Objective To investigate the relationship between glucose variability and severity of coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM).Methods One hundred hospitalized patients with T2DM(55 males and 45 females,39-81 years old) who had undergone angiography were included in the study from February 2012 to October 2012.They were divided into 2 groups:(1) 60 patients with coronary heart disease(CHD)as experimental group and (2) 40 patients without coronary heart disease as control group.All participants underwent selective coronary angiography to evaluate the severity of coronary artery stenosis (Gensini score) and continuous glucose monitoring(CGM) for 72 h.The correlation was analyzed between biochemical findings,and Gensini scores between the 2 groups.The comparison between 2 groups was performed with LSD test,correlation analysis with Pearson correlation and multiple stepwise regression analysis.Result Compared with the levels of largest amplitude of blood glucose excursion (LAGE),standard deviation of blood glucose (SDBG),mean amplitude of glycemic excursion (MAGE),postprandial glucose excursion (MPPGE),and absolute means of daily differences (MODD) in control group [(8.1 ± 2.1),(1.9 ± 0.5),(4.8 ± 1.3),(4.5 ± 1.4),and (2.4 ± 0.8) respectively],the levels in the experimental group[(11.3 ± 3.5),(3.2 ± 1.2),(7.0 ± 2.6),(6.4 ± 1.9),and (3.1 ± 1.3)] were higher respectively.MPPGE,MODD,LAGE,and C-reactive protein(CRP) were positively related to Gensini score(r were 0.498,0.246,and 0.227,all P＜0.05),while left ventricular ejection fraction (LVEF) was negatively related to Gensini score(r=-0.261,P＜0.05).Multiple stepwise regression analysis indicated that MPPGE and LVEF were independent risk factors of Gensini score (Y =59.727 + 11.779 × MPPGE-1.437 × LVEF).Conclusion Glucose variability in patients with T2DM and CHD was markedly enhanced.MPPGE was positively correlated with the severity of coronary artery stenosis in patients with T2DM and CHD.

Objoctive To investigate circulating leveh of soluble vascular cell adhesion molecule-1(sVCAM-1)in the peripheral of intrahepatic cholestasis of pregnancy(ICP).To reveal the pathogenesis of ICP.Methods Maternal scram sVCAM-1 levels were determined in 49 women which 15 eases were normal pregnant women and 34 with ICP.The latter were composed of 14 women with mild,20 with severe ICP.sVCAM-1 was measured by ELISA.Results The levels of serum sVCAM-1 was significantly elevated in women with mild and severe compared with control subjects(P＜0.01),and markedly decreased to normal 5 days after dilively(P＞0.05).The sVCAM-1 level were negatively correlated with weight of neonatal(r=-0.643,P＜0.01).Conclusion Elevated levels of sVCAM-1 indicate that a primary endothelial cell dysfunction play an important role in the ICP.And it influences the neonatal.

Medicated diet has a long history in China. It is a special dietary form under the guidance of basic theo-ries of traditional Chinese medicine (TCM). This article discussed the characteristics, hot spots and methodological development of current study on medicated diet. It also discussed on current misunderstandings on the study of med-icated diet, such as lack of the guidance of systematic theory, not well-formed system, lack of professional personnel and their limitations, in order to promote the subject development of medicated diet.

0.05).CONCLUSION:Mecobalamin and buflomedil hydrochloride are more economic than alprostadil,while mecobalamin more economic than bu?flomedil hydrochloride.

The hospitalpice enterprise has developed vigorously in China ever since 1980s.However,influenced by the long history and traditional Chinese culture,there are some ethical dilemmas in the issues of choice of death and palliative treatment.Choice of death and palliative treatment for the dying patients have been restricted by the traditional Chinese philosophy of death,traditional principles of filial piety,and the absence of support from euthanasia legislation.It is suggested that during the introduction of hospitalpice into china,the traditional Chinese value be respected.Meanwhile,people's cognition of hospitalpice should also be shifted to decrease the constraint of traditional ideas.The whole social power should be united and professional regulation construction should also be strengthened.Besides,it is also important to improve training for related professionals,promote the process of hospitalpice legislation as well as go abide by the current laws in order to achieve a high-quality hospitalpice.

Objective To comfirm the importance of WHO"warm chain" by investigating neonatal body temperature after birth.Methods Axillary temperatures of 302 neonates born in our hospital in spring,summer and winter of 1995 were monitored immediately after cord ceased and 1,2,4,6,8,10,12,14,16,18,20,22,24,48,and 72 hours after birth.The incidence of low body tem- perature in each time was calculated.Resultes The time after birth that average body temperature need to reach 36.5℃ was ten hours in spring,14 hours in summer and winter.The incidence of low body temperature at 2 hours after birth in summer was 95 %,at 6 hours in winter was 97%.The in- cidence of low body temperature at 72 hours were still 16% in spring,34.1% in summer and 27.7% in winter respectively.Conclusion Key point in carrying out"warm chain"is to enhance the re- sponsibility of medical staff not only in rural hospitals,but also in urban hospitals.

