Objective To explore the related risk factors of type 2 diabetic nephropathy,and to provide theoretical basis to make the strategy of prevention of diabetic nephropathy.Methods By case-control study method,98 patients with type 2 diabetic nephropathy were selected as the observation group.98 diabetes mellitus patients without kidney disease were selected as control group.Single factor analysis and non-conditional logistic regression analysis were conducted in two groups.Results The results of single factor analysis showed that type 2 diabetic nephropathy was closely related to family history of diabetes,course of diabetes,high blood pressure,diabetic retinopathy,BMI,coronary heart disease,HbAlc,FPG,2hPG,CRP (P ＜ 0.05).The results of multiple factors of logistic regression showed that type 2 diabetic nephropathy was closely related to course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG(P ＜0.05).Conclusion Course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG are independent risk factors for type 2 diabetic nephropathy.

Objective To investigate the prevalence of occupational asthma,airway inflammation and analyze the risk factors for workers exposed to isocyanates.Methods A cross-sectional study was applied.Totally 429 isocyanates exposed workers were surveyed and the prevalence of occupational asthma and airway inflammation situation were examined by questionnaire,physical examination and laboratory tests.Multivariate logistic regression was applied to analyze the possible risk factors of isocyanate-induced occupational asthma.Results (1) A total of 366 patients with complete data were included in the study,and finally 11 cases were diagnosed as isocyanate-induced occupational asthma with a prevalence of 3.0％.(2) Neutrophil percentage in the induced sputum of occupational asthma increased significantly [42.00％ (34.00％-55.00％) before work and 59.00％ (51.00％-70.00％) after work (Z =-2.940.P ＜ 0.05)].(3) Length of service (OR =3.096,P =0.025) and rhinitis (OR =1.901,P =0.008) were independent dangerous factors,and protective measures (OR =0.074,P =0.015) was protective factors to isocyanateinduced occupational asthma.Conclusions Neutrophilic inflammation can be triggered by isocyanate exposure.Regular health examinations,effective protective measures can reduce the prevalence of isocyanateinduced occupational asthma.

Objective To investigate the mechanism of hydrogen therapy for gouty arthritis,and provide new strategy for gout via a diet therapy by building up the crystal arthritis (gout) animal model.Methods Wistar rats (200±20) g were randomly divided into five groups which were consisted of five rats,including:the hydrogen-water model group,the hydrogen-feed model group,the hydrogen-water and hydrogenfeed model group,the control model group,and the blank group.And the first,the second,the third group collectively referred to as the hydrogen group.The rat model of acute gouty arthritis was established via injecting monosodium urate (MSU) in rats' ankles,after 14 days continuous feeding.On the third day after injection,serum samples were collected and analyzed.The swelling feet were removed and kept in the 40％ neutral formaldehyde for histochemicalstudies.During the three days after MSU injection,the volume of whole feet (including the ankle joint) was also recorded.The results were analyzed with one-way ANOVA and tamhane's T2 methods.Results In this study,a moderate elevated level of observed parameters,such as swelling joints numbers and inflammatory factor levels,was observed in the hydrogen feed model group than other groups.To measure the volume of rats' feet and found that the volume of feet of the control model group was 1.24 times (0.40±0.06,P＜0.05) as big as hydrogen group.And the TNF-α,IL-1,malondialdehyde in the serum of the hydrogen group were also less than those of the control model group.The contention of TNF-α of the control model group was 6.23 times (336±60,P＜0.05) as much as the hydrogen group.The contention of IL-1β of the control model group was 4.02 times (249±42,P＜0.05) as much as the hydrogen group.The contention of MDA of the control model group was 2.18 times (24±4,P＜0.05) as much as the hydrogen group.Conclusion The oral hydrogen intake has a definite therapeutic effect on controlling articular inflammation,which is helpful in exploring the dietary therapy for gouty arthritis.

