Objective To investigate the changes of inflammation levels in patients with impaired glucose tolerance(IGT) and the clinical significance.Methods A total of 30 IGT patients(IGT group) and 30 type 2 diabetes (T2DM) patients (T2DM group) were enrolled in current study.Meanwhile,30 health people were selected as control group (NGT group).The concentration of fasting plasma glucose (FPG),insulin resistance index (HOMA-IR),glycosylated hemoglobin (HbA1c),high-sensitivity C-reactive protein (hsCRP),cystatin C(Cys C) and fibrinogen(FIB) were measured.Results The levels of FPG,2 h glucose(2 h PG),HOMA-IR and HbA1c in three groups were significant (F =8.805,14.403,7.389,10.246 ; P ＜ 0.05).The levels of CRP,Cys C and FIB in three group were also significant (F =6.766,4.733,11.683 ;P ＜ 0.05).The levels of CRP,Cys C,FIB in IGT were (1.12 ±0.22) mg/L,(0.23 ±0.10) mg/L,(0.93 ±0.18) mg/L,higher than that in NGT group((0.70 ±0.16) mg/L,(6.02 ±0.49) g/L and (4.36 ±0.30) g/L).Meanwhile,the levels of CRP,Cys C and FIB in T2DM were significantly higher than of NGT(P ＜ 0.05).Single factor correlation analysis showed that there was positive associationship between hs-CRP,Cys C and FIB with 2 h PG,HbA1 c and HOMA-IR(P ＜ 0.05).Conclusion Endothelial dysfunction is seen in prediabetes stage,which plays an important role in the occurrence and development of vascular disease in impaired glucose regulation and diabetic patients.

Objective To explore the clinico-pathological features and outcomes of primary focal segmental glomerular sclerosis with IgM deposition.Methods One hundred and two patients with primary focal segmental glomemlar sclerosis (pFSGS) in Hangzhou hospital of traditional Chinese medicine between 1996 and 2012 were retrospectively studied.The patients were divided into IgM deposition group (n =66) with IgM deposition in glomeruli and none-IgM deposition group (n =36) without IgM deposition.Baseline and clinical characteristics of all FSGS patients were assessed and outcomes were reviewed.The survival rates of the patients were analyzed using the Kaplan-Meier method.Results (1) There were not difference in age,sex ratio,incidence of microscopic hematuria,hypertension,renal insufficiency,eGFR,Ccr and Scr between two groups.However,proteinuria,incidence of nephrotic syndrome,urine microalbumin,urine NAG,serum cholesterol,serum high-density lipoprotein,and serum IgM in IgM deposition group were significantly higher than those in none-IgM deposition group (P ＜ 0.05),serum albumin and serum IgA in IgM deposition group were significantly lower than those in none-IgM deposition group (P ＜ 0.05).(2) The IgM deposition group had a significantly higher incidence of glomerular deposition of IgA,IgG,C3,C1q and fibrinogen than none-IgM deposition group (P ＜ 0.05).The score of mesangial matrix proliferation in the IgM deposition group was lower than that in none-IgM deposition group (P ＜ 0.05).(3) fifty-four patients (35 patients in IgM deposition group and 19 patients in none-IgM deposition group) were followed-up for a median of 64.6 (22.8,103.8) months.Progression to renal failure was observed in 5 patients of IgM deposition group and none in none-IgM deposition group.Compared with the none-IgM deposition,the survival rates in the IgM deposition group were statistically lower (P ＜ 0.05).Conclusions PFSGS patients with IgM deposition were severer in proteinuria,higher incidence of IgA,IgG,C3,C1q and fibrinogen deposition in glomeruli and worse outcome than those without IgM deposition.

Objective To assess the validity of PKH26 dye for labeling the bone marrow mesenchymal stem cells (BMSCs) and the feasibility of this method for tracing the seed cells of tissue engineering nerve in vivo. Methods BMSCs isolated from Wistar rat's bone marrow were labeled with the PKH26 dye, the marked validity was observed by the fluorescence microscopy and flow cytometer, the cellular vitality was de-tected by MTT, the differentiated abilities were tested by in vitro osteablastic and lipoblastic differentiation. After that, the labelld cells were micro-injected into the acellular nerve grafts(ANG) to build compound grafts and cultured for 3,5,7,14 days in vitro, then frozen sections were made respectively to observe the survival and migration of the implanted cells in ANG. Simultaneously, these compound grafts were used to bridge the 1.5 cm sciatic nerve defects of the Wistar rats, 1,4,6,8 weeks postoperation, the grafts were taken out and frozen section were made in order to observe the survival of the implanted stem cells in vivo inside the ANG. Results PKH26 dye was good for labelling the BMSCs, marked validity was higher than 95%. The cellular vitality and differentiated abilities were not affected compared with the unlabelled cells. Further more, BMSCs could adhere to the ANG, and suvive,magrate in vitro. In vivo, BMSCs was able to survive at least 8 weeks in the nerve regenerative microenvironment. Conclusion PKH26 dye could label the BMSCs effectively, and it's suitable for in vivo seed cells tracing in tissue engineering nerve model.

