Objective To observe the influence of individualized health eduction on the metabolic index in patients with type 2 diabetes mellitus and thus explore the effective measures of altering life style of patients.Methods The health education plan was made by nurses specialized in diabetes mellitus in 58 patients with type 2 diabetes mellitus in a manner of one nurse to one patient.Metabolic indexes such as BMI,FPG,2hPG and HbAlc were observed after the execution of the plan.Results BMI,FPG,2hPG and HbAlc were all loweled 6 months and 12 months after the execution of the plan compared with those baseline values of these indexes,and more than 90％ patients could persist in the dietary and physical treatment.Conclusions Individualized health education can alter the metabofic indexes of patients with type 2 diabetes mellitus better.The way of one to one can enhance the effectiveness of the education,make the patients culture good life style by themselves and thus delay the occurrence and development of chronic complications associated with diabetes mellitus.

50 mm/h were detected in all the patients. Decreasing C 3 in 6 patients and C 4 in 5 were found. Conclusions SLE is one of the general conditions causing retinal vein occlusion. Visual acuity and barrier of retinal vein and capillary are damaged seriously in patients with retinal vein occlusion caused by SLE, which may be accompanied with other ocular or general lesions. It is suggested that retinal vein occlusion is relative with SLE activity.

Objective To investigate the clinical characteristic of ocular fundus complications in systemic lupus erythematosus (SLE). Methods In 25 cases of SLE with the ocular fundus complications, the ocular fundus, the other ocular tissues, general lesions,and antinuclear antibody (ANA), anti-double-stranded DNA(anti-dsDNA), complement 3 (C 3), complement 4 (C 4)and erythrocyte sedimentation rate(ESR) were analyzed retrospectively. Results In the 25 cases, "classic" SLE retinopathy in 15 (25 eyes), retinal vein occlusion (RVO) in 9 (12 eyes), RVO combined with retinal artery occlusion in 1 (2 eyes), exudative retinal detachment in 1 (2 eyes), vitreous hemorrhage combined with neovascular glaucoma in 1 (1 eye), and optic disc edema except RVO in 3 (6 eyes) were found. Nine cases accompanied with other ocular signs and 21 with general lesions. Positive ANA and anti-dsDNA and elevated ESR in all of the patients, decreasing C 3 in 19, and C 4 in 17 were found. Conclusions SLE can cause serious ocular fundus complications accompanied with other ocular signs. Regular ophthalmic examination should be performed on the patients with SLE to detect and treat the ocular complications promptly.

A 65-year-old woman presented with intermittent right hand numbness and elevated serum creatinine for more than 2 months. The histological examination of kidney biopsy showed renal arterioles occlusion and interstitial fibrosis. Pathological abnormality was originally considered as a part of systemic atherosclerosis. Thus, rosuvastatin 20 mg/d, fosinopril 10 mg/d, metoprolol 47.5 mg/d and aspirin 0.1g/d were administrated. No improvement of renal function was seen. Further Congo red staining was applied. Diffuse amorphous eosinophilic substance was deposited in interlobular artery and small arteriolar artery. Combined with the abnormal free light chain (FLC) level and ratio (serum κ 340 mg/L, κ/λ 10.932), the diagnosis of systematic light-chain amyloidosis was confirmed. The patient received 3 courses of chemotherapy regimen as BCD (bortezomib 2 mg d1, 8, 15, 22, cyclophosphamide 0.3 g d1, 8, 15, 22 and dexamethasone 40 mg d1, 8, 15, 22). A hematologic partial response was achieved and serum creatinine decreased to 180 μmol/L.

Objective:To study the experience of frontline medical workers in COVID-19 quarantine points.Methods:Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview. Colaizzi′s seven-step analysis method was adopted to analyze and categorize the data.Results:The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined).Conclusions:The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure. Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules.

Objective To investigate the clinical effect of hyaluric acid sodium injection and functional exercises on patients with comminuted fracture of tibia plateau after reposition. Methods 134 patients with comminuted fracture of tibia plateau after reposition were randomized into the observation group and the control group with 67 cases in each group. The observation group received 2ml of hyaluric acidsodium injection into the knee joint cavity with 1％ lidocaine once a week and 3 times totally. At the same time active and passive functional exercises were applied. The control group was only given routine nursing. The knee function was evaluated by Lysholm Scale 4 months after operation and the results were compared. Results The score of the observation group was higher than that of the control group(P＜0.01).Conclusion The hyaluric acid sodium injection and functional exercises could improve the healing of joint cartilage and contribute to the rehabilitation of joint function in patients with comminuted fracture of tibia plateau after reposition.

