The changes of the levels of C-reactive protein,endothelin and nitric oxide before and after pioglitazone treatment in type 2 diabetic patients suggested that inflammation participated in the pathogenesis of diabetic macroangiopathy and pioglitazone can protect vessels

Objective To Search for the induced factors and therapeutic strategies for ovarian hyperstimulation syndrome(OHSS).Methods 38 cases with OHSS were retrospectively analyzed.Results All cases had symptoms of stomach and intestine,hcmachrosis and ascitic fluid.Human serum albumin through intravenous dripping was one of the most successful treatment as plasma expanders through restoration of effective blood volume.Paracentesis was necessary for critical OHSS patients with severe ascites and hydrothorax.Herus could decrease the cost of albumin significantly.Conclusions OHSS was the severe complication of ovarian stimulation.All patients with OHSS got completely recovered through intense care and effective treatment.

Objective To explore the effects of exercise nursing intervention on renal transplant recipients.Methods A convenient sample of 64 renal transplant recipients during rehabilitation period were divided into the experimental group and the control group with 32 cases in each group.The experimental group received routine care and rehabilitation exercise,while the control group just received routine care.The body mass index(BMI),blood pressure and heart rate were measured in the two groups.Results Before intervention the differences of BMI,heart rate,blood pressure between the two groups were not statistically significant.However,after intervention,the BMI and blood pressure of the experimental group were lower than those of the control group,but there was no significant differences in heart rate.Conclusions Rehabilitation exercise nursing intervention contributes to raise recipients' quality of life and promote whole rehabilitation.

OBJECTIVE To explore the source resulting in nosocomial infection and main component elements managing and controlling nosocomial infection in order to enhance the administration of nosocomial infection and to raise proposition on standardized administration.METHODS Main component elements resulting in nosocomial infection were investigated by reviewing literature and clinical data,and analyzing hierarchy process of administration.RESULTS Emphasis on the administrative measures of main component elements resulting in nosocomial infection might achieve the aim of preventing and reducing nosocomial infection.CONCLUSIONS Reconstruction of administrative links on nosocomial infection can reduce medical risk and cost.

Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.

Objective To apply the health education intervention based on protection motivation theory in community female patients with stress urinary incontinence,in order to establish a health behavior and to control urinary incontinence.Methods 96 female patients with stress urinary incontinence were randomly divided into the control group and the experimental group by random number table method,the control group received routine health education,the experimental group received health education based on protection motivation theory.The ICI-Q-SF score,pelvic muscle exercise compliance scale score,urinary incontinence coping efficacy score were compared between the control group and the experimental group.Results The ICI-Q-SF score of the experimental group after the intervention was 5.43 ± 1.77,which was significant lower than that in the control group,7.96±2.98,t=4.88,P＜0.01.The urinary incontinence coping efficacy scores of experiment groups after the intervention was 17.63±1.85,which was higher than that in the control group,13.49±2.46,t=-9.09,P＜0.01.There were 29 cases accounted for 63.04％ with good compliance and 17 cases accounted for 36.96％ with poor compliance in experimental group after intervention,14 cases accounted for 31.11％ with good compliance and 31 cases accounted for 68.89％ with poor compliance in control group after intervention,the difference was statistically significant,x2=9.306,P＜0.05.Conclusions Health education based on protection motivation theory can promote the coping efficacy and health behavior of community female patients with stress urinary incontinence and can effectively control urinary incontinence symptom.

Objective To evaluate the value of CT scan in patients with obstructive sleep apnea syndrome (OSAS) pre and post surgical operations.Methods 36 patients with OSAS and 50 normal adults were included in this study .The patients were divided into two typesaccording to the location of stricture site .The upper airway from roof of nasopharynx to glottis was evaluated using a Siemens Somatom Spiral Scanner and divided into upper pharyngeal and lower pharyngeal. The cross sectional area of two planes were measured and calculated. Meanwhile, The surgical effect of two types were compared by the pharyngeal area and AHI, SaO2 pre and post operations.Results Ⅰ type:The area of upper pharyngeal expanded (P0.05).AHI from 52.7 to 37.2 and SaO2 from 59.8% to 68%(P

Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.

Objective To explore the impact of pancreatobiliary reflux (PBR) in normal pancreatobiliary junction on gallbladder.Methods A total of 54 patients receiving cholecystectomy for gallbladder diseases underwent ultrasonography to evaluate the thickness of gallbladder wall,inner layer and gallbladder wall blood flow before operation.The bile juice was sampled during ERCP in 45 patients with common bile duct stone and during cholecystectomy in 9 patients to detect amylase level.All patients with normal pancreatobiliary junction enrolled in the study were assigned into PBR group (n =24) and controlled group (n =30) according to their bile amylase level.Resected gallbladder specimens were examined histopathologically and then tested for expression of COX2,Ki-67 and p53 immunohistochemically.Results PBR group included 20 cases of cholelithiasis and 4 gallbladder polyp,among which 23 were occult PBR (OPBR) and 1 high confluence of pancreatobiliary ducts (HCPBD),which was similar to pancreatobiliary maljunction (PBM) pathologically.The control group recruited 28 cases of cholelithiasis and 2 gallbladder polyp.There were no differences in frequency of inflammation,hyperplasia,metaplasia or expression of p53 between the two groups (p ＞ 0.05),while higher presence of dysplasia and higher expression of COX2 and Ki-67 were seen in PBR group (p ＜ 0.05).Conclusion In patients with OPBR,although hyperplasia and metaplasia in gallbladder epithelium were similar to those induced by cholelithiasis,dysplasia and active proliferation might relate to progress to malignancy.

Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness (CIMT) and quantitative carotid stiffness (QCS) in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients (diagnosed according to the World Health Organization criteria) were involved in this study. The subjects were divided into three groups according to the HbAlclevels and duration of diabetes mellitus: 60 with duration ≤2 years (as newly diagnosed) , 96 with duration≥5 years and HbAlc <6.5%, and 118 with duration≥5 years and HbAlc≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an uhrasound unit respectively. Results (1) In categorical analyses, the mean level of CIMT was increased from 720 μm in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus > 2 years and plasma HbAlc< 6.5% (P < 0.05), and to 800 μm in subjects with a duration of diabetes mellitus > 5 years and plasma HbAlc≥ 6.5 % (P < 0.01). The corresponding values for Q CS values were 4.5, 4.5 and 5.1 (P <0.05), respectively. (2) In multiple stepwise regression analyses, CIMT wassignificantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbAlc, systolic blood pressure (P < 0.05 or P < 0.01). Conclusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.