[abstract] Objective To study the health education on diabetes nurse diabetes management mode at the core of application in the patients with follow-up effect. Methods Our hospital endocrinology in October 2015,participate in blood sugar management company research project(namely,doctors,nurses and patients ofthree Eonline and offline (O2O) integration management system).The project is the specialist education nurses,doctors and patients of organic whole,to form a closed-loop management.Use of the project with mobile tablet (PAD),SMS platform on the first base into a group of patients with type 2 diabetes insulin for 5 minutes on education and baseline data collection,and in the next 15 weeks of diabetes health education nurses via text message and phone tracking in the form of blood sugar and insulin dose data,at the same time for more than three months of education,guidance and management,to help patients with initial foundation of insulin self management knowledge and skills,promote the blood glucose control is at target. Results In 12 weeks of the completion of this project and follow-up,425 patients of FPG success rate is 82.6%. Conclusion Nurse diabetes health education as the core of diabetes management model is feasible in patients with type 2 diabetes, the effect is good,that greatly arouse the subjective initiative of patients;Improve the patients′self-management ability,improving according to the medical behavior;Improved treatment adherence to standard prompt patients FPG.

Objective To assess the predictive value of neutrophil gelatinase associated protein lipocalin (uNGAL) in urine for detection of acute kidney injury(AKI) in patients with severe traumatic brain injury. Methods Patients with severe traumatic brain injury from the ICU were collected from Jan. 2011 to May. 2013 in our hospital. 43 cases that met the RIFLE criteria for diagnosis of AKI in the ICU within 7 days were selected as AKI group. Another 43 cases that were matched for age ,gender ,illness severity , surgery method with AKI cases ,selected as non‐AKI group. The levels of uNGAL and Scr were measured when the patients admit‐ted in the ICU with 15 min ,at 24 h ,48 h ,72 h. the sensitivity and specificity of uNGAL and Scr for diagnosis for AKI were evalua‐ted by ROC curve. Results The incidence of severe traumatic brain injury AKI was 42. 16% (43/102). The uNGAL levels in the AKI group were higher when the patient stayed in the ICU longer and no obvious in the non AKI group. When admitted to the ICU 24 h ,the level of uNGAL(720. 32 ± 684. 25)ng/mL in AKI group was significantly higher than that (421. 92 ± 351. 20)ng/mL in non AKI group. The difference was statistically significant (P< 0. 05). The levels of Scr between two groups were not statistically significant. The area under ROC curve of uNGAL and Scr were 0. 879 (95% CI :0. 807 - 0. 949) and 0. 612 (95% CI :0. 493 -0. 731). When the cutoff value of uNGAL was 180 ng/mL ,the sensitivity and specificity were 0. 890 and 0. 823 respectively. The sensitivity was superior to Scr. Conclusion uNGALis superior to Scr for early diagnosis of AKI in patients with severe traumatic brain injury and it could be used as a biomarker for early diagnosis of AKI.

Objective:To identify a suitable biomarker for early diagnosis and prognosis of Candida albicans pneumonia ( CAP) ,we investigated the expression of several biomarkers,such as soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1),soluble hemoglobin-haptoglobin scavenger receptor (sCD163),C-reactive protein (CRP),and procalcitonin (PCT),in rabbits with CAP. Methods:A rabbit model was established after immunosuppression of 40 rabbits,randomly divided into 2 groups of 20 each. The experimental group received 1 ml injection of 5×107 cfu/ml C. albicans solution via percutaneous tracheal puncture,while the control group received normal saline. Rabbit blood samples were collected on days 2,3,4,5,6 and 9 post-inoculation and examined for levels of sTREM-1,sCD163,CRP,PCT,interleukin-6 (IL-6),IL-8,IL-10 and tumor necrosis factor-α (TNF-α). Other tests included routine blood examination,arterial blood gas test,chest thin-layer computed tomography on days 3 and 9 post-inoculation,lung tissue biopsy, and blood culture to confirm C. albicans infection. Results:The levels of sTREM-1,SCD163,PCT,and TNF-αwere higher in the exper-imental group as compared to control. Additionally,sTREM-1 and CRP indices showed an upward trend during 9 days of observation period in the experimental group,while others showed a short-term increase after inoculation and then declined gradually. Areas under the receiver operating characteristic curve for CAP diagnosis were calculated as 0. 882,0. 814,0. 685 and 0. 55 for sTREM-1,SCD163, PCT and CRP,respectively. Conclusion: The diagnostic value of biomarkers,sTREM-1 and SCD163,is superior to that of CRP and PCT in the diagnosis of CAP.

