ObjectiveTo study diabetes self-management skills among outpatient diabetics and their influence on glycemic control.MethodsData were collectedfrom 281 diabetes patients recruited in Tianjin Medical University Metabolic Hospital using a questionnaire covering their diet, physical exercise and glycemic self-monitoring during the last three months.Additional HbA1c and blood lipid information were retrieved from medical records.Logistic regression modified by factor analysis was then conducted.ResultsMore than half patients did well in diet control, physical exercise and drug treatment.23% patients exceeded physician-recommended intervals for self-monitoring.Self-monitoring was primarily conducted through hospital testing or family-owned glucometers.Abnormal blood pressure (53%) or lipid (47%) levels were also common.Overall, self-management practices among men and the younger(<60yr)were worse than that among women and elderly people.The significant related factors for good glycemic control included higher socioeconomic status and positive treatment, but Abnormal cholesterol and inadequate self-monitoring were related with poor glycemic control with the adjusted odds ratios equaling to 059, 039, 189 and 183, respectively.ConclusionsMore attention should be taken on men and the younger (<60yr)to improve their skills of self-management.Self-monitoring, physical exercise, diet control, etc. independently influence blood glucose control.

Objective This study was to assess the anal sphincter function of postoperative patients with anorectal malformation by using vector volume manometry Methods The anal manometric vector volume were assessed in 40 cases by three dimensional PC Polygram HR system Results Results were graded as good, fair and poor group according to the clinical anal function score Anal sphincter pressures were (85?44)mm?Hg, ( 71? 38)mm?Hg and (42?28)mm?Hg respectively Anal sphincter pressure in control group was (161?64)mm?Hg ( P

Survivin is a member of the IAP family, which has been shown to localize to various components of the mitotic apparatus. Survivin is not only an apoptosis inhibitor, but a mitotic regulator as well. Survivin is Absolutely undetectable in normal tissues, but over-expressed in all the most common human cancers. Survivin is considered as an important target in cancer treatment, and the research on its molecular antagonists has gained encouraging achievements.

Objective:To study the expression of extracellular matrix metalloproteinase (MMP-9) inducer CD147 and MMP-9 protein in hepatocellular carcinoma (HCC) and explore their correlation with invasion, metastasis, and prognosis of HCC.Methods:SP immunohistochemistry was used to evaluate the expression of CD147 and MMP-9 in 83 HCC tissues and 15 normal liver tissues. Results:The positive rate was 73.5% for MMP-9 and 68.7% for CD147, significantly higher than normal tissues (MMP-9: 6.7%;CD147: 0%, P<0.05). Expressions of CD147 and MMP-9 were positively correlated with the tumor size, pTNM stages, differentiation degree, the portal vein cancer embolism, and postoperative recurrence (P<0.05), but not with the patient's age, gender, the serum level of alpha-fetal protein (AFP), and the Child-Pugh grades. Patients with positive expression of CD147 and MMP-9 had shorter survival time than those with negative expression of CD147 and MMP-9. Expression of CD147 was positively related with expression of MMP-9 in HCC tissues.Conclusion:CD147 and MMP-9 had positive correlation with tumor size, pTNM stages, differentiation degree, portal vein cancer embolism, and postoperative recurrence. Detection of the expression of CD147 and MMP-9 may be helpful to make a comprehensive prediction of the prognosis of HCC.

