Objective To evaluate the effect of applying nursing cases in promoting accuracy of nursing grading . Methods A specialized-group of nursing cases was built to clear up the problems in nursing grading by using quality control system. The researchers surveyed the accuracy of nursing grading of 84 patients with activities of daily living ( ADL) score less than or equal to 60 ( ADL≤60) in two wards before and after the improvement project. The researchers compared the relative knowledge of nursing grading and sense of dynamically adapting nursing grading of 20 resident doctors, and self-ability of 7 nurses in specialized-group of nursing cases before and after the improvement project. Results The relative knowledge of nursing grading, ability of dynamically adapting classification and accuracy of classification were higher than before (χ2=42. 15, 8. 09,12.2;P<0. 01). The abilities of promoting nursing cases, communication, solving problem, reading literatures were significantly higher than before(t=-3.16,-4.90,-2.57,-4.90,-2.93;P<0.05). The dimension of responsibility had no significant difference ( t=-1.84,P=0.090) . Conclusions Nursing cases is effective in improving the accuracy of nursing grading, and promoting the ability and sense of improving nursing cases actively.

Objective To explore the impact of self-management support on the behavior and metabolic parameters of type 2 diabetic patients with obesity.Methods A total of 96 inpatients of type 2 diabetes with obesity,who hospitalized in the Second Hospital of Hebei Medical University from October 2014 to March 2015, were randomly assigned to control group and intervention group with 49 cases and 47 cases respectively.The patients in the control group received routine health education,while the patients in the intervention group were given self-management support by educational team with eight members constituted by physicians,nurse educators,dietitians,psychologists,etc.additionally.The patients in both groups were followed up for 3 months,self-management behaviors,body weight,body mass index (BMI ), waist circumference and glycosylated hemoglobin(HbA1c)that measured before and 3 months after the intervention.Results The self-management behaviors in the intervention group were significantly better than those in the control group after the intervention (P <0.05 ).The values of HbA1c and waist circumference [(7.14 ±0.68 )%,(94.82 ± 8.90)cm]in the intervention group were significantly lower than [(7.70 ±0.58)% ,(98.31 ±6.38)cm]in the control group after the intervention (P <0.05).The body weight and body mass index(BMI)changed were not significantly compared with the control group (P >0.05 ).Conclusions Self-management support can improve the patients′self management behavior,reduce blood sugar,waist circumference and the risk factors for the occurrence of chronic complications.

ABSTRACT OBJECTIVE：To study the improvement effect of Periplaneta americana extract Ento-A on damp-heat ulcerative colitis（UC）model rats. METHODS：Totally 70 rats were randomly divided into normal control group（n＝8）and modeling group （n＝62）. The damp-heat UC model was induced in modeling group by high sugar，high fat，spicy diet combined with 2，4， 6-trinitrobenzene sulfonic acid enema. 48 modelrats were randomly divided into model control group，mesalazine group （300 mg/kg），Changyanning group（300 mg/kg）and Ento-A low-dose，medium-dose and high-dose（50，100，200 mg/kg，calculated by the extract），with 8 rats in each group. Normal control group and model control group were given normal saline intrsgastrically，and other groups were given relevant medicine intragastrically，once a day，for consecutive 14 days. After last administration， disease activity index （DAI）， colonic mucosal injury index （CMDI） and histopathological score （HS）of rats were determined. The spleen index，liver index and colon index in rats were determined. The serum levels of IL-8，IL-17，SOD and MDA，colonic levels of IL-2，PGE2 and MPO were detected by ELISA. RESULTS：Compared with normal control group，the DAI score，CMDI score，HS score，colonic index，the serum levels of IL-8，IL-17 and MDA， colonic levels of MPO and PGE2 were increased significantly（P＜0.01）；serum level of SOD and colonic level of IL-2 were decreased significantly （P＜0.01）. Compared with model control group，DAI score，CMDI score，serum levels of IL-17 and MDA，colonic levels of PGE2 were decreased significantly in Ento-A high-dose groups（P＜0.05 or P＜0.01），while serum level of SOD and colonic level of IL-2 were increased significantly（P＜0.01）. CMDI score and HS score，serum levels of IL-8，IL-17 and MDA，colonic levels of PGE2 and MPO were decreased significantly in Ento-A medium-dose group（P＜0.05 or P＜0.01）， while colonic level of IL-2 was increased significantly（P＜0.01）. HS score，serum levels of IL-17 and MDA，colonic levels of MPO and PGE2 were decreased significantly in Ento-A low-dose group（P＜0.05 or P＜0.01），while serum level of IL-2 was increased significantly（P＜0.01）. CONCLUSIONS：P. americana extract Ento-A may play improvement effect on damp-heat UC rats by regulating immune system balance and reducing inflammatory damage.