Objective To analyze the clinical efficacy and value of insulin glargine combined with repaglin-ide in the treatment of type 2 diabetes patients with chronic renal insufficiency.Methods 1 16 type 2 diabetes patients with chronic renal failure were divided into two groups according to the time of treatment.58 cases in the control group received premixed insulin treatment,while 58 cases in the observation group were given repaglinide plus insulin glargine,its clinical value was compared between the two groups.Results The FPG,2h PG,HbAlc of the observation group were (5.90 ±0.62)mmol/L,(7.03 ±0.65)mmol/L,(6.20 ±0.64)%,which were significantly reduced compared with before treatment(t=8.01,7.73,8.82,all P<0.05),and compared with the control group, the differences were statistically significant (t=7.23,6.83,7.73,all P<0.05 ).The SCr,BUN,24h UAE of the observation group were (90.90 ±8.43)μmol/L,(6.70 ±0.74)mmol/L,(1.20 ±0.34)g,which were significantly reduced than before treatment (t=7.69,7.89,8.02,all P<0.05),and compared with the control group,the differ-ences were statistically significant(t=6.83,7.03,6.57,all P<0.05).The incidence rate of adverse reaction of the observation group was 12.07%,which was significantly lower than 34.48% of the control group(χ2 =8.29,P<0.05 ),the main adverse reactions were hypoglycemia,patients with self-eating or oral syrup remission.Conclusion Insulin glargine combined with repaglinide in the treatment of type 2 diabetes patients with chronic renal function can control blood sugar levels,improve renal function and reduce adverse reactions,it is effective,safe,reliable and worthy of promotion.

Along with the widely utilization of information technology and network technology, hospital libraries are gradually becoming the center for digital information resources and scientific research base. The paper analyzes the importance of digitalized hospital libraries in medical treatment, teaching and scientific research, and further discusses how to improve the service quality.

Objective: To analyze the challenge and measures of current status in China after dialysis therapy entered in rural medical insurance of serious diseases. Methods: Based on the recent data from renal registry network in China, the primary disease, morbidity, therapy patterns and costs of end stage renal disease (ESRD) patients were analyzed the challenge and issue. Results: The number of ESRD patients is continuous growing during recent years. Hemodialysis is the main dialysis therapy pattern of ESRD and the cost is enormous. The dialysis centers and associated physicians in China are not enough. Conclusion: Prevention of ESRD in the early stage should be recommended, and medical quality of dialysis register should be administrated. It is needed to enhance medical quality management, establish county-level blood purifying center, encourage the business insurance and use medical community, chain operation and technology export to decrease medical costs.

Two-dimensional polyacrylamide gel electrophoresis (2D PAGE) followed by mass spectrometry (MS) is the most widely used method of protein resolution and identification. But it exist shortcomings. In this paper introduce some novel methods for protein resolution and identification,including the methods by high-liquid chromotography,capillary isoelectric focusing,capillary electrophoresis or 1D and 2D microcapillary chromotagraphy.

Objective To study the correlation of uterine segment thickness and time limits for patients with prior cesarean section. Methods A total of 80 women with the first pregnancy after cesarean section in our hospital from April 2013 to February 2015,according to the interval of cesarean section and second pregnancy,were divided into group A (18 cases,interval ≤3 years),group B (23 cases,an in-terval of 3 to 6 years),group C (27 cases,an interval of 7 to 9 years),and group D (12 cases,the interval ≥9 years).The uterine segment thickness and the success rate of vaginal trial production were compared.Surgical failures underwent vaginal trial production due to cesarean section were observed.Results The uterine segment thickness values of group A and group B in were respectively (5.93 ±0.34)mm and (5.45 ±0.27)mm,which were significantly higher than group C (3.24 ±0.52)mm and group D (2.83 ±0.56)mm,the difference was statistically significant (P <0.05).The vaginal trial production success rates of group A and group B were respectively 88.89% (16 /18) and 78.26% (18 /23),which were significantly higher than group C 44.44% (12 /27)and group D 33.33% (4 /12)(P <0.05).The dos-age of oxytocin of group A was (35.34 ±4.32)mL,blood loss was (256.32 ±34.21)mL, The oxytocin hormone dosage of group B was (37.09 ±4.52)mL,blood loss was (260.11 ±35.53)mL,which were lower than those in group C and group D (P <0.05).The postpartum hemorrhage rate of group A,group B and group C was respectively 0(0 /2),20.00% (1 /5),33.33% (5 /15)lower than group D 87.50%(7 /8)(P <0.05).Conclusion Maternal uterus at cesarean section within 7 years about the degree of recovery are in good condition,the higher uterine segment thickness,this time period is good for subsequent pregnancy and childbirth.

