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Gastric bypass surgery for type 2 diabetes in the world,especially Europe,the United States,and other western countries have been widely carried out.The data of type 2 diabetes mellitus treated by weight loss surgery at home and abroad in recent years were collected and analyzed.It was found that gastric bypass Roux.en-Y gastric bypass (RYGB) after type 2 diabetes remission rate of 80％ to 85％,and the treatment effect can be maintained for long time.Therefore,the RYGB in the treatment of type 2 diabetes has been more and more recognized by the authors.This present article summarizes the gastric bypass (Roux.en-Y gastric bypass) in the treatment of type 2 diabetes mellitus (DM).
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Objective To assess effectiveness of implementation of non-pharmaceutical treatment in a standardized community-based hypertension management program in China.MethodsA protocol of standardized community-based hypertension management was developed based on current guidelines for prevention and treatment of hypertension in China.Physicians in community health-care service centers at the grassroots across China were trained in a standardized way using this protocol during 2005 to 2008,and then the trainees were required to manage hypertensive patients according to the protocol.Hypertensive patients eligible for criteria of inclusion and under management for more than one year were analyzed to observe changes in their behavioral risk factors,pharmaceutical and non-pharmaceutical treatment,and effectiveness of blood pressure lowering.ResultsBy the end of 2008,a total of 29 411 hypertensive patients had been managed for one year according to the protocol and 20 077 patients with complete data (47.1％ for male)with mean age of 61±11 years were eligible for analysis.After standardized management of one year,prevalence of smoking,alcohol drinking and proportion of patients who preferred salty diet decreased from 17.7 percent,18.1 percent and 32.8 percent to 8.9 percent,8.7 percent and 15.8 percent,respectively(P＜0.01).Srstolic blood pressure(BP)decreased by 11.6[95％confidence interval(CI)10.8-12.4]mm Hg(1 mm Hg=0.133 kPa),13.7(95％CI 13.3-14.1)mm Hg and 15.2(95％CI14.8-15.6)mmHg in the patients with non-pharmaceutical therapy,pharmaceutical therapy and both,respectively；and diastolic BP decreased by 7.5(95％CI6.9-8.1)mm Hg,8.3(95％CI8.1-8.5)mmHg and 8.0(95％CI7.8-8.2)mm Hg in the three groups,respectively.During the one-year period of management,proportion of the patients with appropriate non-pharmaceutical therapy increased continuously.By the end of one-year management,59.5 percent of smoked patients were required to quit their smoking,55.5 percent of alcohol drinkers were required to limit their drinking,52.3 percent of overweight and obese patients were required to reduce their weight and 47.3 percent of patients with physical exercises less than three times a week were required to increase their regular physical activity.However,certain proportion of the patients with risk factors did not receive appropriate non-pharmaceutical therapy.Conclusion Guideline-oriented hypertension management succeeded in lifestyle changes among the patients,but it is a gradual process to its full implementation.
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Objective To study the application and efficacy of hemihepatie vascular occlusion in HCC resection. Methods 90 ca-ses of HCC patients were roiled in and divided into two groups. Liver resection was performed with Pringle maneuver or hemihepatic vascular occhusion. Ischemia time, operative time, blood loss, postoperative liver function, the occurrence of complications and the recovery of gastro-intestinal function were recorded. The efficacy of the two occlusions was compared. Results There is no significant difference between hemibepatic vascular occlusion and Pringle maneuver in ischemia time, operative time, blood loss (P>0.05). However, there is signifi-cant difference in postoperative liver function, the occurrence of complications and intestinal function recovery time. The former is significant-ly superior to the latter (P<0.05). Conclusions The bemihepatic vascular occlusion and Pringle maneuver occlusion have no difference in ischemia time, operative time and blood loss. But bemihepatic vascular occlusion has less impact on liver function, lower rate of occur-rence of complications and faster recovery speed. Therefore, hemibepatie vascular occlusion is better than Pfingle maneuver occlusion in be-parle inflow occlusion in HCC surgery.
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In this article,the authors analyzed the current status of the therapeutic effect evaluation of TCM and proposed some measures to improve the current therapeutic effect evaluation of TCM,quantificated messages from TCM four diagnostic methods,explored biological parameter reflected essence of diseases,introduced quality of life scale and PRO,in the hope of establishing a comprehensive system of therapeutic effect evaluation reflecting the superiority and characteristics of theory of body and spirit.
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This article through centile computed the result of classification of perimenopausal syndrome(PPS) in 102 periodical literatures,then took types of syndrome with cumulation frequency above 25 centile as the main syndrome types,took symptoms and objective signs with cumulation frequency above 75 centile as the cardinal symptoms and objective signs of each type of syndrome.The differentiation of symptoms and signs for classification of PPS in TCM were concluded as syndrome of deficiency of kidney-yang,syndrome of deficiency of kidney-yin,deficiency syndrome of both kidney yin and yang,syndrome of imbalance between heart-yang and kidney-yin,syndrome of stagnation of liver-qi,deficiency syndrome of both heart and spleen.The cardinal symptoms and objective signs of syndrome of deficiency of kidney-yang are in terms of intolerance to cold,cold limbs and pale corpulent tender tongue with indentation in margin of the tongue;syndrome of deficiency of kidney-yin are in terms of the sore lumbus and knees,vertigo, tinnitus,tidal fever or hectic fever,fidget,hot sensation in the five centers and night sweating,red tongue;deficiency syndrome of both kidney yin and yang are in terms of vertigo,tinnitus and the sore lumbus and knees;syndrome of imbalance between heart-yang and kidney-yin are in terms of vexation,palpitation and insomnia;syndrome of stagnation of liver-qi are in terms of fullness or distending pain in the hypochondrium,depression or irritability,bitter taste of mouth,chest distress,sighing frequently,wiry pulse;deficiency syndrome of both heart and spleen are in terms of palpitation,insomnia,poor appetite with pale tongue.
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The article searched ancient literature from pre-Qin to Qing Dynasty,researched the character meaning,implication of physique and spirit,and the historical evolvement process of view of physique-spirit unity(ghost theory-sporadic physique and spirit theory-systemic view of physique-spirit unity-view of physique-spirit unity combined with Chinese medicine)so that the view of physique and spirit can be applied to medical domain preferably,which will help the clinic diagnosis and treatment.
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Treatment based on syndrome differentiation which is a complicated procession,is a characteristic of Chinese medical diagnosis and treatment.How to appraise the efficacy of treatment based on syndrome differentiation becomes a important question.Randomized controlled trial is called golden design of clinical trial,but it has a strict condition and a low compliance.Cohort study has a high clinical operation,but it is difficult to control bias.Stratified,polycentric and prospective cohort study can avoid the shortcomings of randomized controlled trial and cohort study.So,it can be a prospective design to appraise the curative efficacy of treatment based on syndrome differentiation.
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The theory of body and spirit is one of the basic theories of TCM; it plays an important role in the development of TCM theory system,and has guiding significance in the clinical practice.The connotation of theory of body and sprit is copious and text mining can find potential valuable information from plenty of message.We tried to use text mining to find the connotation of theory of body and sprit,and provided a new way to study the theory of TCM.