Objective To investigate the effects of siRNA against survivin combined with the neoadjuvant chemotherapy (paclitaxel and epirubicin) on the apoptosis in breast cancer MCF-7 cell and reverse drug resistance.Methods Molecular cloning technique was applied to construct the expression vector of siRNA against survivin,and effectene transfection reagent was used to transfect MCF-7 cell.Survivin expression was detected by qPCR and Western blot methods.The effects of paclitaxel or epirubicin combined with or without siRNA against survivin,on the drug susceptibility of MCF-7 cell were detected by CCK-8 assay and that of including MCF-7 cell apoptosis were detected by flow cytometry.Results Survivin-siRNA-2 effectively inhibited the expression of survivin mRNA (0.30±0.03) and protein (0.37±0.09) (P ＜ 0.05).Both paclitaxel [IR 24,48 h =(38.5±4.0) ％,(41.7±6.3) ％] and epirubicin [IR 24,48 h =(37.0±8.6) ％,(40.6± 12.1) ％] can suppress the proliferation of MCF-7 cell and induce its apoptosis,and siRNA against survivin combined with chemotherapy drugs enhanced both effects significantly[paclitaxel IR 24,48 h =(76.0±2.9) ％,(85.1±4.0) ％; epirubicin IR 24,48 h =(74.6±5.6) ％,(82.5±4.8) ％] (P ＜ 0.05).The inhibition rate of MCF-7 was concentration and time dependent.Conclusions Blocking survivin gene expression by RNAi,and combining with the appropriate chemotherapy can significantly enhance the sensitivity of MCF-7 cell to drugs and cell apoptosis.This technology has important potential clinical value in the therapy of breast cancer.

Objectives To investigate the association between health belief and medication adherence in hypertensive patients.Methods A total of 232 hypertensive patients who visited Outpatient Department of Huashan Hospital between October 2013 and May 2014 were recruited in this cross-section study.The degree of medication adherence was measured with Morisky scale and health belief was evaluated with questionnaires of Health Belief Model (HBM).Results Of the 232 participants,61 (26.3％),51 (22.0％) and 120 (51.7％) showed low,medium and high medication adherence in Morisky scale,respectively.Logistic analysis showed that the perceived susceptibility (P ＜ 0.001),and cues to action (P =0.004) were positively correlated,and perceived barriers (P ＜ 0.001) was negatively correlated with medication adherence of patients.Conclusion Effective interventions to improve antihypertensive medication adherence should increase perceived susceptibility,cues to action,and reduce the barriers to medication adherence of patients.

Objective To study the clinical evaluation of gas exchange impairment in neonatal respiratory failure.Methods Blood gas, PaO2/PAO2, Qs/QT, PaO2/FiO2, A-aDO2 and RI of 53 newborn infants with respiratory failure in NICU of PUMCH from Jan. 1993 to Dec. 1997 were measured. Results These infants were divided into two groups according to PaO2/PAO2: moderate and severe respiratory failure. Qs/QT(11±3)%, PaO2/FiO2(183±113), A-aDO2(22.9±6.8)kPa, RI(2.5 ±0.8) in 21 neonates with moderate respiratory failure; Qs/QT(24±6)%, PaO2/FiO2 (82±30), A-aDO2 (49.3 ± 17.8)kPa,RI(7.6 ±3.4) in 32 neonates with severe respiratory failure(P＜0.001). These results in respiratory failure caused by different pathogenesis were different. In meconium aspiration and pneumothorax group there were the highestQs/QT(32±3)% ,A-aDO2 (69.8 ± 12.2)kPa,RI(9.2 ±2.9)and the lowest PaO2/FiO2 (77±39). Mortality of infants with high pulmonary shunt was high. Qs/QT(17±8)% in 38 survives and (24±6)% in 10 died neonates( P＜0.05). Conclusion The clinical evaluation using these indexes for newborn infants with respiratory failure is beneficial in recognizing pathogenesis,guiding therapy and evaluating prognosis.

Stereotactic body radiotherapy (SBRT) can treat the lesions in asurgical manner and inhibit tumor cell proliferation.Furthermore,it has a character of non-invasive,which shortens the duration of treatment.Although surgery and radiotherapy are the major means for early stage peripheral non-small cell lung cancer,some studies in recent years show that SBRT has certain advantages in local control ratio and adverse reaction compared with radiotherapy,and acquires the similar curative effect with surgery.

