A total of 185 patients with type 2 diabetes mellitus (T2DM) were consisted of male group (n =95) and postmenopausal female group (n =90).The parameters of fasting plasma glucose,HbA1c,fasting insulin,fasting C peptide,homeostasis model assessment insulin resistant index (HOMA-IR) and β-cell function (HOMA-β),blood lipid,body mass index,and waist to hip ratio were collected and analyzed by Pearson correlation analysis and stepwise multiple regression analysis.The relationships between osteocalcin and these parameters were investigated.The results revealed that osteocalcin was negatively correlated with HbA1C (P＜0.05),and osteocalcin was an independent relevant factor affecting HbA1Clevels.Osteocalcin may be involved in the regulation of glucose metabolism in T2DM.

Objective To observe the effects of blood pressure by intravenous infusion of different doses ofoxytocin in cesarean section.Methods Sixty full-term pregnant women undergoing cesarean section with continuous epidural anesthesia were divided into three groups by random digits table method with 20 cases each:group A,B and C.Three groups were injected 10 U oxytocin in uterine muscle after infant delivery.Group A,B and C received 5,10 and 20 U oxytocin (sodium lactate ringer,500 ml) continuous intravenous infusion at the speed of 10 ml/min.If happened uterine contractions bad,they were sublingual administering 0.2 mg misoprostol.If happened severe hypotension,they were intravenous injected 5 mg ephedrine.The change of mean arterial pressure (MAP) and heat rate before anesthesia (T0),after fetal childbirth (T1),5 m in (T2),10 min (T3),30 min (T4) after infusion of oxytocin and the dosage of ephedrine and misoprostol were recorded.Results There were no significant differences in MAP and heart rate at every time point between group A and B (P＞ 0.05).MAP decreased and heart rate increased in group C at T2,T3 compared with those in group A and B,and there were significant differences (P＜ 0.05).The number of cases of sublingual misoprostol were increased in group A (7 cases) compared with that in group B (2 cases) and group C(1 case).The 8 patients injected ephedrine in group C were more than group A(1 case) and group B (3 cases).Conclusion Cesarean section after the delivery of the fetus in the uterus muscle injection of oxytocin 10 U,after 10 U of oxytocin added 500 ml sodium lactate ringer injection at the speed of 10 ml/min intravenous infusion has little effect on the blood pressure and heart rate,and has good uterine contractions.

Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Child ; Male ; Female ; Humans ; Meningioma

Erythropoiesis ; physiology ; Humans ; Mitochondria ; physiology ; Mitochondrial Degradation

Objective To apply the sharing mode of nursing observation on typical cases to promote nurses' capability and observation skills of clinical nursing and deepen the connotation of high-quality nursing service.Methods The sharing mode of n ursing observation on typical cases was established in 2010 and run through the process of record-report-evaluate-share-reward.The registration form of nursing observation on typical cases was designed by the nursing department,on which the observers recorded typical cases and reported it via network to the nursing department.And the latter assigned nursing experts at regular intervals to evaluate and shared cases through a variety of forms (publishing briefings,organizing exchange meetings,etc.),in which the excellent examples were rewarded.Results Since 2010,298 cases had been submitted,with more than 100 cases shared and 57 rewarded.Conclusions The sharing mode of nursing observation on typical cases has elevated nurses' observation capability and comprehensive quality,deepened the connotation of high-quality nursing service and ensured the safety of the patients.

Objective To investigate the status quo and existing problems in 2A or higher level general hospitals in Shandong Province,in order to provide information for establishing and perfecting the head nurse training system of Shandong Province.Methods 666 head nurses from 129 hospitals were investigated by a self-designed questionnaire,namely The questionnaire of status quo of head nurse training in 2A or higher level general hospitals in Shandong Province.Results The head nurses participating in the survey were average (40.1±5.8) years old,66.7％ of whom had intermediate titles,78.8％ with vocational school as basic education,86.8％ with bachelor as the highest degree.The head nurse training contents were mainly level hospital evaluation (73.9％),quality of nursing management training (65.8％) and nursing quality control (64.2％); training forms were mainly seminar (63.7％),conference (51.4％)and short-term training courses (40.5％); cumulative training time was within two weeks; 73.8％ of the teachers derived from clinical nursing specialist.79.3％ of the head nurses did not attend personalized evaluation before training,while 54.7％ received different forms of evaluation after training.57.2％ of the head nurses considered there had been problems in previous training,such as less practical knowledge (64.1％),a single mode of training (50.7％),lack of pertinence (34.6％),training teachers level was uneven (32.2％).Conclusions The systematic,hierarchical,normal,required,flexible-form,effective-evaluation and talents head nurse training system should be established to improve the nursing management level of the head nurse fundamentally.

