Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

The common pathogens and cases of secondary infection by acupuncture were classified and described, including staphylococcus aureus, mycobacteria, hepatitis virus and some sporadic infections. The above; cases were summed up according to the common pathogens of the secondary infection by acupuncture. Thus it illustrates the features of the secondary infection cases by acupuncture comprehensively and aims to enhance the infection knowledge of the medical staff in the hospital, so that the infection is effectively prevented in medical work.
Acupuncture Therapy ; trends ; Animals ; Bacterial Infections ; therapy ; Coinfection ; therapy ; Humans ; Virus Diseases ; therapy

The essence of twirling reinforcing-reducing method is discussed to provide theoretical guidance for clinical application of reinforcing-reducing method. Through retrospection on historical literature of twirling reinforcing-reducing method, records and explanatory notes are thoroughly explored. Several existing opinions are analyzed and explained for instance twirling method has connection with circulation direction of channels; twirling method is subdivided into right and left, male and female, hand and foot; twriling method is related to quantity of stimulus and operation time; twriling method belongs to spiral motion and so on. As a result, it is found that the key of twirling reinforcing-reducing method is the posture of needle-holding hand that defines three-dimensional motion. If twirling method is subdivided into right and left, male and female, hand and foot and so on, steric effects of lifting-thrusting movement that come along with twirling method could be ignored at the same time. It is that the essence of twirling reinforcing-reducing method is close to the principle of lifting-thrusting reinforcing-reducing method, enriching effect with slow insertion and fast withdrawal of needle while reducing effect with fast insertion and slow withdrawal, which is recorded in Miraculous Pivot: Nine needle and Twelve Yuan. With this principle as guide, manipulation could be avoided to become a mere formality and illusory metaphysics during clinical application of twirling reinforcing-reducing method.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

BACKGROUND:Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion.Therefore,a novel kind of drug stent,which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis,needs to be developed.OBJECTIVE:To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments.RETRIEVE STRATEGY:The retrieve staffs were the research personnel for this paper.A computer-based online search was conducted in PUBMED for English language publications containing the key words of "drug eluting stents,percutaneous coronary intervention,coronary disease" from January 2002 to April 2007.Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007.The number of total retrieved Iiteratures was 15.Inclusion criteria:①reports about drug stents;②reports on research progress in the field of drug stents;③reports on the clinical application of drug stents.Exclusion criteria:low relevance and duplicated articles.LITERATURE EVALUATION:There were 264 articles about research and clinical applications of DES.Of those,42 literatures and 5 conference reports with high relevance and timeliness were included in this report.DATA SYNTHESIS:An ideal DES is comprised of a platform,a drug carrier vehicle and a pharmaceutical compound in harmony with each other.Given the ongoing development of DES materials and drugs,more effective DESs are introduced in the clinical practice.Recently,clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions,such as chronic total occlusions,complex lesions and multivessel lesions.However,concern that DES may be associated with a risk of late thrombotic events arose,suggesting an imbalance between safety and efficacy of DES.Therefore,novel strategies including bioabsorbable stents,and stents coated with pro-healing agents are promising.CONCLUSION:The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease,especially for restenosis and revascularization.Nevertheless,more endeavour will be necessary to create DES with high efficacy as well as low risk.

First of all,all tutors as well as postgraduates should have concept of innovation.Secondly,favorable environment should be built up for innovative thoughts.Finally,tutors should try their best to cultivate students'innovative thoughts and direct their creationary practice.

Objective To investigate the clinical application of dezocine and remifentanil in elderly patients with painless gastroscopy.Methods According to random number table,180 elderly patients undergoing painless gas-troscopy were randomly divided into dezocine group(group D),remifentanil group(group R)and control group(group C),each group 60 cases.Group D was infusion with dezocine 20μg/kg,Group R was infusion with remifentanil 0.5μg/kg and Group C was infused with normal saline,then three groups patients,respectively,after the interval of 1 minutes were given propofol 1 mg/kg.Objects induced sum of propofol,starting time,awakening time,discharged time,HR,MAP and SpO2 during operation,sedation scores,postoperative side effects such as nausea and vomiting were observed.Results The decrease of MAP was alleviated in group D compared with group C and group S(tDR =2.278,PDR<0.05 and tDC =2.545,PDC <0.05).SpO2 in group C and group R were significantly lower than that in group D(tDR=2.184,PDR<0.05 and tDC =2.206,PDC <0.05).The time for regaining consciousness(tDC =5.401 and tRC =6.674)and propofol dosage(tDC =3.726 and tRC=4.213)in group D and group R were significantly lower than those in group C(P<0.05).The Ramsay of group D was (2.3 ±0.7)points,which was lower than (3.8 ±1.2) points of group C,(3.6 ±0.9)points of group R(tDC =8.938,PDC <0.01;tDR=7.154,PDR<0.01),and there were fewer adverse reactions in group D.Conclusion Dezocine is more suitable for the elderly patients than remifentanil, which has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.

Objective:To investigate the effect of NF-κB p65siRNA of IL-17 inducing the expression of MCP-1 in the primary cultured cardiac myocytes.Methods:The cardiac myocytes were isolated from neonatal mice by different adhesion method.NF-κB P65 siRNA was transfected into cardiac myocytes and the rates of transcription and translation of MCP-1 were detected by RT-PCR and enzyme-linked immunosorbent assay( ELISA) ,the rates of transcription and translation of P-P65 and P65 were detected by RT-PCR and Western blot.Results:Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were increased in negative siRNA +IL-17 group(P<0.05).Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA group( P<0.05).Compared with negative siRNA+IL-17 group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA+IL-17 group(P<0.05).The expression of the NF-κB P65 at mRNA and protein levels in cardiac myocytes were specifically and extensively suppressed by NF-κB P65 siRNA(P<0.05).After stimulated by IL-17,the amount of P-P65 in the cardiac myocytes was significantly increased in time-dependent manner compared with that of black group( P<0.05) , but the levels of P65 changed little ( P>0.05 ) .Conclusion: IL-17 stimulates MCP-1 expression in cardiac myocytes via NF-κB activation,and NF-κB P65 siRNA can effectively inhibit the upregulation of IL-17 on MCP-1.

Fast-track surgery is a new concept in general surgery nowadays.Fluid therapy,one part of fast-track surgery,is an important part,which go through with the whole perioperative process.Fluid therapy includes short time of fasting,no bowel preparation,appropriate postoperative fluid management,new monitoring technologies of hemodynamics,and so on.This new approach benefits preventing postoperative complications such as postoperative insulin resistance and cardiopulmonary failure.Still,this is a new concept which needs to be examed in clinical practices.In the future,the challenges lie within procedure-specific approaches,goaldirected therapy,the balance between the amount and composition of colloid vs crystalloid and the developments of the optimal techniques to monitor intra-and post-operative hemodynamics.

Objective:Observing the therapeutic effectiveness of Erhuangwendan Decoction and Yiqiyangyinningxin Decoction treating acute viral myocarditis.Methods: 344 cases were distributed into the therapeutic group(258cases) and the control group (86 cases). The treapeutic group were first given Erhuangwendan Decoction one packet per day, then Yiqiyangyinningxin Decoction one packet per day after acute attack. The control group were only given myocardial nutrient. All were given 3～6 months. We observed the symptoms,signs ang EKG of the two groups. Results: The effective rate of the therapeutic group was 40% after 3 months. And it was 84% after 6 months. The effective rate of the control group was 15% after 3 months. And it was 34.8% after 6 months. The two groups have obvious difference( P