Objective To study the effect of the health education path on health education in patients with diabetes.Methods According to random number table method,100 type 2 diabetes mellitus(T2DM)patients were divided into control group and health education path group.Health education path group received health education through the health education path and the control group by traditional methods.The rate of diabetes-related knowledge mastery and the control of blood glucose in two groups were compared. Result The rate of diabetes-related knowledge mastery and the control of blood glucose in the health education path group were significantly better than those of the control group(P<0.05,for both).Conclusion Health education according to health education path to the patients with diabetes can increase the degree of knowledge and the control effect of blood sugar.

OBJECTIVETo evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions.

METHODSA total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm(2) (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year after the index procedure.

RESULTSThe baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182).

CONCLUSIONBoth FFR- and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To compare the differences and clinical value of prognostic evaluation between American Joint Committee on Cancer (AJCC) TNM staging system 7th edition and 8th edition for gastric cancer (GC).Methods The retrospective case-control study was conducted.The clinicopathological data of 1 383 GC patients who were admitted to the First People's Hospital of Changzhou between January 2008 and August 2012 were collected.Distal gastrectomy,proximal gastrectomy + pyloroplasty or total gastrectomy were performed according to preoperative evaluation and intraoperative exploration.Observation indicators:(1) surgical and postoperative situations;(2) follow-up and survival situations;(3) T staging comparison between AJCC TNM staging system 7th edition and 8th edition;(4) N staging comparison of AJCC TNM staging system 8th edition;(5) prognostic analysis in N staging of AJCC TNM staging system 8th edition;(6) TNM staging comparison between AJCC TNM staging system 7th edition and 8th edition;(7) prognostic analysis in different TNM staging between AJCC TNM staging system 7th edition and 8th edition.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to October 2017.Measurement data with normal distribution were represented as x ± s.Measurement data with skewed distribution were described as M (range).The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Results (1) Surgical and postoperative situations:1 383 GC patients underwent successful radical gastrectomy,including 923 with distal gastrectomy,165 with proximal gastrectomy and 295 with total gastrectomy.Of 1 383 patients,115 with postoperative complications were improved by symptomatic treatment,including 87 with surgical complications and 28 with non-surgical complications.Postoperative pathological examinations:total number of intraoperative lymph node dissection and number of lymph node metastasis were 25± 12 and 7±4;577 didn't have lymph node metastasis and 806 had regional lymph node metastasis;308 were in early GC and 1 075 in advanced GC.(2) Follow-up and survival situations:1 383 patients were followed up for 1-117 months,with a median time of 34 months.The 1-,3-and 5-year survival rates of 1 383 patients were respectively 90.5％,71.9％ and 61.1％.(3) T staging comparison between AJCC TNM staging system 7th edition and 8th edition:T staging definition between AJCC TNM staging system 7th edition and 8th edition was identical.T staging of 1 383 patients:308,192,65,628 and 190 were respectively detected in T1,T2,T3,T4a and T4b stagings.(4) N staging comparison between AJCC TNM staging system 7th edition and 8th edition:N staging definition between AJCC TNM staging system 7th edition and 8th edition was identical.N staging of 1 383 patients:577,255,207,230 and 114 were respectively detected in N0,N1,N2,N3a and N3b stagings.N3a and N3b were classified as N3 staging of AJCC TNM staging system 7thedition,but they were classified as independent staging of AJCC TNM staging system 8th edition.(5) Prognostic analysis in N staging of AJCC TNM staging system 8th edition:5-year survival rate of patients in N0,N1,N2,N3a and N3b stagings was respectively 85.6％,76.5％,59.4％,45.2％ and 32.5％ based on AJCC TNM staging system 8th edition,with a statistically significant difference in survival (x2 =394.400,P＜0.05).There was a statistically significant difference between N0 and N 1 stagings (x2 =45.630,P＜0.05),between N 1 and N2 stagings (x2 =19.470,P＜0.05),between N2 and N3a stagings (x2 =7.602,P＜0.05) and between N3a and N3b stagings (x2=13.020,P＜0.05).(6) TNM staging comparison between AJCC TNM staging system 7th edition and 8th edition:TNM staging of 366 patients had changes,including 2 in T1N3b staging,2 in T2N3b staging,18 in T3N3b staging,120 in T4aN2 staging,149 in T4aN3a staging,34 in T4bN0 staging and 41 in T4bN2 staging;364 were detected in staging Ⅲ in 7th edition and 8th edition,and sub-staging of staging Ⅲ had a change;2 in T1N3b of ⅡB staging were redistricted into Ⅲ B staging based on AJCC TNM staging system 8th edition.(7) Prognostic analysis in different TNM staging between AJCC TNM staging system 7th edition and 8th edition:according to 7th edition,cases and 5-year survival rate were respectively 247,89.5％ in Ⅰ A staging and 147,83.7％ in Ⅰ B staging and 77,75.9％ in ⅡA staging and 207,70.5％ in ⅡB staging and 136,61.0％ in ⅢA staging and 236,37.5％ in Ⅲ B staging and 333,35.4％ in Ⅲ C staging,with a statistically significant difference in survival among sub-stagings (x2 =228.800,P＜0.05).There was a statistically significant difference in survival among Ⅰ,Ⅱ and Ⅲ stagings (x2=189.000,P＜0.05) and between ⅢA and ⅢB or ⅢC stagings (x2=22.710,18.010,P＜0.05).There was no statistically significant difference in survival between Ⅰ A and Ⅰ B stagings (x2=0.179,P＞0.05),between Ⅱ A and Ⅱ B stagings (x2 =0.265,P＞0.05),and between Ⅲ B and Ⅲ C stagings (x2 =1.550,P＞0.05).According to 8th edition,cases and 5-year survival rate were respectively 247,89.5％ in Ⅰ A staging and 147,83.7％ in Ⅰ B staging and 77,75.9％ in Ⅱ A staging and 205,70.7％ in Ⅱ B staging and 288,53.8％ in ⅢA staging and 258,37.3％ in ⅢB staging and 161,28.5％ in ⅢC staging,with a statistically significant difference in survival among sub-stagings (x2=234.900,P ＜ 0.05).There was no statistically significant difference in survival between Ⅰ A and Ⅰ B stagings (x2 =0.179,P＞0.05) and between Ⅱ A and ⅡB stagings (x2 =0.564,P＞0.05).There was statistically significant differences in survival between Ⅲ A and Ⅲ B or ⅢC stagings (x2 =29.790,43.060,P＜0.05) and between Ⅲ B and Ⅲ C stagings (x2 =7.494,P＜0.05).Further analysis showed that changes of TNM staging system between 7th edition and 8th edition were in T3N3b,T4aN2,T4aN3a,T4bN0 and T4bN2 stagings,5-year survival rate in above stagings was respectively 16.7％,35.8％,30.2％,47.1％ and 26.8％,with statistically significant differences in survival between T3N3b and T4aN2,T4aN3a,T4bN0 and T4bN2 stagings (x2 =19.590,8.039,12.070,3.853,P＜0.05),between T4aN2 and T4aN3a,T4bN2 stagings (x2 =6.529,3.859,P ＜ 0.05),between T4aN3a and T4bN0 stagings (x2 =10.400,P＜0.05) and between T4bN0 and T4bN2 stagings (x2=4.636,P＜0.05).There was no statistically significant difference in survival between T4aN2 and T4bN0 stagings (x2 =3.607,P＞0.05) and between T4aN3a and T4bN2 stagings (x2 =0.029,P＞0.05).Conclusions Compared with AJCC TNM staging system 7th edition,N3a and N3b stagings are classified as independent staging in AJCC TNM staging system 8th edition,and 8th edition is more accurate in prognostic evaluation of GC patients in stage Ⅲ.

