Objective:To investigate the cognition and anxious state of the type 2 diabetes mellitus accepted insulin-treatment for the first time,and offer reference for clinical mental nursing and healthy education. Methods: Use SAS (self-rating anxiety scale) and questionnaire to investigate the cognition of 156 type 2 diabetes mellitus for insulin-treatment at the first time,collect SAS score of different groups from basic understanding for insulin, worry of insulin injection treatment,and influence of their social communication. the statistics and analysis is done by SPSSⅡ10.0. Results: Anxiety score of type 2 diabetes mellitus compared with internal normal norm,the difference has statistical significance. Anxiety score compared in different age,culture degree,and medical cost,the difference has also statistical significance. 51%patients think insulin-treatment means aggravation of pathogenetic condition. 63% patients worry and don’t want injection of insulin. 36% patients think injection of insulin influence their social communication. Conclusion: Type 2 diabetes mellitus who accept insulin-treatment for the first time, have anxiety symptom at different levels. Recognizing the psychological state of every diabetes mellitus for insulin-treatment, will provide some help to clinical management. To insulin-treatment, it is very necessary to strengthen psychological education and eliminate misunderstand of the patients. The patients can accept insulin-treatment protocols early and correctly.

BACKGROUND:Until now, limited information has been neported on the characterization of udines 5-diphosphateglucuronosyl transferase (UGT) 1a1, UGT1a6, and microsomal glutathione S-transferase 1 (mGST1) during the differentiation of mouse embryonic stem cel s. OBJECTIVE:To observe the expression characteristics of UGT1a1, UGT1a6 and mGST1 at different stages of differentiation of mouse embryonic stem cel s. METHODS:Embryonic fibroblasts from Wistar rats were isolated and cultured as feeder cel s. Mouse embryonic stem cel s seeded onto these feeder cel s were induced to differentiate into hepatocytes. Subsequently, expression of UGT1a1, UGT1a6 and mGST1 was detected using western blot assay, and catalytic activity of mGST1 was determined by high performance liquid chromatography. RESULTS AND CONCLUSION:Increasing UGT1a1 expression was visible during the whole cel differentiation, while UGT1a6 exhibited no expression initial y but a higher level at 18 days of differentiation. mGST1 expression was visible at high level throughout the differentiation, but its expressive abundance was stil lower than that in the adult mouse stem cel s. At 18 days after the beginning of differentiation, the catalytic activity of mGST1 in microsomal liver tissue was 7.65μmol/(min?g). Taken together, stabilized UGT1a1, increased UGT1a6 and little mGST1 expression are confirmed in the differentiation of embryonic stem cel s into hepatocytes.

[objective] To investigate the effects of curcumin on the behavior of chronic constrictive injury(CCI)rats and the c-fos expression in spinal cord dorsal horn.[Methods]108 male SD rats were randomly divided into 4 groups:Control group(treated with CCI);Sham operation group;Solvent contrast group;Curcumin treated group.Thermal withdrawal latency(TWL)and mechanical withdrawal threshold(MWT)of rats were determined by Hargreave's thermal radiation apparatus and von Frey's method of microfilament,respectively.The time course of expression of c-fos were assessed by immunohistochemical analysis.[Results]Curcumin could significantly attenuate the activation of c-fos induced by CCI and simultaneously ameliorate thermal and mechanical hyperalgesia induced by CCI.[Conclusion]This study shows that curcumin could attenuate the activation of c-fos to ameliorate the CCI-induced neuropathic pain.

BACKGROUND: Although there are many studies on acute patellar dislocation in adolescents, the optimal treatment strategy is under discussion.OBJECTIVE: To summarize the clinical efficacy of reconstruction of the medial patellofemoral ligament (MPFL) in the treatment of adolescent acute patellar dislocation using double-pulley technique.METHODS: Thirty cases of acute patellar dislocation were enrolled and received reconstruction of the MPFL using double-pulley technique. We proceeded to prepare the bone bed for anchor placement at the medial point of the superior edge of the patella and at the upper 1/3 patella along the long axis of the patella using arthroscopic grinding. Two double-loaded 5.0 anchors were respectively placed at the medial point of patella and at the upper 1/3 patella parallel to the patellar articular surface, and then tied using the double-pulley technique. Long longitudinal incisions were performed at the medial condyle and at the adductor tubercle to expose these two structures, the deep fascias tunnel between two incisions were penetrated to pull the tendon weave end through the tunnel until the lateral side along a femoral tunnel; finally the tendon was fixed using screws in appropriate tightness. All patients were followed for more than 10 months, and the patellar-related parameters and knee function parameters were compared before and after operation. RESULTS AND CONCLUSION: There were 12 cases of intra-articular cartilage injury and 4 cases of meniscus injury. The patella title angle, Q-angle and outward shift distance at the last follow-up were less than those before operation. Lysholm and International Knee Documentation Committee scores at the last follow-up were higher than those before operation. The mean operation time was (90±10.5) minutes. There was one patient with knee movement angle from 0° to 30° and one patient with a patellar fracture caused by slipping and treated with internal fixation. None of patients appeared with patellar dislocation, positive apprehension test infection or poor wound healing. These results indicate that the simple and mini-invasive double-pulley technique is a good treatment strategy for acute patellar dislocation, because it is consistent with patellar anatomical stability, holds patellar trajectory visibility, quick recovery and good curative effect. Additionally, osteotomy is recommended when the simple efficacy is not satisfactory.

Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)％ in the TAO group and (80.05 ±0.38)％ in the control group respectively,with no significant difference between them(t =0.923,P＞0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P＜0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.

Objective To evaluate the blood-saving effect of combination of hemocoagulase artox for injection and tranexamic acid (TXA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Eighty ASA Ⅱ patients (NYHA Ⅰ or Ⅱ),aged 50-70 yr,weighing 50-100 kg,scheduled for elective OPCABG,were randomly divided into 4 groups (n =20 each):control group (group C),hemocoagulase atrox for injection group (group H,n =20),TXA group (group T) and hemocoagulase atrox for injection + ·TXA group (group HT).Hemocoagulase atrox 0.04 U/kg (the highest dose 4 U) was injected at 20 min before skin incision,and additional hemocoagulase atrox 2 U was given every 2 h starting from 15 min after administration of protamine until the end of operation in group H.TXA 20 mg/kg was injected intravenously at skin incision,followed by a continuous infusion of TXA at 10 mg· kg-1 · h-1 until the end of operation in group T.Hemocoagulase atrox and TXA were given as the method described in groups H and T.Venous blood samples were taken from the central vein before operation,at the end of operation,and 24 h after operation to determine the plasma D-Dimer concentration.The amount of blood loss,allogeneic red blood cells and plasma infused during operation,volume of drainage during 0-6 and 6-24 h after operation,total volume of drainage and volume of allogeneic blood transfused during operation were recorded.The deep vein thrombosis was recorded.Results Compared with group C,the amount of blood loss during operation was significantly decreased in groups T and HT,and the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in groups H,T and HT (P ＜ 0.05).Compared with groups H and T,the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in group HT (P ＜ 0.05).No deep vein thrombosis was observed in the 4 groups.Conclusion The combination of hemocoagulase artox for injection and TXA provides better blood-saving effect than either alone for the patients undergoing OPCABG without increasing the risk for thrombosis.

Objective To explore the inner feelings of gestational diabetes at their primary use of the real-time blood glucose monitoring. Method Using the qualitative method, 10 gestational diabetic patients monitored their blood glucose using the real-time blood glucose monitoring for the first time and then were interviewed, the acquired results treated with phenomenological analysis. Result The inner feelings of the 10 patients were summarized including 5 themes:worry about the safety of the fetus, fear on alarming at monitoring, different views on four times input of finger blood glucose values, worry about inaccuracy in blood glucose monitoring data, changes in mental conditions and diets. Conclusion Health care workers should provide the gestational diabetic patients with targeted care strategies based on presence of psychological status and knowledge needs so as to improve their compliance, reduce the psychological burden of patients and control their blood glucose level.

OBJECTIVE:To explore an emergency drug supply mechanism for women and children’s special hospital during earthquake disaster. METHODS: The practice of drug supply in our hospital after "5?12" Wenchuan earthquake was analyzed. RESULTS: The daily and post-earthquake medicine supply of the hospital was guaranteed,including the drugs which supply to the medical treatment rescues team in the disaster area;and the principle and approach of emergency drug supply in women and children's special hospital during earthquake disaster has been established. CONCLUSIONS: The emer-gency drug supply in women and children’s special hospital should cover drugs used for wounded women and children in addition to those special drugs used for earthquake injuries. All the links including drug plan,drug purchase,quantity monitoring and drugs needed for rescue should be considered in detail to form a fast and smooth hospital emergency drug supply mechanism.

OBJECTIVE:To strengthen management of hospital drug storehouse.METHODS:According to Joint Commission International (JCI) accreditation,management of drug storehouse was guided through perfecting working system,workflow,qualification confirmation of employees,reasonable management of drug stock and information management,etc.Related investigation and discussion were carried out.RESULTS & CONCLUSIONS:Management of hospital drug storehouse combining with JCI accreditation and quality assurance system of drug storehouse management can improve workflow and management of drug storehouse,guaranteeing efficiency and quality of drug supply.

OBJECTIVE: To provide references for the practice of the zero inventory management mode in hospital drug supply storeroom.METHODS: The zero inventory management mode in hospital drug supply storeroom was summarized based on experiences of hospital drug supply storeroom management in our hospital.RESULTS & CONCLUSIONS: After introduction of zero inventory management principle in hospital drug supply storeroom,the drug turnover frequency in our hospital reached 8～9 times every quarter,which has greatly lowered drug storage costs,activated the working capital,and brought down the proportion of drug fund to as low as about 15% of total hospital working capital.Therefore,establishing a reasonable managing mode suitable to hospital condition and applying zero inventory principle in the management of hospital drug supply storeroom are of importance for lowering hospital running cots and enhancing working efficiency.