Objective To evaluate the efleet of continuous subcutaneous insulin infusion (CSII)combined with mefformin hydroehloride( Met H)on type 2 diabetic patients. Methods 240 patients with type 2 diabetes melli-tus (T2DM) were divided into 3 groups randomly: CSII combined with Met H ( A group: n=80) ; simple CSII ( B group:n=80) ; multiple deliver insulin (MDI) ( C group: n=80). The levels of blood glucose, HbA1 e, therapeutic time, a-mount of insulin, Fins ,C-P, HOMA-IR and IAI were compared among them before and after 10d of treatment. Results GroupA, B eornpared with group C, the levels of HbA1 e significantly deeroased in other two groups [ ( 8.0±3.2)%vs. (6.9±1.4)% and(7.0±1.2)% ] (aU P<0.05),so did the therapeutic time[(6.0±1.9)d vs. (3.0±1.4) and(3.5±1.5) d] and insulin dose[ (55.0±17.0) U/d vs. (38.0±15.0) U/d and(45.0±16) U/d] (all P<0.05). The insulin dose was much less in group A than in group B. Versus group B and C,the HOMA-IR of group A (0.8±0.3 vs. 1.5±0.4 and 1.6±0.4)decreased(P<0.05) ,and IAI(-2.0±4.3 vs. -3.6±4. 2 and -4.1±4.3) increased (all P<0.05), without the function impairments of heart, liver or kidney. Conclusion CSII in combi-nation with mefformin hydreehloride can significantly enhance the treatment effect of the patients with type 2 diabetes mellitns; reduce blood glucose and HbA1 e, improve insulin resistenee,lessen insulin need.

Objective To evaluate color Doppler sonography in the diagnosis of local recurrence in patients undergoing Miles procedure for rectal carcinoma.[WT5”HZ] Methods Transperineal and transsacral color Doppler blood flow sonography was performed on 51 patients presenting presacral masses after Miles procedure for rectal carcinoma. Blood flow richness and the blood flow dynamics indexes e.g. peak systolic velocity (PSV), diastolic velocity (EDV),resistive index (RI), and pulsatility indexs (PI) were recorded and analyzed. Results Blood flow signals in the recurrent masses were mainly Ⅱ-Ⅲ amounting to 81 82% (27/33), and that of benign masses were mainly 0-Ⅰ,Ⅱ-Ⅲ amounting to 27 78% (5/18). Both were significantly different (? 2=14 55, P

Objective To observe and measure the Doppler sonographic features of benign and malignant ovarian neoplasms,which included morphology and hemodynamics of tumor angiogenesis,and to select the most significant features. Methods Ninety-five patients with one hundred and five ovarian tumors were examined preoperatively by power Doppler sonography to observe the morphology of tumor angiogenesis. The hemodynamic features of tumor angiogenesis referred for pulsed Doppler sonography evaluation were measured,which included peak systolic velocity(V PS ),end diastolic velocity(V ED ),mean flow velocity(V M),pulsatility index(PI),resistance index(RI) and diastolic notch. To assess the variables jointly,stepwise regression analysis was used to identify the group of features that allowed the best prediction of benignity versus malignancy. Results All Doppler features significantly associated with malignancy .The ROC curve of RI revealed that the cutoff of RI( 0.51 ) with the highest accuracy had a sensitivity of 98.0 % and specificity of 96.2 %.Conclusions RI was most significantly associated with malignancy. The combination of RI and gray-scale sonography can maximize the ability to discriminate between benign and malignant ovarian tumors.

Objective To investigate the effect of the whole course health education on heart rehabilitation of old patients with percutaneous coronary intervention(PCI).Methods One hundred and twentyone old patients with coronary heart disease who all underwent complete PCI in Tangshan Gongren Hospital from January 2008 to December 2009 were selected as our subjects.All subjects were randomly divided into the intervention group (60 cases) and the control group (61 cases).All patients were treated by PCI ± standard drug therapy.Patients in control group were given the conventional health education,while in intervention group were given the extending health education plus the conventional health education.Questionnaire was used to collect the coronary heart disease knowledge,recovery and secondary prevention behavior.The levels of blood pressure,density lipoprotein cholesterol,fasting blood glucose (FB) were measured at 6,12,24 months at discharge hospital.Meanwhile the reaching standard rate of coronary heart disease risk factors control was also used to evaluate the effect of education.Results The scores of knowledge of coronary heart disease rehabilitation of intervention group at 6,12 and 24 months after discharge were (79.69 ± 4.66),(83.26± 8.38),(81.81 ± 9.21) respectively,higher than that of control group ((72.36 ± 8.16),(69.96 ± 10.69),(70.00 ± 11.32) respectively),and there were significant differences between groups(t =3.26,5.39 and 4.41respectively,P ＜ 0.05).The scores of the second level prevention act of intervention group were (79.00±5.65),(79.88 ± 6.34) and (79.13 ± 11.21) respectively,higher than that of control group((70.72± 7.59),(68.84 ± 5.36) and (66.52 ± 9.15) respectively),and there was significant difference between groups (t =3.75,5.99 and 3.63 respectively; P ＜ 0.05).The reach standard rate of low density lipoprotein cholesterol(LDL-C),exercise of intervention group at 6 months were 60.0％ (36/60),65.0％ (39/60),higher than that of the control group(37.7％ (23/61),32.8％ (20.61)),and there was significant difference between groups(x2 =6.045,10.871,P ＜0.05),while there was no significant difference in terms of the reach standard rate of blood pressure,FB and quit smoking(P ＞ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were 75.0％ (45/60),76.6％ (46/60),96.6％(58/60),81.7 ％ (49/60),75.0％ (45/60),higher than that of control group (49.2 ％ (30/61),32.8 ％(20/61),80.3％ (49/61),57.4％ (35/61),31.1％ (19/61),and there was significant difference between groups(x2 =8.021,28.438,8.431,10.435 and 23.128 respectively,P ＜ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were (75.0％ (45/60),81.7％ (49/60),95.0％ (57/60),86.7％ (52/60),81.7％ (49/60)),higher than that of control group (44.3％ (27/61),31.1％ (19/61),75.4％ (46/61),47.5％ (29/61),34.4％ (21/61)),and there was significant difference between groups (x2 =11.710,35.810,8.112,25.450 and 25.650 respectively,P＜0.05).Conclusion Whole course health education is proved to reach the purpose of long-term heart rehabilitation,and decrease the risk of the risk factors for PCI.Meanwhile it is a safe,effective,compliant heart rehabilitation model after PCI in old patients.

OBJECTIVE To study the possibility of applying Anerdian skin disinfectant for blood donor skin disinfection. METHODS Put Anerdian at 21℃,35℃ and 42℃ to exposure in air for 24h,48h and 72 h,detect the volatilization volume,effective iodine and appearance of disinfectant,and evaluate its effect on blood donor elbow by culture method. RESULTS At 21℃ exposure for 24 h the volatilization rate for Anerdian was 5%,effective iodine was 0.215%.At 35℃ and 42℃ exposure for 24 h its volatilization rate was more than 5%,and effective iodine was within the range of 0.18-0.22%.The average killing logarithm value of elbow skin natural bacteria in 30 donors was over 1. CONCLUSIONS Anerdian disinfectant is suitable for blood donor predonation skin treatment.

Objective To evaluate the efficacy of Six Sigma management for shortening the waiting time of outpatients accepting radiography and improving patient satisfaction. Methods Six Sigma management was applied to identify the key points critical to quality in the process of radiography,analyze the factors influencing the waiting time,and take targeted measures to modify the process. Results The waiting time of patients accepting radiography was reduced by an average of 25.2min and the rate of dissatisfaction was decreased by 18%. Conclusion The application of Six Sigma management can effectively shorten the waiting time of outpatients accepting radiography and increase patient satisfaction.

Objective　To investigate the preventive measurement of vagal reflex occurrence on patients with percutaneous transluminal coronary angioplasty (PTCA).Methods　On the reason of vagal reflex occurrence,to 75 patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.Then to observe the level of patients with vagal reflex occurrence,and compare with the control group of 75 patients under common care.Results　The prevent group level of patients with vagal reflex occurrence is 2.61%;the control group is 28%.Conclusion　To patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.The effect to decrease the level of vagal reflex occurrence is great.

