objective To explore the effect of diabetes management program with the goal of behavior changes on behavior change and metabolic index of patients with type 2 diabetes mellitus.Methods By setting up the diabetes management team,establishing personalized management file,carrying out education program,setting the goal of behavior changes and evaluating goal's trace,One-year management was carried out for 56 cases of type 2 diabetic patients.Patients' behavior changes were evaluated after six months management and one year later the metabolic indexes were contrasted.Results After 6 months management,the rate of goal achievement was 96%,the rate of one year behavior stabilization was 92%,the body mass index (BMI),fasting and postprandial blood glucose,glycosylated hemoglobin (HbAlc) one year later were decreased dramatically.Conclusions There is important significance of diabetes management program with the goal of behavior changes for behavior changes and metabolic indexes control in type 2 diabetic patients.

Objective:To explore the clinical characteristics of Haff disease in our hospital,be familiar with the disease and provide some experience in diagnosis and treatment.Methods:Inpatients with Haff disease in our Kidney disease center between July and August 2016 were retrospectively analyzed.The clinical data of patients was collected and statistically analyzed.Results:There were 66 patients (28 of male and 38 of female) in total with Haff disease between July and August 2016 in our ward.The average onset age was 35.5 years old (18-76 years old) and the average latency period was 5.6 hours (1-24 hours).All the patients had crayfish before the onset of the disease.The initial symptoms included muscle pain and concentrated brown urine (19 cases,28.8％).Laboratory tests suggested that transaminase and myotropin were increased significantly (alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,creatine kinase,myoglobin and creatine kinase isoenzyme).A trace of blood (45％) and protein (16.7％) was present in some patients' urine test.After treatment,muscle pain was alleviated and urine color turned to clear in all patients.All the transaminase and muscle enzymes were significantly decreased (P＜0.05).No blood or protein was detected in the urine test.Conclusions:The epidemiology of Haffdisease in summer at Nanjing was related to the intake of crayfish.The latency period was short and the initial symptoms were mostly muscle soreness,with or without myoglobinuria.Laboratory tests showed serum creatine phosphokinase,myoglobin,creatine kinase isoenzymes were increased significantly.The treatment period was short with good prognosis.Generally no sequelae was observed.

Objective To observe the effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis. Methods 90 patients with rheumatoid arthritis in our hospital were randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with infliximab and methotrexate. The patients in the observation group were treated with tocilizumab and methotrexate. The patients in the two groups were both treated for 6 months. The clinical efficacy of the two groups was compared after treatment. Before and after treatment, the serum levels of immunoglobulin, Th-1 and Treg of patients in two groups were measured. Results The results showed that after treatment, the situation of morning stiffness, joint pressure pain and joint swelling of the patients in the two groups were improved, and the improvement of morning stiffness, joint pressure pain and joint swelling in the observation group was greater (P<0.05). The levels of IgG and Th1 cells in the serum of patients in the two groups significantly decreased, and the levels of IgG and Th1 cells in the serum of the patients in the observation group were significantly lower than that of the control group (P<0.05). The serum level of Treg cells in the serum of patients in the two groups increased significantly, and the level of Treg in the serum of patients in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Topazumab could effectively improve the clinical symptoms of patients with rheumatoid arthritis, and improve the immune dysfunction of the patients with better clinical efficacy.

Objective To explore the working experiences of rehabilitation specialized nurses and provide references for the development of rehabilitation nursing. Methods Through phenomenological study of qualitative research, 8 rehabilitation specialized nurses in our hospital were selected by purpose sampling method in September 2015, and were interviewed about the current status of work and existing problems. Interview data was analyzed by Colaizzi method. Results Interview results showed that: working experiences with positive effect were mainly reflected in the following themes:change of cognition of rehabilitation concept, improvement of rehabilitation nursing ability,increased job satisfaction,a more clear role. On the contrary, the negative aspects were:difficulties of patient′s evaluation,lack of time engaging in rehabilitation nursing, difficulty of charge,weak strength of rehabilitation team.Conclusions Nursing managers should attach great importance to the cultivation and use of rehabilitation specialist nurses, modify the related system, and promote the development of rehabilitation nursing. Nursing managers also should pay attention to nurses′emotional experience; provide development platform for rehabilitation specialist nurses; and provide interventions and support in many aspects to perfect the related system, so as to promote the development of rehabilitation nursing.