Objective To evaluate the effect of obstructive jaundice on recovery from sevoflurane anesthesia in pediatric patients. Methods A total of 80 pediatric patients scheduled for elective surgery were included, 42 pediatric patients with biliary atresia scheduled for Kasai operation served as obstructive jaundice group ( group OJ ) , and 38 pediatric patients scheduled for other operations served as control group ( group C) . Pediatric patients were 1-4 months old and full?term infants, and weighed 3.2-8.0 kg. Anesthesia was maintained with inhalation of 2%-4% sevoflurane during surgery, and pediatric patients inhaled 4% sevoflurane staring from peritoneum closure until the end of surgery. The duration from closing sevoflurane vaporizer to BIS value reaching 60, 70, 80 and 90 was recorded. The duration from stop of sevoflurane inhalation to BIS value returning to 60, 70, 80 and 90 was recorded. The duration from termination of sevoflurane inhalation to the time for tidal volume returning to 6 ml∕kg, to the time for muscle strength recovering to grade Ⅲ, to spontaneous eye opening and to tracheal extubation, and the corresponding BIS values were recorded. BIS value while entering the operating room, BIS value at the end of surgery, and the highest BIS value during recovery from anesthesia were recorded. The occurrence of delayed emergence from anesthesia was recorded. Results Compared with group C, the duration from termination of sevoflurane inhalation to spontaneous eye opening and to tracheal extubation were significantly prolonged, and BIS value at the end of surgery was decreased, and no significant change was found in the other parameters in group OJ. No pediatric patients developed delayed emergence from anesthesia in the two groups. Conclusion When only sevoflurane is used for inhalation anesthesia, although the time for recovery from anesthesia is prolonged, it shows no significant difference clinically in pediatric patients with obstructive jaundice.

Objective To explore selection of the procedures in one stage urethroplasty for treatment of the coexistence of urethral strictures in anterior and posterior urethra.Methods Between January 2008 and December 2014, a total of 27 patients with coexist strictures simultaneously in anterior urethra and posterior urethra were treated in our hospital.The mean age was 38 years old (ranging 13-83 years old.Stricture etiology was secondary to lichen sclerosus in 2 patients, iatrogenic in 3 and posttraumatic in 22.The mean length of urethral stricture was 11cm (ranging 6-14cm).Two procedures for treatment of anterior urethral stricture, including augmentation of urethroplasty using penile skin flap was performed in 20 patients and augmentation of urethroplasty using lingual mucosa in 7.Three procedures for treatment of posterior urethral stricture, including non-transecting spongiosum end to end anastomosis of the two urethral ends was performed in 3 patients, end to end anastomosis of the two urethral ends was performed in 17 and substitution urethroplasty using different tissues was performed in reminder 7 patients.Of them, pedicle scrotal skin urethroplasty was performed in 2 patients and lingual mucosal graft urethroplasty in 5 patients.Results The patients were mean followed up 2.6 years (ranging 0.545.0 years) with an overall success rate of 88.9％ (24 of 27 cases).Complications developed in 3 patients (11.1％).Of the 17 patients with end to end anastomosis, urethral stricture developed respectively 4 and 6 months in 2 patients and voiding well after pedicle scrotal skin urethroplasty.Urethral pseudodiverticulum developed 9 months after pedicle penile flap urethroplasty in another patient and voiding well after urethroplasty.Urethrography showed patent urethra with adequate lumen in the remaining patients and mean urinary peak flows was 21.3 ml/s (ranging 14.2-37.9 ml/s).Conclusions Substitution urethroplasty using penile skin or oral mucosa was more good procedure for anterior urethral stricture during the treatment of the coexistence of urethral stricture in the anterior and posterior urethra.The treatment of posterior urethral stricture was based on the length of the stricture, local condition to make a choice between anastomotic urethral reconstruction and substitution urethroplasty using other tissue.

