Objective To explore the effect of motivational interviewing on the self-care of type 2 diabetic patients . Methods Totally 96 inpatients with type 2 diabetes were randomly divided into the control group and the intervention group , each group containing 48 patients. The control group received routine diabetes education, while the intervention group received face-to-face and one-by-one motivational interviewing intervention for three months. The patients′self-care level were evaluated by using diabetes self-care scale after intervention. Result After intervention, the score on the self-care behaviors including diet control, exercise therapy, medication , blood glucose monitoring and foot care were significantly higher in the intervention group than those in the control group (P < 0.01). Conclusion Motivational interviewing can improve the ability of type 2 diabetic patients to control the glycemic level.

Objective : To investigate the role of hepatic long-chain non-coding RNA (lncRNA) H19 in key genes associated with glucose metabolism disorder induced by p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE). Methods: Human embryonic liver CCC-HEL-1 cells were divided into the DMSO group, 0.1 μmol/L p,p′-DDE group, 1 μmol/L p,p′-DDE group, 10 μmol/L p,p′-DDE group, small interference RNA (siRNA)+DMSO group and siRNA+10 μmol/L p,p′-DDE group. The promoter region methylation, mRNA expression and protein expression of hepatocyte nuclear factor 4α (HNF4α), forkhead box transcription factor O1 (FoxO1) and insulin-like growth factor (IGF2) were detected in CCC-HEL-1 cells using the bisulfite method, real-time fluorescence quantitative PCR (qPCR) assay and BCA assay, respectively. The changes in H19 mRNA expression, the methylation of associated genes in the promoter region and transcriptional expression were compared in CCC-HEL-1 among groups. Results: Exposure to p,p′-DDE alone at different doses resulted in an increase in H19 expression, and the H19 mRNA expression was higher in the 10 μmol/L p,p′-DDE group than in the DMSO group [(1.31±0.25) vs. (1.02±0.22); P<0.05]. Lower methylation of the HNF4α gene in the pro moter region [(38.59±32.77)% vs. (61.43±24.64)%; P<0.05] and higher HNF4α mRNA expression [(1.33±0.26) vs. (1.03±0.28); P<0.05] were detected in the 10 μmol/L p,p′-DDE group than in the DMSO group, while no significant differences were detected between the two groups in terms of the methylation of FoxO1 and IGF2 genes in the promoter region, FoxO1 and IGF2 mRNA and protein expression (P>0.05). Following siRNA-induced H19 knockdown, higher methylation of the HNF4α gene in the promoter region [(71.33±22.23)% vs. (38.59±32.78)%; P<0.05], lower HNF4α mRNA expression [(0.71±0.17) vs. (1.33±0.26); P<0.05], higher methylation of FoxO1 gene in the promoter region [(47.73±34.24)% vs. (25.09±25.35)%; P<0.05] and higher IGF2 mRNA [(1.39±0.25) vs. (0.80±0.20); P<0.05] were found in the siRNA+DMSO group than in the 10 μmol/L p,p′-DDE group, and higher IGF2 protein expression was detected in the siRNA+DMSO group than in the DMSO group [(1.03±0.11) vs. (0.74±0.12); P<0.05]. Conclusion Hepatic H19 may alter HNF4α, FoxO1 and IGF2 transcription and expression through mediating the methylation of genes in the promoter region, thereby playing a role in p,p′-DDE-induced glucose metabolism disorders.

