Objective To explore the importance of diabetic education and hypoglycemia nursing for population with high risk of hypoglycemia through analysis of the personal factors influencing incidence of hypoglycemia of type 2 diabetic patients during initial use of insulin.Methods There were 257 cases of T2DM hospitalized patients during initial use of insulin,among whom 80 experienced hypoglycemia.They were divided into two groups,one was the hypoglycemia group,another was the non-hypoglycemia group.Firstly,we compared the different characteristics of the two groups such as gender,BMI and HbAlc,and so on.And then,the possible risk factors of hypoglycemia were analyzed by a Logistic regression model.Finally,the most significant factors were analyzed with the ROC curve.Results These two groups were obviously different in seven elements such as BMI,Scr,HbAlc and TG,and so on.BMI and HbAlc were the most primary causes for prevention of hypoglycemia.When patients got HbAlc＜8.65％ or BMI＜26.3 kg/m2,they had more opportunity to occur hypoglycemia.Conclusions BMI and HbAlc of patients are primary causes for hypoglycemia.It is of great significance for nurses to enhance diabetes education to the patients with HbAlc＜8.65％ or BMI＜26.3 kg/m2 to alleviate the incidence of hypoglycemia.

Objective To analyze the feature of SLA specific T cell response in AIH. Methods Thirtyone cases of AIH were enrolled by investigating T-cell reactivity against chemically synthesized peptides spanning the full SLA protein using ELISpot. The 31 cases of AIH included 10 anti-SLA/LP positive cases and 21 negative cases. The control groups included 30 PBC patients, 29 chronic viral hepatitis patients and 30 healthy cases. The secretion of IFN-γ after PBMC stimulated by SLA peptides was observed. Results Eighteen of 31 cases with AIH [56. 08 % ( 18/31 ) ] showed the positive response to SLA peptide pools, and only 1 of 30 patients with primary biliary cirrhosis (3.34%) and 1 of 29 patients with virus hepatitis ( 3.44% ), could be elicited responses by SLA peptide pools. There wasn't positive response in healthy eases. The response frequency to SLA peptides in AIH group was significantly higher than those in PBC cases, chronic viral hepatitis cases and healthy cases (X2 = 21. 295, 20. 655, 15.988, P < 0. 01 ). Amongst 18 AIH patients with positive responds to SLA pool, 8 antigen clusters including aa 1-44, aa 57-132, an 129-180,aa 177-196, aa 193-244, aa 241-268, aa 281-308 and aa 321-428 were highlighted. The mean number of recognized peptides was 6 (2-17), indicating the polyclonal feature. Fourteen of 18 AIH patients with positive response to SLA peptides were subjected to live function test simultaneously when PBMC were collected. There was significant correlation between the breadth of recognized poptides and AST ( logarithm, r = 0. 539, P = 0. 045). Conclusions SLA peptides can induce PBMC in peripheral blood of AIH patients to secrete IFN-γ and it is polyclonal response. The breadth of recognized peptides may reflect the degree of liver inflammation.

Objective To investigate the significance of antibody to Ro-52 in patients with autoim-mune liver disease(AILD). Methods One hundred and fifteen patients with abnormal liver functions, who had anti-Ro-52 detection by immunological blotting, were reviewed retrospectively. According to types of AILD, the clinical features were compared between patients with and without anti-Ro-52, respectively, κ test of concordance was used to provide a chance-corrected valve for immune-serological results. Results The rates of anti-Ro-52 in autoimmune hepatitis( AIH), primary sclerosing cholangitis(PBC) and AIH/PBC o-verlap syndrome groups were 32.43%, 24.56% and 33.33%, respectively, there were no significant differ-enees among three groups ( x2 = 0. 949, P >0. 05). The rate of anti-soluble hver antigen/liver-pancreas ( an-ti-SLA/LP) in AIH patients with anti-Ro-52 (58.33%) was higher than AIH patients without anti-Ro-52 ( 16.00% ,P < 0.05 ). The rate of anti-SLA/LP in AIH/PBC overlap syndrome patients with anti-Ro-52 (85.71%) was also higher than that of control group (28.57% ,P <0.05). Anti-Ro-52 and anti-SLA/LP had concordance according to κ test( κ >0.40, P <0.05). The average level of IgG in AIH/PBC overlap syndrome patients with anti-Ro-52 was higher than patients without anti-Ro-52 ( t = 2. 508, P < 0.05 ). Conclusion The rates of anti-Ro-52 in AIH, PBC and AIH/PBC overlap syndrome were of no significant differences. Anti-Ro-52 may have correlation with anti-SLA/LP. AIH/PBC overlap syndrome patients with anti-Ro-52 shewed higher IgG level than patients without anti-Ro-52.

Objective To study the significance of antibody to double-stranded DNA (anti- dsDNA) in autoimmune hepatitis(AIH). Methods Anti-dsDNA were detected by immunological blotting. According to the anti-dsDNA, the patients were separated two groups: anti-dsDNA positive group and anti-dsDNA negative group. The clinical characteristics were compared between anti-dsDNA positive AIH group and negative group. Results Among the 43 serum samples, 13 (30.23%) eases with anti-dsDNA positive were found. The average level of AST(aspartate aminotransferase) and TBIL(total bilirubin) were (647.56 ±529.77) IU/L and (10.81± 8.08) rag/L, respectively, which was higher than that of the control group (P < 0.05). PTA (prothrombin activity) was 75.72%± 30.23 %, lower than that of the control group(P < 0.05). The liver cirrhosis rate in the anti-dsDNA positive AIH group was 61.5% (8/13), ,significantly higher than that of the control group. The time from the onset to liver cirrhosis was significantly shorter in an- ti-dsDNA positive AIH group than that of control group by the survival analysis and log rank test (P = 0. 0074). Conclusion AIH patients with anti-dsDNA positive generally associate with the serious liver damage, and prognosis is worse.

Objective To explore the feasibility and effectiveness of interventional transcatheter destruction of the aortic valve to establish an animal model with acute aortic valve regurgitation. Methods Eight healthy goats were used for this study. A limited sternotomy approach was used to access the apex of the heart. Puncturing of the apex of the heart was performed to establish a wire track, then, under fluoroscopic guidance a 10 F sheath was inserted along this track of hard wire until to the ascending aorta above the aortic valve. The internal sheath was removed. Via the 10 F sheath a 10 mm occluder of ventricular septal defect (VSD) was introduced into the ascending aorta above the aortic valve. The sheath was pulled back to the left ventricle, while the occluder remained in the ascending aorta above the aortic valve. Then the occluder was quickly pulled back into the left ventricle in order to make some certain damage to the aortic valve. And an acute aortic valve regurgitation model was thus established. Angiography of ascending aorta above the aortic Among the 8 animals, two died of acute left ventricular failure on the spot due to excessive regurgitation blood flow after the operation. Macroscopically, damage of the aortic valve was seen. In the six survivors, angiography of ascending aorta above the aortic valve and Doppler echocardiography showed that moderate degree of regurgitation was detected in 5 and small amount of regurgitation in one. Two experimental goats with moderate degree of regurgitation died of heart failure separately at seven days and fifteen days after the operation. The remaining four experimental goats survived for more than three months. Follow- up checkups with echocardiography suggested the presence of mild- moderate degree of regurgitation. Conclusion Acute aortic valve regurgitation model in experimental goats can be established through transapical transcatheter damage of aortic valve by quickly pulling back a VSD occluder which has been placed in the ascending aorta above the aortic valve. This method is clinically feasible, technically simple and repeatable, the result is reliable, and the degree of regurgitation is controllable.

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.