Diseases of glucose and lipid metabolism disorder,presented rather complicated pathological mechanism,often with clinical pattern of multiple concurrent diseases.Therefore,the traditional single-disease based on treatment methods need improving.In view of plenty of clinical practice,theatrical and fundamental researches,the pathological mechanisms of some chronic disorders,such as hyperlipidemia,nonalcoholic fatty liver disease,type 2 diabetes,hypertension,atherosclerosis and severe cardiovascular complications,resulted from the impairment in the metabolism of glucose and lipid were investigated using the method of integrated Chinese and western medicine.Overall,the features of these diseases and their common characteristics were discovered,and accordingly we defined the new concept of glucolipid metabolic disease (GLMD) and put forward the concept of pivot liver of metabolic regulation system.In addition,we developed the therapeutic strategy of modulating liver,starting pivot and cleaning turbidity,for the comprehensive and integrated treatment and prevention of these diseases.The theory of GLMD shared the critical characteristics with precision medicine,taking its own specialty.Finally,the content and approaches for the research of GLMD were proposed,and some essential and core fields in the precision medical research for GLMD were profoundly analyzed and prospected.

OBJECTIVE:To investigate the effects and safety of rosuvastatin on blood lipid and thyroid nodules in elderly pa-tients with dyslipidemia. METHODS:70 elderly patients with dyslipidemia were selected and randomly divided into control group (33 cases) and treatment group (37 cases). Control group was treated with routine treatment as abstain from tobacco and drink, low fat diet,Aspirin enteric-coated tablets 100 mg at bed time;treatment group was additionally treated with Rosuvastatin calcium tablet 10 mg at bed time,on the basis of control group. Both groups received the treatment for consecutive 12 weeks. BMI,blood lipid and the size of thyroid nodules were compared between 2 groups before and after treatment,and the occurrence of ADR was also observed. RESULTS:There was no significant difference in BMI between 2 groups before and after treatment (P>0.05). There was no significant difference in blood lipid level and the size of thyroid nodules between 2 groups before and after treatment (P>0.05). The blood lipid level and the size of thyroid nodule of 2 groups were improved significantly after treatment,and the treatment group was significantly better than the control group,with statistical significance(P<0.05). 2 pationts of creatment suf-fered from the increase of ALT but recovered withont angtreatment. CONCLUSIONS:Rosuvastatin can significantly improve blood lipid and decrease thyroid nodules in elderly patients with dyslipidemia with good safety.

Purpose To investigate the expression of IGF-Ⅱand IGFBP-6 in co1orecta1 cancer,and to exp1ore the c1inica1 significance in co1orecta1 cancer. Methods IGF-Ⅱand IGFBP-6 were detected by immunohistochemistry and RT-PCR in 50 cases of co1orecta1 cancer(experimenta1 group)and 50 cases of the adjacent mucosa(contro1 group). Results (1)In the experimenta1 group,the ex-pression 1eve1 of IGF-Ⅱprotein and mRNA was significant1y higher than the contro1 group. The expression 1eve1s of IGF-Ⅱprotein and mRNA in co1orecta1 cancer were significant1y 1ower than the contro1 group.(2)The expression 1eve1s of IGF-Ⅱand IGFBP-6 were sig-nificant1y different between different tumor infi1tration depth,1ymph node metastasis,invasion depth and Duke’s stages( P<0. 05), but no difference between genders,age and the degree of tumor differentiation( P>0. 05). Conclusions There is a obvious corre1a-tion between of IGF-Ⅱ and IGFBP-6 in c1inica1 patho1ogica1 parameters in co1orecta1 cancer. Combined detection of the two markers may be the bio1ogica1 indicators of occurrence and prognosis of co1orecta1 cancer,and provide a new scheme for diagnosis and treatment of co1orecta1 cancer.

