Objective To discuss the active role of health education on control of diabetes mdlitus and prevention of its complications.Methods 96 cases of hospitalized patients with diabetes mellitus were randomly divided into the control group and the observation group with 48 patients in each group from June 2009 to June 2010.The control group received conventional diabetes treatment and distribution of health education brochures,based on this,the observation group was given health education,including cognitive,nutrition,behavioral intervention.The general prevention condition of diabetes and its complications as well as the education effect were compared before the education and six months after education.Results The fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index and incidence of complications were greatly improved in the observation group than those of the control group.Conclusions Strengthening health education can improve self-care ability of patients,effectively improve the overall control level of diabetes,reduce acute and chronic complications,disability,death rate.

To evaluate the feasibility and accuracy of contrast-enhanced ultrasonography (CEUS) for the measurement of hemodialysis access recirculation (AR) and access flow rate (Qa), a two pump system was used to simulate access and dialyzer flow. AR and Qa under different conditions, such as reversal connection of dialysis lines and the needle orientation, were compared with each other. The value of access flow and recirculation flow were calculated based on the formulas introduced in this paper, and the correlation and consistency between true flow rate and calculated values were analyzed. The measured R correlated well with true value of flow rate (r = 0.57, P = 0.038, Qa > Qb; r = 0.95, P = 0.001, Qa < Qb). The Bland-altman test showed good agreement between the calculated value based on CEUS and true values. The CEUS can be used as a new advanced technology for AR and Qa measurement.
Arteriovenous Shunt, Surgical ; Blood Flow Velocity ; Computer Simulation ; Contrast Media ; Humans ; Kidney Failure, Chronic ; blood ; therapy ; Models, Biological ; Monitoring, Physiologic ; instrumentation ; Regional Blood Flow ; Renal Dialysis ; methods ; Ultrasonography

OBJECTIVELate onset neonatal septicemia (systemic infection after 72 hours of life) remains a major cause of neonatal morbidity and mortality. Early treatment with appropriate antibiotics is critical since infected infants can deteriorate rapidly. The aim of this study was to review the pathogens responsible for late onset neonatal septicemia (LONS) and their antimicrobial susceptibilities in order to guide the initial selection of appropriate antibiotics for infants with suspected LONS.

METHODSA retrospective chart review of all cases with LONS seen in the neonatal intensive care unit (NICU) of Yuying Children's Hospital of Wenzhou Medical College from January 1, 2002 to December 31, 2005 was conducted. All cases were selected based on the clinical presentation and at least one positive result of blood culture. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were analyzed.

RESULTSA total of 102 cases with LONS were identified. Among those 102 cases, 80 were community acquired (infants admitted from home and the blood culture was done on admission) and 22 were hospital acquired (infants became sick while in the NICU and the blood culture was done prior to use of antibiotics). The clinical presentations were non-specific. Compared to the infants with community acquired LONS, infants with hospital acquired LONS were usually born more prematurely (mean gestational age 33 +/- 3 vs 39 +/- 2 wks, t = 2.255, P < 0.01), with lower weight (mean weight 1.79 +/- 0.70 vs 3.23 +/- 0.67 kg, t = 8.818, P < 0.01) and with younger age (mean age 12 +/- 6 vs 16 +/- 7 days, t = 7.581, P < 0.05). Of the 102 cases, a total of 103 strains of bacteria were isolated. Among the pathogenic bacteria isolated, the most common were coagulase-negative Staphylococcus (CoNS) (50/103, 48.5%), followed by Klebsiella pneumoniae (16/103, 15.5%). The main pathogens for community acquired LONS were Staphylococcus species and Escherichia coli. The most important pathogen responsible for hospital acquired LONS was Klebsiella pneumoniae. Most (> 80%) of the Staphylococcus especially CoNS were resistant to common antibiotics such as penicillin, erythromycin and cefazolin. Significant numbers (6/9) of Staphylococcus aureus isolated were methicillin-resistant Staphylococcus aureus (MRSA). However, all of the Staphyloccus isolates were sensitive to vancomycin. Almost all (15/16) of the Klebsiella pneumoniae isolated were multi-drug resistant due to production of extended-spectrum beta-lactamases (ESBLs). They were sensitive only to a few antibiotics such as carbapenems, aminoglycosides and quinolones. There was also one strain of vancomycin-resistant Enterococcus (VRE). Furthermore, there was no a single case of late onset neonatal sepsis due to infection with group B Streptococcus (GBS).

CONCLUSIONSThe clinical manifestations of late onset neonatal sepsis are usually non-specific. GBS is not a significant pathogen responsible for community acquired LONS in the Wenzhou area. There are increasing numbers of multi-drug resistant bacterial species isolated from the newborn infants with late onset neonatal septicemia, which is most likely due the non-restricted use of antibiotics in the hospitals as well as in the communities. A routine blood culture should be taken from any newborn infant who is suspected of LONS and empirical use of appropriate antibiotics should be initiated as soon as the blood specimen for culture has been drawn. To reduce the occurrence of multi-drug resistant bacteria, the use of antibiotics especially the third generation cephalosporins in neonates should be restricted as much as possible.