Objective:To investigate the protective effect of schisandrin B (SchB)on the cerebral ischemia reperfusion injury of the rats and the influence in HSPA12B/PI3K/Akt signaling pathway,and to explore the mechanisms.Methods:130 SD rats were divided into sham group,cerebral ischemia reperfusion injury model group (model group),low dose of SchB group (SchB 3 mg· kg-1 ,SchB1 group),middle dose of SchB group (SchB 10 mg·kg-1 ,SchB2 group)and high dose of SchB group (SchB 30 mg·kg-1 ,SchB3 group)(n=26).The rats in sham group didn’t plug lines;the rats in model were used to establish ischemia reperfusion models;the rats in SchB1 ,SchB2 and SchB3 groups were firstly pretreated with different doses of SchB for 7 d,and then they were used to build cerebral ischemia reperfusion injury models.The nerve dysfunction of rats was evaluated by neurologic deficit score.The cerebral edema was detected by measuring the content of water in brain tissue.The morphological changes of brain tissue were observed by toluidine blue staining.The levels of nuclear factor kappa B (NF-κB), tumor necrosis factor-α(TNF-α),interleukin-1 (IL-1)and interleukin-6 (IL-6)in the brain tissue were detected by ELISA.Western blotting method was used to detect the protein expression levels of heat shock protein A12B (HSPA12B ), serine-threonine kinase (Akt ) and phosphorylation serine-threonine kinase (p-AKT ). Results:Compared with sham group,the neurologic deficit score of rats in model group was significantly increased (P <0.01),and the content of water in brain tissue was increased (P < 0.01 );the brain tissue structure was loosened,and the mesenchyme appeared edema;the NF-κB,TNF-α,IL-1,and IL-6 levels were increased (P <0.01),and the expression levels of HSPA12B and p-Akt proteins were decreased (P <0.01).Compared with model group,the neurologic deficit scores of the rats in SchB1 ,SchB2 ,and SchB3 groups were decreased (P <0.01),and the contents of water in brain tissue of the rats in SchB2 and SchB3 groups were decreased (P <0.05);the edema of nerve cells was alleviated,and the cavities were reduced;the NF-κB,TNF-α,IL-1,and IL-6 levels were decreased (P <0.05 or P <0.01),the expression levels of the HSPA12B protein in SchB2 ,and SchB3 groups were increased (P <0.05),and the p-Akt protein expression levels of the rats in SchB1 ,SchB2 ,and SchB3 groups were increased (P <0.01).Conclusion:SchB could protect the cerebral ischemia reperfusion injury of rats,its mechanism may be related to regulating the HSPA12B/PI3K/Akt signaling pathway and inhibiting the inflammatory reaction damage to the nerve cells of reperfusion.

Objective To investigate, in vitro, the co-infection of Caco-2 cells ( epithelial cells of intestinal mucosa) with Candida albicans and Enterohemorrhagic escherichia coli ( EHEC) .Methods The ability of both species to invade the Caco-2 cells was evaluated by inverted microscopy.Damage to Caco-2 cells was evaluated by measuring lactate dehydrogenase ( LDH ) activity. C. albicans virulence gene expression ( ALS3, PLB1 and SAP4 ) was evaluated by quantitative real-time polymerase chain reaction ( qRT-PCR) .Results Compared to simple infections with C.albicans alone, a co-infection invaded Caco-2 cells more rapidly, and C.albicans tended to proliferate more easily presenting in cluster shape of distribution.In addition, the LDH activity in the co-infection group (group 3) was the highest compared to groups 1, 2, 4 and 5, (F values of 14.48, 5.48, 11.74 and 3.45 respectively;all P <0.05);There was no significant difference in LDH activity found between the secondary fungous infection group ( group 5) and the EHEC infection group (group 2) (F=2.03, P=0.54) or between the secondary bacterial infection group (group 4) and the Candida albicans infection group (group 1) (F=2.74, P=0.11).The LDH activities in groups 2 and 5 were significantly higher than that in groups 1 and 4 ( all P <0.05 ) .In addition, an up-regulation of toxicity-related genes ( PLB1 and SAP4 ) were detected.The expression of PLB1 was higher in group 3 than that in group 1 ( P=0.014 3 ) and SAP4 was higher in groups 3 and 5 than that in group 1 (P=0.027 2, P=0.001 8, respectively).Conclusions Using Caco-2 cells for an infection model, this study demonstrated that co-infecting in vitro enterocytes with C.albicans and EHEC enhanced the invasiveness and tissue damaging effects of C.albicans.

