Objective To investigate the efficacy of ultrashort and short-acting insulin after subcutaneous insulin infusion pump under glucose monitoring in treatment of diabetes.Methods 110 cases with type 2 diabetes were selected,they were randomly divided into two groups with a random number table:the study group and the control group,55 cases in each group.The study group was treated with short -acting insulin after subcutaneous injection of insulin pump,the control group was treated with short -acting subcutaneous insulin infusion by insulin pump therapy, glucose monitoring system was used to monitor glucose during treatment of the two groups.The clinical efficacy after a month of treatment was observed.Results Before treatment,fasting blood glucose(FPG),postprandial 2 h blood glucose(2h PG),bedtime blood glucose of the two groups had no statistically significant differences.After treatment, FPG and 2hPG,bedtime blood glucose in the study group were (6.01 ±1.06)mmol/L,(7.90 ±0.50)mmol/L, (7.13 ±0.95)mmol/L respectively,which of the control group were (5.98 ±1.04)mmol/L,(7.91 ±0.48)mmol/L, (7.14 ±0.94)mmol/L,which were significantly lower than before treatment (t =9.843,23.669,13.569,9.683, 22.881,13.710,P <0.05),the two groups after treatment showed no significant differences(P >0.05).The blood glucose time and insulin dosage in the study group were (5.59 ±1.30)d,(39.98 ±11.01)u/d,which of the control group were (6.98 ±1.40)d,(51.89 ±11.97)u/d,and there were significant differences between the two groups(t =1.825,5.431,P <0.05).The mean blood glucose,blood glucose standard deviation,time percentage of blood glucose≥10 mmol/L,time percentage of blood glucose≤3.9 mmol/L in the study group were (5.95 ±0.61 )mmol/L, (1.28 ±0.25)mmol/L,(14.16 ±2.13)%,(6.35 ±1.45)%,which in the control group were (6.59 ±0.94)mmol/L, (1.54 ±0.29)mmol/L,(15.15 ±2.14)%,(7.96 ±1.42)% respectively,and the differences were statistically significant between the two groups(t =4.236,503.6,2.432,5.883,P <0.05).Conclusion Glucose monitoring system in monitoring blood glucose is accurate and reliable,ultra -short -acting insulin after subcutaneous insulin pump infusion in treatment of diabetes is better than short -acting insulin.

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

In order to improve the efficiency and quality of medical services,the authors applied the lean production and system simulation into optimizing the transfusion system of a hospital.By means of describing and analyzing the current situation and problems of a transfusion system of the hospital,the paper presented the cause-effect diagram for overlong patient waiting.5W1H and ECRS were adopted to analyze the infusion processes,while Simio was used to simulate the existing infusion system and simulation data so obtained were used to draw a value stream mapping for the system.In line with the ideas of Shojinka and one stream production,nurses deployment and conveyor speed were reconfigured.Based on these ideas,a reform plan is presented and the simulation method is used to verify the outcomes.The study proved that lean production and system simulation can effectively improve the hospital transfusion system,medical efficiency and medical service level.