Micronutrients are closely associated with the progression of diabetes and its complications. Diabetic patients are susceptible to micronutrient deficiency. In this article, we summarize the preventive and therapeutic effects of micronutrients including zinc, selenium, magnesium, and chromium on diabetes mellitus.

As a rational economic man and agent, in the primary care Physicians not only pursue target in-come, but also pursue the utility of the agent. Different health care payment has different effect on physician, due to imperfect physician agent of the primary health care, the health care payment is difficult to achieve economic neutral. Based on the theory of target income and physician-induced demand, the paper proves that in the primary health care with the third party payment, there should be a prospective component of payment and fees should be lower than mar-ginal cost, which can not only improve the role of agent, but also constraint the physician-induced demand, so as to achieve health care for physician’s behavior constraints.

Objective To study treatment method that improve the cronic perapical periodonitis. Methods To fill the tooth channal of chronic perapical periodonitis with a paste of doxycycline and tinidazol, or gutta percha point. Results Among 206 cases of teeth those succeesful rates of two methods were 97.09 % and 98.06 % after 2 years clinical observe. Conclusion To fill the tooth channal of cronic perapical periodonitis with a paste of doxycycline and tinidazol to treat the chronic perapical periodonitis,it shortens the treatment,simplifies operation,makes application more extensive and its nearly period effect is the same as that of using gutta percha point to fill the tooth.

Objective To evaluate the safety of myomectomy by extrusion in cesarean section , in comparison with routine cesarean delivery. Methods From January 2008 to December 2010, a total of 128 operations of myomectomy by extrusion in cesarean section were performed (Myoma Group), while another group of 128 cases undergoing caesarean section , which respectively followed every cases of the Myoma Group but had no hysteromyoma , was selected as the control group .The amount and rate of postpartum hemorrhage , the level of postpartum fever , and postoperative hospital stay between the two groups were compared , respectively. Results In the two groups:the amount of postpartum hemorrhage was (233.6 ±58.9) ml vs.(228.5 ±90.9) ml (t=0.530, P=0.597); the rate of postpartum hemorrhage was 0% (0/128) vs.0.8% (1/128) (P=1.000); the decrease of haemoglobin was (6.17 ±2.83) g/L vs.(6.89 ±3.09) g/L (t=-1.944, P=0.053); the decrease of hematocrit was 2.22%± 0.98%vs.2.27%±1.02% (t=-0.400, P=0.690); the rate of postpartum fever was 2.3% (3/128) vs.5.5% (7/128) (χ2 =1.665, P=0.197);the length of postoperative hospital stay was (4.2 ±0.8) d vs.(4.1 ±1.2) d (t=0.706, P=0.481). There were no significant differences between the two groups in the abovementioned parameters . Conclusions The myomectomy by extrusion in cesarean section does not increase the level of postpartum hemorrhage and the rate of postpartum infections .It is a simple, minimally invasive , safe and feasible surgical method , being worthy of clinical application .

Objective To investigate the appropriate timing of B-lynch suture in the treatment of atonic postpartum hemorrhage during cesarean section.Methods A total of 90 patients with atonic postpartum hemorrhage during cesarean section from January 2012 to December 2014 in our hospital were included in the study.They were divided into two groups, early suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 500 ml, n=66 cases) and late suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 1000 ml, n=24 cases).The hemostatic effect, amount of bleeding, blood transfusion rate, incidence of DIC, duration of hospitalization, and the puerperal morbidity were compared between the two groups.Results All the 90 patients were successfully treated and were discharged after comprehensive treatment.The amount of postpartum hemorrhage of the early suture group was (656±118) ml, which was significantly less than that of the late suture group [(1550±432) ml, t=-10.003, P=0.001].The rate of blood transfusion of the early suture group was 3.0% (2/66), which was significantly lower than that of the late suture group [(50.0%, 12/24), x2=26.092, P=0.000].There was no case of DIC in the early suture group, and the incidence of DIC in the late suture group was 16.7% (4/24), with the difference statistically significant (Fisher''s exact test, P=0.004).The puerperal morbidity in the early suture group was 3.0% (2/66) and that of the late suture group was 25.0% (6/24), with statistically significant difference (x2=7.952, P=0.005).There was no statistically significant difference in the hospitalization stay between the two groups (P>0.05).Conclusions B-Lynch suture is an effective method in the treatment of atonic postpartum hemorrhage during cesarean section, and early use of it can get better curative effect, such as less bleeding amount and lower rates of blood transfusion, DIC and complications like puerperal morbidity.In case the bleeding volume reaches 500 ml and the general conservative hemostatic methods are ineffective, B-Lynch suture is recommended immediately.