Objective To analyze five kinds of allogenic acellular peripheral nerve by different meth-ods and try to establish a standard method for preparing nerve materials. Methods Five kinds of nerve ma-terial prepared by different chemical extractions according to nowaday articles were examined by HE staining. Irmnunohistochemistry and protein ratio was studied by allogenic nerves by virtue of Kjeldahl method in order to know the efficiency of these methods in removal of SCs axons and integrality of the basilar membrane. Results Myelin sheath and cytoblast in group 2 that nerves were extracted by Triton X-100 and Sodium de-oxycholate consecutively twice were completely removed, which was well demonstrated in HE staining. Per-ineurium in red staining were arranged wave-like longitudinally, axons and myelin sheath were replaced by column-like spacing. Col I staining were positive in all groups, structure of basilar membrane became loose slightly in the first and second group, and the structure of the other groups were relatively regular. Group 1 and 2 were negative in S-100 staining. There was no difference between group 2 and group 1,3,4 and 5 in sheath removal demonstrated by TEM. Protein ratio in group 2 was the lowest in the measurement with Kjel-dahl method. Conclusion The method used in group 2 that nerves were extracted by Triton X-100 and Sodium deoxycholate consecutively twice was the best in allogenic acellular peripheral nerve preparations.

Impaired awareness of hypoglycemia is an acquired complication of insulin therapy, which affects people with type 1 and insulin-treated type 2 diabetes mellitus, whereby the ability to perceive the onset of hypoglycemia becomes diminished or absent, which not only affects life health, but also causes fear of hypoglycemia , and causing a serious burden on the quality of life. The paper reviews the concept,the assessment tools,the occurrence,the influencing factors and intervention strategies of impaired awareness of hypoglycemia.In order to provide suggestions for the researches of impaired awareness of hypoglycemia in China.

Objective:To explore disorienting dilemmas during postgraduate study period experienced by postgraduates with master of nursing specialist who participated in the national postgraduate entrance examination and provide a basis for teaching reform based on transformative learning theory.Methods:Using the purposive sampling method and the maximum difference method, 23 full-time masters of nursing specialist who participated in the national postgraduate entrance examination from 3 universities of Jiangsu Province were selected as the research objects from March to June 2019. The descriptive qualitative research method was used to conduct semi-structured interviews, and the traditional content analysis method was used to analyze the interview data.Results:Four themes of disorienting dilemmas of masters of nursing specialist were extracted: the expected hypothesis of challenges of new environment in course learning, a gap between scientific research ability and training target, adjustment of self-positioning in clinical practice and insufficient preparations for graduation of master of nursing specialist.Conclusions:Master of nursing specialist have disorienting dilemmas in course study, scientific research, clinical practice and graduation preparation, and nursing educators can use this as a trigger point to carry out teaching reform based on transformative learning theory.

Objective:To construct a close-loop path management model for aspiration risk screening of patients in Department of Neurosurgery, and verify its application effect in the nursing of inpatients in department of neurosurgery.Methods:Through literature retrieval and expert consultation, the close-loop path management model of aspiration risk screening was constructed. The convenient sampling method was adopted to select inpatients in the Neurosurgery Department of a ClassⅢ Grade A hospital in Jiangmen of Guangdong Province from January to December 2019. The patients admitted from January to June 2019 were set as the control group and received routine aspiration assessment and management while the patients admitted from July to December 2019 were set as the observation group and received close-loop management of aspiration risk screening. The incidences of aspiration and aspiration pneumonia were compared between the two groups.Results:In the control group, there were 506 patients, of whom 92 (18.18%) had aspiration. In the observation group, there were 543 patients, of whom 74 (13.63%) had aspiration. There was a statistically significant difference in the incidence of aspiration between the two groups (χ 2=4.078, P=0.043) . The incidence of aspiration pneumonia was 8.10% (41/506) in the control group and 5.52% (30/543) in the observation group. There was no statistically significant difference between the two groups (χ 2=2.758, P=0.097) . Conclusions:The close-loop management of aspiration risk screening standardizes the process of aspiration risk screening, guarantees the implementation of dynamic assessment and effectively reduces the incidence of aspiration, which can provide a reference for improving the management level of prevention and treatment of aspiration.

