the clinical efficacy of traditional Chinese mental intervention in treating post-apoplexy depressive disorder and its effects on recovery of activities of daily living(ADL).Methods 64 cases of post-apoplexy depressive disorder patients of light or moderate degree(evaluated by HAMD scale)were randomly separated into an experiment group and a control group.On the basis of identical basic clinical treatments,the experiment group was treated with traditional Chinese mental intervention,and the results were evaluated by HAMD scale and ADL scale at the 40th,the 70th and the 100th day.Results There were no differences in marks of the two scale between the experiment group and the control group at the beginning(P＞0.05).At the 40th day,the HAMD scale mark was 13.04±4.86 in the experiment group and 17.92±5.82 in the control group,showing significant differences(P＜0.05)between the two groups.At the same time,the ADL scale mark was 61.85±11.73 in the experiment group and 53.02±10.54 in the control group,showing significant differences between the two groups too(P＜0.05).At the 70th day and 100th day,the differences became much more notable(P＜0.01).Conclusion Traditional Chinese mental intervention was effective in promoting the motor function and activities of daily living and relieving the depress disorder for post-apoplexy depressive disorder.Post-apoplexy depress disorder patients should be treated with Chinese traditional mental intervention as soon as possible.

ObjectiveTo explore the imaging characteristics and the clinical and pathological diagnosis of gliomatosis cerebri in order to raise the awareness of the disease.MethodsThe images of 26 patients with gliomatosis cerebri were analyzed retrospectively.ResultsEight patients were treated with partial excision and 18 patients got stereotactic biopsy.The radiography examination included the plain and enhanced scan of CT and MRI.Twelve patients received 1H magnetic resonance spectroscopy (MRS).The disease in all the patients involved at least two cerebral lobes.There were 22 cases whose CT and MRI manifestations showed that there were large-sheet symmetry low-density image in brain and slightly long T1 and long T2 abnormal signals.And the enhanced scan showed that 20 cases had no obvious enhancement,2 cases had slight enhancement.There were 4 cases with large-sheet asymmetry lesions and no enhancement in enhanced scan.1H MRS examination of 12 cases showed that choline( CHO )/creatine(Cr) and CHO/N-acetyl aspartic acid (NAA) increased,NAA/Cr decreased with different degree,and 8 patients had lactate peak.ConclusionsMRI is the first choice to diagnose gliomatosis cerebri.1H MRS is very helpful for the diagnosis and pathological classification of the disease.MRI combined with biopsy can give out a definite diagnosis.

Objective To evaluate the treatment methods for subtrochanteric femur fractures in children and adolescents.Methods Sixty-two patients (at age of 4-16 years) with subtrochanteric fe-mur fractures were managed with traction and delayed hip spica (14 patients, set as nonoperative group) ,titanium elastic nails or pin combined with cast (38 patients, set as less invasive group) and plates (10 patients, set as traditional operative group).The radiologic outcomes, hip joint function and complica-tions of the patients were analyzed.Results According to Beaty scoring, five patients in nonoperative group and 44 in operative group obtained satisfactory early radiologic outcomes.Late radiologic outcome was satisfactory in nine patients from nonoperative group and 46 from operative group according to Theolo-gis scoring, with statistical differences between two groups (P<0.05).Sanders scoring showed excellent results in 11 patients and good in three from nonoperative group, and excellent results in 43 and good in five from operative group, with no statistical differences between two groups (P > 0.05).Less invasive group and traditional operative group showed significantly statistical different in aspects of complications and Sanders scores (P < 0.05).Conclusions Operative treatment provides more satisfactory early and late radiologic results than nonoperative methods.Less invasive operations have better outcomes than tra-ditional operative methods.Selection of treatment modalities based on age, body weight, fracture features and soft tissue conditions of children is the prerequisite for a good outcome.

Objective To evaluate the clinical efficacy of Dan-Hong Injection and Methycobal combined therapy in treating diabetic peripheral neuropathy(DPN).Methods 72 cases of peripheral neuropathy and type 2 diabetes(conformed to ADA standard published in 1999)were randomly separated into an experimem group and a control group.Members in the experiment group were treated with Dan-Hong injection 20ml/day i.v.and Methycobal 500ug/day i.m.Members in the control group were treated with Methycobal only.At the end of 2 weeks'therapeutic courses,motor nerve conducdon velocity (MNCV)and sural nerve conduction velocity(SNCV)were evaluated.Results The overall effective rate was 92.1% in the experiment group and 67.6% in the control group,showing significant difference between the two groups(P＜0.01).The post-therapeutic values of both SNCV and MNCV were significantly different from those of previous treatment.(P＜0.01)The post-therapeutic values of SNCV and MNCV of the experiment group were also significantly different from those of the control group(P＜0.05).No evidently relative adverse effects were observed in both groups.Conclusions Combined therapy of Dan-Hong injection and Methycobal was more effective in controlling the clinical activity of diabetic peripheral neuropathy.

