Objective To study the relationship of peripheral vascular disease(PVD) with gender and serum uric acid in patients with type 2 diabetes.Methods Lower extremities of 82 male and 70 female patients with type 2 diabetes were screened for PVD by color Doppler uhrasonography,and the levels of serum uric acid,fasting blood glucose,glycosylated hemoglobin and serum lipid were examined.Results In male,serum uric acid(328.12?107.30) ?mol/L,age(65.00?9.66) yrs,durations of diabetes(7.38?6.17) yrs, HBA_1Cc(7.74?1.83)% were significantly higher in the diabetic patients with PVD than those in patients without PVD.And these changes were not shown in female patients.In male,the detectable rate of PVD(82.14%)in diabetics with high level uric acid was also increased than that in normal uric acid group(53.70%).Conclusion The higher level of serum uric acid in type 2 diabetics was closely related with the occurrence of peripheral vascular disease in male.So we should actively control the level of serum uric acid in male.

Objective To study the effect of dexmedetomidine on perioperative stress reaction and postoperative cellular immunity of patients with breast cancer radical surgery.Methods We selected 108 cases of breast cancer patients undergoing elective radical surgery under general anesthesia in our hospital from Janu-ary 2012 to June 2015.These patients were divided into dexmedetomidine group (group D)and the control group (group C)by random number table method,54 cases in each group.Patients in group D were given dexmedetomidine 1.0 μg/kg by intravenous drip within 15 min before anesthesia and maintained 0.5 μg.kg -1 .h -1 after anesthesia induction intubation until operation finish.Patients in group C were given the same capacity of normal saline instead of dexmedetomidine,and the rest of the anesthesia was same as group D.The plasma norepinephrine (NE)and epinephrine (E)and cortisol (COR),serum interleukin-6 and T lymphocyte subsets (CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)and NK cells levels were determined before anes-thesia (T0 ),postoperative 4 h (T1 ),1 d (T2 ),3 d (T3 ),and 7 d (T4 ).Results The level of plasma NE, E,COR and serum IL-6 of the D group in different time had no statistical significance compared with T0 time (P ﹥ 0.05).The plasma level of E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the C group were increased significantly (P ﹤ 0.05).The level of plasma E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the D group were decreased significantly compared with C group (P ﹤ 0.05).The level of CD3 + and NK cells in T1 -T3 of the two groups decreased significantly compared with T0 (P ﹤ 0.05).The level of NK and CD3 + in T1 -T3 and CD4 +,CD4 +/CD8 + in T2-T3 of group D increased significantly com-pared with group C (P ﹤ 0.05).Conclusion Dexmedetomidine of intravenous drip during general anesthesia can effectively reduce stress reaction in perioperative period of breast cancer patients,and improve patients immune status.

Objective To study the effects of mild hypothermia on cognitive function , synapsinⅠexpression and synaptic ultrastructure of hippocampus in epileptic rats induced by global cerebral ischemia. Methods Forty-eight male SD rats were randomly divided into control (NC) group, sham-operated (Sham) group, normothermic epilepsy (NT) group and mild hypothermic epilepsy (HT) group. The model of postischemic audio-genetic seizure was established by chest compression. Hypothermia intervention was given to HT group. Immunocytochemistry was conducted to detect the expressions of synapsin I in hippocampus at days 1 , 3, 14. the synaptic ultrastructure and cognitive function were respectively observed by electron microscope and Morris water maze. Results Compared with NC and Sham group, the expression of synapsinI in NT group was decreased, the escape latency was prolonged and across platform number decreased (P < 0.05). The synapses were decreased in number, and mitochondria was viewed swelling, synaptic membranes unclear, myelin fractured. Compared with NT group, the expression of synapsinⅠin HT group had no obvious change in 24 h but was significantly increased in days 3 and 14 (P < 0.01); The escape latency was decreased and the number of cross platform increased (P < 0.01); Synaptic structure was clear, with interface growing and postsynaptic density thickened. Conclusion Mild hypothermia may improve the cognitive function of the epileptic rats induced by global cerebral ischemia by upregulating the expression of synapsinⅠand alleviating the damage of synaptic structure.

