Objective To compare the efficacy and safety of recombinant insulin lispro and insulin lispro in the treatment of type 2 diabetes mellitus(T2DM ) .Methods Forty‐eight T2DM patients with poor blood glucose control were randomly assigned to the recombinant insulin lispro group (observation group ,n=32) and insulin lispro group (control group ,n=16) according to the ratio of 2∶1 .On the basis of injection of the recombinant insulin glargine once daily before sleep ,the two groups were given the re‐combinant insulin lispro injection or insulin lispro injection once before each meal .The period of treatment was 16 weeks .The levels of HbA1c ,2 h postprandial blood glucose(2hPG) and fasting plasma glucose(FPG) before and after treatment were measured and compared between the two groups .The adverse events were evaluated at the end of treatment .Results Forty‐four cases finished the study ,28 cases in the observation group and 16 cases in the control group .The levels of HbA1c ,FPG and 2hPG after 16‐week treatment in the two groups were decreased significantly (P<0 .05) .The decrease amplitudes of HbA1c in the observation group and the control group were (1 .55 ± 1 .50)% and(1 .06 ± 1 .30)% respectively ,which of FPG were (2 .07 ± 5 .01)mmol/L and (1 .09 ± 3 .18)mmol/L respectively ,and which of 2hPG declined (3 .28 ± 5 .71)mmol/L and(3 .60 ± 5 .89)mmol/L respectively . With HbA1c as the main evaluation index and 0 .40 as the non‐inferiority critical value ,non‐inferiority was found in the recombi‐nant insulin lispro injection as compared with the insulin lispro injection (P<0 .05) .The standard‐reaching rate of HbA1c less than 6 .50% in observation group was 14 .29% ,and which of HbA1c less than 7 .00% was 28 .57% ;in control group ,these two stand‐ard‐reaching rates were 18 .75% and 43 .75% respectively ,and there were no statistically significant differences between two groups (P>0 .05) .Conclusion The recombinant insulin lispro injection has non‐inferiority effects in the aspect of effectiveness compared with the lispro insulin injection ,moreover they have the same safety .

The paper introduced the present full-time practice of medical social workers in China, with in-depth analysis of the roadblocks encountered.The problems include but are not limited to multiple stakeholders without a healthy resources relationship network, lack of powerful government support in policy and resource orientation, absence of drivers for hospitals to deliver social service, immature social organizations, and poor capacity to link resources.Based on such, the authors explored the establishment of a development model for full-time medical social workers on a multiple cooperation platform, in such perspectives as the government, social worker organizations, hospitals, and third-party performance appraisal.

Objective:To discuss the applied value of the ultrasonic light scattering imaging DOT technology in the diagnosis of early breast lumps. Methods: The data of 114 patients that were experted ultrasound imaging of light scattering and were with clear pathological diagnosis results were analyzed retrospectively in our department in three years. Diagnostic indicators (SDI), the mass of the total amount of hemoglobin (HBT), oxygen saturation (SO2), mass direction (Orien) form factor (Forml) and the posterior echo (Pecho) were recorded, and the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, false negative rate and false positive rate were analyzed. The results were proceed and analyzed through SPSS 17.0. Results:There were significant differences in the SDI, HBT, Orien, Forml(t=-4.122,t=-2.275,t=-2.206,t=-2.927,P<0.05)The diagnostic sensitivity was 95.7%, specificity was 95.5%, positive predictive value was 93.8%, negative predictive value was 97.0%,false negative rate was 4.3%and false positive rate was 4.5%. Conclusion: Light scattering of ultrasound imaging use SDI, HBT, Orien, the Forml four quantitative indicators, qualitative evaluation can reach the masses, has a higher value in the differential diagnosis.

After being restored, 69 cases of the two-implant-supported crowns were followed up for 5 years. Except 1 case failed after restored 5 years due to peri-implantitis, and there were no complications which can not be controlled in the other cases. The success rate of implant restoration in 5 years is 98.6%. The two-implant-supported single crown for molar is an effective method to restore the long gap of a single molar-loss.

Objective: To investigate the effect of colloidal solution infusion on cerebral blood flow in patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Methods: Thirty patients diagnosed as aneurysmal subarachnoid hemorrhage with digital subtraction angiography (DSA) were divided into a vasospasm group (n = 12) and a control group (n = 18) according to whether they had cerebral vasospasm or not. After evaluating the regional cerebral blood flow (rCBF) of the bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery with Xe-CT, the colloidal solution (succinylated gelatin, 4 mL/kg) was injected intravenously in the patients of the vasospasm group within 30 minutes. Xe-CT was performed again, and the changes of rCBF before and after the colloidal solution expansion were compared. The changes of blood pressure, heart rate, and central venous pressure before and after infusion were documented. Results: Circled digit oneThe rCBF of bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery was more than 30 mL·100 g-1·min -1 in the control group. The rCBF was lower than 30 mL·100 g-1·min-1at least in 1 blood supplied region in the vasospasm group (72 blood supply regions altogether) , in which CBF were lower than 25 mL·100 g-1·min-1 in 7 blood supplied regions. Circled digit twoBefore and after the expansion, there were no significant differences among the systolic and diastolic blood pressure, mean arterial pressure, and central venous pressure in the vasospasm group (P >0.05). Circled digit threeOf the 65 vessels with rCBF >25 mL·100 g-1·min-1 there were no significant differences in rCBF before and after the expansion (P = 0.272) ; of the 7 vessels with rCBF ≤ 25 mL·100 g-1·min-1, the rCBF increased from 20 ± 3 mL·100 g-1·min-1to 34 ± 6 mL·100 g-1·min-1. There were significant differences (P <0.01). Circled digit oneOne year follow-up after the procedure, there was no significant difference in GOS score between the 2 groups. Conclusion: Colloidal solution expansion may increase the rCBF of the ischemic regions in patients with cerebral vasospasm and help to improve the prognosis of the patients.

