To get information about the status of use of oral hypoglycaemic agents in an inland and coastal hospitals,the ordes of total cost and DDDs were employed to compare the use of oral hypoglycaemic agents in an inland hospital and a coastal hospital.Our results showed that the much less biguanides were used in the coastal hospital as compared with the inland hospital.It is conclinical practice included dimethyl biguanide,glipizide,gliclazide and glibenclamide.

Objective To observe the effect of mirror therapy and sensory reeducation on sensory function recovery after thumb recon-struction with second toe transplantation. Methods Forty patients after thumb reconstruction with second toe transplantation from January, 2011 to January, 2014 were divided into control group (n=20) and training group (n=20). Both groups accepted routine nursing and rehabili-tation, while the training group accepted mirror therapy and sensory reeducation training in addition. They were followed up for six to eigh-teen months after operation (average 9.3 months) with the two-point discrimination (2-PD) of transplanted toe pulp. Results 2-PD was (7.15±1.15) mm in the training group, very shorter than (10.23±2.23) mm of the control group (t=5.4898, P<0.001). Conclusion The mirror therapy combined with sensory reeducation training can improve the sensory function of the finger pulp that transplanted from the second toe.

Objective Colonic short chain fatty acids(SCFA) may maintain colonocyte differentiation and oppose carcinogenesis, although its precise mechanisms remain unclear. The purpose of this study is to investigate SCFA regulation of intestinal epithelial phenotype by characterizing the effects of three kinds of SCFA on differentiation,proliferation,and migration of human colonic adenocarcinoma cell line Caco-2 and discuss its clinical value. Methods Differentiation was assessed by brush border enzyme expression, doubling time (proliferation) calculated directly from serial cell counts and logarithmic transformation method. Cell motility(migration) was quantitated by the expansion of a confluent Caco-2 monolayer(after release from a constraining fence) across bacteriologic plastic dishes precoated with saturating concentrations of type Ⅰ collagen. Results All three SCFA studied altered the Caco-2 phenotype. Treatment with 10 mmol/L SCFA significantly prolonged the cell doubling time, promoted brush border enzyme expression(cathepsin C), and inhibit the motility of the Caco-2 cells. Conclusion The SCFA butyrate, propionate, and acetate inhibit the proliferation and motility of a well-differentiated human colonic cancer cell line while promoting the expression of the differentiation marker cathepsin C. The SCFA produced by bacterial fermentation of dietary fiber may exert a protective effect against the development of colon cancer.

Objective To explore the clinical nursing methods for the treatment of the skin degloving injury in foot by the combination of free femoral anterolateral skin flap transplantation and vacuum sealing drainage (VSD) technique. Methods From January 2010 to January 2014, 18 cases of the skin degloving injury in foot were treated by debridement and implant skin, negative pressure drainage and irrigation at first period, then the operation to repair the foot wound by transplant femoral anterolateral skin flap were done at second period. Nurses applied the key technology of VSD into postoperative nursing. Nurses should master the observation method and characteristics for the flow of blood to the flap skin, the method for foot position nursing, afford effective analgesic care, and flap local high flow oxygen therapy,improve the local tissue oxygen partial pressure and introduce the foot early functional exercise during postoperative. Results Eighteen cases flaps all survived. Clients were followed-up for 6 to 12 months,the discovery showed that all of the clients had good flap blood supply,the skin was soft and elastic,and the function of foot were recovered well. Conclusions The combination of of free femoral anterolateral skin flap transplantation and VSD technique apply into foot degloving injury repairation postoperative care,by application of high quality nursing, it really can improve the success rate of surgery and reduce the pain for clients.

OBJECTIVE:To investigate the optimal administration route of ambroxol in the treatment of pediatric respiratory disease. METHODS:Totally 120 children with respiratory disease in pediatric department of our hospital during Jun. 2014-Jun. 2016 were divided into intravenous dripping group and atomization inhalation group according to even and odd-numbered admission order,with 60 cases in each group. Intravenous drip group was given Ambroxol hydrochloride injection 7.5 mg dissolved in 5%glucose solution 50 mL,ivgtt,bid;aerosol inhalation group was given aerosol inhalation of Ambroxol hydrochloride injection 7.5 mg,for 15 min each time,bid. The two groups were treated with 7 d. Clinical efficacies,p(O2)and p(CO2)level,the times of sputum absorption,clinical indexes and the occurrence of ADR were compared between 2 groups. RESULTS:Total response rate of atomization inhalation group(96.67%)was significantly higher than intravenous dripping group(78.33%);p(O2)level was sig-nificantly higher than intravenous dripping group,while the times of sputum absorption,fever disappearance time,asthma disap-pearance time,oxygen therapy time,pulmonary rales disappearance time,cough disappearance time and average hospitalization time were significantly less or shorter intravenous dripping group,with statistical significance (P<0.05). There was no statistical significance in p(CO2) level and the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Ambroxol is effective in the treatment of pediatric respiratory disease,and clinical efficacy of atomization inhalation is better than intravenous drop.

