Objective To explore the related risk factors of type 2 diabetic nephropathy,and to provide theoretical basis to make the strategy of prevention of diabetic nephropathy.Methods By case-control study method,98 patients with type 2 diabetic nephropathy were selected as the observation group.98 diabetes mellitus patients without kidney disease were selected as control group.Single factor analysis and non-conditional logistic regression analysis were conducted in two groups.Results The results of single factor analysis showed that type 2 diabetic nephropathy was closely related to family history of diabetes,course of diabetes,high blood pressure,diabetic retinopathy,BMI,coronary heart disease,HbAlc,FPG,2hPG,CRP (P ＜ 0.05).The results of multiple factors of logistic regression showed that type 2 diabetic nephropathy was closely related to course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG(P ＜0.05).Conclusion Course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG are independent risk factors for type 2 diabetic nephropathy.

Objective To explore the health-relate quality of life(QOL) status of adult persistent allergic rhinitis (PAR);the change of QOL of pro-post specific immunotherapy (SIT) and pharmacotherapy .Methods Skin prick tests(SPT) were performed on PAR patients .According to the results ,80 adult cases that were allergic to dermatophagoides were enrolled in ENT outpatient clinic of affiliated hospital of Nantong University from April to August 2011 .The patients were randomly allocated to receive either specific immunotherapy(n=40) or pharmacotherapy (n=40) ,all of them were given RQLQ before and after half-year treatment ;40 cases without any allergic diseases were chosen from ENT in-patient department ,and were given RQLQ .The scores of previous treatment of the PAR group were compared with health control group ,then compared with the scores of post-treatment ,and also compared the scores of post-treatment between the immunotherapy group and pharmacotherapy group .Results The scores of the PAR patients were higher than that of health control patients in all dimensions of RQLQ (P< 0 .05) ,and the most troublesome problems were nasal symptoms .The scores of the patients who received SIT were evidently lower than that of pro-treatment in all dimensions of RQLQ(P<0 .05) ,the scores of the patients who received medical treatment were also lower than before (P<0 .05) , and the scores of the SIT group were lower than the pharmacotherapy group (P<0 .05) .Conclusion The QOL of adult patients with PAR was improved after SIT or drug treatment ,and QOL improvement is more obvious treat by SIT .

Objective To investigate the differences in clinical characteristics between children and adults with systemic lupus erythematosus (SLE).Methods A retrospective cohort study was performed to investigate the differences in clinical data from 89 children and 120 adults with SLE.Clinical manifestations,laboratory results,renal pathological changes and disease activities of patients from the 2 groups were evaluated.Results The most common clinical manifestations including fever,rash,arthritis,renal damage and anemia were found in both groups.However,the incidences of symptoms such as fever,lymphadenectasis,anemia,renal damage,damage of digestive system and nerve system were higher in children with SLE than those in adult patients,and there were statistical significances (x2 =5.085,P=0.024;x2 =6.027,P =0.014;X2 =4.261,P =0.039;x2 =4.221,P =0.040;x2 =4.566,P =0.033;,x2 =4.346,P =0.037,respectively).The positive rate of antibodies against double stranded DNA in serum of children with SLE was higher than that in adults (x2 =1.895,P =0.169).However,the positive rate of antibodies against cardiolipin in serum of children with SLE was lower than that in adults,and there was statistical significance (x2 =4.823,P =0.028).Complement C3 and C4 levels in serum of children with SLE were lower than those in group of adults,and there were statistical significance (x2 =4.221,P =0.040;x2 =7.977,P =0.004,respectively).Class Ⅲ and Ⅳ were commonly observed in classification of renal pathological examinations in both groups.But it was shown that the prevalence of renal damage in children with SLE was higher than that in adult patients,and there was statistical significance (x2 =4.128,P =0.042).The most common SLE disease activity was identified as moderate in the both groups.However,the score of SLE Disease Activity Index was higher in children with SLE than that in adults,there was statistical significance (t =2.192,P =0.031).Conclusions Differences in clinical characteristics of SLE were found in children and adults.Compared with adults with SLE,children patients were found to show higher prevalence of disease activities,damage of multisystem and renal damage.Therefore,children with SLE need to be diagnosed as early as possible and treated aggressively.

Objective To understand the blood lipidcondition of perimenopausal women ,control and standard-reaching situ-ation of dyslipidemi.MethodSix hundred and forty inpatientaged 45-55 yearold (including 400 femaleand 200 males) ad-mitted in the Jiangbei People′Hospital from January 2000 to January 2014 and 200 femaleaged ove60 yearwere selected .TG , TLDL-,HDL-,complicating disease,control of blood pressure and blood lipid,and the lipid-regulating drugapplication situ-ation were recorded .ResultThe prevalence rate of dyslipidemiin perimenopausal women wa23 .40% .The blood lipidcontrol standard-reaching rate wa40 .80% ;the average levelof TG ,LDL-and Tin the perimenopausal women were highethan those in the men of the same age ,while the average level of HDL-walowethan thain the men of the same age .The prevalence rate of dyslipidemiwahighethan thain the men .The average lipid level in the femaleaged ove60 yearwere highethan thaof the perimenopausal women .Conclusion The lipid level of perimenopausal women ihighethan thain the men athe same age . The prevalence rate of dyslipidemiilowethan thain the femaleaged ove60 year,and the control standard-reaching rate is lower.

