Objective To investigate the status of self-management behaviors and sense of coherence (SOC) in patients with type 2 diabetes as well as their correlation. Method A total of 348 patients with type 2 diabetes participated in the survey by way of the general demographic data form, diabetes self-care scale (2-DSCS) and sense of coherence scale (SOC-13). Results The total score on 2-DSCS was (65.61 ± 14.55), and 17.24%of them were scored fairly well. The total score on SOC-13 was (63.25 ± 11.46), with an average score of (4.87 ± 0.88) on every dimension of it. The total score on 2-DSCS together with its dimensions was positively correlated with the total score on SOC-13(P<0.05, P<0.01). Conclusions The SOC and self-management in patients with type 2 diabetes should be enhanced. In order to improve the level of self-management, nurses should take some individualized interventional measures based on the level of SOC in patients.

Objective To explore the application of mini-clinical evaluation exercise (Mini-CEX) in training the diagnostic thinking ability for clinical interns.Methods 83 interns who came to the First People's Hospital of Lianyungang for clinical practice in June 2015 were divided into the experimental group (45 interns) and the control group (38 interns) according to their schools.The two groups received the same clinical teaching according to internship program of five-year clinical medicine,while the experimental group had to take a weekly Mini-CEX training in chnical sections.The diagnostic thinking ability of the two groups was measured by the Diagnostic Thinking Inventory in Chinese version at the beginning and the end of the internship respectively.SPSS 21.0 was applied to processing the data.Measurement data were expressed as mean plus or minus standard deviation,and t test was used in the comparison between groups.Results At the end of the internship,the total score of diagnostic thinking,the score of knowledge structure in memory and the score of flexibility in thinking of the experimental group were higher than scores at the beginning statistically,and the experimental group had a statistically higher score than the control groups in knowledge structure in memory [(69.36 ± 4.28) vs.(66.95 ± 4.78),P=0.018].Conclusion Mini-CEX training can enhance the clinical diagnostic thinking ability of interns by improving their knowledge structure in memory.

The effects of vascular endothelial growth factor (VEGF) on neural differentiation of human embryonic stem cells (hESCs) in vitro and the possible mechanism were observed. The hESCs lines, TJMU1 and TJMU2, were established and stored by our laboratory. hESCs differentiated into neuronal cells through embryonic body formation. In this induction process, hESCs were divided into three groups: group A, routine induction; group B, routine induction+10 ng/mL VEGF; group C, routine induction+10 ng/mL VEGF+10 ng/mL VEGFR2/Fc. OCT4, Nestin and GFAP in each group were detected by RT-PCR, and the cells expressing Nestin and GFAP were counted by immunofluorescence. The percentage of Nestin positive cells in group B was significantly higher than in groups A and C, while the percentage of GFAP positive cells in group B was significantly lower than in groups A and C (P<0.01). There was no significant difference between groups A and C (P>0.05). It was concluded that VEGF, via VEGFR2, stimulated the neural differentiation of hESCs in vitro.

Objective: To detect the expression of basic fibroblast growth factor(bFGF), type Ⅲ collagen(Ⅲ-col)and fibronectin(FN) in human dental pulp at different root development stages of permanent teeth. Methods: 10 teeth at stage Ri～R 1/4 ,15 at R 1/3 ～R 3/ 4 and 12 at Rc～Ac were sectioned for following examination.bFGF, Ⅲ-col and F N were qualitatively and quantitatively analyzed by the use of immunohistologica l SP method and image analysis technique. Results: The ex pression of bFGF became gradually weaker and weaker with the development of too th root (P

AIM: To investigate the heterogeneity of basal intracellular free calcium concentration( i) in peritoneal macrophages(PM) and whether it is relative to the reactivity of PM at the single cell level. METHODS: i implicated stimulated were measured by fluorescent microscopic imaging system after loading with fluorescent probe fura-2/AM. Superoxide(O _2)produced by single PM was determined by modified NBT test. RESULTS: The values of basal i determined in 392 PMs of 7 mice showed normal distribution [(54?24) nmol/L, n=392] with wide range(less than 20 nmol/L to more than 100 nmol/L), among which about 50% were in the range of 40-60 nmol/L. When stimulated with PMA or fMLP, i was increased, the peak values were positively correlated with the basal i in one mouse(PMA stimulated cells: r=0.52, P

OBJECTIVE:In order to promote the rational drug use in China,we undertook a multi-center international indicators field survey of rational drug use(RDU).METHODS:According to the international RDU indicators of WHO/IN?RUD,a multi-center,random and on-site survey to the prescriptions and patients was carried out on the same day at7dif?ferent level hospitals.RESULTS:Prescription indicators:the average number of drugs per prescription was2.63;the percent?age of antibiotics prescribed was38.3%;and the percentage of preparations for injection prescribed was20.4%;the percentage of drugs prescribed from essential drug list(EDL)was69.6%.Patient care indicators:average consultation time was7.17minutes;average dispensing time was15.4seconds;percentage of drugs actually dispensed was100%;percentage of drugs ac?tually labeled was99%;percentage of patients'knowledge of correct dosage was86.3%.CONCLUSION:It is practicable and effective to get the data by using the indicators of WHO/INRUD.The rational drug use and the care from doctors and phar?macists to the patients are not enough in China,which remains to be improved.