Objective To explore the effects of follow-up management based on structural family therapy on self efficacy and quality of life in discharged puerpera. Methods A total of 124 hospitalized puerpera with childbirth of the Affiliated Hospital of Medical School of Ningbo University were selected from October 2015 to October 2016. All of them were divided into observation group and control group, 62 cases in each group. Puerpera of control group were treated with conventional nursing. On the basis of the conventional nursing, puerpera of observation group adopted follow-up management based on structural family therapy. We compared the scores of breast feeding knowledge questionnaire, the rate of exclusive breastfeeding and the quality of life with the Exercise of Self-Care Agency Scale (ESCA) and the quality of life index scale of puerpera in two groups. Results The mean score of breast feeding knowledge questionnaire of puerpera in the observation group was higher than that in the control group with a significant difference (P<0.05). The rate of exclusive breastfeeding of puerpera in the observation group was 93.54% higher than that in the control group (74.19%) with a significant difference (P<0.05). There was a statistically significant difference in the total score of self efficacy of puerpera between the observation group and the control group [(143.4±14.0) vs. (109.6±11.6)] (P< 0.05). The total score of quality of life of puerpera in the observation group was significantly higher than that in the control group [(8.8±1.3) vs. (5.6±1.1)](P< 0.05). Conclusions The follow-up management based on structural family therapy is favourable to improve the self efficacy on nursing and quality of life of puerpera so as to increase the rate of breast feeding.

Objective To evaluate the application value of simultaneous amplification and testing for Myco-bacterium tuberculosis(SAT-TB)in evaluating the curative effect of initial treatment of smear-positive pul-monary tuberculosis patients.Methods A total of 62 newly treated smear positive pulmonary tuberculosis pa-tients from June 2022 to June 2023 in Guangzhou Panyu District Chronic Disease Control Station were selected as the study objects,and the curative effect was evaluated by liquid-based sandwich cup method,Roche culture method and SAT-TB detection method.All patients received the standard anti-tuberculosis treatment regimen of 2HRZE/4HR standard regimen,and sputum samples were detected by liquid-based sandwich cup method,Roche culture method,and SAT-TB detection method at the 2nd,4th,and 8th week of treatment,respectively.Results Among 62 patients,54 cases were positive and 8 cases were negative using Roche culture method,47 cases were positive and 15 cases were negative using SAT-TB detection method.60 cases were positive and 2 cases were negative by Mycobacterium tuberculosis(MTB)-DNA test.The positive rates of the three methods were 87.10％(54/62),75.81％(47/62)and 96.77％(60/62),respectively.Taking Roche culture method re-sults as the standard,the sensitivity of SAT-TB detection method and MTB-DNA was 97.87％(46/47)and 90.00％(54/60),and the specificity was 46.67％(7/15)and 100.00％(2/2),respectively.There were signifi-cant differences between Roche culture method and SAT-TB detection method and MTB-DNA test(x2=20.070,P＜0.05,x2=13.985,P＜0.05),the difference between the results of SAT-TB detection method and MTB-DNA test was also statistically significant(x2=8.365,P＜0.05).The negative conversion rates of MTB in sputum samples were 69.35％(43/62),29.03％(18/62)and 41.94％(26/62)at the 2nd,4 th,and 8 th weeks,respectively.77.42％(48/62),59.68％(37/62),58.06％(36/62),82.26％(51/62),79.03％(49/62),75.81％(47/62).There were significant differences in the negative conversion rates of MTB in sputum sam-ples between SAT-TB and liquid-based sandwich cup method at the 2nd and 4th weeks(x2=8.365,P＜0.05,x2=4.465,P＜0.05),while there was no significant difference between the results of Roche culture method at the 2nd,4th and 8th weeks(x2=1.726,P＞0.05,x2=0.000,P＞0.05,x2=0.046,P＞0.05).Conclusion The use of SAT-TB detection method in clinical practice to evaluate the efficacy of smear positive pulmonary tuberculo-sis patients could accurately and quickly assess the negative conversion rate and treatment effect of patients,and provide a reliable basis for guiding clinical treatment.It could be considered as an effective auxiliary diag-nosis and evaluation method of curative effect,worthy of promotion and practical application.

