Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus) in diabetes combined with nerve deafness using 1 H magnetic resonance spectros‐copy (1 H -MRS) ,and to discover the early warning indicator of nerve deafness in type 2 diabetes .Methods PTA was performed in 98 patients with type 2 diabetes (diagnosed by Endocrinology Department) ,and in 15 healthy sub‐jects in the control group .The patients were classified into four groups :the group of type 2 diabetes;type 2 diabe‐tes with unilateral and bilateral deafness ,and the normal control group .Cerebral metabolism was studied by assess‐ing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo-in‐ositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups . The Pearson correlation analysis was applied to determine blood glucose value with the nerve metabolites while the ROC curves were made for those metabolism markers to find the best diagnostic threshold .Results NAA/Cr and NAA/Cho were negatively correlated with AHI index and Cho/Cr ,mI/Cr was positively correlated with blood glu‐cose value .Significantly lower values of NAA/Cho ratio were found in patients'(diabetes without deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) .NAA/Cr and NAA/Cho ratio in diabetes with deafness were significantly lower than those in control group (P< 0 .05) ,Cho/Cr higher than those of in other groups (P<0 .05) .NAA/Cr and NAA/Cho ratio in injured and uninjured auditory cortex of diabetes with unilateral deafness were significantly lower than those of in control group (P<0 .05) ,then we made a self -comparison be‐tween the injured and uninjured auditory cortex ,finding that NAA/Cho ratio had a significant difference .All of the metabolisms were tested by the curve of ROC .The area of NAA/Cho under the ROC curve was 81% ,which had a higher accuracy .NAA/Cho equal to 1 .65 can be used as boundary indicators between diabetes without deafness and diabetes with deafness groups ,the areas of the remaining indicators under the ROC curve was<50% .Conclusion NAA/Cho may be the early warning marker of nerve deafness in type 2 diabetes .

Objective To study three-dimensional computerized quantification for clinical stage Ⅰ lung invasive adenocarcinoma with different histopathological subtypes.Methods Pathological and HRCT data of 273 patients within clinical stage Ⅰ lung invasive adenocarcinoma underwent surgery from January 2005 to December 2012 were retrospectively collected.The proportion of ground glass opacity component and solid component in tumor were calculated by three-dimensional computerized quantification.All specimens were classified into 3 grades (grade 1 as the lepidic pattern of invasive adenocarcinoma,grade 2 acinar or papillary patterns,grade 3 micropapillary or solid patterns).The proportion of different components among different histopathological grades was evaluated by Kruskal-Wallis test.The correlation between components in tumor and histopathologic subtypes grade were evaluated by Spearman correlation.Results In 273 patients,49(17.9％) were assessed as grade 1,208(76.2％) grade 2,and 16(5.9％) grade 3.The proportion of ground glass opacity component and solid component in grade 1,grade 2,and grade 3 were 18.40％ (10.00％-33.45％),6.55％ (2.00％-18.00％),1.70％ (0.20％-3.85％) and 29.80％ (11.75％-47.35％),66.60％ (35.40％-83.85％),88.50％ (75.28％-93.60％),respectively.Significant differences among different histopathological grades were observed(x2=37.74,47.73,P＜0.01).The proportion of ground glass opacity component was negative correlation with histopathologic grade(r=-0.37,P＜0.01),while the proportion of solid component was positive correlation with histopathologie grade(r=0.42,P＜0.01).Conclusion Three-dimensional computerized quantification for lung invasive adenocarcinoma may predict histopathological grade.

