Objective To investigate diabetes specialist nurse training mode and clinical practice conditions in Shandong Province,explore the main factors influencing clinical practice of diabetes specialist nurses,gradually improve diabetes specialist nurses training and application.Methods A total of 232 nurses with diabetes specialist nurses certificates in Shandong Province were carried out with the questionnaire about geneal information,training model,clinical practice conditions by convenient sampling method.Results Diabetes specialist nurse training mode in Shandong Province had achieved remarkable results.The total scores of practical skills were (54.64 ± 9.46),in which the scores of clinical nursing dimension were (12.99 ± 2.90),at top level.By using multivariate linear regression analysis,achiuement in scientific research,assessment form of clinical nursing and sources of training teachers were the ninfluential factors of clinical practice of diabetes specialist nurses.Conclusions It would play a positive stimulating effect in bringing diabetes nurse specialist into full play if we gave diabetes specialist nurse systematic and standardized training,a good learning and communication platform,and effective support system.

Objective To study the influence factor of recurrence in breast cancer.Methods The grouping treatment and tumor by stages,tumor transfer were observed in 105 cases with primary breast cancer.Results Among 105 patients,the inside of 2 years relapse was 47.6%(50/105);Tumor Ⅱ period recurrence rate was 40.0%(10/25),Ⅲ period recurrence rate was 28.0%(7/25);Among 105 cases,the distant place transfer to recurrence rate was 31.4%(33/105);Among 105 patients for surgical operation,its relapsing rate was 40.0%,but in 25 cases after operation putting radiation treatment,relapse rate was 16.0%;The part recurrence rate totally was 58.0%(61/105),among them the chest wall recurrence rate was 13.3%(14/105);The supraclavilar lymphonodes transfer was 20.9%(22/105),the axlla lymphnides transfer was 23.8%(25/105);The distant place transfer was 31.4%(33/105).Conclusion The recurrence rate of association treatment obviously is lower than that pure surgical operation,the relapsing of tumor with tumor by stages and transfer relevanted.

Objective To explore the effrciency of intra-arterial neoadjuvant chemotherapy before radical excision in patients with cervical cancer.Methods 50 cases with cervical cancer were enrolled into the study and were treated with a 2～3 course of intra-arterial neoadjuvant chemotherapy immediately after the pathological diagnosis.The regime included Then radical excision was performed in those who were good for the operation.Results Complete recovery(CR) was acquired in 12 patients and partial recovery(PR) in 26 patients.The total response rate was 76.0 %.The tumor size reduced significantly(P

Objective To evaluate the effect of sufentanil on autophagy during myocardial ischemia-reperfusion (I/R) in rats.Methods Eighteen adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =6 each) using a random number table:sham operation group (group SH),I/R group,and sufentanil group (group S).Myocardial I/R injury was produced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 120 min reperfusion in the rats anesthetized with chloral hydrate in I/R and S groups.Sufentanil 3 μg/kg was injected via the caudal vein at 30 min prior to ischemia in group S.The equal volume of normal saline was given in SH and I/R groups.At 120 min of reperfusion,arterial blood samples were collected for determination of serum creatine kinase-MB (CK-MB) and lactic dehydrogenase (LDH) concentrations,and myocardial specimens were obtained for examination of the ultrastructure of myocardial cells (using transmission electron microscopy) and for determination of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3Ⅱ),Beclin-1 and Bcl-2 expression (by Western blot).Results Compared with group SH,the serum CK-MB and LDH concentrations were significantly increased,the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and Bcl-2 expression was significantly down-regulated in group I/R,and the serum CK-MB concentration was significantly increased,the expression of Beclin-1 and Bcl-2 was significantly down-regulated in group S (P＜0.05).Compared with group I/R,the serum CK-MB concentrations were significantly decreased,the expression of LC3 Ⅱ and Beclin-1 was significantly down-regulated,Bcl-2 expression was significantly up-regulated (P＜ 0.05),no significant change was found in serum LDH concentrations (P＞0.05),and the pathological changes were reduced in group S.Conclusion The mechanism by which sufentanil reduces myocardial I/R injury may be related to decreased autophagy in rats.