Objective To explore the relationship between the expression of EIIIA + fibronectin in incised wound of rat’s skin and injury time. Methods The wounding model was established by cutting the dor-salskin of 48 adult SD rats. The rats were sacrificed atthe pre-setinjury time as immediately, 0. 5h, 1h, 2 h, 3 h, 4 h, 6 h, and 8 h. The skin sam ples were taken at the m argin of wound. The expression of the EIIIA + fibronectin was detected by im m unohistochem istry and W estern blotting and the relationship be-tween its expression and injury time was observed. Results The expression of EIIIA + fibronectin was not observed im m ediately. The basal cell of skin began to showpositive expression 0. 5 h after injury. W ith the extension of injury time, positive staining became stronger. The value of relative optical density was gradually increased with prolonged injury time by the W estern blotting analysis. Conclusion The expres-sion of EIIIA + fibronectin could be used for estimation of injury time in the early stage of skin injury.

With human chromosomes,as antigen,anti—human—chromosome antibodies (AhChrA)were detected specifically from SLE patients sera by the methods of immunogold—silver staining(IGSS)and immnuofluorescenee tese (IFT)。To SLE,the sensitivity and specificity of serumAhChrA was 58.1%and98.5%respeetively in IGSS,34.9%and99.5%respectively in IFT。Boththe incidence and titer of AhChrA were found to be colsely related to the pathoactivity and thedamages of some important organs or tissues,such as kidney damage,abnormal immunity andhematocytopenia.A preliminary analysis of the antigen components reacting to AhChrA was alsoperformed。

To establish a quantitative LC-MS/MS method for the simultaneous detection of components of Erlong Zuoci Pill in rat plasma: verbascoside, oxypaeoniflorin, echinacoside and benzoylpaeoniflorin, and to evaluate the pharmacokinetic characteristics of Erlong Zuoci Pill in rats, plasma samples were purified by protein precipitation using methanol as a protein precipitant.Methanol was used as the organic phase and aqueous solution containing 0.1% formic acid was used as the water phase.The quantitative analysis method of verbascoside, oxypaeoniflorin, echinacoside and benzoylpaeoniflorin was established in negative ion mode, and the validation of bioanalytical method was carried out.Healthy SD rats were selected, and 20 mL/kg (equivalent to the original drug 10 g/kg dose) of Erlong Zuoci Pill extract was administered by intragastric administration.The plasma concentration of the target compounds at different time intervals after administration was determined using the established method, and the pharmacokinetic parameters was calculated by the Phoenix WinNonlin8.3 software using the non-compartmental model.The method validation results showed that verbascoside (r = 0.993 7) and oxypaeoniflorin (r = 0.994 6) had good linear relationship in the concentration range of 0.5-50 ng/mL, echinacoside (r = 0.993 6) and benzoylpaeoniflorin (r = 0.992 6) had good linear relationship in the concentration range of 1-100 ng/mL.The relative standard deviations of the inter- and intra- batch precision of the four compounds were all less than 15%, and the inter- batch and intra- accuracies were between 85% and 115%.Extraction recovery, matrix effect and stability met the relevant requirements.After a single gavage of Erlong Zuoci Pill extract in rats, all the four compounds were rapidly absorbed and eliminated.Oxypaeoniflorin, echinacoside, and benzoylpaeoniflorin showed two peaks in their drug concentration-time curves.Compared with the other three compounds, oxypaeoniflorin has the highest concentration in rat plasma with cmax1 of (24.40 ± 4.78) ng/mL and cmax2 of (22.50 ± 2.70) ng/mL. The results show that the validation results of this method are in line with the guiding principles of biological sample analysis methods, and it can be used to evaluate the pharmacokinetic characteristics of Erlong Zuoci Pill extract in rats.