Objective:To evaluate the occlusal function of patients with Class ⅡDivision 1 malocclusion.Methods:T-Scan II system 4.02 was used to record total occlusal force(TOF),asymmetry index of occlusal force(AOF),number of occlusal contacts(NOC),asymmetry index of occlusal area(AOA),center of force(COF),maximal movement of COF(MMCOF),occlusal interference index(OII)of 26 Class ⅡDivision 1 malocclusion in the intercuspal position(ICP)comparing with 26 normal occlusion.Results:TOF in Class ⅡDivision 1 malocclusion was significantly smaller than that in normal occlusion(P0.05);AOF,AOA,COF,MMCOF,OII in ClassⅡ1 were significantly higher than those in normal occlusion(P

Objective To simulate local hemodynamic factors at particular arterial positions.Method A combination of high-lipid diet and immuoreactive injury was used to establish a hyperlipemia and atherosclerosis model in rabbit.Serrial sections were analysed by OLYSIA software.Data of caliber at different positions of carotid bifurcation,areas and circumference and thickness of the atherosclerotic plaque at carotid bifurcation were obtained and to establish a geometric model of rabbit carotid artery bifurcation with Gambit software.Wall shear stress distribution of the carotid sinus were analysed by numerical simulation.Result 1) A geometric model of rabbit carotid artery bifurcation was obtained.2) The wall shear stress of the carotid sinus of the atherosclerosis(AS) model group was found to be lower than that of the control group at shear rate 128.5 S~(-1).The lowest wall shear stress of the control was 4.028 times that of the AS model.Conclusion Low wall shear stress is a risk hemodynamic factor in the development of atherosclerotic plaque.

Objective:To investigate the application value of ultrasound-guided selective pudendal nerve block during vestibular gland resection.Methods:Ninety patients who underwent vestibular gland resection in Lishui Maternal and Child Health Hospital from January 2017 to January 2020 were included in this study. These patients were divided into a control group and an observation group ( n = 45/group) according to the order of admission. Patients in the control group underwent blind nerve block and those in the observation group underwent ultrasound-guided selective pudendal nerve block. Hemodynamics before and after anesthesia, anesthetic effects, pain severity, and the incidence of complications were compared between the control and observation groups. Results:There were no significant differences in hemodynamics and pain severity between the control and observation groups (both P > 0.05). Systolic blood pressure [(124.37 ± 8.12) mmHg], diastolic blood pressure [(91.68 ± 5.44) mmHg] and heart rate [(74.62 ± 3.56) beats/min] were significantly lower than those in the control group [(128.62 ± 9.27) mmHg, (95.24 ± 6.17) mmHg, (76.12 ± 3.32) beats/min, t = 2.248, 2.903, 2.067, all P < 0.05]. In the observation group, pain scores at 2 and 24 hours after surgery were (3.06 ± 0.25) points and (4.21 ± 0.52) points, respectively, which were significantly lower than those in the control group [(3.28 ± 0.24) points and (4.54 ± 0.48) points, t = 2.618, 3.128, both P < 0.05). Anesthetic effect in the observation group was superior to that in the control group, and incidence of complications in the observation group was significantly lower than that in the control group ( χ2 = 12.869, 4.285, 4.864, 3.920, all P < 0.05). Conclusion:Ultrasound-guided selective pudendal nerve block in vestibular gland resection exhibits better anesthetic effect, has no obvious effect on hemodynamics, and has good analgesic effect with low incidence of complications. Therefore, it deserves clinical popularization.

Objective To construct the core competence index system of nursing postgraduates in TCM colleges and universities.Methods The Delphi method was used to investigate 30 nursing experts and consult about core competence that nursing postgraduates of TCM colleges and universities should have.Results The effective recovery rates of questionnaire were respectively 85.7％ and 86.7％.The authority coefficients were 0.86 and 0.84,and the consistency coefficients were 0.278 and 0.253 with statistical significance.Index system for core competence with 4 first-grade indexes and 20 second-grade indexes was formed.The full score ratio of first-class indexes was 0.96-1.00,coefficients variation was 0.10-0.13; for the second-class,the full score rate was 0.62-1.00,coefficient variation was 0.08-0.19.Conclusions For formation items of core competence index system of nursing postgraduates in TCM colleges and universities,the opinions of experts are centralized,which can provide reference for training program of nursing postgraduates in TCM colleges and universities.

Objective To explore the influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.