Objective To evaluate the effects of right ventricular pressure load on left ventricular ( LV) myocardial mechanics using speckle tracking technology ,and to detect the change of LV function in patients with pulmonary hypertension( PH) at a earlier stage ,in order to provide reference for early clinical intervention . Methods The study included 74 patients with PH and 40 healthy volunteers ,who had of similar age and sex distribution . According to the pulmonary artery systolic pressure ( PASP) ,patients with PH were divided into mild ,moderate and severe groups ,which were marked with A ,B ,C , respectively . All subjects underwent echocardiographic examination . Conventional echocardiographic parameters ,the systolic longitudinal ,radial and circumferential peak strain ( LS ,RS ,CS) in various segments of LV ,as well as basal and apical segment myocardial rotation angle peak and peak time were determined ,LV systolic global longitudinal ,radial and circumferential strain (GLS ,GRS ,GCS) ,free wall (LAT ,lateral wall+ posterior wall) and interventricular septum ( IVS ,anteroseptal+ posteroseptal) overall LS ,RS ,CS were calculated . Results ①LVejectionfraction(LVEF):groupA,B,Chadnosignificantreduction(P>0.05)thanthe control group . ②Overall LS ,RS ,CS of LAT of LV and IVS and GLS ,GRS ,GCS of LV :B ,C group were lower than the control group and group A and C were lower than group B ( P < 0 .05) . ③ The rotation angle in ventricular apical basal segments and segment :group B and C were lower than the control group and group A and C were lower than group B ( P <0 .05) . ④GLS ,GRS ,GCS and overall LS ,RS ,CS of LAT and IVS were similar between group A and the control group( P >0 .05) ,but LV base segment rotation of groupAwaslowerthanthatofthecontrolgroup(P<0.05).Conclusions ①Rightventricularpressure overload can lead to increased LV mechanical damage ,LV strain changes were earlier than the change of LVEF . ②LV strain with increased right ventricular pressure overload is gradually reduced . ③Compared with other strain parameters , LV basal segments rotation angle were able to detect changes of LV myocardiol mechanics in patients with PH more sensitively .

Objective To investigate the characteristics of intestinal flora in infants with different feeding patterns.Methods Sixty-two cases of health infants(30-120 d)were divided into 4 groups according to their feeding patterns:breast feeding,imported powder milk feeding,domestic powder milk feeding and mixed feeding.Samples of their fresh feces in each group were collected and divided into sections equally:the bifidobacteria were isolated in anaerobic box and the number was counted for one section;for the other section,total DNA of intestinal flora was extracted and enterobacterial repetitive intergenic consensus (ERIC) fingerprints were amplified with the method of ERIC-PCR.After that,the specific bands observed in different groups were cloned and sequenced and alignmented.Results The colonies of bifidobacteria were more in breast feeding and mixed feeding groups[(9.10 ± 1.33) cfu/g;(8.62 ± 1.35) cfu/g]than those in domestic powder milk feeding and imported powder milk feeding groups[(7.62 ± 1.22) cfu/g;(7.32 ± 0.80) cfu/g,t =3.23,P ＜ 0.05];while there was no significant difference between breast feeding and mixed feeding groups,and between 2 powder milk feeding groups.Two specific bands were found from the ERIC fingerprints (A:1 100 bp mainly in breast feeding,domestic powder milk feeding and mixed feeding groups;B:1 000 bp mainly in imported powder milk feeding group).Sequencing and analysis of Basic Local Alignment Search Tool showed that homologous bacteria of A and B fragments were bifidobacterium longum.The encoding protein of A fragments might be related to the enzymes of carbohydrate metabolism,and B fragments were related to the enzymes of protein metabolism.Conclusions The colonies of bifidobacteria in intestinal tract are more in breast feeding and mixed feeding infants than those in formula feeding groups.The distribution of intestinal flora in domestic powder milk feeding infants is more similar to that of the breast feeding infants.