Objective To investigate the level of serum cartilage oligomeric matrix protein (COMP) and its relationship with vascular calcification in diabetic nephropathy (DN) patients .Methods COMP was tested in 54 (DN) group and 28 matched healthy persons (healthy group) .DN group was divided into vascular calcification group (VC) and non‐vascular calcification (non VC) group .DN group was also divided into cardiovascular disease group (CVD‐y) and without cardiovascular disease group (CVD‐n) in view of the company of cardiovascular disease .Serum COMP levels was compared between the DN group and the control group ,the VS group and the non VS group ,and the CVD‐y group and the CVD‐n group .The correlations between COMP level and the occur‐rence of cardiovascular disease ,the incidence of vascular calcification were estimated by Wald analysis of the application of Wald test .Results Serum COMP in DN group was significantly higher than the control group;Aortic arch calcification accounted for 75 .9% of the DN group .The serum COMP in VC group was higher than that of non VC group ,CVD‐y group had higher COMP than CVD‐n group old respectively with every 10 ng/mL increased in concentration of serum COMP .Conclusion The higher of concentration of serum COM P ,the more risk of vascular calcification and CVD .

Objective To investigate the protective effect of insulin glargine in myocardium of diabetic rats. Methods Male Wistar rats were randomly divided into normal control group (NC), diabetes mellitus group After 6 weeks, we weighed rats and calculated the heart body weight ratio (H/B), Immunohistochemical technique was used to estimate the expression of transforming growth factor beta 1 (TGF-β_1) and the type-Ⅲ collagen (collagen Ⅲ). Myocardial pathologic changes were observed under expression of TGF-β_1 and collagen Ⅲ of DM group and DI group were significantly higher than those in NC group (P<0.05); the levels of H/B and the expression of TGF-β_1 and collagen Ⅲ of DI group were lower than myofibrils were arranged disorderly, mitochondria increased, with swelling and degeneration, while the changes of myocardial ultrastructure were obviously lightened after treatment with insulin glargine. Conclusion Insulin glargine may partly suppress the increased expression of TGF-β_1 and collagen Ⅲ in myocardial of diabetic rats, and it may decrease significantly the myocardial injury of diabetic rats.

0.05) ;incidence of aleucocytosis was 43.3% vs.27.5%(P

Objective To investigate the clinical effect of McDonald cervical cerclage and the affecting factors. Methods Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups. Results (1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group,there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P<0.01). Neonatal hospitalization rate was lower in preventive group (14.6%, 7/48) than therapeutic group (36.8%, 25/68) , the difference was statistically significant (P< 0.01). (3) In the failure group placental pathology was examed in 7 cases. The placental tissue showed a large number of neutrophils infiltrating in 6 cases (6/7). In the successful group, 27 pregnant women deliveried between 28 to 33+6 weeks (26.0%,27/104), 10 pregnant women deliveried between 34 to 36+6 weeks 10 cases (9.6%, 10/104), 67 cases deliveried after 37 weeks (64.4%, 67/104). A lot of factors including maternal age, the previous cervix operation history, perioperative application of progesterone, operation time and preoperative invasive procedure were compared between the successful group and the failure group. Only maternal age and preoperative invasive proedcure were statistically significant (P<0.05) and the others had no statistical significance (P>0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded;the preoperative cervical os in failure group [ (21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P<0.05);and preoperative vaginal ultrasound measurement of cervical canal length were (18 ± 8) mm versus (19 ± 10) mm, there was no statistically significant difference (P>0.05). Conclusions The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of intervention measures. The term labor rate of prophylactic cervical cerclage was higher than that of the therapeutic cerclage. Older maternal age and preoperative invasive procedure may be the risk factors for cerclage. The infection may play an important factor leading to the failure of McDonald cervical cerclage.

Objective To evaluate the relationship between serum levels of leptin, endothelin and diabetic retinopathy in type 2 diabetes patients. Methods Leptin, endothelia, FBG, PBG, HBA1C, CHOL, TG and other clinical characteristics were tested in 80 type2 diabetes patients and 30 control case. All diabetes patients were divided into three group: non-diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy(PDR) according to the examination results of fundus. Correlations between levels of serum leptin and other parameters were analyzed. Results Plasma level of leptin in the type 2 diabetes with PDR group[(17.41±5.81)μg/L] were higher than that in control, NPDR and NDR group (P＜0.01). Plasma level of ET in the type 2 diabetes with PDR group[(80.68±13.57)mg/L] were higher than that in control, NPDR and NDR group (P＜0.01). The serum leptin levels were positively correlated with BMI(r＝0.468,P＜0.01). Conclusions Serum leptin and endothelin levels were elevated in patient with diabetic retinopathy as diabetic retinopathy aggravated and serum level of leptin and endothelin raised.

Objective To explore the relativity between clinical learning organization culture and core competency among registered nurses,to offer theoretic basis and practical advices for improving core competency among registered nurses.Methods 680 registered nurses in three tertiary hospitals in Ji'nan city were investigated with the general information questionnaire,Competency Inventory for Registered Nurses and the Dimensions of The Learning Organization Questionnaire.Results The total score and all the four subscales of learning organization were positively correlated with the core competency among registered nurses(P＜0.01),the dimension of overall situation senses and strategic leadership were the main influencing factors.Conclusions The cultivation of nurses' overall situation senses should be strengthened,providing strategic leadership for learning,strengthening cooperation and innovation,and promoting inquiry and communication.These will help increase core competency among registered nurses and improve their general competence.

