[Summary] As of 2014, an estimated 387 million people have diabetes mellitus ( DM) worldwide, which represents 8.3%of the adult population.China Noncommunicable Disease Surveillance in 2010 shows that the overall prevalence of DM is estimated to be 11.6%(approximately 113.9 million) in the Chinese adult population, with the prevalence among men of 12.1%and women of 11.0%, respectively.Control of blood glucose is fundamental to DM management.Despite the availability of several antihyperglycemic agents, only 53%of patients with DM achieve the recommended goals for DM care of HbA1C<7.0%.According to the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System Survey during the period of 10 years in the United States, 33.4%to 48.7%of persons with DM still have not met the targets for glycemic control, blood pressure or lipid level.In order to improve glycemic control, there is a need for new therapeutic options with innovative mechanisms of action and acceptable safety profiles.As a newly developed class of oral antidiabetic drugs, sodium-glucose co-transporter 2 inhibitors(SGLT2i) have recently been approved for the treatment of patients with type 2 diabetes mellitus, including canagliflozin, dapagliflozin, and empagliflozin.Evidence from clinical trials has suggested promising efficacy and safety of SGLT2i when used as monotherapy or in combination with other antihyperglycemic medications.SGLT2i significantly reduce HbA1C and fasting plasma glucose, and are well tolerated in general with a low intrinsic propensity to cause hypoglycemia, as well as rare severe renal or cardiovascular adverse events reported.

The PICC application in tumor chemotherapy patients has the advantages of simple operation, long time of implanting catheter, small pain and protect vein. They can ensure the chemotherapy smoothly, and further promotion in the clinical application, but when the patients took the tube back, the complications increased significantly. Health education is the mail channel for patient and family to get the major way to maintain PICC knowledge and skills. Through literature review of PICC health education at home and abroad, in our country, according to the present situation of PICC health education, the health education model, method and effect evaluation were summarized and looked for the problems in the present education of PICC health education. It can provide a basis for exploring new pattern of health education for improving the sevice life of the catheter and the patients’ life quality.

OBJECTIVE:To explore the general regulation and characteristics of adverse drug reactions(ADR)induced by ti-cagrelor,and provide reference for clinical rational drug use. METHODS:672 patients received ticagrelor in our hospital from Dec. 2013 to Jun. 2015 were followed-up,and the situation was analyzed and summarized after taking drug. RESULTS:In the 672 patients,78(11.6%)patients sutfered from 108 cases of ADR,the ratio of male to female was 5.5∶1,there was statistical signifi-cance (P<0.05);patients mostly aged 51-60 years (37.2%);the mainly involved organs/systems were respiratory system (41.7%),and skin and its appendages (38.0%),the main clinical manifestations were minor bleeding (78.7%),dyspnea (17.6%) and bradycardia (2.8%);no severe ADR was found. CONCLUSIONS:Ticagrelor had good safety and tolerability,but due to its shorter time to market in China and absense of evidence-based medicine for large-scale clinical trials in Asian population, clinic should strengthen medication monitoring to reduce the ADR and ensure drug safety.

The glycemic variability is one component of unified glucose tetrad concept.The long-term glycemic fluctuation may enhance the oxidative stress reaction,which can promote the development of micro vascular complications.The relationship between the glycemic variability and the CVD deserves further investigation.CGMS is helpful to monitor the glucose fluctuation especially in those with fragile diabetes and no symptom hypoglycemia.The suitable regime is the key point to control glycemic variability,even after the desired HbA1c target is attained. Abstract:Summ ary:The glycem ic variab ility is one component of un ified glucose tetrad concept.The long-term glycem ic fluctuation m ay enhance the oxidative stress reaction,wh ich can promote the developm ent ofm icro vascu lar comp lications.The rela-tionsh ip between the glycem ic variab ility and the CVD deserves further investigation.CGMS is helpfu l to mon itor the glu-cose fluctuation espec ially in those w ith fragile d iabetes and no symptom hypoglycem ia.The su itab le regim e is the key point to control glycem ic variab ility,even after the desired HbA1c target is attained.

OBJECTIVE To evaluate the risk factors for postoperative nosocomial infection(NI) among inpatients with cervical carcinoma.METHODS A prospective and retrospective study was carried out to investigate the clinical data of patients with cervical carcinoma in department of gynecology during the period from Jan 1 to Dec 31,2003.RESULTS The incidence and case incidence of NI were 22.88% and 23.99%,urinary tract infection((52.3%)) was the most common infection,followed by vaginal margin infection and pelvic infection.NI was closely related with diabetes mellitus,the duration of catheter reservation,and different operators.CONCLUSIONS NI is high in postoperative patients with cervical carcinoma,which should be paid attention during the course of clinical treatment.