Aim To investigate the effects of midazolam on porcine isolated coronary artery rings pre-contracted by potassium chloride(KCl)and the possible mechanism.Methods The vessel tension recorder system was used.Isotonic tension of porcine isolated coronary artery rings precontracted by KCl(30 mmol·L-1)was recorded.The vasorelaxing action of midazolam and effects of various drugs were observed in the rings.Results Midazolam(3×10-6～1×10-4 mol·L-1)respectively concentration-dependently reduced the contraction induced by KCl,and there was significant difference between the rings with intact and denude endothelium(P<0.05).On KCl-induced precontraction,midazolam′s relaxation was depressed by L-NAME and the blend of L-NAME and L-Arg(P<0.05),but was not affected by Indo,L-Arg and 1400W.The contraction was not prevented by pretreatment with the inhibitor of Na+/Ca2+ exchanger(KB-R7943).The inhibitor of KATP(Gli)restrained the diastolic function of midazolam(P<0.05),while the inhibitor of BKCa(TEA),Kir(BaCl2),KV(4-AP)had no obvious effect.Conclusions Midazolam produces remarkable vasodilatation on KCl pre-contracted porcine isolated coronary artery rings.Its relaxtion effect is via concentration-dependent and endothelium-dependent mechanisms and relevant to the production of NO.Na+/Ca2+ exchanger is not involved midazolam′s vasodilatation on KCl pre-contracted porcine coronary artery rings.The relaxant mechanism of midazolam may be concerned with KATP.The Kir,BKCa and KV may be not involved.

Objective To investigate the effect of lysyl oxidase (LOX) gene expression on proliferation, invasion and radiotherapy sensitivity in laryngeal cancer Hep-2 cells. Methods Hep-2 cells were divided into control group (normal cultured), negative control group (transfection reagent) and transfection group (LOX siRNA transfected). The expressions of LOX, Ki-67, PCNA, MMP-2 and MMP-9 mRNA were detected by real time-PCR and Western blot methods. The cell sur-vival rate and apoptosis irradiated by different doses of X-rays (0, 3, 6, 9, 12, 15 and 18 Gy) were detected by MTT and flow cytometry (FCM). Results The expression levels of LOX, Ki-67, PCNA, MMP-2 and MMP-9 protein and mRNA were sig-nificantly lower in Hep-2 cells after transfection than those of control group and negative control group (P<0.05). The cell survival rate was significantly inhibited 24 hours after irradiation (12, 15 and 18 Gy) in a dose-dependent manner (P<0.05). The apoptotic rate of transfection cells combined with radiotherapy was significantly higher than that of control and the nega-tive control groups (%:79.11 ± 1.26 vs 5.01 ± 1.02, 4.95 ± 1.12, 43.21 ± 2.1,P<0.05). Conclusion The expression of LOX can be down-regulated after LOX siRNA transfection, inhibiting proliferation and enhancing radiosensitivity, which may be related to the down-regulation of Ki-67, PCNA, MMP-2 and MMP-9 protein expression.

Objective To investigate histopathological and ultrastructural differences between melasma tissues and normal skin tissues around pigmented nevus. Methods Eight patients with melasma and 16 patients with facial pigmented nevus were included in this study. Two millimeter punch biopsies were taken from melasma lesions and adjacent normal skin of facial pigmented nevus. Biopsy specimens were then subjected to hematoxylin?eosin (HE) staining, Fonton?Masson staining, Verhoeff?van Gieson staining, and immunohistochemical staining with monoclonal antibodies HMB45 and NKI/beteb. Transmission electron microscopy was used to observe the tissue specimens. Semi?quantitative analysis was performed under a light microscope, and quantitative analysis by using a computerized image analysis system. Results Histopathological study revealed increased number of melanin granules mainly in the basal and prickle cell layers, sometimes in the dermis, in melasma tissues compared with normal skin tissues. Melanocytes were only observed in the epidermis of melasma tissues. Compared with normal skin tissues, melasma tissues showed no significant difference in the quantity of melanocytes, but a significant increase in the volume, staining intensity and dendrite number of melanocytes. In all of the 8 patients with melasma, mild to moderate lymphocytic infiltration was observed in the superficial dermis and around capillaries, with moderate telangiectasis in the superficial dermis. Electron microscopy revealed that there were more melanosomes in melanocytes and keratinocytes, and melanocyte dendrites extended into the dermis in melasma tissues. Conclusions Among the 8 patients, there were only two types of melasma, i.e., epidermal melasma and mixed melasma, and no dermal melasma was found. Inflammation and telangiectasis may induce or aggravate melasma.

