Objective To investigate the effectiveness and safety of psychological intervention combined with Metformin Hydrochloride Enteric-Coated Capsules in the treatment of type 2 diabetes mellitus. Methods A total of 80 patients with type 2 diabetes mellitus were selected from May 2015 to October 2016 in our hospital. The subjects were randomly divided into control group and experimental group, with 40 patients in each group. The control group was given repaglinide treatment, given metformin treatment of Metformin Hydrochloride Enteric-Coated Capsules on the basis of the experimental group, psychological intervention on the mental status of patients and patients, strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. Results After the corresponding treatment, the patients in the experimental group and the control group had no serious adverse reactions, and the safety was better. The probability of hypoglycemia in the experimental group (15%) was significantly higher than that in the control group (5%), with statistical difference (P<0.05). Before treatment, the fasting blood glucose levels of the experimental group and the control group were (9.21±2.31) and (9.38±2.28) nmol / L, and there was no significant difference between the two groups, and there was no statistical significance The fasting blood glucose level (7.31±1.02), nmol / L in the experimental group was significantly lower than that in the control group (7.90±0.82) nmol / L. The effect of diabetes treatment in the experimental group was significantly better than that in the control group, with statistical difference (P<0.05). Conclusion Psychological intervention combined with Metformin Hydrochloride Enteric-Coated Capsules in the treatment of type 2 diabetes mellitus has high efficacy and low incidence of adverse reactions. It has clinical significance.

Objective To evaluate the efficacy and safety of intrapleural fibrinolytic agents in the treatment of childhood empyema.Methods The data from China National Knowledge Infrastructure (CNKI),Chinese BioMedical (CBM),PubMed,VIP Database and Cochrane library were reviewed.Randomized control trials by using intrapleural fibrinolytic agents to treat childhood empyema were included.Two reviewers independently extracted the data from the eligible studies and evaluated the quality of the included studies.Meta-analysis was performed for the results of homogeneous studies using RevMan 5.2 software,while others analyzed descriptively.Results Five randomized control trials involving 248 children with empyema were included.Meta-analysis was not made in all of the indexes because of apparent heterogeneity and limited data.Two trials were compared which involved 98 patients receiving fibrinolytic agents or 9 g/L saline.The results suggested that fibrinolytic agents shortened the length of hospital stay and reduced complication(all P ＜ 0.05),but no significant differences were found between the 2 groups in the effective rate,duration of fever and pleural effusion amount(OR =3.61,95％ CI 0.84-15.49,P ＞ 0.05).Three trials involving 150 patients compared fibrinolytic agents and video-assisted thoracoscopic surgery (VATS).The data suggested that no significant differences were found between 2 groups in the effective rate (OR =0.70,95 ％ CI 0.30-0.61,P ＞ 0.05),but fibrinolytic agents cost less (P ＜ 0.05).The adverse drug reactions to intrapleural fibrinolytic agents were mild to moderate,and well tolerated.Conclusions The findings suggest that intrapleural fibrinolytic agents in the treatment of childhood empyema is safe and effective,especially in encapsulated effusion.Compared to 9 g/L saline,it can shorten the length of hospital stay and reduce complication.Compared with VATS,the curative effect is similar,while intrapleural fibrinolytic agents are economic.