OBJECTIVE To explore the risk factors of infection in patients with chemotherapy-induced neutropenia in order to offer scientific references for clinical treatment.METHODS With case-control study,two hundred and fifty-six cancer patients with chemotherapy-induced neutropenia were compared between the infection group and non-infection group.The data were analyzed on risk factors by univariate analysis(Chi-square test) and multivariate analysis(non-conditional Logistic regression models).RESULTS Multivariate analysis showed that early lymphopenia after chemotherapy(OR=3.347),the depth of the Absolute neutrophil count nadir(

Objective To investigate the correlation between adiponectin, CRP and homocysteine (Hcy) and evaluate its mechanism in acute cerebral infarction. Methods Serum adiponectin, hs-CRP,Hcy, blood lipid, FPG and blood pressure were measured in eighty patients with acute cerebral infarction ( cerebral infarction group) and eighty healthy persons ( control group). Results In cerebral infarction group, serum hs-CRP, Hcy, TG , and systolic pressure were significantly higher than in control group ( P ＜0. 05) , while serum adiponectin were significantly lower than in control group ( P ＜0. 05). Serum adiponectin levels were negatively correlated with Hcy( r = -0. 453) , hs-CRP ( r = -0. 397) ,TG( r = -0. 321) , FPG( r = -0. 318) and systolic pressure ( r = -0. 288). Conclusion There is correlation between adiponectin, Hcy, hs-CRP, glucose and lipid metabolism and blood pressure, which plays a role in occurrenc and development of acute cerebral infarction.

Objective A rare HLA phenotype carrying three HLA-A antigens, A2, A11.2 and A24, was identified in a potential bone marrow donor SZHD1. Methods To determine molecular basis of this phenotype the HLA-A gene fragments from this donor and his family members were cloned and sequenced. Results Sequencing analysis indicated that the donor carries an unusual HLA haplotype, A*1102, A*24020101; B*38; DRB1*15. Conclusions Other four family members were found to carry this haplotype, which as a Mendelian gene was segregated and stably transmitted through three generations. This is a first example of a family carrying triple HLA-A antigens to the best of our knowledge.

Objective To find the chemical elements whose contents are abnormal in the soil of the high prevalence areas of birth defects in Shanxi Province. Methods 131 soil samples were collected from the high and low prevalence areas of birth defects respectively in 2005, the contents of 16 elements were determined with inductively coupled plasma (ICP)machine. The data were analyzed with regression and nonparametric tests. Results The total content of elements in the soil of the high prevalence areas was significantly higher than that of the low prevalence area. Compared with the low prevalence area, in a high prevalence area, the content of Mo, As, Pb, Ni, V and Se in soil was abnormal, Mo, As, Ni and Pb showed a significant relationship to the prevalence rate of birth defects, in another high prevalence area, the content of Sn, Se, Mo, Zn, Sr, Pb, Ni, Fe, V, Ca, Cu, Al, Mg and Na was abnormal, Pb, Mg, Ca, Al and Zn showed a significant relationship to the prevalence rate of birth defects. Conclusion Maybe the abnormal content of Mo, As, Ni, Pb, Mg, Ca, Al and Zn in the soil is one of the risk factors for birth defects.

Objective To apply James Sheehy myringoplasty for treatment of large perforation without residual rim and to observe the efficacy.Methods Between January 2001 and June 2003, 60 patients with large perforation without residual rim had underwent James Sheehy myringoplasty, in which 36 were males and 24 were females, aged from 16 to 64 years and with an average of 45.23 years. Preoperative air-bone gap was 5 to 45 dB, averaged 28.5 dB. Fellow-up was done more than 6 months on 54 patients.The key technic: (1) a vascular skin flap was made on the posterior canal wall and the anterior canal wall skin was excised. (2) canaloplasty was performed until the whole tympanic sulcus can be seen under one microscope view. (3) if necessary, the ossicular chain was explored. (4) overlay technic was used to repair perforation with temporal fascia. (5) the free anterior skin and the posterior canal vascular flap were replaced.Results 52 patients were healed in one stage. In 2 patient, two needle tip-like perforations appeared in the center of the grafting tympanic membrane 3 months after surgery, which were closed after gelatin sponge patching. The shape of the tympanic membrane looked as normal. Symptoms of temporomandabular joint appeared in 6 patients and disappeared 3 days later. Lateral displacement of the graft happened in 2 patients.Conclusion James Sheehy myringoplasty is a reliable technique for treatment of large perforation without residual rim, with high success rate, less postoperative response and good shape of new tympanic membrane.