[abstract] Objective To study the health education on diabetes nurse diabetes management mode at the core of application in the patients with follow-up effect. Methods Our hospital endocrinology in October 2015,participate in blood sugar management company research project(namely,doctors,nurses and patients ofthree Eonline and offline (O2O) integration management system).The project is the specialist education nurses,doctors and patients of organic whole,to form a closed-loop management.Use of the project with mobile tablet (PAD),SMS platform on the first base into a group of patients with type 2 diabetes insulin for 5 minutes on education and baseline data collection,and in the next 15 weeks of diabetes health education nurses via text message and phone tracking in the form of blood sugar and insulin dose data,at the same time for more than three months of education,guidance and management,to help patients with initial foundation of insulin self management knowledge and skills,promote the blood glucose control is at target. Results In 12 weeks of the completion of this project and follow-up,425 patients of FPG success rate is 82.6%. Conclusion Nurse diabetes health education as the core of diabetes management model is feasible in patients with type 2 diabetes, the effect is good,that greatly arouse the subjective initiative of patients;Improve the patients′self-management ability,improving according to the medical behavior;Improved treatment adherence to standard prompt patients FPG.

OBJECTIVE To analyze the significance of serum infectious markers in different sources and investigate the prevetion strategy of nosocomial infection in clinical laboratory. METHODS The serum infectious markers(HBsAg,anti-HCV,anti-HIV and syphilis antibody) were detected in outpatient,inpatient and physical check-up people from Jun 2007 to Jun 2008. RESULTS The total percentage of HBsAg,anti-HCV,anti-HIV or syphilis antibody positive in outpatient,inpatient and physical check-up people was 43.30%,13.56% and 7.26%,respectively.The positive rate of HBeAg in outpatient,inpatient and physical check-up people was 12.29%,1.78% and 0.71%,respectively.The average infection rate of syphilis was 1.75% in inpatients,but in inpatients above 60 years old it could be 3.75%.Twenty-one cases were reconfirmed of HIV positive by the reconfirmation laboratory of CDC in Human Province. CONCLUSIONS The positive rates of four serum infectious markers in outpatient or inpatient are markedly higher than that in physical check-up people(? 2=10 117.6,P

Objective To analyze the functional alteration of natural killer (NK) cells from patients with macrophage activation syndrome (MAS) in active phase and after treatment.Methods Peripheral blood samples were collected from 12 healthy subjects,12 patients with systemic onset juvenile rheumatoid arthritis (SoJIA) but without an episode of MAS and 12 patients with MAS.Flow cytometry analysis was performed to detect NK cells and their expression of perforin,granzyme B,interferon (IFN)-γand tumour necrosis factor (TNF)-α.The cytotoxicity of NK cells to K562 cell was also analyzed.All of the patients with MAS were diagnozed by clinical features and the pathologic examination of hemophagocytosis in bone marrow.The function of NK cells were analyzed before any treatment and on the fifth day as well as in third month after treatment with glucocorticoid,intravenous immunoglobulin and/or cyclosporin A.Results Compared with healthy subjects and patients with SoJIA,patients with MAS had lower NK cell counts,reduced cytotoxicity and decreased expression of perforin and granzyme B before or on the fifth day after treatment (P＜0.05).However,increased production of IFN-γ and TNF-α by NK cells were observed (P＜ 0.05).In the third month after treatment,the cytotoxicity of NK cells and the expression of perforin and granzyme B in patients with MAS were lower than those in healthy subjects and patients with SoJIA (P＜ 0.05),but no statistically significant differences with NK cell counts and production of IFN-γand TNF-α were observed beween the patients with MAS and healthy subjects (P＞0.05).Conclusion NK cells from patients with active MAS were characterized by reduced cytotoxicity and enhanced production of IFN-γ and TNF-α.Upon medical treatment,the number of NK cells in patients with MAS were up-regulated and their production of IFN-γand TNF-α were down-regulated.However,the cytotoxicity of NK cells and the expression of perforin and granzyme B were not affected.Reduced cytotoxicity and decreased production of perforin and granzyme B with NK cells might be the durative features for the patients with MAS.

