Objective To evaluate the application value of the one-stepdiabetes education management system in clinic. Methods The “one-step” diabetes education management system was construct.80 newly diagnosed patients with type 2 diabetes mellitus were selected and randomly divided into the control group and the experimental group with 40 patients in each group.The patients in the experimental group received “one-step”diabetes education management system by diabetes specialist nurses,while patients in the con-trol group received routine diabetic education.The fasting blood glucose (FBG),HbAlc,medical compliance behaviors and other indices were compared between two groups. Results FBG,HbAlc and medical compliance were better,and the risk score of complications was higher in the experimental group than those of the control group,there were significant differences between them. Conclusions Application of “one-step”diabetes education management system in treatment and nursing of patients shows maneuverability and practicality.It has clinical application value and deserves to be spread.

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function, diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin (30 mg/kg). After 8 weeks intervention with perindopril (AE, n=10) or valsartan (AR, n=10), the islet function of the animals was evaluated by intravenous insulin release test (IVIRT). The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor (VEGF) in the islets. The microvessel density (MVD) of islets was detected by counting CD34 positive cells. The hypoxia inducible factor (HIF)-1alpha mRNA expression in the islets was detected by RT-PCR. Compared with normal control group (NC, n=10), the area under the curve for insulin from 0 to 30 min (AUCI(0-30)) of diabetes group (DM, n=8) was decreased by 66.3%; the insulin relative concentration (IRC) of betacell was decreased significantly; the relative content of VEGF was increased obviously [(-4.21+/-0.13) vs (-4.06+/-0.29)]; MVD in islets was decreased by 71.4%; the relative expression of HIF-1alpha mRNA was increased by 1.19 times (all P<0.01). Compared with DM group, the AUCI(0-30) of AE and AR group was increased by 44.6% and 34.9% respectively; IRC was also increased significantly; the relative content of VEGF was decreased by 21.2% and 21.7% respectively; MVD was increased by 62.5% and 75.0% respectively; the relative expression of HIF-1alpha was decreased by 27.2% and 29.0% respectively (all P<0.01 or P<0.05). There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

OBJECTIVE: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) versus ultrasonography (US) in symptomatic patients with dense breasts, while using histology as the gold standard.MATERIALS AND METHODS: After obtaining approval from the local ethics board, this prospective study collected data from patients with symptomatic breasts who underwent CESM and US examinations from May 1, 2017 to September 30, 2017. We then selected those with dense breasts and pathological results as our sample population. Both CESM and US results were classified by a radiologist through the Breast Imaging Reporting and Data System, and the results were compared with their corresponding histological results. The chi-square test was conducted to compare the diagnostic performance of CESM and US, and the receiver operating characteristic curves for the two imaging modalities were obtained.RESULTS: A total of 131 lesions from 115 patients with dense breasts were included in this study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 93.8%, 88.1%, 88.2%, 93.7%, and 90.8% for CESM, and 90.6%, 82.1%, 82.9%, 90.2%, and 86.3% for US, respectively. The p values for sensitivity, specificity, PPV, NPV, and accuracy were 0.687, 0.388, 0.370, 0.702, and 0.238, respectively. The area under the curve of CESM (0.917) was comparable with that of US (0.884); however, the differences between CESM and US were not statistically significant (p = 0.225). Eight false-positive cases and 4 false-negative cases for breast cancer were found in CESM, while 12 false-positive cases and 6 false-negative cases were found in US.CONCLUSION: The diagnostic performances of CESM and US are comparable in symptomatic women with dense breasts; however, the routine use of additional US imaging is questionable for lesions that can be detected by CESM.

ObjectiveTo investigate the status quo of parental perception and its influencing factors in parents with children undergoing invasive treatment for congenital heart disease(CHD), and to provide evidence for the development of targeted interventions. MethodsBy convenience sampling, from January to September of 2018, 200 fathers or mothers whose children underwent invasive treatment for CHD in a Class ⅢGrade A hospital in Changchun were selected as participants in the study. The Parental Perception Vulnerability Scale, the Self-rating Anxiety Scale (SAS), and the Social Support Scale (SSRS) were used to investigate the participants. ResultsA total of 200 questionnaires were distributed and 185 valid questionnaires were retrieved. The 185 parents of the sick children achieved a total score of (5.59±2.66) points in the Parental Perception Vulnerability Scale. Whether the sick child was the only child of the parents was the influencing factor of the parents' perception vulnerability (P＜0.05). The parents' age, relationship with the sick children, educational level, family monthly income, degree of social support were the influencing factors of parental perception vulnerability in CHD children's parents(P＜ 0.05). ConclusionsWhether the sick child was the only child of the parents or not, the parents' age, relationship with the sick children, educational level, family monthly income, degree of social support were the influencing factors of parental perception vulnerability in CHD children's parents, therefore, the medical staff should pay more attention to the above population group.

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function,diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin (30 mg/kg). After 8 weeks intervention with perindopril (AE,n=10) or valsartan (AR,n=10),the islet function of the animals was evaluated by intravenous insulin release test (IVIRT). The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor (VEGF) in the islets. The microvessel density (MVD) of islets was detected by counting CD34 positive cells. The hypoxia inducible factor (HIF)-1α mRNA expression in the islets was detected by RT-PCR. Compared with normal control group (NC,n=10),the area under the curve for insulin from 0 to 30 min (AUCI0-30) of diabetes group (DM,n=8) was decreased by 66.3%;the insulin relative concentration (IRC) of βcell was decreased significantly;the relative content of VEGF was increased obviously [(-4.21±0.13) vs (-4.06±0.29)];MVD in islets was decreased by 71.4%;the relative expression of HIF-1α mRNA was increased by 1.19 times (all P＜0.01). Compared with DM group,the AUCI0-30 of AE and AR group was increased by 44.6% and 34.9% respectively;IRC was also increased significantly;the relative content of VEGF was decreased by 21.2% and 21.7% respectively;MVD was increased by 62.5% and 75.0% respectively;the relative expression of HIF-1α was decreased by 27.2% and 29.0% respectively (all P＜0.01 or P＜0.05). There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

Background::The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF.Methods::This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD.Results::The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age; to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2DS 2-VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions::AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.