Artificial intelligence has been widely used in diabetes care. This article reviews summarizes the research of artificial intelligence in diabetes care from the theoretical basis of artificial intelligence intervention, intervention mode and influence on patients in order to provide reference for future clinical research in diabetes care.

Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis(SAT),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 1 865 patients with SAT,who were treated in the Shandong Institute of Prevention and Control for Endemic Disease in 2015-2006,were collected.The SAT patients' sex,age,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results The average age of the 1 865 patients with SAT was 42.16 years old,the youngest was 9 years old,and the oldest was 74 years old.Most of the patients were 21-50 years old,which was accounted for 62.36％ (1 163/1 865),and most of the patients were female,which was accounted for 83.70％ (1 561/1 865).Most of the patients lived in rural areas,which was accounted for 60.54％ (1 129/1 865).Most patients were onset in January,accounted for 20.48％ (382/1 865),and the least in July,accounted for 1.77％ (33/1865).For the clinical classification,the moderate type and the light type were the largest part with 1 716 cases,accounted for 92.01％,while the severe type was 149 cases,accounted for 7.99％.The clinical manifestations were as follows:the neck discomfort in 1 701 cases,accounted for 91.21％;neck pain,sore throat and palpitate in 1 439 cases,1 351 cases and 1 341 cases,accounted for 77.16％,72.44％ and 71.90％,respectively.Laboratory test results were as following:1 865 cases of thyroid 131I absorption rate reduced(100％);1 396 cases of thyroid nodules increased(74.85％);532 cases of FT3 and FT4 significantly increased,while TSH significandy decreased (28.53 ％);949 cases of FT3 and FT4 increased,while TSH decreased (50.88％);53 cases of FT3 and FT4 decreased,while TSH increased (2.84％);331 cases of FT3,FT4 and TSH in the normal range(17.75％).The thyroid 13I absorption rate significantly increased and thyroid nodules significantly reduced with treatment,the difference was statistically significant (t =-34.93,133.2,all P ＜ 0.001).1 813 patients were cured,while 52 cases arised hypothyroidism.Conclusion Majority of SAT patients are young women.The peak of the incidence of SAT lies in autumn and winter.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with SAT.

Objective To discuss the importance of regulatory role of panaxoside Rg1 in Cdk5 in the process of hippocampal neuron radioactive damage protection.Methods Radioactive brain damage in vivo 40 models were built,and divided into 4 groups,including 0 Gy group (short for blank group),pure panaxoside Rg1 preconditioning group (short for control group),30 Gy group (short for model group),and 30Gy + panaxoside Rg1 preconditioning group (short for traditional Chinese medicine group).Hippocampal neurons were separated and trained.Hippocampal neuron apoptosis condition was tested in every group by 4′,6-diamidino2-phenylindole (DAPI) staining method.The p35 and p25 protein expressions were tested with Western blot.Cdk5 was restrained by Cdk5 restrainer roscovitine.Hippocampal neuron damage after Cdk5 blocking-up was observed with changes of X ray in every group.Results Compared with blank group,no significant difference was found in nuclear shrinkage percentage,the number of neuron survival,and the protein expression levels of p35 and p25 in control group ; nuclear shrinkage percentage and the protein expression levels of p35 and p25 were significantly increased and the number of neuron survival was significantly decreased in the model group and traditional Chinese medicine group (P ＜ 0.05).Compared with model group,nuclear shrinkage percentage and the protein expression levels of p35 and p25 were significantly decreased and the number of neuron survival was significantly increased in the traditional Chinese medicine group (P ＜ 0.05).For the addition of dimethyl sulfoxide (DMSO) in every group,the nuclear shrinkage percentage was not significantly changed in control group compared with blank group,was significantly increased in model group and traditional Chinese medicine group compared with blank group (P ＜ 0.05),and was significantly decreased in traditional Chinese medicine group compared with model group (P ＜ 0.05).Conclusions Panaxoside Rg1 can reduce neuron apoptosis by controlling Cdk5,and plays a protective role in hippocampal neuron radioactive damage.

