Obeject To study the association of sulfonylurea receptor (SUR) 1 gene and blood lipids level.Method We investigated the SUR1 gene intron 24 3t/c polymorphism by polymerase chain reaction (PCR) and appropriate restriction enzyme (PCR RFLP) in 132 couples of type 2 diabetic case control and 282 type 2 diabetic pedigrees. The statistical methods were t test, multiple line regression and family based association test (FBAT).Result In the control group, the level of total cholesterol (TC), low density lipoprotein (LDL) and Apo B were higher in the cc genotype than that in the tt and the tc genotype. FBAT showed that sulfonylurea receptor 1 gene intron 24 3t/c polymorphism was significantly associated with TC, ApoB and BMI.Conclusion Sulfonylurea receptor 1 gene intron 24 3t/c polymorphism is associated with blood lipid level in north Chinese population.

OBJECTIVE To search for the correlative factors among nurses with leukcopenia who occupationally contacted with chemotherapeutic agents,so as to increase their occupational protecting level.METHODS Totally 1232 nurses who occupationally contacted with chemotherapeutic agents from 24 hospitals were investigated by a stratified sampling method.The factors leading to leukopenia were surveyed and analyzed.RESULTS The leukopeuia was prominently correlated with five factors,namely nurses' protective knowledge,protective manipulation scoring,protective condition,exposure index and kinds of agents.CONCLUSIONS Low occupational protecting level can lead to leukopenia.A supporting system based on the occupational health and safety management must be established to insure the clinical nurses' health level.

Objective To observe the curative effect of clinically equivalent doses of Xuesaitong and ginaton injections on cerebral ischemia reperfusion (I/R) injury of rats.Methods Male rats were randomly divided into five groups:normal control group,sham-operation group,model control group,Xuesaitong group and ginaton group.The cerebral ischemia rat model was established by middle cerebral artery occlusion (MCAO).Rats in the Xuesaitong group were given 20 mg·kg-1 of Xuesaitong injection,and rats in the ginaton group were intravenously injected with 7.5 mg· kg-1of ginaton immediately after I/R injury and once daily for 7 days.Rats in the sham-operation group and model control group were given the same volume of 0.9％ sodium chloride solution.The score of ethology,volume of cerebral infarction,mortality,superoxide dismutase (SOD),malondialdehyde (MDA),xanthine oxidase (XOD),nitrogen oxide (NO) and NO synthase (NOS) in seruu were examined.Results Compared with model control group,Xuesaitong and ginaton effectively reduced behavioral score 96 h (P ＜ 0.05),120 h (P＜0.01),144 h (P＜0.01) and 168 h (P＜0.01) after I/R injury,the volume of cerebral infarction 168 h after I/R injury and NO content (P ＜ 0.05).But they had no effects on NOS,SOD,MDA,and XOD contents.Conclusion Curatively injecting Xuesaitong and ginaton can effectively reduce cerebral I/R injury,but no significant difference in curative efficacy is observed between Xuesaitong and ginaton at clinically equivalent doses.

Objective To detect the relationship between the polymorphism of the glycogen-targeting regulatory subunit of the skeletal muscle glycogen-associated protein phosphatase 1 (PPP1R3) gene and type 2 diabetes by case-control study. Methods We genotyped the PPP1R3 gene Asp905Tyr polymorphism and a common 3'-untranslated region AT (AU)-rich element (ARE) polymorphism in 101 type 2 diabetic patients and 101controls by oligonucleotide ligation assay (OLA) and polyacrylamide gel elecrophoresis, respectively. Results Subjects with Tyr/Tyr genotypes whose body mass index (BMI)<25 were used as the reference group. Those whose BMI25 with Asp905 had a 3.66-fold increase (95% CI: 1.48-9.06, P=0.005) in type 2 diabetes risk. No association was found between 3'UTR ARE polymorphism and type 2 diabetes mellitus (OR=1.15; 95% CI: 0.62-2.14, P=0.65). Conclusion A joint effect between the Asp905 and BMI increases the risk of type 2 diabetes, and Asp905Tyr and ARE polymorphism of PPP1R3 gene are not the major diabetogenic gene variants in Chinese population.