Objective To study the clinical manifestations and influencing prognostic factors of children with acute paraquat in-toxication ,and to search for reasonable and effective treatments .Methods Retrospectively analyzed the clinical data of 68 children with acute paraquat intoxication from March 2005 to June 2012 .According to the amount of toxic dose and clinical symptoms ,all of them were divided into 3 groups ,mild type(22 cases) ,severe type(26 cases) and fulminant type(14 cases) ,retrospective analysis on clinical manifestation ,auxiliary examination and prognosis among the groups and following up the survival of these patients ,the risk factors which may affect the prognosis were explored .Results 66 cases were poisoned by taking orally and the other 2 cases were poisoned by the skin absorption .Gastrointestinal symptoms were the most common .Among 68 cases ,6 cases was lost the following up ,20 cases died(32 .26% mortality):all children from mild type survived ;8 patients from severe type and 12 patients from fulmi-nant type(30 .77% ,85 .71% ,mortality respectively ) .As the degree of the clinical classification deteriorated ,the mortality in-creased ,there was statistical signification between each other and so did the blood urea nitrogen and serum creatinine (P<0 .05) .By following up ,children who once passed the acute stage can recovery and the pulmonary fibrosis might be reversed by the chest CT follow-up .The logistic regression analysis indicated that children who had been diagnosed with acute kidney injury and multiple or-gan dysfunction syndrome showed the worse prognosis .Conclusion Acute kidney injury is a very important factor for the short term prognosis of paraquat intoxication ,while pulmonary fibrosis determine the long-term outcomes ,lung injury may be reversed in the course of the disease ,so we should take active treatments .

Objective To research the feasibility and accuracy on echocardiography measurement aortic annulus diameter(AAD)at the plane of three Junctions of aortic valve leaflets by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE).Methods Twenty-three patients underwent echocardiography and aortic valve replacement because of acquired aortic valve disease.The AAD was measured in parasternal left ventricle long axis view(TTE-AAD)by transthoracic echocardiography(TTE)preoperative.The AAD was measured in left ventricle long axis view(TEE-AAD)and the distance of three iunctions of aortic valve leaflets (N,L,R) was measured in aortic short axis view by RT-3D-TEE intraoperative.The three-dimensional full volume images were analyzed by online QLAB 7.0 software.The AAD was measured by standard cylindrical valve sizer (OP-AAD)before aortic valve replacement surgery,too.Results Comparing with the three aortic valve leaflets of acquired aortic valve disease,the lines between their junctions constituted an approximate equilateral triangle regardless of the cause and degree of disease,and the length of the three groups was no significant difference(P>0.05).There was no significant difference between TTE-AAD and OP-AAD group(P>0.05),and the correlation was good(r=0.84).The N,L and R group compared separately with the OP-AAD group, there was no significant difference(P>0.05)and correlation was superior to TTE-AAD group(r=0.94, 0.97, 0.96).The difference between TEE-AAD and OP-AAD were significant(P<0.01).Conclusions Echocardiography measurement of AAD at the plane of three junctions of aortic valve leaflets is feasible,and it is better accuracy and repeatability comparing with parasternal left ventricle long axis view.

Objective To study the effect of combining recombinet interferon α -2b gel and loop electrosurgical excision procedure (LEEP) to treat cervical intraepithehal neoplasia (CIN). Methods Prospective, randomly and control study was progressed in 80 patients with CIN Ⅱ-Ⅲ. Before carrying out LEEP, all women were performed high-risk HPV DNA detection by the method of HC2. Among them, forty women were. assigned to be the study group, in which the patients were added to use recombinet interferon α -2b gel for three courses of treatment before and after LEEP, the other forty women who carried out LEEP simply were assigned to be the control group. All patients were examined by hquid-based thinprep cytology test (TCT) and colposcopic site-specific biopsies to doubtful focus of infection in the 3rd, 6th, 9th and 12th month after treatment, and judged the effect by using HC2 in the 6th and 12th month after treatment. Results Eighty patients were not detected residue and recidivafion of CIN diagnosed by coiposcopic site-specific biopsies to doubtful focus of infection. In the study group, 3 women were abnormal detected by TCT, 37 women were negative detected by HC2, the negative rate was 92.5% when LEEP ended 6 months. The cure rate was 100.0% when LEEP ended 12 months. In the control group, 21 women were abnormal detected by TCT, 19 women were negative detected by HC2, the negative rate was 47.5% when LEEP ended 6 months, 8 women were negative detected by TCT, 25 women were negative detected by HC2, the cure rate was 62.5% when LEEP ended 12 months.In the 6th and 12th month after LEEP, the difference was distinguished in the cure rate between two groups. Conclusions There is double interrupted effects by combining recombinets interferon α -2b gel and LEEP to treat CIN. It can raise the one-time cure rate of the patients with CIN.

