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.

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.

Objective To investigate the recognition of graded nursing and its influencing factors among nursing assistants in elder homes.Methods A questionnaire survey was conducted on 116 nursing assistants.Results The nursing assistants showed insufficient recognition of graded nursing,there were significant differences in role cognition,operation and practice training,salary,and the nursing workload,there were no significant differences in working years and educational levels.Conclusions The recognition of graded nursing was insufficient.It is suggested to increase the role cognition education,enhance the theory and practice training,provide higher salaries and allocate workload reasonably to ensure the implementation of graded nursing and increase the satisfaction level of the elderly.

Objective To observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia (VAD).Methods Eighty cases with VAD were randomly divided into the treatment group (40 cases) and the control group (40 cases).The control group were given 30 mg nimodipine for three times a day ;The treatment group was given additionally three times a day of 0.2 g butyiphthalide for 12 consecutive weeks.The Mini-Mental State Examination (MMSE),Clinical Dementia Rating (CDR),and Activities of Daily Living (ADL) scores were used for the assessment of cognitive function.The assessments were done before and after treatment.The adverse effects were also recorded.Results In the treatment and the control groups,the MMSE,CDR and ADL scores (MMSE:23.17 ± 1.89,19.43 ± 2.04; CDR:1.06 ± 0.11,1.21 ±0.50;ADL:40.11 ±5.10,41.22 ±4.80) after treatment were significantly improved than those (MMSE:16.54 ± 1.98,16.28 ± 2.11 ; CDR:1.78 ± 0.25,1.75 ± 0.31 ; ADL:47.45 ± 5.22,46.75 ± 5.31) (MMSE:t =2.42,P ＜0.05,t =2.34,P ＜0.05 ;CDR:t =1.67,P ＜ 0.05,t =1.54,P ＜0.05 ;ADL:t =6.73,P ＜0.05,t =5.24,P ＜ 0.05) before treatment.After 12 weeks of treatment,the MMSE,CDR and ADL scores in the butyiphthalide group were significantly improved than that in the control group (t =1.85,1.84,5.91,respectively; P ＜ 0.05).No serious adverse events were recorded during the treatment.Conclusion Butyiphthalide and nimodipine can prominently improve,better than nimodipine alone,the cognitive function of patients with vascular dementia.Moreover,its security and tolerability are good.

Objective To observe the effect and safety of ambroxol combined with antibiotic in treatment the elderly diabetic patients complicated with pneumonia.Methods 86 elderly diabetic patients with pneumonia were selected and divided into observation group and control group according to different treatment options.All the patients were given oxygen,suction,nutrition therapy,postural drainage and basic treatment for diabetes.Cefoperazone sulbactam was given in control group,5.0g dissolved in 150 ml saline,1 time/d.Ambroxol hydrochloride injection was added in observation group,40mg/kg dissolved in 150 ml saline,1 time/d.Body temperature,sputum,leukocyte and chest X-ray were observed and recorded,and the recovery time was recorded.Results 37 cases were cured,6 cases improved in observation group,and the total effective rate was 100.00％.28 cases were cured,12 cases improved in control group,and the total effective rate was 93.02％.The effective rate of the observation group was higher than the control group(P ＜0.05).The incidence rate of adverse reactions in observation group was 6.98％,while 4.65％ in control group,and there was no statistical difference between the two groups (P ＞ 0.05).Conclusion Ambroxol hydrochloride added to antibiotic routine therapy in treatment the elderly diabetic patients complicated with pneumonia couldimprove the cure rate and shorten the healing time.It was worthy of clinical application.

