Objective The continuous nursing model was introduced into nursing of type 2 diabetes mellitus in order to improve the self-management ability and behavior.Methods One hundred and fifty eight patients with type 2 diabetes mellitus in endocrine department of our hospital from January to December 2013 were selected and divided into the control group and experimental group randomly.There were 79 patients in the control group,5 patients were lost to follow-up and 79 patients in the experimental group,4 patients were lost to follow-up.Traditional nursing were only done in the control group,while continuous nursing model was adopted in the experimental group.The self management ability and behavior were compared between two groups of patients.Results By took the continuous nursing model in our hospital,diet control,sports management,blood glucose monitoring,medication management compliance in the experimental group were better than those of the control group patients,x2 values were 9.86,9.37,10.12 and 17.52.The ratio of patients with better self-management behavior in diet control,sports management,medication management and blood glucose control had significant difference compared with those of the control group,x2 values were 9.497,10.285,10.016 and 13.513.Conclusions The self-management ability and behavior of type 2 diabetes mellitus patients were improved by continuous nursing model.

Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,

Objective:To study the clinical features, experiences of diagnosis and treatment, and treatment process of ovarian nonspecific steroid cell tumor. Methods:The clinical materials of one case of ovarian nonspecific steroid cell tumor were retrospectively analyzed,and the related literaturels were reviewed. Results:The patient displayed amenorrhea and masculine characteristics.Preoperative ultrasonography demonstrated the solid tumor of 53 mm ×39 mm on the right ovary,consideration for the right side of ovarian malignant tumor,and laparotomy was performed.The pathologic results showed that the tumor cells were arranged in nests,and the cytoplasm was bright or eosinophilic, and the nucleus were round or oval with nucleolus.The immunohistochemical staining results revealed that calretinin,vimentin and inhibin were positive in the tumor cells.The patient was diagnosed with ovarian nonspecific steroid cell tumor.The postoperative follow-up of 3 months was performed,and there was no recurrence.Conclusion:The diagnosis of ovarian nonspecific steroid cell tumor should be combined with the clinical manifestation and pathologic results,and operion is the main treatment method.

Objective To retrospectively analyze the influence of intensity-modulated radiotherapy (IMRT) on tumor regression in primary nasopharyngeal carcinoma (NPC).Methods 272 patients with NPC received radical radiotherapy alone,196 by IMRT with a total treatment time of 6 weeks,and 76 by bilateral field conventional radiotherapy (CRT) with the total treatment timc of 7 weeks.Results By the end of radiotherapy,the primary tumor and neck lymph node residual rates of the IMRT group were 36.7％ and 44.2％,respectively,both significantly higher than those of the GRT group (21.1％ and 26.6％,x2 =6.15,3.99,P ＜ 0.05).Three months after the radiotherapy,residual lesions were observed at the nasopharynx or neck lymph nodes in 12 of the IMRT group,with a residual rate of 6.1％,not significantly different from that of the CRT group (9.2％,7/76).The 12 residual lesions of the IMRT group all vanished completely 4 -9 months after the radiotherapy.Conclusions There is an obvious difference in regressive mode between IMRT and CRT technique in NPC treatment.At the end of IMRT,the tumor residual rate is slightly increased.However,the delivered dose of gross tumor volume (GTV) is sufficient,and the boost dose should not be delivered indiscreetly.