Abstract: Objective　To analyze the epidemic characteristics of etiologically positive pulmonary tuberculosis, and the outcome of treatment in Liaoning Province from 2016 to 2022, aiming to provide a scientific basis for the formulation of tuberculosis prevention and control measures in Liaoning Province. Methods　The medical records information of registered pulmonary tuberculosis patients in Liaoning Province from 2016 to 2022 was collected from the "Tuberculosis Information Management System", a subsystem of the "China Disease Prevention and Control Information System". A descriptive analysis was performed on the epidemiological characteristics and treatment outcomes of cases of pathogen-positive pulmonary tuberculosis. Results　From 2016 to 2022, a total of 152 778 cases of active pulmonary tuberculosis were registered in Liaoning Province. Registration rates decreased from 54.48/100 000 in 2016 to 39.12/100 000 in 2022, displaying a downward trend (χ2trend=1 921.17, P<0.001). The etiological positive rate increased from 26.70% in 2016 to 51.21% in 2022, indicating an upward trend (χ2trend=5 203.00, P<0.001). The etiological positive registration rate increased from 14.54/100 000 in 2016 to 20.03/100 000 in 2022, showing an upward trend (χ2trend=647.97, P<0.001). The male-female ratio of etiological positive was 3.35∶1. The age group of 55-<65 had the highest incidence rate at 25.45% (16 127/63 376) among pathogen-positive pulmonary tuberculosis cases. Patients over 45 years of age accounted for 71.27% (41 570/63 376) of total cases, pointing towards an aging trend. The main occupations of the patients were household and unemployed, making up 41.78% (26 477/63 376) of total cases and showed an increasing year-on-year trend (χ2trend=17.404, P<0.001). Direct medical consultation was the primary mode of patient source at 50.28%(31 864/63 376), while 64.54%(40 904/63 376) cases reported a delay in seeking treatment. Seasonality was observed in the occurrence of pathogen-positive pulmonary tuberculosis, with February and September being the months of lowest incidence, while May and June witnessed peak incidences. The etiological positive patients were mainly in Shenyang, Dalian, Jinzhou and other regions. The proportion of successful treatment of etiologically positive decreased from 91.15% in 2016 to 85.88% in 2022, manifesting a downward trend (χ2trend=35.892, P<0.001). Conclusions　From 2016 to 2022, the incidence and registration rates of pathogen-positive pulmonary tuberculosis in Liaoning Province displayed an upward trend. Several characteristics were observed including seasonal variations, delayed treatment, regional distribution differences, and a decline in successful treatment rates. Targeted prevention and control measures should be formulated according to the actual situation in Liaoning Province.

Objective To study the correlation between 8-Iosmerie Porastglnadin-2a(8-iso-PGF2α) 、hypersensitive C-reactive protein(hs-CRP) and coronary heart disease(CHD). Methods 153 CHD patients were divided into 3 groups,including 52 cases of acute myocardial infarction(AMI) ,50 cases of unstable angina(UAP) ,51 cases of stable angina(SAP) and control group consisted of 50 healthy people. The levels of hs-CRP and 8-iso-PGF2α were measured. Person correlation analysis was used to analyze the relationship between the level of hs-CRP and 8-isoPGF2α. Results The levels of hs-CRP and 8-iso-PGF2α were significantly higher in AMI, UAP and SAP group than those in control group(all P ＜0.05). Compared with SAP group,the levels of hs-CRP and 8-iso-PGF2α were increased in AMI and UAP groups (all P ＜ 0. 05) . The level of hs-CRP was positively associated with the level of 8-iso-PGF2α. Conclusion hs-CRP and 8-iso-PGF2α should be the markers of coronary atherosclerosis and involved in the process of CHD. The levels of serum hs-CRP and 8-iso-PGF2α were correlated with the severity of CHD.

