Objective To evaluate the effect of early-phase insulin secretion and insulin resistance in the pathogenesis of type 2 diabetes, and to analysis the risk factors of glucose tolerance deterioration. Methods Oral glucose tolerance test (OGTT) was performed in subjects over 30 years old coming from 78 families with type 2 diabetes. A total of 118 subjects with normal glucose tolerance (NGT) [fasting plasma glucose (FPG)<6.1 mmol/L and 2h postprandial glucose (2hPG)<7.8 mmol/L] were enrolled. Another OGTT was performed in them to define the glucose tolerance status at the end of the 4-7 years follow-up. AINS30/APG30, the ratio of the increment of insulin to that of plasma glucose at 30 min after the glucose load, was used to assess the early phase insulin secretion. HOMA-IR and HOMA-β were calculated to assess the insulin resistance and β-cell function respectively. Results After 4-7 years follow-up, 66 of 118 subjects still remained NGT, while 52 became either diabetic (n=11)or pre-diabetic (n=41). Using the median of HOMA-IR and AINS30/APG30 as the cutoff points, all subjects were divided into four groups: subjects with good early phase insulin secretion and no insulin resistance, subjects with good early insulin secretion but relative insulin resistance, subjects with impaired early phase insulin secretion but no insulin resistance, subjects with impaired early phase insulin secretion and also relative insulin resistance. The incidences of abnormal glucose tolerance among these four groups were 23.1%, 36.4%, 45.5% and 73.1% respectively. There was a statistical difference between the former three groups and the last one (P<0.05). Log/st/c regression analysis showed that only the early phase insulin secretion was the risk factor of glucose tolerance deterioration, while age, gender, insulin resistance or β-cell function were not. Conclusion Impaired early phase insulin secretion is a major risk factor for the disturbance of glucose metabolism in the population with NGT.

Objective:To explore the effects of quality control circle(QCC) on the complaint management and patient satisfaction in the medical insurance center.Methods:We set up QCC,defined the subject,identified the problems and made the cause analysis,made the countermeasures and implemented them.Results:Mter QCC ac-tivities,patients'major unsatisfactory factors such as long waiting time and poor staff coordination ability were signif-icantly improved.In addition,patient complaints decreased significantly (P ＜ 0.01).Conclusion:The application of QCC management on patient complaints can not only increase patient satisfaction,but also provide an importantway for the hospital to build up the brand.

There has been increasing attention over the past few years on the potential for the medical devices to cause changes in the immune systems, and it was necessary to provide guidance on how to address the adverse effects of medical devices on the immune system. Here we introduce the principles and methods for immunotoxicology testing of medical devices.
Biocompatible Materials ; Equipment and Supplies ; adverse effects ; standards ; Humans ; Immune System Diseases ; etiology ; Materials Testing ; methods ; standards ; Prostheses and Implants ; adverse effects ; Toxicity Tests ; methods

OBJECTIVETo observe the difference in acupuncture for pain threshold at different time points among the groups of 9 TCM constitutions.

METHODSThe cross-sectional survey was adopted to investigate TCM constitutions among 600 subjects and determine 9 TCM constitution types (neutral constitution, qi-deficiency constitution, yang-deficiency constitution, yin-deficiency constitution, phlegm-damp constitution, damp-heat constitution, blood-stagnation constitution, qi-stagnation constitution, special diathesis constitution). The same acupuncture manipulation was applied to Zusanli (ST 36) on the left side in the subjects and the needle was retained for 30 min. The tenderness threshold was detected with 2390 type Von Frey apparatus at different time points, named before acupuncture, at the moment after qi arrival, in 10 min of needle retaining, in 30 min of needle retaining and in 15 min after needle withdrawal in the subjects of 9 TCM constitutions.

RESULTSThe interactive effect happened between the constitution type and time point (P < 0.05). Among the groups of 9 TCM constitutions, the pain threshold values at the moment after qi arrival (except blood-stagnation constitution, qi-stagnation constitution, special diathesis constitution) in 10 min of needle retaining and in 30 min of needle retaining were increased as compared with those before acupuncture separately (P < 0.01), among which, the value increase was the most significant in 30 min of needle retaining. The differences in the pain thresholds were significant in 15 min after needle withdrawal in the groups of neutral constitution and damp-heat constitution as compared with those before acupuncture (both P < 0.01). In 10 min of needle retaining and in 30 min of needle retaining, as compared with the group of neutral constitution, the changes in pain thresholds of the rest abnormal constitutions were apparently lower (all P < 0.05).

