[Summary] During recent years, increasing evidences have indicated that type 2 diabetes mellitus(T2DM) might increase the risk of certain tumors; the process might be not only related with the chronic pathologic status of T2DM such as hyperglycemia, hyperinsulinemia, insulin resistance, dyslipidemia, status of chronic inflammation but also associated with the long-term use of anti-diabetic drugs (i. e. sulfonylureas, biguanides, glitazones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptitide-1 receptor agonists), as well as the use of insulin and insulin analogues. Herewith a system review was made about the recent progress in studying T2DM and tumor risk.

Multilevel models are applicable to both the quantitative data and categorical variables. We used the methods, including the multilevel models, analysis of covariance and CMH chi-square test, to analyse different types of data, to explore the application of multilevel models in the analysis of the multicenter clinical trial center effect. The results showed that the analysis of covariance is more sensitive to find the center effect for quantitative data, while multilevel models are more sensitive to categorical variables. It can be seen that results with different analytical methods for center effect are not the same, and the most appropriate method should be selected in accordance with the characteristics of data, the objective of research, and the applicable conditions of the various methods in practical use.
Clinical Trials as Topic ; Humans ; Models, Theoretical ; Research Design

Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.

OBJECTIVES: The Tinnitus Handicap Inventory (THI) is a commonly used self-reporting tinnitus questionnaire. We undertook this study to determine the reliability and validity of the Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM) for measuring tinnitus-related handicaps. METHODS: We tested the test-retest reliability, internal reliability, and construct validity of the THI-CM. Two-hundred patients seeking treatment for primary or secondary tinnitus in Southwest China were asked to complete THI-CM prior to clinical evaluation. Patients were evaluated by a clinician using standard methods, and 40 patients were asked to complete THI-CM a second time 14+/-3 days after the initial interview. RESULTS: The test-retest reliability of THI-CM was high (Pearson correlation, 0.98), as was the internal reliability (Cronbach's alpha, 0.93). Factor analysis indicated that THI-CM has a unifactorial structure. CONCLUSION: The THI-CM version is reliable. The total score in THI-CM can be used to measure tinnitus-related handicaps in Mandarin-speaking populations.
Asian Continental Ancestry Group ; China ; Humans ; Reproducibility of Results ; Tinnitus ; Surveys and Questionnaires

Objective To investigate outpatients' cognition towards common cold and their habituated medication so as to provide evidence for future public healthcare education.Methods Patients who attended hospital for diagnosis and treatment of common cold at least within past three months were asked to fill a questionnaire independently so as to learn their cognition towards common cold and medication habit.Results Among the patients underwent survey,52.2 ％ had incorrect knowledge about common cold; 2.99％ didn't know about the hazards of common cold; 34.80％ couldn't distinguish common cold from influenza; 30.07％ considered common cold couldn't get relief without treatment; 68.24％ didn't know about the proper effects of influenza vaccination; 6.4％ often took oral medicine even intravenous injection when they caught a common cold; 59.77％ often took medication from drugstore without prescription by doctor,and a few asked doctors to prescribe medicine on their request; 9.42％ didn't know about the side effects of drug for cold treatment; and 9.72％ didn't know about the active ingredients of drug for cold treatment.There were significant differences in the common cold cognition among population of different ages and education background.The older or the higher education status patients had a better cognition ( P ＜0.0 ).Conclusion There exist a certain degree of wrong cognition towards common cold among patients of different literacy degree and different age. Public health education on common cold need to be further strengthened.

Objective To investigate the cognition of the common cold and current situation of the treatment among physicians from various levels of hospitals in Chinese mainland,so as to provide evidence for future continuing medical education and rational medication.Methods A questionnaire designed for this survey was used to learn about the general information,cognitive degree of the common cold and prescription habits of physician who prescribed for cold within last three months,from various levels hospitals.Results A total of 1001 physicians were interviewed.Among them,749 physicians chose right options that the cold was the common cold and the influenza with 79.84％ in resident physicians and 56.76％ in chief physicians.A total of 745 physicians chose options that the course of common cold will be lasting 4 to 7 days; 895 physicians chose options that old people are the most susceptible for complication; 669 physicians thought the common cold was the most common infection in winter; 841 physicians used clinical methods to diagnose the common cold; 736 physicians thought although the cold was a kind of self-limited disease and symptomatic treatment could alleviate symptoms and improve life quality,patients should see doctor in time if it turns to severer; and 745 physicians held the opinion that treatment of the common cold should focus on relieving symptoms first. In addition, 61.60％ physicians had made prescription based on clinical symptoms; 505(54.24％ ) of them thought compound drugs were priority in treating the common cold.However,there were still 43 physicians prescribed antibiotics for common cold.Conclusions There is misunderstanding and discrepancy in cognition towards common cold and treatment among physicians from various levels of hospticals in mainland China.Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.

