Objective:To investigate the change of blood glucose and the factor relative to blood glucose in first degree relatives(FDR) with normal blood glucose in type 2 DM family.Methods:The oral glucose tolerance test(OGTT) was conducted in FDR with normal glucose in type 2 DM family.Glucose were compared between FDR and normal group and relative parameters with glucose were analysed.Results:Fasting plasma glucose(FPG),0.5hPG,1hPG and 2hPG of FDR were higher and significantly differently except 0.5hPG( P

Objective: To study the effect of probucol on pancreatic ?-cells in STZ-induced diabetes mice.Methods: The mice were randomly divided into four groups with ten mice in each group.The first group was given standard food(C group),The second group given standard food and 1% probucol(C+T group).The third group given standard food and treated with multiple low-dose of STZ(D group),and the forth group given standard food,1% probucol as well as treated with multiple low-dose of STZ(D+T group).The preventive intervention was undertaken with standard diet mixed with 1% probucol in Kunming mice.At different time after STZ was injected intraperitoneally,fasting blood glucose was measured.Serum insulin and glucose tolerance test was done.The pancreatic pathological changes were investigated under light microscope.Results: The fasting blood glucose at 0,1,2,3 weeks in D+C group was lower than that in D group(P

Objective To evaluate the change about the function of pituitary thyroid axis and the role of human chorionic gonadotropin (hCG) on regulation of pituitary thyroid axis in pregnancy Methods The study was designed to provide longitudinal information of parameters of thyroid function and hCG in 74 healthy women during pregnancy and after delivery Serum free triiodothyronine (FT 3), free thyroxin (FT 4), TT 3, TT 4, hCG and thyroid hormone binding globulin (TBG) concentrations were measured with radioimmunoassary and serum TSH concentration with immunoradiometric assay Results (1) The FT 3 and FT 4 values below the reference range were 5 88% and 9 80%, respectively, in third trimester and after delivery, both were 38 10% The serum TSH level below the reference range was 31 25% in first trimester and supranormal were 11 90% after delivery The serum hCG level at all stages of pregnancy was higher than postpartum (2) The serum FT 3 level was significantly higher in first (4 37?0 78) pmol/L and second (4 75?0 90) pmol/L trimesters than postpartum (2 96?0 84) pmol/L, decreased in third trimester (3 94?0 75) pmol/L and the lowest level after delivery The serum FT 4 level was significantly higher in first (14 07?1 44) poml/L and second (12 86?0 84) pmol/L trimesters than postpartum (10 45?1 45) poml/L, decreased in third trimester (11 29?1 00) pmol/L and the lowest level after delivery (3) The serum TSH level was the lowest values in early pregnancy (0 88?0 83) mU/L, showed significant increase in second (1 86?1 04) mU/L and third (1 48?0 90) mU/L trimesters and reached maximal level after delivery (2 82?1 42) mU/L (4) The serum hCG level was the highest in early pregnancy (309 05?320 02) ?g/L, then significant decreased in second (69 11?19 18) ?g/L and third (86 25?44 60) ?g/L trimesters and was the lowest levels after delivery (29 92?20 91) ?g/L (5) A significant negative correlation between TSH and hCG levels and a significant positive correlation between hCG and FT 4 and TT 4/TBG were demonstrated Conclusions (1) hCG may be as role on regulation of pituitary thyroid axis during pregnancy and during certain time of postpartum (2) After delivery, part of women were transient hypothyroxinemia

Objective To discuss the status of cesarean section in Shao Xing area, to investigate the indications of cesarean section rate and to study the possibility and feasibility for decreasing it. Methods All pregnant women and obstetricians of seven hospitals were asked to answer a designed questionaire, then the indications of cesarean section were appraised by the experts. Results The average cesarean section rate was 46.1%, the indications for cesarean section were as followed: cephalopelvic disproportion, fetal distress, social factors, proper indications for cesarean section were 74.0%. Conclusions The cesarean section rate can be decreased to 30% and less with the current standard of practice.

Professor Shi Qi is a famous traditional Chinese medicine doctor specializing in orthopaedics and traumatology, who has formatted a set of systematic protocols for the diagnosis and treatment of chronic musculoskeletal conditions. When it is time for using tonics in winter, he advocates applying herbal paste for treating chronic musculoskeletal diseases. This paper introduces Professor Shi Qi's commonly used prescription for treating chronic musculoskeletal conditions and puts forward demands and understandings in concocting herbal paste, experience in herbal paste for treating chronic musculoskeletal diseases such as cervical spondylosis, lumbar disc herniation, lumbar spinal stenosis, lumbar muscle strain, ankylosing spondylitis, osteoporosis, knee osteoarthritis and avascular necrosis of femoral head, and the advantages of herbal paste for treating chronic musculoskeletal conditions as opposed to alternative treatments.