Objective To analyze the epidemiological characteristics of measles in the floating population in Daxing District from 2002 to 2015 and to provide a specific guidance for the control and preven-tion of measles. Methods The epidemiological characteristics of measles in the floating population in Dax-ing District were analyzed based on the data collected from Diseases Reporting Information System and Ques-tionnaires for measles cases. Results A total of 1 263 measles cases were reported in the floating population in Daxing District from 2002 to 2015, accounting for 73. 09% of all reported cases in that area. Among the 1 263 measles cases, 1 027 cases (81. 31%) were reported from March to June. The top 5 towns with high incidence of measles were Huangcun, Jiugong, Xihongmen, Yizhuang and Yinghai, from which 80. 29% of measles cases were reported. Age distribution of the measles cases showed that 145 cases were children younger than 8 months, 412 cases were children aged 8 months to 14 years old and the rest 706 cases were a-bove 14 years old. And of all cases, only 224 cases had measles vaccine immunization history. Conclusion It is necessary to maintain the high vaccination rate of 3 doses of measles vaccine by multi-approaches and increase the immunization rate in migrant workers. Moreover, strengthen the surveillance for measles is also an effective way for measles control and elimination.

OBJECTIVE:To investigate the effects of NOS1AP rs12742393 polymorphism on therapeutic efficacy of repaglinide in the treatment of type 2 diabetes mellitus(T2DM)in Chinese Han patients. METHODS:A total of 100 newly-diagnosed T2DM Han patients without any hypoglycemic therapy were selected from the Affiliated Hospital of Xuzhou Medical University during Aug. 2015-Mar. 2017. Based on routine therapy,they were additionally given Repaglinide tablets 1.0 mg,tid,for consecutive 8 weeks at least. PCR-RFLP was used to detect the genotypes at NOS1AP rs12742393 in patients. The levels of FPG,PPG,HbA1c, FINS,PINS,HOMA-IR,TC,TG,HDL-C and LDL-C were observed before and after treatment. RESULTS:There were 1 case of withdrawal and 1 case of follow-up loss,and 98 patients accomplished the study. There were 39 cases of NOS1AP rs12742393 AA genotype,42 cases of AC genotype and 17 cases of CC genotype,the frequency of them were 39.8％,42.9％,17.3％,which were in line with Hardy-Weinberg equilibrium (P>0.05). After 8 weeks,the levels of FPG,PPG,HbA1c,HOMA-IR,TC and TG were decreased significantly,compared with before treatment;the levels of FINS and PINS were increased significantly, compared with before treatment,with statistical significance (P<0.05). Before treatment,there was no statistical significance in each index among different genotypes (P>0.05). After treatment,the levels of FPG,PPG and HbA1c in all genotypes,the level of HOMA-IR in AA genotypes,the level of TC in CC genotype,the level of TG in AA and CC genotype were decreased significantly;the level of PINS in all genotype,the level of FINS in AC and CC genotype and the level of HOMA-IR in CC genotype were increased significantly;the levels of FPG and PPG in CC genotype were significantly higher than AA and AC genotype,and the decrease of two indexes than before treatment were significantly less than AA and AC genotype;the level of FPG in AC genotype was significantly higher than AA genotype;the level and increase than before treatment of FINS,and the level of HOMA-IR in AC and CC genotype was significantly higher than AA genotype;there was statistical significance in the change than before treatment of HOMA-IR among all genotypes (P<0.05). There was no statistical significance in other indexes among all groups before and after treatment(P>0.05). CONCLUSIONS:NOS1AP rs12742393 polymorphism may influence therapeutic efficacy of repaglinide in the treatment of T2DM in Chinese Han patients,and risk gene C may weaken therapeutic efficacy of repaglinide by influencing the levels of FPG,PPG,FINS and HOMA-IR.