Objective:To explore the cognition and nursing needs of patients with urinary incontinence after prostate cancer surgery on "Internet+ nursing service", so as to provide basis for the implementation of high-quality continuous nursing service.Methods:According to the phenomenological research method, 15 patients with urinary incontinence after radical prostatectomy in the Urology Surgery Department of the Affiliated Hospital of Medical School, Ningbo University from October to December 2021 were selected as the research object by intentional sampling method. Semi-structured interview was used to collect data, and Colazzi method was used to sort out, analyze and refine the subject.Results:The patients' awareness of "Internet+ nursing service" was biased. Many factors affected the willingness of patients with urinary incontinence to use "Internet+ nursing service". Factors that promoted willingness to use included public health emergency, traffic, physical and psychological factors. Factors impeding willingness to use included information security, operational and economic factors. The need for the content of "Internet+ nursing service" included the need for rehabilitation treatment related knowledge and supportive relationships. The need for "Internet+ nursing service" included the need to establish a "circle of friends" to obtain support from patients, the need for "online consultation, offline nursing", and the need to enrich the form of health education.Conclusions:The medical and nursing staff should give full play to the role of "Internet+ nursing service", and according to the characteristics of patients with urinary incontinence, enrich the "Internet+ nursing service" in the form of combination of graphics and text, video games, punch card interaction, to meet the needs of patients in rehabilitation training, doctor-nurse communication, patient support and other aspects, while strengthening the convenience of the operation of "Internet+ nursing service" and the timeliness of the service, so as to promote the rapid development of "Internet+ nursing service".

Objective:To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) for Trousseau’s syndrome (TS) in patients with acute multiple cerebral infarctions (AMCI).Methods:The patients with AMCI in Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from July 2013 to March 2022 were retrospectively enrolled. The demographic and baseline clinical data of patients with TS and those without TS were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of TS-AMCI, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR for TS-AMCI. Results:A total of 59 patients with AMCI were enrolled, including 43 males and 16 females, aged 64.9±14.0 years. There were 16 patients in the TS-AMCI group and 43 in the non-TS-AMCI group. The proportions of patients with diabetes mellitus, hypertension and previous stroke or transient ischemic attack in the TS-AMCI group were significantly lower than those in the non-TS-AMCI group (all P<0.05), while the proportion of patients with ischemic heart disease were significantly higher than that in the non-TS-AMCI group ( P<0.05). The proportion of patients with bilateral infarction in the TS-AMCI group was significantly higher than that in the non-TS-AMCI group ( P<0.001). The D-dimer, NLR, white blood cell count, neutrophil count, monocyte count, percentage of neutrophils, total cholesterol and low-density lipoprotein cholesterol in the TS-AMCI group were significantly higher than those in the non-TS-AMCI group (all P<0.001), while the lymphocyte count, lymphocyte percentage, red blood cell count, hemoglobin and hematocrit were significantly lower than those in the non-TS-AMCI group (all P<0.001). Multivariate logistic regression analysis showed that high NLR was an independent predictor of TS-AMCI (odds ratio [ OR] 2.897, 95% confidence interval [ CI] 1.270-6.527; P=0.011), while high hemoglobin was independently negatively correlated with TS-AMCI ( OR 0.839, 95% CI 0.723-0.975; P=0.022). ROC curve analysis showed that the area under the curve of NLR for predicting TS-AMCI was 0.929 (95% CI 0.831-0.979; P<0.001). When the NLR cutoff value was 4.01, the corresponding Youden index was 0.744. At this time, the sensitivity and specificity were 100% and 74.42% respectively. Conclusion:NLR has high predictive value for TS-AMCI.