A total of 185 patients with type 2 diabetes mellitus (T2DM) were consisted of male group (n =95) and postmenopausal female group (n =90).The parameters of fasting plasma glucose,HbA1c,fasting insulin,fasting C peptide,homeostasis model assessment insulin resistant index (HOMA-IR) and β-cell function (HOMA-β),blood lipid,body mass index,and waist to hip ratio were collected and analyzed by Pearson correlation analysis and stepwise multiple regression analysis.The relationships between osteocalcin and these parameters were investigated.The results revealed that osteocalcin was negatively correlated with HbA1C (P＜0.05),and osteocalcin was an independent relevant factor affecting HbA1Clevels.Osteocalcin may be involved in the regulation of glucose metabolism in T2DM.

Objective To observe the effects of blood pressure by intravenous infusion of different doses ofoxytocin in cesarean section.Methods Sixty full-term pregnant women undergoing cesarean section with continuous epidural anesthesia were divided into three groups by random digits table method with 20 cases each:group A,B and C.Three groups were injected 10 U oxytocin in uterine muscle after infant delivery.Group A,B and C received 5,10 and 20 U oxytocin (sodium lactate ringer,500 ml) continuous intravenous infusion at the speed of 10 ml/min.If happened uterine contractions bad,they were sublingual administering 0.2 mg misoprostol.If happened severe hypotension,they were intravenous injected 5 mg ephedrine.The change of mean arterial pressure (MAP) and heat rate before anesthesia (T0),after fetal childbirth (T1),5 m in (T2),10 min (T3),30 min (T4) after infusion of oxytocin and the dosage of ephedrine and misoprostol were recorded.Results There were no significant differences in MAP and heart rate at every time point between group A and B (P＞ 0.05).MAP decreased and heart rate increased in group C at T2,T3 compared with those in group A and B,and there were significant differences (P＜ 0.05).The number of cases of sublingual misoprostol were increased in group A (7 cases) compared with that in group B (2 cases) and group C(1 case).The 8 patients injected ephedrine in group C were more than group A(1 case) and group B (3 cases).Conclusion Cesarean section after the delivery of the fetus in the uterus muscle injection of oxytocin 10 U,after 10 U of oxytocin added 500 ml sodium lactate ringer injection at the speed of 10 ml/min intravenous infusion has little effect on the blood pressure and heart rate,and has good uterine contractions.

Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Child ; Male ; Female ; Humans ; Meningioma

Erythropoiesis ; physiology ; Humans ; Mitochondria ; physiology ; Mitochondrial Degradation

Objective To detect the tissue stiffness of liver lesions by using acoustic radiation force impulse imaging (ARFI) and to evaluate the clinical value on the characteristics of liver lesions.Methods ARFI was perforrned in 91 patients with 103 liver lesions (56 benign,48 malignant).Tbe elastographic images of virtual touch tissue imaging (VTI) and the values of virtual touch tissue quantification (VTQ) were analyzed.The area under the curve and cutoff value for VTQ value were used to assess diagnostic performance.Results On the elastographic images of VTI,79.17 ％ (31/55) malignant liver lesions and 56.36 ％ (38/48) benign liver lesions appeared stiffer compared with the surrounding liver parenchyma.There was statistical difference between malignant and benign liver lesions (x2 =0.627,P ＜ 0.01).The VTQ values of malignant and benign liver lesions were (2.64±0.65) m/s and (1.72±0.39) m/s,respectively,and there was statistical difference between them (t =8.638,P ＜ 0.01).With a cutoff value of 2.10 m/s for VTQ value,the sensitivity and specificity of diagnosis for liver malignancy were 83.3 ％ and 81.8 ％,respectively.Conclusion ARFI can provide information of the tissue stiffuess in live lesions,which is helpful in the differentiation between benign and malignant liver lesions and might become the imaging modality in the future.

Objective To apply the sharing mode of nursing observation on typical cases to promote nurses' capability and observation skills of clinical nursing and deepen the connotation of high-quality nursing service.Methods The sharing mode of n ursing observation on typical cases was established in 2010 and run through the process of record-report-evaluate-share-reward.The registration form of nursing observation on typical cases was designed by the nursing department,on which the observers recorded typical cases and reported it via network to the nursing department.And the latter assigned nursing experts at regular intervals to evaluate and shared cases through a variety of forms (publishing briefings,organizing exchange meetings,etc.),in which the excellent examples were rewarded.Results Since 2010,298 cases had been submitted,with more than 100 cases shared and 57 rewarded.Conclusions The sharing mode of nursing observation on typical cases has elevated nurses' observation capability and comprehensive quality,deepened the connotation of high-quality nursing service and ensured the safety of the patients.

Objective To investigate the status quo and existing problems in 2A or higher level general hospitals in Shandong Province,in order to provide information for establishing and perfecting the head nurse training system of Shandong Province.Methods 666 head nurses from 129 hospitals were investigated by a self-designed questionnaire,namely The questionnaire of status quo of head nurse training in 2A or higher level general hospitals in Shandong Province.Results The head nurses participating in the survey were average (40.1±5.8) years old,66.7％ of whom had intermediate titles,78.8％ with vocational school as basic education,86.8％ with bachelor as the highest degree.The head nurse training contents were mainly level hospital evaluation (73.9％),quality of nursing management training (65.8％) and nursing quality control (64.2％); training forms were mainly seminar (63.7％),conference (51.4％)and short-term training courses (40.5％); cumulative training time was within two weeks; 73.8％ of the teachers derived from clinical nursing specialist.79.3％ of the head nurses did not attend personalized evaluation before training,while 54.7％ received different forms of evaluation after training.57.2％ of the head nurses considered there had been problems in previous training,such as less practical knowledge (64.1％),a single mode of training (50.7％),lack of pertinence (34.6％),training teachers level was uneven (32.2％).Conclusions The systematic,hierarchical,normal,required,flexible-form,effective-evaluation and talents head nurse training system should be established to improve the nursing management level of the head nurse fundamentally.

