Objective To investigate the insulin dosage and analyze the dosage-impacting factors of intensive insulin treatment in Chinese type 2 diabetic patients.Methods Totally 1025 patients with intensive insulin treatment were included,the insulin dosage and clinical characteristics were taken down and analyzed.Results The mean insulin dosage was 39.30U/day,the insulin dosage per kg of body weight was 0.61U/Kg,among which the dosage of intermediate-acting insulin was 9.79 U/day,occupying 25.24%,while the pre-meal one was 29.51 U/day,occupying 74.76%.According to the insulin dosage per kg of body weight,patients were divided into low dosage group and high dosage one.The result showed significant difference in period of diabetes,BMI,HbA1c,and the highest weight level between the two groups.Correlation analysis showed that the average insulin dosage per kg of body weight was positively correlated with period of diabetes,HbA1c,fasting glucose level and LDL-C,while negatively correlated with BMI,fasting and postprandial C-peptide,the highest body weight level and HDL-C.Conclusions The average insulin dosage for type 2 diabetic patients is 39.30U/day,among which the dosage of intermediate-acting insulin occupies 25% while the pre-meal one occupies 75%.The insulin dosage is positively correlated with period of diabetes and HbA1c,while negatively correlated with BMI and the highest body weight level

Objective To analysis and research the clinical pathological characteristics with papillary thyroid carcinoma(PTC)and nodular goiter.Methods 100 cases with thyroid disease were selected,the preoperative ultra-sound diagnosis and pathological diagnosis results were compared,and pathological features were analyzed.Results Ultrasound results:ther were 72 cases with PTC,and 28 cases with NG,and pathologically confirmed 48 cases with PTC,52 cases with NG.The difference of two diagnostic result was statistically significant (χ2 =5.263,P <0.05). Compared with 48 PTC cases,the ratio of single nodule in 52 NG patients was smaller,while multiple nodules and cystic lesions proportion were higher,the differences were statistically significant (χ2 =58.19,73.97,25.40,all P <0.05).PTC was characterized by solid nodules of gray matter,often located near the thyroid capsule.Large tumors may be cystic.NG was characterized by single or multiple nodules,with different size,and some nodules with incomplete capsule,some with thick fibrous capsule.Nodular cystic necrosis hemorrhage was common.Conclusion Ultrasound diagnosis and can make a more accurate judgment between NG and PTC,but there are still misdiagnosed on the two diseases,for PTC and NG accurate judgment also need to rely on pathological identification,so grasping the pathologi-cal features of both can improve diagnostic accuracy.

Objective] To summarize the diagnosis and treatment of Professor Cai Wanru, famous Chinese medicine doctor of the state, the tutor of doctoral student in treating bronchial asthma. [Method] The author studies from the teacher, col ecting medical records, analyzing and learning the dialectical thinking and prescriptions of Professor Cai during treating bronchial asthma. [Results] According to the different stages of bronchial asthma, Professor Cai adopts the combination of differentiation and disease differentiation, uses Chinese medicine to treat bronchial asthma. We should clean lung and phlegm, smoothen breathing during exacerbation of asthma, invigorate the spleen and tonify the lung qi during remission of asthma, at the same time advocate treating winter disease in summer during consolidating period. In addition, clearing lung and regulating Qi should be used throughout al the course of disease. Professor Cai is good at using drug pairs and Chinese medicine flexibly, simply, effectively. [Conclusion] Professor Cai Wanru has been engaged in clinical respiratory department of internal medicine for a long time, having rich experience and unique insights on bronchial asthma, chronic cough, chronic obstructive pulmonary disease and other common respiratory system disease, worth learning.