Objective To analyze the outcome of patients receiving intrauterine insemination with husband sperm,in order to evaluate the effect of relative factors on pregnancy rate after intrauterine insemination. Methods Ninety-eight infertile couples who received intrauterine insemination in the Affiliated Hospital of Nantong University from March 2013 to May 2014 were selected as our subjects and 181 cycles were included. The information including clinical factors including maternal age,infertile time,infertile causes, ovulation induction protocol,time of insemination and postwash total motitle sperm(TMS)and pregnancy rate were recorded. Results (1)Totally 26 patients received clinical pregnancies,and clinical pregnancy rate(CPR) was 14. 36% per cycle. With age increase pregnancy rate decreased( χ2 = 1. 654 9,P = 0. 647).(2)The pregnancy rate of the patients was the same within the infertile time( χ2 = 1. 588 5,P = 0. 662).(3)The pregnancy rate of the patients with secondary infertility was lower than that of the patients with primary infertility,but there was no significant difference(χ2 = 0. 923 3,P = 0. 337).(4)The pregnancy rate of ovulation induction cycles was lower than that of nature cycles,but there was no significant difference(χ2 = 2. 222 0,P= 0. 136).(5)Postwash TMS was showed the same trend(χ2 = 0. 643 4,P = 0. 422). Conclusion In terms of intrauterine insemination with husband sperm,age,infertile time,infertile types,ovulation induction protocol and posrwash TMS can affect pregnancy rate,and the effects of various factors should be considered comprehensively in the process of therapy.

AIM: To gain cdcSTBX25A-fas chimeric gene bearing the regulative fragment cdcSTBX25A and opening read frame of fas in order to construct and identify eukaryotic expression vectors, pAdTrack-CMV-cdcSTBX25A-fas and pAdTrack-cdcSTBX25A-fas, which have the potential to transfer the tumor proliferative signal to promoting-apoptosis signal through up-regulate the fas expression by c-myc. METHODS: A pair of primers were designed according to the known sequences of cdcSTBX25A and fas. The cdcSTBX25A-fas chimeric gene was obtained by PCR reaction and inserted into the two plasmids pAdTrack-CMV and pAdTrack, respectively. The two recombinant plasmids were transferred into E. coli DH5?. The positive clones were screened in LB media with 50 mg/L kanamycin and identified by agarose gel electrophoresis, endonuclease digestion and PCR. The nucleotide sequence of inserted cdcSTBX25A-fas was determined by dideoxy chain termination method. Using software, BLAST was conducted to analyze the structure and sequence of the target fragments and compared with GenBank. RESULTS: The chimeric target gene, cdcSTBX25A-fas, of 1 603 bp was obtained. The positive host bacteria E. coli DH5? of recombinant plasmids were screened and amplified. The double-enzyme digestion showed the pAdTrack-CMV-cdcSTBX25A-fas and pAdTrack-cdcSTBX25A-fas presenting 9.2 kb, 1.6 kb bands, and 8.3 kb, 1.6 kb bands respectively. The sequence analysis confirmed that the two shuttle plasmids containing 1 597 bp cdcSTBX25A-fas with the ORF of fas. CONCLUSION: The eukaryotic expression plasmids pAd-Track-CMV-cdcSTBX25A-fas and pAdTrack-cdcSTBX25A-fas were successfully constructed.

Objective To compare the efficacy of less invasive surfactant administration (LISA) and intubation-surfactant-extubation to CPAP (INSURE) techniques in premature infants with respiratory distress syndrome (RDS).Method From January 2016 to January 2017,premature infants with RDS admitted to our hospital were prospectively and randomly assigned into the LISA group and the INSURE group.A 6F suction tube was used to drip pulmonary surfactant (PS) into the trachea with non-invasive respiratory support in the LISA group.INSURE technique and endotracheal intubation with surfactant administration were used in the INSURE group.The following indicators were examined:the time needed for intubation,the change of percutaneous oxygen partial pressure and the incidence of bradycardia during administration,regurgitation after administration,oxygen therapy duration,mechanical ventilation duration,re-administration of PS and apnea.Secondary indicators included the incidences of pneumothorax,pulmonary hemorrhage,neonatal necrotizing enterocolitis (NEC),intraventricular hemorrhage (IVH),bronchopulmonary dysplasia (BPD),preterm retinopathy (ROP),and periventricular leukomalacia (PVL).Result A total of 145 cases were included including 76 in LISA group and 69 in INSURE group.The gestational age was 27～34 weeks.The birth weight was (1 650±480) g.No statistically significant differences existed between the two groups on the time needed for intubation,the change of percutaneous oxygen partial pressure,mechanical ventilation duration,oxygen therapy duration,the incidence of bradycardia,re-administration of PS,apnea and other complications (P＞0.05).Statistically significant differences existed in the incidence of regurgitation (46.1％ in LISA group vs.29.0％ in INSURE group),mechanical ventilation within 72 hours (13.2％ in LISA group vs.27.5％ in INSURE group) and the incidence of BPD (6.6％ in LISA group vs.17.4％ in INSURE group) (P＜0.05).Conclusion Compared with INSURE,LISA technique is effective for the treatment of RDS and reduce invasive ventilation duration and the occurrence of BPD.