Objective:To investigate the improvement and clinical effect of lip depilation with 810 nm semiconductor laser.Methods:Retrospective analysis was performed on female labial hair removal patients admitted to Bethune Hospital in Shanxi from January 2017 to October 2018. The patients who visited the clinic from January 2018 to October 2018 were taken as the experimental group, and those who visited the clinic from January 2017 to December 2017 were taken as the control group. A combination model of super hair removal(SHR) + hair removal(HR) was adopted to perform the treatment with 810 nm YfTON semiconductor freezing point laser hair removal. The experimental group was treated with surface anesthetic and SHR mode dumbbell sliding mode 8 J/cm 2+ HR mode with high energy (starting from the upper limit of reference energy value), and the patients were treated with local drum and chin coordination. In the control group, no surface anesthetic was applied, and SHR mode was used for linear round-trip sliding + HR mode for reference energy treatment. After the third and fifth treatment, the patients in the two groups were treated with a hair size of 1 cm×1 cm on one side of the mouth corner with heavy hair. A hair analyzer was used to count the number of similar hairs visible to the naked eye at a social distance of about 1 meter. The final hair removal rate was calculated as excellent (70%-90%, including 70%), as improvement (40%-70%, including 40%), as invalid (<40%). The depilation rate after 3 and 5 treatments was compared between the 2 groups, the number of treatments was analyzed, and the recurrence rate and comfort level of the patients were followed up 6 months after treatment. Wilcoxon rank sum test was used to compare the measurement data. Comparison of counting data was tested, and P<0.05 was considered statistically significant. Results:A total of 200 patients were included in this study, including 100 in the experimental group, with an age of (28.58±6.01) years. The control group included 100 patients (28.57±6.07) years old. The skin type of patients was performed according to Fitzpatrick and Chinese characteristics Ⅱ-Ⅳ. After statistical test, there were no statistically significant differences in age and skin type between the two groups. After half a year of follow-up, the average number of treatment times in the experimental group was 5(5, 6) times, lower than that in the control group 7(6, 8) times( T=-9.279, P<0.001). The three and five depilation rates of the experimental group were[70.0%(68.0%, 74.8%), 86.0%(83.0%, 88.0%)], and the final depilation rates of the experimental group were 89.0%(86.7%, 90.0%), all higher than those in the control group[40.0%(37.0%, 42.0%), 72.0%(70.0%, 74.0%), 86.5%(85.0%, 88.0%)]. The differences between the two groups were statistically significant ( T3=43.986, T5=25.151, Tfinal=5.547, all P< 0.001). The intermittent times of single sliding treatment in the experimental group ≤2 times, compared with the control group > 2 times, the comfort level was improved. No blisters or coloration occurred in any of the patients. Patients in the 2 groups were followed up for half a year after the last hair removal. In the 2 groups, there were sparse new fine hairs and soft hair growth that were not included in the hair count, and the included hairs were thinner than those before the treatment. Conclusions:Compared with the control group, the treatment cycle is shorter, the efficiency is higher and the comfort level of the patients is higher in the experimental group.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To explore the value of low-dose multi-slice spiral computed tomography (MSCT) multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma.Methods A total of 40 patients with gastric carcinoma were selected.All the patients were conducted with low-dose MSCT scan,dynamic contrast scanning and three-dimensional reconstruction scan,and then were processed by multi-planar reconstruction,volume reconstruction and CT virtual endoscopy.Primary lesions in gastric cancer,peripheral infiltration and distant metastasis were observed.Results All the patients were satisfied with the low dose MSCT images,and all of them found primary gastric lesions and had satisfactory diagnosis rates of gastric peripheral infiltration,lymph node metastasis and distant metastasis.Conclusion Low-dose MSCT multi-stage scan and three-dimensional reconstruction can reduce the radiation dose and reveal the primary gastric lesions,gastric peripheral infiltration and distant metastasis.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To explore the value of low-dose multi-slice spiral computed tomography (MSCT) multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma.Methods A total of 40 patients with gastric carcinoma were selected.All the patients were conducted with low-dose MSCT scan,dynamic contrast scanning and three-dimensional reconstruction scan,and then were processed by multi-planar reconstruction,volume reconstruction and CT virtual endoscopy.Primary lesions in gastric cancer,peripheral infiltration and distant metastasis were observed.Results All the patients were satisfied with the low dose MSCT images,and all of them found primary gastric lesions and had satisfactory diagnosis rates of gastric peripheral infiltration,lymph node metastasis and distant metastasis.Conclusion Low-dose MSCT multi-stage scan and three-dimensional reconstruction can reduce the radiation dose and reveal the primary gastric lesions,gastric peripheral infiltration and distant metastasis.

