Objective To observe the effect of insulin glargine plus mefformin on inflammatory factors(IF) in the treatment of patients with newly diagnosed type 2 diabetes(T2DM).Methods 110 patients with newly diagnosed T2DM were given insulin glargine(beginning dose:10 U/d) and mefformin(0.5 g,tid) for 12 weeks;while 100 cases selected for the same period from the normal healthy population were taken as control group.Baseline fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin (HbA_1c),C-reactive protein(CRP),TNF-α and IL-6 were observed.Results Before treatment,FPG,2 hPG,HbA_1c and IF in T2DM group were obviously higher than those in control group(P＜0.05),but there was no difference in other clinical data (P＞0.05).After 12 weeks treatment,in T2DM group there was a significant improvement in blood glucose targets [FPG from (14.8±3.9) mmol/L to (6.6±2.1) mmoL/L;2 hPG from (17.6±3.3) mmol/L to (8.3±1.2)mmol/L;HbA1c from (9.6±2.7)% to (6.5±0.8)%,t=7.40,8.37,3.98,P＜0.05],and the level of IF also decreased significantly [CRP from (8.8±2.5) mg/L to (5.5±1.4) mg/L;TNFα from (2.9±0.6) ng/L to (1.6±0.2) ng/L;IL-6 from(170.3±22.2) pg/L to (105.9±14.6) pg/L,t=4.61,3.52,5.68,P＜0.05].Conclusions Insulin glargine and mefformin combined therapy can improve glucose metabolism in patients with newly diagnosed T2DM,and decrease the levels of IF.

Based on competence,this article studied on curriculum reform of nursing pharmacology.It described the model of curriculum construction on making teaching target,training professional quality,designing optimum learning situation,reforming teaching method and constructing curriculum evaluation system.This model is more suitable for nursing work and provide guarantee for cultivating high skilled and applicable nursing talent.

Objective To explore the effect of case teaching method based on ADDIE model in the teaching of surgical nursing. Methods Two classes of the four-year nursing specialty college students (39 students in each class, 78 students in total) in the third grade were selected as samples. According to the principle of randomization, one class was set as the observation group, and the ADDIE model based on case teaching method was adopted. According to the five stages of ADDIE model, namely, analysis, design, development, implementation, and evaluation, the whole process was performed to achieve teaching goals and timely combination of clinical cases, so that the theoretical knowledge of teaching materials and clinical reality were highly connected. The other class was set as the control group. At the end of the semester, the teaching results were evaluated based on two groups of students' test scores and questionnaire findings. SPSS13.0 software was used for statistical analysis. t-test was used to test the significance of the test results,and chi square test was used to test the significance of the survey data. The results of the two teaching methods were compared with the control group. Results The scores of the two groups were significantly higher than those of the control group [(87.0±7.1) vs (78.0±8.6), P=0.000; (93.0±2.4) vs (85.0±3.8), P=0.000]. Significantly more students in the observation group (P<0.05) were satisfied with the teaching methods used to improve the enthusiasm and initiative of learning, improve their interest in learning, broaden their knowledge, improve the effect and efficiency of learning, inspire students to think, associate, and innovate, activate classroom atmosphere, improve the ability of students to analyze and solve problems, apply theories in practice, and accurately grasp the basic concepts and theoretical knowledge. Conclusion The case teaching method based on ADDIE model can effectively improve the teaching quality of nursing courses and improve students' ability to analyze and solve problems. It is well received by students, and it can enhance teachers' teaching skills as well.

