Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide with a trend of increasing morbidity and prevalence. It usually links to a high disability and mortality rate. Stroke is the most important and severe complication of AF, as a core strategy to prevent it, anticoagulation therapy is recommended to reduce the risk of stroke events. However, management risks including poor treatment adherence, individual difference and bleeding risk can′t be ignored. In the western countries, they have successively established a nurse-led integrated chronic care program for patients with atrial fibrillation. We can use it to guide our future work. Anticoagulation therapy is a long-term managing process. To integrate the existing medical resources, nurses must give their full play to access the deep needs and guide them to learn the core skills of management, thus improving the adherence to anticoagulation therapy.

BACKGROUND:Humeral supracondylar fracture is a common fracture occurred in children. The selection of internal fixation for humeral supracondylar fracture remains controversial. OBJECTIVE:To compare the biocompatibility between internal fixation with Kirschner wire and bioabsorbable implants for humeral supracondylar fractures. METHODS: From January 2007 to January 2013, 246 cases of humeral supracondylar fractures, from Affiliated Hospital of Luzhou Medical Colege, were treated by internal fixation with Kirschner wire. Meanwhile, the studies on internal fixation for treating supracondylar fracture of humerus in children were searched. Efficacy was evaluated by preoperative and postoperative elbow range of motion and the incidence of cubitus varus, and the results were statisticaly analyzed, and compared with other therapeutic methods. RESULTS AND CONCLUSION:Al cases were folowed up for 6-36 months, averagely 18 months. According to Mayo elbow performance score, function of the elbow joint was excelent in 194 cases, and good in 48 cases, with good and excelent rate being 98.4%. Four cases suffered < 5° cubitus varus, with incidence rate of 1.63%. The internal fixation with Kirschner wire provided functional recovery of elbow joint, but the second stage operation was needed to pick out the wires. And it might be perplexed by Kirschner wire loosening or needle withdrawal, resulting in instable fixation. Bioabsorbable implants were effective in the treatment of supracondylar fracture of humerus. Bioabsorbable sticks would break down over time, without harming to human body or influencing imaging examination. Elbow function development of the epiphysis would not be affected. However, due to lack of large-sample observation, long-term effects of bioabsorbable implants for treating supracondylar fracture of humerus in children deserve further studies.

Objective To investigate the relationship between homocystine (Hcy) ,methylenetetra hydrofolate reductase(M T H-FR) C677T and gestational diabetes mellitus (GDM ) .Methods A total of 91 GDM cases(GDM group) and 123 cases with normal pregnancy(control group) were detected for the C677T polymorphism of M T HFR and serum levels of Hcy and glucose .Results Serum Hcy level in GDM group was remarkable higher than that of control group (P< 0 .05) .Hcy level was positively correlated with fasting plasma glucose ( P < 0 .05) .The genotype frequencies (CC ,CT ,TT ) of M T HFR C677T in GDM group and control group were with significantly difference(P< 0 .05) .Hcy was significantly higher in women with C677T TT genotype than those with CC genotype(P< 0 .05) .Conclusion Hcy could be related to GDM .The mutation of M T HFR might affect serum Hcy level , and be involved in the occurrence and development of GDM .

From July 2006 to April 2008,103 patients(107 hips) undergoing first total hip arthroplasty(THA) were selected from Department of Bone and Joint Surgery,Affiliated Hospital of Luzhou Medical College.According to treatment methods,minimally invasive group(47 cases,47 hips) including 15 cases(15 hips) of necrosis of the femoral head,28 cases(28 hips) of femoral neck fracture,and 4 cases(4 hips) of osteoarthritis,were treated with small posterior skin incision and cementless prosthesis;the routine group(56 cases,60 hips) underwent routine THA.The blood loss,incision length,pain,functional recovery,length of stay,and perioperative complications were recorded.103 patients were followed up,of which minimally invasive THA was followed up for 3-11 months,and routine group followed up for 7-22 months.In the minimally invasive THA group,the patients had less blood loss(P 0.05).The results show that minimally invasive THA has the advantages of less complication,shorter hospital stay,slighter pain and faster function recovery compared to routine THA.

BACKGROUND:In recent years a large number of studies have suggested that bone marrow mesenchymal stem cells can ease hyperglycemia of diabetic rats, but the related mechanism is unclear and controversial. OBJECTIVE:To investigate the relevant mechanism of bone marrow mesenchymal stem cells on pancreas microenvironment in vivo in diabetic rats. METHODS:Bone marrow mesenchymal stem cells were transfected with enhanced green fluorescent protein (EGFP) and administered to diabetic rats via the subcapsular pancreas. Blood glucose levels were monitored. The expressions of the key genes in islet development in these EGFP positive pancreatic cells were analyzed by Real-time quantitative PCR at different times. EGFP and insulin double-positive cells were detected by immunofluorescence. Flow cytometry was performed to analyze cellcycle and DNA ploidy. RESULTS AND CONCLUSION:Blood glucose levels were effectively reduced after transplantation. The expressions of the key genes in islet development reached their own peak values at different times after transplantation:Nestin at week 1, Nkx 2.2 at week 3, Pax 4 and Ngn 3 at week 4, insulin and glucagon at week 12, PDX-1 at week 8 until week 12. The cells double-positive for EGFP and insulin cells were observed. In the pancreas, EGFP positive cells at S+G 2/M phase were significantly increased, and there were no polyploid and aneuploid cells. In pancreas microenvironment, the bone marrow mesenchymal stem cells transplanted into the diabetic pancreas can differentiate into isletβ-like cells under gene control, but not through the fusion with tissue cells.

