Objective To investigate and analyze the effect and insulin dosage of continuous subcutaneous insulin infusion(CSII) in type 2 diabetes.Methods 106 hospitalized patients with type 2 diabetes,who had poorly controlled blood glucose,were treated by insulin pump for 8 days,without oral hypoglycemic agents.The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed.The related foctors for the therapeutic effects were analyzed.Results When blood glucose were well controlled,the mean time was 5.4±1.8 days,the(basal) insulin was 0.23±0.07(u/kg,day),the bolus before breakfest was 0.12±0.05(u/kg),the bolus before dinner was 0.14±0.06(u/kg),the bolus before supper was 0.14±0.06(u/kg).The dosage of insulin was decreased after blood glucose were well controlled.The frequency of hypoglycemia was 0.04±0.21(times/per patient),the frequency of biochemical hypoglycemia was 0.07±0.25(times/per patient) and reaction of hypoglycemia was 0.96±1.18(times/per patient).Conclusions The hyperglycemia of type 2 diabetes could be corrected by intensive insulin pump within 5-6 days.Multiple regression showed that fasting blood glucose and age were the factors that affect the time for blood glucose to be targeted.Duration of diabetes,fasting and postprandial blood glucose levels before treatment affect the required insulin dosage.

Objective To study feasibility in extraction of calcific sign within pulmonary nodules with pattern classification.Meth-ods 49 cases with pulmonary nodules (benign in 16 and malignant in 33)confirmed by pathology or clinical follow-up were included in this study and all cases underwent chest CT examinations.CT images were interpreted double-blind by two associate chief radiolo-gists to draw a conclusion that there were any calcification within pulmonary nodules.Meanwhile,the calcifications in the regions of interest(ROI)on CT images were estimated with extraction of the sign of gray value,geometric and lung markings in ROI,and based on pattern classification algorithm at supporting vector machine(SVM).Results According to the results assessed by senior radiologists for classification within pulmonary nodules,the area under ROC curve was 0.95 which was extracted by automatic pat-tern classification algorithm,the extraction performance was stable(k=1),and was goodness fit with visual observation by doctors (k=0.939).Conclusion The ability of automatic pattern classification in detecting calcification within pulmonary nodules is about the same as that of visual assessment by senior doctors.

Objective To compare the pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in the patients undergoing spinal surgery in prone position supported by a Wilson frame.Methods Forty patients,of ASA physical status Ⅰ or Ⅱ,aged 30-64 yr,with body mass index ＜ 30 kg/m2,scheduled for elective spinal surgery in prone position supported by a Wilson frame under general anesthesia,were randomly allocated to receive mechanical ventilation using either VCV (n =20) or PCV (n =20) mode.Endotracheal intubation and mechanical ventilation were performed after induction of anesthesia.The tidal volume (VT) was set at 10 ml/kg according to the ideal body weight in group VCV.The maximal inspiratory pressure of the anesthesia machine was adjusted to maintain the VT at 10 ml/kg in group P.Both ventilation modes were required to maintain PET CO2 within the normal range.VT,respiratory rate,minute ventilation (MV),dynamic lung compliance (Cdyn),peak and mean airway pressure (Ppeak,Pmean),mean arterial pressure (MAP) and HR were recorded at 10 min after the patients were turned to supine position and at 30 min after the patients were turned to prone position after intubation.Arterial blood samples were collected for blood gas analysis,and oxygenation index(OI) and physiologic dead space fraction (VD/VT) were calculated.Results Compared with those at 10 min after turning to supine position,Ppeak was significantly increased and Cdyn,VT and MV were decreased at 30 min after turning to prone position in both groups.Compared with group VCV,Ppeak was significantly decreased,respiratory rate and Cdyn were increased,and no significant change was found in VT,MV,OI,VD/VT,Pmean,MAP and HR in PCV group.Conclusion Compared with VCV,PCV can improve the ventilatory efficacy and reduce the influence of prone position on respiratory dynamics in the patients undergoing spinal surgery in prone position supported by a Wilson frame.

