Objective To explore the effect of insulin subcutaneous pump combined with psychological intervention on gestational diabetes mellitus.Methods A total of 118 patients were enrolled in this study from November 2015 to October 2016 in Lishui central hospital.The patients were randomly divided into the experimental group and the control group according to the time of hospitalization.The experimental group was given insulin subcutaneous pump combined with psychological intervention.The control group was given insulin subcutaneous pump.Results After intervention, the degree of complete compliance in the experimental group was 86.44% and 28.81% before intervention, the difference was statistically significant(P<0.05).Compared with before treatment, blood glucose and glycosylated hemoglobin were decreased after treatment(P<0.05).The incidence of complications in the two groups include: pregnant women with excessive amniotic, neonatal hypoglycemia, pregnancy induced hypertension syndrome and so on.The difference of complication rate between the two groups was statistically significant(P<0.05).Conclusion The timely and accurate psychological guidance of pregnant women with diabetes mellitus can control the blood glucose in the normal range, reduce the occurrence and development of maternal and child complications, and ensure the safe and healthy mother and child health.

The study aimed to investigate the effects of small ubiquitin-related modifier (SUMO) specific protease 1 (SENP1) on human PXR-mediated MDR1 transcriptional activity and mRNA expression. Empty vector and expression plasmids, including PXR, SENP1 and SENP1 mutant (SENP1m) were transiently transfected into HepG2 and LS174T cells using Lipo2000. Transcriptional activity was detected by dual luciferase reporter gene assay, and mRNA level was measured using real-time polymerase chain reaction. The results showed that SENP1 could remarkably reduce the rifampicin (RIF)-induced MDR1 reporter activity and mRNA level in hPXR over expressed HepG2 and LS174T cells (P < 0.05), whereas adding SENP1m restored the RIF-induced increases (P < 0.05). These results indicated that SENP1 could repress the RIF-induced hPXR-mediated MDR1 transcriptional activity and mRNA expression.

Knowledge-attitude-practice model is widely used in the self-management of type-2 diabetes.Through proper education,patients can gain diabetic knowledge as well as positive attitude on glucose control.By regulating diet,exercise,self glucose monitoring and medication compliance,diabetic patients are able to control blood glucose more effectively,and have less complications and higher quality of life.Researches on the application and effectiveness of various diabetic knowledge,attitude and self-management behavior scales are reviewed in this article.

[ABSTRACT]AIM:ToinvestigatetheroleofquercetinintheapoptosisofhumanbreastcancercelllineMCF-7 and the association with Fas/Fas ligand (FasL) pathway.METHODS: The apoptosis model of MCF-7 cells was estab-lished by the induction with quercetin .The morphological characteristics of apoptotic MCF-7 cells were observed under transmission electron microscope .The apoptotic rates and alternation of mitochondrial membrane potential (Δψm ) in the MCF-7 cells were measured by flow cytometry using fluorescein labeled Annexin V-FITC/PI and JC-1, respectively.FasL neutralizing antibody was applied to block the apoptosis .The expression of Fas/FasL on the cells was detected by immuno-fluorescence technique and flow cytometry , respectively.The influence of SB203580 (an inhibitor of p38 MAPK) on the expression of Fas/FasL was also examined by flow cytometry .The protein levels of p 38 MAPK and p-p38 MAPK were de-termined by Western blot .RESULTS: The phenomenon of nuclear condensation and marginalization in the MCF -7 cells treated with quercetin at 80.0 μmol/L for 48 h was observed under transmission electron microscope .Compared with the control cells , theΔψm was decreased by 17.4%, 44.3% and 68.9% in the MCF-7 cells treated with quercetin at 80.0μmol/L for 24 h, 48 h and 72 h, respectively .The apoptotic rates of MCF-7 cells treated with quercetin at 80.0 μmol/L for 24 h, 48 h and 72 h were (10.2 ±3.3)%, (28.9 ±7.5)%and (39.2 ±8.9)%, respectively.However, the apop-totic rates were decreased to (8.2 ±2.8)%, (19.2 ±5.3)% and (22.5 ±6.9)% after the cells were pretreated with FasL neutralizing antibody , respectively .When MCF-7 cells were treated with quercetin for 24 h, 48 h and 72 h, Fas/FasL expression rates were increased in a time-dependent manner , which were largely inhibited by SB203580.The protein level of p38 MAPK was not changed obviously , but the protein level of p-p38 MAPK was significantly increased at 48 h and 72 h.CONCLUSION: Quercetin up-regulates the expression of Fas/FasL on MCF-7 cells, and induces apoptosis via Fas/FasL pathway .Meanwhile , p-p38 MAPK is potentially critical signaling molecule for up-regulating the expression of Fas/FasL.