Objective To investigate the indications and clinical effect of the low-big hole choledochoduodenostomy. Methods Two hundred and ninty-eight patients, had bile duct stone accompanied with common bile duct lower segment stenosis, were prospectively enrolled into the study and randomly divided into the low-big hole choledochoduodenostomy (improved CD ) group (n = 148 ) and the Roux-en-Y choledochojejunostomy (CJ) group (n = 150). Their perioperative period and long term effect indices were recorded and compared. Results Perioperative period indices:The time of cholangio-jejunostomy was much shorter in improved CD group than the CJ group ([31.0±10.5] min vs [53.0±12.3] min, P＜0.001);The anastomotic leakage was significantly less in improved CD group than the CJ group (2 vs 9, P ＜ 0. 001 ). The long term effect indices: The occurrence of peptic ulcer (3 vs 15 ) and the bile duct cecum or blind loop syndrome (5 vs 158) were significantly lower in group improved CD group than CJ group (Ps＜0.01);The occurrence of bile duct backflow (70 vs 42) was significantly higher in improved CD group than CJ group (P＜0. 0l). Conclusion The clinical effect of the low-big hole choledochoduodenostomy gastrointestinal had excellent effect for bile duct stone accompanied with common bile duct lower segment stenosis, especially for old,weak and critical patients,and it can not be replaced by the Roux-en-Y choledochojejunostomy.

Objective To investigate the effects of the wound isolation in prevention of abdominal wound infection. Methods 2549 patients who bearded abdominal operation in 3 years in our hospital were randomly divid-ed into wound isolation group (n=1300) and control group(n=1249). The wound infection rates were summarized by operation ways and major influencing factors. Results The overall wound infection rate of control group and wound isolation group was 5.9% (76/1300) and 2.6% (32/1249). The infection rate was 13.4% (40/300) and 3.1% (9/280) in gallbladder resection, 14.7 % (24/165) and 3.5 % (6/159) in radical operation for carcinoma of colon, 13.6% (15/108) and 3.2% (13/114) in intestine block operation, 9.6% (18/187) and 1.8% (3/169) in stomach resection (P<0.01);The infection rate was 9.3% (13/145)and 2.9% (4/153)in biliary exploration, 14.6% (8/55) and 1.8% (1/56) in WHIPPLE, 10.6% (9/85) and 2.3% (2/88) in cholecystectomy (P<0.05);The infection rate was 6.3% (6/95) and 2.3% (2/86) in liver resection, 5.3% (5/95) and 1.2% (1/87) in spleen resection, 4.6% (3/65) and 1.8% (1/57) in porto-azygos venous disconnection (P>0.05). The wound infection rate of type Ⅰ resection of control group and wound isolation group was 2.0% (6/305) and 1.4% (4/280) (P> 0.05);The infection rate of type Ⅱ and Ⅲ resection was 7.0% (70/995) and 2.9% (28/969), for old man (≥60) was 12.6% (36/286) and 3.6% (10/279), the emergency operation was 10.0% (38/381) and 2.8% (10/362), the operation time ≥3 h was 9.0% (39/435) and 2.8% (12/426), with diabetes was 14.5% (21/145) and 4.9% (6/123), with obesity was 12.3% (40/325) and 3.9% (12/310), with malnutrition was 8.5% (39/458) and 3.2% (14/433), with cancer was 8.6% (40/465) and 3.0% (15/496) (P<0.01).;undergoing unemergency operation was 4.1% (38/919) and 2.5% (22/887),for yong persons (<60) was 3.9% (40/1014) and 2.3% (22/970), with operation time<3 h was (37/865) and 2.4% (20/823), without diabetes was 3.9% (45/1155) and 2.3 % (26/1126), without obesity was 3.7 % (36/975) and 2.1% (20/939), without malnutrition was 4.4% (37/842) and 2.2% (18/816)and without cancer was 4.3% (36/835) and 2.3% (17/753) (P<0.05). Conclu-sions The wound isolation can decrease the wound infection rates by reducing the chance of bacterial contamina-tion.

OBJECTIVETo determine the relationships of Met416Val and XbaI polymorphism of muscle glycogen synthase (GYS1) gene and Trg64Arg variant of the beta(3)-adrenergic-receptor (beta(3)-AR) gene with type 2 diabetes mellitus (DM) and its intermediate phenotypes in the Chinese population.

METHODSPolymerase chain reaction-oligonucleotide ligation assay and restriction fragment length polymorphism assay were used to evaluate the GYS1 and beta(3)-AR gene polymorphisms in 102 pairs of case-control Chinese spouses.

RESULTSSubjects with Met416Val variant had a significantly higher 2-hour post-glucose level than subjects without this variant had in diabetic group (P = 0.032). The Met416Val polymorphism of GYS1 gene was not significantly associated with the risk of type 2 DM (adjusted OR = 1.67; 95% CI: 0.73 - 3.81, P = 0.223). Subjects with Trp64Arg variant had a significantly higher serum uric acid level than subjects without this variant had in diabetic group (P = 0.034). The combination of BMI and Arg64 allele carrier of the beta(3)-AR gene increased the diabetic risk over four-fold (adjusted OR = 4.00; 95% CI: 1.53 - 10.45, P = 0.005).

CONCLUSIONSIn the Chinese population, Met416Val polymorphism is identified in a subgroup of diabetic subjects with high 2-hour post-glucose. It will explain why some diabetic patients appear to be genetically predisposed to developing high postpradial glucose level. The presence of the Arg64 allele in the beta(3)-AR gene may predispose patients to higher serum uric acid level.