Objective: Through managing objectives in our hospital, promote the hospital management. Methods:Use expert advice method to establish the target assessment index system, with the weighted index method to calculate the final score. Results: According to the characteristics of the department, develop differentiated, personalized indicators; objective management system consists of 3 level indicators medical examination standard (680 points), scientific research and teaching standards (220 points), departmental management assessment criteria(100 points), and 45 secondary indicator of internal medicine, surgical 49 second-level indicators. Conclusion: Objective management is the starting point of the hospital and meticulous management, and implementation of objective management enhance the awareness of the collective participation of the medical staffs at all levels, so that the department changes from passive management to active management, and it enhances department execution and promotes the hospital science directly.

Objective To clarify the signaling mechanisms underlying angiotensin Ⅱ biphasic regulation of renal proximal Na+-HCO3- transport. Methods Different concentration Ang Ⅱ to the responses of Na+-HCO3- cotransporter (NBC) activity in isolated proximal tubules, with or without ATR, MAPK, cPLA2α, P450 blockade was compared in wild-type and Ang Ⅱ type 1a receptor (AT1aR)-deficient mice. The phospholipase of ERK was examined by Western blotting. AT1aR mRNA was examined by RT-PCR from kidney proximal tubules. Results (1)In isolated wild-type mouse, renal proximal tubules showed biphasic effects of Ang Ⅱ on NBC activity. Low concentration Ang Ⅱ (10-10 mol/L) increased NBC activity, but high concentration Ang Ⅱ (10-6 mol/L) decreased NBC activity. Olmcsartan (AT1 antagonist) blocked both stimnlatory and inhibitory effects of Ang Ⅱ on NBC activity, but PD98059 (mitogen-activated protein kinase inhibitor) blocked only the stimulatory effect of low concentration Ang Ⅱ ( 10-10 mol/L). (2)In AT1aR-deficient mice, only the stimulatory effect by high concentration of Ang Ⅱ (10-6 mol/L) was observed, which was blocked by olmesartan and PD98059. (3)In wild-type mice, pharmacological blockade of cPLA2 or P450 converted the inhibition effect by high concentration Ang Ⅱ (10-6 mol/L) to the stimulation, which was blocked by olmesanan and PD98059. These results indicated that the extracellular sigual-regulated kinase (ERK) activation via AT1 mediated only the stimulatory effect of Ang Ⅱ, while the cPLA2α/P450 activation via AT1 mediated the inhibitory effect of Ang Ⅱ independently of ERK. The analysis of ERK phosphorylation by Ang Ⅱ also supported a view that the cPLA2α/P450 pathway worked to suppress the ERK activation. Conclusions Ang Ⅱ activates ERK and cPLA2α with different concentration dependency via AT1. The balance between ERK and cPLA2α activities determines the final responses to Ang Ⅱ in intact proximal tubules.