Objective To compare the effectiveness,safety and related clinical indicators between simple drainage treatment and drainage treatment combined with intrathoracic urokinase for children with parapneumonic pleural effusion(PPE).Methods Twenty-nine in patients with PPE given pleural effusion drainage in the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2015 were selected as research subjects,who were divided into a simple group and an urokinase group based on whether intrathoracic urokinase was injected or not.The total number of hospital stay,the total drainage volume,the total number of catheter days,the total cost,the days with fever,efficient rate,operation rate and security of the patients were retrospectively analyzed between two groups.Results The intrathoracic days of hospital stay [M(P25,P75)] of urokinase group[19(11,30) days]were less than those of simple group[30(21,38) days],and the difference was significant (Z =-2.545,P =0.011);the total drainage volume[M(P25,P75)] of the urokinase group [430 (175,1 308) mL] was more than that of the simple group [110 (10,325)mL],and the difference was significant (Z =-2.811,P =0.005);the total number of catheter days [M (P25,P75)] of urokinase group [9 (7,19) days] was less than that of the simple group [20 (10,30) days],and the difference was significant (Z =-2.020,P =0.043);the total cost [M(P25,P75)] of the urokinase group [20 000(10 000,30 000)RMB] was less than that of the simple group [40 000 (30 000,50 000) RMB],and the difference was significant (Z =-2.631,P =0.009);the days with fever between urokinase group and the simple group was not significant (Z =-0.820,P =0.412).The urokinase group had a higher cure rate[76.9％ (10/13 cases)] and a lower surgical rate [23.1％ (3/13 cases)] compared with those of the simple group[18.7％ (3/16 cases),81.3％ (3/16 cases)],and the difference was significant (x2 =9.814,P =0.003).Conclusions Intrapleural urokinase therapy as an adjuvant treatment of PPE is simple and convenient,economic,higher efficiency,lower risk,which can be used as an effective clinical solution such disease.

The application of Geographical Information System (GIS) and research the application of GIS on Medical Information System were introduced. The function and character of CIS, analysis and control of infectious disease source, application of ambulance dispatcher were recounted. The efficiency of treatment and rescue can be improved in modern information condition. It has played an active role in medical service system and reasonable distribution of medical resources.

Aim To investigate the influence of iridosides of cornus officinalis(ICO) on morphology, cell cycle and oxidative stress of glomerular mesangial cells(GMC) cultured with advanced glycation end products(AGEs). Methods GMC were incubated in culture medium containing AGEs in the presence of ICO and aminoguanidin for 48 hours. At the same time, the control and model groups were added. Then the cultured GMC were stained by mixed fluorescence liquid and observed under fluorescence microscope. Cell cycle of GMC were analyzed using flowcytometry. The content of MDA, activity of SOD and GSH-Px in GMC supernatant were measured. The level of ROS was detected using flowcytometry. Result Morphology analysis showed that the morphology and structure of normal GMC were normal. The structure of most cells in AGEs were unclear, cell counts increased largely and they grow intensively. Cell cycle analysis showed that cell percentage of S phase increased and G_0/G_1 reduced. The level of ROS, MDA remarkably increased, and SOD, GSH-Px activity reduced. When the ICO were added, cell morphology tended to be basically normal and cell counts decreased, the percentale of S phase also decreased. The level of ROS, MDA and the SOD, GSH-Px activity restored in comparison with the model groups. Conclusion ICO can prevent the cultured GMC from lesion caused by AGEs. ICO may protect GMC from AGES to retard the progression of diabetic nepropathy by partially inhibiting the occurrence of oxidative stress.

Objective To observe the effect of recombinant human mannose-binding lectin (RhMBL)on the expression of Bcl-2 and p53 gene in thyroid cancer cell lines.Methods Two kinds of thyroid cancer cell lines( K1 cells and FTC-133 cells) were dealed with different concentrations of rhMBL( control group:0 mg/L;experimental group:1 mg/L),then total protein was extracted to detect the expression of Bcl-2 and p53 by Western Blot.Results The expression level of p53 and Bcl-2 were observed to be obviously down-regulated after incubation with RhMBL.( 1 ) K1 cells:There was significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 1.51 ± 0.29) vs (0.74 ±0.07),t =7.63 ; P =0.040;Bcl-2:( 1.20 ± 0.07 ) vs ( 0.59 ± 0.04 ),t =6.28,P =0.001 ] ; ( 2 ) FTC-133 cells:there was also significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 0.88 ±0.14) vs(0.35 ±0.08),t =3.29,P=0.003; Bcl-2:(1.07±0.11) vs (0.33 ±0.06),t =5.73,P=0.000 ].Conclusion Bcl-2 and p53 may play an important role on the induction of thyroid cancer cell apoptosis and inhibition its proliferation by RhMBL.