Objective To prepare targeted micorbubble with low immunogenicity. Methods The microbubbles were produced with different phospholipids and identified by the fluorescent method. Detect the level of C3a after reaction with human serum in vitro with enzyme-linked immunosorboent assay (ELISA) method and the number of microbubble binding with the streptavidin packed on the dish by using the parallel plate flow chamber. Results The level of C3a was (1.037±0.047)ng/ml in MBb group,(1. 326 ± 0. 042)ng/ml in MBe group and ( 1.004 ± 0.031 ) ng/ml in MBc group. The level of C3a in MBb group was significantly lower than that in MBe group( P ＜0.05),and there was no significantly difference between MBb group and MBc group ( P ＞ 0. 05). The parallel plate flow experiments showed that the number of MBb(15.2 ± 11.3) in each field of view binding with the streptavidin packed on the dish was significantly fewer than that of MBe ( 103.2 ± 28.3) ( P＜0.05 ), and there was no significantly difference between MBb and MBc(17.8 ± 11.9) ( P ＞0.05). Conclusions The targeted microbubble with low immunogenicity has been prepared successfully,which can be used for further experiment in vivo.

Objective To discuss the value of diagnosing gastrointestinal dysfunction in.critically ill children.Methods Seventy-six critically ill patients were reviewed,48 cases combined with gastrointestinal dysfunction.Plasma D-lactate,intestinal fatty acid binding protein(IFABP)of serum and urine were performed in all patients,detected the sensitivity and specificity,ealculated the area under the ROC curve (AUC).Results Plasma D-Iactate level≥9.63 mg/L had a sensitivity of 85.2%,specificity of 70.9%,and AUC of 0.822 for diagnosing gastrointestinal dysfunction.Serum IFABP level≥0.129μg/L had a sensitivity of 65.2%,specificity of 63.8%,and AUC of 0.744 for diagnosing gastrointestinal dysfunction.Urine IFABP ≥0.330μg/Lhad a sensitivity of 78.3%,specificity of 72.3%,and AUC of 0.820 for diagnosing gastrointestinal dysfunction.There was no significant difference in AUC between plasma and urine IFABP(P＞0.05),there was no significant difference in AUC between serum D-lactate and serum IFABP(P＞0.05).Conclusions Plasma D-Lactgte,serum and urine WABP may be useful markers as warning gastrointestinal dysfunction of critically ill children.Plasma D-lactate and urine IFABP level may be more sensitively,but they need to be further studied.

Objective To compare the safety and effectiveness between treatments with autologous platelet gel (APG) versus standard care for treating refractory diabetic dermal ulcers.Methods The 46 patients with proved nonhealing diabetic dermal ulcers were enrolled. Eligible for the study were patients with grade II/III ulcers according to Wagner, lasting for at least 2 weeks and with no signs of infection at recruitment.Patients were given their informed consent document and randomly assigned to two groups: standard care (ST, n=23) or standard care plus topic application of APG (APG, n=23) for twelve weeks.The treatment of blood glucose, blood pressure and lipids was optimized and the empiric antibiotic treatment was further adjusted according to the results of culture and sensitivity testing in all patients. APG treatment consisted of wound dressing with APG, followed by topical washing and cleaning. The APG was then covered with vaseline gauze for 72 hours, after which the ulcers were treated by standard care. Participants were seen thrice a week, twice a week, or at weekly intervals. Twelve weeks observation was set as the end point.Results The would of APG group were improved in 22 patients with ulcers healed completely and 1 case with would area reduced. In the ST group, 13 ulcers were healed, 6 worsened and 4 with would area reduced. The cumulative rate of ulcer healing was 95.7% in the APG group versus 56.5% in the ST group (P=0.002). The total effective rate in APG vs ST group was 100.0% vs 73.9% (P=0.009). By Kaplan-Meier analysis,the time-to-healing of ulcer and time-to-lutation of sinus were significantly different between two groups (log-rank, P=0.006, 0.000, respectively). No treatment-related adverse events were observed. Conclusions Treatment with APG in addition to standard care results in a significantly faster and better healing for a refractory diabetic dermal ulcer and does not raise any safety concerns. So APG treatment can be a valuable and effective aid in the management of diabetic foot ulcers.

The authors briefly introduced the management of clinical test for new drug development, clinical trials for drugs prepared in hospital and post-market drugs, and other types of clinical trials. The mechanism of WHO International Clinical Trial Register Platform (WHO ICTRP), Chinese Clinical Trial Register (ChiCTR) and Chinese Clinical Trial Registration and Publishing Collaboration (ChiCTRPC) were also introduced. The authors suggested the trialists to practice the basic philosophy of evidence-based medicine as the rules of their thought and action, and considered that this is the inner guarantee system for the validity of clinical trials.