The author used five Chinese medicinal herbs,Barbat skullcap,Wolly yam,Anemarrhena,Phellodendron bark,and Dandelion herb,to make up decoctions to treat urinary tract infection(UTI). Ex-trinsic bacteriostatic experiments for colibacillus and bacillus proteus,which commonly occure in urinarytract infection,were observed.The result shows that both Barbat skullcap and Wolly yam are most effectivein treating UTI.So single Chinese medicinal herb can also be used in clinical.

Fibroblast growth factor -21 (FGF-21) is a recently discovered metabolic regulation factor, regulating glucose and lipid metabolism and increasing insulin sensitivity. FGF-21 is expected to be a potential anti-diabetic drug. Expression of FGF-21 as inclusion bodies has advantages for high yield and purity, but the bioactivity of the protein is almost totally lost after denature and renature. That is why FGF-21 is currently expressed in soluble form. As a result, the yield is considerably low. In this study, we used SUMO vector to express SUMO-human FGF-21 (SUMO-hFGF-21) in form of inclusion body. We optimized the culture conditions to increase the yield of the bioactive human fibroblast growth factor-21. We applied the hollow fiber membrane filtration column to enrich the bacteria, wash, denature and renature inclusion bodies. After affinity and gel filtration chromatography, we examined the hypoglycemic activity of FGF-21 by the glucose uptake assay in HepG2 cells. We also detected the blood glucose concentration of type 2 diabetic db/db model mice after short or long-term treatment. The results show that the yield of ihFGF-21 was 4 times higher than that of shFGF-21. The yield was 20 mg/L for ihFGF-21 vs. 6 mg/L for shFGF-21. The purity of ihFGF-21 was above 95%, while shFGF-21 was 90%. Compared with the traditional method of extracting inclusion bodies, the production cycle was about three times shortened by application of hollow fiber membrane filtration column technology, but the bioactivity did not significantly differ. This method provides an efficient and cost-effective strategy to the pilot and industrial production of hFGF-21.
Animals ; Bacteria ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; Disease Models, Animal ; Fibroblast Growth Factors ; biosynthesis ; Genetic Vectors ; Glucose ; metabolism ; Hep G2 Cells ; Humans ; Hypoglycemic Agents ; isolation & purification ; Inclusion Bodies ; metabolism ; Mice ; Recombinant Fusion Proteins ; biosynthesis ; Small Ubiquitin-Related Modifier Proteins ; biosynthesis

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Objective To evaluate the roles of 1-phosphatidylinositol 3-kinase (PI3K) and extracellular signal-regulated kinase (ERK) signaling pathways in reduction of ischemia-reperfusion (I/R) injury to the isolated hearts by morphine preconditioning in the rats with chronic heart failure.Methods Adult male Sprague-Dawley rats,weighing 200-230 g,in which doxorubicin 2.0 mg/kg was injected via the tail vein once a week for 6 weeks to induce chronic heart failure,were studied.At the end of 8th week,42 rats with chronic heart failure were randomly divided into 7 groups (n =6 each) using a random number table:sham operation group (group S),I/R group,morphine preconditioning group (group MP),PD98059 (ERK inhibitor) + morphine preconditioning group (group PD + MP),wortmannin (PI3K inhibitor) + morphine preconditioning group (group WT + MP),PD98059 group (group PD) and wortmannin group (group WT).The hearts were quickly excised and passively perfused in a Langendorff apparatus and subjected to 30 min of occlusion of the left coronary artery followed by 2 h of reperfusion to establish the model of I/R injury.In group S,the hearts were only sutured,but not ligated and were continuously perfused with K-H solution for 195 min.In group I/R,the hearts were perfused with K-H solution for 45 min before ischemia.In group MP,the hearts were perfused with K-H solution for 15 min,with K-H solution containing morphine 1 μmol/L for 5 min and then with K-H solution for 5 min (3 cycles in total) before ischemia.In PD + MP and WT + MP groups,the hearts were perfused with K-H solution containing PD98059 (10 μmol/L) and wortmannin (100 nmol/L),respectively,starting from 10 min before morphine preconditioning until 5 min of ischemia.In PD and WT groups,the hearts were perfused with K-H solution containing PD98059 (10 μmol/L) and wortmannin (100 nmol/L),respectively,starting from 40 min before ischemia until 5 rin of ischemia.At 15 min of equilibration (baseline) and 5 and 10 min of reperfusion,the coronary flow was collected to detect the activity of lactate dehydrogenase (LDH).Infarct size (IS) and area at risk (AAR) were measured at the end of reperfusion and IS/AAR ratio was calculated.Results Compared with group S,LDH activity was significantly increased at 5 and 10 min of reperfusion,IS and IS/AAR ratio were also increased (P ＜ 0.05),and no significant change was found in AAR in group I/R (P ＞ 0.05).Compared with group I/R,LDH activity was significantly decreased at 5 min of reperfusion,IS and IS/AAR ratio were also decreased (P ＜ 0.05),and no significant change was found in AAR in group MP,and no significant change was found in LDH activity,IS,AAR and IS/AAR ratio in WT and PD groups (P ＞ 0.05).Compared with group MP,LDH activity was significantly increased at 5 and 10 min of reperfusion (P ＜ 0.05),and IS and IS/AAR ratio were decreased in group PD + MP,and no significant change was found in LDH activity,IS,AAR and IS/AAR ratio in group WT + MP (P ＞ 0.05).Conclusion Activation of ERK signaling pathway is involved in reduction of I/R injury to isolated hearts by morphine preconditioning in rats with chronic heart failure,however,PI3K signaling pathway has no such effect.