Objective:To understand the current situation of postpartum maternal perceived spouse support for breastfeeding, and explore its mediating role in the spouse support for breastfeeding and maternal breastfeeding self-efficacy.Methods:From October 2021 to October 2022, convenience sampling was used to select 602 postpartum women (42 days postpartum) and their spouses who underwent follow-up visits at Obstetric Clinics in four ClassⅢ hospitals in Shanghai as the research subject. A questionnaire survey was conducted using the General Information Questionnaire, Partner Breastfeeding Influence Scale (PBIS) , and Breastfeeding Self-efficacy Scale Short Form (BSES-SF) .Results:The PBIS score of 602 postpartum women was (121.07±25.41) , and the PBIS score of 602 maternal spouses was (134.37±18.94) . Pearson correlation analysis results showed that maternal perceived spouse support has a positive correlation with spouse support ( P<0.01) , and a positive correlation with maternal self-efficacy in breastfeeding ( P<0.01) ; spouse support was positively correlated with maternal self-efficacy in breastfeeding ( P<0.01) . The mediating effect analysis that maternal perceived spouse support played a complete mediating role between spouse support and maternal self-efficacy in breastfeeding. Conclusions:There are both connections and differences between maternal perceived spouse support and spouse support, and the positive promoting effect of spouse support on maternal self-efficacy in breastfeeding can be completely mediated by maternal perception. Medical and nursing staff should pay attention to the assessment of maternal perceived spouse support and guide spouse breastfeeding support behavior based on maternal needs and experiences of spouse support, so as to improve breastfeeding outcomes.

Objective:To investigate the effect of situational simulation drill in nurses training on prevention and treatment of venous thromboembolism (VTE).Methods:Totally 120 nurses in 1-3 years from a tertiary general hospital were selected to participate in the training for prevention and treatment of venous thromboembolism. They were divided into intervention group and control group according to the number of single and double packet ward. A total of 62 nurses in the single wards were selected as the intervention group, and a total of 58 nurses in the double wards were selected as the control group. The control group and the intervention group were trained on the prevention and treatment of venous thromboembolism by traditional teaching method and scenario simulation drill, and the effect was evaluated by Kirkpatrick Model.Results:After training, intervention group training object theory examination score, operation assessment score, clinical nursing work assessment score, and nurses ability to scale score (83.79±6.85), (87.00±4.57), (7.90±0.62), (79.03±8.24) respectively, were higher than the control group (80.67±7.90), (84.02±4.70), (7.21±0.72), (70.86±11.59), the score comparison difference was statistically significant ( t values were -3.660-5.670, P < 0.05); The satisfaction of the training object to the teaching plan, teaching content and teaching form in the intervention group was 88.71% (55/62), 87.10% (54/62) and 87.10% (54/62), which were all higher than the control group 74.14% (43/58), 72.41% (42/58) and 68.97% (40/58), with statistically significant differences ( χ2 values were 4.250, 4.038, 5.804, P<0.05). Conclusion:The application of situational simulation drill in the nursing training of prevention and treatment of VTE is helpful to improve the theoretical skills and clinical work ability of nurses in the prevention and treatment of VTE, and to increase the satisfaction of nurses with the training.

Objective:To explore the therapeutic law of moxibustion in Professor Zhou Meisheng's medical manuscripts for epidemic hemorrhagic fever (EHF) based on data mining and knowledge map technology.Methods:The manuscript data of Professor Zhou Meisheng's moxibustion treatment of EHFwere collected from Infectious Diseases Department of Dangshan County People's Hospital from December 16, 1985 to December 25, 1987. Graphpad Grism 8.0 software was used for descriptive analysis. PHP 5.4 program code was used for association rule analysis. SPSS Statistics 26.0 was used for clustering analysis. Neo4j Community 3.5.25 database was used to analyze the syndrome-weight graph.Results:205 prescriptions were included. There were 21 symptoms with frequency>40, in which the frequency of aversion to cold, fever, rash and irritability was 100%. The main types of moxibustion methods used in the treatment included moxibustion frame fumigation moxibustion, Wanying acupoint moxibustion pen moxibustion, and fire needle instead of moxibustion. There were 29 acupoints with a frequency of >25, including Zhongwan (CV12), Shenshu (BL23) and Mingmen (DU4), etc. Association rules showed that Sanyinjiao (SP6)-Zhongwan (CV12)-Feishu (BL13)-Shenshu (BL23)-Zhiyang (DU9) had the highest correlation. Six effective clustering combinations of moxibustion for EHF were summarized by clustering analysis. The weight graph can obtained the first 30 relationships with high correlation of target syndromes.Conclusions:Professor Zhou applied the idea of "moxibustion for heat syndrome" to the treatment of EHF, and took the method of "acupoint selection according to symptoms" as the main acupoint selection idea for moxibustion treatment of EHF. In clinical practice, moxibustion combined with auxiliary operation of TCM is often used to treat EHF, which can achieve good results.