Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

BACKGROUND:Compared with bone marrow transplantation, peripheral blood stem cel transplantation has its own advantages, including rich resources of stem cel s from the peripheral blood, convenient and easy col ection, without anesthesia, smal trauma, easily accepted, high safety, and easy to restore the patient’s hematopoietic system.
OBJECTIVE:To observe the function and safety of autologous peripheral blood mononuclear cel s in the treatment of patients with decompensated cirrhosis.
METHODS:Four patients with decompensated liver cirrhosis were selected from November 2010 to July 2011 in the First Affiliated Hospital of Dalian Medical University, aged 31-67 (averagely 44 years). Among them, three cases had hepatitis B, and another one had autoimmune liver disease. Peripheral blood stem cel s were col ected after being mobilized by granulocyte colony stimulating factor. Then, autologous peripheral blood stem cel s were transplanted via a hepatic artery catheter.
RESULTS AND CONCLUSION:There were no adverse reactions such as fever, bleeding and nausea after peripheral blood stem cel col ection and hepatic artery transplantation. Symptoms such as fatigue, poor appetite and abdominal distension gradual y improved at 1, 3 and 6 months after transplantation. Liver function and liver fibrosis indexes were improved to some extent after transplantation.

Objective:To analyze the satisfaction degree and related factors of community health services among residents in Zhejiang province.Methods:A service satisfaction survey was conducted during July to October 2019; using purpose sampling method three community health service centers were selected as survey sites in Hangzhou, Jiaxing, and Lishui cities, representing high, medium, and low economic development levels in Zhejiang province. The short-form Patient Satisfaction Questionnaire (PSQ-18) was used in the survey. SPSS 19.0 was adapted for data analysis, and multivariate logistic regression was applied use of analyze the affecting factors of satisfaction.Results:A total of 464 questionnaires were distributed, and 429 valid ones were returned with a response rate of 92.46%. Among them, 112 were from Hangzhou, 159 from Jiaxing, and 158 from Lishui. The overall satisfaction score of community health services was (4.22±0.59), and the satisfaction rate was 85.8%(368/429).Among the three cities, the overall satisfaction score in Lishui was the highest (4.28±0.51) with a satisfaction rate of 88.7% (140/158). The satisfaction scores of service quality, doctors' interpersonal communication ability, doctor-patient communication level, economic efficiency of service, timeliness of service, and accessability of service were (3.99±0.57), (4.10±0.77), (4.27±0.56), (3.54±0.84), (4.13±0.68) and (3.88±0.55); the satisfaction rates of those items were 59.6%(256/429), 79.4%(340/429), 86.3%(370/429), 43.6%(187/429), 78.9%(338/429)and 50.3%(216/429), respectively. Multivariate logistic regression analysis indicated that the quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service were the affecting factors of the residents' satisfaction to community health services ( OR=3.734, 2.928, 7.732, 4.275; P<0.05). Conclusion:The residents of Zhejiang province have a high overall satisfaction with community health services. The quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service are the affecting factors of the overall satisfaction degree.

Objective: To establish the quality standard for Shangtongning capsules. Methods: Microscopic identification was used for the qualitative identification of Bombyx batryticatus, Scorpio, Eupolyphaga steleophada, Pheretima, Notoginseng radix et rhizo-ma and Gastrodiae rhizoma. A TLC method was used for the qualitative identification of Chuanxiong Rhizoma, Angelicae Sinensis Ra-dix, Notoginseng Radix ET Rhizoma, Dipsaci Radix and Glycyrrhizae Radix ET Rhizoma. HPLC was used to determine the content of liquiriti. The determination was performed on an Agilent TC C18 (250 mm × 4. 6 mm,5μm) column with the mobile phase consisting of acetonitrile-water(15:85)at the flow rate of 1. 0 ml·min-1. The detection wavelength was set at 276 nm. Results: The features of the microscopic identification were significantly visible. The TLC spots were clear and well-separated without any negative interference. The linear range of liquiriti was 0. 341-1. 193 μg (r=0. 999 9)with the average recovery of 98. 97%(RSD=0. 77%, n=6). Con-clusion:The method is simple, accurate and reproducible, which is effective in controlling the quality of Shangtongning capsules and provides the basis for improving the quality standard for Shangtongning capsules.

