Objective To study the effects of standardized-lifestyle intervention on the type 2 diabetic elder patients.Methods The study group enrolled 270 individuals with type 2 diabetes mellitus randomly by using the model of “Zhiji Health Care” and the software of the lifestyle and disease prevention system.Parameters were collected during a six month period for the evaluation,such as fasting plasma glucose(FPG),postprandial glucose(PPG),cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),body mass(BMI),glycosylated hemoglobin(HbAlc),blood pressure,daily intake,total physical activity and effective physical activity and other indicators.Results After six months' standardized lifestyle intervention:(1)in the type 2 diabetic patients,the parameters of weight,BMI,waist circumference,systolic and diastolic blood pressure were significantly decreased(t values were:23.82,25.91,19.56,23.37 and 19.53,respectively,all P ＜ 0.01); FPG,PPG,HbA1c,TC,TG and LDL-C were significant decreased compared with that before intervention(t values were: 12.06,11.82,9.74,6.98,5.79 and 6.10,respectively,all P ＜ 0.0l).Meanwhile,HDL-C was significantly increased(t =2.51,P ＜ 0.05).(2)the total daily intake was significantly reduced compared with that before intervention.The effective exercise burden was significantly increased,compared with that before intervention(P ＜ 0.01).Conclusion Standard lifestyle management helps to control the blood glucose,blood pressurem,body weight and other risk factors,with reduction of complications and medical costs.

Objective To compare the serum thyroid hormones level in patients with pre-diabetes,newly diagnosed type 2 diabetes mellitus(T2DM)and healthy people,and to investigate the association of glucose metabolism with thyroid function.Methods Sixty newly diagnosed T2DM patients(T2DM group),60 pre-diabetes patients(pre-diabetes group),and 60 healthy people(healthy group) from outpatient departments were randomly enrolled in the study.Their thyroid peroxidase antibodies(TPOAb),thyroglobulin antibodies(TGAb),thyrotropin receptor antibodies(TRAb),and thyroid color dopplar ultrasound were all normal.Thyroid hormones was measured.Glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),glycated albumin(GA) was additionally measured in T2DM patients.We compared the difference of thyroid hormones among the 3 groups and investigated the factors that influence thyroid hormones level in each T2DM patients.Results There was no significant difference found on thyroid hormones level between the pre-diabetes group and healthy group(P＜0.05).T3 and FT3 level were(1.34±0.24)nmol/L and(3.88±0.51)pmol/L in the T2DM group,respectively,which were significantly lower than those in the pre-diabetes group([1.48±0.29]nmol/L and [4.12±0.55]pmol/L,t=-0.135 and -0.145,respectively,Ps＜0.01＝ and in the healthy group([1.49±0.26]nmol/L and [4.13±0.55]pmol/L,t=-0.240 and -0.260,respectively,P＜0.05 or 0.01) .In the T2DM group,T3 and FT3 were negatively correlated with FPG,GA,HbA1c(For T3:r=-0.275,-0.318 and -0.453,respectively,Ps＜0.05;For FT3:r=-0.280,-0.291 and -0.336 ,respectively,Ps＜0.05).Conclusion In patients with abnormal glucose metabolism, thyroid hormone was influenced only when the glucose metabolism level reached a certain abnormal degree.

Objective To investigate the nursing cooperation in clinical application of RetCamⅢ wide-field digital pediatric retinal imaging system.Methods 119 patients were given pointed nursing guidance while they underwent RetCamⅢ wide-field digital pediatric retinal imaging system examination.Results All patients accomplished the examination.29 cases had adverse reactions after using mydriatic.27 cases felt discomfort during the examination.22 cases appeared adverse reactions after examination,but relieved after nursing cooperation and guidance.Conclusions RetCamⅢ wide-field digital pediatric retinal imaging system is a rapid,safe and effective method for pediatric fundus examination.Favorable nursing cooperation and guidance is the guarantee of accurate and effective examination and harmonious relationship between doctor-nurse-patient.

Objective To investigate the association of leptin receptor gene Gln223Arg polymorphism with metabolism syndrome and insulin resistance. Methods The genotypes of leptin receptor in 167 patients with metabolic syndrome and 216 healthy subjects were determined by polymerase chain reaction restriction fragment length polymorphism. The biochemical indicators were detected. Results The frequency of A alleles was significantly higher in patients with metabolic syndrome than in healthy subjects. The risk of metabolic syndrome in inviduals with allele A was 3. 302 folds of that with allele G( P<0.01 ). Compared with allele G, the patients withA allele had higher body mass index,blood pressure, blood glucose, insulin level, waist circumference, and more serious dyslipidemia. The risk of insulin resistance in patients with A allele was 3. 446 folds of that with allele G (P<0.01). Conclusions Leptin receptor gene Gln223Arg polymorphism is associated with an increased risk of metabolic syndrome and insulin resistance.

