THe insulin-like growth factor(IGF) system,a very important polypeptide growth hormone,has been found to have some relation with primary adrenocortical tumorigenesis and modulates its growth.This article reviews the general biological characteristics of IGF and the relations of the IGF system with the normal adrenal cortex and primary adrenocortical tumor.It also and discuss the clinical meaning of its possible presence in the primary adrenocortical tumor.

OBJECTIVE:To evaluate the cumulative incidence of end-stage renal disease(ESRD)in Chinese hypertensive type2diabetic patients with microalbuminuria(DHM)treated with different regimes,and to provide reference for decision makers.METHODS:A peer-reviewed Markov model that simulated progression from microalbuminuria to nephropathy,dou?bling of serum creatinine,ESRD,and all-cause mortality in patients with DHM was adapted to China.Three strategies were compared:(1)early use of irbesartan(i.e.prompt treatment in subjects with microalbuminuria);(2)late use of irebesartan(i.e.as from overt nephropathy);(3)standard hypertension care(with comparable blood pressure control).Cumulative incidence of ESRD,costs and life expectancy were projected for a hypothetical cohort of1000subjects.Treatment-specific progression and mortality probabilities were derived from published trials:IRMA-2(in microalbuminuria)and IDNT(in overt nephropathy).Medical management and cost data per state were obtained from published local sources.A flexible time horizon up to25years and third party payer perspective were used.Future costs and LE were discounted at3%yearly.RESULTS:When compared with standard blood pressure control,early use of irbesartan was evaluated to reduce the cumulative incidence of ESRD from(mean?standard deviation)8%to22%,save RMB30348(US＄3667),and add0.638life years per treated patient.Late use of irbesartan was dominant over control group but dominated by early irbesartan.Break-even occurred after13years.CON?CLUSION:Treating DHM patients by early use of irbesartan is evaluated to reduce the incidence of ESRD,extend life and reduce costs.Treating patients at a later stage is still beneficial,however to a lower extent.

Regeneration ; Tissue Engineering ; Vocal Cords

More and more attention was aroused to'students' evaluating teaching'. However,there were still some problems in the issue,including the aim,methods,index system,reliability and efficiency,which reduced the effect of'students' evaluating teaching'. These problems were discussed here,and the countermeasures were put forward.

Objective To analyze the relationship between serum HBV-DNA and hepatic fibrosis in patients with hepatitis B. Methods Serum HBV-DNA load and hepatic fibrosis hyaluronic acid (HA),Ⅲ procollagen N terminal peptide(PⅢNP),laminin (LN),Ⅳ collagen(Ⅳ-C)of 154 cases were detected by real-time fluorescence quantitative PCR and chemiluminescence method. Statistical analysis of the correlation between HBV-DNA load and hepatic fibrosis indicator was performed.Results The data of HBV-DNA load after taking lg value was 5.49±1.39;The serum concentration of hepatic fibrosis HA was (166.95±148.20)ng/mL,PⅢNP was (12.14±7.37)ng/mL,Ⅳ-C was (65.29±45.48)ng/mL,LN was (59.52±35.67)ng/mL.The difference between experimental group and control group in hepatic fibrosis was significant(P <0.05).Serum HBV-DNA only correlated with LN(r=0.284,P =0.015).Conclusion There is no significant correlation between serum HBV-DNA and hepatic fibrosis in hepatitis B pa-tients.Anti-fibrosis treatment should also be strengthened for hepatitis B patients in the course of antiviral treatment.

Objective To explore the effect of the health education with teaching -back method on senior citizens' hypertension related health literacy in nursing homes. Methods Six nursing homes, randomly selected using stratified cluster random sampling method, were randomly divided into the experiment group and the control group,151 cases in each group. The control group received peer education method, and the experiment group received the health education with teaching-back method on the basis of the control group. The hypertension related health literacy total scores and 4 dimension scores of the two groups were compared before and after the intervention. Results There was no significant difference in the total score and each dimension score of the hypertension related health literacy between the experiment group and the control one before intervention (P>0.05). There was significant difference in the total score and each dimension score of the hypertension related health literacy between the experiment group and the control one after intervention (P<0.001). The total score and each dimension score of the hypertension related health literacy of the experiment group were significantly higher than that of the control group. There was significant difference in the total score and each dimension score of the experiment group before and after intervention (P<0.001). The scores of the experiment group after intervention were significantly higher than before. There was significant difference in the total score, knowledge attainment score, faith accomplishment score and technical accomplishment score of the control group before and after intervention (P < 0.01). The score of the control group after intervention were significantly higher than before. But the behavior literacy before and after intervention was not statistically significant (P>0.05). Conclusion The health education with teaching-back method can improve the elderly hypertension related health literacy level and improve the quality of health education.

Objective To study the efficacy and safety of endoscopic submucosal dissection ( ESD ) for colorectal neuroendocrine tumor .Methods Clinical data of 43 cases of colorectal neuroendocrine tumor receiving ESD therapy from Sep .2010 to Feb.2014 were retrospectively analyzed , and the safety and efficacy were evalua-ted.Results All the 43 cases received ESD therapy , among whom 2(4.65%)cases developed delayed bleeding and recovered after endoscopic treatment .No perforation was found .4 cases had high fever and recovered after antibiotic treatment.One case(2.33%)of recurrence was found by colonoscopy 1 year later, and underwent sur-gery.The other 42 cases were followed up for 6 months to 2 years, during which no recurrence or metastasis was found.Conclusion ESD is a simple, safe and effective modality for colorectal neuroendocrine tumor .

Acute traumatic coagulopathy (ATC) is one of coagulopathy induced by severe trauma in the early phase of trauma.It is always with high morbidity,mortality and multiple organ failure.Early diagnosis and treatment is the main content of trauma surgery in the department of emergency and the key to reduce mortality.Thrombelastography (TEG) can comprehensively assess the different stages of coagulation,early diagnose disturbance of blood coagulation and guide the goal-directed therapy with low complications,mortality and medical costs.TEG has been widely used in the operation of cardiac surgery,liver transplantation and trauma surgery to monitor coagulation and guide therapy.This paper mainly reviews the clinical value of thrombelastography in diagnosis and treatment of acute traumatic coagulopathy.

Good standardized training of resident physicians is indispensable for high quality medical personnel building.This paper gives a brief introduction to the experiences of endocrinology fellowship trainings in three top hospitals in USA.On the basis of current simation in China,a new and improve the quality'is proposed,and a new approach is explored,which is a valuable reference for the endocrine resident trainings in China.

To meet the demands of high definition of video and transmission at real-time during the surgery of endoscope, this paper designs an HD mobile video transmission system. This system uses H.264/AVC to encode the original video data and transports it in the network by RTP/RTCP protocol. Meanwhile, the system implements a stable video transmission in portable terminals (such as tablet PCs, mobile phones) under the 3G mobile network. The test result verifies the strong repair ability and stability under the conditions of low bandwidth, high packet loss rate, and high delay and shows a high practical value.
Equipment Design ; Telemedicine ; instrumentation ; Video Recording ; instrumentation