Objective To explore effects of mild hypothermia on early neurological deterioration (END) after main arterial occlusive with intra-arterial thrombolysis. Methods Fifty patients were randomly divided into mild hypothermia and conventional group, to compared the changes of ICP, CVP, MAP, Blood K+, PT, PLT, ScvO2 and NIHSS before- treatment and 24 h and 7 d after- treatment , prognosis and mortality were evaluated by MRS after 90 d. Results (1) Compared with pre-treatment, 7 d NIHSS of mild hypothermia group decreased (P < 0.01); 24 h, 7 d ICP and ScvO2 improved significantly (P < 0.05); 24 h decreased significantly (P <0.05), while 7 d blood K+ showed no differences. (2) Compared with conventional group, mild hypothermia group 7 d NIHSS and 24 h, 7 d ICP and ScvO2 improved significantly (P < 0.05). (3) The CVP, MAP, PT, and PLT showed no difference in two groups before and after-treatment . ( 4 ) Rate of good outcome in mild hypothermia group was significantly higher than conventional group in 90 days (P < 0.01); while the mortality rate showed no difference. Conclusions Mild hypothermia can obviously improve END in stroke with intra-arterial thrombolysise, bring better outcome among survival patients, though can not reduce mortality.

Totally 1136 individuals aged over 40 underwent health check up in March to May 2009. Fasting blood glucose, 2-h post-challenge blood glucose, glycated hemoglobin A1c ( HbA1c), total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and serum uric acid were measured. The diagnosis of metabolic syndrome was based on the International Diabetes Federation Criteria. The results shows that total body fat, region body fat indices, blood pressure, blood glucose and serum uric acid levels increased with the age ( P < 0.01) . The prevalence rate of metabolic syndrome in this group of individuals were 15. 1% (171/1136) , and increased with age (P<0.01). The most common combination of metabolic syndrome was central obesity-hypertension-dyslipidemia (40. 9% , 70/171). Unconditional logistic regression revealed that waist-hip-ratio, body mass index and uric acid were the risk factors for metabolic syndrome.

A total of 1342 individuals underwent physical examinations according to the criteria of metabolic syndrome of International Diabetes Federation (IDF) in 2005.And 314 patients with metabolic disorders were screened for diabetes by standard meal and methods oral glucose tolerance test (OGTT).Newly diagnosed diabetics was 12 (4.1％ ) vs.17 (5.8％) respectively.No significant difference existed between two methods (P =0.332).Kendall's (τ)b =0.313,Kendall's (τ)c =0.208 and Gamma coefficient =0.580 (P =0.000).The mixed meal method was correlated with OGTT,Kappa =0.258 (P =0.000) and two methods were consistent.Diabetic screening should be stressed in the subjects with metabolic abnormalities.And the detecting efficiency of postprandial plasma glucose is similar to OGTT.

Objective To understand teachers' cognition and behavior of PBL teaching in nursing college.Methods Eighty teachers were investigated by questionnaire at eight nursing colleges in Hunan province.The percentage was used to do statistical description.Results Totally 75 copies of valid questionnaires were returned,the effective recovery rate was 93.75％.Among all,96％ of teachers thought that teacher was the guide;85.3％ teachers thought that students were knowledge's seekers;93.3％ teachers heard of PBL teaching;81.3％ teaches thought that PBL teaching played a positive role ;74.7％ teaches understood PBL teaching by communication or reading literature; 72％ teachers were willing to try PBL teaching;46.8％ teachers emphasized on multidisciplinary knowledge fusion in teaching; 88.3％ teachers encouraged student discussion in class.The main factors effecting PBL teaching were case and problem design,teaching result evaluation,lack of expert guidance and teacher instruction.Conclusion Teachers have certain understanding of PBL.Organizers should formulate related policies for teachers and students in order to create good education environment.

This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis ( MDR-TB) . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was (410.17±14.62) ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was (476.33±6.16) ms.The increase of QTc interval was 47-85 ms, while the average was ( 66 ± 11. 48 ) ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.

Objective This study aimed to evaluate the clinical significance of detecting cytokine expression with Crohn's disease(CD) by Luminex liquid chip.Methods A total of 76 patients with CD and 50 healthy volunteers as healthy control group were recruited in this study.The expression of cytokines IL-2,IFN-γ,TNF-α,IL-4,IL-6,IL-10 and IL-17A were detected by Luminex liquid chip according to the instruction of MILLIPLEX MAP Kit.Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of anti-saccharomyces cerevisiae antibodies(ASCA).Then the relationship and differences among these groups were analyzed.Results Except IL-17A,the level of IL-2,IFN-γ,TNF-α,IL-4,IL-6,IL-10 was higher in the CD group than those in control group.The serum levels of IFN-γ,TNF-α and IL-6 in patients with active stage of CD group were significantly higher than those with remission stage and healthy control group.The level of TNF-α and IL-6 in moderate and severe stages were higher than those in slight stage.The serum level of ASCA had significant difference between CD group and control group.Compared with ASCA negative group,the ASCA positive patients have a higher level of IL-6 and TNF-α.ConclusionThe cytokines like IL-6 and TNF-α is correlated with CD severity,which is important for inflammatory activity and progression of CD.Altogether,these results demonstrated that the dynamic change of cytokines had a clear relativity in stage of CD,which is very imperative for diagnosis and clinical appraisal of CD.