Objective　To investigate morphological changes of endothelial cells after nordihydroguaiaretic acid (NDGA) treatment in vitro. Methods　The morphological changes of human umbilical vein endothelial cells (HUVEC) cell line ECV-304 and the cell apoptosis rate in sub-G0 phase were observed with invert, light and electron microscope and flow cytometry after NDGA treatment at different concentrations or with PBS (0.01 mol/L) as control. Results　①After the treatment of NDGA at 50～200 μmol/L for 1～3 d or up to 8 d at 100 μmol/L, ECV-304 cells tended to elongate into a shuttle-like sparse appearance and those in mitosis were decreased, indicating the suppression of cell proliferation. All these alteration was in a time-and dose-dependent manner. ②NDGA-treated ECV-304 cells displayed morphological features of apoptosis, especially at the 48th h after the treatment. With flow cytometry, the cells in sub-G0 phase were significantly increased, and reached its peak at hour 12 (20.42%) after NDGA treatment. In addition, the degeneration and necrosis of ECV-304 cells were related to the concentrations of NDGA. Conclusion　NDGA can inhibit the proliferation and growth of endothhelial cells, and induce apopotosis, which might also inhibit angiogenesis.

Objective　To explore the effect of nordihydroguaiaretic acid (NDGA) on the expressions of vascular endothelial growth factor (VEGF) and its receptor, kinase-inserted domain containing receptor(KDR) and the possible mechanism. Methods　The expression of VEGF in human malignant glioma cell line SHG-44 and that of KDR in human umbilical vein endothelial cell (HUVEC) line ECV-304 were observed 1～3 d after NDGA treatment with immunohistochemistry, in situ hybridization and image analysis. Results　The expression of VEGF was declined at protein or mRNA levels in SHG-44 cells after treated with 100 μmol/L NDGA for 1 to 3 d. The expression of KDR in endothelial cells with 100 μmol/L NDGA treatment for 1 to 3 d was decreased too, in a more obvious way compared with the decline of VEGF expression in SHG-44 cells. Conclusion　The results suggest that NDGA inhibits the expression of VEGF in glioma cells as well as that of VEGF receptor KDR in endothelial cells, which may be the important molecular mechanism of anti-angiogenesis of NDGA.

Objective To investigate the NOTCH3 gene mutation and clinical features in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) families.Methods The clinical features of 4 CADASIL probands in Henan,China were analyzed retrospectively,and the incidences of other members in their families were investigated.The NOTCH3 gene mutations in the 3rd,4th,llth,and 18th exons were detected and the results were analyzed in the patients and some family members.Results Gene sequencing showed that 6 patients in 4 families and 1 mutant carrier had NOTCH3 gene R607C mutation in exon llth,they all met the clinical features of CADASIL.Three patients accompanied with vascular risk factors.The clinical stroke patients had unilateral limb weakness.All 5 patients with complete head MRIdata had thalamic infarction.Conclusions In the 4 CADASIL families of R607C mutation,the clinical features of 6 patients with CADASIL were similar,but there were individual differences in different family members.Imaging examination has important role in the diagnosis of CADASIL.The vascular risk factors,such as hyperte.

Objective To discuss the clinical characteristics and prognosis of lipoprotein glomerulopathy (LPG) in chil-dren. Method Clinical data of one pediatric LPG patient were retrospectively analyzed. The clinical features and prognosis of childhood LPG were summarized based on literature review. Results A nine years old girl presented with frequent urination. The ifrst urine test revealed hematuria and proteinuria. After one week anti-infection treatment, the hematuria and proteinuria were continued. The serum albumin was slightly reduced. The hyperlipidemia and mild anemia were emerged. Kidney biopsy showed that enlarged glomeruli, with dilated capillary loops and weak eosinophilic lipoprotein thrombi in the capillary lumina under the light microscope;layered or tuftedemboluscontaining particulated lipid vacuoles under electron microscope. Gene sequencing identified APOE Tokyo (Leu141-Lys143→0). The diagnosis of LPG was confirmed. The lipid-lowering therapy was administrated and the disease was alleviated. Conclusion LPG is a rare disease in children. The level of blood lipid was signiifcantly increased, and the hormone therapy was ineffective. Kidney biopsy is the main basis for diagnosis. The genetic testing can prompt the genetic background. Lipid lowering therapy can relieve the progress of the disease.