Objective To investigate the safety of novopen needle after repeated uses in order to save the expenses of patients. Methods 60 diabetic patients undergoing insulin therapy were random-ized into the common temperature group and the refrigerated storage group. The novopens were stored at common temperature in a clean and dry place, while the refrigerated storage group was stored in cold clos-et of a refrigerator. Oropharyngeal swab bacterial culture was used to compare the incidence of infection in two groups on the first, third, fifth, and seventh days. Results There was no bacterial growth in either storage condition. Conclusions The novopen needle can be repeatedly used in clinic work.But they must be used individually. Storage at common temperature or in a refrigerater can reach the same effect.

Many data show that hyperhomocysteinemia is correlated with the increased rate of cardiovascular diseases.Yet,there is controversy about the relationship between mild hyperhomocysteinemia and cardiovascular diseases.Lots of study suggest that the concentration of plasma homocysteine was reduced by using folic acid in patients with cardiovascular diseases.But,the effect of folic aicd can not be identified from other factors reducing the concentration of plasma homocysteine.

Objective:To explore the impact of continuous nursing education on the quality of life, psychological state and satisfaction of patients with inflammatory bowel disease based on micro-video.Methods:In chronological order, 83 patients with inflammatory bowel disease (hospitalized from January to June, 2019 in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology) were divided into two groups, the control group with 42 cases (discharged from the hospital from January to March, 2019) carried out regular telephone continuing nursing education and the intervention group with 41 cases (discharged from hospital from April to June, 2019) were provided the continuous nursing education in the form of telephone plus micro-video. Before intervention and after 3 months of intervention, quality of life, levels of anxiety and depression and nursing satisfaction were evaluated by inflammatory bowel disease questionnaire (IBDQ), Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS), digital table method and compared between the two groups.Results:There was no significant difference in quality of life, levels of anxiety and depression before intervention between the two groups( P>0.05). After 3 months of intervention, the scores of IBDQ, SAS, SDS were 155.1±23.7, 58.7±15.1, 59.5±11.1 in the intervention group and 115.7±21.7, 71.5±16.7, 72.8±12.0 in the control group, the differences between the two groups were statistically significant ( t values were 7.910, 3.642, 5.223, P<0.01). The nursing satisfaction score was 89.32±6.34 in the intervention group and 81.45±7.21 in the control group, the difference between the two groups was statistically significant ( t value was -5.284, P<0.01). Conclusions:Continuous nursing education in the form of micro-videos can increase the quality of life of the inflammatory bowel disease patients, improve mental state and their nursing satisfaction in further.

Objective To analyze the levels of Th17,CD4+ CDhigh25and the related cytokines (IL-17,IL-21,TGF-β,IL-10)in the plasma of patients with SLE.Methods The percentage of Th17 and CD4+ CDhigh25 Treg cells in peripheral blood were examined by flow cytometry.QRTPCR was used to detect the mRNA expression level of RORγt and Foxp3 of 56 SLE patients (26 patients are inactive and 30 patients are active) and 28 healthy controls.Plasma cytokines levels were measured by ELISA.Results The percentage of Th17 cells in patients with SLE was higher than that of healthy controls [ (3.44 ± 0.96) ％ vs (2.42 ± 0.52) ％,t =5.38,P =0.000 ].The percentage of CD4+ CDhigh25 Treg cells in patients with SLE was lower than that of healthy controls [ ( 1.32 ± 0.57 ) ％ vs ( 2.07 ± 0.67 ) ％,t =3.28,P =0.034].The expressions of RORγt mRNA was increased compared with healthy controls[ (0.219 ±0.063) vs (0.087 ± 0.045 ),t =6.41,P =0.000 ],but the expressions of Foxp3 mRNA was decreased compared with healthy controls [ (0.063 ±0.045) vs (0.128 ±0.056),t =5.28,P =0.000].Plasma levelsof IL-17,IL-21 and IL-10 in SLE patients were 122.4 ( 60.5 - 188.3 ),167.2 ( 128.7 - 871.4 ),51.3(20.9 - 123.7 ) ng/L,respectively,and in the control group were 27.1 ( 18.1 - 86.2 ),31.0 ( 31.0 -424.5),33.5( 16.4 - 54.1 ) ng/L,respectively,they were significantly different between the two groups (Z =3.83,4.54,1.87,all P ＜ 0.05 ).However,TGF-β levels were markedly decreased in SLE patients compared with controls [ 31.0 ( 31.0 - 168.6 ) ng/L vs 159.8 ( 63.4 - 389.7 ) ng/L,Z =4.87,P ＜0.05.IL-17 was positive correlation with Th17 cells,SLEDAI score,dsDNA antibody titers ( r =0.621,0.581,0.512,respectively,all P ＜ 0.05 ),but was negative correlation with C3 ( r =- 0.543,P ＜ 0.05 ) in SLE patients.Although the percentage of CD4 + CDhigh25 Treg cells were negatively correlated with SLEDAI score ( r =- 0.423,P ＜ 0.05 ),it was positively correlated with C3 ( r =0.511,P ＜ 0.05 ).Conclusion This study suggests that the imbalance of Th17 cells and CD4+ CDhigh25 Treg cells and the disorder of related cytokines are important in the pathogenesis of SLE patients.

