Objective In this study, the glucose and energy metabolism-related genes (PGC-1α, Glut-4, ERRα, NRF-1, TFAM and mtDNA gene) were detected in type 2 diabetes mellitus ( T2DM) and non-T2DM minipigs, and the gene function was explored for T2DM pathogenesis.Methods The longissimus muscle of T2DM and non-T2DM Guangxi Bama mini-pigs was used as experiment material.The expression of glucose and energy metabolism-related genes was detec-ted by QRT-PCR.Results The expressions of PGC-1α, Glut-4, ERRαand NRF-1 genes were significantly higher than that of non-T2DM group, the expressions of TFAM and mtDNA gene were lower than that of non-T2DM group.Conclu-sions The upregulated expression of PGC-1αgene and its downstream genes Glut-4, ERRα, NRF-1 may improve the glu-cose metabolic functions in skeletal muscle in the Bama minipigs, whereas insufficient mitochondrial synthesis may induce decreasing ATP synthesis, and results in skeletal muscle insulin resistance, finally leading to the T2DM occurrence.

Objective To clone the coding sequence of Guangxi Bama mini-pig PGC-1αgene, and to analyze the expression of PGC-1αgene in various tissues of mini-pigs using RT-PCR and QRT-PCR techniques.Methods The PGC-1αgene coding sequence ( CDS) was amplified by PCR from the cDNA of longissimus muscle of Guangxi Bama mini-pig. The PCR products were inserted into pEASY-T5 vector, transfected E.coli, identified and sequenced.The PGC-1αgene expression in different tissues of the Bama mini-pigs was detected by RT-PCR and QRT-PCR assays.Results The PGC-1αgene CDS of Guangxi Bama mini-pig was cloned.It was 2391 bp in length.It had 99.9%homology with the reference sequence, and had two synonymous mutations that were C-A1105 and G-A1524.The expression level of PGC-1αgene was higher in the heart and kidney, followed by liver, subcutaneous fat and longissimus muscle, but the expression was not de-tected in pancreas of Guangxi Bama mini-pig.Conclusions We have successfully cloned the PGC-1αgene of Guangxi Bama mini-pig, and detected this gene expression in six tissues.The results of this study will provide a basis for studying the effect of PGC-1αon type 2 diabetes mellitus (T2DM) in Bama mini-pigs.

Objective To apply the Plan -Do -Check -Act ( PDCA ) cycle in glucose management in inpatients with diabetes , in order to decrease the incidence of hypoglycemia and related complications .Methods 517 inpatients with diabetes were divided into 4 groups according to the quarter ,the monthly incidence rates of hypo-glycemia were collected.The association of monthly incidence of hypoglycemia with age (≥65 years),longer diabetic history (≥5 years),lower C-peptide (<0.370nmol/L),receiving combined regimen (basal insulin plus 3 doses of pre-prandial short-acting insulin ) were analyzed .PDCA cycle was applied for hypoglycemia detection and etiolo-gy control in order to achieve quality improvement via effective glucose control measures .Theχ2 test was used to ana-lyze the incidence of the hypoglycemia in each group .The hypoglycemic incidence based on different characteristics , were also compared with the overall hypoglycemic incidences of all patients .Results The incidence of hypoglycemia was significantly reduced with the application of PDCA cycle in inpatients with diabetes ,from 44.09％ in the first quarter to 13.04％ in the fourth quarter (χ2 =32.815,P<0.001).The annual hypoglycemic incidence rate was 26.89％.The patients with low C-peptide or receiving combined regimen had significantly higher incidence rate of hypoglycemia (53.57％and 31.88％) as compared to general inpatients with diabetes (χ2 =35.721,7.105,all P<0.05).Conclusion The application of PDCA cycle can effectively decrease the incidence of hypoglycemia ,and it can be a great asset for management of inpatients with diabetes .

Objective:To construct transitional care evaluation system for lung cancer patients with chemotherapy based on Omaha systemtheory.Methods:Based on literature research, the first draft of transitional care evaluation system for lung cancer patients with chemotherapy was preliminarily formulated by combining Omaha system, content analysis, cross-mapping method and expert group meeting. By using Delphi expert consultation method, 15 experts from the field of oncology medicine and oncology nursing were conducted two rounds of expert consultation from January 2019 to March 2019. Finally, the transitional care evaluation system for lung cancer patients with chemotherapy was formed. From April 2019 to May 2019, 30 lung cancer patients with chemotherapy in a cancer specialist hospital were selected to evaluate the importance of the contents of the transitional care nursing evaluation system. The enthusiasm of experts was expressed by the effective recovery rate of the questionnaire, the authority of experts was expressed by the expert authority coefficient ( Cr) , the coordination degree of expert opinions was expressed by the coefficient of variation and Kendall coordination coefficient, and the concentration degree of opinions was expressed by the value of importance. Results:The recovery rates of the two rounds of expert consultation questionnaires were 100%. The expert authority coefficient of the second round of expert consultation was 0.80. Kendall's coordination coefficients of the first-levelindicators and second indicators were 0.300 and 0.160 respectively ( P<0.001) . The evaluation opinions of experts and patients tended to be consistent. The transitional care evaluation system for lung cancer patients with chemotherapy was finally constructed, including 8 first-level indicators and 62 second-level indicators. Conclusions:In this study, contents of transitional care evaluation system for lung cancer patients with chemotherapy are scientific and reasonable, which can provide a reference for the effective implementation of transitional care for lung cancer patients with chemotherapy.

Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.