Objective To investigate the prevalence and risk predictors of depressive tendency in type 2 diabetic patients with peripheral neuropathy.Methods From May 2017 to December 2017,150 diabetic patients with peripheral neuropathy and 150 diabetic patients without peripheral neuropathy in the First Affiliated Hospital of Harbin Medical University were collected.The general clinical data,including age,sex,diabetic duration,height,weight,body mass index (BMI),fasting blood glucose (FBG),fasting insulin (FINS),homeostasis modal assessment-insulin resistance index(HOMA-IR),glycated hemoglobin(HbA1c),blood lipid and blood pressure were collected.The motor nerve and sensory nerve conduction velocity of lower limbs were measured by electromyograph.Zung depression self-rating scale(SDS) was used for self-rating of depression syndrome.Results There were 46 cases(30.67％) suffered from depression(SDS ＞50) in the neuropathic group,and 25 cases(16.67％) suffered from depression in the non-neuropathic group.The incidence rate of depression in the neuropathic group was significantly higher than that in the non-neuropathic group and tended to be severe (x2 =12.732,P =0.005).Non-conditional Logistic multivariate stepwise regression analysis showed that sex,the course of diabetes and low density lipoprotein (LDL) were associated with depressive tendency (x2 =3.994,P =0.049;x2 =5.334,P =0.032;x2 =6.172,P =0.020).Conclusion The prevalence of depression in diabetic patients with peripheral neuropathy is higher and tends to be severe.Sex,the course of diabetes and LDL are risk factors of depressive tendency.

Objective To study the clinical effects of bundle intervention strategy on the prevention of CVC-related bloodstream infections. Methods A total of 847 patients were enrolled, of whom 411 cases received central venous catheterization ( CVC) from June 2008 to June 2010 were allocated to control group with 5760 catheter days and traditional central venous catheter care. While a total of 436 cases from September 2010 to September 2012 were allocated to observation group with 6110 catheter days and performed bundle intervention strategy. The site and duration of CVC, and incidence of CVC-related bloodstream infections between two groups were compared. Results The length of catheter indwelling in the observation group was ( 8 ± 3 ) d which was shorter than (13 ± 7)d in the control group (t=2. 672,P=0. 008). A total of 436 patients of observation group had total 6 110 d catheter indwelling time, in whom14 cases happened CRBSI with incidence rate 2. 3 per one thousand catheter day;411 patients of the control group had 5 760 d catheter indwelling time, in whom 38 cases occurred CRBSI with incidence rate 6. 6 per one thousand catheter day; the difference of CRBSI rate in two groups had statistical significance (χ2 =12. 60,P =0. 002). Conclusions The implementation of bundle intervention strategy can effectively minimize the incidence of CVC-related bloodstream infections.

Objective To investigate the prevalence of gestational transient thyrotoxicosis(GTT) and analyze the cause of thyrotoxicosis encountered in this period MethodsAn epidemiologic survey in ten hospitals in Shenyang was performed and 534 pregnant women during the first trimester of pregnancy filled questionaire,received physical examination and had serum thyroid-stimulating hormone(TSH),free T4 (FT4),free T3(FT3),thyroid peroxjdase antibody(TPOAb),thyrotrophin receptor antibody(TRAb),and human chorionic gonadotrophin(hCG)tests.Results(1)The total prevalence of thyrotoxicosis was 9.75%(52/534)in the first trimester and the prevalence of Grrr was 7.86%.which accounted for 80.77%of the thyroxicosis encountered in this period.A total of 88.89%of the overt GTT showed only elevated FT3 level.(2)The level of serum hCG increased gradually in the first trimester.The medians of hCG were 25 300,85 220 and 81 780 IU/L 6,8-10 and 12 weeks after gestation.respectively(P=0.000).The medians of serum TSH were 1.45.1.10 and 0.84 mlU/I,6.8-10 and 12 weeks after gestation,respectively(P＜0.01).(3)When segum hCG was more than 50 000 IU/L,the prevalece of GTT increased obviously.When serum hCG was between 80000 IU/L and 110000 IU/L,subclinical GTT increased significantly.When serum hCG was more than 110000 IU/L,overt GTT increased significantly.Correlation analysis showed that serum hCG was related negatively with TSH(r=-0.402,P=0.000)and positively with FT3(r=0.165,P=0.000),but not related with FT4.Conclusions The prevalence of GTT is 7.86%in the first trimester and it is the main cause of thyrotoxicosis found in the first trimester,accounting for 80.77%of all the causes.The serological characteristic of overt GTT is mainly the elevation of serum FT3 leveL Serum hCG level is related with the severity of GTT.