Objective To investigate the effect of diabetic health education pictures on blood sugar control and self-care ability of type 2 diabetic patients. Methods Using the registration number and random digit table, 84 patients with type 2 diabetes mellitus were divided into the experiment group and the control group with 42 cases in each group. The control group received traditional diabetes knowledge education, and the experiment group was educated with the mode ofpicture and dialoguehealth education, 60 to 90min per week for 8 weeks. The patients in the two groups were observed before and after the intervention in terms of the fasting blood glucose, postprandial 2h blood glucose, glycatedhemoglobin (gycated, hemoglobin, HbAlc) and self-care ability. Result The differences in blood sugar value index and self-care behavior score after the intervention between the two groups were statistically significant (P<0.05). Conclusion Application of′picture and dialogue′education mode can enhance patients′ability of self-care behaviors the effect of health education and stabilize the level of blood glucose of patients.

Objective To explore clinical significance of constriction of fetal ductus arteriosus diagnosed by echocardiography.Methods Seventy-one cases with constriction of fetal ductus arteriosus (DA) and one fetus with premature closure of DA were detected by fetal echocardiography among 2380 singleton fetuses.The echocardiographic characteristics and clinical outcomes were reviewed and analyzed.Results Of 71 cases with constriction of fetal DA,58 cases were found with right heart enlargement,12 cases with tricuspid regurgitation,8 cases with arrhythmia and 1 case with pericardial effusion.The echocardiographic characteristics showed narrowed diameter of DA,dilatation of pulmonary artery and descending aorta was also noted,DA was markedly curved.The peak systolic velocity(PSV) and enddiastolic velocity(EDV) in the ductus arteriosus measured by pulsed Doppler echocardiography increased (PSV≥ 180 cm/s,EDV≥35 cm/s).All cases were confirmed normal by neonate echocardiography.Conclusions Prenatal echocardiography plays important role in diagnosis of constriction of fetal DA.Early diagnosis and intimate follow-up can direct clinician to offer suitable consultation for parents and management for fetuses.

Objective To explore the psychological status of patients after hand tenolysis and the pertinent nursing countermeasures. Methods 47 patients after hand tenolyais were selected and investigated their psychological status and relevant influencing factors with serf-designed questionnaire and symptom checklist-90(SCL-90). Besides, corresponding psychological nursing were applied. The SCL-90 results of Chinese Norm were adopted to undergo comparison with them and t test was chosen. Results On the first day after operation, the score of the investigation objectives was significantly different compared with that of the Chinese norm. After pertinent mental nursing, their symptoms alleviated, and no significant difference was seen between them. Conclusions There are obvious psychological obstacles in patients after hand tenolysis. The pertinent mental nursing has important effect on rehabilitation training and functional rehabilitation after hand tenolysis.

Objective To assess the prognostic value of progesterone receptor (PR) in Luminal B HER2(-) lymph-node-negative breast cancer.Methods The clinical data of 196 Luminal B HER2 (-) lymph-node-negative breast cancer patients were collected in this study.The correlation between PR and clinicopathological factors and its influence on prognosis was analyzed.Results Among 196 patients with Luminal B HER2 (-) lymph-node-negative breast cancer,14.8％(29/196)were PR-negative and 85.2％(167/196)were PR-positive (HR=3.25,95.0％ CI:0.73-1.45,P=0.123).PR negativity indicated postmenopausal status (P=0.029) and high tumor grade (P=0.001).Mter a median follow-up of 60 months,9.7％(19/196) of the patients had relapses and 4.1％(8/196) died of breast cancer.The 5-year disease-free survival(DFS) was 75.9％ in PR-negative group and 92.8％ in PR-positive group (Log-rank P=0.001).The 5-year overall survival (OS) was 89.7％ in PR-negative group and 97.0％ in PR-positive group (Log-rank P=0.023).In multivariate analysis,PR negativity was significantly associated with a poor 5-year DFS (HR=2.85,95.0％ CI:1.05-7.72,P=0.039)but not with 5-year OS (HR=1.78,95.0％ CI:0.34-9.35,P=0.495).Conclusion In this study,PR is a prognostic factor for relapse in Luminal B HER (-) lymph-node-negative breast cancer.