Objective To investigate the effect of dichloroacetate on the expression of Kv1.5 in a rat model of pulmonary arterial hypertension (PAH) .Methods Thirty-two male SD rats weighing 200-250 g were randomly divided into 4 groups ( n = 8 each): normal control group (group C), dichloroacetate control group (group D),PAH group, and PAH + dichloroacetate group (group PD). PAH was induced by left lung resection combined with subcutaneous injection of monocrotaline 60 mg/kg in PAH and PD groups. In group PD, dichloroacetate 80 mg/kg was given through a gastric tube into stomach once a day for 28 consecutive days after monocrotaline injection,while the equal volume of normal saline was given instead of dichloroacetate in group PAH. Group D only received dichloroacetate 80 mg/kg through a gastric tube into stomach once a day for 28 consecutive days. Pulmonary arterial pressure (PAP) was measured at day 28 after monocrotaline injection. The rats were then sacrificed and lung tissues were removed to calculate the percentage of thickness of the tunica media of pulmonary artery and right venicular hypertrophy index and to determine the proliferating cell nuclear antigen (PCNA) and Kv1.5 protein expression (by Western blot) and Kv1.5 mRNA expression (by RT-PCR).Results Compared with group C, the PAP,percentage of thickness of the tunica media, right ventricular hypertrophy index were significantly increased, Kv1.5 mRNA and protein expression was down-regulated and PCNA expression was up-regulated in groups PAH and PD ( P ＜ 0.05). Compared with group PAH, the PAP, percentage of thickness of the tunica media, right ventricular hypertrophy index were significantly decreased, Kv1.5 mRNA and protein expression was up-regulated and PCNA expression was down-regulated in group PD (P ＜ 0.05). There was no significant difference in the indexes mentioned above between group C and group D ( P ＞ 0.05). Conclusion Dichloroacetat alleviates PAH through upregulating Kv1.5 expression in lung tissues and inhibiting pulmonary vascular remodeling in rats.

Objective: To determine the efficacy of lobectomy and wedge resection in the management of early stage (T 1N 0M 0) non small cell lung cancer. Methods: We analyzed the results of 109 patients with pathologic stage (T 1N 0M 0) non small cell lung cancer who underwent open wedge resection (n=21), video assisted wedge resection (n=30), and lobectomy (n=58) to assess perioperative morbidity and mortality, recurrence rates, survival difference and late pulmonary function among the three groups. Results: There were no differences among the three groups in regard to histologic tumor type, perioperative morbidity and mortality, late pulmonary function. Analysis demonstrated the wedge resection groups to be significantly older and to have reduced pulmonary function despite a higher incidence of treatment for chronic obstructive pulmonary disease when compared with patients having lobectomy. Statistically, the mean hospital stay was significantly less and locoregional recurrences rate higher in the wedge resection groups. Kaplan Meier survival curves were nearly identical at 1 year (open wedge resection, 94%; video assisted wedge resection, 95%; lobectomy, 91%). 5 year survival was 58%, 65% and 70% respectively. Log rank testing demonstrated significant differences between the survival curves during the 5 year period of study (P=0.02). Conclusion: Wedge resection, done by thoracotomy or video assisted techniques, appears to be a viable surgical treatment of stageⅠ(T 1N 0M 0) non small cell lung cancer for patients with cardiopulmonary physiologic impairment. Because of the increased risk for local recurrence, anatomic lobectomy remains the surgical treatment of choice for patients with stage I non small cell lung cancer who have adequate physiologic reserve.

Based on the taxonomic system of Nelson et al. (1993) ,a preliminary computerized identification system with groupaverage method of hierachical cluster analysis for the genus Fusarium was established. Three unidentified isolates, Fusarium sp. 1 F. sp. 2 and F. sp. 3 from Zea mays L. , were identified by use of this analysis. The results clearly showed that F. sp. 1 was identified as F. graminearum, F. sp. 2 as F. moniliforme and F. sp. 3 as F. subflutinans or F. proliferatum. The facts proved its applicability to comparison and identification of Fusarium.

With the development of proteomics, the application in the research for the function of proteins becomes popular. This review article presents that proteomics, a kind of tools of molecular biology, has been successfully used for studying the pathogenesis of type 1 and type 2 diabetes.