[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

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

Objective To compare the effects of peripherally inserted central catheter(PICC)and venous port access (VPA)on the complication incidence of breast cancer.Methods A total of 191 breast cancer patients with VPA and 218 ones with PICC for chemotherapy from January 2012 to January 2014 were involved.The two groups were compared in respect of incidence of complications during intubation.Result The complication incidence in the VPA group was lower than the PICC group(P<0.05). Conclusion VPA is an ideal pathway for intravenous infusion in breast cancer patients undergoing chemotherapy.

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 compare in vitro fertilization and embryo transfer( IVF-ET ) outcome of gonadotropin-releasing hormone( GnRH ) antagonist protocol and GnRH agonist long protocol in patients with polycystic ovary syndrome ( PCOS)and to provide reference for rational selection of ovulation stimulation protocol for PCOS patients. Methods One hundred and four patients with PCOS who underwent IVF-ET were randomly divided into two groups. In the study group,41 patients were subjected to the GnRH antagonist protocol;In the control group,63 patients were subjected to a long protocol of GnRH agonist. Doses and duration of gonadotropin therapy,the thickness of endometrium and the profile of hormone level on the day of HCG administration,the number of retrieved oocytes,the ratio of fertilization,the ratio of cleavage,the ratio of the good quantity embryos,implantation rate of embryo,pregnancy rate,the cycle cancellation rate and the incidence rate of ovarian hyperstimulation syndrome( OHSS)were recorded. Results The IVF-ET outcome of the two groups was similar with respects to the number of oocytes,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate( P﹥0. 05). Significant differences were found(P﹤0. 05)between the two groups regarding to the doses and duration of gonadotropin therapy,the levels of serum E2 and LH on the day of HCG administration,and the cycle cancellation rate. The incidence rate of OHSS was not significantly different ( 2. 44% vs. 12. 70%) between the two groups. Conclusion The duration of gonadotropins administration,the cycle cancellation rate,incidence of OHSS and the financial burdern are reduced in patients treated with GnRH antagonist. The growth of follicle,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate are not different between the two methods. The GnRH antagonist protocol is optimal for patients with PCOS.

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.

Abstact:Objective To investigate the clinical value of mean platelet mass(MPM)and the procalcitonin(PCT)in diagnosis of Kawasaki disease (KD).Methods A Total of 117 children with KD in the acute stage and 126 children of the control group were detected respectively and compared each other.The indexes contain MPM,PLT,MPV,PDW and PCT.Mean-while,the comparison of each index’s positive rate and the linear correlation analysis of each index were conducted.Results①The level of MPM of the KD group was significant lower than that of the control group,PLT,MPV and PCT significant higher than those (P<0.05,α=0.05).The difference of PDW between the two groups was no statistical significance (P>0.05,α=0.05).②The positive rate of the MPM was significant higher than that of the other indexes (P<0.05,α=0.05). Conclusion The detection of MPM is helpful to the diagnosis of KD and can be used as an indicator of KD clinically.

Objective To investigate the level of 25-hydroxyvitamin D[25(OH)D]and relationship to C-reactive protein(CRP) and procalcitonin(PCT)in children with severe pneumonia.Methods Serum 25 (OH)D levels of 86 cases of children with severe pneumonia,81 cases of children with mild pneumonia and 85 cases of children in healthy control group on admission were deter-mined by ELISA respectively and compared.At the same time,CRP and PCT were tested and the correlation to 25(OH)D in chil-dren with severe pneumonia was analyzed.Results There are statistical differences among three groups(P <0.05,α=0.05 ).The mean values of serum 25 (OH)D were (62.03 ±17.94),(68.90 ±15.22)and (82.21 ±17.89)μmol/L in severe pneumonia pa-tients,mild pneumonia patients and healthy children respectively,furthermore,prevalence of vitamin D deficiency of the sever pneu-monia group was significantly higher than that of the case-control group and normal group (P < 0.05,α= 0.05 ).The level of 25(OH)D was not significantly related to CRP and PCT level in children with severe pneumonia(P <0.05,α=0.05).Conclusion The mean level of vitamin D in children with severe pneumonia was significantly lower,which may be associated with the occurrence and develop-ment of severe pneumonia in children.

Objective To investigate the influence on the ovarian reserved function of Gn-RH injection in the bilateral laparoscopic cys-tectomy. Methods The clinical data of 100 patients with endometriosis undergoing bilateral laparoscopic cystectomy were included in this study. 50 patients treated by routine bilateral laparoscopic cystectomy were set as control group. 50 patients treated by Gn-RH injection addi-tionally during the surgery were set as study group. The operative situation,serum FSH level,FSH/LH,E2 level,ovarian reserved function, pregnancy situation and recurrent rate were compared between two groups. Results The operative duration and electrocautery times in study group was significantly less than those in control group(P<0. 01). The residual ovarian tissue capsule wall thickness in study group was sig-nificantly more than that in control group(P<0. 01). At different time points,the serum FSH level,FSH/LH and E2 level in study group were significantly less than those in control group(P<0. 01,P<0. 05). The incidence of ovarian reserved function damage in study group was significantly less than those in control group(P<0. 05). The pregnancy rate was significantly higher and the time between surgery and pregnancy was significantly shorter in study group than those in control group(P<0. 05,P<0. 01). The recurrent rate in study group was sig-nificantly less than those in control group(P<0. 01). Conclusion There is a influence on ovarian reserved function of bilateral laparoscopic cystectomy. By inject Gn-RH during surgery,the ovarian reserved function could be protected,which increase the pregnancy rate and reduce recurrence.