Objective:To investigate the improvement and clinical effect of lip depilation with 810 nm semiconductor laser.Methods:Retrospective analysis was performed on female labial hair removal patients admitted to Bethune Hospital in Shanxi from January 2017 to October 2018. The patients who visited the clinic from January 2018 to October 2018 were taken as the experimental group, and those who visited the clinic from January 2017 to December 2017 were taken as the control group. A combination model of super hair removal(SHR) + hair removal(HR) was adopted to perform the treatment with 810 nm YfTON semiconductor freezing point laser hair removal. The experimental group was treated with surface anesthetic and SHR mode dumbbell sliding mode 8 J/cm 2+ HR mode with high energy (starting from the upper limit of reference energy value), and the patients were treated with local drum and chin coordination. In the control group, no surface anesthetic was applied, and SHR mode was used for linear round-trip sliding + HR mode for reference energy treatment. After the third and fifth treatment, the patients in the two groups were treated with a hair size of 1 cm×1 cm on one side of the mouth corner with heavy hair. A hair analyzer was used to count the number of similar hairs visible to the naked eye at a social distance of about 1 meter. The final hair removal rate was calculated as excellent (70%-90%, including 70%), as improvement (40%-70%, including 40%), as invalid (<40%). The depilation rate after 3 and 5 treatments was compared between the 2 groups, the number of treatments was analyzed, and the recurrence rate and comfort level of the patients were followed up 6 months after treatment. Wilcoxon rank sum test was used to compare the measurement data. Comparison of counting data was tested, and P<0.05 was considered statistically significant. Results:A total of 200 patients were included in this study, including 100 in the experimental group, with an age of (28.58±6.01) years. The control group included 100 patients (28.57±6.07) years old. The skin type of patients was performed according to Fitzpatrick and Chinese characteristics Ⅱ-Ⅳ. After statistical test, there were no statistically significant differences in age and skin type between the two groups. After half a year of follow-up, the average number of treatment times in the experimental group was 5(5, 6) times, lower than that in the control group 7(6, 8) times( T=-9.279, P<0.001). The three and five depilation rates of the experimental group were[70.0%(68.0%, 74.8%), 86.0%(83.0%, 88.0%)], and the final depilation rates of the experimental group were 89.0%(86.7%, 90.0%), all higher than those in the control group[40.0%(37.0%, 42.0%), 72.0%(70.0%, 74.0%), 86.5%(85.0%, 88.0%)]. The differences between the two groups were statistically significant ( T3=43.986, T5=25.151, Tfinal=5.547, all P< 0.001). The intermittent times of single sliding treatment in the experimental group ≤2 times, compared with the control group > 2 times, the comfort level was improved. No blisters or coloration occurred in any of the patients. Patients in the 2 groups were followed up for half a year after the last hair removal. In the 2 groups, there were sparse new fine hairs and soft hair growth that were not included in the hair count, and the included hairs were thinner than those before the treatment. Conclusions:Compared with the control group, the treatment cycle is shorter, the efficiency is higher and the comfort level of the patients is higher in the experimental group.