Objective To investigate the impact of carotid atherosclerotic plaque on short-term outcomes of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF).Methods A total of 288 patients with acute cerebral embolism due to NVAF were recruited in this study.All patients underwent carotid ultrasonography screening to estimate carotid intima-medium thickness (IMT) and atherosclerotic plaque.The short-term outcomes were assessed.The correlation between carotid atherosclerotic plaque and short-term outcomes of cardioembolic stroke due to NVAF were determined by partial correlation analysis.Results Among the 288 patients,carotid atherosclerosis occurred in 202 cases (70.1％) of the patients,poor outcomes in 113 cases (39.1％),worsening neurological function in 43 cases(14.9％),and stroke recurrence in 24 cases(8.3％).Carotid atherosclerosis plaque was positively associated with neurological worsening (r =0.247,P =0.000) and poor outcomes (r=0.139,P=0.018).The use of aspirin was negatively correlated with both neurological worsening (r=-0.235,P=0.000) and recurrence of stroke (r=-0.177,P=0.003).The use of statin was negatively correlated with recurrence of stroke (r =-0.223,P =0.000),neurological worsening (r=-0.147,P=0.013) and poor outcomes (r=-0.286,P=0.000).Conclusions Carotid atherosclerotic plaque is an independent predictive factor for poor short-term outcomes of cardioembolic stroke due to NVAF,and the aggressive management for carotid plaque can improve the poor short-term outcomes.

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of sudden hearing loss.Methods Total of 58 patients with sudden hearing loss were ran-domly divided into two groups.The systemic application group:dexamethasone (DEX)was applied by intravenous injection in dose of 10mg ×3d,followed by 5mg ×4d.And the postauricular injection group:methylprednisolone sodium succinate of 40mg was injected into cortical bone of mastoid region every three days,until hearing back to normal,or 15 days.SPSS 13.0 software was used to analyze the data.Results The total effective rate of systemic application group was 67.7%,the total effective rate of postauricular injection group was 64.7%.There was no statistical differ-ence between the two groups (χ2 =2.58,P =0.316).The recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group,but no statistical difference between the two groups(t =2.71,P =0.062).Patients with hearing loss in low frequencies(250Hz,500Hz),the recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group (t =3.82,P =0.031;t =3.26,P =0.042).Conclusion Postauricular topical injection and systemic application of glucocorticoids in the treatment of sudden hearing loss are all have good curative effect.Systemic application is select-ed by conventional treatment,and topical injection has a better effect in the hearing loss of low -middle frequencies.

Objective To explore the role of 256 CT iterative reconstruction in improving image quality and reducing radiation dose of carotid artery into cranial segment.Methods Sixty patients underwent head and neck CTA on a 256 CT scanner.Conventional dose scanning was performed in 30 patients using a filtered back projection (FBP) reconstruction (group A) and iterative iDose4 reconstruction (group B).Low dose scanning was performed in the other 30 patients using FBP reconstruction (group C) and iDose4 reconstruction (group D).The noise,SNR,CNR,score of image quality and effective radiation dose were evaluated in four groups.One-way ANOVA was used to analyze the image quality index between groups.Independent sample of Kruskal-Wallis test of ranked data was used to compare image quality score between groups.Paired t test was used to compare the effective radiation doses between the low dose group and conventional dose group.Results The image noise of four groups were 8.21 ±0.88,7.31 ± 0.33,11.17 ± 2.02 and 6.50 ± 0.49 respectively.SNR were 43.21 ± 4.49,5 1.83 ± 3.64,42.88 ± 9.19 and 53.47 ± 4.88,respectively.CNR were 37.88 ± 4.02,61.21 ± 6.31,36.63 ± 8.20 and 62.99 ±5.90,respectively.There were statistic differences (F =112.786,97.041 and 86.098,P ＜0.01).The differences of image noise between group A and B had no statistic significance,which was statistic different between group A and C (P ＜ 0.01).Except that the differences of SNR and CNR between group A and C,B and D had no statistic significance,the differences between other two groups had statistic significance (P ＜ 0.01).In case of image quality score of 1,2 and 3,there were 2,13 and 15 patients in group A; 0,7 and 23 patients in group B; 5,15 and 10 patients in group C; and 0,5 and 25 patients in group D.There was statistic differences of image quality score between each group (H =22.575,P ＜0.01).The effective radiation dose was (2.31 ±0.13) mSv in conventional dose group and (0.84 ±0.04) mSv in low dose group.There was statistic difference between the two groups (t =60.682,P ＜ 0.05).Conclusion Compared with conventional dose,iDose4 iterative reconstruction algorithms can obtain excellent images of CTA for carotid artery into the cranial segment with more than 50％ radiation dose decrease.

BACKGROUND:The third molar extraction may lead to different degrees of soft tissue damage. Ultrasound and ultrashort waves belong to hyperthermia, which can increase tissue temperature and improve the therapeutic efficacy of soft tissue stretch. OBJECTIVE:To observe the effects of soft tissue stretch combined with ultrasound and ultrashort wave therapy for patients who were recently diagnosed with trismus and pain folowing third molar removal. METHODS:Sixteen patients with trismus and pain after third molar removal were randomly divided into two groups: patients in stretch group received soft tissue stretch with ultrasound and ultrashort wave therapy, while those in control group received only ultrasound and ultrashort wave therapy. Patients received the treatment five times per week, totaly for 2 weeks. RESULTS AND CONCLUSION:It was found that after treatment pain was significantly reduced at the temporomandibular joint, and the range of maximum active mouth opening increased significantly. The improvement in mouth opening and temporomandibular joint function was better in the stretch group than the control group. These findings indicate that ultrasound and ultrashort wave therapy can improve symptoms of trismus and pain folowing third molar removal, and the combination of ultrasound and ultrashort wave therapy and soft tissue stretch therapy can achieve more effective results.