Objective Through the analysis of the pathogens distribution of out-patient department and emergency department patients with diarrhea from Shenzhen Hospital of Peking University in 2013~2014,so as to provide reference for the clinical diagnosis and treatment of diarrhea disease.While understanding the improved Salmonella detection results.Methods Var-ied pathogenic bacteria were isolated and identified from 1 719 diarhea stool samples of native Shenzhen Hospital of Peking University from 2013 to 2014 through enrich culture,separate culture,biochemistry,serology etc.Pathogenic virus were test-ed for 451 watery stool specimens by fluorescence PCR.Analyzed statistical differences between the direct inoculation and selenite cystine broth enrichment for Salmonella.Results Picked out 143 disease germs from 1 719 examples diarrhea pa-tient’s stool samples,among which there were 25 strains of ETEC,12 strains of EPEC,8 strains of EAEC,1 strains of EIEC,19 strains ofVibrio parahemolyticus,76 strains Salmonella,2 strains Shigella and 0 strain ofVibrio cholera.There were 10 samples with two disease germs timely.Picked out 189 disease viruses from 451 examples diarrhea patient’s stool without disease germs,among which there were 79 Rotaviruspositive,91 Norwalkvirus positive,9 Adenoviruspositive,10 Astrovirus positive.There were 4 samples with Rotavirus and Norwalkvirus timely.After Salmonella ways to improve the positive rate of 0.6% (17/2 627)increased to 4.4% (76/1 719),χ2=67.2,P<0.01,the difference was statistically signifi-cant.Conclusion The detectable rate of Salmonella and Norwalk virus was the majority,and the clinic enhance the test of the diarrhea pathogenic microorganism,including the improvement of detection method,to reduce the missing rate of them,to provide the scientific basis for the diagnostical therapectic measures.

Objective　To study the relationship between gene's mutation in sputum cells and smoking consumption of patients with lung cancer. Methods　Sputum dispose liquid was added into 0.5?ml sputum, DNA was extracted twicely with saturated phenol-chloroform and ethanol precipitate; p53 and K-ras gene mutations were detected by using SSCP-PCR and RFLP-PCR methods. Results　Seventy-one of 110 patients with lung cancer were heavy smokers (index of smoking≥400), 55 of 71(77.5％) patients with heavy smoking were detected with gene alterations of p53 or K-ras (P＜0.05). Average indexes of smoking in the patients with p53 or K-ras were 861 and 630 respectively, whereas those in non-smokers were 284 and 554 (χ2＝36.56，P＝0.002). Conclusion　Detection of oncogene alterations in sputum is a simple method to practice. Oncogene alteration in smoking patients with lung cancer is higher, especially in heavy smokers, than those with no smoking. The results show that heavy smoking is one of the causes in oncogene mutations of bronchus and further investigation is necessary.

Objective To compare the dissolution of Chuangxiong powder in different medium and discuss the dissolution characteristics in vitro of Changxiong powder. Methods The paddle method was adopted, the UV spectrophotometric method was developed to determine the in vitro dissolution quantity of Changxiong powder in five medium (water, 0.1 mol/L hydrochloric acid, acetate buffer of pH 4.5, phosphate buffer of pH 6.8, phosphate buffer of pH 7.4) with ferulic acid as index, and evaluated by drawing the dissolution curve and using the similar factor method and Weibull model. Results The dissolution quantity of Changxiong oral powder in five medium was different. The dissolution quantity in water, 0.1 mol/L hydrochloric acid, acetate buffer of pH 4.5 and phosphate buffer of pH 6.8 was similar and fit Weibull model, but it mutated in phosphate buffer of pH 7.4 and reached the maximum amount at 30 min. Conclusion The dissolution quantity of Changxiong powder is gradually increasing and the time is shorted in the medium from acidic to neutral then to alkaline. Dissolution curve is similar in the acidic and neutral medium. Changxiong powder dissolves out fast and completely in the alkaline medium.