CONCLUSIONAcupuncture at Zusanli (ST 36) presents different effects among the groups of different constitution types. The effect maintaining durations are different.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Pain Management ; Pain Threshold ; Yang Deficiency ; therapy ; Yin Deficiency ; therapy ; Young Adult

This study is to investigate the tumor invasion and metastasis inhibition effects of the immunoconjugate composed of lidamycin and anti-type IV collagenase monoclonal antibody Fab' fragment. Boyden chamber assay was used to evaluate the influence of Fab'-LDM on HT-1080 cells invasion ability, gelatinase spectrum was used to measure the change of invasion factor MMP-2 and MMP-9's secretion, and RT-PCR was adopted to determine TIMP-1 mRNA expression level. The immunoconjugate inhibition of tumor in situ metastasis was also tested in nude mice. The Fab'-LDM conjugates had dose-dependent inhibition effect on HT-1080 cells' invasion. At the concentrations of 5 and 10 nmol L(-1), the Fab'-LDM inhibited the invasion by (60 +/- 12) % and (79 +/- 11) % respectively. At the concentration of 5 and 10 nmol L(-1), the Fab'-LDM inhibited the secretion of MMP-2 by (42 +/- 8) % and (54 +/- 6) % and that of MMP-9 by (57 +/- 3) % and (87 +/- 1) %, respectively. RT-PCR indicated that conjugates increased the anti-invasion factor TIMP-1 level. The in vivo experiment showed that, compared with the control group, the tumor inhibition rate in Fab', Fab'-LDM, and LDM group equaled to (30 +/- 13) %, (86 +/- 26) %, (74 +/- 22) % respectively. In conclusion, Fab'-LDM could inhibit the invasion and metastasis of tumor and it might be a new tumor biotherapy agent.

Objective: To assess the trends in clinical characteristics and treatments for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in western rural China from 2001 to 2011. Methods: A two-stage random sampling procedure was used in our study. In 1st stage, stratiifed random sampling was applied to identify the participating hospitals and in 2nd stage, random sampling was applied to determine the patients to be studied. Taking 2001, 2006 and 2011 as 3 time points to study the in-hospital records for STEMI treatments. The results in each year were analyzed by weighted calculation in order to adjust the proportional impact by different sampling and therefore, to relfect the entire condition in western rural area. Results: A total of 32/35 hospitals with 1028 STEMI records were enrolled. From 2001 to 2011, the admitted STEMI patients from 64 (54-70) years of age increased to 67 (56-75) years,Ptrend<0.05, while gender composition was similar, the risk factors for cardiovascular disease such as hypertension, dyslipidemia and smoking substantially increased. Among patients without contraindications, the ues of following medications increased from 2001 to 2011: aspirin from 73.6% to 89.9%, clopidogrel from 0% to 66.5%, β-blockers from 25.4% to 64.3% and statins from 7.5% to 89.8%, allPtrend<0.01. From 2001 to 2011, the rates of primary PCI application were from 0% to 0.3%,Ptrend=0.51, the rates of thrombolytic therapy increased from 33.4% to 55.4%,Ptrend<0.01. At the year of 2001, 2006 and 2011, the reperfusion rates were 33.4%, 50.7% and 55.4%, Ptrend<0.01; the mortality within 7 days of admission were 3.0%, 10.1% and 6.7%, the rates of death or treatment withdrawal because of terminal status were 5.3%, 12.3% and 10.9%, there was no signiifcant trend in the above 2 rates after adjustments. Conclusion: The quality of medical care for STEMI was signiifcantly improved in western rural China from 2001 to 2011, while there are still gaps between western rural area and other regions.

Objective: To assess the trends of clinical characteristics, diagnostic and treatment conditions and outcomes for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in eastern rural China from 2001 to 2011.
Methods: Through a two-stage random sampling, a representative in-hospital STEMI patient group in eastern rural China of 2001, 2006 and 2011 were enrolled. In 1st step, a simple random-sampling procedure was conducted to identify the collaborating hospitals and in 2nd step, a systematic sampling procedure was performed to select representative patients from those admitted to each collaborating hospital for STEMI during the study period. Then we obtained patients’ clinical information from their medical records. Finally, we weighted the ifndings for each year to represent the overall situation.
Results: A total of 2820 STEMI medical records from 32 collaborating hospitals were enrolled. From 2001 to 2011, the median age of STEMI patients increased from 66 to 68 years, P<0.01, the percentage of female patients elevated from 31.4%to 35.8%, P<0.05. The ratios of cardiovascular risk factors were gradually increased. Among the patients without documented contraindications, application of percutaneous coronary intervention (PCI) increased from 0%to 27.5%, P<0.01, reperfusion increased from 49.7%to 58.8%, P<0.01. Administration of aspirin elevated form 80%to 87.8%, Clopidogrel from 0%to 72.6%, statins from 16.7%to 89.6%;administration ofβ-blockers within 24 h of admission elevated from 41.5%to 55.5%, P<0.05 and ACEI/ARB from 58.3%to 69%, P<0.01. In 2001, 2006 and 2011, the in-hospital mortality within 7 days were 6.8%, 8.3%and 5.7%respectively;mortality plus treatment withdrawal because of terminal status at discharge were 10.2%, 12.4%and 9.5%respectively. After adjustment, the above ratios did not change signiifcantly.
Conclusion: From 2001 to 2011, application of PCI grew from nothing and effective medication was improved for in-hospital STEMI patients in eastern rural China. However, there were still obvious gaps for diagnosis and treatment from the guideline requirement;the patient outcomes have not been improved.