Adult ; Aged ; Alleles ; Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; genetics ; Glycogen Synthase ; genetics ; Humans ; Hyperglycemia ; genetics ; Middle Aged ; Polymorphism, Genetic ; Postprandial Period ; physiology ; Receptors, Adrenergic, beta-3 ; genetics ; Uric Acid ; blood

Objective To assess the dignosis value of CT three-dimensional reconstruction with Fisher discriminant model in small solitary pulmonary nodules before operation.Methods CT data of 40 cases with SPN were retrospectively analyzed and divided into into malignant pulmonary nodules (25 cases),squamous cell carcinoma (4 cases),adenocarcinoma (13 cases),lung cancer (4 ca-ses),small cell lung cancer (2 cases),large cell carcinoma (1 case),metastases tumor (1 case),benign nodules (1 5 cases,6 cases of tuberculosis,2 cases of hamartoma,and 7 cases of non-specific inflammatory nodules)by pathology and follow-up results.The CT features of pulmonary nodules were evaluated through multi-planar reformation (MPR),curved-planar reformation (CPR),volume rendering (VR),maximum intensity proj ection (MIP)and other three-dimensional reconstruction.The three-dimensional data were divided into benign and malignant groups.In each of the two groups,the significant signs of morphological signs of discrimination indicators were adminstrated Fisher discriminant,and the probalitiy of false positives were estimated using cross-validation method. Results The positive features of pulmonary nodules in there-dismensional images were much more than in two-dimensional images. Fisher discriminant formula of solitary pulmonary nodules in three-dimensional images was Z=1.143X1 + 0.454X2+1.606X3-0.262X4+0.04X5+0.483X6+1.611X7-2.164.Discriminant boundary value Zc was-0.516.When Zcgreater than -0.516,nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nod-ules.In 1 5 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in dif-fereiating diagonsis of pulmonary nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nodules. In 15 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in differeiating diagonsis of pulmonary nodules.

Objective To understand the correlation between health beliefs and family environment of stroke patients. Methods A questionnaire survey was carried out on 115 stroke patients with the first onset of stroke by using the special health belief simple table (SF-HBMS) and the family environment scale (Chinese version FES-CV), and the correlation was analyzed. The scores of each subscale of the family environment were compared with the domestic norm. Results The total score of health belief (75.15 ± 10.20) was at the middle level. There were significant differences in age (F=8.41), education level (F=4.44), complications (F=4.05), family history (t=2.68) and first visit time (F=3.76) among different characteristics of health belief scores (P < 0.01 or 0.05). The score of intimacy (6.23 ± 1.27) in family environment, emotional expression score (5.30 ± 1.97), success score (5.88 ±1.62), cultural score (4.54 ± 2.20) and organizational score (5.60 ±1.67) were all lower than the domestic norm and spear. The score of shield score (3.16 ± 2.00) was higher than that of domestic norm (P<0.01 or 0.05), and the total score of health belief was positively correlated with family intimacy (r=0.190), emotional expression (r=0.204), culture (r=0.206) and tissue (r=0.227) (P<0.05), and was negatively correlated with the contradiction (r=-0.186, P<0.05); regression analysis, whether there were family history (β=0.338, P<0.01), first onset time (β=0.242, P<0.01), family intimacy (β=1.614, P<0.05), emotional expression (β=1.114, P<0.05) were the factors affecting the health belief level of first stroke patients. Conclusions The level of health belief is closely related to family environment. It is suggested that the clinical medical staff should pay attention to the negative emotion and family psychological intervention, provide psychological support for the patients and their families, promote the promotion of their health beliefs, and reduce the rate of recurrence and disability.

Objective To provide a bases for higher vocational nursing talents training programme with specifying the condition of higher vocational nursing talents demand. Methods Using the questionnaires, seven higher vocational colleges were surveyed, including their arrangements, student enrollments, employments, teaching staff, curriculum design and practical training base developments. At the same time, eight third-grade class-A hospitals and nine second-grade class-A hospitals were surveyed on the current situations of nurses and nursing talents demands. Results The arrangements of higher vocational nursing in Guangdong were reasonable, and practice teaching were emphasized and high employment rates were achieved. But the student enrollments were not enough for talents supply. The teaching staffs′ educational levels, professional titles and quantities were not high enough. There was a great difference of curriculum design among these higher vocational colleges. The prior recruitments of nursing staff in hospitals were given to the higher vocational college nursing students. Conclusions Guided by the social needs, higher vocational colleges should appropriately enlarge the enrollments of higher vocational nursing, and strengthen the construction of the faculty team with training teachers into double-qualifications type, establish a unified teaching standard specification, and improve the quality of talents training by enhancing quality-oriented education.