Objective To analyze the clinicopathological characteris tics of systemic lupus erythematosus (SLE) with secondary antiphospholid syndrome (APS) . Methods Data of 11 cases of SLE with secondary APS (SLE with APS) admitted to Peking Union Medical College Hospital from January 2000 to March 2010 were retrospectively analyzed. Kidney biopsy was performed on all of these patients. Differences of clinicopathology and outcomes between SLE with and without APS were compared. Results Renal involvement was found in all the SLE with APS patients. The prominent clinical manifestations included hypertension (54.5%), nephrotic level of proteinuria (24 h proteinuria ≥3.5 g)(72.7%) and renal insufficiency (45.5%). Diastolic blood pressure, mean arterial pressure and glomerular filtration rate in SLE with APS were significantly higher than those in SLE without APS (all P＜0.05). In 8 out of 11 cases (72.7%), APS nephropathy (APSN) in kidney biopsy was found, characterized by small vessel vaso-occlusive lesions. These included thrombotic microangiopathy (TMA), fibrous intimal hyperplasia (FIH), focal cortical atrophy (FCA) and tubular thyroidization. Among those, 5 cases (45.5%) had chronic APSN and 4 (36.4%) had acute APSN (one case had acute and chronic APSN at the same time). The incidences of APSN and acute APSN in the SLE with APS group were significantly higher than those in SLE without APS group (P＜0.05). Conclusions The major renal manifestations of SLE with APS are hypertension, nephrotic level of proteinuria and renal insufficiency. Other than lupus nephritis, also a high incidence of APSN is found in SLE with APS patients.

Objective To investigate the homology of methicillin-resistant Stphylococcusaureus(MRSA)from the neonatal intensive care unit(NICU)of a children's hospital,and evaluate routes and preventive strategies of MRSA healthcare-associated infection(HAI). Methods MRSA strains from neonates and environment of NICU between October and December 2014 were collected,and strains were identified by VITEK-2 microbial analysis system and cefoxitin Kirby-Bauer method,homology of MRSA was analyzed by pulsed-field gel electrophoresis (PFGE ). Results A total of 6 MRSA strains were isolated from NICU between October and December 2014,3 of which (bed-58,70,and 100)were detected MRSA from specimens,MRSA were isolated from neonatal incubator and nurse (nasal swabs and hands)who cared for neonate at bed 58. 5 of 6 MRSA strains were homology,antimicrobial susceptibility testing result showed that No. 1-5 strains were resistant to clindamycin and amoxicillin/clavulanic acid,No. 6 strain was slightly different from No. 1-5 strains,No. 6 strain was susceptible to both clindamycin and amoxicillin/clavulanic acid. PFGE results showed that No. 1-5 strains were of the same type,No. 6 strain was a different type. Conclusion The main route of this MRSA transmission is contact transmission,especially through the hands of health care workers,identification and analysis of epidemic strains by PFGE technique is an effective measures to prevent HAI outbreak and perform epidemiological study.

Objective Preparation of a stable and reliable atrioventricular blockage ( AVB) animal model is of great im-portance to anti-arrhythmic drugs and biological engineering research .The aim of the article was to establish a rat model of AVB in-duced by chemical ablation, providing an effective animal model for the development of new drugs . Methods 60 adult SD rats were randomly divided into 4 groups(n=15): normal saline (NS) group, Verapmil (Ver) group, chemical ablation group 1 and chemical ablation group 2.0.9%NaCl (5 mg/kg) was injected into caudal vein of each rat in NS group .Verapmil (5 mg/kg) was injected into the caudal vein in Ver group.Anhydrous ethanol(50μL)was injected into atrioventricular groove area in chemical abla-tion group 1.Anhydrous ethanol(50μL) was injected into atrioventricular node area in chemical ablation group 2.The electrocardio-grams of the rats were examined by electrophysiological recorder.HE staining and Connexin 43 (CX43) immunohistochemical tech-nique were applied to atrioventricular junctions of the rats . Results A rat model of AVB was successfully established .Compared with NS group([45 ±2.24]per field of view), there was a significant decrease in the CX43 expressions of chemical ablation group 1 and group 2 ([15.20 ±2.23]per field of view, [22.10 ±4.70]per field of view)(P<0.05).Concerning NS group and Ver group, myocyte tissues of the atrioventricular nodal region were detected to remain in order without obvious changes and the expres-sion of CX43 immunoreactive protein was obvious under light microscope.As to chemical ablation group 1 and group 2, myocyte tissues were in degenerative necrosis and the expression of CX43 im-munoreactive protein was in lighter staining.Compared with Ver group, the incidence rate(73.3%, 60.6%) and the mortality rate (33.3%, 26.7%)of third-degree AVB decreased remarkably(P<0.05). Conclusion Chemical ablation can be induced to estab-lish a stable and reliable rat model of AVB , providing an effective
animal model for the research and development of new anti-arrhythmic drugs.

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.