Objective To study the insulin‐like growth factor binding protein (IGFBP)‐2 and IGFBP‐6 expression and clini‐cal significance in colorectal adenomas .Methods A collection of Chengde Medical College Hospital from July 2012 to March 2013 after surgical treatment of colorectal cancer confirmed by pathology (colorectal cancer ,CRC) tissue samples of 50 patients ,colorec‐tal adenomas (colorectal adenoma ,CRA) 50 cases ,20 cases of colorectal normal mucosa .Immunohistochemistry and RT‐PCR were used to detect the expression of IGFBP‐2 and IGFBP‐6 protein and mRNA ,combined with clinical and pathological data were statis‐tically analyzed .Results IGFBP‐2 protein positive expression and the amount of mRNA expression in the CRA group compared with normal colorectal mucosa had a rising trend;While compared with CRC group had a tendency to reduce ,and the differences are obvious statistical significance (P<0 .05) ,and IGFBP‐6 protein positive expression in the CRA group compared with normal color‐ectal mucosa had a lower trend;While compared with CRC group amount IGFBP‐6 mRNA expression in the CRA group compared with normal colorectal mucosa had a rising trend;While compared with CRC group had a tendency to reduce ,and the differences were obvious statistical significance (P<0 .05) .In the CRA group ,IGFBP‐2 ,IGFBP‐6 positive expression and the patient′s age , sex ,tumor and the number of parts were no significant statistical difference (P>0 .05) ,but with the degree of hyperplasia had sig‐nificant statistical difference(P<0 .05);In the CRA group ,IGFBP‐2 and IGFBP‐6 expression were negatively related to each other , and the difference was statistically significant (P<0 .01) .Conclusion Colorectal adenomas in normal colorectal mucosa of colorec‐tal cancer to the middle part of the transformation process ,and in its occurrence and development process ,insulin‐like growth factor family (IGFs) and IGFS‐R axis plays an important and irreplaceable role ,so IGFBP‐2 ,IGFBP‐6 may be used as diagnostic colorectal adenomas and early predictors of prognosis ,clinical studies on colorectal adenomas is important .

Aim To explore the effects of depression on tumors, as well as its molecular mechanisms. Methods The chronic unpredictable mild stress model (CUMS) was constructed. Tumor was inoculated after behavioral test, and the differences in serum norepinephrine and tumor volume between groups were detected. Breast cancer cells were stimulated by administration and invasion, migration, proliferation and cell cycle distribution were detected. Western blot and immunofluorescence were utilized to detect cell surface receptors and intracellular signaling pathways. Results Depression up-regulated the level of norepinephrine (N E) and increased the phosphorylation of p38 MAPK, resulting in increased malignancy of breast cancer cells. Conclusions Depression may increase the malignancy of breast cancer through norepinephrine-induced p38 MAPK signaling pathway, thus increasing the malignant degree of breast cancer.

Objective To analyze the impac factors of serum N?terminal pro?brain natriuretic peptide (NT?proBNP) in patients with renal failure in non?dialysis phase, and to determine the cut?off point of as a diagnostic values in these patients with heart failure (HF). Methods Cross?sectional study was applied. Clinical data of 145 patients (37 cases of CKD4, 89 cases of CKD5, and 19 cases of acute renal injury (AKI) with renal failure in non?dialysis phase were collected. Comparison between groups and lineal regression analysis were utilized to investigate the impact factors of NT?proBNP, and the receiver operating characteristic curve (ROC curve) to select a better cut?off point of diagnosis in these patients with HF. Results (1) Compared with patients without HF, patients with HF had significantly higher edema, cardiac troponin I, serum phosphorus concentration, and left atrial diameter (LA), while ALB and left ventricular ejection fraction (LVEF) were decreased (P<0.05). (2) The NT?proBNP was divided into 4 groups with four points: First groups of 36 cases, NT?proBNP 1 ?862 ng/L, second groups 37 cases, 866?2670 ng/L, third groups 37 cases, 2790?20 000 ng/L, fourth groups 35 cases, 20 900?35 000 ng/L. With the increase of NT?proBNP levels, the occurrence of AKI and CKD4 decreased gradually while the occurrence of CKD and edema were significantly increased (P<0.01). Systolic blood pressure, troponin I, uric acid, serum phosphorus, parathyroid hormone, 24 hours urine protein, LA, interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW) level gradually increased. Hb, ALB, calcium, CO2, eGFR, LVEF significantly decreased (P<0.01). The serum NT?proBNP of patients with HF was significantly higher than that of patients without HF (19 150 ng/L vs 1530 ng/L, P<0.01). The serum NT?proBNP of patients with edema was significantly higher than that in patients without edema (5460 ng/L vs 1630 ng/L, P<0.01). (3) Single factor linear regression analysis indicated that higher NT?proBNP was positive correlated with HF, edema, cardiac troponin I, uric acid, serum phosphorus, LA, IVS and LVPW (P<0.05), while negative correlated with Hb, eGFR, ALB, serum calcium, CO2, LVEF (P<0.05), and not correlated with eGFR, uric acid, serum calcium (P>0.05). (4) The best cut?off point of NT?proBNP predicting HF in patients with renal failure in non?dialysis phase was 3805 ng/L, AUC=0.848, 95%CI 0.786?0.910. Sensitivity was 82.4%, specificity 74.5%, positive predictive value 62.1%, negative predictive value 87.3%, positive likelihood ratio 3.2, negative likelihood ratio 0.24. Conclusions The level of NT?proBNP>20 000 ng/L is mainly found in end?stage renal disease patients with HF. HF is a main factor for the increase of NT?proBNP in patients with renal failure in non?dialysis phase. High phosphorus viremia, anemia, and hypoalbuminemia are closely related to NT?proBNP. Therefore NT?proBNP predicting HF should take into account the effects of these confounding factors in these patients.