The paper introduced the general picture of Xiangya Hospital in the past five years in its development of ahigh-level research hospital of international influence.Aiming at this strategic goal, the hospital proceeds by means of discipline development,talent training,research platform building, international academic exchange,performance appraisal and incentive,budget guarantee and system development.All these efforts contribute to the building of a mutual-supportive,efficient and sustainable medical science innovation system tailored to large hospitals.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in ICU,then instruct clinical application of antibiotics reasonably.METHODS The identification of bacteria,isolated from patients in ICU from Jan 2005 to Dec 2006,and antibiotic susceptibility by ATB expression were used.RESULTS A total of 1197 pathogens strains were isolated,Gram-negative bacilli,Gram-postive cocci and fungi accounted for 64.2%,19.6% and 15.8%,respectively.The most common pathogens of them were Pseudomonas aeruginosa(22.1%).Except Escherichia coli(40%),the rate of the ESBL-producing strains of Serratia marcescens,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae were higher than 70%.The most common pathogens of Gram-postive cocci were Staphylococcus.Meticillin-resistant strains of Staphylococcus aureus accounted for 93.8%.Mainly pathogenic bacteria were multi-resistant to some antibiotics.There were 189 strains fungi.And all the fungi were sensitive to amphotericin B,fluconazole and ketoconazole.CONCLUSIONS The infection and multi-drug resistance of pathogens are serious in ICU.It′s important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.

OBJECTIVE To investigate the influence on air quality in cleaning room of the supply department when the water/gas blast gun is used to clean endoscope,to give basis for valuable protective procedures. METHODS Bacterial number of the air in the supply department was sampled using flat plate settling process pre-and post-operation. Simultaneously,the air purification effect of the laminar purification equipment was evaluated. RESULTS The air bacterial content before the water/gas blast gun ran was significantly different from that when the gun stopped (P

Objective To evaluate the usefulness of diffusion-weighted imaging(DWI) in the diagnosis and differential diagnosis of gallbladder wall thickening diseases.Methods 42 patients with gallbladder wall thickening (16 patients with carcinoma and 26 patients with benign lesion) were included in this study.All patients performed conventional MRI and DWI.The diagnostic performances of three methods (conventional MRI,visual assessment of color fusion image from DWI and T2WI,and ADC measurement) were evaluated by two radiologists.Results The area under the receiver operating characteristic curve were 0.570,0.849,0.901 for conventional MRI,visual assessment and ADC measurement respectively.The accuracy,sensitivity and specificity were 59.5%,62.5%,57.7% for conventional MRI,85.7%,81.2%,88.5% for visual assessment of color fusion image,and 83.3%,80.0%,85.2% for ADC measurement,respectivily.The mean ADC value of gallbladder cacinoma[(1.15±0.35)×10-3mm2/s]was significantly less than that of gallbladder benign lesion [(1.99±0.61)×10-3mm2/s](P<0.01).Conclusion The DWI(visual assessment of color fusion image and ADC measurement)might be a useful tool for diagnosis and differential diagnosis of the gallbladder wall thickening diseases.

Objective To study the relationship between ultrasonography of arteria dorsalis pedis and Hemorheology in patient with diabetic foot.Methods According to with or without frank anabrosis,51 patients were devided into two sub-groups:anabrosis group (23 patients) and no-anabrosis group (28 patients).The correlativity was analysed between the parameters of ultrasonography in arteria dorsalis pedis and hemorheological indices on patients with diabetic foot.Results When compared to patients without ulcers,vascular inner diameter (D),peak systolic velocity (PSV),resistent index (RI) and pulsatility index (PI) on patients with frank anabrosis were decreased significantly,but whole blood viscosity at high shear rate (BVH),whole blood viscosity at low shear rate (BVL),plasma viscosity (PV),fibrinogen (Fib) were increased.Multiple regression analyses indicated that the relationship between BVH,BVL and D was presence,partial regression coefficient (r) was -0.004 and -0.009 ; the relationship between PSV and BVH,PV was intimate,r was -0.957 and -25.655 ; the relationship between RI and BVH,PI and BVH,PV,Fib were relatively intimate,r was -0.009 , -0.141 , -2.666 , -0.383 ,respectively.Conclusions The changes of hemorheology can aggravate the abnormality of hemodynamics and the degree of vascular lesion in small vessels of lower limb,so it is one of influencing factor leading to lower limb arterial ischaemia and diabetic foot deterioration.