Objective Beagle dogs are commonly used animal for drug safety evaluation .As the necessary parameters , blood biochemical indicators are detected in acute or chronic toxicity tests .This study aims at assessing the influence of different preservation conditions and different preservation time on blood biochemical indicators to ensure the reliability of test results of long-term toxicity assessment .Methods Six Beagle dogs (3 males and 3 females) were used in this study .After collection and preparation of serum samples , biochemical indicators were detected after preservation in refrigerator at 2-8℃for 1, 2, 5, 8, and 12 hours;after preservation in ice transportation boxes at 2-10℃for 2, 5, and 8 hours;and after preservation in refrigerator at -20℃ for 1, 3, and 5 days.The biochemical indicators included alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and alkaline phosphatase ( ALP ) , total protein ( TP ) , albumin (propagated), urea, creatinine (CREA), glucose (GLU), total cholesterol (TCHO), total bilirubin (TBIL), creatine kinase ( CK ) , gamma pancreatic acyl transferase ( GGT ) , calcium ( CA ) , lactate dehydrogenase ( LDH ) , phosphorus ( P) , high-density lipoprotein cholesterol ( HDL-C) , low density lipoprotein cholesterol ( LDL-C) , triglyceride ( TG) , sodium ( Na+) , potassium ( K+) and chloride ( Cl -) .Results Compared with the results of samples preserved for 1 hour, the LDL-C result of that preserved in refrigerator at -20℃for 5 days was significantly increased (P<0.05), and the coefficient of variation was 39%.The CK and LDH results of specimens preserved in refrigerator at -20℃ for 5 days was increased but not significantly ( P>0.05 ) , and the coefficient of variation of LDH was 41%.Conclusions According to the test results of blood biochemical indicators in the Beagle dogs detected after different preservation conditions and different preservation time in this study , detection test should be done within 1 hour, if not, detection should be done within 12 hours for the samples preserved at 2~8℃, or within 3 days for the sample preserved at -20℃.For transportation of serum samples , the serum samples should be placed in the ice box at 2~10℃, and detection test should be done within 8 hours .

Objective:To discuss the correlation between the immune instability of Th17/Treg and the pathogenesis of the Henoch-Schonlein purpura(HSP)with Mpcoplasma pneumoniae(MP)infection.Methods:From June 2018 to December 2019, children who had been diagnosed as HSP in the Department of Pediatrics at Qinhuangdao First Hospital and Qinhuangdao Maternal and Child Health Care Hospital, as well as in-patients with MP infection and outpatients, who had health check-up were collected.The subjects were divided into HSP group(41 cases), MP group(25 cases), HSP-MP group(19 cases) and control group(20 cases) according to the diagnosis of HSP and MP infection.The percentage of Th17 and Treg cells in peripheral venous blood of four groups were determined by flow cytometry, and the levels of interleukin(IL)-17, IL-6 and transforming growth factor-β(TGF-β)in peripheral venous serum of four groups were detected by ELISA.Results:There were no statistically significant differences regarding age and gender distribution among four groups( P>0.05). The percentages of Th17 cells, IL-17 and IL-6 levels in peripheral blood of the HSP-MP group was significantly higher than those in the other three groups( P<0.05), which in HSP group and MP group were higher than that in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). The percentage of Treg cells in peripheral blood was significantly lower in HSP-MP group than those in the other three groups( P<0.05), which in the HSP group and MP group were lower than those in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). There were no statistically significant differences of TGF-β among the four groups( P>0.05). Conclusion:High levels of IL-17 and IL-6 may be an important factor causing severe Th17/Treg immune disorders in children with HSP combined with MP infection, which may play an important role in the pathogenesis of HSP combined with MP infection.

Objective To describe the general condition of workplace violence against emergency department nurses in five hospitals of Guangzhou;to investigate the status of the post-traumatic stress disorder in the emergency department nurses after suffering from workplace violence;to analyze the relative factors of post-traumatic stress disorder.Methods 143 emergency department nurses from 5 hospitals in Guangzhou were investigated by general information questionnaire,workplace violence questionnaire,PCLC and SSRS.The investigation data were analyzed.Results 86.7％ of emergency department nurses suffered from workplace violence during the past 1 year;the most popular style was non-physical violence.The emergency department nurses suffered from negative emotional experience,such as grievance,chagrin,low work passion,not focused spirit.The scores of PCL-C of emergency department nurses who had suffered from workplace violence were obviously higher than those who hadn't.21.8％ of the emergency department nurses who suffered from workplace violence in the past one year had certain degree of the signs of PTSD,12.1％ had obvious signs of PTSD.The influencing factors of PTSD:degree of hurt,objective support and availability of social support.Conclusions The situation of workplace violence which the emergency department nurses were faced with was more and more grave.The emergency department nurses who had suffered from workplace violence were in different degree of PTSD.The more social supports the nurses get,the better mental health status they will possess.

Objective To investigate the value of prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia.Methods The ultrasonographic features of 65 fetuses with congenital diaphragmatic hernia were analyzed,which were confirmed by after birth surgery or examination.The lung-to-head ratio (LHR) of unaffected side and O/E LHR (LHR compared to normal fetuses on same gestational weeks) were obtained,and then the relationship with the prognosis of neonates were analyzed.Results In 65 cases,45 fetuses survived and 8 fetuses died after surgery,while 12 cases did not undergo surgery and death promptly.Overall mortality was 30.77％ (20/65).In 12 hepatic intrathoracic type of diaphragmatic hernia cases,the mortality rate was 66.67 ％ (8/12).In 53 hepatic intra-abdominal type of diaphragmatic hernia cases,the mortality rate was 22.64 ％ (12/53).In 9 cases combined with other structural abnormalities,there were 8 cases were dead and 6 cases (6/8) with abnormal chest structure.LHR values were from 0.40 to 2.72,the average value was 1.59±0.69.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different LHR (x2 =19.360,P＜0.001),The mortality rate in fetal of congenital diaphragmatic hernia with LHR 1.0 or less was higher than that with LHR ＞1.0.O/E LHR measurement values were from 23％ to 90％ and the average value was (58.25±17.61) ％.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different O/E LHR (x2 15.261,P=0.002).The mortality rate in fetal of congenital diaphragmatic hernia with O/E LHR ≤45 ％ was higher than that with O/E LHR＞45 ％.Conclusion The prenatal ultrasound can be used to diagnose congenital diaphragmatic hernia,and to assess the development of unaffected lung and prognosis.