Objective To study the effect and mechanisms of berberine (BBR) on the proliferation of papillary thyroid cancer K1 cells induced by high glucose.Methods K1 cells were cultured under 5.5 mmol/L or 25 mmol/L glucose condition with or without different concentration of BBR (0,10,40 and 80 μmol/L) for 24 hours.The proliferations of K1 cells in each condition were detected by MTT.Western blot was used to measure the expression of nuclear factor erythroid 2-related factor 2 (Nrt2),phosphoinositide 3-kinase (PI3K),protein kinase B (Akt) and phosphorylated-Akt (p-Akt).The distribution pattern of Nrf2 in K1 cells was determined using immunofluorescent staining.Results Compared with 5.5 mmol/L condition,the proliferation rate [(126.64 ± 5.41) ％ vs (87.31 ± 3.67) ％],expression levels of PI3K (0.425 ±0.019 vs 0.272 ±0.039),p-Akt/Akt (0.446 ±0.021 vs 0.168 ±0.035) and Nrf2 (0.597 ± 0.014 vs 0.308 ± 0.026),and Nrf2 distribution (93.0％ vs 23.1％) in nuclear of K 1 cells under 25 mmol/L condition were significantly elevated,respectively (all P ＜0.01).Addition of BBR in 25 mmol/L condition dose dependently (10,40,80 μmol/L) lowered the proliferation rate of K1 cells [(111.76 ± 4.10)％,(70.03 ±2.18)％,(32.41 ±3.76)％ vs (126.64 ±5.41)％,all P＜0.05],and suppressed the expression of PI3K,p-Akt/Akt,Nrf2,and Nrf2 nuclear distribution (P ＜ 0.05).Conclusions BBR dose dependently inhibited the proliferation of high glucose-induced K1 cells.This effect was associated with the suppression on of PI3K/Akt signaling activation,Nrf2 expression and its nuclear translocation.

To study the anticoagulant effect of Xiang-Qi-Tang (XQT),the mice model of endotoxemia was established to detect the expression of coagulation factors and their regulatory proteins in serum and aorta.The results showed that XQT could decrease the expression of TF and increase the expression of tPA in the aorta of mice with endotoxemia,and also decrease the expression of sEPCR in the serum.We further found that XQT caused the decrease of sEPCR through the regulation of PKC δ and ADAM17 to contribute the anticoagulation in mice.This study may provide a new strategy for treating endotoxin-induced disease and provide evidences for further researching the pharmacological action of XQT.

Objective:The standardized medical device clinical trials in China began in a short time, and the quality of trials needs to be improved.This article intends to explore possible ways for the improvement of quality management of the medical device clinical trials.Methods:Through working practice and literature review, analyze the current status of medical device clinical trials and in vitro diagnostic reagent in China; put forward targeted improved measures for the quality management system; as well as verify its feasibility through practice.Results:This article summarizes three factors that limit the improvement of the quality of medical device clinical trials, including the insufficient research and development strength of sponsors, the limited professional level of research teams, and the differences in verification and drugs, based on the risk-based quality management concepts, puts forward improved measures from three aspects, which including building risk-based quality certification system, making full use of electronic information systems to ensure the trial quality, and strengthening training of clinical trial capacity of researchers, and verifies the feasibility of these measures via the practical experience of our hospital since 2016.Conclusions:The application of risk-based quality management system, electronic information system and clinical trial capacity training can improve the management quality for medical device clinical trial centers.

Objective To discuss the clinical diagnosis and treatment of primary thyroid lymphoma (PTL) by reporting a case and reviewing relevant literatures.Methods Clinical data of a case diagnosed as PTL by pathology was retrospectively analyzed,and literatures related to this disease were reviewed.Results A male patient aged 71 years with a progressive enlargement of neck mass and hoarseness was suspected to have a malignant thyroid tumor and admitted to our hospital.Changes in a fine needle aspiration cytopathology before operation were considered as a malignant thyroid lesion.A final diagnosis of bilateral mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid was confirmed by the thyroid tissue pathological changes of surgical resection specimen.Chemotherapies were carried out.Recurrence of primary thyroid lymphoma was not found after following up to this day.Conclusions Primary thyroid lymphoma is a rare disease and easy to be misdiagnosed as Hashimoto's thyroiditis or thyroid cancer due to the lacking of specificities in clinical manifestations and in imaging examinations.Its diagnosis is based on pathological biopsy and immunohistochemistry.The optimal treatment is based on its pathological type,clinical stage and patients' age.