Community-Acquired Infections ; microbiology ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Infant, Newborn ; Male ; Retrospective Studies ; Sepsis ; microbiology

Objective To explore the diagnostic value of serum carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724) combined with long non-coding RNA MALAT1 in gastric cancer. Methods A total of 100 patients with gastric cancer diagnosed in Changzhou Cancer Hospital, Soochow University from March 2013 to February 2018 were collected as the case group, and 100 healthy people during the same period in our hospital were collected as the control group. The levels of serum CEA, CA724 were detected by using chemiluminesent immunoassay assay, and the relative expression of MALAT1 was detected by using real-time fluorescence quantification polymerase chain reaction (PCR). The relationships between CEA, CA724, MALAT1 and the clinicopathological features of gastric cancer were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of CEA, CA724 and MALAT1 in patients with gastric cancer. The odds ratio (OR) and 95％ confidence interval (CI) were calculated by using logistic regression. Results The levels of serum CEA, CA724 and MALAT1 in the case group were higher than those in the control group [(3.08 ±0.21) ng/ml vs. (0.74 ±0.11) ng/ml, t= 3.814, P= 0.002; (4.28 ±0.17) U/ml vs. (0.51± 0.07) U/ml, t=4.703, P<0.01; (113.9±3.9) vs. (36.1±1.2), t=7.160, P<0.01 respectively], and the three indexes were related to the pathological types and TNM staging of gastric cancer (all P< 0.05), and the most significant increase was seen in tubular adenocarcinoma patients and stage Ⅲ-Ⅳ patients. ROC curve analysis showed that the area under curve (AUC) of serum CEA, CA724 and MALAT1 in the differential diagnosis between the gastric cancer and the healthy people were 0.675 (95％CI 0.578-0.755, P= 0.001), 0.865 (95％CI 0.800-0.922, P< 0.01) and 0.847 (95％CI 0.771-0.911, P< 0.01), and the sensitivity was 69.1％, 80.2％, 85.8％, and specificity was 63.5％, 77.4％, 74.5％, respectively. AUC of combination of the three indicators for diagnosis of gastric cancer was 0.887 (95％CI 0.821-0.949, P<0.001), and the sensitivity was 84.3％ and the specificity was 91.9％. Logistic regression results showed that high levels of serum CEA, CA724 and MALAT1 were risk factors for gastric cancer. After adjusting for age, sex, smoking history and drinking history, high levels of serum CEA, CA724 and MALAT1 remained the independent risk factors for gastric cancer. Conclusion The combined detection of serum CEA, CA724 and MALAT1 can be used to predict the risk of gastric cancer, and the three have a value for the diagnosis of gastric cancer, which is worthy of clinical application.

Kidney transplantation is the treatment of choice for patients with end-stage renal disease, as it extends survival and increases quality of life in these patients. However, chronic allograft injury continues to be a major problem, and leads to eventual graft loss. Early detection of allograft injury is essential for guiding appropriate intervention to delay or prevent irreversible damage. Several advanced MRI techniques can offer some important information regarding functional changes such as perfusion, diffusion, structural complexity, as well as oxygenation and fibrosis. This review highlights the potential of multiparametric MRI for noninvasive and comprehensive assessment of renal allograft injury.
Allografts ; Diffusion ; Fibrosis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Magnetic Resonance Imaging ; Oxygen ; Perfusion ; Quality of Life ; Transplants

Adolescent ; Adult ; Female ; Humans ; Lithiasis ; genetics ; Lung Diseases ; genetics ; Male ; Middle Aged ; Pedigree ; Pulmonary Alveoli

OBJECTIVETo observe the effects of temporary acid exposure on cell proliferation and extracellular signal-regulated protein kinase (ERK) activity in normal human esophageal epithelial cells in vitro.

METHODSNormal human esophageal epithelial cells cultured in vitro were exposed to acidic media (pH 4.0-6.5) for 3 to 60 min, and the control cells were cultured at pH 7.3. MTT assay and flow cytometry were employed for cell proliferation assessment. The expression of phosphorylated ERK1/2 protein was determined by immunoblotting.

RESULTSEsophageal epithelial cells with acid exposure for 3 min exhibited a significant increase in cell proliferation, increased number of cells in S phase and enhanced expression of phosphorylated ERK1/2 protein. Acid exposure of the esophageal epithelial cells exceeding 6 min resulted in depressed proliferation and decreased S-phase cells, and cell proliferation induced by acid exposure was abolished by pretreatment with U0126.

CONCLUSIONTemporary acid stimulus increases cell proliferation of normal human esophageal epithelial cells in vitro by activating the ERK pathway.

Acids ; pharmacology ; Blotting, Western ; Butadienes ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media ; pharmacology ; Enzyme Inhibitors ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; metabolism ; Esophagus ; cytology ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; metabolism ; Humans ; Hydrogen-Ion Concentration ; Immunohistochemistry ; Keratin-14 ; analysis ; Nitriles ; pharmacology ; Signal Transduction ; drug effects ; Time Factors

OBJECTIVETo investigate the relationship between the aldosterone synthase (CYP11B2)-344C/T polymorphism and small artery compliance (C(2)).