Objective To investigate the incidence,treatment and prognosis of neonatal respiratory failure (NRF) in the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province.Methods The medical data of 626 NRF newborns admitted to the Neonatal Intensive Care Unit of Children's Hospital of Hebei Province from January 1st,2008 to December 31st,2008 were collected,and the pathogenesis of NRF,management,risk factors of their deaths and cost for the disease were studied.The results were compared with the national study in the same period and the local study of 2004-2005 by Chi-square test.Results During the 12 consecutive months,the incidence of NRF in neonatal intensive care unit was 38.9％ (626/1608).The mortality in hospital was 22.5％ (141/626),among which,most deaths (134,95.0％) occured after early discharge required by the parents.The mortality decreased by 14.7％ compared with that during 2004 2005 (37.2％,113/304),and was also lower than that (24.7％,1683/6864) in the national study at the same period.Pneumonia/sepsis ( 34.8 ％,218/626 ),neonatal respiratory distress syndrome ( 31.6 ％,198/626 ),and meconium aspiration syndrome (10.7％,67/626) were leading primary causes of NRF.The major complications were pneumonia/sepsis (5.4 ％,34/626),intracranial hemorrhage (4.6 ％,29/626) and persistent pulmonary hypertension (3.2％,20/626 ).The percentage of NRF babies requiring pulmonary surfactant rose from 14.1％ (43/304) during 2004-2005 to 23.6％ (149/626) in 2008,which almost reached the national level of 26.8％ (1840/6864).Pulmonary surfactant treatment was accepted by 70.2％ (139/198) patients with neonatal respiratory distress syndrome.12.1％ (24/198)of neonatal respiratory distress syndrome infant was administered immediate intubation-surfactant-extubation.Seventeen (2.7％) patients accepted nitric oxygen treatment.Nasal continuous positive airway pressure was given to 76.5％(479/626) patients,which was higher than before (47.1％,143/304).Conventional mechanical ventilation rate decreased from 72.7％ (221/304) to 49.8％ (312/626),and high frequency oscillatory rate increased from 0.7％ (2/304) to 10.5％ (66/626),which were similar to the national level.Of the 480 patients discharged after recovery,the mean time of hospital stay was (15.1 ± 4.0) days,and the mean medical cost was (12752 ± 5148) CNY.Conclusions The patient number increases and the medical skills and treatment methods of our hospital improve a lot.Utilization of pulmonary surfactant,nasal continuous positive airway pressure and high frequency oscillatory ventilation increase significantly.However,the burden of NRF is still heavy.

Long period of constipation will affect the health of the elderly people. The constipation of the elderly people often appears deficient characteristics. In TCM, the principles of tonifying the spleen for helping digestion, simultaneously applying of moistening and subduing, and wanning and supplementing the Vital Gate are commonly used.

TBX20 gene, a member of the T-box gene family, plays an important role during heart development and is required for maintaining adult heart function.TBX20 can act as both transcriptional activator and transcriptional suppressor during the development of the heart, and shows complex spatiotemporal regulation.TBX20 is an important candidate transcription factor for the pathogenesis of congenital heart disease(CHD), and its mutation or expression change can lead to the occurrence of CHD.In this paper, the latest research progress of TBX20 gene in the field of heart development is reviewed from the relationship between TBX20 and CHD, the signaling pathway involved in heart development and its interactions with other cardiac transcription factors.

Objective To explore whether and how the medical students' performance in English and biochemistry studies on their exam scores in toxicology basics (in short:toxicology) with allEnglish questions.Methods The correlations between scores of toxicology exam with all-English questions and scores in college English test band 6 (CET6) and biochemistry test of 187 students in the eight-year medical program were analyzed.Results Score of toxicology exam was positively correlated with scores of CET6 and biochemistry tests to some degree ( the correlation coefficients were 0.359 and 0.413 respectively,P ＜ 0.01 ) ; the students who passed CET6 had higher score in toxicology exam than those who did not pass CET6 (P ＜ 0.01,by t-test).Conclusion Passing CET6 and having a good command of related subjects may be essential for adapting to all-English exam questions.