Objective To investigate the predictive factors for death within 30 days after admission in patients with decompensated liver cirrhosis and acute kidney injury(AKI),and to establish and validate a nomogram prediction model.Methods The Joint Medical Record Management System of The First Affiliated Hospital of Nanchang University was used to obtain the patients with decompensated liver cirrhosis who were hospitalized in Department of Gastroenterology and Department of Infectious Diseases from January 2015 to December 2020,among whom 330 patients who met the 2015 International Club of Ascites diagnostic criteria for AKI were enrolled and divided into training group with 193 patients and validation group with 137 patients.A Cox regression analysis was used to investigate the predictive factors for death,and then a nomogram prediction model for the risk of death within 30 days after admission was established and validated.The independent-samples t-test was used for comparison of normally distributed continuous data between two groups,and a one-way analysis of variance was used for comparison between multiple groups,while the least significant difference t-test was used for further comparison between two groups;The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,while the Kruskal-Wallis H test was used for comparison between multiple groups.The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.Results The prevalence rate of AKI was 16.5%in patients with decompensated liver cirrhosis.The 330 patients included in the study had a mean age of 53.6±12.4 years,and male patients accounted for 79.1%.The mortality rate was 50.0%within 30 days after admission,with a mortality rate of 46.6%in the training group and 54.7%in the validation group.The presence of acute-on-chronic liver failure(ACLF)on admission was an independent risk factor for the progression of AKI into stage 1(odds ratio=2.571,95%confidence interval:1.143-5.780,P=0.022).The nomogram based on white blood cell count,international normalized ratio,presence or absence of hepatic encephalopathy,and AKI stage on admission could well predict the risk of death with 30 days after admission,with a C-index of 0.680 in the training group and 0.683 in the validation group,and it was not inferior to CTP score and MELD score.Conclusion ACLF is an independent risk factor for the progression of AKI into stage 1.The nomogram prediction model established in this study can effectively predict the risk of death within 30 days after admission and thus has important guiding significance for the early identification and management of patients with decompensated liver cirrhosis and AKI.

OBJECTIVE： Te analyze the problems of clinical use in pediatric drug in China， and to put forward related countermeasures and suggestions. METHODS： Using “children” and “pediatrics” as retrieval words， registered drug information were retrieved from the website of China Food and Drug Administration； the data of pediatric drug use prescription was retrieved from hospital prescription system of 9 hospitals； all drug information were retrieved from national drug data management system； off-label drug use investigation and the literatures of pediatric drug use in medical institutions （5 representative third grade general medical institutions） were retrieved from CNKI and Wanfang database. General information and problems of pediatric drug use in China were investigated. RESULTS： A total of 170 009 items of registered drug information were retrieved， including 2 784 drug information items labeled with ”children” or ”pediatrics”， accounting for 1.64％；320 000 drug prescriptions from hospital prescription system of 9 hospitals covered 22 treatment areas involving 1 186 drugs and 51 dosage forms. Only 10％ suitable for children. The retrieval results of database showed that the incidence of children off-label drug use in outpatients prescriptions of 5 hospitals was in high level， mainly manifesting as without the information of pediatric drug use， hyper-indication drug use， hyper-dosage drug use. There were many problems in clinical pediatric drug use in China， such as less variety for children， single dosage form and specification， widespread off-label drug use， lack of scientific reference for drug use， difficulty in developing pediatric drug clinical trials， etc. CONCLUSIONS： Although the policies to protect children’s clinical drug use have been introduced in China， the problems facing children’s clinical drug use in China are still very serious. While further implementing relevant policies， it is necessary to establish a linkage management system led by government departments， with the full participation and mutual cooperation of society， enterprises， medical institutions and patients so as to guaratee the safety of pediatric drug use in clinic.