O-GlcNAcylation is the addition of a single N-acetylglucosamine(GlcNAc)moiety to the hydroxyl groups of serine or threonine residues of nuclear and cytoplasmic proteins. The transcription factors, kinases of the metabolic pathways and some cytoplasmic enzymes can be O-GlcNAcylated to affect cell transcription, signal transduction, cell metabolism and other biological functions. Abnormal glucose metabolism of tumors has been a hotspot in the research field of tumor pathogenesis and therapeutic targets recently. O-GlcNAclation regulates the glucose metabolism of tumor by affecting the activity of kinases in the metabolic pathway, which is closely associated with the abnormal glucose metabolism of tumor. The abnormal O-GlcNAcylation is one of the potential reasons of cancer. In this review, in order to provide a theoretical reference for developing anti-tumor targets and drugs targeting O-GlcNAc modification, we briefly summarized how O-GlcNAcylation regulated glucose metabolism on glucose metabolism, glucose uptake, glycolysis, pentose phosphate pathway and tricarboxylic acid cycle in cancer cell.

BACKGROUND: Encopresis after operation for congenital.ectopic anus can cause psychological, physiological and social ability disorders.OBJECTIVE: To treat the children with encopresis with biofeedback training so as to improve the function of post-operative defecation.DESIGN: A self-controlled trial.SETTING: Department of Pediatric Surgery, Second Clinical College of China Medical University.PARTICIPANTS: Totally 20 cases of encopresis after treatment with operation for ectopic anus,were recruited from the Department of Pediatric Surgery, Second Clinical College of China Medical University, between January 1998 and October 2004. Among them, there were 4 cases of complete encopresis, 7 cases of loose encopresis and 9 cases of blotch. All the cases were followed up. There were 9 cases of ectopic anus in the middle and lower parts, and 11 cases of ectopic anus at the high part.METHODS: The objective measuring methods of biofeedback training such as anorectal pressure and anus sphincter electromyography were used to train the patients with postoperative encopresis. After one-month self-directed training in anus contraction and defecation habit, the children received proper biofeedback training. ① Biofeedback training to strengthen the muscles around the anus twice per day. The portable biofeedback-training machine was taken home after the children patients could automically contract the muscles around the anus 3 weeks later. ② Biofeedback training to improve rectal sensitivity and coordination of anus sphincter, and repeated training in expanding saccus. A normal defecation reflex was established. Anus sphincter presented reflex contraction to prevent encopresis once the rectum expanded. ③ Defecation training was performed for 30 minutes after meals every day. ④ Electrostimulation combined with biofeedback training was performed for 10 minutes twice a day for 3 or 4 consecutive weeks.MAIN OUTCOME MEASURES: ① The maximum contraction anal pressure, vector volume, and electromyographic amplitude of external sphincter of anus; ② positive rate of anorectal contraction reflex of the children patients before and after training.RESULTS: According to actual treatment analysis, all the 20 children patients entered the result analysis. ① In middle and lower parts groups, the maximum contraction anal pressure increased from (11.87±5.61) kPa before training to (24.88±16.58) kPa after training; in high part group, they increased from (5.76±3.84)kPa to (18.18±13.71) kPa (P＜ 0.05). ② In middle and lower parts groups, the vector volume increased from (139.17±130.02) cm (cm Hg)2 to 608.10±131.06 cm·(cmHg)2, whereas in high group it increased from (117.01±74.35) cm(cm Hg)2 to (452.17±69.43) cm(cm Hg)2 (P＜ 0.05). ③ In middle and lower parts groups, the electromyographic amplitude of external sphincter of anus increased from (152.20±37.42) μV to (324.12±67.78) μV; in high part group, it rose from (114.08±51.41)μV to (266.18±49.38)μV (P ＜ 0.05). ④ The positive rate of anorectal contraction reflex improved from pretraining 55％ (11/20) to post-training 90％ (18/20).CONCLUSION: After biofeedback training, the maximum contraction anal pressure, anorectal sensitivity and the coordination of anus external sphincter, defecation habit, and contractibility of external sphincter of anus were all improved obviously, especially in those with ectopic anus in the middle or lower parts. Anus external sphincter function can be improved to the uttermost so as to cure encopresis.