Objective To identify the model parameters of surface Electromyography (sEMG) by comparison between simulated and recorded signals. Methods A physiological model of sEMG signal was established basing on several logical hypothetical conditions, such as motor unit action potentials (MUAP), motor unit recruitment and firing behavior caused by excitation, architecture of volume conductor and other simulated factors. According to the matched shapes between the simulated and recorded sEMG signals, a group of model parameters was obtained; according to the similar power spectrum variations of real sEMG signals, decreased muscle fiber conduction velocity (MFCV) was applied to simulate the sEMG signals of the fatigued muscle. Results The experimental results showed that the simulated superimposed MUAP shapes could be matched with the recorded MUAPs satisfactorily by adjusting some proper physiological parameters of the model. When the MFCV of each fiber was assumed to decrease, the mean and median frequency (MNF, MDF) of the simulated sEMG signals declined, and this phenomenon was very similar to that of the recorded sEMG signals and could be used to interpret the muscle fatigue process. Conclusion This model provides an effective approach to simulate real sEMG signals, and the simulated signals can also be used to help the analysis of recorded sEMG signals.

Objective:To investigate the effects of intensity modulated radiation therapy (imRT) and risk factors of radiation pneumonia caused by imRT in elderly patients with esophageal cancer.Methods:The clinical data of 80 elderly patients diagnosed with esophageal cancer and performed imRT in Traditional Chinese Medicine Hospital of Kunshan from February 2018 to February 2020 were analyzed, and the therapeutic effect and the incidence of adverse reactions were counted.Results:In the 80 patients, 13 patients occurred radiation pneumonia.The results of univariate analysis showed that the gender, smoking history, pathological stage and age had no correlation with radiation pneumonia ( P> 0.05), while tumor location, diabetes, concurrent chemotherapy, reradiotherapy and chronic obstructive pulmonary disease had correlation with the occurrence of radioactive pneumonia ( P<0.05). The levels of V30, V35, V40 between radioactive pneumonia patients and non-radioactive pneumonia patients had no significant differences ( P>0.05), but the levels of V5, V10, V15, V20 and mean lung dose(MLD) between radioactive pneumonia patients and non-radioactive pneumonia patients had significant differences ( P<0.05). The effect of imRT was no remission in 9 cases (11.25%), partial remission in 59 cases (73.75%) and complete remission in 12 cases (15.00%), and the clinical effective rate was 88.75%(71/80). By comparing the adverse reactions caused by imRT, it was found that the incidence of radiation esophagitis, leukopenia, and acute radiation pneumonia were 93.75%(75/80), 12.50%(10/80) and 22.50%(18/80), respectively, with grade 1 and grade 2 adverse reactions. Conclusions:Risk factors for radiation pneumonia in elderly patients with esophageal cancer after imRT include tumor location, diabetes, V5, V10, V15, V20, MLD, concurrent chemotherapy, reradiotherapy and chronic obstructive pulmonary disease.

Objective:To investigate the lymphocyte subsets and clinical characteristics of children with abnormal reaction to Bacillus Calmette-Guérin(BCG)vaccination.Methods:A total of 35 children with BCG disease diagnosed in the Children′s Hospital Affiliated to Xi′an Jiaotong University from January 2013 to December 2019 were enrolled retrospectively.Patients with strong local reaction and lymphadenitis after vaccine injection were selected as the localized group, and with lymphadenitis complicated with distant organ involvement were classified as the disseminated group.The differences in clinical infection indicators, demographic data, lymphocyte subsets and prognosis between the two groups were compared.Results:There are 25 cases in the localized group and 10 cases in the disseminated group, male 20 cases and female 15 cases.Compared with the localized group, the incidence of cough, fever and growth retardation all increased in the disseminated group, with statistical significance(all P<0.05). Lymphocyte ratio[(61.14±18.61)% vs.(39.64±31.45)%], T lymphocytes [CD3 + (×10 6/L): (1 821±487)vs.(1 065±539)], helper/inducible T lymphocytes[CD3 + CD4 + (×10 6/L): (1 058±357)vs.(445±140)], double positive T lymphocytes[CD3 + CD4 + CD8 + (×10 6/L): (24.07±7.17)vs.(14.10±8.89)], CD4 + /CD8 + ratio[CD4 + /CD8 + (%): (1.65±0.73)vs.(1.00±0.25)], natural killer cells[CD16 + CD56 + (×10 6/L): (19.70±2.34)vs.(12.76±7.01)]were lower in the disseminated group than those in the localized group and the differences were significant(all P<0.05). In the disseminated group, 6 cases were diagnosed with immunodeficiency disease and 7 cases died during the follow-up period.All the children in the localized group were cured. Conclusion:Most BCG reaction have a good prognosis, while disseminated children combined with primary immune deficiency have worst prognosis.Early lymphocyte subsets analysis is effective for BCG disease screening.