The authors summarize Professor SHI Qi's clinical experience in diagnosing and treating chronic tendon and bone disease.The specific diagnosing and treating thinking and methods could be summarized as follows:1)Three stages,which means chronic tendon and bone disease could be treated according to early,medium and late stages.2) Three differentiations,which include differentiating disease,type and syndrome.3) Three examining,which include seeing patient clearly,reading the disease and getting the key point.In addition,Prof.SHI emphasizes threepoint syndrome differentiation which means the combination of the lesion's target,peri-target and whole syndrome characteristics differentiation.In the process of treatment,Prof.SHI emphasizes three methods combination of herb,technique and breathing technique.Both internal and external treatments should be used.Prof.SHI advocates that the control strategy should be the prevention,treatment and recuperation integration concept,including preventing disease,early treatment to prevent deterioration and preventing reoccurrence after cure.

This study was aimed to observe the clinical efficacy of Highly Active Antiretroviral Therapy (HAART) combined withPing-Ai(PA) Mixture in the treatment of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) patients with non-infectious skin lesions, in order to study the advantages of integrative medicine in AIDS prevention and treatment. A total of 9 cases, who met the inclusion criteria of AIDS-associated non-infectious skin lesion with the pattern ofqi-yin deficiency and internal obstruction of phlegm-stasis, were selected. The combination of HAART and number 1 and 4 prescription of PA Mixture were used in the treatment for 3 months. The observations were made on changes of clinical symptoms, body signs, Karovsky integral and CD4+ T cells of patients before and after treatment. Stata 12.0 was used in the statistical analysis. The results showed that after integrative therapy, the single integral of clinical symptoms and body signs, such as skin spot papula, subcutaneous nodules, skin itching, fatigue was obviously reduced compared to that of the pretreatment. The total score decreased than that of the pretreatment. The patients’ quality of life (QOL) significantly increased. The Karovsky integral increased compared with that of pretreatment. The CD4+ T cells values were higher than that of the pretreatment. It was concluded that the integrative therapy had a certain effect in the treatment of AIDS-associated non-infectious skin lesions, which can improve the clinical symptoms, body signs, obviously increase the patients’ QOL and immune function.

Objective To establish a REDE-DHPLC method for detecting the EGFR and KRAS mutations in plasma DNA from tumor patients, and investigate its clinical significance. Methods Restriction endonucleases Mse Ⅰ , Msc Ⅰ , BstN Ⅰ and Bgl Ⅰ were used to digest the wild type fragments of exon 19,exon 21 of EGFR gene and coden 12, 13 of KRAS gene for enriching the mutation fragments, and REDE-DHPLC method was established to detect EGFR and KRAS mutations. The sensitivities of REDE-DHPLC and conventional DHPLC were analyzed by using a series of plasmids containing 50%, 10%, 5%, 1% and 0. 1% mutation genes. Then, Plasma samples and paraffin-embedded tissue samples of 120 NSCLC patients and 120 colorectal cancer patients were detected by REDE-DHPLC. Compared with conventional DHPLC and sequencing, the diagnostic efficiency of REDE-DHPLC method was evaluated by detecting the mutation status of 2 genes in plasma of NSCLC and colorectal cancer patients. Results The sensitivity values of REDE-DHPLC and conventional DHPLC for detecting mutations in 4 loci were 0. 1% and 1%respectively. Plasmid DNA containing 0.1% mutation gene was detected to be positive continually for 2 to 3 times by REDE-DHPLC. EGFR mutation rates of 120 plasma from NSCLC patients detected by REDE-DHPLC, conventional DHPLC and sequencing methods were 27. 5%, 16. 7% and 12.5% respectively, and KRAS mutation rates of 120 plasma from colorectal cancer patients were 38. 3%, 25. 8% and 16. 7%,respectively. The positive rates of EGFR and KRAS mutation detected by REDE-DHPLC were significantly higher than conventional DHPLC(x2 = 4. 092, 4. 301, all P ＜ 0. 05 ) and sequencing method (x2= 8. 438,14. 127,all P ＜ 0. 05 ). In comparison with conventional DHPLC, the sensitivities of REDE-DHPLC for detecting EGFR and KRAS mutation were 100% (20/20,31/31), the specificities were 87. 0% (87/100)and 83. 2% (74/89). In comparison with sequencing method, the sensitivities of REDE-DHPLC were 100%( 15/15,20/20), the specificities were 82.9% (87/105)and 74. 0% (74/100). The coincidence rate of the two methods for detecting EGFR and KRAS mutation were 89. 2% ( 107/120, Kappa = 0. 690, P ＜ 0. 05 ) and 87.5% ( 105/120, Kappa= 0. 718, P ＜ 0. 05 ). The Consistency of EGFR and KRAS mutation status in plasma and tissues detected by REDE-DHPLC were 91.7% (33/36, Kappa =0. 939,P ＜0. 05)and 90. 2 %(46/51, Kappa = 0. 914, P ＜ 0. 05 ), respectively. Conclusions The REDE-DHPLC method is highly sensitive and specific for detecting EGFR and KRAS mutations in plasma DNA from tumor patients. The results are easy to be interpreted without missing homozygous point mutation, which indicate that the detection of EGFR and KRAS mutations in plasma DNA by REDE-DHPLC could therefore extend to be usedin clinical laboratory.

