Objective To analyze the influencing factors of hemoglobin A1c in type 2 diabetic patients,including blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.Methods Seventy-eight type 2 diabetic patients were divided into two groups by different degree of blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.The levels of hemoglobin A1c in two groups were compared.Results There were significant changes in the levels of hemoglobin A1c between fasting blood glucose (FBG) ≤ 6.1 mmol/L group (30 cases) and FBG ＞ 6.1 mmol/L group (48cases),2 h postprandial blood glucose (2hBG) ≤8.0 mmol/L group (32 cases) and 2hBG ＞ 8.0 mmol/L group (46 cases ),insulin treatment group (27 cases) and no-insulin treatment group ( 51 cases ),combined drugs treatment group ( 36 cases ) and single drug treatment group ( 15 cases),age ≤ 65 years old group (41cases) and age ＞65 years old group (37 cases),disease course≤ 10 years group (39 cases) and disease course ＞ 10 years group( 39 cases),degree-educated above high grade group( 34 cases) and degree-educated below high grade group (44 cases),diabetic education ≥2 times/month group (20 cases) and diabetic education ＜ 2 times/month group (58 cases),self-monitoring blood glucose≥2 times/week group ( 19 cases)and self-monitoring blood glucose ＜ 2 times/week group (59 cases)[ (6.7 ± 1.5 )％ vs.(7.9 ± 1.3 )％,(6.8 ±1.1)％ vs.(7.8 ± 1.2)％,(6.7 ± 1.5)％ vs.(8.1 ± 1.4)％,(6.8 ± l.0)％vs.(8.0 ± 1.6)％,(6.9 ± 1.7)％ vs.(7.4 ± 1.6)％,(6.5 ± 1.2)％ vs.(8.2 ± 1.3)％,(6.9 ± 1.0)％ vs.(7.6 ± 1.4)％,(6.1 ± 1.7)％ vs.(8.0 ±1.1 ) ％,(6.7 ± 1.1 )％ vs.(7.6 ± 1.2)％ ] (P ＜ 0.01 or ＜ 0.05 ).Conclusion Blood glucose,anti-diabetic therapeutic regiments,disease course,diabetic,degree-educated,self-monitoring blood glucose are the important factors influencing hemoglobin A1c.

Hemodynamic effects of Laigechongji (LGCJ)were studied in anesthetized open-chest dogs. LGCJ(in doseof 8. 5 and 17.0g/kg,id. )decreased significantly SBP, DBP, MAP, HR, LVSP, +dp/dt max and TPVR, 30~45 mins after medication,and continued for about 90~ 150mins. However,they had no significant effects ondp/dt max,LVEDP,CO,CI,SV and SI. These results suggest that LGCJ may cause hypotension,and its hypotensive effects may be related to its bradycardiac,negative inotropic and vascular resistance reducing activities.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

Objective To investigate the effects of paired associative stimulation (PAS) on the recovery of upper limb motor function in stroke patients,and to analyze the relationship between the change of motor cortex excitability in the contralesional hemisphere and the recovery of motor function in the affected upper limb.Methods Thirty hemiplegic stroke patients were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation therapy,but the treatment group also received PAS consisting of transcranial magnetic stimulation (TMS) of the intact motor cortex and electrical stimulation (ES) of the median nerve at the wrist of the intact arm with an interval of 10 ms between the TMS and ES (PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ the resting motor threshold (RMT),once daily for 30 minutes,five times a week for 4 weeks.Corticospinal excitability was measured using motor evoked potentials (MEP) and the RMT.The FuglMeyer upper limb assessment (FMA),Brunnstrom staging and the modified Barthel index (MBI) were also applied before and at the end of the 4 weeks of treatment.Correlation was sought between any changes in MEP amplitude,the RMT of the contralesional hemisphere and changes in the FMA results.Results Before the intervention there were no significant differences between the two groups in terms of any of the assessments.After 4 weeks of treatment,all the assessments had changed significantly compared to those before the treatment,but there were still no significant differences between the two groups in terms of any the assessments.After 4 weeks of treatment,the differences in MEP amplitude from the contra-lesional hemisphere and the differences in FMA scores were positively and significantly correlated with a correlation coefficient of r =0.431.The lesioned hemisphere was also positively correlated with the differences in FMA scores with a significant correlation coefficient of r =0.608.Conclusion PAS10 can facilitate the recovery of upper limb motor function.The change in motor cortex excitability of the contra-lesional hemisphere significantly correlates with functional recovery in the upper limb.