Objective To construct a reliable continent tube, which is easy to catheterize and is surgically simple. Methods 10 patients with bladder cancer underwent a procedure in which ileal segment was tapered as an efferent tube,a part of which was placed between the back surface of the rectus muscle and wall of the ileal pouch. Internal orifice of the tapered ileum was anastomosed to the ileal pouch and external orifice of the tapered ileum was anastomosed to umbilicus. Urodynamic and radiological studies were carried out postoperatively on 9 patients. Results The stoma could be easily catheterized with a 16 F catheter in all the patients. One patient died of heart disease 55 days postoperatively. In the other 9 patients, 8 were completely continent day and night. The urodynamic study of the efferent tubes showed a maximum close pressure with a full pouch was significantly higher than those with an empty pouch (t=-7.14,P=0.000098 ). Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis. Conclusion This study suggested that the continent mechanism of tapered ileum can be greatly enhanced by fixing it between the abdominal and the pouch wall,allowing also easy catheterization and surgical simplicity.

Objective To study clinical diagnosis value of using magnifying endoscopy with narrow-band imaging(NBI-ME) in the CEA positive cases of microvascular parting to gastric cancer and colorectal cancer .Methods 873 cases in our hospital from 2012~2013 ,who had serum CEA positive were choosen ,the 114 patients who first diagnosis for suspected gastric cancer ,35 pa-tients who first diagnosis forsuspected colorectal cancer were included in this study .Using NBI-ME to check and the pathology bi-opsy .NBI-M E check key observation microvascular properties and classification :rules ,slightly irregular ,irregular ,disappeared ,the microvascular parting situation compared with pathological findings .Results 13 patients diagnosed with cancer by pathology ,the positive rate was 8 .72% ;intraepithelial neoplasia in 10 cases ,the positive rate was 6 .71% .No cases of cancer were regular and slightly irregular type ,all cancer cases in the disappearance .The sensitivity of type of disappeared was 100 .00% ,and the sensitivity of irregular type of canceration possibility intestinal large atrophy and high grade intraepithelial neoplasia was 87 .50% ,the differ-ence was statistically significant(P<0 .05) .Conclusion Using NBI-ME microvascular classification diagnosis could help observa-tion CEA positive cases in the screening of gastric cancer and colorectal cancer .

Adult ; Biomarkers, Tumor ; metabolism ; Epididymis ; metabolism ; pathology ; surgery ; Humans ; Inhibins ; metabolism ; Leydig Cell Tumor ; metabolism ; pathology ; surgery ; Male ; Testicular Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C (sCys-C),urinary kidney injury molecule 1 (uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL) and urinary interleukin 18 (uIL-18) for early diagnosis of acute kidney injury (AKI) in critically ill patients.Methods A total of 256 adult patients who stayed Intensive Care Unit for 24 hours in the Third People's Hospital of Liaocheng between Aug 2011 and Dec 2012 were enrolled.According to Kidney Injury Net(AKIN) work,the patients were divided into non-AKI group and AKI group (including state 1,2 and 3).The concentrations of urine NGAL,KIM-1,IL-18 and serum sCys-C were measured.The diagnosis value of four biomarkers joint detection and single detection for AKI were analyzed with the receiver operating characteristic (ROC) curve and the area under curve (AUC).Results (1) The levels of uNGAL,uKIM-1,uIL-18 and sCys-C were higher in patients with AKI than the patients with no AKI (P ＜ 0.01).(2) The area under curves of uNGAL,uKIM-1,uIL-18,sCys-C and joint detection were 0.742,0.871,0.803,0.703,0.925 respectively.(3) The sensitivity and specificity of parallel tests and serial tests of four biomarkers were 97.9％,62.8％,64.3％ and 96.2％ respectively.There were significant differences of sensitivity or specificity between single test and joint tests.Conclusions The urine NGAL,KIM-1,IL-18 and serum Cys-C are sensitive indexes for the early diagnosis of acute kidney injury.Joint detection has high value for early diagnosis of AKI.

Objective To investigate the characteristics of acoustic parameters and spectrograph of organic and functional voice disorder and evaluate the value of acoustic analysis technique by computer in the differential diagnosis of voice disorder. MethodsThe voice signals of sustained vowel "a" were measured with a microcomputer (Dr.Speech Software) in 70 healthy adults, 60 patients with varying organic diseases of vocal cords and 50 cases with functional voice disorder. The acoustic parame ters (jitter, shimmer, NNE) and spectrographic characteristics were analyzed and compared. ResultsIn 60 patients with organic diseases of vocal cords, all the acoustic parameters were significantly increased and the spectrograph showed irregularity,breakage or lack of harmonic waves and formants, and increase of noise. In 50 cases with functional voice disorder, the shimmer and NNE were significantly increased but the jitter was usually normal. The spectrograph showed pathologic changes of harmonic waves and formants in middle and high frequencies. The normal acoustic characteristics could be found in 94% (47/50) of the patients with functional voice disorder. ConcluisionThe acoustic analysis by computer technique is of value in the differential diagnosis of or ganic and functional voice disorder.