Objective To observe the effects of deep electroacupuncture on carlilage tissue in knee osteoarthritis (KOA) rabbits. Meth-ods 40 New Zealand rabbits were randomly divided into normal group (A, n=10) and model group (n=30). The model group was modeled KOA with Hulth-Telhag way, and identified with X-ray. Then they were divided into no-treated group (B, n=10), deep electroacupuncture group (C, n=10) and routine electroacupuncture group (D, n=10) randomly. The groups C and D accepted electroacupuncture since 6 weeks after modeling, for 4 weeks. They were measured with pH of joint fluid, observed structure and pathology of cartilage under transmission electron microscope, detected apoptosis index, and determined the expression of acid-sensing ion channel 1 (ASIC1), p38 mitogen-activated protein kinases (p38MAPK) and p53 with Western blotting, and distribution of ASIC1 with immunohistochemistry in cartilage tissue. Re-sults The pHs of joint fluid from high to low were ranged as the groups A=C>D>B (P<0.01). The cartilage structure was more complete in the groups A, C and D than in the group B. The apoptosis rates from less to more were ranged as the groups A=C

Objective:To study the genetic characteristics and genetic evolution of echovirus 30 (ECHO30) isolates in Yunnan Province, China.Methods:Virus isolation was performed on nucleic acid-positive samples for hand, foot, and mouth disease pathogen surveillance in Yunnan Province, and VP1 gene sequencing was performed. The sequences of eight ECHO30 isolates from Yunnan Province and the gene sequences of the VP1 region of the ECHO30 reference strain downloaded from GenBank were compared and analyzed using MEGA 5.0 software, and then a phylogenetic tree was constructed to measure the homology of nucleotides and amino acids between the isolates.Results:The ECHO30 virus was distributed in Wenshan, Qujing, Chuxiong, and Kunming in Yunnan Province. The ECHO30 virus was relatively common in Wenshan. ECHO30 isolates belonged to the H2 subtype of the H genotype, which was close to the local reference strain LC120939 in Yunnan Province. On the VP1 gene at site 5, the amino acid change ratio was more active, the amino acids were diverse, and mutations also occurred at sites 54, 156, 258, and so on. Nucleotide and amino acid homology were 84.0% - 100.0% and 98.4% - 100.0%, respectively.Conclusions:ECHO30 isolates from Yunnan Province have certain geographical characteristics and belong to H2 of the H genotype. The nucleotide differences in virus sequences among subtypes are small and have a close genetic relationship.

BACKGROUNDTo evaluate the efficacy and toxicity of combined chemotherapy of domestic paclitaxel and vinorelbine plus cisplatin and carboplatin in the treatment of advanced non-small cell lung cancer (NSCLC).

METHODSA total of 181 initially treated patients with advanced NSCLC were enrolled in this study and treated by NP (vinorelbine plus cisplatin), TC (domestic paclitaxel plus carboplatin) and TP (domestic paclitaxel plus cisplatin). The efficacy and side effects were analysed after at least two cycles of chemotherapy.

RESULTSThe overall response rates (CR+PR) were 42.4% in the NP arm, 40.3% in the TC arm and 43.3% in the TP arm respectively. No significant statistical difference was found among the three groups ( Chi-square= 0.108 6 , P > 0.05). The median survival times were 8.4 months, 9.4 months and 8.9 months respectively in the NP, TC and TP groups ( P > 0.05). The 1-, 2-, 3-year survival rates were 39.0%, 16.9%, 5.1% in the NP group and 41.9%, 21.0%, 6.5% in the TC group and 40.0%, 18.3%, 5.0% in the TP group respectively. No significant statistical difference was found among the three groups ( Chi-square=0.140 4, P > 0.05). The major side effects were myelosuppression, alopecia and nausea/vomiting in the three groups. There were no chemotherapy-related death among the three groups.

CONCLUSIONSThe combined regimens of NP, TC and TP are effective and well-tolerated regimens for advanced NSCLC.