Objective To investigate the correlation between diabetic distress and coping styles among patients with type 2 diabetes. Method One hundred inpatients with type 2 diabetes were engaged in the investigation of their diabetes distress and coping styles by the diabetes distress scale (DDS) and medical coping modes questionnaire (MCMQ) and the correlation between them. Results The average score of diabetic distress was (2.17 ± 0.71), which was at mild level. 57%of them were at the higher level of diabetic distress. Confrontation and avoidance dimensions were lower than the norm in coping styles, and the acceptance dimension was higher than the norm (all P<0.01). The average scores of diabetic distress, regimen-related distress and physician-related distress subscales were negatively correlated with confrontation (all P<0.05). The average score on diabetic distress and the subscales were positively correlated with avoidance and acceptance dimension (all P<0.01). Conclusions Diabetic distress is prevalent in type 2 diabetic patients and the degree of positive coping is still not insufficient. The diabetic distress is negatively correlated to the confrontation, and positively correlated to the avoidance and the acceptance dimension. The medical staff should instruct the patients to adopt positive coping styles, and avoid negative coping styles to reduce diabetic distress. It will be conductive to the physical and mental rehabilitation of the patients as well.

Objective:To explore the effect of handicraft training administered over the Internet on sensation disorders and on the mental status and life quality of stroke survivors.Methods:A total of 75 stroke survivors in the sequelae stage and with sensory disturbance were randomly divided into a general training group of 26 (group A), a handicraft training group of 26 (group B), and a handicraft training group of 23 using Internet instruction (group C). In addition to 40 minutes of routine physical and sensory training rehabilitation every morning, groups A and B were given traditional training and handicraft training, while group C was given handicraft training delivered over the Internet for 40 minutes every afternoon, five days a week for 4 weeks. The traditional training involved inserting wooden boards, plate grinding, as well as sorting beans. The handicraft training involved digital painting, making non-woven flowers, silk screening flowers and paper-rolling. Before and after the 4 weeks of treatment, all of the subjects were assessed using the Fugl-Meyer sensory assessment (FMA-S), the Hamilton Anxiety Scale (HAMA), the Modified Barthel Index (MBI), and the physical component summary scale (PCS) and mental component summary scale (MCS) of the 36-item short-form health survey.Results:After the treatment, significant improvement was observed in their average scores of all three groups in all of the assessments. Groups B and C showed significantly greater improvement in the average FMA-S, HAMA and MBI scores than group A. And the average HAMA and MCS scores of group C were significantly better than those of group B.Conclusion:Handicraft training delivered over the Internet can improve the sensory functioning, mental status and life quality of stroke survivors in the sequelae stage with sensory disturbance.

Objective To analyze the antioxidant activities of extracts from Scutellaria baicalensis Georgi. by different solvents, and to determine the contents of total flavonoids. Methods By employing colorimetric method, contents of total flavonoids in different extracts were determined. The free radical scavenging activity of each extract was measured by DPPH method. Results Different extracts from Scutellaria baicalensis Georgi. by different solvents were provided with DPPH free radical scavenging activities, of which the ethyl alcohol extracts were the highest in scavenging activities. In addition, total flavonoids content of ethyl alcohol extracts was significantly higher than that of others. Conclusion The antioxidant activity of extracts from Scutellaria baicalensis Georgi. was related to the content of total flavonoids in it.

Flipped classroom as a new teaching mode provides a new idea for the reform of teaching and learning of medical genetics. This paper analyzes the feasibility of flipped classroom applied in medical genetics teaching and puts forward the concrete teaching design and practice process. That is, establishing task list, making teaching materials, drafting progress process and so on before class; implementing group reporting, teacher reviewing and in-class test in class; after class conducting comprehensive evaluating, summarizing and feedback, etc. Meanwhile, combining the practice, the experience and deficiency of flipped classroom is summarized in the end. Preliminary evaluation shows that the flipped classroom teaching im-proves students'!autonomous learning initiative, but it still needs to be improved in the course of medical genetics.

Objective To study the effects of different types of exercise training on learning and memory, as well as on the expression of synaptophysin (SYP) and on postsynaptic density protein 95 (PSD-95) in rats in which a model of vascular dementia had been created.Methods Forty male Wistar rats were divided randomly into a voluntary exercise group (V-EX) , a forced exercise group (F-EX) , an involuntary exercise group (I-EX) , a vascular dementia group (VD) and a sham-operation group (Sham) , with 8 rats in each group.Two-vessel occlusion (2-VO) of the arteria carotis communis was used to create a model of vascular dementia in all of the rats except those in the sham-operation group.Beginning one week after the surgery, the V-Ex rats were free to run in a running wheel.The F-EX rats were forced to run 270 m a day in an electric wheel.The I-EX rats were stimulated to imitate the gait pattern of their forelimbs running at 9 m/min three times a day for l0 minutes each time.No special training was given to the rats in the other 2 groups.Three weeks after the surgery, their learning and memory were tested using a novel object recognition test.Immediately after the test, their prefrontal cortex was sampled and the expression of SYP and PSD-95 was detected using western blotting.Results The average novel object recognition indices of the rats in the V-EX, F-EX and I-EX groups were all significantly higher than that of the VD group.Average PSD-95 expression was also significandy higher than in the VD group.Conclusion Exercise, whether voluntary, forced or induced by functional electrical stimulation can improve learning and memory in vascular dementia, at least in rats.The mechanism is possibly that the training can increase the expression of PSD-95 in the prefrontal cortex, though not SYP.