BACKGROUND:Human umbilical cord mesenchymal stem cel s belong to a special class of stem cel s with a limited number, which are difficult to isolate and purify. Importantly, there is a lack of clinical understanding of biological characteristics of human umbilical cord mesenchymal stem cel s. OBJECTIVE:To study the bioactive properties and cardiomyocyte-like differentiation of human umbilical cord mesenchymal stem cel s. METHODS:Under a sterile col ection, umbilical cord blood of newborn from cesarean section was col ected to isolate human mesenchymal stem cel s by digestion using col agenase II. Immunohistochemical staining was used to detect cel surface markers and observe morphological characteristics, and MTT assay used to detect cel proliferation and draw cel growth curve. Cel s grown to 70%-80%confluence were treated with 10μmol/L 5-azacytidine for 24 hours. RESULTS AND CONCLUSION:One week after adherent tissue culture, human umbilical cord mesenchymal stem cel s were seen, and then the cel s cultured in culture medium showed colony growth. Within 24 hours of cel seeding, cel s at passages 3 and 10 were at latency period and then grew logarithmical y with a doubling time of 30 hours. Immunocytochemical staining showed that passage 3 cel s at over 90%confluence expressed CD44 and CD29, rather than CD28 and CD31.Three weeks after induced culture, the cel s with the absence of processes grew irregularly;after 4 weeks, the cel s were round in shape and expressed cardiac-specific immune markers. Taken together, isolated human umbilical cord mesenchymal stem cel s with strong proliferative ability have the basic biological characteristics of mesenchymal stem cel s, which are capable of differentiating into cardiomyocyte-like cel s induced by 5-azacytidine.

Objective To analyze the value of serum procalcitonin (PCT) in patients with community acquired pneumonia (CAP),and to evaluate the role of PCT in the therapeutic effect,severity and prognosis.Methods A retrospective analysis of data and laboratory tests of 50 patients with CAP admitted from November 15,2011 to November 15,2012 in GICU was carried out.Patients with infection of other parts of body,surgical treatment and trauma were ruled out.The level of PCT (ng/mL) before and during treatment,and the relationships between PCT and respiratory failure,mechanical ventilation,treatment results were analyzed respectively.Results According to the occurrence of sepsis,50 patients were divided into sepsis group and non-sepsis group.In the non-sepsis group,the PCT level before treatment,the highest and average PCT levels during the treatment were 0.1125 (0.078,0.269),0.1235 (0.078,0.494),and 0.1355 (0.08,0.245) respectively.Correspondingly,the PCT levels in the sepsis group were 8.92 (2.715,16.33),13.53 (6.305,25.625),and 4.26 (2.1415,8.2455),and there were statistically significant differences in three values of PCT between groups (ZIst =-4.743,PIST ＜ 0.05 ; ZMax =-5.783,PMax ＜ 0.05 ; ZMean =-5.644,PMean ＜ 0.05).According to the emergence of respiratory failure during treatment,average PCT level in the patients with respiratory failure was 1.7375 (0.224,5.092),and that in the patients without respiratory failure was 0.081 ng/mL (0.049,0.146),presenting the statistically significant difference between two groups (Z =4.472,P ＜ 0.05).In case of using mechanical ventilation (MV),the average PCT level of the patients with mechanical ventilation was 1.618 ng/mL (0.224,5.092),and that in the patients without MV was 0.086 ng/mL (0.061,0.465),producing a significant difference between the two groups (Z =-3.788,P ＜ 0.05).Grouped according to the outcome of patients,the mean value of PCT level in death group was 7.4585 ng/mL (2.392,16.25),and that in the survival group was 0.1965 ng/mL (0.885,0.618),showing statistically significant difference between two groups (Z =3.857,P ＜ 0.05).The first PCT level in the GICU within 24 h after admission was used to make the receiver operating characteristic curve (ROC),and the area under the curve (AUC) was 0.9867,cutoff point was 1.25 ng/mL.Conclusions In case of CAP,the PCT level in patients with sepsis is significantly higher than that in patients without sepsis,and PCT can distinguish sepsis from pneumonia precisely.In addition,PCT is an important biomarker to judge the severity and outcomes of CAP at early stage.