Objective To select the optimum conditions of Echinococcosis ELISA kit and kit preparation by using orthogonal experiments,then to test their detection performance.Methods Taking the absorbance of the samples as the indicator,orthogonal experiments of three factors four levels were taken to optimize the conditions of hydatid disease detection ELISA kit.Through L16 (43)orthogonal experiments,the concentration of the antigen(A),the dilution multiple of the sample (B) and the dilution multiple of the enzyme labeled antigen (C) were studied.The specimen were provided by The First Affiliated Hospital of Xinjiang Medical University specimen library collected between March 2011 and June 2013,including 36 sera confirmed alveolar Echinococcus by the gold standard,56 sera confirmed Echinococcus granulosus disease by the gold standard and 72 sera as the control group(including healthy people,cirrhosis,hepatitis,etc).Detecting sensitivity and specificity were compared using F test for statistical analysis.Results Orthogonal design showed the size proportion of three factors of echinococcosis ELISA kit:antibody dilution ＞ sample dilution ＞ antigen coating concentration.The optimal preparation conditions were A1 B2 C4,that was,the concentration of antigen was 1 mg/L,sample dilution of 1∶ 100,dilution of secondary antibody of 1∶160 000.Through the 3-factor and 4-level orthogonal design using F-test analysis,the fact of the concentration of the kit antigen(A),F =1.181,P =0.393; the fact of the dilution multiple of the sample (B),F =2.544,P =0.152,the fact of enzyme labeled antigen dilution (C) F =2.544,P =0.039.The sensitivity of the kit to Echinococcus granulosus disease and alveolar Echinococcus were 83％ (30/36),and 91％ (51/56),respectively; the specificity was 91％ (29/32) and 83％ (33/40); the misdiagnosis rate of 17％ (6/36) and 9％ (5/56) ; the misdiagnosis rate 9％ (3/32) and 18％ (7/40) ; positive likelihood ratio 8.86％ (83/9) and 5.20％ (91/18) ; negative likelihood ratio of 0.18％ (17/91) and 0.11％ (9/83).Conclusion Orthogonal design is a good method that can find out optimal conditions of preparation for Echinococcosis ELISA kit and improve the test performance.

Objective To evaluate the effects of applying clinical pathway in clinic teaching of kidney diseases. Methods Data of average in-hospital days,costs,percentage of antibiotic drugs, improvement rate and satisfaction of patients who received the clinic pathway in nephrology depart-ment from January 2010 to December 2012 were used to evaluate the quality of clinical pathway and were compared with those of patients not received clinic pathway in 2009. Teaching effects of eight-year clinic medical students whose scores were provided by internal medical teaching section were al-so analyzed. Questionnaire of hospital quality was adopted to assess satisfaction of patients,nurses and doctors and the results were compared with those of 2009 students. All data were analyzed by SPSS 13.0 software. Chi-square test was used for enumeration data and results were expressed as percentage while t test was used for measurement data and results were expressed as (x±s),with P<0.05 stand-ing for statistically significant differences. Results After applying clinical pathway,average in-hos-pital days were reduced from 10.7 d in 2009 to 8.7 d in 2012,percentage of medical drugs were de-creased from 86.6% in 2009 to 33.4% in 2012 and percentage of antibiotic drug were reduced from 79.1%to 23.0%. Average in-hospital days and costs of IgA nephropathy and lupus nephritis were de-creased. Satisfaction of patients was increased from 94.1% to 99.0% and scores of students were in-creased from (81.0 ±2.5)points to (89.5 ±2.8)points. Conclusions Application of clinical path-way in clinic medical teaching should be encouraged. It can enhance the teaching quality and is help-ful for culturing inno-vative clinic thinking of medical students and cultivate practical medical talents.

Objective To study the clinical effect of drug intervention on the treatment of peptic ulcer with blood clots in the Department of internal medicine.Methods From 62 cases of peptic ulcer adherent blood clot were randomly divided into study group and control group according to the random number table,31 cases in each group,in each group.The control group was treated with esomeprazole infusion and subsequent oral treatment.The study group was given endoscopic hemostasis and subsequent oral esomeprazole treatment.Compare the two groups of curative effect,treatment profile and treatment before and after the study of the changes in the situation.Results The total effective rate of the study group was 90.32％,which was significantly better than that of the control group(P<0.05),which was significantly better than that of the control group 70.97％.Research group of rebleeding rate and transfer rate of surgery was significantly lower than that of control group(P<0.05),the study group,the time of hemostasis,the time of hospitalization significantly faster than that of the control group(P<0.05),study group medical expenses are significantly less than the control group(P<0.05).The two groups before treatment Blatchford score,Rockall score,SF-36 score no significant difference,after treatment in the two groups of the three scores were compared with those before treatment significantly optimized(P<0.05)study group the score optimization was significantly better than the control group(P<0.05).Conclusion Peptic ulcer adhesion blood clot give endoscopic therapy can greatly enhance the efficacy,reduce bleeding and transfer the risk of surgery,more effectively improve the acute upper digestive tract bleeding symptoms and signs,improve the life quality of the patients.