Objective To discuss the influence of psychological nursing on the therapeutic effect of patients with newly diagnosed type 2 diabetes. Methods Patients (60 cases) who received psychological nursing were set as the nursing group. Patients (65 cases) who did not received psychological nursing were set as the control group. The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment was observed. Results The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment in the nursing group was higher than that of the control group (P<0.01). Conclusions Psychological nursing of patients with newly diagnosed type 2 diabetes could make patients obey doctors' advice and accept early insulin treatment to control plasma glucose and delete the toxicity of high concentration of plasma glucose as soon as possible.

AIM:To investigate the role of potassium channel expression alteration in chronic cigarette smoking-induced increase in pulmonary vascular responsiveness,the effect of chronic cigarette smoking on large-conductance calcium-activated potassium channel(BKCa) and voltage-dependent delayed rectifier potassium channel(Kv1.5) expression in rat pulmonary smooth muscle cells were investigated in vivo.METHODS: HE staining,immuno-histochemistry and in situ hybridization techniques were used.RESULTS:(1) Chronic cigarette smoking downregulates the protein and mRNA expression of BKCa in pulmonary arterial smooth muscles.(2) Chronic cigarette smoking downregulated the protein and mRNA expression of Kv1.5 in pulmonary arterial smooth muscles.(3) In big artery,BKCa decreased more makedly than Kv1.5,but in small artery,both of them decreased equally.CONCLUSION: Chronic cigarette smoking downregulates the levels of BKCa and Kv1.5 in rat pulmonary arterial smooth muscle cells in vivo,which maybe contribute to the mechanism of cigarette smoking-induced increase in pulmonary vascular responsiveness.

BACKGROUND:Stem cel therapy has been used for prevention and treatment of degenerative disc disease. Considering the special microenvironment in the intervertebral disc, the survival rate and differentiation ability of transplanted cels are decreased, which may lead to the poor efficacy of stem cel therapy. How to improve the survival ability and therapeutic effect of the transplanted cels is the focus of stem cel therapy for degenerative disc disease.
OBJECTIVE: To investigate the effects of cobalt chloride combined with hypertonic solution pretreatment on bone marrow mesenchymal stem cels that wil be transplanted for treatment of degenerative disc disease.
METHODS:(1)In vitro cel experiment: bone marrow mesenchymal stem cels were divided into three groups and subjected to normal culture medium (normal control group), 1% hypertonic mother solution (hypertonic group), 100 μmol/L cobalt chloride (hypoxia group), or 1% hypertonic mother solution plus 100 μmol/L cobalt chloride (combined group) for 1 week. Then, 2% hypertonic solution and 200 μmol/L cobalt chloride cobalt chloride were used to simulate the anaerobic and hypertonic environment intervenes in pretreated and untreated bone marrow mesenchymal stem cels for 24 hours. After that, RT-PCR was used to detect the expression of caspase-3 for apoptosis evaluation. (2)In vivo animal experiment: Sprague-Dawley rats were divided into model, cel transplantation and hypertonic plus hypoxic groups. Rat models of intervertebral disc degeneration were made in these three groups. After modeling, rats in these three groups were given no treatment, bone marrow mesenchymal stem cel transplantation or transplantation of bone marrow mesenchymal stem cels which were subjected to hypertonic and hypoxia pretreatments into the intervertebral disc. Two weeks later, immunohistochemistry and RT-PCR methods were used to detect cel distribution and related gene expression, respectively, thereby to evaluate the therapeutic effect of stem cels.
RESULTS AND CONCLUSION: (1)In vitro cel experiment: caspase-3 mRNA expression was significantly reduced in pretreated bone marrow mesenchymal stem cels compared with the untreated cels (P < 0.05). (2)In vivo animal experiment: compared with the control group, the caspase-3 and interleukin-1β in the intervertebral disc and a number of degenerative indexes were decreased in the cel transplantation. Compared with the cel transplantation group, these indicators had better outcomes in the hypertonic plus hypoxic group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels have therapeutic potential for degenerative disc disease, and have better adaptability and transplantation effects by hypertonic and hypoxia pretreatments.