Objective To discuss the application effect of peer support education in improving theself-management ability of old patients with diabetes. Methods A total of 160 cases of old patients with type 2 diabetes who were treated and hospitalized from June 2014 to August 2015 were selected, then equally divided into observation group and control group through using random number method.Finally, 76 cases were studiedin observation group, while 75 cases in control group. The health education guidance of conventional diabetes had been used in two groups for six months, and the peer support education was also conducted for the patients in observation group on the basis of conventional education. The self-management ability, insulin standard injection knowledge-belief and attitude-behavior/practice (KAP) and glycosylated hemoglobin (HbA1c) value of old patients with diabetes were observed before intervention, 3 months and 6 months later, respectively. Also,the hypoglycemia frequency in two groups was compared during intervention. Results After three months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 4.63 ± 0.92, 4.18 ± 0.97, 2.86 ± 0.96, 2.35 ± 0.59, 4.01 ± 1.43 and 0.62 ± 0.29, respectively, while that of these indicators in control group was 3.69 ± 0.83, 3.52 ± 0.67, 1.75 ± 0.67, 1.63 ± 0.72, 3.05 ± 1.39 and 0.59 ± 0.38. Except smoke (P > 0.05), the differences between two groups were statistically significant (t=2.987-5.965, P < 0.05). After six months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 5.86±0.93, 5.37±0.61, 3.97±0.94, 5.06±0.92, 5.81±0.73 and 0.89 ± 0.31, respectively, while that of these indicators in control group was 3.68 ± 0.96, 3.65 ± 0.95, 1.86 ± 0.88, 2.65±0.88, 3.21±1.13 and 0.81±0.39. The difference was statistically significant (t=9.336-15.633, P<0.01), except smoke (P>0.05). Then, the insulin was normally injected in observation group after six months of intervention, the score of knowledge, attitude and behavior was 5.63 ± 1.87, 43.17 ± 6.03 and 16.57 ± 1.59, while that in control group was 3.76 ± 0.83, 23.71 ± 0.59 and 10.16 ± 0.95. The differences between two groups were statistically significant (t= 8.569, 15.623, 6.751, P<0.01). Also, the level of glycosylated hemoglobin was decreased from (8.17 ± 0.32) % to (7.16 ± 0.41) %, and the difference was statistically significant (t=-3.560, P=0.000). Conclusions Peer support education couldenhance the self-management consciousness of old patients with diabetes, standardize the insulin injection, improve the ability of self-management and improve glucose metabolism index so that it is worthy of being clinically popularized and applied.

Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.

OBJECTIVE:To establish a high performenc capillary zone electrophoresis method for the determination of the water-soluble active ingredients in different parts of the Salvia miltiorrhiza.METHODS:Capillary electrophoresis was conducted using uncoated capillary column(75 ?m?50.2 cm,effective length=40 cm)with 5 mmol?L-1 phosphate-borax(ph7.4)as running buffer by pressure injection(0.5 psi/4 s)and constant voltage separation(20 kV)with a detection length of 210 nm and a column temperature of 25 ℃.RESULTS:A complete baseline separation of PAH,DSS and PA was achieved within 8 min under the optimized conditions.The good linear range was from 2.5 ?g?mL-1 to 200.0 ?g?mL-1 for all the three ingredients.The average recoveries of the 3 ingredients were 100.04%,99.99%,and 100.01%,respectively,with RSD at 1.75%,1.73%,and 1.74%,respectively.CONCLUSION:The method is satisfactory in precision,recovery and linearity,and it can be used to determine three water-soluble active ingredients in different parts of the Salvia miltiorrhiza.

Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis (SAT),so as to provide a basis for prevention and treatment of the disease.Methods The epidemiological and clinical datas of 121 SAT patients,who were treated at the Shandong Provincial Institute for Endemic Disease Prevention and Control in 2015,were collected.The SAT patient's age,sex,lived in urban or rural areas,occupation and time of onset distributions were analyzed retrospectively.According to the clinical manifestations,the SAT patients were divided into types Ⅰ (mild/nodule type),Ⅱ (medium/normal),Ⅲ (severe/hyperthyroidism),and Ⅳ (delay),and clinical manifestations,auxiliary examination findings,treatment and outcome were summarized.Results Average age of the 121 cases of SAT patients was 41.36 years old,the youngest was 10 years old and the oldest was 76 years old.Most of the patients were 30-＜ 50 years old,which was accounted for 55.37％ (67/121).Most of the patients were female,which was accounted for 90.08％ (109/121).Most of the patients lived in rural areas,which was accounted for 59.50％ (72/121).Majority of the SAT patients were farmers,which was accounted for 43.80％ (53/121).Most onset of the disease was in November,accounted for 19.83％ (24/121),and the least was in June,accounted for 2.48％ (3/121),the peak of the incidence of SAT lied in autumn,and it was sporadic in the rest of the year.From the clinical classification,the mild type (61) and the medium type (46) were the largest part,a total of 107 cases,accounted for 88.43％ (107/121);while the severe type had 5 cases,accounted for 4.13％ (5/121);the delay type had 9 cases,accounted for 7.44％ (9/121).The clinical manifestations were as follows:anterior neck discomfort was 109 cases,accounted for 90.08％ (109/121);sore throat was 93 cases,accounted for 76.86％ (93/121).Auxiliary examination findings were as follows:thyroid iodine taken rate reduced in 121 cases,accounted for 100.00％ (121/121);thyroid nodule 96 cases,accounted for 79.34％ (96/ 121);total number of white blood cells increased in 52 cases,accounted for 42.98％ (52/121);neutrophil increased in 61 cases,accounted for 50.41％ (61/121);blood sedimentation significantly speed up in 49 cases,accounted for 40.50％ (49/121).All of the 121 patients were cured.Conclusions Majority of the patients are female,young aduhs and farmers.The peak of the incidence of SAT lies in autumn.The proportion of mild,medium type is the highest,we suggest this disease should be early diagnosis and treatment.

Objective:To investigate the relationship between iodine nutrition level and thyroid disease.Methods:Totally 299 patients with thyroid disease who were treated at Shandong Provincial Institute for Endemic Disease Prevention and Control from 2016 to 2018 were selected as case group which was further divided into Graves' disease group (GD group, 137 patients), chronic lymphocytic thyroiditis group (HT group, 90 patients) and thyroid nodule group (72 patients). At the same time, 75 healthy people with no history of thyroid disease, normal thyroid color ultrasound and thyroid function were selected as control group. Morning urine was collected and urinary iodine was detected by arsenic cerium catalytic spectrophotometry. Fasting venous blood was extracted, and serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were detected by electrochemiluminescence method. Results:The difference of median urinary iodine in the 4 groups was statistically significant ( H = 42.530, P < 0.05). The medians urinary iodine in GD and HT groups (326.79, 341.91 μg/L) were higher than those of thyroid nodule group and control group (235.01, 187.32 μg/L, P < 0.05). The levels of TSH, FT 3 and FT 4 in GD group were compared with those of control group, and the differences were statistically significant ( P < 0.05). The positive rates of TgAb and TPOAb in HT group were significantly higher than those in GD, thyroid nodule and control groups, and the positive rates of TgAb and TPOAb in GD group were higher than those in thyroid nodule and control groups ( P < 0.05). Conclusions:GD and HT patients have excessive iodine nutrition, and high iodine intake may lead to the occurrence of these thyroid diseases (GD and HT). Thyroid function test combined with laboratory urinary iodine test can be used to diagnose thyroid diseases simply and quickly.

