Objective To observe the corneal nerve fibres damage in different stage of diabetic retinopathy (DR) with type 2 diabetes.Methods A cross-sectional study.One hundred and twenty eyes of 120 patients with type 2 diabetes served as diabetes group.According to International Clinical Diabetic Retinopathy Disease Severity Scales (2002),diabetes patients were classified into 4 subgroups:patients without diabetic retinopathy (NDR),patients with mild or moderate non-proliferative diabetic retinopathy (mNPDR),patients with severe non-proliferative diabetic retinopathy (sNPDR) and patients with proliferative diabetic retinopathy (PDR),each subgroup has 30 eyes of 30 patients.Another 30 eyes of 30 healthy participants served as control group.All eyes were scanned with HRT3 in vivo corneal confocal microscopy.Images of sub-basal nerve plexus were quantified including nerve fiber length (NFL),nerve fiber density (NFD),nerve fiber branch density (NFB),and nerve tortuosity (NT).The correlations of corneal nerve fiber with age,duration of diabetes and glycated hemoglobin (HbA1 c) were analyzed using Spearman correlation analysis.Results NFL,NFD and NFB were found to be significantly lower in diabetic patients (F=147.315,142.586,65.898;P=0.000,0.000,0.000),NT was significantly greater in diabetic patients (F=39.431,P=0.000),when compared to control group.In diabetic patients,NFL,NFD and NFB were gradually reduced with DR severity,NT was gradually increased with DR severity.While the difference ofNFL,NFD,NFB,NT was not statistically significant between sNPDR and PDR subgroups (P＞.0.05),but was statistically significant between other subgroups (P＜0.05).Spearman correlation analysis results showed that age (r=-0.071,-0.080,0.001,0.100;P=0.391,0.328,0.991,0.224) and HbAlc (r=-0.109,-0.115,-0.126,0.025;P=0.238,0.211,0.169,0.781) had no correlation with NFL,NFD,NFB,NT.Duration of diabetes was negatively correlated with the NFL,NFD (r=-0.212,-0.264;P=0.020,0.004),positive correlated with NT (r=0.261,P=0.004),and had no correlation with NFB (r=-0.119,P=0.194).Conclusions Corneal nerve fiber loss and nerve tortuosity increased were found in patients with type 2 diabetes,and even without diabetic retinopathy.The progress of corneal neuropathy was correlated with the severity of DR,but it was not change significantly between sNPDR and PDR.

Sini decoction (SND), a classical traditional Chinese medicine emergency formula recorded in Shanghan Lun (Treatise on Febrile Diseases), which is composed of Aconiti Lateralis Preparata Radix, Glycyrrhizae Preparata Radix and Zingiberis Rhizoma. Modern clinical and pharmacological researches have shown that SND can protect the myocardium effectively during myocardial ischemia reperfusion injury (MI-RI). A myocardial ischemia reperfusion injury model of H9c2 cardiomyocytes in vitro has been established. Four groups, control group, MI-RI Model group, SND group and SND without Glycyrrhizae Radix group, were arranged. The livability, the level of LDH and CK activity in H9c2 cardiomyocytes in different groups were tested. By combining with principal components analysis (PCA), partial least squares discriminant analysis (PLS-DA), orthogonal partial least squares projection of latent structures-discriminant analysis (OPLS-DA), 17 biomarkers in extracellular fluid were identified and 15 of them were related to the pathway of biological processes. The results showed that the attenuate and synergistic mechanism between Aconiti Lateralis Praeparata Radix and Glycyrrhizae Radix for toxicity reduction was related with the glycolysis, lipid metabolism, citrate cycle and nitrogen metabolism of amino acids metabolism. The study proved the effect on H9c2 cardiomyocyte treated by MI-RI injury both SND group and SND without Glycyrrhizae Radix group, and compared with the SND without Glycyrrhizae Radix, the protective effect of myocardial ischemia reperfusion injury model of H9c2 cardiomyocyte from SND was stronger.
Aconitum ; chemistry ; Animals ; Drug Synergism ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Glycyrrhiza ; chemistry ; Humans ; Male ; Metabolomics ; Myocardial Reperfusion Injury ; drug therapy ; genetics ; metabolism ; Myocytes, Cardiac ; drug effects ; Rats, Sprague-Dawley

