Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

Telomerase can inhibit the shortening of telomere and stimulate continuous cell proliferation to form tumor.The activity of telomerase can be prohibited by G-quadruplex formed by the single chain in G-rich field of telomere 3' end, resulting in tumor cell apoptosis.Ligands which can induce the formation or stabilize the structure of G-quadruplex in G-rich field of oncogene exhibit antitumor function. Nowadays it becomes the core concern of chemists and biologists to screen and structurally design the compounds targeting G-quadruplex.This paper summarized the discoveries in the G-quadruplex-targeted telomerase inhibitors in recent years.

Objective To investigate the nutrition support during stress response period after tumor ex-tirpation in middle-aged and elderly patients with oral and maxillofacial tumors. Methods Sixty patients who had undergone maxillofacial tumor extirpation were randomly divided into nutrition therapy group (n = 35) and control group ( n = 25 ). Patients in nutrition therapy group received enteral nutritional treatment, while patients in control group fed themselves. The nutritional status of the two groups before operations were evaluated with Concise Nutritional Assessment Indicators of human body measurement and biochemistry were used to evaluate the nutritional conditions. The incidence of post-operational complications and recovery time ( from the operation to discharge) were analyzed. Results The weight and arm muscle circumference in the nutrition therapy group significantly decreased after operations (P <0. 05). However, in the control group, all the nutritional indica-tors except the total lymphocyte count were significantly lower than the baseline levels after operations (P < 0. 05 ) ; particularly, of the average body weight decreased by about 6 kg. The incidence of complications in the nutrition therapy group was significantly lower than that in control group (5. 7% vs. 12. 0% , P <0. 05). The recovery time was significantly longer in the control group than that in the nutrition therapy group [ (28. 62± 2.38) vs. (22. 76± 3. 24) d, P < 0. 01 ]. Conclusion The nutritional support during the stress response period can satisfy the demands of high catabolism after maxillofacial tumor extirpation operation in middle-aged and elderly patients.

BACKGROUND:Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion.Therefore,a novel kind of drug stent,which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis,needs to be developed.OBJECTIVE:To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments.RETRIEVE STRATEGY:The retrieve staffs were the research personnel for this paper.A computer-based online search was conducted in PUBMED for English language publications containing the key words of "drug eluting stents,percutaneous coronary intervention,coronary disease" from January 2002 to April 2007.Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007.The number of total retrieved Iiteratures was 15.Inclusion criteria:①reports about drug stents;②reports on research progress in the field of drug stents;③reports on the clinical application of drug stents.Exclusion criteria:low relevance and duplicated articles.LITERATURE EVALUATION:There were 264 articles about research and clinical applications of DES.Of those,42 literatures and 5 conference reports with high relevance and timeliness were included in this report.DATA SYNTHESIS:An ideal DES is comprised of a platform,a drug carrier vehicle and a pharmaceutical compound in harmony with each other.Given the ongoing development of DES materials and drugs,more effective DESs are introduced in the clinical practice.Recently,clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions,such as chronic total occlusions,complex lesions and multivessel lesions.However,concern that DES may be associated with a risk of late thrombotic events arose,suggesting an imbalance between safety and efficacy of DES.Therefore,novel strategies including bioabsorbable stents,and stents coated with pro-healing agents are promising.CONCLUSION:The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease,especially for restenosis and revascularization.Nevertheless,more endeavour will be necessary to create DES with high efficacy as well as low risk.

The morbidity and mortality of heart failure (HF) were gradually incrcased,around 2％-3％ of the population suffered from HF.As a biomarker,NT-proBNP has been shown to be widely used in the diagnosis of HF patients.NT-proBNP lever is affected by many factors,especially the age,age-specific NT-proBNP lever is very important in diagnosis of elderly HF patients.

Objective To investigate the recognition of graded nursing and its influencing factors among nursing assistants in elder homes.Methods A questionnaire survey was conducted on 116 nursing assistants.Results The nursing assistants showed insufficient recognition of graded nursing,there were significant differences in role cognition,operation and practice training,salary,and the nursing workload,there were no significant differences in working years and educational levels.Conclusions The recognition of graded nursing was insufficient.It is suggested to increase the role cognition education,enhance the theory and practice training,provide higher salaries and allocate workload reasonably to ensure the implementation of graded nursing and increase the satisfaction level of the elderly.