Objective To approach a way to induce MSCs to dopaminergic neuron by mesencephalic conditional media and cytokines in vitro,and supply an ideal cells source for the treatment of Parkinson's disease.Methods The rat MSCs were isolated primarily from the femurs and tibias of the Wistar rats.MSCs were cultured,proliferated and purified by passage culture.Cultuered MSCs were divided into the control and the experimental group.In control group,MSCs were cultured without any induction medium.MSCs of experimental group were first cultured at medium containing bFGF for 24 hours.Then media were replaced with induction media which contained the agents as follows,respectively:GM_1,GDNF, GDNF+GM_1,GDNF+GM_1+mesencephalic conditional media.The surface markers of the differentiated neuron,such as NSE and TH were detected by immunocytoehemistry after MSCs were cultured in induction media for 3 and 7 days.Results In control groups,the NSE expression of MSCs was very lower than experimental groups.The percentage of NSE-positive cells of GDNF+GM_1+mesencephalic conditional media group in 7 day((45.257?5.999)/HP)was significantly more than other groups(control group is 2.214?0.779,GM_1 group is 22.014?3.624,GDNF group is 31.345?2.850,GDNF?GM_1 group is 40.314?4.203,P

Constitution of TCM is based on the study of individual constitution and physical health,and it has also drawn attention from the medical profession in the world.This commentary has reviewed about the development of constitution of TCM over the past few years,summed up the past 30 years,especially analysis the new research fruits during 2005-2006,expounded the important status of Chinese medical constitution in the development of Chinese medicine and the significance in socio-economic sustainable development,and put forward the direction of development and research for Chinese medical constitution.

OBJECTIVE:To observe the effects of total organic acid of Thladiantha dubia fruit(TOATF)on coagulation time and hemorheology of rats with cold coagulation and blood stasis. METHODS:60 rats were randomly divided in normal control group (water),model control group (water),aspirin group (positive drug,50 mg/kg) and TOATF low-dose,medium-dose and high-dose groups(50,100,200 mg/kg)with 10 rats in each group. Except for normal control group,cold coagulation and blood stasis model was induced by 4 ℃ water bath and subcutaneous injection of adrenaline hydrochloride,and then given correspon-dence medicine intragastrically,once a day,for consecutive 14 d. 24 h after last administration,blood samples were collected from aorta abdominalis. The coagulating time(CT),erythrocrit(HCT),plasma viscosity(PV),prothrombin time(PT),thrombin time (TT),activated partial thromboplastin time (APTT),platelet aggregation rate (PAR) and whole blood low-shear,middle-shear and high-shear viscosity were measured and blood sedimentation equation K value was calculated. RESULTS:Compared with nor-mal control group,CT,PT,TT and APTT of model control group were shortened,and HCT,PV,blood sedimentation equation K value,PAR and whole blood low-shear,middle-shear and high-shear viscosity increased(P<0.05 or P<0.01). Compared with model control group,CT,PT and APTT prolonged in aspirin group and TOATF medium-dose and high-dose groups,and PAR de-creased;PT of treatment groups prolonged,while HCT,PV,blood sedimentation equation K value and whole blood low-shear and middle-shear viscosity decreased(P<0.05 or P<0.01). CONCLUSIONS:TOATF has obvious improvement effects on anticoagula-tion and hemorheology in rats with cold coagulation and blood stasis.