Objective:To investigate the clinical effect of myocutaneous flap combined with antibiotic-loaded polymethylmethacrylate (PMMA) cement in the treatment of Cierny-Mader type III-IV osteomyelitis.Methods:From April, 2014 to March, 2019, 53 patients with Cierny-Mader type III-IV chronic osteomyelitis were treated with myocutaneous flap combined with antibiotic-loaded PMMA cement. There were 33 males and 20 females, with an average age of (52.2±3.0) (29-78) years old. The area of the wound ranged from 2.0 cm×2.0 cm to 14.0 cm×28.0 cm. All flaps were closed directly. There were 23 patients who were removed the cement at 3 months after surgery, and the other 30 were not. After the surgery, the blood supply of the flap, the effusion of the wound, the complications of the donor area, signs of fresh bone destruction on X-ray and the color, the texture and scar of the flap were observed in the follow-up at the clinic.Results:Forty-nine cases healed in one stage, and 4 had delayed healing. Postoperative vascular crisis occurred in 6 cases and releasesd by prompt surgical exploration. The patients were followed-up for 0.6-3.0 years, with an average of 18 months. All 53 myocutaneous flaps completely survived ultimately. The color of flaps was similar to the recipient areas, and the flaps were smooth and soft and satisfactory in appearance. During the follow-up period, X-ray examination showed no sign of fresh bone destruction. Osteomyelitis was significantly controlled. There was no inflammation reaction such as swelling, pain, ulceration and effusion of the flaps, and there was no recurrence of osteomyelitis. All donor areas healed primarily.Conclusion:Myocutaneous flap combined with antibiotic-loaded PMMA cement has achieved good anti-infection effects in satisfactory results, less postoperative complications and low recurrence rate in the treatment of Cierny-Mader type III-IV osteomyelitis. Application and promotion of such technique would deliver good benefits.

Objective To evaluate the clinical diagnosis and treatment of acute renal infarction.Methods Two cases (3 sides) of acute renal infarction were reported.The patients were 1 male and 1 female,with the age of 62 and 54 years.Case 1 presented acute left flank pain,and enhanced CT showed a non-enhanced area in the upper and mid pole of the left kidney.The diagnosis of focal renal infarction was made and treated with low-molecular heparin (6000 U ).Case 2 presented acute both right abdominal and flank pain,and enhanced CT showed right renal artery embolism and right renal complete infarction.Digital subtraction angiography (DSA) and catheter thrombolytic therapy was applied.4 months later,the patient presented acute left flank pain,and enhanced CT showed a low density area in left kidney without enhanced by contrast,and DSA and catheter thrombolytic therapy was applied again.Results In case 1,contrastenhanced MRI showed a still low signal area like enhanced CT after 2 days of treatment.The renal function remained normal in the follow-up of 36 months.In case 2,the right kidney resorted to moderate blood flow but became atrophy later.In the follow-up of 4 months,a recurrent focal infarction was confirmed in left kidney by enhanced CT.The left kidney also resorted to moderate bloodflow after DSA and catheter thrombolytic therapy.The renal function became normal after follow-up of 10 months and no new infarction was observed.Conclusions The diagnosis of acute renal infraction could be made by enhanced CT or MRI.Early diagnosis and location of the infraction renal artery is critical for recovery of the impaired renal function.Acute renal infraction should be suspected in patients with unexplained persistent and steady flank or abdominal pain in emergence department.

Objective To raise the level of clinical diagnosis for the patients with pituitary stalk interruption syndrome (PSIS). Methods Five patients (4 males) with PSIS were retrospectively analyzed with respects to the clinical features, endocrine status and image characteristics. Magnetic resonance imaging (MRI) scan was performed at hypothalamic-pituitary region. Results The clinical manifestations of all patients consisted of growth retardation and delayed puberty without polyuria. Deficiency of multiple anterior pituitary hormones was revealed in all patients by the evaluation of endocrine status. The features of MRI included a lack of visible pituitary stalk, absence of posterior lobe hypersignal in the sella turcica and a hyperintense spot in the region of the thalamus opticus. Conclusion The clinical characteristics of patients with PSIS are growth retardation and delayed puberty. The evaluation of anterior pituitary function is necessary. The detection of an anatomical abnormality around hypothalamic-pituitary region by MRI is important diagnostic evidence.

Objective: To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal. Methods: The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion. Results: From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed. Conclusions The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.