Objective To investigate the prevalence and risk factors of diabetic retinopathy(DR) in Chinese elderly diabetic patients. Methods One hundred and ninety patients with type 2 diabetic aged 60 years and over,including 93 males and 97 females were selected.The average age was 68.9 years and the average diabetic duration was 11.5 years.HbA1c,insulin,C-peptide and other clinical characteristics in all patients were tested.The retinopathy of the patients were examined by the retina-camera. Results There were 103 patients without deabetic retinopathy,59 patients carrying nonproliferative deabetic retinopathy and 28 patients carrying proliferative diabetic retinopathy.The above three groups had statistically different diabetic duration((121.1?93.2) vs(149.6?112.1) vs(182.2?83.5)months,P

OBJECTIVE:To observe the changes of lipid oxidation and polyol pathway metabolism of rat erythrocytes cultured in high glucose medium and intervention effect of metformin.METHODS:Rat erythrocytes were cultured in high glucose medium and the content of sorbitol in erythrocytes and the content of NO in culture medium were determined.The effect of metformin at different concentrations(2?10-5 mol?L-1,4?10-6 mol?L-1,8?10-7 mol?L-1)on the level of sorbitol and NO were studied with rat erythrocytes cultured in low glucose medium as normal control.RESULTS:Compared with normal control group,the level of sorbitol in high glucose group was increased while the content of NO was decreased(P

Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.

Objective To evaluate the value of multi-slice spiral CT in nasal endoscopic surgery.Methods The multi-slice spiral CT data of 232 patients who were scanned prior to nasal endosopic surgery were analyzed.Results The nasal and sinus disease could be diagnosed correctly with multi-slice spiral CT.The ostiomeatal complex and the channels of the frontal sinus' drainage could be showed clearly.All the manifestation of the multi-slice spiral CT was in correspondence with the endoscopy showed in the surgery.Conclusion The multi-slice CT has the advantages of short scan time,less radiation dosage and multiplanar reconstruction.So it can display the nasal and sinus structures in detail,and has a great value in guiding the nasal endoscopic surgery.

0.05),while were significantly increased in the Group G(P0.05) while remarkably increased in the Group G(P

[Objective]To analyze the result of mini-type T plate for treatment of Mason type-III radial head fracture.[Method]Seven cases of Mason type-Ⅲ radial head fractures,6 male and 1 female,including 2 cases with radial neck fractures,were treated by open reduction and mini-type T plate fixation associated with Kirscher wires.If necessary,bone graft was placed between radial head and neck.[Result]The patients were followed up for an average of 20.3 months(ranged from 14 to 39 months).All fractured radial heads were heal and no case appeared ischemic necrosis.According to the Brobrg and Morrey functional elbow index,the averaged score was 87 points and the outcome was excellent in 2 patients,good in 4,the excellent and good rate was 85.7%.[Conclusion]Treatment of Mason type-Ⅲ radial head fractures by open reduction,mini type T plate fixation assocated with Kerscher's wire and autogenous bone graft showed a high union rate of fracture and satisfactory joint function but no ischemic necrosis with the advantages of reservation of radial head and decreasing the rate of re-section and prosthesis replacement.Further observation should be taken to get more clinical cases number.

[Objective]To discuss the surgical treatment of huge tumor invovled sacrum.[Method]A review of records in 18 patients with tumors invovled sacrum was made.Age at surgery averaged 43 years(range:31~65),eleven patients were male,seven patients were female.In this series,malignant tumor was in 14 cases,according to Enneking classification,these cases were classified toⅠA~ⅠB subtypies,which concluded chordoma(8 cases),giant cell tumor(5 cases)and osteochondroma(1 case).Benign tumor was in 4 cases with neurogenic tumor(3 cases)and aneurysmal bone cyst(1 cases).[Result]Over all,no patients were dead in the operation,no other major complications were occurred,the blood loss during surgery was 1 000 ml to 5 000 ml.All incisional wound were primary healing except 4 cases,two of them gained secondary closure after gluteus maximus pushing flap.Eighteen patients gained follow-up visiting,the average time of follow-up was 30 months,only 2 cases were tumor recurrence.[Conclusion]Huge tumors invovled sacrum present a great challenge,because of many organs surrounding sacrum invovled and complexity in anatomic region,sacrectomy of sacral tumor always complic generous blood loss,disorder of urination and defecation,disorder of sexual function et al.Abdominosacral approach can lead to a safer and relative radical local control of tumor,it is benefit to protect blood vessel and nerves.