Objective To assess the effects of management by diabetes specialist nurse (DSN) on blood glucose control.Methods A comprehensive search of databases was carried out including PubMed,the Cochrane Library,Web of Science,China National Knowledge Infrastructure (CNKI),Chinese Biomedical Literature Database (CBM),China Scientific Journal Database (VIP) and Wanfang Database from their inception to November 2013 in any language to identify trials.Searching of relevant publications was undertaken to identify additional trials.Randomized controlled trials and quasi-randomized controlled trials dealing with the effects of management by DSN on glycosylated hemoglobin (HbA lc) were included in the review.Two investigators performed data extraction and quality assessment independently.Statistic analysis were carried out using RevMan5.2 software.Results Eighteen trials were included finally.Meta-analysis showed that management by DSN can better control the blood glucose of patients(WMD=-0.63,95％CI-0.88--0.38),but the effect was influenced by intervention time,location and type of the diabetes mellitus.Conclusions The presence of a DSN can improve patients' blood glucose control,especially in the long-term control of blood glucose.

Objective To study the relationship between gene polymorphism of apolipoprotein E (apolipoproteinE,ApoE)of peripheral blood and Mycoplasma pneumoniae infection in children.Methods Collected 236 cases serum of inpatient and outpatient screening in children with Mycoplasma pneumoniae infection and healthy children between March 2011 and March 2014 in the First Affiliated Hospital of Xi’an Medical University and Xi’an Children’s Hospital,at the age of 3~8 years old,divided into two groups:110 cases of control group and 126 cases of Mycoplasma pneumoniae infection in chil-dren.Used multiple allele-specific PCR (multi-AS PCR)to detect gene polymorphism of ApoE in each group.Results ApoE gene was polymorphic and 6 genotypes:3 homozygous (ε2/2,ε3/3,ε4/4)and 3 heterozygote (ε3/2,ε3/4,ε4/2).Theε3/2 had four bands,ε3/3,ε3/4 and 4/2 had three bands,ε2/2 andε4/4 had two bands.ε3/3 of ApoE genotype distribution in two groups was the most common,control group was 66.7%,infection group was 46.4%.Allele frequencies ofε3 and genotype frequencies ofε3/3 inMycoplasmapneumoniae infection of children were lower than those in control group (P<0.05).But allele frequencies ofε4 and genotype frequency ofε4/4 in Mycoplasma pneumoniae infection of children were increased, which were compared with those in control group (P<0.05).Conclusion There were an association between ApoE gene polymorphism and the incidence of Mycoplasma pneumoniae infection in children.Allelesε3 seems to be a protective factor and allelesε4 may contribute to the development of Mycoplasma pneumoniae infection of children.

Objective To investigate the clinical significance of the antenatal detection of four indices of coagulation(PT,APTT, TT,FIB),D-dimer(DD)and platelet(PLT)in the judgment of parturient coagulation function and bleeding risk.Methods 795 pregnant women and childbearing age non-pregnant women with physical examination in this hospital from June 2012 to September 2013 were collected and divided into the normal pregnancy group(early pregnancy,middle pregnancy,late pregnancy,parturient pe-riod),obstetric accident group,pregnancy complicating other disease group and healthy control group.At the same time,PT, APTT,TT,FIB,DD and PLT were detected and the related statistical analysis was conducted.Results DD and FIB in the normal pregnancy group were significantly higher than those in the healthy control group(P<0.05),PT and APTT were significantly low-er than those in the healthy control group(P <0.05),TT had no statistically significant difference between these two groups(P >0.05 );DD and FIB in the obstetric accident group and the pregnancy complicating other disease group were significantly higher than those in the normal pregnancy group(P <0.05),while PT was significantly lower than that in the normal pregnancy group(P <0.05).PLT in the obstetric accident group and the pregnancy complicating other disease group was significantly lower than that in the normal pregnancy group(P <0.05).The sensitivity and specificity of the combined detection of 3 indices in diagnosing the ob-stetrical accidents were greatly superior to those of the single index detection or the combined detection of two indices.Conclusion The prenatal combination detection of four coagulation indices,DD and PLT can preliminarily judge the coagulation status of preg-nancy period in pregnant women,help to treat abnormal bleeding of pregnant women an possess the important guidance significance in formulating the labor scheme and preventing the occurrence of obstetric accidents.