METHODSC(2) was measured by CVProfilor DO-2020 in 224 subjects, including 123 subjects with an abnormal C(2) and 101 normal controls. Genotypes of CYP11B2 were determined by polymerase chain reaction-based restriction fragment length polymorphism analysis.

RESULTSThe frequencies of the CYP11B TT genotype and T allele in subjects with an abnormal C(2) were slightly higher than in normal controls, but the differences did not reach statistical significance (55.3% vs 41.6%, P > 0.05, 75.6% vs 66.8%, P > 0.05. However, when CT was combined with CC, the frequency of TT in subjects with an abnormal C(2) was significantly higher than in normal controls (P < 0.05). By CANOVA, TT subjects had a lower C(2) than CT and CC subjects (P < 0.05). Logistic regression analysis revealed that TT genotype was associated with abnormal C(2) (P = 0.043, OR = 1.93 95% CI 1.02-3.63).

CONCLUSIONSThe CYP11B-344C/T polymorphism is associated with small artery compliance, and TT subjects are susceptible to abnormality of small arterial compliance.

Adult ; Arterioles ; physiology ; Cytochrome P-450 CYP11B2 ; genetics ; Elasticity ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

OBJECTIVETo understand the epidemiological characteristics of syphilis infection in blood donors of Chinese Nanjing area, to strengthen control of blood quality and to provide the scientific evidence for working out the strategy of prevention and treatment of syphilis infection.

METHODSFirstly the double antigen sandwich ELISA was carried out according to its instructions, test results showing positive will be examed by double orifice second-round.

RESULTSA total of 362425 blood samples were collected from 2010 to 2014, among them 1277 positive samples were detected. The average rate of syphilis infection was 0.35％. The positive rates of different old years were statistically different（X(2)=265.679,P<0.001）, and the change trend of 5 years was statistically different(X(2)trend=237.928,P<0.001）. Among all age groups in the detection of treponema pallidema(TP), the most amount of positive samples and the lowest positive ratio 0.23% were found in the group 18 to 29 years old. The highest positive ratio was shown in age 50 years old and above. There was statistical different in all age groups(X(2)=361.620,P<0.001）. The positive ratio of the detection of TP was 0.32% in male donors which was lower than that in female donors(0.42%). There was statistical different in all sex groups(X(2)=24.659,P<0.001）. Peasant group had the highest positive ratio(1.07%) in the detection of TP and the student group had the lowest positive ratio(0.19%). There was statistical different in all occupation groups(X(2)=300.198,P<0.001）. Junior and under group had the highest positive ratio(0.59%) in the detection of TP and the undergraduates group has the lowest positive ratio(0.19%). There was statistical different in all education groups(X(2)=241.734,P<0.001）. Through chi-square test and trend test analysis showed that there was statistical different in sex, age, educational level and occupation differences. The tendency of the groups' statistics in 5 years is equally important.

CONCLUSIONIt is necessary to publicize blood donation information consultation scientifically before blood donation, especially for high-risk population. To ensure blood supply safety, it is important to recruit low-risk blood donors and develop permanent voluntary blood donors for reducing blood waste.

Asian Continental Ancestry Group ; Blood Donors ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Syphilis

Objective: To study therapeutic effect of TriVex system minimally invasive phlebectomy on lower extremity varicose veins (LEVV). Methods: A total of 100 LEVV patients treated in our department were selected, randomly and equally divided into minimally invasive phlebectomy group (received TriVex system minimally invasive phlebectomy) and traditional treatment group (received high ligation and exfoliation). Therapeutic effect, treatment-related indexes and postoperative complications were assessed in two groups, and they received assessments of venous clinical severity score (VCSS), chronic venous insufficiency questionnaire (CIVIQ) and clinical-etiology-anatomic-pathophysiologic (CEAP) class on three and six months after operation. Results: There was no significant difference in therapeutic effect between two groups (P＞ 0. 05). Compared with traditional treatment group, there were significant reductions in number of incisions [(8. 6±1. 7) vs. (4. 2±1. 1)], surgery time [(70. 17±15. 92) min vs. (32. 45±11. 74) min], recovery time after surgery [(6. 82± 1. 51) h vs. (3. 93±1. 13) h], incidence rates of superficial vein thrombosis (18. 0％ vs. 0) and recurrence rate (12. 0％ vs. 0) in minimally invasive phlebectomy group, P=0. 001 all. Compared with traditional treatment group on three and six months after surgery, there was significant reduction in VCSS score [three months: (7. 23±1. 48) scores vs. (4. 16±1. 35) scores], and significant rise in CIVIQ score [three months: (67. 23±9. 47) scores vs. (81. 16±8. 38) scores]in minimally invasive phlebectomy group, P=0. 001 all; CEAP classes of two groups were significantly lower than those of before surgery (P=0. 001 all), but there was no significant difference between two groups (P＞0. 05 all). Conclusion: TriVex system minimally invasive phlebectomy possesses similar therapeutic effect with traditional surgeries on multiple-cause varicose veins. The method is simpler and therapeutic effect is definite with less pain and complications, and patients recover rapidly and accept it easily, which is worth extending.