Objective To investigate the factors affecting the efficacy of leflunomide combined with medium/low dose corticosteroids in the treatment of progressive IgA nephropathy (IgAN).Methods Clinical and pathological parameters were collected retrospectively in patients of primary IgAN with proteinuria＞ 1.0 g/24 h and chronic kidney disease (CKD) stage 1-3 treated with leflunomide combined with medium/low dose corticosteroids in Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University from Jan 2005 to Dec 2010.According to the treatment effects,patients were divided into complete remission group and non-complete remission group.The biochemical and pathological indexes of the two groups were compared.Results A total of 42 patients were included.The remission rates at 3,6,9 and 12 months were 62％,64％,67％ and 74％,respectively.Seventeen (40.5％) and fourteen (33.3％) patients achieved complete and partial remission after one-year treatment,and the remission rate remained stable within one year after withdrawal of drugs.The 24hour proteinuria was 1.50 (0.67,2.66) g,which was significantly reduced compared with the baseline 2.44 (1.36,3.74) g (P ＜ 0.01).The decrease rate was 31.3％.There was a slight decrease in proteinuriawithin one year after withdrawal of drugs.Estimated glomerular filtration rate (eGFR) remained stable during the treatment and a year of follow-up.No serious adverse event was observed during the followup period.Among 31 responder patients,6(19.4％) patients relapsed.Logistic multivariate regression analysis suggested that the degree of renal interstitial inflammatory infiltration was an independent predictor of complete remission with one-year treatment of leflunomide combined with medium / low dose corticosteroids (HR=0.067,95％ CI 0.008-0.535,P=0.011).Conclusions IgAN treated with leflunomide and medium/low dose corticosteroids can achieve remission in early stage,and the remission rate remains stable after withdrawal of drugs.It is a safe option for the treatment of IgAN.Renal interstitial inflammatory infiltration is an independent predictor of complete remission.