Objective To evaluate the effect of FOCUS- PDCA model in hypoglycemia management during hemodialysis in patients with diabetic nephropathy. Methods Totally 107 patients with diabetic nephropathy were divided into two groups. Patients in the control group received traditional hypoglycemia management, while FOCUS- PDCA model was implemented in the experimental group in hypoglycemia management, including reducing insulin dosage before hemodialysis,injecting 50%glucose and taking hyperglycemia food during hemodialysis,enhancing the monitoring of blood glucose and health education. Compared the incidence of blood glucose levels and hypoglycemia in two groups of patients at different time of dialysis. Results The frequency of hypoglycemia in the experimental group at the beginning of dialysis [ (9.04±2.08) mmol/L ], 2 hours after dialysis[ (5.78±1.82) mmol/L ]and at the end of dialysis[ (6.94±2.04) mmol/L ] were significantly lower than that in the control group[ (8.60±2.02) mmol/L, (5.20±1.62) mmol/L, (4.97±1.05) mmol/L ], (P <0.05), and the total incidence rate of hypoglycemia was 1.6%(61/3 889), which significantly lower than that 4.8%(185/3 816) in the control group, the difference was statistically significant (χ2=5.288, P < 0.05). Conclusions The application of FOCUS- PDCA model in the hypog1ycemia management of patients with diabetic nephropathy can reduced the incidence of hypoglycemia during hemodialysis. It deserves to be widely used in clinical practice to improve the patients′quality of life.

To state the importance of scientific research capability and general practitioners training for the poor scientific innovation conditions of general practitioner standardization training by the analysis of several ways to improve the scientific research capacity and the probe of the impact on strengthening the consciousness of scientific research to help general practitioner to better work in the areas of primary care and public health.

Background and purpose: Urokinase-type plasminogen activator receptor is related to invasion and metastasis of tumor. Inhibition of uPAR expression in tumor cells results in reducing its metastasis. This study was aimed to construct an expression vector with short hairpin RNA (shRNA) of uPAR, which could pave the way for RNAi-mediated tongue squamous cell carcinoma therapy. Methods: Genome sequences of uPAR gene were retrieved from Genhank and cDNA was designed to code expression of shRNA for uPAR gene. The cDNA was synthesized and inserted into the eukaryotic expression vector pWH1, and the recombinant pWH1-uPAR expression vector was identified by enzyme cutting method. Then, pWH1-uPAR expression vector was transfected into tongue squamous cell carcinoma Ts cells by Lipofectomine 2000. At last, the expression of uPAR in Ts cells transfected with pWH1-uPAR expression vector was observed by RT-PCR, immunocytochemistry staining and Western blot. MTT assay was performed to measure the proliferation of Ts cell. Results: The uPAR shRNA eukaryotic expression vector was successfully constructed. Compared with Ts cells and Ts cells transfected with plasmid pWH1, the Ts cells transfected with pWHI-uPAR expression vector showed a lower mRNA and protein expression of uPAR. The inhibition rate of proliferation was 32.9% of Ts cells by transfected with pWHl- uPAR. Conclusion: The constructed uPAR shR.NA expression vector could inhibit the expression of uPAR in tongue squamous cell carcinoma, which may be helpful for further research on the function of uPAR and provide effective methods for therapy of tongue squamous cell carcinoma.

Objective To compare the colonization rates of group B streptococcus (GBS) detected by using fluorescent PCR and bacterial culture in late pregnant women in Xuzhou area and analyze the drug resistance of GBS .Methods The fluorescence PCR assay and bacterial culture assay for GBS were both performed for the late‐pregnant women′s vaginal swabs and anal swabs samples which were collected in this area .The diagnostic efficiency were compared between the two methods .Then the drug sensitivity test were performed for stains isolated for the bacteria culture .Results Among the 484 spcimens ,53 cases were positive detected by u‐sing fluorescent PCR ,and the positive rate was 11 .0% ,the sensitivity was 100 .0% .31 cases were detected positive by using bacte‐rial culture ,and the positive rate was 6 .4% ,the sensitivity was 59 .6% .There were statistically significant differences between the positive rate and the sensitivity of the two groups(P<0 .05) .The drug sensitivity test showed that the sensitive rates were 100 .0%to penicillin ,ceftriaxone ,vancomycin .The resistance rates to erythromycin ,clindamycin ,levofloxacin were 71 .0% ,64 .5% and 58 .1% ,respectively .Conclusion The screening rate of GBS in late pregnant women is not low in Xuzhou area .PCR is a more rap‐id ,specificific and sensitive method .Routine detection of GBS should carried out by using the method of fluorescent PCR .Resistance rate of GBS to erythromycin and clindamycin were high in Xuzhou area .More attention should be paid to the rational use of antibi‐otics to prevent drug‐resistant producing in strains of GBS .

Objective To evaluate the effect of transnasal optic nerve decompression for traumatic optic neuropathy in different surgery time. Methods The databases of the Cochrane library, Embase, PubMed, Wanfang Database, China Journal Full-text Database (CNKI), Weipu Database(VIP) were searched for retrospective studies and clinical controlled trials. The search words included traumatic optic neuropathy, TON, eye traumas, transnasal endoscopicoptic decompression, TEOND, decompression of optic canal and endoscopy. According to the inclusion and exclusion criteria, the data were extracted. The RevMan 5.3 was used to analyze the data. Results All of 1 087 studies were detected. Sixteen eligible studies were enrolled, including 803 eyes. Meta analysis showed that the recovery degree of visual acuity, curative effect in operation group within 7 d of trauma was obviously superior to the operation group 7 d after trauma (OR=2.78;95%CI:2.02-3.82;P<0.01). Conclusions Transnasal endoscopic optic nerve decompression in treatment of traumatic optic neuropathy should be operated as soon as possible, and it is better to operate within 7 d.

Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients (28 males,12 females,aged from 66 to 90,with mean age of 73) with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 (87.5％ ) patients were followed-up from 1 to 13 years (mean 5.7 y).Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 (t =15.91,P =0.000 ).Popliteal arterial velocity rose from preoperative ( 14 ±6) cm/s to postoperative (34 ± 10) cm/s (t =15.63,P =0.000) ; Tibial arterial velocity rose from ( 10 ±4) cm/s to (22 ±7) cm/s (t =15.71,P =0.000).The primary and secondary patency rates were 60.1％,44.3％,25.3％,and 93.5％,86.8％,57.9％ at 5,7 and 10 years,respectively.Limb salvage rates were 97.5％,95％,and 90％,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.

Adult ; Brain Neoplasms ; pathology ; Glioblastoma ; pathology ; Humans ; Male ; Pineal Gland ; pathology

Objective To evaluate the commutability of certified reference material IRMM ERM-DA 471/IFCC for cystatin C measurement among 8 methods.Methods 46 individual samples used for the commutability study were residual serum samples collected from clinical laboratories.The individual samples interspersedwith pooled sera and the certified reference material IRMM ERM-DA 471/IFCC and the whole set of samples was divided into 2 subsets for measurements in 2 days.The measurements were performed by8 different methods o.The samples were measured in duplicate order.Calibration was performed every day. Passing-Bablok regression was performed to compare the slopes and intercepts of mean values of the serum samples derived from different methods. Pearson correlation cofficient was also calculated. Deming regeression and 95%confidence intervals were calculated to evaluate the statistics commutability of ERM-DA 471/IFCC.The minimal specification of bias derived from biological variations was calculated to evaluate the clinical commutability.Results The within-laboratory CVs of pool sera ranged from 0.5% to 4.0%.The Passing-Bablok slope ranged from 0.765 to 1.311 and intercepts ranged from -0.04 to 0.241.The determination coefficient of Pearson regression ranged from 0.988 to 0.999.Deming regeression and 95%confidence intervals demonstrated commutability of ERM-DA 471/IFCC in 4/28 (14.3%) methods pairs. The minimal specfication bias ( 5.12%) demonstrated commutability of ERM-DA 471/IFCC in15/28 (53.6%) methods pairs.Conclusions The ERM-DA 471/IFCC domonstrated poor commutability between some methods pairs. The commutability of ERM-DA 471/IFCC should be evaluated before used as calibrators.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism (PHPT) with urolithiasis.Methods The clinical data of 9 PHPT patients who were evaluated with simple metabolic evaluation in 881 urolithiasis from 2000 to 2005 were summarized and the references were reviewed.Results The level of serum calcium was (2.96±0.48)mmol/L before operation, (1.94±0.42) mmol/L after operation.The level of parathyroid hormone(PTH) was(1133.53±788.21)pmol/L before op-eration,(74.52±49.17)pmol/L after operation.The level of serum calcium and PTH changed significantly after the parathyroidectomy (P<0.01).Follow-up for 14 months to 6 years.the ureteral stones fragments with lithotripsy were clear after 3 months and followed without recurrence,although the renal stones without lithotripsy were followed with no significant change.Conclusions Increase of serum calcium or increase of PTH above double with normal serum calcium may be helpful for diagnosis of PHPT with urolithiasis.Ureteral stone with PHPT should be treated together.Renal stone with PHPT may be followed up after the parathv-roidectomy,and be treated until the complications were occurred.It suggests that the maidend diagnosed pa-tient with urolithiasis should be added with simple metabolic evaluation,including serum calcium, phospho-nium and PTH.

Objective:To study the abnormal suppressive capacity of regulatory T cells ( Tregs) to effector cells,Th17 cells and Th9 cells in patients with mild to moderate asthma attack.Methods: Recruited asthmatic patients (n=30) and healthy control (n=30),collected peripheral venous blood from healthy control and asthmatic patients in mild to moderate attack stage respectively,and then isolated CD4+CD25+CD127-/low Tregs and CD4+CD25-T effect cells with immunomagnetic beads method ( purity was above 90%).The effect cells were cultured with PHA stimulation with or without Tregs.Measured the proliferation (3H-Thymidine), expression of RORC and PU.1 ( RT-PCR) genes,production of IL-17 and IL-9 ( LUMNEX) in effect cells with or without Tregs inter-vention.Analyzed the abnormality of Th17 and Th9 cells and the supressive capacity of Tregs on Th17 and Th9 cells in patients with asthma attack,comparing with control group.Results:Tregs of asthmatic patients could suppress the proliferation of effector cells,but less effectively than healthy control (P=0.03).In asthmatic patients,RORC expression and IL-17 production increased (P<0.05), and the suppressive capacity of Tregs to RORC expression decreased, when compared with healthy group ( P<0.05 ) .In asthmatic patients,IL-9 production of effector cells increased significantly (P<0.05),but PU.1 expression was higher than healthy group only with intervention of Tregs ( P=0.04 ) .And the suppressive capacity of Tregs to the expression of PU.1 and production of IL-9 in patients with asthma attack did not decrease (P>0.05).Conclusion:The suppressive capacity and amount of Tregs decreased,but the specific gene expression and cytokines production of Th17 cells and Th9 cells were upregulated in patients with mild to moderate asthma attack.This deficiency for the suppressive capacity of Tregs to Th17 but not Th9 cells may indicate some pathogenesis of asthma devel-opment.