Humans ; Tinnitus ; diagnosis ; therapy

Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Child ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; physiopathology ; Glucagon-Like Peptide 1 ; metabolism ; therapeutic use ; Humans ; Incretins ; therapeutic use ; Treatment Outcome

Objective:To investigate the protective effect of dagglitazine on cardiovascular and renal function in patients with type 2 diabetes mellitus.Methods:A total of 200 patients with type 2 diabetes patients with poor blood glucose control who received treatment in Huxi Hospital Affiliated to Jining Medical University (Shanxian Central Hospital) from January to December 2019 were included in this study. They were randomly assigned to receive treatment with either metformin ( n = 100, control group) or dagglitazine ( n = 100, observation group) based on diet control and exercise therapy for 12 weeks. Before and after treatment, blood glucose, blood lipid, blood pressure, body mass index, cardiac function and renal function were compared between the control and observation groups. Adverse reactions were also monitored in each group. Results:After treatment, blood glucose, blood lipid, body mass index, cardiac function and renal function in each group were improved compared with before treatment (all P < 0.05). Fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, body mass index, left ventricular end diastolic diameter, serum creatinine, uric acid and cystatin C in the observation group were (6.48 ± 0.72) mmol/L, (8.03 ± 0.77) mmol/L, (6.16 ± 0.63)%, (126.03 ± 3.86) mmHg, (75.62 ± 2.87) mmHg, (3.83 ± 0.17) mmol/L, (2.21 ± 0.36) mmol/L, (2.34 ± 0.15) mmol/L, (23.03 ± 0.55) kg/m 2, (52.10 ± 2.13) mm, (39.97 ± 1.62) μmol/L, (237.17 ± 20.34) μmol/L, (0.64 ± 0.06) mg/L, respectively, which were significantly lower than (8.01 ± 0.84) mmol/L, (10.03 ± 0.90) mmol/L, (7.30 ± 0.72)%, (130.06 ± 4.79) mmHg, (79.60 ± 3.19) mmHg, (4.67 ± 0.37) mmol/L, (2.51 ± 0.57) mmol/L, (2.74 ± 0.19) mmol/L, (24.03 ± 0.60) kg/m 2, (57.22 ± 1.74) mm, (80.00 ± 6.88) μmol/L, (281.62 ± 40.52) μmol/L, (0.76 ± 0.09) mg/L, t = 13.850, 16.866, 11.933, 6.549, 9.263, 20.879, 4.469, 16.982, 12.410, 18.634, 10.626, 9.804, 18.876, all P < 0.001). After treatment, high density lipoprotein cholesterol, left ventricular ejection fraction, and the average distance walked by patients during the 6-min walk test in the observation group were (2.47 ± 0.15) mmol/L, (39.97 ± 1.62)%, (366.50 ± 17.74) m, which were significantly superior to those in the control group [(1.70 ± 0.20) mmol/L, (36.77 ± 1.21)%, (323.70 ± 12.48) m, t = 30.255, 16.435, 19.733, all P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dagglitazine protects cardiovascular and renal function by reducing blood glucose, blood pressure, blood lipid, serum creatinine, serum uric acid levels and decreasing body mass index in patients with type 2 diabetes mellitus.

Objective To explore the efficacy of Tai Ji Quan on the elders with mild cognitive impairment (MCI). Methods From June to October, 2015, 108 old people with MCI were divided into control group (n=54) and intervention group (n=54). Both groups studied rele-vant knowledge about MCI and received handbooks. The excise of Tai Ji Quan was regularly conducted in the intervention group at least for-ty minutes a time and four times per week for three months. They were assessed with the Peking Union Medical College Version of Montre-al Cognitive Assessment (MoCA-P) before and after intervention. Results There was no significant difference in the scores of MoCA-P be-tween two groups before intervention (Z<1.425, P>0.05). After intervention, the total scores of MoCA-P, and the scores of visual space func-tion and long delayed recall were higher in the intervention group than in the control group (Z>3.425, P<0.01). Conclusion Tai Ji Quan can effectively improve the cognitive function, especially memory and executive function, in the elderly with MCI.

