Objective Diabetes is a common chronic disease in the elderly and needs long-term treatment. This study aims to determine the effect of extended nursing service in rehabilitation of army retired officers with diabetes. Methods We selected 78 ca-ses of military retired officers with diabetes from September 2010 to September 2012 in Nanjing General Hospital of Nanjing Military Region. According to the different intervention methods, patients were divided into experimental group and control group( n=39 cases) . The control group used conventional nursing service, and the experimental group added extended nursing service on the basis of the control group . After one year follow-up, the fasting blood glucose level, glycosylated hemoglobin ( HbAlc) , self-rating depression scale (SDS) evaluation and self-rating anxiety scale (SAS) and the changes of patients′ satisfaction of the two groups were observed. Results The fasting blood glucose levels and HbAlc of experimental group were significantly better than control group, with statisticalsignificance (P<0.05);The SAS scores (34.9±5.9)and SDS scores (36.9±4.5) of experimental group were significantly lower than the control group(52.3±4.2 and 55.9±3.9), with statistical significance ( t=5.489, t=5.226, P<0.05);The satisfaction degree of the exper-imental group was significantly higher than the control group (99.8%vs 79.9%, χ2=4.898, P<0.05). Conclusion the extension ofnursing service in health rehabilitation in the retired veteran cadres in the army with diabetes can effectively improve the patient′s fast-ing blood glucose levels, reduce depression, as well as improving the nursing service satisfaction.

BACKGROUND: The most commonly used rod-screw posterior spinal fixation system has some biomechanical drawbacks. The screw-plate system is more preferred for patients.OBJECTIVE: To prepare a new posterior spinal fixation system based on imaging results of distance between two pedicles,radian of spine flexion, extension and the height of intervertebral space of Chinese population.METHODS: The thoracolumbar data of 129 normal people were measured. According to the imaging measurements and relative documents, a device of gear-distraction plate (GDP) for spine reduction and fixation was designed. Eighteen fresh calf lumbar specimens were randomly divided into 3 groups, the test group was fixed by GDP and the other groups were fixed by CD and Steffee plate, respectively. The results of the displacement, strain, strength, stiffness and ultimate strength were measured under the states of vertical compression, flexion, extension and lateral bending respectively, and the results were statistically analyzed.RESULTS AND CONCLUSION: GDP could meet the need of strength and stiffness of human bodies. It showed superior to the CD and Steffee plate groups in strength and stiffness (P ＜ 0.05), with 13% or 14% torsion intensity greater than that of the CD or Steffee plate groups. The ultimate mechanical performance test showed that, the load bearing of the GDP group was greater than that of the CD and Steffee plate groups (P ＜ 0.05). The findings demonstrated that GDP for Chinese human presented with good biomechanical stability, which can promote vertebrae fracture union and prevent kyphosis relapses or vertebral height loses.

Objective To explore the long-term effect, prognosis and administration of corticosteroid treatment on autoimmune pancreatitis (AIP). Methods Clinical data were analyzed in 13 diagnosed and followed up AIP patients of Peking Union Medicine College Hospital during August 2004 to August 2008. Results Of 13 patients, 12 were males and 1 was female, with a mean age of 58.7 years old, and a mean follow-up of 30 months. Of 11 patients compliated with bile duct disease,biliary stents were placed in 9 patients and already taken out. Corticosteroid treatment was received by cured patients. The average corticosteroid therapeutic time was 9.2 months, 7.9 months in 6 biliary stent placed patients, 13.4 months in corticosteroid treated alone patients, the statistical difference was significant (P = 0. 023). Serum inflammatory parameters normalized range from 5. 3 to 8.8 weeks. After corticosteroid treatment, pancreas enlargement improved in all patients at the first imaging reexamination (1.0 to 11.3 weeks), pancreatic size normalized in 9 patients with an average of 16.6 weeks corticosteroid treatment. No relapsing sign was found with imaging examination during follow-up. Of 8 newly onset diabetes patients, glucose level normalized in 4 patients after corticosteroid treatment. Two patients complicated with autoimmune hepatitis developed early hepatic cirrhosis symptoms at the end of the follow-up. Swollen submandibular gland enlargement relapsed in one patient after corticosteroid withdrawn for six months. Conclsion AIP patients responsed well to corticosteroid treatment. Placement of biliary stent could shorten corticosteroid therapeutic time.Patients with bile duct complications and newly onset diabetes could partially relieve after the corticosteroid treatment, the prognosis of patients with autoimmune hepatitis complications was relatively poor.

