Objective:To investigate the cognition and anxious state of the type 2 diabetes mellitus accepted insulin-treatment for the first time,and offer reference for clinical mental nursing and healthy education. Methods: Use SAS (self-rating anxiety scale) and questionnaire to investigate the cognition of 156 type 2 diabetes mellitus for insulin-treatment at the first time,collect SAS score of different groups from basic understanding for insulin, worry of insulin injection treatment,and influence of their social communication. the statistics and analysis is done by SPSSⅡ10.0. Results: Anxiety score of type 2 diabetes mellitus compared with internal normal norm,the difference has statistical significance. Anxiety score compared in different age,culture degree,and medical cost,the difference has also statistical significance. 51%patients think insulin-treatment means aggravation of pathogenetic condition. 63% patients worry and don’t want injection of insulin. 36% patients think injection of insulin influence their social communication. Conclusion: Type 2 diabetes mellitus who accept insulin-treatment for the first time, have anxiety symptom at different levels. Recognizing the psychological state of every diabetes mellitus for insulin-treatment, will provide some help to clinical management. To insulin-treatment, it is very necessary to strengthen psychological education and eliminate misunderstand of the patients. The patients can accept insulin-treatment protocols early and correctly.

BACKGROUND:Until now, limited information has been neported on the characterization of udines 5-diphosphateglucuronosyl transferase (UGT) 1a1, UGT1a6, and microsomal glutathione S-transferase 1 (mGST1) during the differentiation of mouse embryonic stem cel s. OBJECTIVE:To observe the expression characteristics of UGT1a1, UGT1a6 and mGST1 at different stages of differentiation of mouse embryonic stem cel s. METHODS:Embryonic fibroblasts from Wistar rats were isolated and cultured as feeder cel s. Mouse embryonic stem cel s seeded onto these feeder cel s were induced to differentiate into hepatocytes. Subsequently, expression of UGT1a1, UGT1a6 and mGST1 was detected using western blot assay, and catalytic activity of mGST1 was determined by high performance liquid chromatography. RESULTS AND CONCLUSION:Increasing UGT1a1 expression was visible during the whole cel differentiation, while UGT1a6 exhibited no expression initial y but a higher level at 18 days of differentiation. mGST1 expression was visible at high level throughout the differentiation, but its expressive abundance was stil lower than that in the adult mouse stem cel s. At 18 days after the beginning of differentiation, the catalytic activity of mGST1 in microsomal liver tissue was 7.65μmol/(min?g). Taken together, stabilized UGT1a1, increased UGT1a6 and little mGST1 expression are confirmed in the differentiation of embryonic stem cel s into hepatocytes.

[objective] To investigate the effects of curcumin on the behavior of chronic constrictive injury(CCI)rats and the c-fos expression in spinal cord dorsal horn.[Methods]108 male SD rats were randomly divided into 4 groups:Control group(treated with CCI);Sham operation group;Solvent contrast group;Curcumin treated group.Thermal withdrawal latency(TWL)and mechanical withdrawal threshold(MWT)of rats were determined by Hargreave's thermal radiation apparatus and von Frey's method of microfilament,respectively.The time course of expression of c-fos were assessed by immunohistochemical analysis.[Results]Curcumin could significantly attenuate the activation of c-fos induced by CCI and simultaneously ameliorate thermal and mechanical hyperalgesia induced by CCI.[Conclusion]This study shows that curcumin could attenuate the activation of c-fos to ameliorate the CCI-induced neuropathic pain.

Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)％ in the TAO group and (80.05 ±0.38)％ in the control group respectively,with no significant difference between them(t =0.923,P＞0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P＜0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.

BACKGROUND: Although there are many studies on acute patellar dislocation in adolescents, the optimal treatment strategy is under discussion.OBJECTIVE: To summarize the clinical efficacy of reconstruction of the medial patellofemoral ligament (MPFL) in the treatment of adolescent acute patellar dislocation using double-pulley technique.METHODS: Thirty cases of acute patellar dislocation were enrolled and received reconstruction of the MPFL using double-pulley technique. We proceeded to prepare the bone bed for anchor placement at the medial point of the superior edge of the patella and at the upper 1/3 patella along the long axis of the patella using arthroscopic grinding. Two double-loaded 5.0 anchors were respectively placed at the medial point of patella and at the upper 1/3 patella parallel to the patellar articular surface, and then tied using the double-pulley technique. Long longitudinal incisions were performed at the medial condyle and at the adductor tubercle to expose these two structures, the deep fascias tunnel between two incisions were penetrated to pull the tendon weave end through the tunnel until the lateral side along a femoral tunnel; finally the tendon was fixed using screws in appropriate tightness. All patients were followed for more than 10 months, and the patellar-related parameters and knee function parameters were compared before and after operation. RESULTS AND CONCLUSION: There were 12 cases of intra-articular cartilage injury and 4 cases of meniscus injury. The patella title angle, Q-angle and outward shift distance at the last follow-up were less than those before operation. Lysholm and International Knee Documentation Committee scores at the last follow-up were higher than those before operation. The mean operation time was (90±10.5) minutes. There was one patient with knee movement angle from 0° to 30° and one patient with a patellar fracture caused by slipping and treated with internal fixation. None of patients appeared with patellar dislocation, positive apprehension test infection or poor wound healing. These results indicate that the simple and mini-invasive double-pulley technique is a good treatment strategy for acute patellar dislocation, because it is consistent with patellar anatomical stability, holds patellar trajectory visibility, quick recovery and good curative effect. Additionally, osteotomy is recommended when the simple efficacy is not satisfactory.

