Objective To study the effect of different insulin administration methods on glucose control of gestational diabetes mellitus ( GDM) .Methods Sixty-four cases with GDM were randomly divided into observation group and control group.The observation group received continuous subcutaneous insulin infusion insulin pump therapy, the control group received multiple subcutaneous insulin therapy.Then,the glucose control effect,SAS and SDS score were compared between two groups.Results After 4 weeks,the FBG,HbA1c,2h PG of observation group were significantly lower than the control group[(5.89 ±0.66)mmol/L vs (7.13 ±0.74)mmol/L,(7.14 ±0.82)% vs (8.92 ±0.95)%,(8.87 ±0.92)mmol/L vs (10.13 ±1.32)mmol/L](t=7.074,4.430,8.024,all P<0.05). The glucose fluctuations,insulin amount,hypoglycemia incidence of the observation group were significantly lower than the control group,blood sugar standard time was shorter than the control group[(5.64 ±0.65)mmol/L vs (8.44 ± 0.92)mmol/L,(0.52 ±0.06)U· kg-1· d-1 vs (0.73 ±0.09)U· kg-1· d-1,6.25% vs 28.13%,(4.76 ± 0.55)d vs (7.41 ±0.94)d,t/χ2 =14.061,10.983,5.379,13.764,all P<0.05)];SAS score,SDS score of the observation group were significantly lower than the control group[(34.95 ±4.2) points vs (40.23 ±3.98) points, (35.12 ±3.95)points vs (38.36 ±3.88)points,t=5.162,3.310,all P<0.05)].Conclusion Continuous subcu-taneous insulin infusion insulin pump therapy is helpful to control glucose levels,reduce blood sugar fluctuations and mitigate negative sentiment during treatment,it is an ideal insulin administration method for the treatment of GDM.

The paper analyses the function of mutual communication in solving physician-patient conflict. Some feasible suggestions on the mutual communication between doctors and patients are also raised in order to solve the physician-patient conflict effectively.

Objective To discuss the related factors about the rising cesarean section rates, and to propose feasible measures to reduce cesarean section rates. Methods Cesarean section cases in our hospital from January, 2000 to December, 2009 were retrospectively analyzed. Results The cesarean section rate increased year by year,32.0% in 2000,34.5% in 2001,35.0% in 2002,32.3% in 2003,37.1% in 2004,37.9% in 2005,40.2% in 2006,41.7% in 2007,43.6% in 2008,46.1% in 2009. Conclusions Effective measures should be taken to reduce the cesarean section rate.

The basic nature of medical ethics education is the cultivation of morality for medical students,in which humanistic spirit is the fundamental element.Humanistic spirit is in great need for the development of medical ethics,the transformation of medical mode,the harmonious development of physician-patient relationship,and the healthy growth of medical students.Based on present realistic conditions,humanistic spirit should be developed in the fields of classroom training,medical professional education,and other aspects of campus culture.It would be necessary to find multi-path training modes of humanistic spirit.

This paper introduces a new perspective of case choice in medical ethics teaching,which breaks through the limitations of the choice of teaching cases,chooses the hot-case analogy teaching methods out of medical field,and proves to have received good teaching results.

The specialization of medical science determines the objective existence of asymmetric information in medical and health industry.These different understandings in the psychological and behavioral area influenced the development of physician-patient relationship.Medical personnel should look squarely at the professional attributes and dare to play a leading role.Meanwhile,the exchange of the role of patient and medical personnel,understanding patient,clearing of communication channels and enlarging patients′ means of communication will promote harmonious relations between doctors and patients.