Objective To explore the feasibility and application value of saving the left colic artery (LCA) feasibility in laparoscopic anterior resection of rectal carcinoma (Dixon).Methods Collecting the clinical data of 63 patients diagnosed by rectal cancer and underwent laparoscopic anterior resection of rectal carcinoma from January 2009 to June 2012,including 32 cases underwent saving LCA (saving LCA group) and 31 cases not saving LCA (no saving LCA group).The amount of bleeding volume,operation time,the number of lymph node dissection of inferior mesenteric artery in the operation,pass wind time,anastomotic ischemia,anastomotic leakage,and recurrence and metastasis were compared.Results No significant difference was found in the bleeding volume [(62.82 ± 19.72) ml vs.(60.68 ± 21.39) ml],operation time [(129.48 ± 13.69) min vs.(129.45 ± 19.78) min],the number of lymph node dissection of inferior mesenteric artery in the operation (2.93 ± 1.54 vs.3.21 ± 1.30) between two groups (P ＞0.05).No significant difference was found in pass wind time [(2.82 ± 1.16) d vs.(3.14 ± 0.92) d] after operation (P ＞ 0.05).The saving LCA group was not performed freeing colon splenic area and the terminal ileum stoma,the proximal intestinal blood circulation disorder and anastomotic leakage were not found.In no saving LCA group,4 cases were underwent ileostomy because of the proximal intestinal blood circulation disorder,2 cases occurred anastomotic leakage.During the follow-up of 2-24 months,1 case had a recurrence,3 cases had metastasis in saving LCA group.1 case had a recurrence,4 cases had metastasis in no saving LCA group.Conclusion Saving LCA in Dixon operation can ensure the anastomotic part with adequate blood supply,and reduce the occurrence of anastomotic leakage.

Objective To study the clinical effect of endoscopic thoracic sympathectomy at different segments on palmar hyperhidrosis and research the incidence of postoperative compensatory hyperhidrosis.Methods One hundred palmar hyperhidrosis patients who underwent endoscopic thoracic sympathectomy were divided into 2 groups according to treatment method,the patients in A group (46 cases) received T4 surgery,the patients in B group (54 cases) received T3-4 surgery.The success rate of postoperative,incidence of postoperative compensatory hyperhidrosis and postoperative satisfaction rate between the 2 groups were compared.Results The surgery of 2 groups were successful.There was no statistical difference in total effective rate between the 2 groups (P ＞ 0.05).The incidence of postoperative compensatory hyperhidrosis in A group was significantly lower than that in B group [4.3％ (2/46) vs.20.4％ (11/54)],the postoperative satisfaction rate was significantly higher than that in B group [93.5％(43/46) vs.79.6％ (43/54)],there were statistical differences (P ＜ 0.05).Conclusion Endoscopic thoracic sympathectomy T3-4 or T4 surgery is very effective and safe treatment of palmar hyperhidrosis,but T4 surgery has a lower incidence of postoperative compensatory hyperhidrosis.

Objective To explore the effectiveness of short-term integrated intervention to reduce discrimination against people living with HIV/AIDS(PLWHA)among medical students.Methods A quasi-experimental survey was conducted.Two medical schools in Beijing,one as intervention group and the other as control group were selected by convenience sampling,from which 123 undergraduate students or interns of medical and nursing specialties were recruited,62 in the intervention group and 61 in the control group.The intervention group was provided with 13 hour long antidiscrimination intervention by increasing HIV/AIDS related knowledge,sympathy and skill in dealing with people living with HIV/AIDS,while the control group was deprived of any intervention.The attitude of the students in the 2 groups were assessed by questionnaire survey in 5 time points after the intervention.Results Compared with the control group,at 4 time points after the intervention students in the intervention group had less discrimination against PLWHA in general;and significantly less discrimination in dealing with them as patients(P

Objective To investigate self efficacy of condom use among mobile female population and to analyze related factors so as to provide evidence for relevant interventions.Methods One hundred and eighteen women working as waitresses in hotels in Beijing were interviewed with questionnaires.Results The average score of self-efficacy of condom use among the studied women was 45.42?8.26,and the self-efficay of condom use among them varied with their age,marital status and incomes;their attitude towards condom use and knowledge about correct condom use had obvious effect on the score of self-efficacy.Conclusion Mobile female population have a middle level of condom use self-efficacy,and there is a need to improve their condom use efficacy through training,especially for those unmarried young women with lower incomes.

Objective To summarize the experience of examination and treatment of 237 cases of eye diseases with portable slit lamp in earthquake area of Dujiangyan, Sichuan Province, from May 14 to July 8, 2008. Methods 237 cases of the eye diseases were examined and diagnosed. With portable slit lamp, the foreign bodies in 25 cases of conjunctival foreign body and 62 cases of corneal foreign body were removed. Results Of the 237 cases, 39 were diagnosed as conjunctivitis, 25 as conjunctival foreign body, 13 as pterygium, 27 as keratitis, 11 as corneal ulcer, 62 as cornea foreign body, 24 as cornea injury, 7 as hyphema, 16 as iridocyclitis, 5 as glaucoma and 8 as cataract. With portable slit lamp, the foreign bodies in 25 cases of conjunctival foreign body and 62 cases of corneal foreign body were removed in one lump with no corneal perforation or infection. Follow-up examination showed that the wounded cornea repaired pretty well. Conclusions With portable slit lamp, ophthalmologists can not only make a precise diagnosis for the eye diseases in the anterior segment, but also are able to timely to remove foreign bodies in conjunctiva and cornea. Portable slit lamp is a useful and convenient instrument for ophthalmologists in the field of earthquake disaster relief.