By means of genetic cloning and recombinant techniques, full genome cDNA sequences of rotavirus strain TB-Chen were isolated from an infantile hospitalized with acute gastroenteritis. Nucleotide sequences analyses showed that the full genome of strain TB-Chen contains 18613 nucleotides, encoding 5791 amino acids. Genotyping results showed that the strain TB-Chen belongs to genotype G2P[4]/NSp4[A]. This is the first report on a full genome of Group A rotavirus in China, and has important significance for deep understanding structure and functions of rotaviruses and developing rotavirus vaccines.

Objective To explore the content of the psychological contract of pregnant nurses and analyze the main reasons resulting in the recessive loss of pregnant nurses, in an attempt to put forward a management strategy about pregnancy nurses. Methods Totals of 30 pregnant nurses and 15 nurse managers were randomly selected and interviewed to formulate the content of the psychological contract of pregnant nurses. Thereafter, the content was perfected by Delphi method to ensure the main psychological contract factors influencing the recessive loss of the pregnancy nurses. Results The content of the psychological contract of pregnant nurses included 12 factors of management responsibility ( posts of duty, workload, working atmosphere, bonus distribution, social welfare, education and training, opportunity to display the ability, promotion opportunity, respect for dignity, caring about the daily life of pregnant nurses, psychological comfort, pregnancy health care) and 11 factors of pregnant nurses responsibility ( fulfillment of duties, abidance by rules, rigorous thinking, enthusiasm for work, professional knowledge and skills, insist on the job, acceptance to the assignment, report for sick leave, interests of the hospitals, hospital image and development with the hospital) . Conclusions This index models a useful and reliable method to assess the psychological contract of pregnant nurses and can provide a guidance to reduce the recessive loss rate of pregnant nurses.

Objective The primary goal of this work is to discuss the molecular mechanism of multi-drug resistant Pseudomonas spp. resistance to carbapenam and aminoglycoside antibiotics. Methods From June 2012 to March 2013, six strains of P. aeruginosa and P. putida producing carbapenemasefrom 4 different district were collected. Species identification was performed using VITEK-2 compact system and by sequencing of 16S rDNA amplicons. Minimum inhibitory concentrations were determined by E-test method. Production of carbapenemase were detected by Carba NP method. Carbapenemase genes and aminoglycoside 16s rRNAmethylase genes were screened by PCR, and their subtypes combined with their immediate genetic context were worked out by assemble the sequence of overlapped PCR amplicons. SpeI-PFGE (Pulse field gel electrophoresis after SpeI enzyme digestion) were conducted to evaluate their clonal relatedness. S1-PFGE (Pulse field gel electrophoresis after S1 enzyme digestion) were conducted to conform the relatedness of plasmids they carried. Results Three multidrug resistant P. aeruginosa and three P. putida, were all positive for Carba NP test and conformed producing class B carbapenemase. PCR screening followed by sequencing confirmed carriage of blaIMP-45 and armA, which confer resistance to β-lactams (except aztreonam) and aminoglycosides. These two genes co-located in a Tn1548-associatedregion. SpeI-PFGE disclosed that these isolates were not clonal closely related to each other, except two P. aeruginosa isolates were clonal related. S1-PFGE results showed that these isolates all carried plasmids of large size (300-600 kb). Conclusions This study showed that Pseudomonas spp. isolates co-carried blaIMP-45 and armA were disseminated in clinical settings. Spread of these genes may attribute to horizontal gene transfer of related entities.

