Objective To evaluate the value of continuous glucose monitoring system (CGMS) in the gestational patients with impaired glucose regulation. Methods The glucose level in the subcutaneous tissue was monitored by CGMS for 3 days in 6 patients with gestational diabetes mellitus (GDM) and 6 patients with gestational impaired glucose tolerance (GIGT). The fluctuation coefficient of blood glucose, percentage of hyperglycemic time, and percentage of hypoglycemic time were calculated. Results As shown by CGMS, the fluctuation coefficient of blood glucose, mean glucose level, percentage of hyperglycemic time, percentage of hypoglycemic time, mean fasting blood glucose, and mean postprandial blood glucose (PBG) levels were not significantly different between GDM group and GIGT group (P ＞ 0. 05). The time for reaching the peak PBG level ranged 90-120minutes in both two groups (P ＞ 0. 05). No sensor-related adverse events were noted. Conclusions It is safe to apply CGMS sensor in pregnant women. The blood glucose profiles are comparable between GDM and GIGT patients by CGMS; therefore, control of blood glucose should be equally strict in patients with GIGT as those with GDM.

Objective To explore the clinical application of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (CPR)in the treatment of critically ill children with cardiac arrest.Methods The clinical data of critically ill children due to cardiac arrest who were treated with ECMO assisted CPR from June 2012 to December 2015 in Affiliated Bayi Children's Hospital,Clinical Medical College in Army General Hospital,Southern Medical University were retrospectively reviewed,and the datas were analyzed by SPSS 20.0 software.Results A total of 17 patients received ECMO assisted CPR treatment,13 cases were male,4 cases were female,aged from 5 hours to 5 years old,the weight ranged from 3 to 16 kg;5 cases survived,and the survival rate 29.41％;12 cases died,the mortality rate 70.59％,of which 5 cases died of hear failure in withdrawal of ECMO,and 7 cases died of complications after withdrawal of ECMO.The age,sex ratio,body weight and other demographic data between 2 groups were not statistically significant (all P ＞ 0.05).There was no significant difference in the primary diseases between 2 groups (P ＞ 0.05).There was no significant difference in CPR time and ECMO support time between 2 groups (t =1.541,0.375,all P ＞ 0.05).Among 11 cases of children with ECMO-related complications,the incidence rate was 64.71％,the incidence of complication in the survival group was significantly less than that in the death group (x2 =8.709,P =0.003).The common complications of ECMO were bleeding,acral necrosis,infection,multiple organ failure,nervous system injury and acute kidney injury.There was no significant difference in the level of lactic acid between the survival group and the death group (P ＞ 0.05) before ECMO support started,but after 24 h of ECMO support,the lactic acid level in the survival group was significantly lower than that in the death group (t =2.896,P =0.014).Conclusions ECMO assisted CPR can improve the survival rate of critically ill children who have cardiac arrest and have no response to the conventional CPR.The serum lactic acid level after 24 h ECMO support has a guiding significance for the prognosis assessment,and ECMO patients' complications are still the most important factor affecting the prognosis of ECMO assisted CPR patients.

