Objective To investigate the correlation between self-nursing and the quality of life,thereby provide the basis of enhancing the patients' quality of life.Methods A total of 119 patients with type 2 diabetes metillus (T2DM) in the People's Hospital of Changyi City,Shandong Province,were selected,then they were investigated with Exercise of Self-care Agency Scale (ESCA) and Diabetes Specific Quality of Life Scale (DSQL).The correlations between self-nursing and the quality of life were analyzed.Results The self-nursing total score in 118 efficient patients was (108.36±21.94),and the low level,intermediate level and high level accounted for 2.54％ (3/118),64.41％ (76/118) and 33.05％ (39/118),respectively.The total score of DSQL was (69.95±9.74),among all factors,physiology and mentality played a significant role in the quality of life.According to Pearson correlation analysis,the self-nursing ability and the quality of life was positively correlated.Conclusions In the process of nursing intervention to T2DM,nurses should value the improvement of self-nursing ability,solidify the correct awareness of T2DM,eventually to elevate the quality of life.

Objective To investigate the effect of Yunnan Baiyao Plaster on serum related markers levels in the patients with stroke ,to evaluate its improvement effect on the neurological dysfunction and pain and to analyze its effect mechanism .Methods Eighty cases of hemorrhagic stroke treated in the neurosurgical department of our hospital from February 2015 to June 2016 were screened as the research subjects and divided into the control group and observation group according to the random number table method ,40 cases in each group .All subjects were given the routine treatment ,while the observation group received the external use of Yunnan Baiyao Plaster around the head operative incision and drilling ,to give Yunnan white ointment ,with the attaching area of 5 cm × 4 cm ,once daily ,for consecutive 7 d ,meanwhile took oral Yunnan Baiyao Plaster 0 .5 g with warm boiling water ,once daily for consecutive 7 d .The serum markers levels before and after treatment ,neural function defect score ,decline proportion of NIHSS scores and prognostic indicators were compared between the two groups .Results The mean pain value within 1 week in the obser-vation group was lower than that in the control group ,the difference was statistically significant (P<0 .05);the pain peak value and valley value within 1 weeks had no statistical difference between the observation group and control group ,the difference was not statistically significant (P> 0 .05);after 2 weeks ,ET ,TNF-α and IL-1β levels in the observation group and control group were lower than those before treatment in the intra-group comparison ,while the comparison between the two groups showed that the ob-servation group was lower than the control group ,the difference was statistically significant (P<0 .05);the decrease rate of NIH-SS scores within 2 weeks in the observation group was (74 .4 ± 5 .2)% ,which was higher than (66 .3 ± 10 .3)% in the control group ,the difference was statistically significant (P<0 .05);the occurrence rate of severe complications within 2 weeks in the ob-servation group was 7 .5% (3/40) ,the mortality rate was 2 .5% (1/40) ,which in the control group were 12 .5% (5/40) and 2 .5%(1/40) ,the difference was not statistically significant (P>0 .05) .Conclusion The combined treatment of Yunnan Baiyao Plaster in the patients with hemorrhagic stroke conld relieve pain and reduce the neurological deficit ,which might be related to the mechanism of anti-inflammation and analgesia .

Objective To explore the application value of ultrasound in the diagnosis and treatment for cesarean scar pregnancy. Method The ultrasonic features, clinical treatment of 42 cases of cesarean scar pregnancy were reviewed retrospectively. Results Among 42 patients,35 patients (83.3% ,35/42) were diagnosed accurately by ultrasound. The sonographic appearance showed 15 cases were gestational sac-type and 22 cases were mixed mass-type,the other 5 cases were classified into type three in which the gestational sac mostly located at the uterine cavity and only the inferior part implanted in the cesarean scar. Uterine artery embolisation and suction curettage with the sonographic guidance with 2 cases, intra-amniotic administration of MTX under sonographic guidance with 15 cases, expectant treatment with 20 cases or complex treatment with 5 cases. During treatment,ultrasonography showed focus of infection was shrinked gradually and blood flow disappeared, blood (3 -human chorionic gonadotrophin was decreased to normal level. ConclusionUltrasound can diagnose cesarean scar pregnancy promptly and accurately, proportionate treatment would be selected according to the type of cesarean scar pregnancy, and also can evaluate the therapeutic effect.