Abstract: Objective To evaluate the application of TB laboratory detection technology in Liaoning Province from 2016 to 2022, and to provide scientific basis for further improving the detection rate of Mycobacterium tuberculosis in the province. Methods The medical records of registered tuberculosis patients in Liaoning Province from 2016 to 2022 were collected from the "Tuberculosis Information Management System" in the "China Disease Prevention and Control Information System" subsystem. Statistical analysis was performed for sputum coating, sputum culture, and molecular biology testing. Results From 2016 to 2022, a total of 152 778 patients with pulmonary tuberculosis were registered in Liaoning Province. The detection rate of sputum smear microscopy was 98.03% (149 775/152 778), the detection rate of sputum culture was 20.72% (31 661/152 778), and the detection rate of molecular biology testing was 20.21% (30 737/152 778). From 2018 to 2022, the rate of molecular biological detection showed an increasing trend (χ2trend=7 104.466, P<0.01), while from 2016 to 2021, the detection rate of sputum culture showed an increasing trend, with statistical significance (χ2trend=3,068.701, P<0.01). The sputum smear detection rate showed a downward trend（χ2trend=689.913, P<0.01). . There were significant differences in the results of sputum smear microscopy, sputum culture, and molecular biology testing, as confirmed by the McNemar test (P<0.01). The positive rate of pathogenic academics increased from 26.27% in 2016 to 51.55% in 2022, showing a yearly upward trend (χ2trend=5 262.863, P<0.01), with significant differences between each year (χ2=5 686.935, P<0.01). Among pulmonary tuberculosis patients with positive pathogenic microorganisms, the proportion of sputum smear-positive cases decreased from 94.32% to 52.36%, showing a downward trend (χ2trend=5 010.104, P<0.01). The proportion of culture-positive cases increased from 5.68% in 2016 to 12.83% in 2022, showing an upward trend (χ2trend=122.501, P<0.01). In Liaoning Province, molecular biology testing has been carried out since 2018, and the proportion of molecular biology-positive cases increased from 11.51% to 34.81%, showing an increasing trend (χ2trend=1 969.326, P<0.01). The number of positive patients in molecular biological tests in municipal hospitals accounted for 18.69% (8 386/44 778) of etiological positive patients, while the number of positive patients in county-level hospitals accounted for 13.61% (2 439/17 924) of etiological positive patients, with significant differences (χ2=231.594, P<0.01). Conclusions The implementation of molecular biology testing for tuberculosis in Liaoning Province is one of the main measures to improve the positive rate of etiology, and it helps to diagnose tuberculosis patients timely and accurately

Objective To study the optimal management of the closed-loop management in safe practice of nursing teaching in private hospitals.Method Through analyzing the causes and problems during the teaching of nursing adverse events,the closed-loop management in safe practice of nursing teaching was investigated,including the closed-loop management team,implementation cycle and range,etc.Totally 100 teachers and 220 students were chosen in 27 clinical teaching departments of our hospital during January 2013 and March 2014.The teachers were divided into experimental group (n=50) and the control group (n=50).The closed-loop management model was applied in experimental group while routing management was applied in control group.At the same time,220 students' behavior in experimental group was compared before and after the closed-loop management.Through the evaluation of nursing teaching' safe hidden trouble and questionnaire survey,the nursing teaching of both groups were safe.SAS 9.2 was applied to do statistical analysis and non-parametric Wilcoxon Fisher exact test and x2 test were used.Results The number of teachers' operating key points in experimental group was significantly higher than the control group,with statistically significant differences (46 vs.15) (P=0.000).The safety hazard times of nursing teaching were 38 and 8 respectively before and after the closed loop management,and the difference was statistically significant (P=0.000).In addition,the comparison before the students' implementing the check system,hospital safety index patients and regulation for technical operations and hospital infection was significant after the closedloop management (P＜0.01 for all).Conclusion The full implementation of the closed-loop management,effective tracking and prevention in place,can optimize the safety management of nursing teaching.