Objective To construct multiple myeloma mucin MUC1-2VNTR gene eukaryotic expressing vector,which provided the basic material for further study of multiple myeloma DNA vaccine.Methods MUC1-2VNTR coding gene as target gene,and a KOZAK sequence was inserted before it.Hind Ⅲ and Xba Ⅰ restriction enzyme site were inserted on both ends.Then the whole sequence was synthesized and cloned into pcDNA3.1/myc-his B vector,and the recombinant vector was identified by restriction enzyme digestion and DNA sequencing.Results Synthesized MUC1-2VNTR gene was 140 bp.Restriction enzyme digestion and DNA sequencing confirmed pcDNA3.1/MUC1-2VNTR/myc-his B including the whole exact translation frame region and MUC1-2VNTR gene.Condnsion The pcDNA3.1/MUC1-2VNTR/myc-his B has been successfully constructed,which provides the basic material for further studies of MUC1 mucin function and multiple myloma DNA vaccine.

Objective To explore the efficacy and safety of tacrolimus among Chinese Takayasu arteritis (TAK) patients. Methods This was a single center, prospective study of active TAK patients treated with tacrolimus. Clinical manifestations, white blood cell count, hemoglobin level, erythrocyte sedimentation rate (ESR), hypersensitivity C reactive protein (hsCRP), alanine and aspartate aminotransferase and serum creatinine were recorded before and during tacrolimus treatment. Vascular changes were repeated every 6 months during tacrolimus treatment. All data were analyzed by statistical product and service solutions (SPSS) 20.0 statistical software, unpaired t test and Fisher exact probability and Kruskal-Wallis H test were used for statistical analysis. Results A total of 19 consecutive patients with an average age of (26 ±6) years were analyzed in this study. Sixteen of them were women. Pulselessness, fatigue, asymmetric blood pressure and fever were the most common clinical findings. Cervical and subclavian artery were more vulnerable. The most common artery involvement pattern was Numano type Ⅰ, followed by type Ⅱa and type Ⅴ. The median tacrolimus dosage was 2(2, 3) mg. Tacrolimus was effective in 9 out of the 19 patients. Patients who responded to tacrolimus tended to have lower mean ESR [(33±29) mm/1 h vs (42±20) mm/1 h, t=-0.776, P=0.448] and hsCRP [(20 ±31) mg/L vs (54 ±45) mg/L, t=-1.758, P=0.099] levels. However, no statistical significance was observed. During tacrolimus treatment, no drug related side effect was observed. Conclusion Tacrolimus is an alternative and effective therapy for some of the TAK patients.

Objective To explore the effect of electroacupuncture at Quchi (LI11), Zusanli (ST36) on differentiation of neural stem cells after cerebral ischemia-reperfusion in rats. Methods Thirty-six male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and electroacupuncture group (n=12). The latter two groups were occluded the left middle cerebral arteries for 90 min-utes and reperfused. The electroacupuncture group received electroacupuncture at Quchi and Zusanli acupoints for 21 days. They were evalu-ated with modified Neurological Severity Scores 7, 14 and 21 days after electroacupuncture. Their infarct volumes were tested with MRI T2WI 21 days after electroacupuncture, while the differentiation of neural stem cells was observed with double-immunopositive BrdU/Dcx and BrdU/NeuN. Results Compared with the model group, the neurological deficits score improved in the electroacupuncture group in all the time points (P<0.05). The infarct volumes decreased in the electroacupuncture group (P<0.05), with less number of BrdU+/Dcx+cells in subventricular zone (P<0.001) and more number of BrdU+/NeuN+ cells in peri-infarct cortex (P<0.001) 21 days after electroacupuncture. Conclusion Electroacupuncture at Quchi and Zusanli acupoints can improve neurological function and decrease the infarct volumes in rats after cerebral ischemia-reperfusion, which may be associated with promoting differentiation of neural stem cells to neurons.