Objective To understand the master condition of knowledge of smoking /smoking cessation in patients with type 2 diabetes mellitus , and to analyze the correlation between the knowledge of smoking /smoking cessation , the compliance of smoking cessation and fasting plasma glucose in patients with type 2 diabetes mellitus .Methods The knowledge of smoking/smoking cessation and the compliance of smoking cessation were surveyed by the questionnaire in patients with type 2 diabetes mellitus .The average of fasting plasma glucose during 12 months in patients with type 2 diabetes mellitus was longitudinally observed through the prospective randomized study . The correlation between the knowledge of smoking/smoking cessation , the compliance of smoking cessation and fasting plasma glucose was analyzed by the statistical analysis .Results Two hundred and twenty patients with type 2 diabetes mellitus were interviewed , and 193 patients including 100 cases with smoking and 93 cases with non-smoking finished the follow-up study.The score of the knowledge of“smoking is harmful to the diabetes” was (18.30 ±6.07), and was lower than the scores of knowledge of smoking cessation (19.81 ±4.94) and “smoking is harmful to health” in all patients, and the difference was statistically significant ( P<0 .05 ) , but no difference was found in the smoking group and non-smoking group (P>0.05).The difference was found in the fasting plasma glucose in the smoking group and non-smoking group one month after the treatment (P=0.29).The average score of compliance of smoking cessation in the smoking group was (2.14 ±0.88) one month after the treatment, and was better than (2.52 ±1.04) six months after the treatment and (2.68 ±1.12) twelve months after the treatment , and difference was statistically significant (P<0.01).No correlation was found in scores of the knowledge of smoking /smoking cessation and the compliance of smoking cessation in the smoking group (P>0.05); there was the correlation between the compliance of smoking cessation and the number of smoking before the treatment , the average fasting plasma glucose every month after the treatment;there was the correlation between the scores of knowledge of smoking /smoking cessation and history of smoking (P<0.05).Conclusions The patients with type 2 diabetes mellitus do not fully master the knowledge of smoking cessation;the smoking can affect the control level of fasting plasma glucose to a certain extent , but is not the decisive factor; the knowledge of smoking/smoking cessation is separate from the behavior of smoking/smoking cessation .The compliance of smoking cessation in patients with type 2 diabetes mellitus can be improved through guiding the content and mode of health education in the future using the related psychological mechanism of decision-making behavior , strengthening the behavior training , and actively guiding the participation of families and other supervision .

Although tumor immune checkpoint inhibitors therapy brings survival benefits to cancer patients,it also faces many challenges,such as the occurrence of immune-mediated hepatotoxicity.Therefore,an in-depth understanding of the conditions,possible mechanisms,and risk factors that cause liver injury during the treatment of tumor immune checkpoint inhibitors will facilitate better clinical management.

Objective To explore the influences of continued nursing care on the recovery of intra-articular fractures of joint function of limbs and the quality of life after operation. Methods A total of 493 intra-articular fracture of limbs postoperative patients,who were discharged from our department from January 2015 to December 2016,were randomly divided into observation group and reference group.After operation,the reference group used self-management mode to practice joint functional exercise,while the observation group uses continued nursing mode to guide physical therapy to recover joint functions.After they discharged 12 weeks,we compared these two groups of patients with satisfaction of nursing care,joint function recovery and quality of life. Results After 12 weeks of operation, in observation group, the patients' joint function recovery rate was close to 79.27%(195/246), which was significantly higher than the rates 55.47%(137/247)in reference group,the difference was statistically significant(χ2=32.947,P<0.01). Respectively, the physiological function score,vigor score, mental health score, physiology role score, body pain score, health condition score, social function score and health score of the observation group in the quality of life assessment were (72.66 ± 4.41), (89.27 ± 4.10), (93.01 ± 3.05), (88.03 ± 3.19), (91.68±3.99),(76.78±4.86),(79.11±4.68),(85.57±7.07).The scores of control groups were(65.71±3.41),(64.02±4.51),(61.43±4.29),(66.49±4.52),(64.24±4.30),(62.02±6.24),(62.94±4.50),(65.02±7.72).The comparative difference of the two groups has statistical significance (t=12.48- 60.15, P<0.05). Meanwhile,in the satisfaction rate of nursing care,the great satisfaction rate of observation group(70.73%, 174/246) was much higher than reference group (37.65%, 93/247), the difference was statistically significant (χ2=59.789, P<0.01). Conclusion Offered outside continued nursing care to the intra-articular fracture of limbs postoperative patients can effectively improve the joint function of patients,their qualities of life and can considerably increase satisfaction of nursing care. Thus,it should to be clinically promoted.

Drug induced autoimmune hepatitis (DIAIH) refers to the liver injury mediated by druginduced autoimmune reaction.Since it has similar clinical features as idiopathic autoimmune hepatitis,it is often difficult to make differential diagnosis in clinical practice.A deep understanding of the development,pathogenesis,related drugs,risk factors,and clinical and histological features of DIAIH helps with the correct diagnosis and treatment of DIAIH.