Objective To determine the proper dosage of fentanyl for open heart surgery performed under cardiopulmonary bypass (CPB) without aortic cross-clamping and cardioplegia.Methods Twenty-seven ASA Ⅰ -H patients (10 male, 17 female) with fairly good cardiac function (NYHA Ⅰ - Ⅱ) scheduled for surgical repair of atrioseptal defect ( ASD) or ventricular septal defect (VSD) or mitral valve replacement (MVR) were studied. Age ranged from 18 to 44 years and body weight from 35 to 58 kg. The patients were randomly divided into three fentanyl dosage groups: group Ⅰ 10?kg ; group II 30 ?g kg-1 and group Ⅲ 50 ?g kg-1. Premedication consisted of intramuscular pethidine 1-2 mg kg-1 and scopolamine 0.05-0.06 mg kg-1 . Anesthesia was induced with midazolam 0.2 mg kg-1 and fentanyl 5 ?g kg-1 . Tracheal intubation was facilitated with vecuronium 0.15 mg g-1 . The patients were mechanically ventilated (Vr 8-10 ml kg-1 ,F 10-12 bpm,FiO2 100% ). The rest of the total dose of fentanyl (5 ?g kg-1 in group I , 25 ?g kg-1 in group II , 45 ?g kg-1 in group III) was infused after induction of anesthesia until the initiation of CPB, supplemented with inhalation of 0.6 % isoflurane. During CPB propofol was infused at 5 mg kg-1 h-1 . after discontinuation of CPB, again 0.6% isoflurane was inhaled until the end of surgery. Vecuronium 0.05 mg kg was given every 25-30 min during operation. EGG, HR, BP, CVP, SpO2, PET CO2 and body temperature (naso-pharyngeal and rectal) were continuously monitored during operation. Arterial blood samples were obtained before anesthesia (T0), 5 min after tracheal intubation (T, ) , immediately after thoracotomy (T2) , immediately before CPB (T3), 15 min after CPB was initiated (T4) , 10 min after termination of CPB (T5) and 5 min after chest was closed (T6) for blood gas analyses and determination of blood electrolytes and acid-base balance and blood concentrations of glucose, ACTH, angiotensin Ⅱ (A- Ⅱ ) and cortisol. Time of emergence from anesthesia and extubation were recorded.Results The demographic data, including age and body weight, CPB time and duration of surgery were comparable among the three groups. There were no significant changes in SpO2 , PETCO2 , body temperature, blood gases and electrolytes during operation in the three groups. MAP decreased significantly during CPB. The blood glucose, ACTH, A- Ⅱ and cortisol concentrations increased significantly during and after CPB as compared with the preanesthetic baseline (T0 ) ( P

Objective To evaluate the accuracy of Intraoperative Iso-C3D navigation guiding cervical pedicle screw fixation. Methods Twenty-two cases adopted cervical pedicle screw fixation of cervical spine, including 9 cervical spine fractures, 4 cervical tumors, 6 cervical destabilizing, 3 cervical syndrome. The cervical pedicle screw position were assessed with post-operative CT by grade. Results One hundred and twelve screws were fixed in 22 cases successfully. Grade: 107 in A grade (95.5%); 3 in B grade: 1 in C grade; 1 in D grade. There were not any complication. Conclusion Intraoperative Iso-C3D navigation can improve precision of cervical petiole screw fixation distinctively.

Objective To investigate if rat enhancer of split- and hairy-related protein-2 (SHARP-2) short hairpin RNA interference (shRNAi) prolongs the survival time of rat kidney transplant recipients. Methods Gene recombinant procedures, transfection and co-transfection were carried out to introduce short hairpin RNA interference sequences target for SHARP-2 into 3rd generation self-inactivated lentiviral-ViraPower packaging mix. Limiting dilution method was used for viral titration. Real-time PCR was employed for quantification of gene expression. Rat kidney transplantation was utilized to investigate the effect of SHARP-2 gene silence on the recipient survival. Results A lentiviral-based shRNAi construct LV-SHARP-2iC showed 84% SHARP-2 gene silence efficiency in normal rat kidney cells. At multiplicity of infection 20, 57% T cells could be transfected by lentivirus with spinoculation method. In activated T cells, SHARP-2 g ene silence resulted in 61.3% and 68.7% reduction of intedeukin 2 (IL-2) and interferon γ (IFN-γ) gene expression. When donor kidney was perfused with 5×107 TU LV-SHARP-2iC, the median survival time prolonged for 4-5 days as compared to blank and scramble control groups. Conclusions A recombinant lentivirus LV-SHARP-2iC that effectively silence SHARP-2 gene expression is constructed successfully, leading to the inhibition of IL-2 and IFN-γ. LV-SHARP-2iC treatment can prolong the survival time of rat kidney transplant recipients.