Objective To evaluate the application value of percutaneous transsplenic varices embolization(PTSVE)in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. Methods Sixteen schistosomiasis cir-rhosis patients(12 males and 4 females)with portal hypertension complicated with esophageal and upper gastrointestinal hemor-rhage were selected as the investigation subjects,all the patients had been treated by esophageal vein ligation and sclerothera-py,but with bleeding again post-operation. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition,the patients received PTSVE were reexamined with abdominal CT one month post-operation,and the degrees of varices were compared before and after PTSVE. Results Four-teen cases(87.50%)were successfully treated with PTSVE. Two cases(12.50%)failed,and one case had an abdominal bleed-ing 1 week post-operation. The abdominal CT showed the degrees of esophageal varices(P < 0.001),esophageal vein(P <0.001)and gastric varices(P < 0.001)were significantly decreased in the patients who received PTSVE one month after the op-eration. Conclusions PTSVE is a safe and effective method in the treatment of upper gastrointestinal hemorrhage in the pa-tients with schistosomiasis cirrhosis. PTSVE is especially suitable for the patients with severe liver cirrhosis,significantly bor-dered liver split,and bared main portal vein and even the branches.

Objective To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointes-tinal bleeding in patients with hepatic schistosomiasis. Methods Thirty - three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis(a bleeding group)and 29 schistosomiasis cirrhosis patients without bleeding(a non-bleeding group)were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT. The portal systemic shunting vessels were reconstructed by using thin slab maximum intensity projection(TSMIP)and multi-planar reconstruction(MPR). The degrees of the shunting vessels of the subjects were evaluated and compared,and the relation-ship between upper gastrointestinal bleeding and the degree of the shunting was analyzed. Results In the bleeding group,the occurrence rates of the shunting vessels were found as follows:86.4% in left gastric varices,68.2% in short gastric varices, 50.0% in esophageal varices,50.0% in para-esophageal varices,37.9% in gastric varices,69.7% in gastric-renal varices, 51.5% in spleen-renal varices,25.8% in abdominal wall varices,15.2% in omentum varices,63.6% in para-splenic varices, 34.8% in umbilical varices,40.9% in retroperitoneal-paravertebral varices,and 36.4% in mesenteric varices. In the bleeding group,the occurrence rates and the degree of shunt were significantly higher than those in the non-bleeding group in esophageal varices,esophageal vein,left gastric vein and gastric varices(all P < 0.05). Conclusions CT portal vein reconstruction can accurately display the location,degree and walking of all kinds of shunting vessels. Esophageal varices,esophageal vein,left gastric vein and gastric varices can accurately predict the risk of upper gastrointestinal bleeding in patients with hepatic schisto-somiasis. The patents with higher degree of the shunting vessels have a higher risk of gastrointestinal bleeding.

Objective To investigate the association of chest pain patients with primary level in high-sensitivity troponin T (hs-cTnT) level no more than 14 ng/L in the onset of acute myocardial infarction in pa-tients with chest pain. Methods We enrolled 3 096 participants from January 2012 to December 2013 in West China Hospital, Sichuan University. All patients were classified two groups (hs-cTnT > 14 ng/L, hs-cTnT ≤14 ng/L and no ischemia on ECG) according to hs-cTnT levels and ECG. We evaluated the risk of myocardial in-farction and death and negative predictive value in 30 days. Results Thirty-seven patients were diagnosed in having acute myocardial infarction (AMI) and 4 patients were dead in the hs-cTnT > 14 ng/L group in 30 days in the absolute risk 2.35(1.86-2.74) and 0.29(0.12-0.53); 9 patients were diagnosed as having AMI and no patients were dead in the hs-cTnT ≤ 14 ng/L group in 30 days in the absolute risk 0.58 (0.42-0.74). Conclu-sion Chest pain patients whose primary levels no more than 14 ng/L in hs-cTnT with no ischemia on ECG can be ruled out AMI in negative predictive value 99.6%. the levels of hs-cTnT which were dynamic monitored at least 5 h and still no more than 14 ng/L can rule out AMI directly.