OBJECTIVE　To study the effects of Panax quinquef olium 20S-protopanaxdiol saponins extracted from the leaves of panax qu inque-folium (PQDS) on the hemodynamics and cardial oxygen metabolism in dogs with acute myocardial infarction (AMI).METHODS　The paramete rs of hemodynamics and cardial oxygen metabolism were determined by using the mo del of ligation of LAD in the anaesthetized open-chest dogs.RESULTS 　In dogs treated with PQDS (in a dosage of 10 and 20 mg*kg-1 iv infusion),the myocardial blood flow (MBF) was increased and coronary vascular re sistance (CVR) was decreased significantly.The heart rate (HR) was slowed.The ar terial blood pressure (ABP),left ventricular pressure (LVP),the maximum rise rat e of left ventricular pressure(+dp/dtmax),left ventricular work index (LVW I) and total periphery resistance(TPR) were reduced,whereas the stroke index(SI) and cardiac index (CI) were increased.In addition,the decreasing range of the m aximum decline rate of left ventricular pressure(-dp/dtmax) and the rising range of left ventricular end diastolic pressure (LVEDP) were reduced.Meanwhile the cardiac oxygen consumption,myocardial oxygen utilization rate and cardiac o xygen consumption index were also decreased.CONCLUSION　PQDS had protective effects on acute myocardial ischemia including improving heart fu nction,decreasing cardiac oxygen consumption and increasing myocardial blood flo w,etc.

Objective To compare the effects of paired associative stimulation (PAS) and repetitive transcranial magnetic stimulation (rTMS) on motor cortex excitability.Methods The baseline corticospinal excitability of the left hemispheres of 10 healthy subjects was measured in terms of resting motor threshold (RMT) and other indicators of motor evoked potentials (MEP).On the following day they received PAS composed of trascranial magnetic stimulation (TMS) to the motor cortex of the left hemisphere and electric stimulation (ES) of the median nerve contralateral to the motor cortex,with an interval of 10ms between the TMS and ES (termed PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ of the RMT,for a total of 90 pulses.The MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.After the PAS intervention,an interval of one week was allowed to eliminate any effect of PAS on motor cortex excitability.Then rTMS was delivered to the subjects' left motor cortex at the same time of day at a frequency of 1 Hz and an intensity of 120％ of the RMT,for a total of 1000 pulses.MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.The two interventions were compared in terms of MEP amplitude,MEP latency and RMT.Results The average MEP amplitude,MEP latency and RMT at baseline were (2.93 ± 0.99) mV,(20.97 ± 1.67) ms,and (46.06 ±5.32) ％,respectively.One minute after PAS10,the MEP amplitude,MEP latency and RMT were (1.14 ± 0.76) mV,(21.87 ± 1.09) ms and (52.06 ±4.20) ％,respectively.One minute after rTMS,the MEP amplitude and latency and the RMT were (2.24 ± 0.79) mV,(20.88 ± 1.94) ms,and (49.00 ± 4.54) ％,respectively.The differences in MEP amplitude,MEP latency and RMT pre-and post-intervention were (0.69 ± 0.10) mV,(0.09 ±0.05) ms and (3.94 ± 0.93) ％,respectively for rTMS.For PAS10 they were (1.83 ± 0.14) mV,(0.90 ± 0.26)ms and (6.00 ± 1.13)％,respectively.The differences in MEP amplitude decrease and MEP latency lengthening between the two stimulation protocols were significant,but the difference in RMT elevation was not.Conclusion Both PAS10 and low frequency rTMS suppressed motor cortex excitability,but the suppressive effect of PAS10 is more significant.