Purpose: The purpose of this study was to assess the method of compartment resection and evaluate its application to patients with extremity soft tissue sarcomas. Methods: From 1997 to 2002, 10 cases of thigh sarcoma underwent this operation (7 cases of posterior compartment and 3 anterior compartment) while 2 cases with upper limb disease received similar resection. Results: All the limbs of this group with such tumors were preserved. We followed up the 12 patients in the range of 10 to 60 months, 10(82%) were alive without tumor recurrence or metastases. One patient local with recurrent tumor is receiving radiotherapy now and another died from distance metastases. Conclusions: This improvement in the rate of limb -preserving resection in our series has been the result of compartment resection.

Objective To explore the indications of simultaneous pancreas-kidney (SPK) transplantation for type 2 diabetes mellitus (DM) combined with end-stage renal disease by comparing the outcome of patients with type 1 and type 2 DM combined with end-stage renal disease after renal transplantation.Methods 109 patients accepting SPK from January 2008 to July 2016 in our center were divided into two groups according to the types of DM:T1DM (n =36),and T2DM (n =73).The basic characteristics of recipients,outcome,and pancreas and kidney functions after operation were compared between two groups.Results There was no significant difference in 5-year survival rate and surgical complications between two groups although recipients of T2DM group were older and had higher BMI than T1DM group.But rejection rate was higher in T1DM group.Conclusion SPK for T2DM recipients will not increase the surgical risk and can get good long-term outcome.

Objective To discuss the influence of psychological nursing on the therapeutic effect of patients with newly diagnosed type 2 diabetes. Methods Patients (60 cases) who received psychological nursing were set as the nursing group. Patients (65 cases) who did not received psychological nursing were set as the control group. The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment was observed. Results The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment in the nursing group was higher than that of the control group (P<0.01). Conclusions Psychological nursing of patients with newly diagnosed type 2 diabetes could make patients obey doctors' advice and accept early insulin treatment to control plasma glucose and delete the toxicity of high concentration of plasma glucose as soon as possible.

Objective Measure the variation trend and the problems of bed allocation and its equity at primary medical institutions and provide theoretical basis for optimizing the policy of health resources allocation for the government.Methods Analysis of the distribution and equity of the inpatient beds at primary medical institutions in terms of geographical area by means of the survey of regular overall statistics forms and the methods of Gini coefficient and Theil index.Results From 2009 to 2012,the number increase of beds at such institutions geographically was 7.72%,while that in eastern,central and western regions of China were respectively 5.35%, 3.97% and 27.88%.The number increase at community healthcare centers was 46.58%,while that in eastern,central and western regions of the country were respectively 18.09%,29.57%和 81.53%.The number increase at township hospitals was 2.33%,while that in eastern,central and western regions were respectively - 3.83%,- 0.43% and 22%.The Gini coefficient of bed allocation at such institutions was beyond 0.6,while that in eastern, central and western regions were respectively under 0.3,0.3-0.4 and 0.6 above.The Gini coefficient of bed allocation at community healthcare centers fell from above 0.4 to under 0.4.The Gini coefficient in the western regions increased from 0.3-0.4 to over 0.4.The variation trend of township hospitals was similar with the overall conditions at such institutions.The intra-regional Theil indexes and their contribution rates of bed allocation at such institutions were higher than those of inter-regional. Conclusions The overall variation trend of bed allocation at such institutions was on the rise,yet its variation trend of equity remains unchanged.The bed allocation and its equity at such institutions were higher than those at township hospitals.The growth rate in western regions was the highest,but the absolute number was the lowest.Moreover,the equity of bed allocation in such regions was not only the lowest,but also was found rising.The influence of bed allocation in intra-region terms was large,while its equity was not only lower but falling as well.

This paper introduces the history of Ilizarov technology,led to the design and application of Bone Lengthening Growth Diary,and describes the specific application effect.On this basis,to think about Bone Lengthe-ning Growth Diary’ clincial application:constantly improve the nurses’ professional level; follow the basic princi-ples of medical ethics;strengthen the doctor-patient communication and humanstic care.