BACKGROUND:Human umbilical cord mesenchymal stem cells (hUC-MSCs) may be mutated duringin vitro culture based on the spontaneous malignant transformation of adult stem cells and tumor stem cell theory, and there may be a risk of tumorigenesis after in vivo transplantation. Therefore, to establish and perfect the in vitro safety testing procedures will actively promote the clinical application of stem cells. OBJECTIVE:To investigate the tumorigenic mechanism of hUC-MSCs and the expression level of DNA methyltransferase (DNMTs) in hUC-MSCs. METHODS:Primary hUC-MSCs were isolated and expanded by tissue adherent culture. 3-Methycholanthrene was used to cause the malignant transformation in hUC-MSCs (experimental group), followed by morphological observation and tumorigenesis experiment in nude mice. Then, the tumor tissues were obtained and identified by pathological examination and primary cell culture, and the levels of DNMTs mRNA in hUC-MSCs treated with 3-methycholanthrene and dimethyl sulfoxide (control group) were detected by real-time RT-PCR and compared. RESULTS AND CONCLUSION:hUC-MSCs treated with 3-methycholanthrene led to malignant transformation, which showed malignant growth and non-integer ploidy changes in the cell nuclei, and formed a malignant tumor in immune-deficient mice after injection. Compared with the control group, the cells in the experimental group showed higher expression of DNMTs mRNA as detected by real-time RT-PCR. To conclude, hUC-MSCs can trigger malignant transformation in the morphology and the epigenetics under certain conditions. DNMTs can be a candidate for prevention against malignant transformation of transplanted stem cells.

Objective To establish and identify the induced pluripotent stem cell(iPSC) line reprogrammed from human umbilical cord mesenchymal cells(HuMSCs).Methods HuMSCs were cultured by adhesion method,and OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 were transfected into HuMSCs with lentiviral victor to reprogramme HuMSCs into iPSC.Morphological observation,pluripotency genes (SOX2,TDGF1,THY-1,OCT4,REX1 and TERF1) expression,alkaline phosphatase detection,karyotype analysis,embryonic stem cells (ESC) specific proteins (NANOG,OCT4,SSEA-4,TRA-1-81) immunofluorescence staining,differentiated into teratomas in vivo(inject the iPSC into SCID mice) and embryniod bodies in vitro were performed to exam the pluripotency of the iPSC.Results Four days after being infected by lentivirus,the HuMSCs became round-shape; 10 days after infection,some embryonic stem(ESC)-like colonies appeared.Fourteen days after infection,picked up the regularly shaped colonies and cultured several passages.About 1.25％ HuMSCs were reprogrammed into iPSC.The iPSC presented clone-like growth like ESC.All the cells were positive to alkaline phosphatase staining and expressed the pluripotency genes.The iPSC also expressed the ESC specific proteins,and karyotype analysis showed normal chromosome caryotype (46,XY).Furthermore,the iPSC could form embryoid bodies in vitro,expressed alpha fetoprotein(AFP),smooth muscle actin(SMA) and β-tubulin.The iPSC could alsoform teratomas in vivo.Conclusion OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 can reprogram HuMSCs into iPSC efficiently.

Objective:To investigate the effect of DKK1 on linearly patterned programmed cell necrosis (LPPCN) and vasculogenic mim-icry (VM) and the related molecular mechanism in non-small cell lung cancer (NSCLC). Methods:A total of 173 human NSCLC speci-mens were collected to detect LPPCN by H&E staining, detect VM with CD31/PAS double staining, and investigate DKK1 and related protein expression by immunohistochemistry. The clinical pathological significance of LPPCN, VM, and DKK1 and the correlation of them were analyzed. Human NSCLC H460-DKK1 cells were engrafed in nude mice to evaluate the influence of DKK1 up-regulation on VM and LPPCN in vivo. Results:Approximately, 14.45%(25/173) of NSCLC had VM and 49.71%(86/173) had LPPCN. 25.6%(22/86) of NSCLC cases in LPPCN-positive group formed VM. Both of VM and LPPCN were all correlated with poor differentiation, late TNM stage, easy recurrence and metastasis and poor prognosis in NSCLC. DKK1 expression in the VM-positive group and the LPPCN-positive group was higher than that in the VM-negative group and the LPPCN-negative group, respectively. DKK1, LPPCN, and VM were positive-ly correlated with VE-cadherin, MMP-2,β-catenin nuclear expression and Twist1. H460-DKK1 transplantation tumor model confirmed that DKK1 promotes the expression of VM and LPPCN and related proteins in NSCLC. Conclusion:The increase of theβ-catenin and Twist1 expression induced by DKK1 may promote the formation of LPPCN and VM in NSCLC.