Objective To analyze the ultrasonographic features of fetal palate in the second and third trimester. Methods Two-dimensional ultrasound was performed in 1 885 fetuses during 21 to 36 gestational weeks of pregnancy, including 1 023 cases in 2nd trimester and 862 cases in 3nd trimester. The normal fetal palate ultrasound images were conifrmed by postnatal examination. In the ultrasound examination, fetal palate coronary plane was scanned through submandibular region, oral ifssure and prootic region;longitudinal plane was scanned through oral ifssure. The detection rate of completely and continuously displayed fetal palate was calculated. Results In prenatal ultrasonography, the normal fetal hard palate was shown as a bright band and the normal soft palate as a hypoechoic band in coronary section through fetal submandibular region, oral ifssure and prootic region. The detection rate was 76%(777/1 023)in 2nd trimester group and 53%(458/862) in 3rd trimester group. The normal fetal palate was shown as continuous camber echogenic band in longitudinal plane through oral ifssure. The detection rate was 49%(501/1 023) in 2nd trimester group and 13%(113/862) in 3rd trimester group. The detection rate was 94%(961/1 023) in 2nd trimester group and 56%(483/862) in 3rd trimester group by the combination of two scanning approaches. Conclusions There is usually an obvious gap between mandible gristles in 2nd trimester fetus. Fetal palate is accessible regardless of fetal head position by coronary scanning through submandibular region, oral ifssure and prootic region and longitudinal scanning through oral ifssure. These planes could display fetal palate well, and might be useful in detecting isolated secondary cleft palate. But these scanning approaches and planes might not suitable for routine screening due to operator dependence.

Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.

Objective:To evaluate the efficacy by using domestic recombinant human thyroid-stimulating hormone (rhTSH) in patients with differentiated thyroid cancer (DTC) before or after 131I therapy. Methods:From May 2019 to November 2020, a total of 24 patients with DTC (5 males, 19 females, median age 41 years) in Peking Union Medical College Hospital and Affiliated Tumor Hospital of Zhengzhou University were enrolled into the open-label, dose escalation phase Ⅰ study. All patients were divided into 4 domestic rhTSH dose groups: 0.9 mg×1 d (group A), 0.9 mg×2 d (group B), 1.8 mg×1 d (group C), 1.8 mg×2 d (group D) in succession, with 6 patients in each group. Each patient underwent rhTSH phase and thyroid hormone withdrawal (THW) phase. The end point included safety, tolerability, the quality of life (hypothyroidism symptom and sign score (Billewicz score), profile of mood states (POMS)), effectiveness (thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels, diagnostic whole-body scan (Dx-WBS)) and pharmacokinetic characteristics (peak time, peak concentration) of rhTSH. Paired t test and Wilcoxon signed rank test were used for statistical analysis. Results:There were no dose-limiting toxicities, serious adverse events, or no grade ≥3 adverse events reported. The quality of life in rhTSH phase was significantly better than those in THW phase, including the lower Billewicz score (-53.00(-53.00, -53.00) vs -39.50(-47.00, -23.00); S=119.50, P<0.001) and the lower POMS score (91.92±12.06 vs 99.67±19.13; t=0.95, P=0.025). Serum TSH level was increased from 0.04(0.02, 0.11) mU/L (baseline) to 150.00(105.20, 173.31) mU/L 24 h after the last rhTSH administration, which was increased along with the elevation of rhTSH doses. In the THW phase, patients′ TSH levels were≥30 mU/L after 23 d (median) of THW, with the median of 73.51(57.22, 106.22) mU/L. Median Tg level of baseline was 0.10(0.10, 0.41) μg/L, which reached a peak of 0.85(0.12, 3.01) μg/L at 48 h after rhTSH administration. The peak Tg level in the THW phase was 0.88(0.15, 8.04) μg/L. The Dx-WBS consistency rate between rhTSH and THW phase was 95.8%(23/24). Conclusion:rhTSH is a safe and effective method to stimulate the serum Tg level and radioiodine uptake in patients undergoing post-operation or post- 131I assessment for DTC, as well as maintain a higher quality of life in comparison to THW phase.