Objective To investigate the prevalence of Helicobacter pylori infection and the incidence of gastric mucosal lesions in type 2 diabetes mellitus(DM)and diabetic kidney disease(DKD)patients with dyspepsia symptoms.Methods A total of 241 type 2 diabetic patients and 69 non -diabetic subjects with dyspeptic symptoms were enrolled in the study.Gastroduodenal lesions were observed by gastrointestinal endoscopy and the presence of Helicobacter pylori infection was identified by rapid urease test and serum IgG antibodies to Helicobacter pylori.Urine albumin excretion rate(UAE)at 24 hours was measured in all subjects.According to the urinary albumin excretion rate,patients were classified into diabetes mellitus group(DMgroup,with UAE <30mg/24h),diabetic kidney disease group 1(DKD group 1,with UAE 30mg/24h to <300mg/24h)and diabetic kidney disease group 2(DKD group 2 >300mg/24h).Estimated glomerular filtration rate were above 60mL·min -1 ·(1.73m2 )-1 in the three groups of patients.The 69 cases of non -diabetic subjects were used as the control group.Results The prevalence of H pylori infection in the DKD group[145 /72(62.5%)]and the DKD group 2[34 /53(64.15%)]were significantly higher than those in the control group[28 /65(43.1%)](χ2 =3.901,P =0.04;χ2 =4.223,P =0.03)and the DM group [27 /63 (42.9%)](χ2 =4.104,P =0.04;χ2 =5.116,P =0.03).No significant differences of H.pylori prevalence were detected between the DKD groups(χ2 =1.304,P =0.29)as well as the DMgroup and the control group (χ2 =0.723,P =0.40).Gastroscopy results showed that the incidence of normal endoscopic performance in the DMgroup was higher than that of the control group(57.1% vs.38.5%,χ2 =4.612,P =0.03).There were no significant differences between the control group and DM group,DKD1 group and DKD2 group in the incidence of gastric mucosal lesions (Superficial gastritis:χ2 =1.206,0.912,0.707;erosive gastritis:χ2 =1.422,1.836 0.870;duodenal ulcer:χ2 =243.1, 1.716,2.233;gastric ulcer:χ2 =1.440,0.971,1.322 and esophagitis:χ2 =2.116,2.318,2.488,all P >0.05). Conclusion Diabetic nephropathy patients are more susceptible to Helicobacter pylori infection.There is no significant difference in the infection rate of Helicobacter pylori between type 2 diabetic nephropathy with microalbuminuria and with macroalbuminuria.There are no significant differences in the type of gastric mucosal lesion between Type 2 diabetes mellitus,diabetic nephropathy patients and non diabetic patients.

Objective To observe the effects of hyperbaric oxygen therapy(HBOT) on Glasgow coma scale(GCS) in patients with traumatic brain injury(TBI) and the influences of course and initiating time of HBOT on the therapeutic effects.Methods 105 cases of TBI patients,which performed HBOT more than 30 days in HBOT Center of Southwest Hospital,were analyzed retrospectively.The GCS improvements were compared with 29 cases of TBI patients without HBOT during the same period.They were also compared between patients with different severity,initiating times and courses of HBOT.Results The GCS improvement of patients with HBOT was 3.97?2.65,especially in severe TBI patients(5.22?2.49),Both were higher than that without HBOT(2.38?2.16)(P

OBJECTIVE:To investigate the current situation of anticoagulant therapy for patients with non-valvular atrial fibril-lation,and to provide reference for standardized anticoagulant therapy. METHODS:A total of 1056 patients with non-valvular atri-al fibrillation were collected from our hospital during Jul. 2015-Jun. 2016. According to 2012 European Society of Cardiology Guide-lines for the Management of Atrial Fibrillation,the risks of thrombosis and hemorrhage were evaluated,and the standardized anti-coagulant therapy was also evaluated. RESULTS:Among 1056 patients with non-valvular atrial fibrillation,the number of patients with thrombosis risk score ≥1 was 1028,accounting for 97.3%. 763 patients received antithrombosis therapy,and only 139 pa-tients were given warfarin anticoagulant therapy. The international normalized ratio(INR)of prothrombin time in just 30.9% of pa-tients receiving warfarin was in line with the standard before discharge. CONCLUSIONS:The anticoagulant therapy for patients with non-valvular atrial fibrillation is still not optimistic,and effective measure should be adopted to improve the standardization of anticoagulant therapy in the patients with atrial fibrillation.