Objective To observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia (VAD).Methods Eighty cases with VAD were randomly divided into the treatment group (40 cases) and the control group (40 cases).The control group were given 30 mg nimodipine for three times a day ;The treatment group was given additionally three times a day of 0.2 g butyiphthalide for 12 consecutive weeks.The Mini-Mental State Examination (MMSE),Clinical Dementia Rating (CDR),and Activities of Daily Living (ADL) scores were used for the assessment of cognitive function.The assessments were done before and after treatment.The adverse effects were also recorded.Results In the treatment and the control groups,the MMSE,CDR and ADL scores (MMSE:23.17 ± 1.89,19.43 ± 2.04; CDR:1.06 ± 0.11,1.21 ±0.50;ADL:40.11 ±5.10,41.22 ±4.80) after treatment were significantly improved than those (MMSE:16.54 ± 1.98,16.28 ± 2.11 ; CDR:1.78 ± 0.25,1.75 ± 0.31 ; ADL:47.45 ± 5.22,46.75 ± 5.31) (MMSE:t =2.42,P ＜0.05,t =2.34,P ＜0.05 ;CDR:t =1.67,P ＜ 0.05,t =1.54,P ＜0.05 ;ADL:t =6.73,P ＜0.05,t =5.24,P ＜ 0.05) before treatment.After 12 weeks of treatment,the MMSE,CDR and ADL scores in the butyiphthalide group were significantly improved than that in the control group (t =1.85,1.84,5.91,respectively; P ＜ 0.05).No serious adverse events were recorded during the treatment.Conclusion Butyiphthalide and nimodipine can prominently improve,better than nimodipine alone,the cognitive function of patients with vascular dementia.Moreover,its security and tolerability are good.

Objective:Observing the therapeutic effectiveness of Erhuangwendan Decoction and Yiqiyangyinningxin Decoction treating acute viral myocarditis.Methods: 344 cases were distributed into the therapeutic group(258cases) and the control group (86 cases). The treapeutic group were first given Erhuangwendan Decoction one packet per day, then Yiqiyangyinningxin Decoction one packet per day after acute attack. The control group were only given myocardial nutrient. All were given 3～6 months. We observed the symptoms,signs ang EKG of the two groups. Results: The effective rate of the therapeutic group was 40% after 3 months. And it was 84% after 6 months. The effective rate of the control group was 15% after 3 months. And it was 34.8% after 6 months. The two groups have obvious difference( P

Objective: To determine the efficacy of lobectomy and wedge resection in the management of early stage (T 1N 0M 0) non small cell lung cancer. Methods: We analyzed the results of 109 patients with pathologic stage (T 1N 0M 0) non small cell lung cancer who underwent open wedge resection (n=21), video assisted wedge resection (n=30), and lobectomy (n=58) to assess perioperative morbidity and mortality, recurrence rates, survival difference and late pulmonary function among the three groups. Results: There were no differences among the three groups in regard to histologic tumor type, perioperative morbidity and mortality, late pulmonary function. Analysis demonstrated the wedge resection groups to be significantly older and to have reduced pulmonary function despite a higher incidence of treatment for chronic obstructive pulmonary disease when compared with patients having lobectomy. Statistically, the mean hospital stay was significantly less and locoregional recurrences rate higher in the wedge resection groups. Kaplan Meier survival curves were nearly identical at 1 year (open wedge resection, 94%; video assisted wedge resection, 95%; lobectomy, 91%). 5 year survival was 58%, 65% and 70% respectively. Log rank testing demonstrated significant differences between the survival curves during the 5 year period of study (P=0.02). Conclusion: Wedge resection, done by thoracotomy or video assisted techniques, appears to be a viable surgical treatment of stageⅠ(T 1N 0M 0) non small cell lung cancer for patients with cardiopulmonary physiologic impairment. Because of the increased risk for local recurrence, anatomic lobectomy remains the surgical treatment of choice for patients with stage I non small cell lung cancer who have adequate physiologic reserve.

Fast-track surgery is a new concept in general surgery nowadays.Fluid therapy,one part of fast-track surgery,is an important part,which go through with the whole perioperative process.Fluid therapy includes short time of fasting,no bowel preparation,appropriate postoperative fluid management,new monitoring technologies of hemodynamics,and so on.This new approach benefits preventing postoperative complications such as postoperative insulin resistance and cardiopulmonary failure.Still,this is a new concept which needs to be examed in clinical practices.In the future,the challenges lie within procedure-specific approaches,goaldirected therapy,the balance between the amount and composition of colloid vs crystalloid and the developments of the optimal techniques to monitor intra-and post-operative hemodynamics.