Objective To explore the effect of electroacupuncture on activation of microglia in peri-infarct cortex after cerebral isch-emia-reperfusion in rats. Methods 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and electroacupuncture group (n=12). The latter two groups were occluded the left middle cerebral arteries with modified Longa's method for 2 hours and reperfused. The electroacupuncture group received electroacupuncture at Quchi (LI11) and Zusanli (ST36) acupoints for 3 days. The nerve cell damage in peri-infarct cortex was observed with HE staining, while the expression of ED1 was determined with immunohisto-chemical staining, and the expression of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and IL-6 were determined with Western blotting. Results The neurological deficits score improved significantly in the electroacupuncture group (P<0.05), with less nerve cell dam-age, less number of ED1 positive microglia (P<0.05) and less levels of TNF-α, IL-1βand IL-6 (P<0.05), compared with the model group. Conclusion The electroacupuncture at Quchi (LI11) and Zusanli (ST36) acupoints can protect brain from ischemia-reperfusion injury, which might be associated with inhibiting the microglial activation and proinflammatory response in peri-infarct cortex.

Objective To investigate the effects of electroacupuncture (EA) at Quchi (LI11) and Zusanli (ST36) acupoints on the ultrastructural structure of cortical neurons in peripheral area and the protein expression of caspase- 3, Bcl- 2, Bax in rats with cerebral ischemia- reperfusion injury. Methods 36 male adult Sprague-Dawley rats were randomly divided into sham operation group, model group, and electroacupuncture group, with 12 rats in each group. The model group and electroacupuncture group were performed with left middle cerebral artery occlusion (MCAO) according to the modified Longa' methods. The electroacupuncture group received electroacupuncture at Quchi (LI11) and Zusanli (ST36) on the paralyzed limb, for 30 minute. The neurobehavioral scores were recorded before and after treatment. The ultrastructural structure of cortical neurons was observed with transmission electron microscope (TEM). The protein expression of caspase- 3, Bcl-2 and Bax were detected by Western blotting technique. Results The neurobehavioral score was lower in the electroacupuncture group than in the control group (P<0.05). Compared with the model group, the chromatin of neurons was even relatively, and the number of mitochondria increased. The expression of Bcl-2 was higher and the expression of caspase-3 and Bax was lower in the electroacupuncture group than in the model group (P<0.05). Conclusion Electroacupuncture at Quchi (LI11) and Zusanli (ST36) acupoints can inhibit the neurons apoptosis in peripheral area through mitochondria-caspase-3 pathway.

Objective To evaluate the effectiveness and safety of acupuncture in the management of post-stroke spasticity.Methods Six domestic and abroad databases were screened by computer.Randomized controlled trials (RCT)were included if acupuncture treatment was used as the sole intervention or as an adjunction to another conventional treatment on post-stroke spasticity. Two independent reviewers screened the articles,extracted data and assessed the risk of bias.The evaluation of the quality was performed using Cochrane Risk of Bias Tool and the data was analyzed by using RevMan 5.3.Mean difference (MD)and 95% confidence interval (CI)were used to describe quantitative data.Results A total 29 RCT were included,7 of them had high risk of bias and the rest of them had unclear risk of bias. Acupuncture was better than rehabilitation therapy in remission of spasticity (-0.40 [-0.68,-0.12]).The 4 or 8 weeks of treatment in studies of unmentioned spasmodic regions showed that acu-puncture with rehabilitation therapy was better than rehabilitation therapy (-0.31 [-0.50,-0.11],-0.41[-0.54,-0.28]).The studies of 4 weeks of treatment showed superior effect of acupuncture with conventional treatment compared with rehabilitation therapy with conventional treatment (-0.96 [-1.73,-0.19]),and acupuncture with rehabilitation therapy was superior to conventional treatment with rehabilitation therapy (-0.57[-0.80,-0.34]).After 6 months of treatment,acupuncture with nerve block therapy and rehabilitation therapy was better than nerve block therapy with rehabilitation therapy (-0.63[-1.12,-0.14]),and acupuncture with nerve block therapy was better than nerve block therapy (-0.70[-1.08,-0.32]).In improving the physical activity,acupuncture,acupunc-ture with rehabilitation therapy,acupuncture with conventional treatment and rehabilitation therapy 1 or 4 weeks of follow-up,and acupuncture with nerve block therapy was better than that of control group. Conclusion Acupuncture could remiss the spasticity after stroke and improve the ability of daily life and motor function of patient,but the conclusion of subgroups are not the same.The high quality RCT studies with clear spasmodic position and measurement at more time points are needed to confirm the effectiveness and safety of acupuncture in post-stroke patients with spasticity.