Objective:To investigate the prevalence of liver fibrosis in patients with HBV infection detected by ultrasound transient elastography.Methods:A total of 2 689 patients with HBV infection who received liver transient elastography examination at the Department of Hepatology, Zhongnan Hospital of Wuhan University from November 2021 to April 2022 were enrolled in the study. The severity of liver fibrosis was graded according to the liver stiffness value. The association of liver fibrosis detection rate with gender, age and physiological stages of patients was analyzed, and the correlation between liver stiffness value and HBV DNA, HBsAg, HBeAg level, alanine aminotransferase (AST), aspartate aminotransferase (ALT) and serum albumin levels was further analyzed.Results:Among 2 689 patients with chronic HBV infection, there were 1 417 males aged 46 (34, 57) years and 1 272 females aged 45 (33, 55) years. A total of 1 382 patients (51.03%) showed varying degrees of liver fibrosis, including 381 cases (14.20%) of significant liver fibrosis and 259 (9.60%) cases of progressive fibrosis. Male patients had a significantly higher prevalence of liver fibrosis than that of female patients [60.78%(840/1 382) vs. 39.22%(542/1 382), χ2=74.566, P<0.001]. There were significant differences in liver stiffness values and liver fibrosis detection rates ( F=46.516, 199.079, P<0.001) among patients of different age groups. The liver stiffness index (9.41±4.49 vs. 8.10±3.89, t=9.011, P<0.001) and the prevalence of liver fibrosis in males was higher than those in females in age groups younger than 60 years [61.59%(643/1 044) vs. 38.41%(401/1 044), χ2=78.418, P<0.001]; However, there was no significant gender difference in people over 60 years of age [73.80%(200/271) vs. 71.71%(142/198), χ2=0.252, P>0.05; 20.30%(55/271) vs. 21.21%(42/198), χ2=0.059, P>0.05]. The prevalence of liver fibrosis was significantly lower in premenopausal and perimenopausal females than that in males of the same age groups [29.70%(188/633)and 52.20%(154/295) vs. 64.50%(202/313), χ 2=56.683, P<0.001; χ 2=9.519, P=0.029], whereas there was no significant difference between postmenopausal females and males in the same age group [65.40%(220/336) vs. 72.20%(319/441), χ 2=5.822, P=0.061]. The prevalence of liver fibrosis increased significantly in postmenopausal females as compared to premenopausal females[38.40%(497/1 294) vs. 67.50%(532/787), χ 2=56.683, P=0.002]. The value of liver stiffness in patients with chronic HBV infection was positively correlated with total bilirubin, AST and ALT levels( r=0.208, 0.227, 0.218, P<0.05). Conclusions:The prevalence of liver fibrosis detected by ultrasound transient elastography in chronic HBV-infected patients is substantial, the liver stiffness value and detection rate are higher in males than those in females, however, the prevalence is increased in postmenopausal females. The liver stifness value is related to some biochemical indicators of the liver.

Objective To evaluate the efficacy of one-stop hybrid coronary revascularization [simultaneous minimally invasive direct coronary artery bypass surgery (MIDCAB) and percutaneous coronary intervention (PCI) procedures performed in an enhanced (or called "hybrid") operative unit] for the treatment of unprotected left main coronary artery (ULMCA) disease. Methods From June 2007 to April 2009, 14 patients [13 male, mean age: (60.4±15.4) years] underwent the one-stop hybrid approach in the "hybrid" operating room. Proximal lesions were evidenced in 5 patients and distal or bifurcation lesions in 11 patients. MIDCAB procedure for grafting of the left intramammary artery (LIMA) with the left anterior descending (LAD) artery was first performed via lower partial ministernotomy on the beating heart, followed by PCI on the LMCA disease and non-LAD coronary lesions. Results Operation was successful in all patients underwent the one-stop hybrid procedure. LIMA grafts were used in all 14 patients and confirmed to be patent by angiography. A total of 25 non-LAD coronary lesions were treated by PCI and 29 stents (27drug-elutiag stents and 2 bare-mental stents) were implanted to 23 lesions and coronary angioplasty was performed in the remaining lesions. There was no death, perioperative myocardial infarction, stroke or repeat revascularization during the procedure and the follow-up period. All the patients remained free from angina during the 7.9 months (range 1-15 months) follow-up period. LIMA grafts and stents were patent in 5 patients at 1-year follow-up. Conclusions Our initial experience demonstrates that one-stop hybrid coronary revascularization provides a reasonable, feasible and safe alternative for selected patients with LMCA diseases.

