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 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 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 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 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 investigate the applicability of autoregressive integrated moving average (ARIMA) model in predicting healthcare-associated infection(HAI) in children.Methods The ARIMA model was constructed according to the incidence of HAI in a hospital from January 2011 to December 2014.With the use of information criterion,optimal model was determined;HAI data in 2015 was as test samples,the feasibility of the model was evaluated.Results ARIMA (0,1,1) was the optimal prediction model for HAI rate,the Akaike Information Criterion (AIC) and Bayesian Information Criterion(BIC) of the ARIMA (0,1,1) were 66.61 and 70.76,respectively.The Ljung-Box statistics value Q =14.14 was not significantly different (P =0.658),suggesting a white noise sequence of residuals with a good model fitting.The mean absolute percent error(MAPE) between actual and fitting value of HAI was 22.4,the actual values were within the 95％ confidence interval.Conclusion ARIMA model fits the time series data,and can achieve satisfactory effect on predicting the incidence of HAI in hospitalized children.

Objective To evaluate the clinical effectiveness of early-stage keep warm intervention on improving low temperature risk children treated with blood purification (BP). Methods Ninety children were randomized into observation group (46 cases) and control group of (44 cases) from July 2013 to September 2015. Control group were nursed with conventional BP standard operation process, while the observation group were nursed additionally with heat insulation blanket before 30 min of booting machine, and recorded the central body temperature of 0 min,30 min,60 min,90 min,120 min for each 60 min 1 time in the future. Until the end of the blood purification 60 min. Low temperature complications were recorded and judged between the two groups. Results In the observation group, 107 cases of low body temperature occurred during the course of 7 cases of blood purification, occurrence rate of 6.5% (7/107). The control group was 15.8% (16/101). The difference between the 2 groups was statistically significant (χ2=4.569,P<0.05);In the continuous blood purification group, observation group 10.6% (5/47), The incidence rate of control group was 29.3% (12/41), he difference between the 2 groups was statistically significant (χ2=4.876,P<0.05). Conclusions Application of heat insulation blanket at the early-stage may effectively reduce the risk of hypothermia complications in the children treated with blood purification. The continuous blood purification effect is more significant.

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