Objective To study the changes of endothelin,nitric oxide and vascular endothelial growth factor level in patients with type 2 diabetic retinopathy (DR). Methods Eighty diabetes patients (53 with diabetic retinopathy and 27 without). Another 30 healthy volunteers were recruited as control. Plasma ET and VEGF levels were measured by enzyme-linked immunosorbent assay. NO levels were measured by nitrate reductase method. Results Plasma levels of ET were higher in patients with type 2 diabetes with DR (DR)(80. 68 ± 13.57) mg/L than (65. 33 ± 11.24) mg/L, (45.25 ±9. 06) mg/L, in control and in type 2 diabetes patients without DR (NDR) (Ps ＜ 0, 01 ). Plasna levels of NO in DR group (69. 82 ± 14. 89) μmol/L were higher than (37. 85 ±-9. 11 ) μmol'L, in control group,but lower than (77.52 ±± 18.56) μmol/L in NDR group (Ps ＜ 0. 05 ). Plasma levels of VEGF ( 110. 52 ± 25.65 ) μg/L in DR were significantly increased compared with control (82.42 ± 18. 47 ) μg/L, and NDR(97.55 ±25.61)μg/L, (Ps ＜0.05).Conclusion ET, NO and VEGF may be involved in the pathogenesis of type 2 diabetic retinopathy.

Objective To investigate the changes of serum homocysteine and it s relationship with oxidative stress and diabetic microangiopathy.Methods Eighty health participants were recruited as control 100 type 2 diabetis patients without diabetic microangiopathy were recruited as DM group,100 type 2 diabetis patients with diabetic nephropathy were recruited as DN group,and 100 type 2 diabetis patients with diabetic retinopathy were recruited as DR group.Their serum levels of homocysteine,malonaldehyde(MDA),superoxide dismutase (SOD)and glutathione(GSH)were measured.Results The homocysteine was(98.86 ± 21.46),(198.95 ±19.35),(138.65 ± 15.25)ng/L in the DM,DN and DR group respectively,which were signigicantly higher than that of(62.48 ± 15.36)ng/L in the control group(F =7.95,P ＜ 0.01).MDA was(17.49 ± 1.64),(22.47 ± 1.86)and(22.47 ± 1.86)mmol/L,which was significantly higher than that of(11.86 ± 0.48)mmol/L in the control group(F =6.89,P ＜0.01).The homocysteine and MDA in the DN and DR group were both significantly higher than those in the DM group(P ＜ 0.01).The SOD and GSH was(107.80 ± 15.62)mg/L and(179.26 ± 25.8)mg/L in the DM group,(79.86 ± 14.63)mg/L and(143.36 ± 21.75)mg/L in the DN group,(89.34 ± 12.75)mg/L and(156.96 ± 19.35)mg/L in the DR group,which were significantly higher than those of(128.32 ± 19.21)mg/L and(237.38 ± 27.31)mg/L in the control group(F =7.89 and 8.76 respectively,P＜0.01).The SOD and GSH in the DN and DR group were both significantly lower than those in the DM group(P ＜ 0.01),and the DN group was significantly lower than the DR group(P ＜ 0.01)Serum homocysteine was positively correlated with MDA(r =0.79,P ＜ 0.05),and negtively correlated with SOD and GSH(r =-0.71 and-0.78,P ＜0.01).Conclusion Diabetic microangiopathy patients have higher serum homocysteine level and severe oxidative stress.Oxidative stress were related to higher serum homocysteine level.The higher serum homocysteine level and oxidative stress might play an important role in development of diabetic Microangiopathy

Objective To investigate the relationship between serum levels of homocysteine (HCy) and adiponectin (APN) in patients with type 2 diabetes mellitus(T2DM).Methods 65 patients with T2DM (diabetes mellitus group) and 25 healthy controls (control group) matched in the age and sex were recruited in the study.Serum HCy,APN,fasting plasma glucose (FPG),fasting insulin (FINS),total cholesterol (TC) and triglyceride (TG) were simultaneously measured.The homeostatic model assessment for insulin resistance(HOMA-IR) was calculated according to FPG and FINS.All the serum indicators were compared between the two groups.Results Serum level of HCy in T2DM group was (15.74 ± 2.76) μmol/L,which was significantly higher than (6.98 ± 1.94) μmol/L in the healthy control group (t =16.88,P ＜ 0.01).The serum level of APN in T2DM group was (8.14 ± 2.70) mg/L,which was significantly lower than (16.10 ± 1.93)mg/L in the healthy control group (t =13.44,P ＜ 0.01).Serum levels of FPG,HOMA-IR,TC,TG in T2DM group were significantly higher than those in the healthy control group (t =10.62,17.49,6.30,7.52,P ＜ 0.05).Serum level of APN in HCy ≥ 15μmol/L group was significantly decreased compared with HCy ＜ 15μmol/L group.Serum level of HCy was negatively correlated with APN in T2DM group after the influence of FPG,HOMA-IR,TG,TC were corrected in the partial correlation analysis.Conclusion In T2DM group,serum level of HCy was increased,but serum level of APN was decreased,serum HCy was negatively correlated with APN,higher serum level of HCy and lower serum level of APN are related with the process of insulin resistance and T2DM.

OBJECTIVE:To observe the analgesia effects of transdermal fentanyl in the treatment of pharynx oralis pain caused by radiotherapy.METHODS:30patients with pate squamous carcinoma and serious membrana mucosa ulcerate and pain after a whole range radiotherapy,who were treated with3to5patches2.5mg(25?g/h)of transdermal fentanyl every9～15days if their VAS scores were found to be more than6scores.The analgesia effect,life quality and the adverse reaction were evaluated respectively with VAS,Digit-scale and east American carcinoma cooperation group toxicity criteria.RESULTS:The average VAS scores has been lowered from7.86?1.18before the treatment to2.24?1.31on10th day of the treatment(P