Objective To investigate the therapeutic effects of alendronate combined with Caltrate D on regional bone mineral density (BMD) in elderly type 2 diabetic women with osteoporosis. Methods Thirty-four elderly type 2 diabetic women with osteoporosis aged 60-79 years (average 68. 0±4.5 years), with body mass index (BMI) of (25.0±3.7) kg/cm2 and duration of diabetes (8.9 ±4.4) years were enrolled. At the basis of a comprehensive management, the patients were treated with alendronate combined with Caltrate D for 6 months. BMD of the lumbar spine and hip, several biochemical indexes were measured before and after treatment. Results After the 6 months treatment, the BMD of different regions at lumbar spine and hip all increased. The T value and BMD were significantly higher at lumbar spines than at hip (both P＜0.01). The differences of T value and BMD of different regions were significant (P = 0.003 and 0.005,respectively). BMD percent change at lumbar spine were L4 (44.7%) ＞ L3 (31.9%) ＞ L total (27.3 % ) ＞ L1 (20.0%) ＞ L2 (14.3 % ), and the BMD percent changes were significantly higher in L3 and L4 than in other regions at lumbar spine (P=0. 038 and 0. 008, respectively). The changes of T value and BMD were significantly higher in L3, L total, L1 and L4 than in L2 (T value: P=0. 036,0. 042, 0. 006 and 0. 004, respectively; BMD: P=0. 002, 0. 002, 0. 003 and 0. 001, respectively).Conclusions On the basis of comprehensive management, the 6 months treatment with alendronate combined with Caltrate D in elderly type 2 diabetic women with osteoporosis may achieve good therapeutic effect at lumbar spines, especially at the lower lumbar spines, while less effective at hip.

Objective:To explore the value of magnetic resonance imaging (MRI) parameters combined with serum macrophage migration inhibitory factor (MIF) and microRNA-1203 (miR-1203) in the early diagnosis of hepatocellular carcinoma (HCC) and its relationship with efficacy.Methods:From October 2017 to October 2019, 100 patients with HCC in Hunan Provincial Hospital of Traditional Chinese Medicine were selected as the observation group. 92 patients with benign liver tumor and 102 healthy people were randomly selected as the control group and normal control group. The clinicopathological features, MRI parameters [hepatic artery perfusion index (HPI), volume transfer constant (K trans)], serum MIF and miR-1203 levels were compared among the three groups; the value of MRI parameters, serum MIF and miR-1203 in single and combined diagnosis of HCC was explored; the relationship between each index and curative effect of HCC patients was analyzed. Results:The levels of HPI, K trans, serum MIF and miR-1203 in observation group were higher than those in control group and normal control group ( P<0.05); There were significant differences in HPI, K trans, serum MIF and miR-1203 levels among patients with different tumor length, differentiation degree, Child Pugh grade and distant metastasis in the observation group ( P<0.05). Among HPI, K trans and serum MIF, miR-1203, the specificity of HPI and K trans for diagnosis of HCC were the largest (94.57%), and the sensitivity of K trans for diagnosis of HCC was the largest (75.00%); the area under the curve (AUC) of the combined diagnosis of HCC was 0.879, which was greater than the AUC of the single diagnosis of HPI, K trans and serum MIF, miR-1203 (0.753, 0.793, 0.792, 0.809); the optimal sensitivity and specificity of the combined diagnosis were 79.00% and 86.96%, respectively; the levels of HPI, K trans, serum MIF, and miR-1203 in effective patients in the observation group were lower than those in the ineffective patients after treatment ( P<0.05); the clinical efficacy of HCC patients were significantly correlated with the levels of HPI, K trans, serum MIF and miR-1203 ( P<0.05). Conclusions:The MRI parameters HPI, K trans and serum MIF, miR-1203 levels in patients with HCC increased significantly, which has high application value in assisting clinical diagnosis of HCC, and is closely related to the clinical efficacy of patients, and has great development potential in efficacy evaluation.