Objective To make students at different levels not only learn theoretical knowledge of acupuncture-moxibustion manipulation skills but also achieve full operating training, strengthen the combination of theory and practice and improve the teaching quality of clinical disciplines by applyingmultimedia-subject participationteaching method to acupuncture-moxibustion manipulation techniques in the experimental teaching of acupuncture and moxibustion. Method The students were randomized, according to grade, into experiment (n=114) and control (n=115) groups. The teaching content was the same in the two groups. The experiment group received multimedia-subject participationteaching method. After the multimedia teaching, the students did an independent demonstration and made a self-evaluation, the teachers made a comment and the students did independent practice again in groups. The control group received conventional theory teaching and did practice under demonstration in the experimental lesson. The examination and questionnaire were used as assessment indicators to evaluate the effect ofmultimedia-subject participationteaching method applied to acupuncture-moxibustion technique teaching. Result Statistical analysis was made using the SPSS11.5 statistical software package. The independent samples t-test is used for a between-groups comparison. The statistical result showed that satisfaction was 100%in the experiment group and 75.7%in the control group;there was a statistically significant difference between the two groups (P<0.05). Conclusion Multimedia-subject participationteaching method is an innovation in acupuncture-moxibustion technique teaching and helps the students to better master acupuncture-moxibustion manipulation skills. Mastery of theoretical knowledge before real practice is the key to proficient manipulation. The combination of the two in classroom teaching yields twice the result with half the effort. Carrying out multimedia-subject participation teaching method will help to further deepen the teaching reform and to improve the level and quality of“Acupuncture and Moxibustion”teaching.

Objective To study feasibility of differentiation of benign and malignant by using eccentric rate of calcification in pulmonary spherical lesions.Methods Two hundred and forty cases with pulmonary spherical lesions(malignant in 170 and benign in 70) confirmed by pathology or clinical follow-up were collected in this study.All cases were underwent chest CT examinations.Nodule CAD software was used to demarcation of pulmonary spherical lesions and internal calcification.Calcification was defined as an area more than 3 pixel with calcification density(CT value＞120 HU).Furthermore,the ratio of calcification center distanceand calcification edge distance was calculated as Ecc.Mann-Whitney U test was used to compare the eccentric calcification rates between the malignant and the benign pulmonary spherical lesions.Taking pathological results as golden standard,the diagnostic efficacy of Ecc was analyzed using ROC curves.Results In 240 lesions,65 calcifications were detected,of which 18 were malignant calcification distributed in 10 lesions,and 47 were benign calcifications distributed in 16 lesions.The median of Ecc in benign and in malignant lesions were 0.80(0.28-1.29) and 3.01(1.52-4.47).The Ecc of calcification in benign lesions were lower than those in malignant lesions (U=183.000,P＜0.01).Under the cut-off value of 1.00,benign calcifications were more likely to lie inner 1/2 part of lesion [61.70％(29/47)],while malignant calcifications were more likely to lie outer 1/2 part of lesion [77.78％(14/18)].The difference was statistically significant(x2=8.117,P＜0.01).Under the cut-off value of 1.72,the resultant sensitivity,specificity,accurate rate were 83.1％,77.8％,81.5％ respectively.The area under the ROC was 0.804.Conclusions Ecc exhibits the location characteristics of calcification and may be an ideal parameter in quantitative diagnostic modeling for providing evidence of quantitative diagnosis.

Objective To investigate the variations of mtDNA from high and low metastatic mouse hepatocarcinoma cell sublines Hca-F and Hca-P, and the relationship between mutations of mtDNA and carcinogenesis. Methods The variations of D-loop, ND3 and tRNA Met+Glu+Ile gene fragments of mtDNA from Hca-F and Hca-P cells were analyzed by PCR-RFLP and sequencing techniques. Results No amplification fragment length polymorphism and restriction fragment length polymorphism were observed in tRNA Met+Glu+Ile , ND3 and D-loop of mtDNA from the 2 cell sublines. Sequence difference between these 2 cell sublines were found in mtDNA D-loop region by sequencing. Conclusions Genetic alteration of mtDNA non-coding region in tumors, which may reflect the environmental and genetic influences operative during tumor progression, can be linked to their tumorigenic phenotype.