Objective To investigate the characteristics of intestinal flora in infants with different feeding patterns.Methods Sixty-two cases of health infants(30-120 d)were divided into 4 groups according to their feeding patterns:breast feeding,imported powder milk feeding,domestic powder milk feeding and mixed feeding.Samples of their fresh feces in each group were collected and divided into sections equally:the bifidobacteria were isolated in anaerobic box and the number was counted for one section;for the other section,total DNA of intestinal flora was extracted and enterobacterial repetitive intergenic consensus (ERIC) fingerprints were amplified with the method of ERIC-PCR.After that,the specific bands observed in different groups were cloned and sequenced and alignmented.Results The colonies of bifidobacteria were more in breast feeding and mixed feeding groups[(9.10 ± 1.33) cfu/g;(8.62 ± 1.35) cfu/g]than those in domestic powder milk feeding and imported powder milk feeding groups[(7.62 ± 1.22) cfu/g;(7.32 ± 0.80) cfu/g,t =3.23,P ＜ 0.05];while there was no significant difference between breast feeding and mixed feeding groups,and between 2 powder milk feeding groups.Two specific bands were found from the ERIC fingerprints (A:1 100 bp mainly in breast feeding,domestic powder milk feeding and mixed feeding groups;B:1 000 bp mainly in imported powder milk feeding group).Sequencing and analysis of Basic Local Alignment Search Tool showed that homologous bacteria of A and B fragments were bifidobacterium longum.The encoding protein of A fragments might be related to the enzymes of carbohydrate metabolism,and B fragments were related to the enzymes of protein metabolism.Conclusions The colonies of bifidobacteria in intestinal tract are more in breast feeding and mixed feeding infants than those in formula feeding groups.The distribution of intestinal flora in domestic powder milk feeding infants is more similar to that of the breast feeding infants.

Objective To evaluate the effect of obstructive jaundice on recovery from sevoflurane anesthesia in pediatric patients. Methods A total of 80 pediatric patients scheduled for elective surgery were included, 42 pediatric patients with biliary atresia scheduled for Kasai operation served as obstructive jaundice group ( group OJ ) , and 38 pediatric patients scheduled for other operations served as control group ( group C) . Pediatric patients were 1-4 months old and full?term infants, and weighed 3.2-8.0 kg. Anesthesia was maintained with inhalation of 2%-4% sevoflurane during surgery, and pediatric patients inhaled 4% sevoflurane staring from peritoneum closure until the end of surgery. The duration from closing sevoflurane vaporizer to BIS value reaching 60, 70, 80 and 90 was recorded. The duration from stop of sevoflurane inhalation to BIS value returning to 60, 70, 80 and 90 was recorded. The duration from termination of sevoflurane inhalation to the time for tidal volume returning to 6 ml∕kg, to the time for muscle strength recovering to grade Ⅲ, to spontaneous eye opening and to tracheal extubation, and the corresponding BIS values were recorded. BIS value while entering the operating room, BIS value at the end of surgery, and the highest BIS value during recovery from anesthesia were recorded. The occurrence of delayed emergence from anesthesia was recorded. Results Compared with group C, the duration from termination of sevoflurane inhalation to spontaneous eye opening and to tracheal extubation were significantly prolonged, and BIS value at the end of surgery was decreased, and no significant change was found in the other parameters in group OJ. No pediatric patients developed delayed emergence from anesthesia in the two groups. Conclusion When only sevoflurane is used for inhalation anesthesia, although the time for recovery from anesthesia is prolonged, it shows no significant difference clinically in pediatric patients with obstructive jaundice.

Objective To investigate the efficiency of intraoperative neurophysiological monitoring in cervical spinal tumor surgery.Methods Retrospective case-control study comparing 23 cervical spinal tumor patients received surgery under neurophysiological monitoring (case) and 23 cases without neurophysiological monitoring (control).Results All of 46 cases,there were no significant differences of age,gender and preoperative neurological function.Duration of operation and estimated blood loss in the IONM cohort was less than the control group with significant difference.The preoperative JOA score of IONM group and control group were 12.0±2.4 and 12.7±2.1,with no significant difference.The postoperative JOA score of each group were 15.0±1.5 and 15.2±1.7,with no significant difference.The rate of cervical cord neurological improvement of IONM group was higher than control group,but there was no significant difference.In the IONM cohort,abnormal signal appeared in 8 cases,with 1 case developed new postoperative deficit,and the sensitivity and specificity of SEP were 100％ and 77.3％,the sensitivity and specificity of MEP were 100％ and 86.4％.Compared with preoperative SEP,4 cases showed major improvement (baseline increase ＞ 40％),2 cases showed moderate improvement (baseline increase:15％-40％).The coincidence rate of the SEP improvement and the AISA grade was 66.7％.Conclusion IONM could reduce the duration of operation and intraoperative blood loss.Changes of IONM were correlated with postoperative neurological function improvement.