【Objective】 To evaluate the efficacy and safety of human coagulation factor Ⅷ developed by Shenzhen Weiguang Biological products Co, Ltd in the treatment of patients with hemophilia A. 【Methods】 A prospective, multi-center, open, single-group clinical study was conducted. A total of 65 subjects with hemophilia A were enrolled, and human coagulation factor Ⅷ(FⅧ) was injected according to the patients’ bleeding severity. The improvement score of bleeding symptoms and signs after the first infusion of the first bleeding event and the transfusion efficiency of FⅧ activity at 10 min and 1 hour after infusion were taken as the main efficacy indexes. The improvement scores of bleeding symptoms and signs after the first infusion and the increase of FⅧ activity at 10 min and 1 hour after infusion were the secondary efficacy indexes. 【Results】 The 65 subjects were enrolled in safety analysis set (SS) and full analysis set (FAS), and 58 of them were enrolled in protocol analysis set (PPS). Ten minutes and one hour after the first infusion, the level of factor Ⅷ activity in the subjects increased significantly, and the FⅧ activity increased by 100% or more in more than 79% of the subjects. The average infusion efficiency of FⅧ activity in all subjects was more than 100%. In 70% of the subjects, the pain was relieved rapidly and /or the bleeding symptoms were significantly improved 8 hours after each bleeding infusion, and the improvement rate of bleeding symptoms and signs reached 100% 72 hours after infusion. 【Conclusion】 After infusion of human coagulation factor Ⅷ, the activity level of factor Ⅷ in patients with hemophilia A significantly increased. The infusion efficiency can reach a optimal level, and the bleeding symptoms can be significantly improved.

【Objective】 To evaluate the clinical efficacy and safety of one kind of human prothrombin complex concentrate in treatment of patients with hemophilia B. 【Methods】 The clinical data of 36 patients with hemophilia B treated with human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. from May 2018 to April 2019 were retrospectively analyzed, and its clinical efficacy and safety were analyzed. 【Results】 A total of 35 subjects entered the full analysis set (FAS)and safety set (SS), 33 subjects entered the per protocol Set (PPS). Thirty minutes after the first infusion of FAS subjects, the activity of coagulation factor Ⅸ increased from (3.93±0.975) IU/dL to (25.61±9.337) IU/dL, and the infusion efficiency was (96.43±22.007)%. The increased value of coagulation factor Ⅱ activity was (73.25±14.874) IU/dL. The activity of coagulation factor Ⅶ was (42.79±16.847) IU/dL. The increased value of coagulation factor Ⅹ activity was (65.29±17.042) IU/dL. The increased value of coagulation factor Ⅸ activity was (21.68±9.434%) IU/dL. Twenty-four hours after the first infusion of FAS subjects, the improvement of bleeding symptoms and signs was excellent in 21 cases (60%), improved in 14 cases (40.0%), and the effective rate was 100%. The incidence of adverse reactions was 2.9%(1/35), and there was no antibody to human coagulation factor Ⅸ and new virus infection. 【Conclusion】 Infusion of human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. in the treatment of hemophilia B has significant clinical efficacy and good safety.