Polymyxin E shows effective treatment of the infection induced by resistant gramnegative bacteria, but its nephrotoxicity severely limits the clinical application of this drug. In this work, methoxypolyethylene glycols 2000 (mPEG2K)-polymyxin E (PME) was synthesized via chemical grafting reaction and had been characterized. The antimicrobial activity and cytotoxicity of mPEG2K-PME in vitro were investigated on Escherichia coli and HK-2 cells, separately. Intra-abdominal infection model was further established in order to study the therapeutic effect and the toxic effect on kidney of mice. The results showed that mPEG2K-PME exhibited significant inhibitory effect on Escherichia coli and had a lower toxicity on HK-2 cells in vitro. At the same time, mPEG2K-PME had a good efficacy in the treatment of Escherichia coli infected mice in vivo. Moreover, nephrotoxicity caused by mPEG2K-PME was significantly reduced compared to free PME. mPEG2K-PME is promising in development of new preparations with high efficiency and low toxicity.

Due to the limitations of drug treatment of vestibular migraine VM,the exploration of non-drug treatment is particularly important.In recent years,the research on non-drug treatment of VM mainly focuses on four aspects:lifestyle management,vestibular rehabilitation training,neuroregulatory therapy and acupuncture therapy.A number of studies suggest that all VM patients should consider vestibular rehabilitation training,but the choice of neuroregulatory therapy stimulation and adverse reactions after treatment still need to be systematically studied.A comprehensive description of non-drug therapy for VM is helpful to develop a more comprehensive and scientific treatment plan for VM patients.

Objective To explore the application of ropivacaine local infiltration anesthesia combined with patient controlled intravenous analgesia(PCIA)for postoperative analgesia and its influences on pain stress indexes in elderly patients after laparoscopic cholecystectomy(LC).Methods 518 elderly patients underwent LC under general anesthesia in the hospital were retrospectively enrolled from January 2020 to October 2023.According to different analgesia regimens,they were divided into group A(n=316,ropivacaine local infiltration anesthesia combined with PCIA)and group B(n=202,PCIA).The perioperative anesthesia indexes,scores of visual analogue scale(VAS)and Ramsay sedation after surgery,dosage of PCIA drug,hemodynamics,pain stress indexes[adrenaline(AD),norepinephrine(NE),cortisol(Cor)]and adverse events at 24 h after surgery were compared between the two groups.Results There were no differences in anesthesia time,recovery time,extubation time or intraoperative dosages of main anesthetics(dexmedetomidine,remifentanil and cisatracurium besilate)between the two groups(P＞0.05).Rest VAS and motion VAS in group A were lower than those in group B at 6,12 and 24 h after surgery,Ramsay sedation scale were higher than those in group B at 12 and 24 h after surgery,the differences were statistically significant(P＜0.05),dosage of PCIA drug and effective compression times were lower than those in group B at 24 h after surgery,the differences were statistically significant(P＜0.05).There was no difference in percutaneous arterial oxygen saturation(SpO2)level between the two groups(P＞0.05).The levels of mean arterial pressure(MAP),heart rate(HR),AD,NE and Cor in group A were lower than those in group B,the differences were statistically significant(P＜0.05).There was no difference of adverse events rate between the two groups at 24 h after surgery(P＞0.05).Conclusion Ropivacaine Calot's triangle block combined with PCIA for postoperative analgesia can effectively reduce rest VAS and motion VAS,improve sedation effect,maintain hemodynamics balance and reduce levels of pain stress factors in elderly patients after LC,with good safety.

Objective: To investigate the effect of Gradient treatment for acute superior mesenteric venous thrombosis (ASMVT). Methods: Clinic data of 68 patients of ASMVT admitted in Department of General Surgery, Jinling Hospital, Medical School of Nanjing University from January 2009 to December 2014 were analyzed retrospectively. There were 50 male and 18 female patients with a mean age of (45±12) years. These patients were conducted by the stepwise treatment model (endovascular treatment-damage control surgery-surgical intensive care-intestinal rehabilitation treatment). Clinical outcomes and complications were compared during the follow-up period. Differences about bowel resection length of endovascular treatment and surgical procedures were evaluated with t test. Results: In the 68 cases, 24 cases were cured simply by endovascular treatment, 19 cases received surgical procedures alone (group surgery). Twenty-five patients received endovascular treatment combined with surgical procedures (group combined), including 6 cases temporary abdominal closure. The overall mortality rate was 2.9% (2/68) during hospitalization. The range of bowel resection of group combined significantly reduced compared with group surgery ((92±14) cm vs. (162±27) cm, t=-2.377, P=0.022). During 1-year follow-up period, 4 cases suffered from short bowel syndrome, whom underwent surgery alone. Conclusions Early diagnosis and treatment is the key to treatment of ASMVT, the rapid improvement of intestinal ischemia is particularly important for prognosis. Combination therapy significantly save more residual small intestine and avoid short bowel syndrome. The selection of early gradient treatment can significantly reduce the mortality and improve the prognosis of ASMVT patients.

Objective: To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors. Methods: The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed. Results: The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ²=12.86, F=31.20, F=60.17, χ²=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ²=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ²=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R²=0.142, 0.196). Conclusion PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.