Objective To study the transfeetion efficiency and safety of liposome microbubble(LM)on red fluorescent protein(RFP)in vitro and in vivo under ultrasound mediated gene transfection(USMGT)conditions.Methods Plasmids containing RFP were added to cultured Hela cells followed by ultrasound (US)exposure with LM.Different concentration of LM,US intensity and exposure time were optimized.Transfection efficiency was evaluated by fluorescent microscopy and FACS.Cell viability was verified by propidium iodide assay.In transplanted tumors in vivo study,LM and plasmid(P)were injected into the nude mice followed by US exposure(P+LM+US group).Nude mice undergoing plasmid injection alone(P group),plasmid injection and US exposure(P+US group)and plasmid and LM injection(P+LM group)were used as controls.Frozen section and histological examination were conducted and RFP expression was evaluated.Results LM and US exposure significantly increased transfeetion efficiency in cultured Hela cells (P＜ 0.01).Transfection efficiency was the most prominent under the condition of US intensity of 1.0 W/cm2 with 6%LM,duration 3 min.No apparent cell damage was found in the all groups.In transplanted tumors,strong RFP was seen in P+LM+US group.It was significantly higher than in any other groups(P＜0.0 1).No tissue damage was seen histologically.Conclusions LM could enhance USMGT effectively without causing any apparently adverse effect in vitro and in vivo.This method would be a novel,effective,safe non-viral gene transfection method and provide an alternative to current clinical gene therapy.

Objective To probe into the clinical value of left atrial(LA) volme tracking method (LAVT) on the assessment of left atrial function in patients with hypertension. Methods Thirty-one patients with hypertension and 31 control subjects were involved. Images of apical two-chamber and four-chamber views were obtained by two-dimensional echocardiography. LA maximal volume (LAVmax), LA minimal volume (LAVmin), LA presystolic volume (LAVpre), systolic LA filling rate (dv/dtS), early diastolic LA emptying rate (dv/dtE) and late diastolic LA emptying rate (dv/dtA) were derived using LAVT. LA passive emptying volume(LAVp), LA passive emptying fraction(LAVpEF), LA active emptying volume(LAVa), LA active emptying fraction (LAVaEF), LA total emptying volume (LAVt), LA total emptying fraction(LAVtEF) were calculated. All volume measurements were corrected to body surface area (LAVI). Results There were significant differences in the LAVImax, LAVImin, LAVIpre, LAVpEF, LAVIa, LAVIt,dv/dtS, dv/dtA between hypertensive patients and control subjects(P <0.05~0.001), but no significant differences were found in the LAVp, LAVaEF, LAVtEF,dv/dtE between the two groups. The LAVImax has shown significant positive correlation with LAVIp, LAVIa and LAVIt(r = 0.588~0.812, P <0.001). LAVaEF has shown positive correlation with the LAVtEF(r = 0.833, P<0.001), whereas LAVpEF has not(r = 0.420, P <0.01). There was a significant positive correlation with LAVImax and LAVIpre(r = 0.908, P <0.001), LAVIpre and LAVIa(r = 0.689, P <0.001) ,dv/dtE and LAVIp(r = 0.690, P <0.001),dv/dtA and LAVIa(r = 0.600, P <0.001). Conclusions In hypertensive patients,left atrial reservoir function and booster pump function increase, while left atrial conduit function decreases. LAVT has a potential ability to evaluate left atrial function.

Objective To compare broth microdilution and agar dilution methods for in vitro testing of activities of fluconazole,ketoconazole and itraconazole against clinical Malassezia isolates.Methods Broth microdilution and agar dilution methods were used to determine the minimal inhibitory concentration(MIC)of fluconazole,ketoconazole and itraconazole for 27 clinical strains(5 species)of Malassezia.Results The minimal inhibitory concentration(MIC)ranges of fluconazole,ketoconazole and itraconazole were 0.25-≥64 mg/L,≤0.03-0.5 mg/L and ≤0.03-0.125 mg/L respectively as shown by broth microdilution method,2-≥64 mg/L,≤0.03-0.5 mg/L and ≤0.03-0.25 mg/L respectively as revealed by agar dilution method.Both methods demonstrated that itraconazole possessed the strongest activity against Malassezia species,followed by ketoconazole and fluconazole.The agreement rate in MICs between the two methods was 78.8％,85.2％ and 88.9％,respectively for fluconazole,ketoconazole and itraconazole,with the intraclass correlation coefficients (ICCs)being 0.88,0.80 and 0.76 respectively.Conclusions Fluconazole,ketoconazole and itraconazole are highly active against Malassezia species in vitro,and itraconazole is the most active.Broth microdilution and agar dilution method coincide well in,and are applicable for,the antifungal susceptibility testing of Malassezia species in vitro.