Background:China is an area with high incidence of gastric cancer,studies have shown that serum pepsinogen (PG) and gastrin-17 (G-17)levels can be used for gastric cancer screening. Aims:To investigate the values of serum PG and G-17 levels in screening gastric precancerous lesion and gastric cancer. Methods:A total of 211 patients with gastroduodenal disease diagnosed by endoscopy and biopsy from March 2016 to October 2016 at the First Affiliated Hospital of Soochow University were enrolled,and 67 healthy subjects were served as controls. Serum levels of PGⅠ,PGⅡ,G-17 and Hp-IgG antibodies were determined by ELISA. Results:Compared with control group,PGⅠ level and PGR were significantly decreased in atrophic gastritis group (P < 0. 01);serum PGⅠ level and PGR were significantly decreased, and G-17 level was significantly increased in low grade intraepithelial neoplasia group,high grade intraepithelial neoplasia group and gastric cancer group (P < 0. 01). ROC curve showed that the best cutoff values of PGⅠ,PGR and G-17 for diagnosing gastric cancer and gastric precancerous lesion were 74. 74 ng/ mL (sensitivity 88. 3％,specificity 78. 0％), 6. 59 (sensitivity 87. 0％,specificity 73. 8％),13. 02 pmol/ L (sensitivity 54. 2％,specificity 84. 4％),respectively. PGR and G-17 were the independent predictors of gastric cancer and gastric precancerous lesion. The sensitivity and specificity of combined detection of PGⅠ,PGR and G-17 for diagnosing gastric precancerous lesion and gastric cancer were 89. 9％ and 84. 4％,respectively. Conclusions:Serum PGⅠ,PGR and G-17 may be used as indicators of gastric cancer and gastric precancerous lesion screening. PG combined with G-17 for diagnosing gastric cancer and gastric precancerous lesion is more sensitive and specific than using serum PG or G-17 alone.

Objective To analyze the clinical features and risk factors of recurrent acute pancreatitis (RAP).Methods From September 2012 to September 2014,the clinical data of 411 patients with primary acute pancreatitis (AP) were collected.From March to June 2016,patients were followed up.The clinical features of patients with RAP were analyzed.Univariate and multivariate regression analysis were performed to analyze the risk factors of RAP.Results Among the 411 patients with AP,those caused by biliary disease,hyperlipidemia,alcohol,other known causes and idiopathic AP were 265 cases (64.5％),61 cases (14.8％),19 cases (4.6％),21 cases (5.1％) and 45 cases (10.9％),respectively.In two weeks of AP onset,the recurrent rate of biliary AP in cholecystectomy group was 7.1％ (5/70),which was lower than that of non-cholecystectomy group (30.2％,42/139),and the difference was statistically significant (xz =14.218,P＜0.01).The results of univariate regression analysis suggested that gender,body mass index (BMI),complicated with diabetes,etiology,history of smoking,history of drinking and pancreatic necrosis were correlated with RAP (all P＜0.05).The results of multivariate regression analysis indicated that complicated with diabetes (odd ratios (OR) =3.417,95 ％ confidence interval (CI) 1.979 to 5.900,P＜0.01),hyperlipidemic pancreatitis (OR=2.247,95％CI 1.077 to 4.688,P=0.023),history of smoking (OR=4.023,95％CI 2.377 to 6.809,P＜0.01),complicated with pancreatic necrosis (OR=3.312,95％ CI 1.675 to 6.546,P＜0.01) were independent risk factors of RAP.Conclusions Hypertriglyceridemia,smoking,complicated with pancreatic necrosis and diabetes are independent risk factors of RAP.Patients with biliary AP should receive cholecystectomy as early as possible,which could reduce RAP.

Objective To investigate the nurse self-directed learning readiness in some 3A hospital in Shandong province and discuss the strategies how to improve it. Methods Self-designed questionnaire and The Nurses Self-Directed Learning Readiness Scale were used to investigate 210 nurses from 23 departments in Shandong provincial hospital. Results Before and after the implementation of the video training, a total of 230 and 210 self-directed learning readiness scales were distributed, 210 and 210 questionnaires were returned, the effective recovery rate was 91.30%and 100%respectively. The data of questionnaires were statistically analyzed by the method of paired t test. The results showed that after the implementation of the project, the total score of the after test (156.63±19.48) was higher than the before (137.91 ± 13.71). The difference was statistically significant (t=-9.54, P<0.05). The score in the three dimensions of self-management, self-control, and desire for study (48.03 ± 7.25), (48.71 ± 6.44), (59.89 ± 7.61) points, were higher than (40.11±5.48), (43.40±5.34), (54.40±6.26) pointsbefore implementation. The difference was statistically significant (t=-10.22,-7.67,-6.83,P<0.05). Conclusions The video training would provide the convenient and quick way and could inspire the nurses′ learning motivation even more which is of great significance to improve the nurses ability of autonomic learning.