Objective To study the changes of gonadotropin releasing hormone agonist (GnRH-a) in pinopodes during luteal phase and to explore the possible mechanism of GnRH-a in luteal phase support of assisted reproductive technology (ART).Methods Totally 40 primary infertility women who were treated with ART due to male factors were enrolled,according to the order of the group they were randomly divided into experimental group and control group.On the 7th day after ovulation,the experimental group received a subcutaneous injection of 0.1 mg of GnRH-a,while the control group received a subcutaneous injection of placebo only (0.9％ salinc 2 ml),3 days later they came to the clinic again.Serum estradiol and progesterone levels were measured before and after treatment in each group.Pinopodes were collected for electron microscopic examination.Levels of ER and PR were detected by western blot.Results (1) There was no significant difference between the experimental group and the control group in the estrogen level before and after the treatment (all P＞0.05).The level of progesterone in the experimental group after treatment [(66.8± 14.9) nmol/L] was significantly higher than that before treatment(P＜0.05);also significantly higher than the same period of the control group (P＜0.05).(2) There was no significant difference in the expression of ER protein in the experimental group before and after treatment (P＞0.05).The expression of PR in the experimental group after treatment was significantly lower than that before treatment (P＜0.05);also lower than the same period of the control group (P＜0.05).(3) Expression amount of pinopodes in the experimental group after treatment was significantly higher than that before treatment [65％ (13/20) versus 25％ (5/20),P＜ 0.05],and the development trend was more mature [the percentage of maturation:75％ (15/20) versus 35％ (7/ 20),P＜0.05].Expression amount of pinopodes after treatment and the percentage of maturation in the experimental group were significantly higher than those in the same period of control group (P＜0.05).Conclusion GnRH-a in luteal phase support may play a role through the corpus luteum,which may promote the secretion of progesterone,downregulation of PR expression,promote the growth of pinopodes,and improve the endometrial receptivity.

Objective:To explore the possible mechanism of astragaloside involved in the mouse podocytes injury induced by TGF-β1 in vitro.Methods:Mouse podocytes were cultured in vitro and then all cell were divided into 5 groups:normal control group , TGF-β1 treatment group ,TGF-β1 treatment +astragaloside low dose group ,TGF-β1 treatment +astragaloside middle dose group and TGF-β1 treatment +astragaloside high dose group.The proliferation rate of each group was investigated by MTT assay ,the expression of TRPC6 protein and mRNA were measured by Western blot and RT-PCR respectively after 48 hours.Results:TGF-β1 can significantly inhibit the proliferation of podocytes ( P<0.05) ,fusions of foot processes or even effaced of podocytes were observed .TGF-β1 could also increase the expression of TRPC6.Astragaloside could reduce the inhibition of TGF-β1 to the proliferain of podocytes significantly ,make the cell shape tend to be normal,and reduce the expression of TRPC6 mRNA and protein with dose-effect relation.Conclusion:TRPC6 play an impor-tant role in the TGF-β1 induecd podocytes injury .Astragaloside can alleviate podocytes injury by reduce the expression of TRPC 6.

ObjectiveTo investigate the current situation of the quality of life of aging people living in the rural areas in Hainan province. Methods253 permanent residents at age of 60 and above in Zhongyuan Town were sampled at random, and were investigated face to face at home. Results96.0% of them were independently managing their activities of daily life with 77.5% lived by themselves. In a self evaluation questionnaire on health status, 32.0% perceived good, 50.8% moderate and 17.2% bad,70.75% had history of chronic illnesse, cataract, hypertension, chronic bronchitis, bone and joint diseases and anemia appeared to occupy the previous five positions.41.0% were satisfied with the current medical condition,52.4% moderate and 6.6% un satisfied. 75.1% thought medical costs too expensive. At the degree of satisfaction to life, 20.2% were high, 63.8% moderate and 16.0% low. ConclusionsDue to the huge amount of demand on health services of the rural elderly people, it was suggested that more medical care should be provided to the rural elderly people, with emphasis on the chronic diseases, and the policy of prevention first and combining prevention with treatment should be sticked to.