Objective To investigate the value of time parameters(the transit time in coronary and the half filling time in myocardium)in assessing the blood flow of ischemia myocardium through establishing canine model of acute myocardial infarction.Methods Eighteen healthy anesthetized open-chest dogs were ligated the left anterior descending(LAD),3 hours later the contrast agent(C3F8)was injected into femoral vein in a fixed velocity to perform myocardial contrast echocardiography(MCE)examination.The first perfusion and the replenishment processes were recorded by real-time tri-plane MCE(RT-TP-MCE)and real-time single-plane MCE(RT-SP-MCE)respectively.both the two different processes were analyzed by the function Y=A ×(1-e-βt)+B.RT-SP-MCE used A(plat of peak intensity)and β(slope rate of the curve)values to quantitatively calculate the myocardial blood flow(MBF=A×β).The time point of the first microbubbles coming into the left ventricle was normalized to O in RT-TP-MCE,the time point of the first microbubbles coming into the myocardium was defined as the transit time in coronary(Tc),and the time point when microbubbles in myocardium achieved the 50% plat video intensity was defined as the half filling time in myocardium(Tm).Evans blue dye and TTC staining were performed to identify normal.ischemic and infarct myocardium.Results The time parameters of the two groups-normal myocardium and ischemic myocardium from RT-TP-MCE were:Tc(10.1±1.3)s and(20.4±7.1)s(P＜0.01),Tm(17.1±2.2)s and(39.7±8.8)s(P＜0.01).There were significantly negative correlation between the time parameters(Tc,Tm)and MBF from RT-SP-MCE in ischemic myocardium(r=-0.876,P＜0.01;r2=-0.894,P＜0.01).Conclusions The first perfusion imaging with RT-TP-MCE could be used to simultaneously,quantitatively evaluate the myocardial perfusion.The lower flow,the longer transit time in coronary and half filling time in ischemic myocardium.

Objective By analysing the clinical features of Indigo Naturalis-associated ischemic lesion of colon mucosa to improve the precautionary and therapeutic level of the disease.Methods Thirteen patients diagnosed as Indigo Naturalis-associated ischemic lesion of colon mucosa in Peking University Third Hospital from 2005 to 2010 were reviewed.The endoscopic and clinical features were analysed.Results The 13 patients with an average age of(60.6±14.1)years old were prescribed Chinese traditional medicine containing Indigo Naturalis for psoriasis or idiopathic thrombocytopenic purpura(ITP).The ratio of males to females was 1:1.6.The typical manifestations were abdominal pain and bloody stool with watering diarrhea before bloody stool in 61.5%patients.Endoscopic and pathological characteristics were coincident with ischemic lesion and more like a chronic index.Vasodilatic medicine was effective and the average hemostatic time was(1.7±0.8)days.The prognosis was well and no recurrence was found during 3 months follow-up.Conclusions Patients having psoriasis or ITP treated with Chinese traditional medicine containing Indigo Naturalis have an inclination to colon mucosa lesions, even ischemic lesion. Careful assessment and observation before prescribing arc necessary in these patients.

Objective To establish a human keratinocyte cell line (HaCaT) stably expressing HPV16E7 protein. Methods HPV16E7 gene was amplified from CaSki cells using PCR and inserted into the eukaryotic expression plasmid pcDNA3.1. Then, the recombinant expression plasmid pcDNA3.1-HPV16E7 was transfected into HaCaT cells followed by G418 selection and identification by RT-PCR and Western blot. Results The recombinant eukaryotic expression plasmid pcDNA3.1-HPV16E7 was successfully identified by restriction enzyme digestion pattern and sequence analysis. Agarose gel electrophoresis of RT-PCR products detected the 297-bp fragment of HPV16E7 cDNA, and Western blot confirmed the stable expression of HPV16E7 protein. Conclusion A human keratinocyte cell line (HaCaT) stably expressing HPV16E7 protein is successfully established.

This study is to investigate the effects of phenytoin sodium, lidocaine (sodium channel blockers), propranolol (beta-adrenergic receptor antagonist), amiodarone (drugs prolonging the action potential duration) and verapamil (calcium channel blockers) on arrhythmia of mice induced by Bufonis Venenum (Chansu) and isolated mouse hearts lethal dose of Chansu. Arrhythmia of mice were induced by Chansu and then electrocardiograms (ECGs) were recorded. The changes of P-R interval, QRS complex, Q-T interval, T wave amplitude, heart rate (HR) were observed. Moreover, arrhythmia rate, survival rate and arrhythmia score were counted. Isolated mouse hearts were prefused, and the lethal dose of Chansu was recorded. Compared with control group, after pretreatment with phenytoin sodium, broadening of QRS complex and HR were inhibited, and the incidence of ventricular arrhythmia was reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with lidocaine, the prolongation of P-R interval and broadening of QRS complex were inhibited, and the incidences of ventricular arrhythmia were reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with propranolol, prolongation of P-R interval, broadening of QRS complex, prolongation of Q-T interval and HR were inhibited, and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically, while survival rate was improved. After pretreatment with amiodarone, HR was inhibited, the incidences of ventricular tachycardia were reduced dramatically. Lastly, after pretreatment with verapamil, the prolongation of P-R interval and Q-T interval were inhibited and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically; the isolated mouse hearts lethal dose of Chansu was reduced significantly. In in vivo experiments, phenytoin sodium was most effective against the mice arrhythmias induced by Chansu while cautious use of verapamil for Chansu inducing arrhythmia should be noted. It is also concluded that mice ventricular arrhythmias induced by Chansu might be most closely related to sodium channel, supraventricular arrhythmias might be related to beta-adrenergic receptor, and calcium channel plays an important role in conduction block. In in vitro experiments, phenytoin sodium was most effective, followed by lidocaine and propranolol, and amiodarone had no obvious effect and verapamil reduced the lethal dose of Chansu.