Objective To investigate the change of umbilical cord blood gas from early-stage neonates with pregnancy-induced hypertension syndrome (PHIS) affected mothers and its influence upon internal environment of body,and to evaluate the significance of postpartum umbilical cord blood gas analysis.Methods Retrospective study of 101 neonates(born of 97 PHIS-affected mothers),41 cases of mild group,34 cases of moderate group,26 cases of severe group,and enrolled 52 neonates born of non-PHIS mothers as the control group.Prior to neonate's first breath,umbilical cord artery blood gas analysis was performedimmediately to determine the values of pH,arterial carbon dioxide partial pressure (PaCO2),arterial oxygen tension (PaO2),HCO3-,base excess (BE),and Apgar score was completed within 1 min after birth.Results The pH,PaO2,HCO3-,BE in severe group was significantly lower than those in mild group,moderate group,and control group [7.16 ± 0.18 vs.7.25 ± 0.09,7.22 ± 0.11,7.29 ± 0.08 ; (12.01 ± 2.75) mmHg (1 mmHg =0.133 kPa) vs.(18.35 ± 1.75),(14.21 ± 2.01),(22.23 ± 1.45) mmHg; (17.11 ± 2.42) mmoFL vs.(19.82 ±3.85),(17.32 ± 3.21),(22.56 ± 3.38) mmol/L; (-9.15 ± 0.32) mmol/L vs.(-7.95 ± 0.60),(-7.21 ± 0.08),(-6.76 ± 0.03) mmol/L] (P ＜ 0.05),the PaCO2 in severe group was significantly higher than that in mild group,moderate group,and control group [(61.84 ± 32.93) mmHg vs.(54.48 ± 12.82),(58.38 ± 15.32),(51.66 ± 10.52) mmHg] (P ＜ 0.05),Apgar score 1 min after birth was positively correlated with umbilical arterial pH (P ＜ 0.05),the lower Apgar score,the lower pH.Among 65 cases of Apgar score ≤ 7 scores,37 cases of acidosis (pH ＜ 7.20),the incidence rate was 56.92％ (37/65) ; among 88 cases of Apgar score ≥ 8 scores,11 cases of acidosis,the incidence rate was 12.50％ (11/88),the difference was statistically significant (P ＜ 0.01).Conclusions Umbilical cord blood gas analysis is more objective than Apgar score,which could reflect neonate's hypoxia-ischemia degree bore of PIHS mothers,as well as contributed to the assessment of neonate' s prognosis.Conventional umbilical cord blood gas analysis is necessary for neonates bore of PIHS-affected mothers.Enhanced monitoring should be performed in a timely manner on those neonates born after intrauterine distress signs or with low Apgar score,the prevention and therapy as early as possible can improve the quality of birth.

Objective To investigate the clinical effect of gastric bypass operation on treating type 2diabetes,and analyze the management status.Methods Fifty-seven patients wiith type 2 diabetes treated by gastric bypass operation were divided by different body mass index(BMI) into 4 groups:group A( BMI ＜ 20kg/m2) with 8 cases,group B (20 kg/m2≤BMI ＜24 kg/m2) with 21 cases,group C (24 kg/m2≤BMI ＜27kg/m2) with 17 cases and group D (BMI ≥27 kg/m2) with 11 cases.The control of blood glucose and glycosylated hemoglobin,changes of diets and body weight,diabetes complications,adverse reactions after operation and postoperative management were followed up or reviewed.The clinical data were analyzed comprehensively.Results The cure rate of group C was the highest [ 70.6％( 12/17 ) ],while the cure rate of group A was the lowest (0).The overall cure rate was 43.9％(25/57) and the overall improvement rate was 28.1％(16/57).The overall efficient rate was 71.9％(41/57) and the overall inefficient rate was 28.1％(16/57).Apart from a few patients had malnutrition,amenorrhea,bad stomach,diarrhea and poor diet after leaving the hospital,other patients had no surgery complications and no patients died.There was no clinician to follow up and did education to these patients after operation.Conchusions Gastric bypass operation is safe and effective for obese and non-obese patients with type 2 diabetes.It is a new method to weat type 2diabetes at present,but the indications should be grasped and operation enlargement must he prevented.The management of teams of physicians,surgeons,dietitians,nurses should be established afler operation.

Objective To study the location and the expression of nerve growth factor(NGF)in mouse testes at different developmental stages.Methods The testes were taken out from mice at different developmental stages,respectively.Parts of the testis tissue were used to extract total RNA and real-time PCR was used to detect the expression of NGF.The rest tissues were fixed and embedded in paraffin.SABC immunohistochemical staining was used to observe the location of NGF in the testes. Results Reat-time PCR results showed that NGF mRNA could be detected in the testes of mouse at postnatal 1 st week and its expression level increased with the development,and reached the highest point at 3rd week.After 5 weeks it lowered down to a stable level.Immunohistochemistry showed that NGF expressed in the mouse testes at all developmental stages.At postnatal 1 st week immunopositive reaction of NGF was detected mainly in sustentacular cells and the spermatogonia also showed positive staining.NGF positive staining in the testes was observed in interstitial cells,spermatogenetic cells,sustentacular cells and Leydig cells at 3rd week.After the postnatal 5th week,NGF-positive immunostaining was also detected in intersitial cells and spermatogenetic cells,but the intensity of reaction was weaker than that at 1 st and 3rd weeks.Conclusion The expression levels of NGF in mouse testes show regular changes and the expression profile and location of NGF in the testes are different at different developmental stages.