Objective To explore the effects of empowerment education model on glycemic control and self-management behavior of community patients with diabetes. Method A total of 120 diabetics from 2 different communities were set as the observation group and control group. The control group was treated by routine medications and health education and the observation group was intervened with empowerment education model. After intervention for 6 months, the patients′blood glucose index and the diabetes self-management behavior were assessed and compared by scale of the diabetes self-care activities (SDSCA) between the two groups. Result By the end of the study, the glycemic index and SDSCA score in the former group were both significantly decreased than those in the control group (P<0.05), indicating the patients in the experiment group had better glycemic control and self-management behaviors compared with those in the control group. Conclusions Empowerment education model can arouse the internal motivation of patients to change their behaviors from passive to active acceptance in the health education. Empowerment education model can enhance diabetes patients′self-management conduct and the glycemic level.

Objective:To investigate the changes and clinical significance of serum immunoregulatory cytokines in patients with rheumatoid arthritis (RA) complicated with osteoporosis (OP).Methods:The clinical data of 420 patients with RA admitted to Mianyang Central Hospital from January 2019 to December 2019 were analyzed. According to their bone mineral density, they were divided into OP group (220 cases) and non OP group (200 cases). The immunoregulatory cytokines and bone metabolism indexes of the two groups were compared, and the correlation between them was analyzed.Results:The age, course of disease, glucocorticoid use history, fracture history, swelling joint number and tenderness joint number of OP group were significantly higher than those of non OP group ( P<0.05). In OP group, the serum levels of interleukin (IL)-6, IL-17, tumor necrosis factor-α (TNF-α) and C-terminal peptide cross-linking (CTX) of type Ⅰ collagen were significantly higher than those in control group ( P<0.05), while the IL-10 and transforming growth factor-β1 (TGF-β1) were significantly higher than that of non OP group ( P<0.05). The serum level of CTX in patients with RA complicated with OP was positively corrected with IL-6, IL-17, TNF-α ( r=0.913, 0.915, 0.921, P<0.001), and negatively correlated with IL-10 and TGF-β1 ( r=-0.921, -0.920, P<0.001). Conclusions:RA patients complicated with OP have higher age, longer course of disease, history of fracture, history of glucocorticoid use, more joint swelling and pain, higher IL-6, IL-17, TNF-α levels, lower IL-10 and TGF-β1 levels. Immunoregulatory cytokines may regulate the proliferation and differentiation of osteoclasts and osteoblasts, and play an important role in RA complicated with OP.

Objective:To analyze the effect of the multipoint tiny incision with continuous buried suture method in double eyelidplasty for patients with mild or moderate dermatolysis.Methods:Totally, 1 161 patients from May 2008 to February 2019 underwent the double-eyelid surgical procedure with the multipoint tiny incision with continuous buried suture method. 1 148 patients were female and 13 patients were male, ranging from 25 to 50 years old. All the patients had normal single-eyelid or inborn narrow double-eyelid without blepharoptosis and they were performed double eyelidplasty for the first time. During the operation, moderate orbicularis oculi muscle and orbital septum fat were cut down from the four or five tiny incisions which were all 2 mm long. Skin levator fixation was performed through continuous buring suture between subcutaneous and the levator aponeurosis. Postoperative follow-up time points were 3 months, 1 year and 5 years.Results:There were 10 patients that showed slight asymmetry, 8 patients' eyes showed shallow creases and 5 patients' double eyelids narrowed. These 23 patients were operated for the second time. Besides that, all the creases were symmetry, parallel and natural. Notched scars did not occur, and patients' satisfaction was achieved in the rest of the cases.Conclusions:Our double eyelid procedure creates natural and beautiful double eyelids without depressed scars. The blepharoplasty of multipoint tiny incision with continuous buried suture method can produce a desired aesthetic effect and it lasts for a long time.