Objective To clarify the protective effect of nrsodeoxycholic acid ( UDCA ) on endoplasmic reticulum stress-mediated apoptosis in pancreatic β-cell of streptozotocin ( STZ )-induced diabetic rats.Methods Rats( n =40) received a single injection STZ( 50 mg/kg) intra-peritoneally and formed a β-cell injury model.Weight-matched normal rats( the control group,n =10 ) were injected with the buffer alone.STZ-treated rats with persistent random blood glucose higher than 16.7 mmol/L for 1 week were considered as diabetic status( n=14 ),then divided randomly into STZ-induced diabetes mellitus ( DM ) group ( n =7 ) and UDCA-treated DM group ( n =7 ).UDCA (40 mg· kg- 1,d-1 ) was administered daily by intragastric intubations throughout the experimental period (30 d).During the entire experiment,blood glucose in all rats was assessed.By the end of the experiment,all rats were sacrificed with the pancreas removed and the blood sample collected immediately.Fasting insulin levels were assayed by radioimmunoassay.The morphological changes of pancreatic β-cells apoptosis were determined by TUNEL assay.RNA in pancreas was abstracted and microarray containing 89 pieces of apoptosis related genes was applied.The related gene expressions were detected by RT-PCR and Western blot.Results The concentration of blood glucose in diabetic rats was gradually decreased after UDCA treatment,but at the end of the experiment it was still higher than that in the normal control group.The treatment with UDCA raised the fasting insulin level in diabetic rats,but this concentration was significantly lower as compared to the control group.Based on TUNEL stained tissue sections,the percentage of β-cell apoptosis of UDCA-treated DM group was significantly lower than that of STZ-induced diabetic group(P＜0.05 ).Among 89 genes,42 genes up-regulated and 46 genes down-regulated in diabetic rats,some of which were ameliorated by UDCA treatment.The expressions of Caspase-3,Bax,Bip,and CHOP mRNA in pancreas of DM group were significantly up-regulated as compared with those in the control group ( P ＜ 0.05 ) ; while the expression of Bcl-2 mRNA was markedly down-regulated (P＜0.05 ).However,these parameters in the U DCA-treated animals showed a marked improvement.Conclusion Ursodeoxycholic acid seems to protect pancreatic β-cell from apoptosis in STZ-induced diabetes by attenuating the severity of endoplasmic reticulum stress.

Objective To detect the signaling pathways involved in aldosterone (ALDO)induced mesangial cell (MC) proliferation. Methods The incorporation of 3H-thymidine (3H-TdR)and cell count were used as the measure of mesangial cell (MC) proliferation. Reactive oxygen species (ROS) production was determined by DCFDA fluorescence. Epidermal growth factor receptor (EGFR) activation was assayed by Western blotting. Results ALDO induced MC proliferation.When incubation with 100 nmol/L ALDO for 24 h, the 3H-TdR incorporation and cell number increased by 2.63- and 2.15-fold, respectively. Mineralocorticoid receptor (MR) antagonist EPLE almost completely blocked ALDO-induced MC proliferation (P<0.01), however, glucocorticoid receptor (GR) antagonist RU-486 had no effect on MC proliferation. ALDO increased intracellular ROS production in cultured human MCs. When incubation with ALDO (100 nmol/L) for 60 min,ROS production increased by 2.14-fold. ALDO-induced ROS generation was completely blocked by EPLE as well as mitochondrial complex Ⅰ inhibitor rotenone (P<0.01=, NADPH oxidase inhibitors diphenyleneiodonium sulfate (DPI) and apocynin inhibited ALDO-induced ROS production by 30%to 35% (P<0.05=. In contrast, inhibitors of other oxidant-producing enzymes, including allopurinol,indomethacin, nordihydroguiaretic acid, ketoconazole and G-nitro-L-arginine methyl ester (L-NAME)had no effect on ALDO-induced ROS production. Antioxidant N-acetyl-L-cysteine (NAC) and ROT inhibited ALDO-induced MC proliferation by 75% to 80%, whereas the inhibition of NADPH oxidase inhibitor apocynin and DPI on ALDO-induced MC proliferation was 25% to 30%. ALDO induced EGFR transactivation. When incubation with 100 nmol/L ALDO for 60 min, EGFR phosphorylation was increased by 4.95-fold, which was completely inhibited by EPLE and antioxidant NAC (P<0.01=. NAC and EGFR antagonist AG1478 significantly blocked ALDO-induced MC proliferation (P<0.01=. Conclusions ALDO-induced MC proliferation is mediated by ROS-dependent EGFR transactivation. ALDO-stimulated ROS is mainly generated by mitochondria.