This paper presents the design of smart data collection system to deal with the drawbacks like EHR data second hand input which is time-consuming and EHR's poor usability. The system comprises security certification, information management and data transmission modules. Through WLAN, EHR data can transmit between smart terminals and server. Also it provides a real-time communication platform for both terminal users and medical care personnel.
Computer Security ; Database Management Systems ; Information Systems ; Medical Records Systems, Computerized ; organization & administration ; Software Design

Objecve To observe the clinical effect and safety of the Chinese medicine syndrome differentiation combined with HAART for the ADC(acquried immune deficiency syndrom dementia complex). Methods A total of 80 patients with ADC were divided into the treatment group and control group based on random number table, 40 in each group. The patients in the control group were treated by highly active anti-retrovital therapy (HAART). The patients in the treatment group were treated with TCM treatment on the based of the control group. Both groups received the treatment for 3 months.These outcomes were measured: TCM syndrome integral, mini mental state examination(MMSE), daily behavior scale(ADL), change of clinical stage, and adverse reactions. Results The effect rate of treatment group was 82.5%, which was significant higher than 65% of the control group (χ2=8.115,P=0.024). After the treatment, the ADL integral of the treatment group (37.69 ± 5.31vs.33.67 ± 5.16;t=2.528,P=0.021) was significantly higher than that before the treatment; and the ADL integral of the control group(36.96 ± 5.52vs.34.54 ± 4.98;t=2.747,P=0.027) was significantly higher than that before the treatment.But there was no significant difference between the two groups after the treatment (t=2.003,P=0.139). After the treatment, the MMSE integral of the treatment group (24.76 ± 4.43 vs.19.97 ± 5.46;t=1.006,P=0.013) was significantly higher than that before the treatment; the MMSE integral of the control group(24.65 ± 4.36 vs. 20.11 ± 4.87;t=1.035,P=0.014) was significantly higher than that before the treatment. But there was no significant difference between the two groups after the treatment (t=0.953, P=0.347).There was no significant difference between the two groups in the clinical stage change (phase1χ2=1.231,P=0.954; phase2χ2=2.726,P=1.053). There was no adverse reaction in the two groups during the treatment.Conclusions The Traditional Chinese medcine combined with HAART was better than HAART alonein the treatment of ADC.

Objective To study the relationship between different syndromes of AIDS dementia complex (ADC) and different disease severity, age, CD4+ T cell count and infection. Methods Totally 186 patients with ADC were classified into different syndrome types, and the distribution in different degree of disease, different age, different CD4+T cell count and different routes of infection was analyzed. Results There were 48, 51, 15, 37 and 35 cases of deficiency of kidney and marrow, yin deficiency of liver and kidney, deficiency of heart and spleen, syndrome of phlegm obstruction, syndrome of qi deficiency and blood stasis, respectively. Moderate and severe degrees with yin deficiency of liver and kidney were more common. There was statistical significance in the distribution of different syndromes in different degree of disease (χ2=82.495, P=0.000). Deficiency of kidney and marrow, yin deficiency of liver and kidney were more common in different age groups. The distribution of the syndrome types in different age groups was statistically significant (χ2=72.710, P=0.000), the patients were mainly in two age groups of>50–60 years old and>60 years old. The distribution of the syndrom types in diffenrent CD4+T cell count stratum was statistically significant (χ2=66.778, P=0.000). Blood pathway infection mainly included deficiency of kidney and marrow and syndrome of qi deficiency and blood stasis, sexual pathogens mainly yin deficiency of liver and kidney. Conclusion CD4+T cells layers, age group, progression of disease and transmission way are the influencing factors of syndrom type.

Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.