This study was performed to explore the impact of glutamine(Gln)on the anti-tumor immune response of CD8+ T cells and its mechanism.TCGA database was used to analysis the relationship between tumor Gln metabolism and the quantity and functionality of infiltrating CD8+ T cells.CRISPR/Cas9 was employed to knock down GLS expression in mouse MC38 cells,and a mouse tumor model was established.Flow cytometry was conducted to assess tumor proliferation,apoptosis,and the quantity and functionality of tumor-infiltrating immune cells.Lymphocytes isolated from health individuals were treated with Gln-deficient media,complete media or media supplemented with GSH,RSL3 in vitro.Then the apoptosis,the expression levels of GPX4,Lipid-ROS,and effector function protein of CD8+ T cells were detected by flow cytometry.Furthermore,RNA-seq was performed to analyze the differential gene expression on the Gln-depleted CD8+ T cells.Data showed that tumor Gln metabolism was inversely associated with the quantity and functionality of tumor-infiltrating CD8+ T cells.Low expression of GLS in MC38 cells could inhibit C57BL/6 tumor growth,decrease Ki-67 expression,promote casepase-3 expression,increase the amount of tumor-infiltrating immune cells,suppress PD-1,TIM-3,and LAG-3 expression,and enhance CD137,CD107a,IFN-γ and TNF-α expression in tumor-infiltrating CD8+ T cells.RNA-seq results indicated an upregulation of ferroptosis genes TFRC,HMOX1,CYBB and SLC7A11 in CD8+ T cells following glutamine deficiency.Gln deficiency led to lower CD137,CD107a,IFN-γ,GSH,GPX4 expression,increased Lipid-ROS level,and caused cell death in CD8+ T cells.Supplementation of GSH upregulated GPX4 expression,downregulated Lipid-ROS level,and increased IFN-γ secretion in CD8+ T cells.In conclusion,Gln deficiency inhibits the effector function of CD8+ T cells by inducing ferroptosis,and promotes tumor growth.

Objective To investigate the etiological characteristics of infection after percutaneous biliary drainage or stent implantation in patients with malignant biliary obstruction (MBO). Methods Clinical data were collected from MBO patients who underwent interventional therapy in Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, from January 2016 to December 2020 and had or were suspected of biliary tract infection, with samples submitted for bile culture and/or simultaneous blood culture. Analysis was performed for the aspects of positive rate of culture, flora distribution, consistency between blood culture and bile culture, and drug resistance rate of major pathogenic bacteria. Results A total of 219 patients were enrolled, among whom 105(47.95%) were positive for bile culture, and the composition ratios of Gram-negative bacteria, Gram-positive bacteria, and fungi were 64.89%, 28.24%, and 6.87%, respectively. A total of 69 patients had samples submitted for blood culture during the same period of time, among whom 33(47.82%) had positive results. Positive results of both bile culture and blood culture were observed in 25 patients, and consistency analysis showed that the patients with complete consistency, partial consistency, and complete inconsistency accounted for 36%(9/25), 20%(5/25), and 44%(11/25), respectively. Common Gram-negative bacteria were Escherichia coli , Klebsiella pneumoniae , and Enterobacter cloacae , with a relatively low level of drug resistance to antibiotics including cefoperazone/sulbactam, amikacin, and imipenem. Common Gram-positive bacteria were Enterococcus faecium and Enterococcus faecalis , with a relatively low level(< 15%) of drug resistance to antibiotics including vancomycin, linezolid, and teicoplanin. Conclusion Common pathogens of infection after percutaneous biliary drainage or stent implantation in MBO patients include Escherichia coli , Klebsiella pneumoniae , Enterococcus, and Enterobacter cloacae . There is a relatively low level of consistency between blood culture and bile culture, and thus samples should be submitted for both tests.

Objective To investigate the short-term mortality of transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer, and explore the possible causes of death and countermeasures. Methods All patients who underwent TACE at the Department of Interventional Radiology, First Affiliated Hospital of Soochow University from January 2015 to December 2020 were studied, but those with metastatic liver cancer or receiving combined treatment were excluded. The clinical and imaging data of all patients were collected before and 30 days after TACE, and the clinical characteristics of the patients with short-term postoperative death were analyzed. Death within 30 days after TACE was defined as short-term death. Results A total of 1466 TACE in 741 patients with primary liver cancer were included. Ten patients (10/741, 1.35%) died within 30 days after TACE, with a mortality rate of 0.68% for all TACE. The mortality rate of d-TACE and c-TACE was 1.62% (3/185) and 0.55 % (7/1281), respectively. The mortality rates of patients at China Liver Cancer Staging Ⅰ, Ⅱ, and Ⅲ stages were 0.45% (2/448), 0.33% (2/599), and 1.43% (6/419), respectively. The mean diameter of the largest lesion in death cases was 10.1±0.8 cm. The possible causes of death were liver failure (4 cases), rupture bleeding (3 cases), myelotoxicity (1 case), pulmonary embolism (1 case), and heart failure (1 case). Conclusion The mortality rate after TACE in patients with primary liver cancer is low, with occasional short-term postoperative deaths. The death cases are characterized by a large tumor volume, and the most common causes of short-term death are liver failure and rupture bleeding.