Objective To study the effects of RNA interference(RNAi)-mediated silencing of mitofusin-2 (Mfn2) gene on glycornetabolism and insulin resistance in BALB/c mice. Methods Mfn2 short hairpin RNA (shRNA) and negative control green fluorescent protein(GFP) -expressed plasmid vectors were constructed. 44 mice were randomly divided into transfection group (Mfn2) and negative control group (HK). 1.5 ml GFP-expressed plasmid(negative control or Mfn2 shRNA,75 μg for each mouse)was injected into the mice in 5 seconds through vena caudalis. Five days later, intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test(IPITT)were performed to evaluate glycometabolism and insulin sensitivity. D-3-[3~H]-glucose in PBS buffer were injected via the tail vein. Blood samples were taken at specific time points. Radioactivity was measured in all samples with liquid scintillation counter. The rates of hepatic glucose production in vivo were calculated. Mfn2 protein expression in hepatic tissue was detected by Western blot. Results Compared with HK mice, the Mfn2 expressions of Mfn2 mice decreased markedly(8.05±0.15 vs 8.56±0.01 ,P<0.05). The fasted blood glucose leves [(6.95±0. 83 vs 4.68±0. 29) mmol/L,P<0. 05] in Mfn2 mice were higher than those in HK mice. The insulin sensitivity of Mfn2 mice decreased markedly compared with HK mice. The rate of hepatic glucose production was significantly elevated in Mfn2 mice [(49.53±16.31)μmol·kg~(-1)·min~(-1)],compared with negative control mice[(24.91±4.07)μmol·kg~(-1)·min~(-1),P<0.05].Conclusion The down-regulatd expression of Mfn2 induces glycometabolic disorder and insulin resistance in BALB/c mice. Mfn2 plays an important role in maintaining glucose homeostasis in vivo.

Study of the strategic objectives chosen by hospitals from the perspective of stakeholders is now under the spotlight of researchers at large. To identify whether there exist differences in strategic objectives among various groups in the hospital and probe into the causes, the author called into play the competing values framework as the analysis tool. An evidenced-based study on public hospitals in Hangzhou identified marked differences on choices of strategic objectives among various internal stakeholders in the hospital For example, hospital administrators tend to focus on internal control, while medical doctors tend to focus on interactions between the hospital and the external environment. On this basis, further studies are proposed.