Objective To investigate the practice status of the newNursing practice standards for intravenous therapy in secondary and above hospitals in Shandong province. Methods Self-designed questionnaire was used to investigate 3051 nurses from 129 hospitals in 17 cities in Shandong province. Results Nurses′ awareness rate of the new Nursing practice standards for intravenous therapy was 92.69%(2828/3051);92.13%(2811/3051) nurses reported that their hospitals used the new standard, 65.78%(2007/3051) nurses reported that their hospitals had applied the standard since the second half of 2014; 92.92% (2835/3051) nurses reported that their hospitals had revised their practice rules according to the new standard;93.54%(2854/3051) nurses reported that their hospitals had revised the related nursing process; 50.08% (1528/3051) nurses thought the new standard helpful to clinical practice;22.98%(701/3051) nurses knew well about the new standard;53.85%(1643/3051) nurses thought the standard applicable to clinical practice. Conclusions As nurses do not master the Nursing practice standards for intravenous therapy well, they need strengthened training. Hospitals should fresh their rules, protocolsand supply training program to improve nurses′ knowledge and skill. Meanwhile, Nursing practice standards for intravenous therapyalso needs to be revised and improved according to nurses feedback.

Background Exfoliation syndrome (XFS) is a systemic disease with abnormal accumulation of extracellular matrix.Researches showed that the single nucleotide polymorphisms (SNPs) of lysyl oxidase-like 1 (LOXL1) gene is associated with the pathogenesis of XFS in global population.However,the results are varied among different ethnicity and regions.Objective This study aimed to assess the association between LOXL1 gene polymorphisms and XFS in Uygur population.Methods One-hundred and fifty-two Uygur XFS patients without relativeness were enrolled from January to August in 2014,and 228 ethnicity-and gender-matched normal controls were recruited at the same period from the same region.Each individual underwent comprehensive eye examinations and 5 ml peripheral blood was collected.Genomic DNA was extracted from peripheral blood.PCR-ligase detection response (LDR) was used to determine the allele and genotype frequencies of the six SNPs rs12914489,rs4886467,rs4558370,rs4461027,rs4886761 and rs16958477 in the promoter region of LOXL1 gene.The distribution frequency between the patients and normal controls was compared by x2 test.Logistic regression analysis was used for age adjustment.This study was approved by Ethic Committe of Xinjiang Medical University,and informed consent was obtained from the subjects.Results rs12914489 site in the normal control group diverged from Hardy-Weinberg equilibrium (HWE) (P =0.033),and the rs4886467,rs4558370,rs4461027,rs4886761 and rs16958477 sites followed HWE.The frequencies of G allele and GG genotype of rs4886467 in the XFS group were lower than those in the control group (both at P =0.00) and were protective factors of XFS (OR =0.54,95 ％ CI:0.40-0.74,P =0.000;OR=0.51,95％ CI:0.33-0.78,P=0.001);the frequencies of T allele and TT genotype of rs4558370 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=1.96,95％ CI:1.23-3.11,P =0.004;OR =2.18,95％ CI:1.31-3.64,P =0.002);the frequencies of C allele and CC genotype of rs4461027 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=2.25,95％ CI:1.67-3.04,P=0.000;OR=3.06,95％ CI:1.89-4.96,P=0.000);the frequencies of T allele and TT genotype of rs4886761 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=2.44,95％ CI:1.79-3.33,P =0.000;OR =3.02,95％ CI:1.63-5.60,P =0.000);the frequencies of C allele and CC genotype of rs16958477 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR =2.00,95 ％ CI:1.47-2.71,P =0.000;OR =2.37,95 ％ CI:1.31-4.27,P =0.004).Conclusions The SNPs of promoter region of LOXL1 gene are associated with hereditary susceptibility of XFS individually in Uygur population.The SNPs of rs4886467 locus are protective factor,while the SNPs of rs4558370,rs4461027,rs4886761 and rs16958477 locus are risk factors for pathogenesis of XFS.