Objective:To assess the changes in IOL-Master 700 parameters after administering sodium hyaluronate eye drops to moderate and severe dry eye and non-dry eye patients.Methods:Non-randomized controlled clinical research was performed.Patients with moderate and severe dry eye and non dry eye were enrolled in this study, with 40 patients in each group.All patients underwent IOL-Master 700 bioassay before and 5, 10 and 15 minutes after the administration of 0.1% sodium hyaluronate eye drops.The differences in axial length (AL), central corneal thickness (CCT), corneal curvature, and intraocular lens (IOL) were compared before and after the administration.All subjects signed informed consent.Results:In the dry eye group, the AL, CCT and IOL power were increased and the K1 were decreased at 5 and 10 minutes after administering sodium hyaluronate eye drops (P<0.05/3). IOL power of 17.5% increased by 0.5 D at 5 minutes after administering sodium hyaluronate eye drops.Further, 22.5% IOL power increased by 0.5 D or 1.0 D at 10 minutes after administering sodium hyalruonate eye drops.At 15 minutes after the administration, the IOL-Master parameters returned to the pre-intervention level.For the non-dry eye group, the AL and CCT were increased at 5 minutes after administering sodium hyalruonate eye drops, and the IOL power was decreased (P<0.01). The IOL power was decreased by a maximum of 0.5 D. At 10 and 15 minutes after administering sodium hyalruonate eye drops, the AL and CCT were significantly higher than those before the administration (all at P<0.05/3), but there was no significant change in IOL power (P>0.05).Conclusions:The IOL power of moderate and severe dry eye patients is increased at 5-10 minutes after administering sodium hyaluronate eye drops, and the IOL power of non-dry eye patients is decreased within 5 minutes after the administration.

Objective To analyze the methods and effects for treating unstable posterior pelvic ring fracture combined with sacral nerve injury and further identify the relationships among the diagnostic methods,surgical approaches and clinical outcomes.Methods A total of 38 patients with posterior pelvic ring fracture combined with sacral plexus injury treated from January 2000 to January 2010 were enrolled in the study.There were 20 males and 18 females at an average age of 35 years (range,10 to 59 years).The causes of fractures included traffic injury in 20 patients,fall injury in 12,weighty object impingement injury in five,and stabbing injury in one.Classification of posterior pelvic ring fractures included fracture and dislocation of sacroiliac joints in eight patients,fracture of ilium wing in two and sacrum fracture in 28.According to the Denis typing of sacrum fractures,there was one patient with type Ⅰ fracture,14 with type Ⅱ fracture and 13 with type Ⅲ fracture.All 38 patients presented the decrease or loss of skin sensation around the lower extremities,perineal region and crissum.Simultaneously,30 patients suffered motor dysfunction of the lower extremities,while 20 patients had bladder and anus sphincter dysfunction or sexual disorder.Thirteen patients were suspected of sacral plexus avulsion and four of them were confirmed by myelography or MRI examination.All patients had at least one associated injury.The average ISS was 21.9 points ( range,9 to 47 points).Therapeutic methods were fracture reduction and fixation in the absence of nerve decompression for eight patients and nerve decompression for 30 patients including 26 patients being also managed by fracture reduction and fixation.Operation time ranged from 6 days to 6 months.The clinical outcomes were evaluated according to the British Medical Research Council (BMRC) evaluation criteria of sensation and movement function.Results Thirty-four patients were followed up for average 4.9 years ( range,1 to 10 years),during which their pelvis obtained stable recovery.The neurological outcome was excellent in two patients,good in four and unchanged in two in the nondecompression group and was excellent in 16 patients,good in nine and unchanged in one in the decompression group,with the decompression group superior to the non-decompression group ( P ＜ O.05 ).Conclusions For unstable posterior pelvic ring fracture combined with sacral nerve injury,nerve decompression and release combined with internal fixation can better improve the sacral nerve function and obtain good pelvic ring stability and is worth of clinical application.

OBJECTIVE: To identify the newborns who should receive hearing evaluation by hearing screening in high risk newborns; to find and confirm the high risk factors of hearing disorders in high risk newborns. METHOD: The first screening was performed by DPOAE. Newborns did not passed the first screening undertook second screening using DPOAE + ABR. and newborns did not passed the second screening received hearing evaluation. High risk factors of hearing loss were found by Logistic regression analysis. RESULT: Three hundred and twenty-seven cases were screened. The positive ratio in first screening was 37.0%. The positive ratio in second screening was 11.0%. Ten cases were diagnosed as hearing loss and the incidence of hearing loss was 3.39%. High risk factors of hearing loss were asphyxiation, very low born weight (<1,500 g) and head and neck abnormality. CONCLUSION (1) DPOAE combined with ABR is credible and feasible in hearing screening of high risk newborns. (2) High risk factors of hearing loss were asphyxiation, very low born weight (<1,500 g) and head and neck abnormality in this study.
Female ; Hearing Disorders ; diagnosis ; epidemiology ; prevention & control ; Hearing Loss ; diagnosis ; epidemiology ; prevention & control ; Hearing Tests ; Humans ; Incidence ; Infant, Newborn ; Male ; Neonatal Screening ; Risk Factors