OBJECTIVETo construct a Mycobacterium tuberculosis DNA vaccine pVAX1/ESAT-6 plasmid and investigate its immunoreactivity.

METHODSThe ESAT-6 gene fragment amplified from Mycobacterium tuberculosis genome was inserted into pVAX1 vector to construct the recombinant plasmid pVAX1/ESAT-6, which was identified by restriction enzyme digestion and sequencing. The recombinant plasmid was transformed into Hela cells using Sofast® Transfection reagent, and the cellular expressions of ESAT-6 mRNA and protein were analyzed by RT-PCR and immunofluorescence assay, respectively. The recombinant plasmid pVAX1/ESAT-6 was also transfected into mouse by electronic pulse method, and the mouse serum IFN-γ level and anti-ESAT-6 IgG antibody level were detected by ELISA, mouse lymphocyte proliferation assessed with flow cytometry, and IFN-γ-secreting lymphocytes counted using ELISPOT.

RESULTSDouble restriction-enzyme digestion and sequencing showed that the inserted fragment in the recombinant plasmid pVAX1/ESAT-6 was identical to ESAT-6 gene with an inframe insertion. RT-PCR yielded the target band as expected on agarose gel, and immunofluorescence assay of the transfected cells showed specific green fluorescence signals. The mice transfected with the recombinant plasmid showed significantly elevated serum level of anti-ESAT-6 IgG antibody and increased serum IFN-γ level, spleen cell proliferation, and number of IFN-γ-secreting lymphocytes.

CONCLUSIONThe Mycobacterium tuberculosis DNA vaccine pVAX1/ESAT-6 plasmid we constructed can induce high levels of cellular and humoral immunoreactivity in mice.

Animals ; Antibodies, Bacterial ; blood ; Antibody Formation ; Antigens, Bacterial ; immunology ; Bacterial Proteins ; immunology ; Female ; Genetic Vectors ; HeLa Cells ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin G ; blood ; Interferon-gamma ; blood ; Mice ; Mice, Inbred BALB C ; Mycobacterium tuberculosis ; immunology ; Plasmids ; immunology ; Tuberculosis Vaccines ; genetics ; immunology ; Vaccines, DNA ; genetics ; immunology

Objective To investigate the factors associated with the success rate of external cephalic version (ECV) for singleton and non-cephalic presentation pregnancies in the third trimester.Methods A retrospective study of ECV among singleton and non-cephalic presentation pregnant women in 36-40 weeks of gestation at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2018 was analyzed.Results (1) Totally,251 cases of 358 pregnant women who underwent ECV were successful,with a total success rate of 70.1％ (251/358).The success rate of multipara was 79.1％ (129/163),while 62.6％ (122/195) in primipara (P＜0.01).The total vaginal delivery rate was 52.2％ (187/358),the vaginal delivery rate of multipara was 61.3％ (100/163),while 44.6％ (87/195) in primipara (P＜0.01).(2) Spontaneous reversion occurred in 7.6％(19/251) of ECV successful women,the rate of reversion of multipara was 10.9％ (14/129),higher than that of the primipara [4.1％ (5/122);P＜0.01].(3) Among the 232 pregnant women who did not reverted after successful ECV,187 cases of successful vaginal delivery,the vaginal delivery rate was 80.6％ (187/232);the vaginal delivery rate of the multipara was 87.0％(100/115),which was higher than that of the primipara [74.4％(87/117);P＜0.01].(4) The variables significantly associated with ECV success were parity,type of breech,whether fetal presentation was in pelvic or not (all P＜0.05).The complication rate was 2.2％ (8/358),among which the incidence of fetal distress,placental abruption and transient fetal heart abnormalities were 0.6％ (2/358),0.3％ (1/358) and 1.4％ (5/358) respectively.Conclusion By close monitoring,ECV is a safe and effective procedure in selected appropriate cases,and worthy of clinical application.