Objective To study the clinical and THR?gene mutation of two cases of pituitary thyroid hormone resistance. Methods The clinical data and peripheral blood samples of the patients and their family members were collected, and then DNA was isolated. PCR and direct sequencing techniques were performed to determine if there were mutations in their THR?gene. Results No mutation was found in exon 1-10. Conclusion Pathogenesis of sporadic pituitary resistance to thyroid hormone usually has no relation with mutation of THR?gene.

Objective To observe the distribution of dopaminergic neurons in SNpc and to establish standard curve in normal mice so as to measure the changes of dopaminergic neurons in number in SNpc of the mice toxicated with MPTP. Methods Ten male C57BL6 mice aged 8-12 weeks, weight 20-22 g, were randomized to receive 20 mg/kg MPTP or physical saline every 3 h for 4 times, then killed 7 d later. The mouse mesocerebrum was taken out and fixed, frozen, sectioned. All sections containing SNpc were observed under the guide of mouse brain atlas. Every other sections were chosen to stain tyrosine hydroxylase (TH) to show dopaminergic neurons immunohistochemically. The TH positive cells in SNpc were counted in each section and the standard curve was established. Results The standard curve of SNpc compact part position and TH positive cells was established. By comparing the standard curves for the MPTP intoxicated mice and the saline mice, TH positive cells in SNpc from MPTP toxicated mice decreased significantly, which confirmed the validity and feasibility of the standard curve. Conclusion The establishment of standard curve greatly facilitates the comparison of specimen from different groups and makes the assessment of dopaminergic neuron loss more accurate and efficient. The standard curve can serve as an excellent reference curve for the assessment of dopaminergic neurons in SNpc in normal C57BL6 mice.

Objective To evaluate how proprioception affect ankle stability through comparing angle position awareness and peroneus reaction time between chronic ankle lateral instability patients and healthy controls.Methods A total of 51 participants were recruited into an experimental group of 21 patients with chronic ankle lateral instability (17 males,aged 31.6±2.6) and a control group of 30 healthy counterparts (24 males,aged 34.2±2.3).All the participants were asked to reoccur passive ankle position under the angular velocity at 2 degree per second when they were resting with non-weight bearing in their recruited ankles.The muscle reaction time (MRT)of peroneus longus(PL) and peroneus brevis (PB) in all the recruited ankles was measured during sudden ankle inversion both with and without ankle protective brace wearing.Results The difference between angle recurrence and the target angle (ankle inversion 20° and 30°) was significantly higher (P＜0.05) in the experimental group compared to the control group.The average MRTs of PL and PB were also significantly longer (P＜0.05) in the experimental group than the control group,whether wearing ankle protective braces or not.However,within both groups,no significant differences of PL and PB's MRT were identified between brace wearing and no brace (P＞0.05).Conclusions In patients with chronic lateral ankle instability,the position awareness decreases and the reaction time of peroneus is prolonged.Ankle braces can provide mechanical protection to the injured joints,but cannot promote MRT significantly.

Private cloud is an internal cloud featuring multi-tenant,dynamic configuration and optimization infrastructure,which enables developers to achieve service self-deployment and self-hosting within security coverage of the enterprise data center.This paper introduced the concept of cloud computing.Then it went on to present the private cloud architecture of the hospital by analysis of problems in the hospital including information construction costs,management and maintenance,and information expansion.In the end,the authors analyzed the cloud computing service model,hospital private cloud architecture,along with outcome analysis for hospital private cloud implementations.

This is a follow-up study in two patients who were diagnosed with the occult ectopic adrenocorticotropin syndrome ( EAS) and treated with mifepristone in our hospital. The efficacy and adverse reactions of mifepristone in these two patients with EAS were investigated. The patients had significant improvement in clinical manifestations, the plasma adrenocorticotropic hormone ( ACTH) and cortisol levels decreased in patient 1, while patient 2 remained stable during the treatment. Patient 1 with diabetes mellitus stopped hypoglycemic agents, while the dose of antihypertensive drugs decreased in patient 2 with hypertension, and she was treated with surgery and suffered from transient adrenocortical insufficiency after surgical excision of the lesion. Mifepristone is effective and safe in treating EAS. Surgical treatment should be performed once the lesion is found during the follow-up.