Objective To study the effect of estrogen on myocardial injury in hypothyroidism rats and to reveal the pathology of occurrence and development of the myocardial injury in hypothyroidism rats.Methods The model of hypothyroidism rats was established by feeding propylthiouracil.The pathology of the female group ( n =40 ) and male group ( n =40 ) was observed dynamicly.The presence of myocardial apoptosis cell was demonstrated by the method of terminal deoxynucleotidyl transferase mediated dTUP nick end labeling (TUNEL).And the immunohistochemistry was used to determine the expression of Caspase-3 and Bcl-2 in the myocardial cells.Results The myocardial cell apoptosis appeared in hypothyroidism rats.With the development of the disease,the apoptosis myocardial cell was increased progressively (Female rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 weeks were 16.40 ± 2.62,29.50 ± 2.67,34.50 ± 3.34,42.70 ±3.24,and 56.00 ± 2.90 respectively,P ＜ 0.05 ; Male rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 week were 21.60 ± 2.67,35.50 ± 2.94,41.70 ± 2.96,46.70 ± 3.11,and 60.70 ± 3.31respectively,P ＜ 0.05 ),which indicated that estrogen may be related to myocardial cell apoptosis.Conclusion The myocardial cell apoptosis is related with the myocardial injury in hypothyroidism rats.Myocardial cell apoptosis may result in the myocardial injury.The estrogen participates in regulating apoptosis,but its function gradually weakens with the development of the hypothyroidism.

Objective To explore the effect of inhibiting Akt phosphorylation on tumor necrosis factor related apoptosis inducing ligand (TRAIL)-induced apoptosis of human non-small cell lung cancer (NSCLC) H1299 cells with wild type EGFR and KRAS.Methods The TRAIL-induced apoptosis was examined by the Annexin V-FITC/PI.The expressions of TRAIL-activated Akt phosphorylation and p-Akt were measured by Western blot.After cells were treated with LY294002, an inhibitor of PI3K-Akt pathway, Annexin V-FITC/PI and Western blot were used to analyze the alteration of TRAIL-induced apoptosis and Akt phosphorylation, respectively.Results H1299 cells were not sensitive to TRAIL-induced apoptosis.When TRAIL concentration was 100 ng/ml, the apoptosis rate of the test group was significantly higher than that of the control group [(15.06±1.29) ％ vs (3.56±0.50) ％, t =66.953, P =0.000].When TRAIL concentration was 500 ng/ml, the difference was not statistically significant compared with apoptosis rate of 100 ng/ml TRAIL group [(18.65±2.09) ％ vs (15.06±1.29) ％, t =2.423, P =0.136].The expression level of Akt phosphorylation in H1299 cells was increased by TRAIL in a time-dependent way.When cells were pretreated with LY294002, TRAIL-induced Akt phosphorylation was suppressed to baseline level.At the same time, the apoptosis rate in LY294002-treated group was significantly higher than that in TRAIL group [(41.65±4.62) ％ vs (15.82±0.61) ％, t =39.028, P =0.001].Conclusions TRAIL-induced Akt phosphorylation can antagonize TRAIL-induced apoptosis.Inhibition of Akt phosphorylation can significantly enhance the sensitivity of NSCLC H1299 cells with wild type EGFR and KRAS to TRAIL-induced apoptosis.

Objective To study the changes and mechanism of calcaneal quantitative ultrasound (QUS)and the bone mineral density( BMD) of AP lumbar spine( L 2-L 4 ) in elderly patients with type 2 diabetes mellitus. Methods Calcaneal broadband ultrasound attenuation ( BUA) ,sound of speed ( SOS ) and stiffness( STI) by QUS ,BMD of the AP lumber spine by dual energy X-ray absorptometry ( DXA ) and some biochemical markers of bone metabolism in elderly patients with type 2 diabetes mellitus ( n=94 )and in healthy control group ( n=90 ) were measured . Results L 2 BMD values(g/cm 2)of male group with type 2 diabetes mellitus was 0.863, which was lower than that of control group ( 0.931, P

Objective To translate Parents' Perception of Uncertainty Scale (PPUS) into Chinese,analyze and selected items,and then test the reliability and validity of the Chinese version of PPUS initially.Methods 210 parents of hospitalized children were recruited for the investigation.Frequency analysis,dispersion degree analysis,correlation analysis and so on were applied to analyze and select items.Internal consistency test,Pearson correlation analysis and exploratory factor analysis etc.were applied to test reliability and validity of the scale.Results The final Chinese version of PPUS contained 28 items.The Cronbach α and parity split-half reliability coefficients were 0.844 and 0.835; The Cronbach α coefficient of 4 dimensions ranged from 0.537 to 0.770.The item-total scale correlation coefficient ranged from 0.300 to 0.737.Item-dimension correlation coefficients ranged from 0.376 to 0.762.Item-other dimension correlation coefficients ranged from 0.028 to 0.514.Dimension-total scale correlation coefficients ranged from 0.480 to 0.863 and those between dimensions ranged from 0.226 to 0.536.In the content validity assessed by experts,I-CVI ranged from 0.75 to 1.00,S-CVI/Ave was 0.928.Four-factor model was performed in the principal component analysis and they explained for 41.401％ variances.The maximum factor loading of all items were higher than 0.3,and most of items had adequate loadings in related dimensions.Conclusions Chinese version of PPUS had appropriate reliability and validity as an assessment tool for parental uncertainty in illness of hospitalized children' parents.