Objective To investigate the expressions of matrix metalloproteinases(MMPs) in Kashin-Beck disease(KBD) cartilage as well as in a KBD rat model of T-2 toxin poisoning under selenium deficient conditions, and to investigate the effect of T-2 toxin on MMP-13 expression in human chondrocytes in vitro in order to determine a possible mechanism underlying KBD. Methods Samples of articular cartilage were divided into 2 groups:controls(samples from 5 normal children, traffic accident or operation), and KBD(samples from 5 children with KBD, auctopsy). Thirty-two Sprague-Dawley rats were divided into two groups by body weight using random number table: normal diet group(n = 16) and selenium-deficient diet group(n=16). The selenium level in normal diet was 101.500μg/kg, and in selenium-deficient diet was 1.118μg/kg. Rats were fed for 4 weeks with selenium-deficient or normal diet, respectively. After successful build up of the low selenium rat model, normal diet group was then subdivided into 2 sub-groups: normal group(n = 8) and normal diet plus low T-2 toxin group(n = 8);and selenium-deficient diet group was also subdivided into 2 sub-groups: selenium-deficient group ( n = 8 ) and selenium-deficient diet plus T-2 toxin group ( n = 8 ) . T-2 toxin of 100 μg·kg-1·d-1 was administered by intragastric administration for 30 days. Then the rats were sacrificed, and their knee joints were processed for histopathological evaluation. MMP-1 and MMP-13 locations in cartilages were performed by inmmunohistochemistry. Human chondrocytes C28/I2 were cultured in vitro. The experiment was divided into 4 groups: empty vector plasmid group, MMP-13 promoter plasmid group, MMP-13 promoter plasmid plus 20 μg/L T-2 toxin group and MMP-13 promoter plasmid plus 40 μg/L T-2 toxin group. MMP-13-luciferase reporter plasmid and vector plasmid were transiently transfected into C28/I2 cells for 24 hours, and then treated with 20 - 40 μg/L T-2 toxin for 24 hours. Transactivation of human MMP-13 promoter was analyzed using luciferase reporter constructs containing sequences spanning-1602 to+20 bp in C28/I2 chondrocytes. Results The percentages of chondrocytes staining for MMP-1 in the superficial and middle zones of KBD samples [(29.73 ± 10.12)%, (28.27 ± 0.91)%] were significantly higher than those of controls[(2.47 ± 0.11)%, (0.00 ± 0.00)%, all P < 0.05]. The percentages of chondrocytes staining for MMP-13 in the superficial and middle zones of KBD samples [(13.21 ± 4.32)%, (41.85 ± 6.32)%] were significantly higher than those of controls[(5.72 ± 0.31)%, (0.00 ± 0.00)%, all P<0.05]. The percentages of chondrocytes staining for MMP-13 in the superficial and middle zones of rats fed with selenium-deficient diet plus T-2 toxin group[(13.21 ± 4.32)%, (61.85 ± 8.68)%] were significantly higher than those of the normal and selenium-deficient groups[(2.43 ± 0.22)%, (5.89 ± 0.69)%, (3.03 ± 0.29)%, (25.99 ± 0.57)%, all P < 0.05]. Moreover, T-2 toxin activated the MMP-13 promoter detected with luciferase reporter assays in C28/I2 cells. The luciferase activities in MMP-13 promoter plasmid plus 20 μg/L T-2 toxin group and MMP-13 promoter plasmid plus 40μg/L T-2 toxin group(0.082 78 ± 0.008 40, 0.103 35 ± 0.013 19) were significantly higher than those in empty vector plasmid group and MMP-13 promoter plasmid group(0.024 19 ± 0.000 96, 0.040 32 ± 0.003 56, all P < 0.05). Conclusions These data suggest that T-2 toxin induces cartilage matrix degradation through up-regulation of MMP-13 promoter expression. Increased MMPs staining intensity in KBD cartilage and the rat KBD model of T-2 toxin poisoning under selenium deficient conditions suggest that matrix degradation appear to be driven by MMPs activity.

Objective To develop a new method to expose the stellate ganglion to increase the success rate of establishing a dog model of atrial fibrillation indinced by sympathetic stimulation .Methods A total of 28 adult dogs were randomly divided into traditional group and improvement group , 14 dogs in each group .The stellate ganglions were separated by the two different methods , respectively , to establish a sympathetic stimulation induced atrial fibrillation model in all the dogs .Changes of vital signs , survival rate of the dogs and the voltage required to stimulate the stellate ganglion were recorded intraoperatively .Changes of cardiac electrophysiology were recorded before and after electric stimulation . The levels of released neurotransmitters were detected by immunohistochemistry . Results The survival rate of the improvement group was 100%(14/14), significantly higher than the 64.3%(9/14) of the traditional group (P<0.05). The operation time of the improvement group was 122.71 ±3.62 min, significantly shorter than the 269.44 ±8.79 min of the traditional group (P<0.05).The threshold voltage of the improvement group was significantly lower than that of the traditional group ( P<0.05) .Conclusions Our modified surgical procedure can effectively reduce the mortality of dogs , significantly shorten the operation time , and reduce the intraoperative blood loss , keeping a more intact stellate ganglion , and maintains a more stable voltage of electric stimulation , Therefore, it is a new method more suitable for establishment of a sympathetic stimulation induced atrial fibrillation model in dogs .