Objective To study the effect of different insulin administration methods on glucose control of gestational diabetes mellitus ( GDM) .Methods Sixty-four cases with GDM were randomly divided into observation group and control group.The observation group received continuous subcutaneous insulin infusion insulin pump therapy, the control group received multiple subcutaneous insulin therapy.Then,the glucose control effect,SAS and SDS score were compared between two groups.Results After 4 weeks,the FBG,HbA1c,2h PG of observation group were significantly lower than the control group[(5.89 ±0.66)mmol/L vs (7.13 ±0.74)mmol/L,(7.14 ±0.82)% vs (8.92 ±0.95)%,(8.87 ±0.92)mmol/L vs (10.13 ±1.32)mmol/L](t=7.074,4.430,8.024,all P<0.05). The glucose fluctuations,insulin amount,hypoglycemia incidence of the observation group were significantly lower than the control group,blood sugar standard time was shorter than the control group[(5.64 ±0.65)mmol/L vs (8.44 ± 0.92)mmol/L,(0.52 ±0.06)U· kg-1· d-1 vs (0.73 ±0.09)U· kg-1· d-1,6.25% vs 28.13%,(4.76 ± 0.55)d vs (7.41 ±0.94)d,t/χ2 =14.061,10.983,5.379,13.764,all P<0.05)];SAS score,SDS score of the observation group were significantly lower than the control group[(34.95 ±4.2) points vs (40.23 ±3.98) points, (35.12 ±3.95)points vs (38.36 ±3.88)points,t=5.162,3.310,all P<0.05)].Conclusion Continuous subcu-taneous insulin infusion insulin pump therapy is helpful to control glucose levels,reduce blood sugar fluctuations and mitigate negative sentiment during treatment,it is an ideal insulin administration method for the treatment of GDM.

The paper analyses the function of mutual communication in solving physician-patient conflict. Some feasible suggestions on the mutual communication between doctors and patients are also raised in order to solve the physician-patient conflict effectively.

This paper introduces a new perspective of case choice in medical ethics teaching,which breaks through the limitations of the choice of teaching cases,chooses the hot-case analogy teaching methods out of medical field,and proves to have received good teaching results.

The specialization of medical science determines the objective existence of asymmetric information in medical and health industry.These different understandings in the psychological and behavioral area influenced the development of physician-patient relationship.Medical personnel should look squarely at the professional attributes and dare to play a leading role.Meanwhile,the exchange of the role of patient and medical personnel,understanding patient,clearing of communication channels and enlarging patients′ means of communication will promote harmonious relations between doctors and patients.

The basic nature of medical ethics education is the cultivation of morality for medical students,in which humanistic spirit is the fundamental element.Humanistic spirit is in great need for the development of medical ethics,the transformation of medical mode,the harmonious development of physician-patient relationship,and the healthy growth of medical students.Based on present realistic conditions,humanistic spirit should be developed in the fields of classroom training,medical professional education,and other aspects of campus culture.It would be necessary to find multi-path training modes of humanistic spirit.

Objective To discuss the related factors about the rising cesarean section rates, and to propose feasible measures to reduce cesarean section rates. Methods Cesarean section cases in our hospital from January, 2000 to December, 2009 were retrospectively analyzed. Results The cesarean section rate increased year by year,32.0% in 2000,34.5% in 2001,35.0% in 2002,32.3% in 2003,37.1% in 2004,37.9% in 2005,40.2% in 2006,41.7% in 2007,43.6% in 2008,46.1% in 2009. Conclusions Effective measures should be taken to reduce the cesarean section rate.

OBJECTIVE:To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemo-therapy alone for non-small lung cancer(NSCLC),and to provide reference for drug payment and clinical treatment. METHODS:By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with che-motherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS:5 dimensions FACT-L score:the patients of Shenqi fuzheng injection combined with chemo-therapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score:the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group (1 632.44 vs. 11 145.30),and incremental cost-effectiveness ratio was 448.69. ZPS score:Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone(-17 398.77 vs. 384 513.00). Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs(1 313 326 yuan vs. 13 374 365 yuan). CONCLUSIONS:Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemo-therapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.

Objective To investigate the incidence and the possible risk factors of hepatic dysfunction in patients with Graves' disease (GD). Methods Totally 280 outpatients with hyperthyroidism (caused by GD) were divided in two groups: untreated group (131 patients) and treated group (149 patients). The hepatic function, serum thyroid hormone, TGAb and TMAb were detected for analysis of the incidence, clinical characteristics and correlative factors of the hepatic dysfunction. Results Patients who had at least one abnormal result of liver function test accounted for 70.99% in untreated group and 61.07% in treated group. The most common abnormal hepatic function parameter in patients with thyrotoxic hepatic lesion was increased alkaline phosphate enzyme (ALP), which was 57.3% in untreated group and 51.0% in treated group. Abnormalities of alanine transaminase (ALT), aspartate transaminase(AST), gamma-glutamyl tyanspeptidase (GGT) and total bilirubin (TBIL) were 28.2% (37/131), 18.3% (24/131), 10.7% (14/131) and 21.4% (28/131) in untreated group and 21.5%(32/149), 15.4%(23/148), 4.7% (7/149) and 20.1% (30/149) in treated group, respectively. The possibility of thyrotoxic hepatic dysfunction was correlated with the patients' age and FT3 and FT4 levels, but not with the genesis and course of disease, sex, family history of hyperthyroidism, or levels of TGAb and TMAb. Conclusion Abnormal results of liver function test are commom in patients with hyperthyroidism. Increased alkaline phosphate enzyme and alanine transaminase are the most common abnormal hepatic function parameters; the possibility of thyrotoxic hepatic dysfunction is correlated with patients' age and the level of thyroid hormones.

BACKGROUND:Studies on the proteomics contribute not only to exploring the laws governing life activities, but also to elucidating the pathogenesis of a variety of diseases to find the treatment strategies. OBJECTIVE:To summarize the application of proteomics in the plateau medical research. METHODS:A computer-based online search was conducted in PubMed and Wanfang databases from 1995 to 2015 to screen the relevant literatures using the key words“proteomics, medical research, plateau medicine”in English and Chinese, respectively. A total of approximately 200 English and 60 Chinese relevant literatures were selected and the 59 eligible literatures were included after screening final y. RESULTS AND CONCLUSION:Currently, the human genome has been decoded through the studies on exploring the proteomics changes under the pathological conditions and the underlying mechanisms. Construction of physiological and pathological mapping based on the human proteome contributes to revealing the novel treatment targets, diagnostic markers, and drugs for the prevention and treatment of diseases. Proteomics has become the frontier and hot research field both at home and abroad, including al the proteins expressed in the tissue, cel or organism, and becomes a bridge between the genome and clinical application.