Objective To investigate the relationship between glucose variability and severity of coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM).Methods One hundred hospitalized patients with T2DM(55 males and 45 females,39-81 years old) who had undergone angiography were included in the study from February 2012 to October 2012.They were divided into 2 groups:(1) 60 patients with coronary heart disease(CHD)as experimental group and (2) 40 patients without coronary heart disease as control group.All participants underwent selective coronary angiography to evaluate the severity of coronary artery stenosis (Gensini score) and continuous glucose monitoring(CGM) for 72 h.The correlation was analyzed between biochemical findings,and Gensini scores between the 2 groups.The comparison between 2 groups was performed with LSD test,correlation analysis with Pearson correlation and multiple stepwise regression analysis.Result Compared with the levels of largest amplitude of blood glucose excursion (LAGE),standard deviation of blood glucose (SDBG),mean amplitude of glycemic excursion (MAGE),postprandial glucose excursion (MPPGE),and absolute means of daily differences (MODD) in control group [(8.1 ± 2.1),(1.9 ± 0.5),(4.8 ± 1.3),(4.5 ± 1.4),and (2.4 ± 0.8) respectively],the levels in the experimental group[(11.3 ± 3.5),(3.2 ± 1.2),(7.0 ± 2.6),(6.4 ± 1.9),and (3.1 ± 1.3)] were higher respectively.MPPGE,MODD,LAGE,and C-reactive protein(CRP) were positively related to Gensini score(r were 0.498,0.246,and 0.227,all P＜0.05),while left ventricular ejection fraction (LVEF) was negatively related to Gensini score(r=-0.261,P＜0.05).Multiple stepwise regression analysis indicated that MPPGE and LVEF were independent risk factors of Gensini score (Y =59.727 + 11.779 × MPPGE-1.437 × LVEF).Conclusion Glucose variability in patients with T2DM and CHD was markedly enhanced.MPPGE was positively correlated with the severity of coronary artery stenosis in patients with T2DM and CHD.

Objective To compare the therapeutic effect of three treatment regimens on H 22 tumor-bearing mice. Methods H22 tumor-bearing mice were treated by local injection of compound chemotherapeutic agents (5-FU, mitomy-cin and cisplatin ) , oral administration of sorafeni , or the both combined , respectively .Standardized and quantitative syn-drome differentiation methods were used to assess the syndromes and tumor-inhibition rate in the mice .Results All these three therapeutic regimens were effective in suppressing the tumor growth in mice .Among them, the combined therapeutic regimen of local injection of compound chemotherapeutic drugs plus oral administration of sorafeni was the best .Conclu-sion The effect of sorafenib combined with local injection of compound chemotherapeutic agents is better than the other two regimens used separately .

BACKGROUND:Nasolabial fold flap has been widely used in clinical surgery. The facial artery anatomy has been widely used in clinical research. Angular artery dissection is becoming more and more important to nasolabial groove area surgery, but at present, there is a lack of anatomical analysis of internal angular artery.
OBJECTIVE:To study the anatomy of the angular artery, and to provide anatomical data for protecting the nasolabial flap during surgery.
METHODS:Twenty sides of adult cadaver specimens on head and face were dissected. A reference coordinate system was made based on the line between the connection of two medial angles of eyes (axis X) and the facial midline line (axis Y). The location of the angular artery was measured taking A-F as reference points.
RESULTS AND CONCLUSION:(1) The slant angles of the angular artery on BC section, CD section, DE section and EF section were (11.1±4.3)°, (34.1±8.8)°, (21.5±10.5)°, and (17.0±4.7)°, respectively. (2) The angular artery sourced from facial artery was more than it sourced from ophthalmic artery. The diameter of right blood vessel was larger than that of left side. (3) The angular artery sourced from ophthalmic artery comes from the location which extended 8.1 mm to both sides from the point which was 10 mm up from the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.7±0.2) mm. The whole range was 20.1 mm. (4) The angular artery sourced from facial artery comes from the location which extended 25.8 mm to both sides from the point which was 40 mm down to the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.9±0.3) mm. Point to the wing of nose the lateral distance was (5.0±1.2) mm. The whole range was 68.7 mm. The surface projecting of angular artery coming from research results provided anatomic basis for surgery of nasolabial flap.

Objective To study the effect of tumor size on the expression of adrenal cholesterol homeostasis mole -cules in H22 hepatoma-bearing mice.Methods Two hundred and twenty mice were injected with H 22 hepatoma cells to their right armpit.On the 11th day after injection, the mice were sorted according to the tumor size .18 mice with large tumor (large tumor group) and 18 mice with small tumor (small tumor group) were sacrificed, and the tumors were weighed.A control group consisting of 18 normal Kunming mice was also included in this study .The plasma TC, TG and HDL-C were detected using total cholesterol , triglycerides or HDL-C assay kits , respectively .The mRNA expressions of Srb1, Ldlr, Npc1, Npc2, Stard3, Hmgcr, Lipe, Acat1, Abca1, Abcg1, Srebp-1c, Lxrα, Lxrβ, Rxrα, Apoa1 and Apoe were tested by real-time quantitative RT-PCR ( qRT-PCR ) , and Gapdh and β-actin were used for normalization .SRB1 and ApoA1 proteins were analyzed by Western blot .Results The tumor weight was significantly higher in the large tumor group than that in the small tumor group (P<0.05).Compared with the control group , the plasma HDL-C was significant-ly decreased in the two hepatoma groups (P<0.05).The expression levels of Srb1, Ldlr, Apoa1 mRNA and SRB1 protein were significantly increased in the large tumor group (P<0.05 for all).The ApoA1 protein level was significantly higher in the large tumor group than that in the small tumor group (P<0.05).The expressions of Acat1, Lipe, Abca1 and Abcg1 mRNA were significantly lower in the large tumor group than those in the small tumor group (P<0.05 for all).However, the expressions of Srebp-1c, Lxrαand RxrαmRNA were not significantly changed , then, Srebp-1c, Lxrβand RxrαmRNA expressions were significantly up-regulated in the small tumor group (P<0.05).The expressions of Hmgcr and Apoe mR-NA were not significantly different in the two groups .Conclusions In hepatoma-bearing mice , due to the adaptation to tumor-induced chronic stress response , the adrenal cortical cells can effectively utilize intracellular cholesterol to synthetize cortical hormones .