Objective To observe the expression of Rock Ⅰand its functional activation in renal tissue from a rat UUO model, and to investigate its role in the progression of renal interstitial fibrosis(RIF). Methods Expression of RockI mRNA and protein were examined by RT PCR and Western blotting, respectively.The phosphorylation of MBS(binding subunit of myosin phosphatase)—a substrate of Rock Ⅰwas detected by Western blotting and defined,as the mark of functional activation of the kinase. Results (1)The expression of Rock ⅠmRNA was increased before the onset of RIF(the 3rd day after the experiment) (F=15 18,P

Helicobacter pylori ( HP ) is the most common infectious pathogen of the digestive tract , since being identified in 1880s, its critical roles in many gastrointestinal and extra -gastrointestinal diseases have been confirmed.HP is involved in disease processes by different mechanisms ,one of which significantly important is the local or systemic inflammatory response and immune damage .HP could colonize in the gastric mucosa ,resulting in the elevation of many inflammatory mediators in stomach and serum .Many kidney diseases ,like glomerulonephritis ,renal failure and diabetic nephropathy have been confirmed to be related to inflammatory responses ,and HP could partici-pate in different kinds of kidney diseases by enhancing inflammatory responses to influence humoral or cellular immune response.This manuscript reviewed the research progress on the relationship between Hp and renal disease .

Objective:To explore the application value of conventional ultrasound(US) in detecting occult bleeding lesions in joints of patients with hemophilia.Methods:Twenty-seven children with severe hemophilia A who received factor Ⅷ prophylactic treatment from March 2017 to April 2018 in Nanfang Hospital, Southern Medical University were enrolled. Clinical data were collected from routine practice accompanied with US examination, hemophilia joint health score (HJHS) 2.1 assessment and the history of hemarthrosis of both ankles, elbows and knees at baseline and at 1 year follow-up.Results:A total of 157 joints of 27 patients were followed up for one year. During the treatments, 74 joints were found without history of hemarthrosis, among which the total US score of 14(14/74, 18.9%) joints increased, and HJHS 2.1 score of 11(11/74, 14.9%) joints developed. There was no significant change in the HJHS 2.1 score of 108 joints, among which 25 joints (25/108, 23.1%) had an increase in the total US score.However, there was no significant change in the total US score for 93 joints, of which 9(9/93, 9.7%) had an increase in HJHS 2.1 score.Conclusions:US examination can sensitively detect hemophilia arthropathy in joints without history of hemarthrosis and without obvious progression of arthropathy by HJHS 2.1 examination, and provide clinicians with more accurate joint information.

Objective? To explore the status quo of work-life balance and resilience of nurses in second pregnancy, to analyze the correlation between the two and to provide a reference for improving mental health of nurses in second pregnancy. Methods? The nurses in second pregnancy from 4 Class Ⅲ hospitals in Huzhou were selected using convenient sampling and investigated with the general demographic information questionnaire, Work-life Balance Scale, Chinese Medical and Nursing Staff Resilience Scale between January and April 2018. Totally 465 questionnaires were distributed and 460 of them were collected, with a valid collection rate of 98.92%. Results? The 460 nurses' work-life balance score totaled (37.44±7.84) and their resilience totaled (54.76±9.27). The two were positively correlated with each other (r=0.314,P=0.008). There was a statistically significant difference in the scores of resilience between nurses in the second trimester of pregnancy with different working years, professional titles, and monthly household income (P＜0.05). Work-life balance was the main influence factor for the resilience of nurses in second pregnancy. Conclusions? The work-life balance and resilience of nurses in second pregnancy stay has relevance. The higher their work-life balance is, the stronger their resilience. Nursing managers may consider flexible working time and team management, reduce working pressure over nurses in second pregnancy, and improve work-life balance. Meanwhile, nurses themselves, spouses and families should work together to improve the nurses' resilience in the face of daily stressors.

?? [Abstract]? Objective? To explore the effects of reciprocal behavior on perceived stress among nurses during the second pregnancy. Methods? From January to March 2018, we selected clinical nurses during the second pregnancy at five Class Ⅲ hospitals in Zhejiang as subjects by convenience sampling. The questionnaire survey was carried out with the employee reciprocal behavior questionnaire and the Chinese version Perceived Stress Scale (CPSS) to explore the correlation between them. A total of 500 questionnaires were sent out and 482 valid of them were collected with 96.40% for the valid recovery rate. Results? Among 482 nurses during the second pregnancy, the scores of reciprocal behavior and perceived stress were (42.35±8.65) and (38.38±7.58) respectively. Perceived stress of 33.61% of nurses during the second pregnancy was at a normal level. Reciprocal behavior had a negative correlation with the perceived stress (r=-0.411,P＜ 0.01). Hierarchical regression analysis showed that reciprocal behavior was the influencing factor of the perceived stress of nurses during the second pregnancy. Conclusions? Reciprocal behavior has the influence on perceived stress among nurses during the second pregnancy which points out that managers and individuals can improve reciprocal behavior so as to reduce the stress of nurses during the second pregnancy.