Objective To construct the nurse post management questionnaire which could suit the condition of our country such as Jiangsu province. So as to know the present situation of the cities in Jiangsu province and perfect the nurse job management mechanism by small-scale empirical study,which provides the basis for further advance the quality of nursing service. Methods Firstly,through the nurse position management guidance,to construct the first draft of the questionnaire on the basis of literature review,then carrying on two rounds of 15 expert consultation by Delphi technique. Secondly,to select different nurses,nurse managements from Jiangsu province expediently,who can take part in the small-scale survey. Results Two rounds of the recovery rate was 100%,Crs were 0.887 and 0.903. The basic content of post questionnaire was determined after two rounds of expert consultation. A total of 98 personnel were investigated in the empirical study. In terms of Jiangsu province,the differences and deficiencies of nurse management station were still exist,including settings and responsibilities, performance appraisal system,the training of nurses,job satisfaction,etc. Conclusions The research provides a comprehensive and effective tool to understand the nursing job management related issues. At present there are regional differences in nurse station management,fully reflecting the urgency and importance of further understanding and perfecting our work.

ObjectiveTo study the effects of dexamethasone local injection as an adjunctive therapy for Hashimoto thyroiditis (HT). Methods60 HT cases were equally divided into 2 groups at random. The patients in the control group were given euthyrpx while the patients in the treated group were injected dexamethasone in addition to the medicine used in the control group. The thyroid characters such as thickness, lymphocytic infiltration and changes of thyroid follicle were observed. The patients were followed up before treatment and 4, 12, 24weeks and 1 year after treatment. ResultsIn the treatment group, all thyroid glands turned significantly softer,and the mass became smaller compared with that in the control group. The pathology of thyroids indicated that lymphocytic infiltration decreased, local immune reaction was ameliorated, and no obvious hormone side effects were observed. ConclusionLocal use of dexamethasone can modify the structure and function of thyroid.

Objective To quantize the synergistic force in movement of upper limbs between shoulders and elbows. Methods The trans-verse forces of elbows and shoulders during movement were recorded in a healthy adult with an upper-limb-force-measuring plate form which comprised of 2 three-dimensional force sensors, respectively. Then he performed shoulder abduction/adduction and elbow extension/flexion at 100%, 75%, 50%and 25%of the maximum contraction force, respectively. The ratio of the active action force and the joint action force (named assessment index) was used to assess the synergistic degree of the forearm and the upper arm. Results In the shoulder abduc-tion motion, the assessment index decreased as the strength of active action decreased, meant interference of joint action increased. Howev-er, it was almost stable in the shoulder adduction, increased in the elbow extensionas, and was irregular in the elbow flexion, as the active ac-tion strength decreased, respectively. Conclusion It may be more difficult to control upper arm than the forearm.

Objective To detect the methylation status of the promoter of BNIP3 gene in gastric cancer cell lines MKN1,and to explore the mecha?nism of DNA methylation regulating the expression of BNIP3 in gastric cancer cells. Methods The methylation status of BNIP3 promoter was de?tected by bisulfate sequencing PCR. Reverse transcription PCR was used to evaluate BNIP3 mRNA expression. MKN1 cells were treated with 5?Aza?2′?deoxycytidine(5?Aza?CdR),and after the treatment,the methylation status and BNIP3 mRNA expression were observed. Chromatin immuno?precipitation(ChIP)was used to determine the combination of BNIP3 with DNA methyltransferase 1(DNMT1). Results The promoter DNA of BNIP3 in MKN1 cells was in state of hypermethylation. Compared to the control group,methylation status and mRNA expression of BNIP3 in the drug treatment group(the 5?Aza?CdR concentration was 10μmol/L)were reversed,which showed statistical differences(P<0.05). 5?Aza?CdR inhibited the combination of BNIP3 with DNMT1. Conclusion CpG island methylation regulates BNIP3 gene expression in MKN1 cells. DNA methylation is related with the binding between the promoter of BNIP3 and DNMT1.