Objective In order to analyze the research situation,development tendency and deficiencies in the aspects of nursing competency through investigating about 10 kinds of core nursing periodicals published from the year 2009 to 2013 in China.Methods Using bibliometrics methods to analyze the researches about nursing competency in the periodical literature including Chinese Journal of Nursing,Journal of Advanced Study for Nurses,Chinese Journal of Practical Nursing,Chinese Nursing Research,Journal of Nursing Science,Journal of Nursing Administration,Nursing Journal of Chinese People's Liberation Army,Chinese Nursing Management,Shanghai Nursing,Modern Clinical Nursing published from 2009 to 2013.Results There were 215 research papers about nursing competency in periodicals in the past five years,and a quantity of papers increased stably each year.The study contents mainly involved nursing education,training,competency model and standard system based on nursing competency and so on.Conclusions The researches on nursing competency are getting started in China.The quantity is keeping increase and the related research contents become more colorful and deeply than before.

Forensic science is a cross discipline,involving both the subjects of natural sciences and the humanities & social sciences.It needs not only the application of forensic techniques and other theoretical results of natural sciences,but also be bounded by moral and ethical guidance.This paper discusses ethical issues involved in the teaching of forensic medicine in medical colleges,exploring the relationship between the teaching of forensic medicine and ethics,so as to promote the development of forensic science education.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.

Objective To analyze the prevention and nursing measures of adverse drug reaction in patients with rheumatoid arthritis treated with Tolicizumab.Method The clinical data and nursing measures in 30 patients with rheumatoid arthritis treated with Tolicizumab were reviewed and analyzed.Result All the patients completed the treatment and no infusion reaction was observed in the first 24 hours.Conclusions Comprehensive and intensive assessment is necessary before application of Tocilizumab. Executing standard drug dispensing and injection process,mastering the infusion reaction emergency processing measures and establishing injection related systems are of great significance to observe and treat various adverse reactions in time,ensuring drug effects and safety of the patients.

Objective To investigate the effects of Danzhi Jiangtang Capsule on CXCL9 and IL-8 in type 2 diabetic model rats, and discuss the mechanism in TCM intervention in type 2 diabetes. Methods Fifty male SD rats were randomly divided into 5 groups:normal control group, high-dosage group of Danzhi Jiangtang Capsule, low-dosage group of Danzhi Jiangtang Capsule, pioglitazone group and model group. Normal control group was fed with basal diet, while the other groups were fed with high fat diet. A single intraperitoneal injection of STZ of 35 mg/kg was employed to establish the animal model of diabetes mellitus. When the diabetic rodent model was built, high-dosage group of Danzhi Jiangtang Capsule and low-dosage group of Danzhi Jiangtang Capsule were treated with 1.08 g/(kg?d) and 0.54 g/(kg?d) by gavage, pioglitazone group was treated with 10 mg/(kg?d) by gavage, the blank group and the model group were treated with physiological saline 5 mL/(kg?d) by gavage for 8 weeks. CXCL9, IL-8 and blood glucose, and lipid in serum of rats were determined with double antibody sandwich method. Results Expressions of CXCL9 and IL-8 in model group increased significantly, compared with the normal control group (P<0.05, P<0.01). Expressions of CXCL9 and IL-8 in high and low dosage Danzhi Jiangtang Capsule group significantly decreased, the blood glucose and lipid also decreased, compared with model group (P<0.01). Conclusion Danzhi Jiangtang Capsule has inhibitory effects on the high expression of inflammatory factors in diabetes, and can also lower bloodglucose, and regulate blood lipid.

Objective To evaluate the possible association among serum folate,polymorphisms related reduced folate carrier gene (RFC-1) AS0G,methionine synthase reductase gene (MTRR) A66G,and cervical cancer,and to provide clues for the etiology of cervical cancer.Methods Based on a hospital-based case-control study,107 cases diagnosed as cervical cancer pathematologically and 107 controls with hysteromyoma,were selected by frequency,matched with age and habitation.Serum folate concentration was detected by RIA and polymorphism RFC-1 A80G and MTRR A66G was examed by RFLP-PCR.Results Serum folate concentration in patient group [(1.86±0.60) ng/rml] was significantly lower than that in control group [(2.30 ± 1.14) ng/ml],and risk of cervical cancer increased with the decreased serum folate levels (x2trend =12.57,P =0.001).Risks to catch cervical cancer for women with RFC-1 80 GG were 2.42 times (95 ％ CI 1.01-5.81) as much as for those with RFC-1 80 AA,and 1.65 times (95 ％ CI 0.77-3.53) for those with RFC-1 80 AA and RFC-1 80 AG,risks to catch cervical cancer for women with MTRR 66 GG were 1.35 times (95 ％ CI 0.40-4.56) as much as for those with MTRR 66 AA and 1.26 times (95 ％ CI 0.38-4.16) for those with RFC-1 80 AA and RFC-1 80 AG.Conclusion Serum folate deficiency to a certain degree can increase the risk of cervical cancer.RFC-1 A80G mutation may be a risk factor for cervical cancer and homozygous (GG) gene may increase the susceptibility of cervical cancer.MTRR A66G gene mutation may have nothing to do with cervical cancer.