Objective To study the clinical effect of interventional therapy and cryosurgery by bronchoscopy in the treatment of bronchial tuberculosis.Methods 70 cases with bronchial tuberculosis were randomly divided into two groups 35 cases in each group.The drug treatment group was treated by internal medicine,and the combination therapy group was treated by the interventional therapy of the bronchus mirror on the basis of the drug treatment group.The total effective rate,the improvement time of cough and dyspnea,the number of treatment,the quality of life of patients were compared between the two groups.Results The total effective rate of the combination therapy group was higher than the drug treatment group (94.24％ vs 77.14％,x2 =4.200,P =0.04).The improvement time of cough and dyspnea in the comprehensive treatment group was shorter than those in the drug treatment group,the treatment times was less than that in the drug treatment group[comprehensive treatment group:(7.51 ± 1.41) d,(4.51 ± 1.61) d,(5.62 ± 1.21) times;drug treatment group:(9.39 ± 2.77) d,(5.39 ± 2.57) d,(7.61 ± 2.59) times;t =8.213,9.153,10.242,all P =0.00].Before treatment,the life quality scores between the two groups had no significant difference (P ＞ 0.05).After treatment,the improvement of quality of life in the combination therapy group was more significant[before treatment and after treatment of combination therapy group:physiological function:t =15.539,P ＜ 0.001;emotional function:t =11.789,P ＜ 0.001;social function:t =8.753,P ＜ 0.001.Before treatment and after treatment of drug treatment group:physiological function:t =10.128,P ＜ 0.001;emotional function:t =8.132,P ＜ 0.001;social function:t =6.931,P ＜ 0.001.After treatment,combination therapy group compared with drug treatment group:physiological function:t =7.433,P ＜ 0.001;emotional function:t =4.692,P ＜0.001;social function:t =3.297,P ＜ 0.001].Conclusion The clinical efficacy of bronchoscopic interventional cryotherapy in the treatment of bronchial tuberculosis is effective,it can effectively improve the clinical symptoms,improve lesions absorption,shorten symptoms subsided time,reduce the number of treatment,it is helpful to improve the quality of life of patients and worthy of popularization and application.

The management of hospital volunteers is one of the main tasks of medical social workers. In practical work， they are often in a dilemma due to ethical problems， which restricts the scientific development of hospital volunteer organizations. Based on the experience of frontline medical social workers in the “Guangji Boat” Volunteer Service Alliance of the Second Affiliated Hospital Zhejiang University School of Medicine， while investigating other public hospitals， this paper summarized and organized ethical issues， analyzed their causes， and proposed improvement strategies. The ethical dilemma of hospital volunteer service was mainly in the conflict between the dual relationship of human emotion and norm， the conflict between incentive mechanism and non-reward value， as well as the conflict between participation motivation and organizational goal. The ethical dilemma in the management of hospital volunteers was attributed to the lack of standardized practical operation systems. Based on the above ethical dilemmas， combined with the development experience of volunteer service in public hospitals， this paper proposed reasonable countermeasures to provide a reference for the management of hospital volunteers.