Objective:To investigate the effects of multiple trace elements in neonatal parenteral nutrition (PN) on the stability of fat emulsion, and to assess the changes of stability indexes after filtration.Methods:With the standard body weight of 1.5 kg, seven groups of neonatal PN solutions with different concentrations of multiple trace elements were designed, including blank group (without multiple trace elements), normal dose group (1 ml/kg, i.e., 0.75 ml per 100 ml PN) and five experimental groups (i.e., 1.5 ml, 3 ml, 4.5 ml, 6 ml, and 7.5 ml per 100 ml PN respectively). Macroscopic observation was performed 0 h and 24 h after preparation. The mean droplet diameter (MDD) of lipid emulsion was determined with dynamic light scattering before and after filtration. The percentage of fat residing in globules larger than 5 μm (PFAT5) and the globule size distribution before and after filtration were determined with light blockage method.Results:Macroscopic examination of the 7 groups of PN solutions identified neither changes in color nor stratification within 24 hours after solution preparation. Within 24 hours after solution preparation, the MDDs of all PN solutions before filtration were between (338.67±6.11) nm and (370.00±15.13) nm, and the PFAT5 values before filtration ranged from (32.00±1.00) ×10 -3% to (85.67±6.81) ×10 -3%. The MDDs of all PN solutions after filtration were between (310.67±8.62) nm and (362.33±19.86) nm, and the PFAT5 values after filtration ranged from (4.67±1.15) ×10 -3% to (17.33±0.58) ×10 -3%. The concentration of multiple trace elements was positively correlated with PFAT5 ( P<0.05). There was statistically significant difference in PFAT5 values at 0 h and 24 h after preparation ( P=0.004). The difference of PFAT5 values before and after filtration was also statistically significant ( P=0.000). Conclusions:Within 24 hours after solution preparation at room temperature, the appearance of neonatal PN solutions with different concentrations of trace elements supplementation was unchanged, and the MDDs of fat emulsions were all within the safe range. However, when the concentration of monovalent cations (Na +, K +) was 38.9 mmol/L, the concentration of divalent cation (Ca 2+) was 5 mmol/L, and the concentration of trace elements (Zn 2+, Cu 2+, Mn 2+, and Se 4+) was higher than 0.063 mmol/L, the PFAT5 value was higher than 0.05%. In this case, filtration with a 1.2 μm filter was necessary, which could significantly reduce the PFAT5 value and the globule size distribution, and improve the safety and standardization of the clinical application of PN solutions. It is suggested that the neonatal PN solutions supplemented with multiple trace elements injection (I) may be administered through a terminal filter.

Objective The study was designed to analyze the efficacy of standardized house dust mite allergen vaccine to allergic rhinitis by subcutaneous injection and investigate the possible mechanism of specific immunotherapy(SIT).Methods From January 2011 to December 2011 a prospective study was performed in the Department of Otorhinolaryngology Head and Neck Surgery,the Affiliated Hospital of Nantong University,involving 90 patients with perennial AR,of whom 60 patients received Der p-SIT +pharmacotherapy after their approval and 30 received only pharmacotherapy.All patients were allergic to house dust mites.Symptom and medication scores were recorded three times:before the treatment,at the middle of treatment and at the end of treatment.Over a period of 1 yr.prior to and at the end of treatment,CD4 + CD25 + Foxp3 + Treg cells and Th17 cells were measured by flow cytometry.SPSS 21.0 software was used to analyze the data.Results The symptom scores using VAS and medication scores in AR patients treated with SIT and medication were reduced,the differences were significant (14.25 ± 6.40,1.00 ± 0.84 vs.32.18 ± 7.78,3.12 ± 1.54,t value was 19.65,10.71,both P ＜ 0.05).The symptom of VAS score in medication group was reduced after treatment (30.30 ±5.97 vs.20.30 ±5.79,t =10.09,P ＜0.05),but the medication score had not significant difference (P ＞ 0.05).The frequency of Thl7 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT,whereas the frequency of Treg cells were increased (x2 value was 2.81,2.80,both P ＜ 0.05),but not in medication group.Conclusions Both SIT and pharmacotherapy can improve symptoms of allergic rhinitis,but SIT can also reduce medication use.The effect of immunotherapy is better than drug treatment alone.The frequency of blood Th17 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT,whereas the frequency of Treg cells were increased.

Objective:To construct a program for improving care ability of caregivers for children with home enteral tube feeding (HETF) based on timing theory, and explore its preliminary effects.Methods:Based on the framework of timing theory and literature review, intervention measures to improve the care ability of caregivers for children with HETF were extracted and summarized to form a preliminary program draft. Fourteen caregivers with experience in caring for children with HETF were subjected to qualitative interviews to supplement the content of the program, and the program was revised through expert meetings to form the final draft. Non-synchronous control method was adopted, and 89 children with HETF and 89 caregivers of them admitted to the Children's Hospital of Fudan University from March 2022 to February 2023 were continuously included as study subjects. The children and their caregivers included from March to August 2022 were in control group ( n=42), and the children and their caregivers included from September 2022 to February 2023 were in intervention group ( n=47), and the plan was preliminarily applied. Family Caregiver Task Inventory (FCTI) was used to evaluate the impact of the program on improving caregiver care ability. Age specific body weight z-values, height specific body weight z-values, and complications were used to evaluate the impact of the program on the growth and development of children and the incidence of tube feeding complications. The data was collected at the time of enrollment and one, two, and three months after discharge. Results:There were 66 children who completed the whole study, including 33 children in the control group and the intervention group, and 33 caregivers in each group. The application results showed that the total score of FCTI in the intervention group decreased from (25.91±2.94) at enrollment to (5.85±2.60) at three months after discharge, while the total score of FCTI in the control group decreased from (26.12±4.34) at enrollment to (12.52±3.60) at three months after discharge, and the total score of FCTI in both groups decreased over time. At one, two, and three months after discharge, the total FCTI score of the intervention group was lower than that of the control group, and the difference was statistically significant ( P<0.05). At three months after discharge, the incidence of complications in children with HETF in the intervention group was lower than that in the control group with a statistical difference ( P<0.05) . Conclusions:The program for improving care ability of caregivers for children with HETF based on timing theory is scientific and provides basis for the management of home tube feeding of children.