Objective To analyze and evaluate the changes of quantity and function of TCBVα24+ Vβ11+ NKT in PBMC of the patients with PBC and its relationship with the occurrence of PBC. Methods Flow cytometry was utilized to count TCRVα24+ Vβ11+ NKT cells in PBMC in 60 cases of PBC and 60 cases of age-matched and gender-matched controls. NKT cells were activated and expanded by α-galcer and IL-2 in vitro. The percentages of positive NKT cells expressing IL-4 and IFN-γ were determined by ICS-FC. The levels of serum IL-4 and IFN-γ were tested by ELSIA. The numbers of cells secreting IFN-γ and IL-4 were detected by ELISpot. Results The ratios of NKT cells in PBC group were [0. 16(0. 11-0. 26) ]% before expansion and [0. 82 (0. 61-0. 89) ]% after expansion, significantly lower than control group [(0.33 (0.27-0.38) ]% and [27.40 (23.52-33.87) ]%, respectively, (Z=6.563, 7.707, P<0. 01 ). Seven days after expansion by α-galcer and IL-2, the expansion folds of NKT cells were 96. 05 (80.50-100.27) in PBC group and 134.65 (121.60-142. 13) in control group, respectively (Z =6.462,P < 0. 01 ). At the same time, the ratio of IFN-γ+ and TCRVα24+ Vβ11+ NKT detected by ICS-FC in PBC group was significantly higher than that in control group [ 38. 98 ( 36.73-42. 98 ) ]% vs [ 34. 56 ( 30. 12-36. 78 ) ] %, Z = 3. 158, P < 0. 05, while the ratio of IL-4+ and TCRVα24 + Vβ11+ NKT cells in PBC group was significantly lower than that in control group[0. 193(0. 179-0. 218) ]% vs [34. 36 (30. 93-38. 77) ]%,Z =6. 476, P <0. 01. The number of IFN-γ SFC detected by ELISpot were [410(380 ~500) ] SFC/1 × 106 PBMC in PBC group and [ 340(280 ~ 390)] SFC/1 × 106 PBMC in control group, respectively (Z = 4. 312, P <0. 05). The levels of serum IFN-γ in PBC group and control group were (67.21 ± 11.27) ng/L and (31.45 ± 8. 17) ng/L, respectively ( t = 27.25, P < 0. 01 ). The level of IFN-γ in PBC group was higher than that of control group. The number of IL-4 SFC were [73(60 ~ 100) ]SFC/1 × 106 PBMC in PBC group vs [245(230 -280) ] SFC/1 × 106 PBMC in control group, Z=5. 112,P <0. 01. The levels of serum IL-4 in PBC group and control group were (12.65 ±4. 17) μ/L and (28.31 ±6.31) μg/L, respectively (t =25.34,P < 0. 01 ). The level of IL-4 in PBC group was lower than that of control group. Conclusions The quantity of TCRVα2.4+ Vβ11+ NKT in PBC group is lower than that in control group. After in vitro activation, the capacity of expansion and producing IL-4 of NKT is decreased in PBC group, while the capacity of producing IFN-γ of NKT is increased in PBC group. The reduction of NKT cells and the immune dysfunction may be one of the important factors in the pathogenesis of PBC.

OBJECTIVE: To discuss the correlation between the consumption of antibacterials and the antibiotic resistance of Pseudomonas aeruginosa(PA) in our hospital.METHODS: The total antibacterial consumption expressed as defined daily doses(DDDs/day/100 persons) as well as the synchronous antibiotic resistance rate of PA were computed and the correlation beween the them was analyzed.RESULTS: The resistance rates of PA to cefepime,gentamycin and ciprofloxacin were positively correlated with the consumption of ciprofloxacin.A significant positive correlation was noted between the resistance rates of PA to gentamycin and imipenem cilastatin and the consumption of imipenem.The resistance rates of PA to ceftazidime and ceftriaxone were positively correlated with the consumption of piperacillin/tazobactam.The resistance rates of PA to amikacin and gentamycin were positively correlated with the consumption of amikacin and gentamycin respectively.CONCLUSION: A positive correlation was noted between antimicrobial consumption and antibiotic resistance of PA.

[Objective]To evaluate the application value of minimally invasive release operation about congenital vertical talus(CVT).[Method]All operation were operated with single method by author.Firstly,Achilles tendon,capsulotomy of the ankle and subtalar joint were released through a small straight posterior inside of Achilles tendon end point.Secondly,astragaloscaphoid and subtalar front joint were released bluntly through a straight posterior incision.Thirdly,based on circs subtalar joint were released through calcaneocuboid articulation outside foot.Then one K-wire were passed through the body of talus from its axis,and passed through instep after reposition of astragaloscaphoid joint.Two K-wires was passed through calcaneus to talus from planta.[Result]Eight cases were available for follow-up from 17 to 36 months(mean,28 months),follow-up results was evaluated by using a version of Adelaar and Kodros score,there were excellent result in 1 foot,good in 5,fair in 2.The presence of hindfoot valgus and forefoot abduce were noted in one foot,forefoot pronation was appeared in one foot.Two parameters-talar and calcaneus axis-first metalarsal base angles,calcaneus talus angles of eutopic and lateral radiograph were basally normal.[Conclusion]Operative reduction has been advocated as the only effective treatment for CVT,it is the best choice to use minimally invasive release operation for infant.

0.05). The difference of CT values among the regions of middle portion had statistical significance(F=4.539,P