Premixed insulin is currently the most popular insulin starter in China.According to the different ratios of basal and prandial components,premixed insulin analogues could be classified into low-and midmixtures.The former is now mainly used as insulin starter in the patients with type 2 diabetes mellitus after the failure of monotherapy or combination with oral antidiabetic drugs,while the later is usually used as simplified intensive insulin treatment in patients with type 2 diabetes mellitus inadequately controlled on insulin once-or twice-daily.

ObjectiveTo investigate the clinicalefficacy of warm needling plus Chinese herb fumigation in treating plantar fasciitis.MethodSixty-one patients with plantar fasciitis were randomly allocated to a treatment group of 31 cases and a control group of 30 cases. The treatment group receivedwarm needling plus Chinese herb fumigation and the control group, warm needling alone.ResultThe total efficacy rate and the cure rate were 100.0% and 61.3%, respectively, in the treatment group and 96.7%and 40.0%, respectively, in the control group. There was no statistically significant difference in the total efficacy rate between the two groups (P>0.05), but the cure rate was significantly higher in the treatment group than in the control group and there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P<0.01), indicating that both the groups had a good analgesic effect. There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P<0.01), indicating that theanalgesic effect was better in the treatment group than in the control group.ConclusionThe efficacy of warm needling plus Chinese herb fumigation is better than that of warm needling alone in treating plantar fasciitis.

Objective: To study the effect of esomeprazole in treating elderly patients with NSAIDs correlated peptic ulcer bleeding. Methods: Patients with NSAIDs correlated peptic ulcer bleeding in our hospital from January, 2010-December, 2012 were enrolled and randomly divided into observation group given esomeprazole and control group given omeprazole. Then the baseline data were surveyed and effect of ulcer bleeding, condition of abdominal pain alleviation and ulcer ulcer, adverse reaction cases were observed. Results: (1)there were no significant difference between the baseline data of two group;(P>0.05);(2)in observation group, excellence rate was 42/70(60%), effective rate was 24/70(34.3%), the overall treatment effect was better than that of control group, the difference had statistical significant(P<0.05);(3)there were no significant difference between two group of abdominal pain and ulcer healing;(4) during treatment, there were no serious adverse reactions in the two groups. Conclusion:Compared with omeprazole, esomeprazole has equal effect on abdominal pain relief and ulcer healing, and it is much more effective in treating elderly patients with NSAIDs correlated peptic ulcer bleeding.

Pyroptosis is a newly discovered form of programmed cell death, which has a close relationship with infectious diseases and spontaneous inflammatory disease and autoimmune disease.Gasdermin-D is the effector of pyroptosis.Inflammatory caspases cleave Gasdermin-D, break the structural autoinhibition and active the pore-forming activity of Gasdermin-D.Gasdermin-D-N domain is the active form of Gasdermin-D.Oligomerized Gasdermin-D-N domain forms membrane pores.Both pyroptosis and necroptosis can form pores.In this article, the progress of the research on pyroptosis, the involvement of Gasdermin-D in the molecular mechanism of pyroptosis, the distinguishment of pyroptosis from necroptosis and pyroptosis-related diseases are reviewed.

Objective To realize centralized supply of hospital compressed air to reduce repeate investment.Methods Air turned into compressed one after passing through air pressure pump, which undergoes preliminary cooling and drying by refrigerated drier, then the compressed air went into air tank for further cooling and storage, and finally was transmitted into hyperbaric oxygen chamber, ICU and operating room as desired.Results Centralized supply was realized for hospital compressed air with little technical modification and investment.Conclusion The compressed air of hyperbaric oxygen chamber is introduced into ICU and operating room and gains economic and social benefits, and thus is worth popularizing practically.

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

Micro-syringe as a result of the high frequency of clinical use, direct contact with patients, the failure of its equipment will have a direct impact on the patient's disease status. Researchers in this paper, by simulating the test fluid, electrical safety testing and analysis of statistical methods such as maintenance records, consider six kinds of common injection pump, in terms of performance, safety and the failure rate of three performance. Compared the performance analysis, summarized the various types of injection pump characteristics, researchers make suggestions to clinical departments, equipment procurement and equipment management departments for usage and improvement.
Equipment Failure ; Equipment Safety ; Syringes

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI:1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI:1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI: 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI: 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.

Objective To explore the expression of angiopoietin like protein-1(Ang-1)and angiopoietin like protein-2(Ang-2)in type 2 diabetes mellitus(T2DM)and its relationship with angiopathy.Methods Ang-1,Ang-2,FBG,FINS and HbA1c were meas-ured in 120 cases of T2DM,including 32 cases of macroangiopathy,52 cases of microangiopathy and 36 cases without angiopathy, and 50 healthy subjects with physical examination were selected as the control group.The detection results were compared between the two groups.Results Compared with control group,the Ang-1 level in the T2DM group was no statistical difference(P >0.05), but the Ang-2 level was significantly higher than that in the control group(t=2.6,P <0.01).The Ang-2 level in T2DM with com-plicating angiopathy was significantly higher than that in T2DM without angiopathy and closely correlated with the blood vessel number of angiopathy.The Ang-2 level in T2DM was significantly positively correlated with HOMA-IR and HbA1c(r=0.577 and 0.509,P <0.01),and there was no correlation between the Ang-1 level and HOMA-IR(P >0.05).Conclusion The Ang-2 level in the patients with T2DM is significantly increased,which is closely related with HbA1c and insulin resistance,furthermore Ang-2 may participate in the generation and development of pathogenesis in T2DM.

BACKGROUND: Studies have shown that after bone marrow stem cell transplantation, there are juvenile cells with the episode of myocardial cells around the infarct areas, which was recognized as deriving from bone marrow stem cells.OBJECTIVE: To explore the homing situation of bone marrow stem cells by autologous mobilization around the infarct areas aftar myocardial infarction.DESIGN, TIME AND SETTING: The cytological in vitro study was performed at the China-Japan Clinical Pathology Center, Daliar Medical University from February 2005 to April 2006.MATERIALS: A total of 30 myocardial samples from the autopsy at the Department of Pathology and Forensic Medicine, Dalian Medical University between 2000 and 2005. Fifteen normal samples dyed from the mechanical injuries or craniocerebral injury,without abnormity following autopsy. Fifteen samples in the myocardial infarction group suffered from coronary atherosclerosis and coronary tube stenosis, and died within 10 days after myocardial infarction.METHODS: The autopsy was performed within 48 hours after the death and the tissues were obtained from antedor wall, lateral wall and posterior wall of the left ventricle, and made into tissue sections. We checked the expression of CD34, CD133 and transforming growth factor-β, in the normal area, infarct area and around the infarct area by immunohistochemistry.MAIN OUTCOME MEASURES: The expression of CD34, CD133 and transforming growth factor-β in different areas and the relationship between them.RESULTS: The positive expression of CD34 in infarct area was significantly stronger than that around the infarct area and in normal area (P < 0.01). The positive expression of transforming growth factor-β in infarct area was significantly stronger than that around the infarct area (P < 0.01), and the expression of transforming growth factor-β showed negative reactJon in normal area. The expression of CD34, CD133 and transforming growth factor-β, in infarct areas and around the infarct area was closely related (P < 0.01).CONCLUSION: There are the homing of bone marrow hemopoietic stem cells in infarct area and around the infarct ares after myocardial infarction. The increase in transforming growth factor-β in infarct area provides the possibility for the differentiation of the homing stem cells, the following angiogenesis and the regeneration of cardiomyocytes.