Objective: To study the effect of ghrelin on L-type calcium channel current (ICa-L) of ventricular myocytes in experimental rats. Methods: The single ventricular myocyte in experimental rats were obtained by enzymolysis method, and the whole-cell patch-clamp technique was used to investigate the effect of ghrelin on ICa-L of ventricular myocytes at different doses of 10 nmol/L, 100 nmol/L and 1μmol/L respectively. Results: Ghrelin at 10 nmol/L, 100 nmol/L and 1μmol/L may inhibit ICa-L at (8.95 ± 2.13) %, (31.18 ± 4.78) % and (64.63 ± 8.57)% respectively,P<0.05, and the current-voltage curve was shifted upwards. The channel half inactivation curve decreased from (-1.34 ± 1.9) mV to (-8.04 ± 1.32 ) mV, (9.76 ± 1.17) mV and (-11.81 ± 0.73) mV respectively,P<0.05, and the recovery time after inactivation was prolonged as τ value from (63.23 ± 9.32) to (98.95 ± 10.74), (109.56 ± 13.42) and (127.39 ± 16.13) respectively,P<0.05. Conclusion: Ghrelin may accelerate ICa-L inactivation and prolong the recovery time after inactivation. Ghrelin inhibits ICa-L in a dose-dependent manner.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

Objective To explore the effects of wogonin on hyperlipidemia in mice and clarify the molecule mechanism. Methods Thirty mice were evenly divided into three group normal control group,model control group and treatment group. The normal control group was given normal diet,the model control group received high-fat diet,the treatment group received high-fat diet with wogonin (500 mg·kg-1 ). Results The mice developed hyperlipidemia 12 weeks after starting the high-fat diet. The body weight,visceral fat and fat index were increased (P<0. 05). After treatment,these indices were reduced ( P < 0. 01). Wogonin significantly reduced the total cholesterol ( TC),low density lipoprotein ( LDL),high density lipoprotein (HDL),except the triglyceride (TG). Compared to the model control group,the hepatic lipase(HL) and lipoprotein lipase(LPL) activity in the treatment group were recovered (P<0. 05),but HMG-CoA reductase activity was inhibited ( P<0. 01). Mechanistic study suggested that the lipid-lowering effect might be related to the lipid synthesis genes (SREBP-1c,FAS, PPARγ) and the lipid metabolism genes (PPARα,CPT-1). Conclusion Wogonin can prevent hyperlipidemia,which might be related to the regulation of enzyme activity and the changes of lipid synthesis and oxidative metabolism.

Objective To explore the value of iteration algorithm (AIDR 3D) and filter-back projection (FBP) combined with CT low dose scanning in evaluation of lumbar intervertebral disc hernia.Methods Totally 150 patients with lumbar degenerative osteoarthropathy were randomly divided into A＞E groups,with 30 cases in each group.Scanning parameters of A＞D groups were 120 kV of tube voltage,and 100 mAs,50 mAs,30 mAs,as well as 20 mAs of tube current.While parameters of group E were 80 kV of tube voltage and 100 mAs of tube current.Each group was reconstructed with FBP and AIDR 3D,respectively,and their noises,SNRs and CNRs of groups were compared.And 3-point evaluation method was used to score the imaging,while score ≥2 were acceptable image quantity for clinical imaging.Results Under different radiation doses,AIDR 3D reconstruction images were superior to FBP in noise,SNR,CNR and display of intervertebral disc hernia.Under the same reconstruction technology,with the reduction of dose,noise increased,SNR and display of intervertebral disc hernia decreased.Except for slightly lower in AIDR 3D reconstruction with 50 mAs than that with 30 mAs,CNR decreased with the reduction of dose.Two reconstruction technologies under the same dose,image quality of reducing the tube current were better than that of lowering the tube voltage.Conclusion It is valuable of AIDR 3D combined with CT low dose scanning in evaluation on lumbar intervertebral disc hernia.

Objective Investigate the effect of EC50 of propofol target-injection in the different TCM (traditional Chinese medicine) physique types of patients who are in unconscious phase. Methods Depend on the standard protocol of TCM physique types sort and determination, we sorted 60 patients into three groups:Ping He (group A), Yang Xu (group B) and Yin Xu (group C), 20 patients per group. We applied the sequential experiment to measure the minimal EC50 and NI values of propofol when the patients were in the unconscious phase. Results The EC50 of propofol of group A, B and C are 3.85 μg/mL, 4.12 μg/mL and 3.43 μg/mL respectively. 95% confidence intervals of group A, B and C are 3.64 ~ 4.07 μg/mL, 3.92 ~ 4.33μg/mL and 3.26 ~ 3.60 μg/mL respectively. Conclusion There is a correlation between the different TCM physique types and the dosage of propofol target-injection.

Objective To observe the effect of early multidisciplinary rehabilitation therapy on stroke patients.Methods 80 cases of acute stroke were randomly divided into the rehabilitation group (n=40) and control group (n=40). All patients of two groups were treated with routine treatment, and those of the rehabilitation group were added with early multidisciplinary rehabilitation therapy. The degrees of clinical neural function defect, motor function and activities of daily living (ADL) of all patients in two groups were assessed by the clinical neural function defect assessment (NIHSS), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and one month after treatment.Results The scores of NIHSS, FMA and BI of patients in two groups were not different before treatment ( P>0.05). After treatment, the scores of patients of the rehabilitation group were significantly higher than that of the control group ( P<0.01).Conclusion Early multidisciplinary rehabilitation therapy can improve the neural function, ADL and raise the quality of life of post stoke patients.