Objective To study the function of ginsenoside Rg3 on proliferation in human breast cancer cell line MCF-7 and effect of ginsenoside Rg3 on Cx26 gene expression and gap junctional intercellular communication (GJIC) in MCF-7, cultured in vitro. MethodsHuman breast cancer cells MCF-7 was exposed to ginsenoside Rg3 at differential concentrations for 24 h, respectively. The cell proliferation inhibition was measured by 3-[4,5-dimethylthiazo-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. The expression of Cx26 mRNA was measured by RT-PCR in experimental groups and control goup. The GJIC function of MCF-7 cell was examined with scrape-loading dye transfer assay.ResultsHuman breast cancer cell line MCF-7 was exposed to ginsenoside Rg3 at a concentration of 10, 20, 40, 80, 160 μg/ml, respectively.The inhibition ratio was 3.1%, 5.2 %, 16.0 %, 26.3 %, 29.1% respectively after 24 h. Compared with control group, the concentration of 40 μg/ml above could significantly inhibit MCF-7 cell proliferation (P ＜0.05), so the experimental groups were exposed to ginsenoside Rg3 at a concentration of 40, 80, 160 μg/ml,respectively. The expression of Cx26 mRNA in every experimental group compared with control group was enhanced when MCF-7 cell was exposed to ginsenoside Rg3 at a higher concentration. It was observed that Lucifer yellow fluorescent staining was limited to a single cell in control group through fluorescent microscope,but Lucifer yellow fluorescent transfered through gap junction cells to neighboring cells, then came into being flake fluorescent staining in experiment groups. ConclusionGinsenoside Rg3 can enhance the expression of Cx26 mRNA in MCF-7 cell and restore the gap junctional intercellular communication, which may be one of important mechanisms of ginsenoside Rg3 in antitumor.

Objective To study the predictive value of HER2/neu amplification and lymphovascular invasion for axillary lymph node metastasis in T1 breast cancer patients(mass<2 cm).Methods Reviewed the medical record of 206 T1 breast cancer patients who were the presence or absence of lymph node metastasis with IHC and FISH,analyzed the association be-tween ALNM and various clinicopathological predictive factors such as age,tumor size (T1a,T1b,T1c),multiplicity,the his-tologic grade,the nuclear grade,the presence of lymphovascular invasion (LVI),the estrogen and progesterone receptor sta-tus,an HER2/neu expression,the Ki-67 labeling index and the bcl-2 expression,and discussed the correlation of the various factors with axillary lymph node metastasis of T1 breast cancer.Results One hundred and thirty-nine were the node nega-tive group (T1N0)and the remaining 67 cases were allotted to the node positive group (T1N1-3),age (χ2 = 6.484,P =0.011),LVI (χ2 =72.813,P <0.001),histologic grade (χ2 =74.813,P =0.019),HER2/neu (χ2 =74.813,P <0.005),Ki-67 (χ2 =6.255,P =0.012)and bcl-2 (χ2 =4.977,P =0.026)were the statistically significant predictive factors related to node metastasis.The factors such as tumor size (χ2 =1.544,P =0.254),surgical method (χ2 =2.414,P =2.414),and ucle-ar grading HG (χ2 =2.017,P =0.159),estrogen receptors ER (χ2 =0.140,P =0.709),progesterone receptor PgR (χ2 =2.199,P =2.199),have no significant statistical correlation with early breast cancer lymph node metastasis.Conclusion HER2/neu overexpression and LVI were related to the increased incidence of ALNM in T1 breast cancer patients,LVI was the most predictive factor of ALNM.

Objective To summarize the nursing methods and effect of artificial femoral head replacement in treatment of osteoporotic interttochanteric fracture in elderly patients. Methods 55 patients with esteoporotic intertrochanteric fracture were selected in our hospital from February 2007 to February 2011.All patients were cared by targeted preoperative and postoperative nursing,helping them conducting functional training in time,giving discharge counseling and follow-up.The hip functional recovery of patients was evaluated by using the Harris evaluation standard,and the excellent rate of surgery was also evaluated. Results After the targeted care,55 patients went through the perioperative period safely,the average length of stay was ( 14.0 ± 3.1 )days,a total of 5 cases (9.09％)patiants suffered varying degrees of complications which were improved after symptomatic treatment.Patients were followed up for 3 to 36 months,only 2 patients died of cerebral vascular accident,all patients gained good recovery of hip function.Harris score was (84.45 ± 9.38),the excellent rate of surgery reached 78.18％. Conclusions Atificial femoral head replacement proves significant effect in treatment of osteoporotic intertrochanteric fractures in elderly patients,but with the accompanying surgical compliuations,special care and timely functional exercise methods should be paid attention to.