Objective To investigate the correlation of plasma matrix metalloproteinase-3 (MMP-3)levels and MMP-3 Lys45Glu (rs679620) polyrnorphism with ischemic stroke and its TOAST subtypes.Methods The patients with large artery atherosclerotic stroke (LAA) and small artery occlusion stroke (SAO)according to TOAST etiological typing (ischemic stroke group) and healthy subjects (control group) were enrolled.The enzyme-linked immunosorbent assay was used to detect plasma MMP-3 level.The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genotypes of MMP-3 Lys45Glu.Results A total of 233 patients with ischemic stroke were enrolled,in which 162 were LAA and 71 were SAO; 200 healthy subjects were taken as controls.The plasma MMP-3 level in the ischernic stroke group was significantly higher than that in the control goup (253.99 ± 75.02 ng/ml vs.196.38 ± 78.17 ng/ml;t =7.813,P=0.000).The plasma MMP-3 level in the LAA group (262.81 ±69.23 ng/ml) was significantly higher than those in thegroups of SAO (233.85 ± 83.90 ng/ml,P =0.008) and control (P =0.000),and the plasma MMP-3 level in the SAO was also significantly higher than that in the control group (P =0.000).Multivariate logistic regression analysis showed that the increased serum MMP-3 level was an independent risk factor for ischemic stroke (odds ratio [OR] 1.012,95％ confidence interval [CI] 1.008-1.015; P =0.000).There was no significant difference in the frequencies of genotype (x2 =2.085,P =0.353) and allele (x2 =2.29,P =0.130) of MMP-3 Lys45Glu between the ischemic stroke group and the control group.However,there were significant difference in MMP-3 Lys45Glu genotype frequencies among.the groups of LAA,SAO and control (x2 =10.39,P=0.034).The AA + GA genotype frequency in the LAA group was significant higher than those in the groups of SAO (65.4％ vs.49.3％ ;x2 =5.375,P =0.020) and control (65.4％ vs.54.0％ ;x2 =4.84,P =0.028).There was no significant difference in the allele frequencies among the groups of LAA,SAO and control (x2 =3.887,P =0.143).Multivariate logistic regression analysis showed that MMP-3 Lys45Glu polymorphism was an independent risk factor for LAA (OR 1.783,95％ CI 1.183-2.688; P =0.006).The plasma MMP-3 level in patients with the genotypes AA (n =73),GA (n =176) and GG (n =184)were 235.70 ± 70.85 ng/ml,(244.20 ± 85.90 ng/ml and 207.98 ± 77.61 ng/ml.There were significant difference in the plasma MMP-3 levels among the patients with the genotypes AA,GA and GG (F=9.682,P =0.000).The plasma MMP-3 level in the patients with the genotype AA + GA was significantly higher than that in patients with genotype GG (241.71 ± 81.73 ng/ml vs.207.98 ± 77.61 ng/ml; t =4.336,P =0.000).Conclusions The plasma MMP-3 level increased in patients with LAA or SAO,especially in the patients with LAA.The MMP-3 Lys45Glu polymorphism might be associated with the plasma MMP-3 level and LAA.

BACKGROUNDTo investigate the clinical possibility of detection of lung cancer cells in the peripheral blood with cytokeratin and 2F7/S5A monoclonal antibody by flow cytometry (FCM) in patients with lung cancer.

METHODSFive mililiter peripheral blood was collected. The mononuclear cells were isolated by Ficoll-Hypaquegradient centrifugation. Then the cells were labeled with lung specific antibody (2F7/S5A) and antibodies against CD45, cytokeratin (CK). The quantitation of CD45 -CK +2F7/S5A + cells were performed by FCM.

RESULTSA total of 151 people were studied, including 20 healthy controls, 116 patients with lung cancer and 15 patients with benign pulmonary diseases. The phenotype of monocytes of peripheral blood was CD45 +CK -2F7/S5A -, while the phenotype of lung cancer cells was CD45 -CK +2F7/S5A +. No cancer cell was found in peripheral blood of all the healthy controls. One out of 15 cases of benign pulmonary diseases was found to have CD45 +CK -2F7/S5A - cells in peripheral blood. And 39 out of 116 patients with lung cancer were found to have circulating lung cancer cells. The sensitivity, specificity, positive predictive value and negative predictive value of detection was 33.62% , 93.33%, 97.50% and 15.38%, respectively. The average quantitation of circulating cancer cell detected was 0.12×10⁶/L.

CONCLUSIONSThere is high specificity and positive predictive value of the examination of circulating cancer cells in patients with lung cancer by FCM, which could detect trace cancer cell in peripheral blood of lung cancer. It may be valuable in diagnosis and treatment of lung cancer.