Objective:To develop the Perioperative Blood Glucose Management Knowledge Questionnaire for Surgical Nurses and test its reliability and validity.Methods:From January to June 2019, the questionnaire item pool was constructed through literature review, and 13 experts were included in two rounds of Delphi consultation using purposive sampling. In July 2019, convenience sampling was used to select 50 clinical nurses from the surgical ward of the First Affiliated Hospital of Xi'an Jiaotong University as the research subject. A preliminary survey was conducted to form an initial Perioperative Blood Glucose Management Knowledge Questionnaire for Surgical Nurses. From August to September 2019, 110 clinical nurses from this ward were selected as the research subject again, and the questionnaire was subjected to item screening and reliability and validity testing.Results:The final Perioperative Blood Glucose Management Knowledge Questionnaire for Surgical Nurses included five dimensions of factors influencing blood glucose abnormalities, hazards of blood glucose abnormalities, preoperative and postoperative nursing observation points, emergency treatment of perioperative critical conditions, and key points for perioperative blood glucose management, with a total of 19 items. In the two rounds of consultation, the positivity coefficients of experts were both 100.00% (13/13), the authority coefficient of experts was 0.88, and the coefficients of variation for two rounds of consultation were 0 to 0.30 and 0 to 0.17. Exploratory factor analysis extracted five common factors, with a cumulative variance contribution rate of 66.70%. The Cronbach's α coefficient of the total questionnaire was 0.92, the test-retest reliability coefficient was 0.97, and the scale-level content validity index was 0.98.Conclusions:The Perioperative Blood Glucose Management Knowledge Questionnaire for Surgical Nurses has good scientific and practical significance, and can be used as an effective tool to evaluate the perioperative blood glucose management knowledge among surgical nurses.

Objective To develop a blood glucose management knowledge questionnaire for perioperative patients with hyperglycemia and test its reliability and validity.Methods The initial questionnaire was formed through literature review,expert consultation,two rounds of Delphi letter consultation,and pre-survey.From August to September 2019,a total of 125 perioperative patients with hyperglycemia who were hospitalized in the surgical ward of the First Affiliated Hospital of Xi'an Jiaotong University were selected as the survey objects by the convenient sampling method.The items of the questionnaire were screened and the reliability and validity were tested.Results A total of 125 questionnaires were distributed and 115 valid questionnaires were returned,with an effective recovery rate of 92.0%.The blood glucose management knowledge questionnaire for perioperative patients with hyperglycemia included five dimensions(17 items in total),including influencing factors and hazards of abnormal blood glucose,key points of preoperative and postoperative nursing observation,perioperative blood glucose control goals,perioperative blood glucose management points,and emergency treatment of perioperative critical conditions.The effective recovery rates for both rounds of inquiry are 100.00%,the expert authority coefficient was 0.880 and the average coefficient of variation was 0.086 and 0.065(P＜0.01).Exploratory factor analysis extracted a total of five common factors,and the cumulative variance contribution rate was 79.895%.The Cronbach's α coefficient of the questionnaire was 0.905,the test-retest reliability was 0.955,and the content validity index was 0.968.Conclusions The blood glucose management knowledge questionnaire for perioperative patients with hyperglycemia is scientific and practical,which can be used as an effective tool to evaluate the blood glucose management knowledge level during perioperative period.

Objective:To explore the effect of nursing multidisciplinary team (MDT) combined with informational blood glucose management in blood glucose management of perioperative patients in virtual ward.Methods:We selected 132 responsible nurses in 9 wards of the First Affiliated Hospital of Xi'an Jiaotong University for professional training by convenience sampling, and established a nursing MDT of blood glucose management. Remote treatment for perioperative hyperglycemic patients was carried out to achieve standardized management of perioperative glucose by using the blood glucose information networking platform and the hospital information management system to build a virtual ward. A total of 416 perioperative hyperglycemic patients hospitalized in our hospital from January to August 2018 were selected and divided into control group and experimental group according to the admission time. A total of 209 patients of control group were treated with traditional blood glucose management, and 207 patients of experimental group were treated with nursing MDT combined with informational blood glucose management. We compared the theoretical performance of the responsible nurses in the target department before and after training, the blood glucose one day after admission, one day before surgery, one day before discharge, fasting blood glucose, 2-hour blood glucose after three meals of patients between two groups. We also observed number of hyperglycemia reports, the number of timely treatments for hyperglycemia, the time from admission of perioperative hyperglycemic patients to issuing medical orders for endocrine consultation and the time for the endocrine consultation implementation in patients between two groups.Results:After training, the theoretical performance of the responsible nurses in the target department was improved compared with that before training, and the difference was statistically significant ( P<0.01) . There was no statistical difference in the blood glucose one day after admission between two groups ( P>0.05) . The blood glucose of patients in experimental group was lower than that in control group one day before surgery, one day before discharge, fasting blood glucose, and blood glucose of 2-hour blood glucose after breakfast, lunch and dinner with statistical differences ( P<0.01) . The number of hyperglycemia reports, the number of timely treatments for hyperglycemia of patients in experimental group was more than that in control group; the time from admission of perioperative hyperglycemic patients to issuing medical orders for endocrine consultation and the time for the endocrine consultation implementation of experimental group was shorter than that of control group also with statistical differences ( P<0.01) . Conclusions:This study builds the informational blood glucose management networking platform and develops virtual ward management through establishing nursing MDT of blood glucose management. It enhances the target department nurses' perioperative blood glucose management knowledge level, and raises the target department's medical and nursing staff's blood glucose management awareness, and improves the blood glucose effects of perioperative hyperglycemic patients, which has certain clinical promotion value.