Objective To explore the prevalence and possible risk factors of depressive /anxious symptoms of patients with digestive disease .Methods Totally 245 patients with digestive diseases were recruited consecutively .Face-to-face interview and the hospital anxiety and depression scale ( HADS) ,self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS) were employed to collect the clinical data .The non-condition logistic regression was performed to analyze the data .Results The prevalence of depression and anxiety in patients with organic diseases in digestive system was 36.3%.Among them,the higher incidence of depression and anxiety symptoms were digestive system tumors , peptic ulcer , acute pancreatitis and cirrhosis .The educational degree was correlated with simple depression,pure anxiety,depression complicated with anxiety (χ2 =8.781,P=0.013;χ2 =7.976,P=0.018;χ2 =15.807,P=0.003),the degree of high school or above was a protective factor ,the OR values were 0.347, 0.373,0.301.The gender was also correlated with depression ,anxiety,depression complicated with anxiety (χ2 =4.343,P=0.031;χ2 =1.056,P=0.017;χ2 =2.382,P=0.03),female was the risk factor of mental illness ,the OR values were 2.72,2.438,2.671.The age was correlated with depression ,depression complicated with anxiety (χ2 =9.872,P=0.002;χ2 =15.710,P=0.031),the age of over 40 years old was the risk factor of mental illness ,the OR values were 5.137,5.731.The occupation was correlated with depression (χ2 =6.017,P=0.017),the non-physical labor was the risk factors of depression , the OR value was 2.752.Conclusion There is a higher prevalence of depression and anxious symptoms in patients with digestive organic diseases .Female,senior high school or lower ,older than 40 years,and non-manual work are the risk factors of these symptoms .

Objective To develop a nurse medication unsafe behavior scale, so as to provide an effective tool for evaluating nurses' unsafe behaviors and provide scientific basis for the safe medication management of clinical nurses. Methods From July to August 2016, a semi-structured interview was conducted among 5 nursing managers and 5 clinical nurses from an affiliated hospital of a medical university in Harbin city selected by purposive sampling method. The initial scale was formed by analyzing semi-structured interview data, combining with relevant literature. From November to December 2016, a pre-test was conducted among 380 nurses from an affiliated hospital of a medical university in Harbin city, who met the inclusion criteria, selected by convenience sampling method, by pre-test version of the scale. A large sample test scale was formed by expert review and pre-test. From January to February 2017, a total of 1 243 clinical nurses from 2 medical university affiliated hospitals, 2 provincial class Ⅲ grade A hospitals and 1 municipal class Ⅲ grade A hospital were selected by convenience sampling method for a large sample test, and the reliability and validity of the scale were tested to form the final scale. Results The nurse medication unsafe behavior scale consisted of 4 factors (treatment of medical orders, medication preservation and dispensing, medication administration and medication monitoring) and 25 items. The cumulative variance contribution rate was 60.897%. Confirmatory factor analysis showed that the fit indexes χ2/df, GFI, CFI, IFI and RMSEA were 2.872, 0.922, 0.951, 0.951 and 0.050 respectively. The content validity index was 0.96. The Cronbach's α coefficient and split half were 0.935 and 0.841 respectively. Conclusions The nurse medication unsafe behavior scale has good reliability and validity. It can be used as a valid tool to measure nurse medication unsafe behavior.

Objective:To explore disorienting dilemmas during postgraduate study period experienced by postgraduates with master of nursing specialist who participated in the national postgraduate entrance examination and provide a basis for teaching reform based on transformative learning theory.Methods:Using the purposive sampling method and the maximum difference method, 23 full-time masters of nursing specialist who participated in the national postgraduate entrance examination from 3 universities of Jiangsu Province were selected as the research objects from March to June 2019. The descriptive qualitative research method was used to conduct semi-structured interviews, and the traditional content analysis method was used to analyze the interview data.Results:Four themes of disorienting dilemmas of masters of nursing specialist were extracted: the expected hypothesis of challenges of new environment in course learning, a gap between scientific research ability and training target, adjustment of self-positioning in clinical practice and insufficient preparations for graduation of master of nursing specialist.Conclusions:Master of nursing specialist have disorienting dilemmas in course study, scientific research, clinical practice and graduation preparation, and nursing educators can use this as a trigger point to carry out teaching reform based on transformative learning theory.