Objective? To investigate the leadership status of new nurses, and to provide some reference for the training and education of new nurses and efficient quality nursing service. Methods? In September 2018, a total of 129 new nurses from a ClassⅢ Grade A hospital were randomly recruited by convenience sampling method. Questionnaire survey was conducted to compare the difference of leadership among new nurses with different characteristics by General Information Questionnaire and Nurse Leadership Questionnaire. A total of 129 questionnaires were sent out and 125 valid questionnaires were collected. Results? The average leadership score of the 125 new nurses was (3.59±0.67). The score of nursing professional ability dimension was the highest (3.73±0.64), and the score of critical thinking ability dimension was the lowest (3.47±0.71). The scores of five dimensions of interpersonal communication ability, communication ability, critical thinking ability, planning and organizing ability and self-care ability of new nurses of different genders in the nurse leadership questionnaire were compared, and the differences were statistically significant (t=-3.950,-3.145,-3.389,-3.451,-2.179;P＜0.05). The difference in critical thinking ability score of new nurses with different marital status was statistically significant (t=3.235,P＜ 0.01). Conclusions? The overall level of leadership status of new nurses is low. It is suggested that in the standardized training and education of newly recruited nurses, early education and training of career leadership should be emphasized, and the strengths of different groups of nurses should be brought into play, so as to improve their professional value and quality service.

Objective:To explore the effects of motivational interviewing strategy based on WeChat platform on blood glucose, self-management behavior and pain degree in young and middle-aged patients with type 2 diabetes mellitus (T2DM) .Methods:The convenience sampling method was used to select a total of 84 young and middle-aged patients with T2DM who were admitted to Department of Endocrinology of a ClassⅢ Grade A hospital from August to October 2018 as the research objects. According to the random number table, all patients were divided into the observation group and the control group with 42 cases in each group. The observation group was given the motivational interviewing strategy based on WeChat platform for intervention. The control group received routine diabetes education. Before and 6 months after the intervention, the blood glucose, self-management behavior and pain degree of the patients in the two groups were evaluated.Results:After 6 months of intervention, the patients' blood glucose, self-management behavior and pain degree were all better than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The motivational interview strategy based on WeChat platform can improve the blood glucose level and self-management behavior of young and middle-aged T2DM patients, reduce the degree of pain, and provide a reference for the development of home care and continuous care.

The genomic island(GI)characteristics and virulence factor differences of clinical isolates of Burkholderia pseudomallei in Hainan Province,China were analyzed to provide a scientific basis for diagnosis and treatment of melioidosis.In total,52 B.pseudomallei isolates were collected for detection of virulence-related GIs by PCR.The whole genome sequence annotation format file was submitted on Islandviwer 4 platform,and the genomes of the same species and close relatives were added for comparison.Two algorithms,SIGI-HMM and IslandPath-DIMOB,were integrated to predict GIs and sequence a-lignments were conducted to identify specific GIs and differences in virulence factors.The genomes of 52 clinical strains could be divided into three branches based on evolutionary distance,with 82.69％(43/52)of strains concentrated in branch 1.In to-tal,828 GIs were identified among the 52 B.pseudomallei genomes,which formed 157 GI clusters based on sequence similari-ty.GIs accounted for 2.05％-6.38％of the genome content.While GI clusters 1 and 2 were present in all strains,a total of 84(53.50％)GI clusters only clustered within a single genome isolate.Of 10 GI likely specific clusters,five were from the same genus,two from another genus,and three with uncertain origins.Moreover,25 GI clusters were associated with virulence,which included eight shared by B.pseudomallei BP76 and BP169,which had the highest number of virulence-associated GIs among all isolates.O the 52 B.pseudomallei isolates,variations were identified in the virulence genes fhaB1,fhaB2,BPSL1661,cheY1,wzM,tssH-5/clpV,tssA-5,boaA,and boaB.Comparisons of these findings with clinical isolates from Thailand and Australia showed that B.pseudomallei isolates from Hainan had significant differences in the sequences of boaA,boaB,cheY1,and chbp.Additionally,fhaB1,fhaB3,and bimA displayed significant variations specifically within the Australian isolates.B.pseudomallei GI was conserved and specific to Hainan.The identification of specific GI and virulence factors was useful to clarify the source of horizontal gene transfer and differences in virulence at the molecular level.