Objective To evaluate the blood-saving effect of combination of hemocoagulase artox for injection and tranexamic acid (TXA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Eighty ASA Ⅱ patients (NYHA Ⅰ or Ⅱ),aged 50-70 yr,weighing 50-100 kg,scheduled for elective OPCABG,were randomly divided into 4 groups (n =20 each):control group (group C),hemocoagulase atrox for injection group (group H,n =20),TXA group (group T) and hemocoagulase atrox for injection + ·TXA group (group HT).Hemocoagulase atrox 0.04 U/kg (the highest dose 4 U) was injected at 20 min before skin incision,and additional hemocoagulase atrox 2 U was given every 2 h starting from 15 min after administration of protamine until the end of operation in group H.TXA 20 mg/kg was injected intravenously at skin incision,followed by a continuous infusion of TXA at 10 mg· kg-1 · h-1 until the end of operation in group T.Hemocoagulase atrox and TXA were given as the method described in groups H and T.Venous blood samples were taken from the central vein before operation,at the end of operation,and 24 h after operation to determine the plasma D-Dimer concentration.The amount of blood loss,allogeneic red blood cells and plasma infused during operation,volume of drainage during 0-6 and 6-24 h after operation,total volume of drainage and volume of allogeneic blood transfused during operation were recorded.The deep vein thrombosis was recorded.Results Compared with group C,the amount of blood loss during operation was significantly decreased in groups T and HT,and the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in groups H,T and HT (P ＜ 0.05).Compared with groups H and T,the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in group HT (P ＜ 0.05).No deep vein thrombosis was observed in the 4 groups.Conclusion The combination of hemocoagulase artox for injection and TXA provides better blood-saving effect than either alone for the patients undergoing OPCABG without increasing the risk for thrombosis.

BACKGROUND:Because of its advantages, Endobutton has been widely used in clinic. Currently, its shortcomings are increasingly recognized. Tightrope that overcomes the shortcomings of Endobutton has been gradualy accepted by a doctor skiled in sports injuries.
OBJECTIVE: To analyze and compare the differences in the effects of Tightrope and Endobutton in the reconstruction of the cruciate ligament.
METHODS:Totaly 60 cases of anterior cruciate ligament rupture were selected and subjected to anterior cruciate ligament reconstruction under arthroscopy, of which 30 cases were randomly assigned to reconstruction by Endobutton device and 30 cases underwent reconstruction by Tightrope device. Al operations were performed by the same surgeon. Al patients were subjected to regular functional exercise and were folowed up regularly after operation. Effects of Tightrope and Endobutton in the cruciate ligament reconstruction were evaluated by comparing various indexes in the two groups.
RESULTS AND CONCLUSION:Compared to the Endobutton fixation system, the Tightrope fixation system could shorten the operation time, reduce the length of tendon incision, and decrease the loss of bone mass in the femoral bone tunnel. There were no significant differences in the maximum knee flexion, knee joint score and Tegner movement level score between the two groups at 3 and 6 months after operation. These findings indicate that the Tightrope fixation system is superior to the Endobutton fixation system, because it is more simple and convenient to operate and has less bone loss. However, their clinical efficacy has no difference after 6 months.

Objective To understand the present situation of safety organizing and quality of nurse work life in pediatric intensive care unit(PICU),and to discuss the relationship between safety organizing and quality of nurse work life.Methods A total of 279 PICU nurses in eight hospitals in Zhejiang were selected by the safety organizing scale (SOS)and quality of nursing work life(QNWL).Results The score of SOS was (45.23 ±10.88)points,and the score of QNWL was (159.46 ±33.60)points.There was a positive correlation between safety organizing and quality of nurse work life(r =0.256,P <0.05).Conclusion The nurse managers should improve the level of quality of nurse work life by safety organizing.

Objective To investigate effects of total flavonoids of litchi (TFL) on the proliferation of rat hepatic stellate cells (HSC-T6) in comparison with western medicine rosiglitazone, and to explore the mechanism of anti hepatic fibrosis of TFL. Methods Effect of TFL on proliferation of HSC-T6 was examined by MTT. The expression of peroxisome proliferator-activated receptor-γ (PPAR-γ) mRNA, connective tissue growth factor (CTGF) mRNA in HSC-T6 cells exposured were examined by real-time quantitative PCR. Effects on HSC-T6 CTGF protein from TFL and rosiglitazone were detected by Western bloting. Results The expression of PPAR-γ mRNA was upregulated and the expression of CTGF mRNA and protein was downregulated after exposure to TFL and rosiglitazone for 72 hours. And the effect of TFL increased with the increase of concentration. Conclusion TFL can inhibit the proliferation of HSC-T6 and antagonizing liver fibrosis. This mechanism may be associated with the upregulation of PPAR-γ expression and the downregulation of CTGF expression.

Objective To investigate whether sulfonylurea ( SU) increases the risk of stroke in patients with type 2 diabetes mellitus(T2DM). Methods A systemic meta-analysis including 17 random control trails(RCT) was performed to compare the risk of stroke between type 2 diabetic patients treated with SUs and comparators. Results 1 612 articles were retrieved, and finally 17 articles were included. Patients receiving SUs treatment had a higher relative risk of stroke (RR 1. 35, 95% CI 1. 13-1. 60) than those who received comparators. The I2 statistic for heterogeneity between 17 trails was 0. 0%(P=0. 687). No major asymmetry appeared in the funnel plot and Begg′adjusted rank correlation test(kendall′s score=22, P=0. 387). Conclusion The use of SUs may raise the risk of stroke which is already high in patients with T2DM.