Objective To investigate the characteristic and satisfaction degree of clinical applica-tion of "fingers pain score model" from the aspects of nurses and patients in order to evaluated the fea- sibility and pragmatism of the model. Methods "Fingers pain score model" was designed and to-gether with the NRS- 10 scale were applied in clinic for 2 years. Evaluation from both nurses and patients were in-vestigated after two-year probation, and the results underwent χ<'2> test. Results Evaluation from nurses on convenience, fidelity, communication and satisfaction of "fingers pain score model"were all sig-nificantly higher compared with the control. And evaluation from patients on direct-viewing,accuracy,re-ception and satisfaction of "fingers pain score model"were different from the NRS- 10 control, except for the fidelity. Conclusions Outweighing the NRS- 10 scale, the "fingers pain score model" is a better choice to meet the needs of the nurses and patients in pain evaluation in clinic.

Objective To evaluate the efficacy of laparuseopic and open D_2 radical gastrectomy for gastric cancer. Methods From January 2008 to February 2009, 64 gastric cancer patients received laparoscopic radical gastrectomy (LAP group) and 60 gastric cancer patients received open gastrectomy (open group) at Changzhou No. 2 People's Hospital. Clinical parameters including operation time, blood loss, resection margin of gastric cancer, number of lymph nodes dissected, time for passage of flatus, time for out-of-bed activity, hospital stay and postoperative complications in the 2 groups were analyzed via t test and chi-square test. Results Gastrectomy was successfully performed on all patients. Mean operation time in LAP group was significantly longer than open group (t=5.56, P<0.05). There was no significant difference in the length of resection margin and number of lymph nodes dissected between the 2 groups (t=0.67, 0.86, 1.09, P>0.05). The mean blood loss, time for passage of flatus, time for out-of-bed activity and hospital stay in LAP group were significantly lesser than in open group (t=4.59, 5.56, 16.39, 4.79, P<0.05). Six patients in LAP group and 5 patients in open group had compli-cations postoperatively. All patients were followed up for 1-13 months, and no recurrence or death occurred. Conclusion Laparoscopic D_2 radical gastrectomy is safe and effective for gastric cancer.

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.

OBJECTIVETo compare the differences in the clinical efficacy on insomnia between shujing massage therapy and medication with estazolam.

METHODSEighty patients of insomnia were randomized into a shujing mass age therapy group (40 cases) and a medication group (40 cases). In the shujing massage therapy group, the spreading massage manipulation was applied along the running course of the gallbladder meridian of foot-shaoyang on the temporal area. The pressing and kneading manipulation was done at Yangbai (GB 14), Benshen (GB 13), Toulinqi (GB 15), Zhengying (GB 17), Chengling (GB 18), Shuaigu (GB 8), and Fengchi (GB 20), etc, 1 min at each acupoint. In the medication group, 1 mg estazolam was taken orally half an hour before sleep. The treatment was given once every day in the two groups. After the continuous treatment for 1 month, every dimensional score and the total score in the Pittsburgh sleep quality index scale (PSQI) and the clinical efficacy were evaluated between the two groups.

RESULTSAfter the intervention, the each item score of PSQI was improved as compared with that before treatment in the patients of the two groups (all P<0. 05). The differences in sleep time and the time for falling into sleep were not significant between the two groups (both P>0. 05). In the shujing massage therapy group, the scores of sleep quality, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score were all lower than those in the medication group (all P<0. 05). The total effective rate was 92. 1% (35/38) in the shujing massage group and was 84. 2% (32/38) in the medication group, indicating the significant difference (P<0. 05).

CONCLUSIONShujing massage therapy achieves the superior efficacy on insomnia compared with the oral administration of estazolam.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Male ; Massage ; Meridians ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome