Objective To analyze the influencing factors of hemoglobin A1c in type 2 diabetic patients,including blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.Methods Seventy-eight type 2 diabetic patients were divided into two groups by different degree of blood glucose,anti-diabetic therapeutic regiments,disease course,age,diabetic education,degree-educated,self-monitoring blood glucose.The levels of hemoglobin A1c in two groups were compared.Results There were significant changes in the levels of hemoglobin A1c between fasting blood glucose (FBG) ≤ 6.1 mmol/L group (30 cases) and FBG ＞ 6.1 mmol/L group (48cases),2 h postprandial blood glucose (2hBG) ≤8.0 mmol/L group (32 cases) and 2hBG ＞ 8.0 mmol/L group (46 cases ),insulin treatment group (27 cases) and no-insulin treatment group ( 51 cases ),combined drugs treatment group ( 36 cases ) and single drug treatment group ( 15 cases),age ≤ 65 years old group (41cases) and age ＞65 years old group (37 cases),disease course≤ 10 years group (39 cases) and disease course ＞ 10 years group( 39 cases),degree-educated above high grade group( 34 cases) and degree-educated below high grade group (44 cases),diabetic education ≥2 times/month group (20 cases) and diabetic education ＜ 2 times/month group (58 cases),self-monitoring blood glucose≥2 times/week group ( 19 cases)and self-monitoring blood glucose ＜ 2 times/week group (59 cases)[ (6.7 ± 1.5 )％ vs.(7.9 ± 1.3 )％,(6.8 ±1.1)％ vs.(7.8 ± 1.2)％,(6.7 ± 1.5)％ vs.(8.1 ± 1.4)％,(6.8 ± l.0)％vs.(8.0 ± 1.6)％,(6.9 ± 1.7)％ vs.(7.4 ± 1.6)％,(6.5 ± 1.2)％ vs.(8.2 ± 1.3)％,(6.9 ± 1.0)％ vs.(7.6 ± 1.4)％,(6.1 ± 1.7)％ vs.(8.0 ±1.1 ) ％,(6.7 ± 1.1 )％ vs.(7.6 ± 1.2)％ ] (P ＜ 0.01 or ＜ 0.05 ).Conclusion Blood glucose,anti-diabetic therapeutic regiments,disease course,diabetic,degree-educated,self-monitoring blood glucose are the important factors influencing hemoglobin A1c.

Objective To explore the clinical efficacy of anti-helicobacter pylori (HP) treatment on patients with type 2 diabetes mellitus and HP infection.Methods A total of 112 type 2 Diabetes patients were diagnosed with HP infection in Combine Traditional Chinese and Western Medicine Hospital of Taizhou from April 2012 to June 2016.These patients were divided into control and treatment group based on the preprandial blood glucose averages from lower to higher hierarchy.Thus,there were 56 patients in each of the two groups.The control group was given Motilium and Talcid for gastric symptoms in addition to anti-diabetes treatment,while the treatment was administered the same treatments as well as the quadruple anti-HP therapy (omeprazole,amoxicillin,clarithromycin and colloidal-bismuth-subcitrate,with Talcid stopped while colloidal-bismuth-subcitrate was administered).The anti-HP lasted for 14 days.The two groups were compared the gastric symptoms,the blood glucose levels,and the HbA1c one month after treatment.Half a year and one year post treatment,the two groups were compared the gastric mucus signs under gastroscopy.Results The improvement rates after treatment with the treatment group in abdominal pain,bloating,regurgitation,belching and diarrhea/constipation were 88.5％ (23/26),83.3％ (25/30),74.1％ (20/27),83.9％ (26/31),82.6％ (19/23),respectively,and with the control group being 29.2％(7/24),32.1％(9/28),28％(7/25),30.3％(10/33),18.2％ (4/22),respectively.The differences between the two groups were significant (x2=8.06,6.62,3.92,7.65,6.66,P＜0.05 or P＜0.01).The control group did not show significant changes in preprandial glucose levels,the glucose levels two hours post meals and the HbA1c(P＞0.05) while the treatment group showed statistically significant changes(P＜0.05 or P＜0.01).The differences in the three indicators after treatment between the two groups were significant (t =4.07,7.85,4.16,P＜ 0.05).The Gastric mucus signs under gastroscopy showed improvements in both groups after treatment.The improvement rates with the treatment group were 86.2％(25/29),86.7％ (13/15),77.8％ (14/18),72.7％ (8/11) respectively,with the control group being 36％ (9/16),27.3％ (3/11),13.3％ (2/15),14.3％ (1/7),respectively.The differences between the two groups were significant (x2 =6.71,4.12,4.38,3.85,P ＜ 0.05 or P＜ 0.01).The effectiveness rate,which was based on combined improvements in gastric symptoms,glucose levels and gastric mucus signs,was 76.8％ with the treatment group and 32.1％ with the control group.The difference was statistically significant (x2 =6.78,P＜0.01).Conclusion Anti-HP treatment can relieve the gastric symptoms,stabilize the glucose levels,and help to reverse the changed gastric mucus.All these can reduce the complications of the diabetes and improve the prognosis of the patients.

Objective To discuss the clinicopathologic characteristics and risk factors for lung metastasis of early-stage cervical cancer after radical hysterectomy. Methods The complete clinicopathologic data of patients with lung metastasis of cervical cancer after radical surgery from January 2008 to December 2013 admitted in Zhejiang Cancer Hospital were retrospectively analyzed by univariate and multivariate analysis. Results (1)There were 38 cases of early cervical cancer suffered from lung metastasis after radical hysterectomy during the period. The median age at diagnosis of cervical cancer was 46 years, the average lung metastasis time was 13 months after operation, 50.0%(19/38) cases occurred in the first year. Thirty-one cases were squamous cell carcinoma and 7 cases were non-squamous cell carcinoma.(2)Univariate analysis showed that age,clinical stage, manner of tumor growth, tumor grade, perineuronal invasion, para-aortic lymph node metastasis were not significant effect on postoperative lung metastasis(all P>0.05). But tumor size, histologic types, depth of stromal invasion, uterine body infiltration, lympho-vascular space invasion,pelvic lymph node metastasis, positive margin and abnormal tumor markers were significantly correlated with postoperative lung metastasis(all P<0.05). Multivariate analysis showed that only tumor size, histologic types and pelvic lymph node metastasis were independent risk factors for lung metastasis of cervical cancer(P<0.05). Conclusions Patients of early-stage cervical cancer with lung metastasis mostly occurs within 1 year after radical hysterectomy. Local large tumor lesions (tumor size>4 cm), non-squamous cell carcinoma and pelvic lymph node metastasis were more likely to have lung metastasis.

Objective To study the effect of three-dimensional (3D) animation on preoperative anxiety in patients with lumbar disc herniation (LDH). Methods One hundred and eighty-four LDH patients were randomly divided into experiment and control group in equal number. The control group was educated in traditional method and the experiment group in the form of 3D animation. The self-rating anxiety scale (SAS) was used for the assessment 2 h after admission into the hospital and 1d before operation. Results After the intervention, the score by SAS in the observation group was significantly lower than that before the intervention and control groups (P<0.001). The score by SAS in the control group was significantly lower than that of the control group and that before intervention (P<0.001). Conclusion Health education by 3D animation can relieve preoperative anxiety in the patients with lumbar disc herniation.

Objective To investigate the long-term toxicity of an Uyhgur medicine, Kursi Kaknaq, on hematological parameters in the rats.Methods A total of 120 healthy Sprague-Dawley rats were randomly divided into the control, low dose (0.32 g/kg? d ), moderate dose (1.6 g/kg? d) and high dose (3.2g/kg? d) Kursi Kaknaq groups.The drug was given orally, 6 days per week for 180 days.The control group was given 0.5% sodium carboxymethyl cellulose suspension. Results No death was recorded in the rats and no obvious toxic events were observed during the experiment. Hematological parameters including RBC, HGB, MCH, MCHC, LYMP%, WBC, and PLT; biochemical parameters including ALT,AST, ALP, GLU, BUN, ALB ,TBIL, Crea, TCHO, TG, and CK; electrolyte time parameters such as K+, Na+, Cl-and prothrombin time(PT) showed statistically significant differences (P <0.05 and P <0.01), but did not show time and dose effect regularity, and no pathological significance.Conclusions No obvious toxic effects on hematological parameters are observed in the SD rats treated with Kursi Kaknaq at doses of 0.32 g, 1.6 g, or 3.2 g (crude drug) /kg? d orally administered for 180 days, indicating that this drug is safe for long-term clinical use.

Objective To observe the effects of melatonin on synaptic plasticity impaired by spinal cord injury in rats. Methods A total of 54 female Sprague-Dawley rats were divided into sham group (n=18), control group (n=18) and melatonin group (n=18). Spinal cord inju-ry model was established with modified Allen's method at T10 (10 g from 25 mm height). The number of neurons and the expression of the Nissl body were detected with immunofluorescence and Nissl staining. The expression of neurofilament-200 (NF-200), brain-derived neuro-trophic factors (BDNF), Synapsin I and growth-associated protein-43 (GAP-43) was detected with Western blotting. Results Seven days af-ter injury, the number of motoneurons, the expression of Nissl body in motoneurons, and the expression of BDNF, Synapsin I and GAP-43 decreased in the control group compared with those in the sham group, and they increased in the melatonin group compared with those in the control group. Conclusion Melatonin can repair the impaired synaptic plasticity, which might promote the functional recovery after spi-nal cord injury.

Objective To investigate the influence of matrix metalloproteinases-9 (MMP-9) on permeability of blood-spinal cord barrier (BSCB) after spinal cord injury (SCI). Methods 68 male C57BL/6 mice were randomly divided into sham group, 2 days group (S2), 7 days group (S7) and 14 days group (S14) after SCI with 17 mice in each group. All the groups received a moderate impacted spinal cord injury except the sham group. Evan's Blue (EB) was administered intraperitoneally to detect the permeability of BSCB. Occludin was analyzed by immunofluorescence, the expressions of occludin and MMP-9 were detected by Western blotting. Results After SCI, BMS score significantly reduced, compared with S2 group, S14 group showed a significant increase (P<0.01). The permeability of BSCB was seriously damaged after SCI. Compared with S2 group, S14 group showed a notable down-regulation in the permeability of injured micro-vessels (P<0.05). The expression of occludin was down-regulated and the expression of MMP-9 was up-regulated 7 days after SCI (P<0.05). Compared with S2 group, S14 group showed a significant up-regulation of occludin and a remarkable down-regulation of MMP-9 (P<0.05). Conclusion After SCI, MMP-9 might mediate the expression of occludin to influence the BSCB permeability.

Objective To explore the glomerular change of renin-angiotensin system (RAS) expression in ATIaR gene knockout mice and its effects on extracellular matrix (ECM) remodeling under diabetic condition. Methods ATlaR knockout mice were generated previously. Hyperglycemia was induced by peritoneal injection of streptozotocin in ATIaR knockout mice and wild type mice. Normal AT1aR knockout mice and wild type mice were used as control group. Twelve weeks later, kidneys were harvested and frozen quickly in dry ice-acetone. Glomendi were collected by laser capture microdissection and total RNA was extracted, mRNA expression of AT1aR, AT1bR, AT2R, angiotensinogen, ACE, renin, and CYP11B2 was assessed by real-time PCR. ECM accumulation was evaluated by PAS staining. Protein levels of transforming growth factor β1(TGF-β1), type 1 plasminogen activator inhibitor(PAI-1), monocyte chemotactie protein 1(MCP-1) and renin were semi-quantitated by immunostaining. Results Compared to the wild type, mRNA expression of AT1bR, angiotensinogen, renin, CYP11B2 within glomeruli was upregulated significantly in ATlaR knockout mice (P<0.05), but no change of ACE expression was found in these two groups. AT2R protein was poorly detected in AT1aR knockout glomeruli and downregulated in wild type glomemli. ECM accumulation was significanfly increased associated with the parallel increase in TGF-β1, PAI-1, MCP-1 and renin within glomendi (P <0.05). Conclusions AT1aR gene knockout cannot improve ECM deposition in diabetic nephropathy. The compensate change of RAS components may be involved in this scenario: upregulation of AT1bR, downregulation of AT2R. CYP11B2 and renin may function in a novel pathway.

Objective To identify the high-touched object surface in different special intensive care units(ICUs) through the observation and statistical analysis on the number of touching with common object surfaces in different ICUs, so as to provide basis for hospital environmental management.Methods Direct observation method was used to observe the daily activities of health care workers, the number of touching with various common object surfaces was recorded, Poisson distribution was adopted to statistically analyze the data.Results The average number of touching from high to low was as follows : medical record folder(n=28.00), chair(n=18.38), emergency rescue cart(treatment cart, n=17.29), bed surface(n=13.90), intravenous infusion line(n=13.76), medical pen(n=13.38), and intravenous transfusion pump(n=11.81), these objects accounted for 64.01% of all surface touching number.Different special ICUs were slightly different, general ICU high-touch object included the first 6 categories;cardiothoracic surgery ICU included the above 7 categories besides keyboard and mouse;internal medicine ICU included the first 6 categories and mobile phone.Conclusion High-touched object surface varied with different special ICUs of the same hospital, hospital should make the corresponding disinfection management measures according to the actual situation of high-touched surface of each department, so as to reduce the incidence of healthcare-associated infection.

Objective To explore the levels of sense of coherence,social support and coping style of permanent colostomy,and explicit the relationships among the three variables.the structural equation model(SEM) was used to investigate the relationship of the three variables in order to provide the theory basis for patients with permanent colostomy. Methods Self designed questionnaire,Sense of coherence scale, Medical Coping Modes Questionnaire and social support Scale were used to investigate 172 permanent colostomy patients from two grade 3 class A hospitals in Harbin. Results The total score of SOC in patients with permanent colostomy was (65.09 ± 11.71) points;The total score of social support in patients with permanent colostomy was (42.60 ± 7.26) points;the three subscales of medical coping modes questionnaire in descending sequence were avoidance, confrontation and acceptance-resignation with (18.53 ± 2.82), (17.37 ± 5.48), (9.49 ± 3.25) points. The abusive social support and coping style were significantly correlated to sense of coherence (P< 0.01 for both). Moreover, sense of coherence can be predicted directly by social support,and predicted indirectly via the mediating effect of coping style. Conclusion Effective measures should be taken to improve social support and via coping style to improve sense of coherence.