Objective:To investigate the predictive value of central nervous system specific protein B (S100B)combined with neuron specific enolase(NSE)and serum lactate for severe neonatal hypoxic ischemic encephalopathy(HIE)induced by perinatal asphyxia.Methods:A retrospective study was conducted.A total of 126 neonates admitted to the Intensive Care Unit of Children′s Hospital Affiliated to Xi ′an Jiaotong University due to perinatal asphyxia from April 2019 to April 2022 were selected as the research subjects.Neonates who were clinically diagnosed with HIE were selected as the observation group(45 cases), and those without HIE were selected as the control group(81 cases). The differences of each parameter between the two groups were compared.Univariate and multivariate Logistic regression were used to analyze the indicators that might cause severe HIE.The risk factors were put into the receiver operating characteristic curve(ROC)to analyze their predictive value for prognosis.Results:There were no significant differences in gestational age, weight and gender between the two groups(all P>0.05). The Apgar scores in the observation group were lower than those in the control group; the rates of cardiopulmonary resuscitation, mechanical ventilation, and prolonged labor were higher than those in the control group.These differences are statistically significant(all P< 0.05). Compared with the control group, the observation group showed significantly higher rates of abnormal brain electroencephalogram and cranial magnetic resonance imaging, as well as increased levels of lactate, S100B( t-values for 8 h and 72 h were 13.10 and 2.00 respectively), and NSE( t-values for 8 h and 72 h were 10.85 and 15.57 respectively), all with statistical significance(all P< 0.05). By conducting binary Logistic regression analysis on indicators that might cause HIE, it was found that Apgar scores at 5 minutes and 10 minutes were negatively correlated with the risk of severe HIE( OR<1 and P<0.05). Prolonged labor, as well as factors such as cardiopulmonary resuscitation, mechanical ventilation, S100B concentration at 8 hours after birth, NSE concentration at 8 hours after birth, and lactate levels were all risk factors for poor prognosis( OR>1 and P<0.05). The predictive threshold values for severe HIE using the biochemical markers S100B, NSE, and lactate were 1.87 μg/L, 19 μg/L, and 4.6 mmol/L respectively.The sensitivity of prediction were 78%, 68%, and 75% respectively; while the specificity were 66%, 71%, and 67%, and all area under the curve(AUC)was greater than 0.5.The sensitivity of the combined prediction by the three factors was 87%, with a specificity of 79% and AUC 0.86( P<0.05). Conclusion:S100B, NSE and serum lactate are independent risk factors for predicting neonatal serve HIE, and the combination of the three indicators can improve the predictive efficiency.

Objective To survey the status of knowledge and management capability on diabetic kidney disease (DKD) among general practitioners (GPs) in community health service centers (CHCs) of Shanghai.Methods A questionnaire survey was conducted among 152 GPs from 6 CHCs in 3 districts of Shanghai during May 2015 and March 2016.Results In the current survey,138 (90.8％) valid questionnaires of DKD knowledge and 152 (100.0％) valid questionnaires of DKD management capability were retrieved.The overall accuracy rate of DKD knowledge was 60.2％ (1 246/2 070);the accurate rates of epidemiology,diagnosis,treatment,and community management knowledge were 62.7％ (173/276),62.8％ (520/828),60.6％ (502/828)and 35.5％ (49/138),respectively.There were significant differences in accuracy rates of treatment related questions among GPs with different years of working (P =0.032 2);but no significant differences were observed in accuracy rates of 4 aspects related questions among GPs with different education and professional title (P ＞0.05).Among 152 participants,113 (74.3％) responded to conduct DKD screening in clinic work;97(63.8％) chose renal function,86 (56.6％) chose urine routine and 86 (56.6％) chose urinary microalbumin for screening,respectively.The top three answers to "how to intervene patients with DKD" were blood glucose control(107,70.4％),medication of ACEI or ARB (77,50.7％),and high-quality low protein diet (68,44.7％).Conclusion The knowledge and management capability on DKD among GPs in CHCs are insufficient.The capability of diagnosis and treatment of DKD should be improved by joint efforts of GPs,trainers,and community health administrators.

Objective: To investigate the association between tea consumption and lung cancer risk in Chinese males. Methods: Tea consumption and incident lung cancer cases were collected on a biennial basis among males in Kailuan Cohort during 2006-2015. Up to 31st December 2015, a total of 103 010 male candidates from the Chinese Kailuan Male Cohort Study were enrolled in the present study. Cox proportional hazards regression model was used to evaluate the association between tea consumption and risk of lung cancer in males. Results: The age of male candidates was (51.3±13.4)years old. There were 828 810.74 person-years of follow-up and 8.91 years of median follow-up period. During the follow-up, 964 lung cancer cases were identified. In male, the rate of never cosumers, tea drinkers (<4/week) and tea drinkers (≥4/week) were 58.17%(n=59 926), 24.04%(n=24 765) and 17.78%(n=18 319), respectively. After adjustment for potential confounding factors, HR (95%CI) of lung cancer for subjects with tea drinkers (<4/week) and tea drinkers (≥4/week) were 0.80 (0.63-1.02) and 1.02 (0.80-1.30), respectively, as compared with never cosumers. The results showed no significant association with lung cancer. Stratification analysis and sensitivity analysis showed no significant changes. Conclusion Our study has not found that tea consumption is significantly associated with the risk of male lung cancer.