Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

Objective:To evaluate the preservation efficacy of 7 non-inactivating virus preservation solutions.Methods:Equal amounts of H1N1 virus were added to 7 commercially available non-inactivating virus preservation solutions, and the samples were stored at -20 ℃, 4 ℃, 25 ℃ and 37 ℃ for 1 hour, 6 hours, 1 day, 3 days, and 5 days. The viral nucleic acid in each simulated sample under different storage conditions was measured using real-time quantitative PCR. The hemagglutination (HA) titer was determined through viral isolation culture and hemagglutination assay, comparing the differences in viral growth activity across different storage solutions and conditions.Results:Except for solution E, the other solutions effectively protected viral nucleic acid at the 4 storage temperatures. In terms of viral activity, solutions A, B, C, and D effectively maintained viral viability. A and B showing the best performance, E and F showed poorer performance, and G performed the worst.Conclusions:Most non-inactivating virus preservation solutions effectively protect viral nucleic acid, but there are significant differences in their ability to maintain viral viability. To ensure optimal virus preservation, it is recommended that medical institutions evaluate the effectiveness of preservation solutions before use.

Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

Objective:To evaluate the preservation efficacy of 7 non-inactivating virus preservation solutions.Methods:Equal amounts of H1N1 virus were added to 7 commercially available non-inactivating virus preservation solutions, and the samples were stored at -20 ℃, 4 ℃, 25 ℃ and 37 ℃ for 1 hour, 6 hours, 1 day, 3 days, and 5 days. The viral nucleic acid in each simulated sample under different storage conditions was measured using real-time quantitative PCR. The hemagglutination (HA) titer was determined through viral isolation culture and hemagglutination assay, comparing the differences in viral growth activity across different storage solutions and conditions.Results:Except for solution E, the other solutions effectively protected viral nucleic acid at the 4 storage temperatures. In terms of viral activity, solutions A, B, C, and D effectively maintained viral viability. A and B showing the best performance, E and F showed poorer performance, and G performed the worst.Conclusions:Most non-inactivating virus preservation solutions effectively protect viral nucleic acid, but there are significant differences in their ability to maintain viral viability. To ensure optimal virus preservation, it is recommended that medical institutions evaluate the effectiveness of preservation solutions before use.

Objective:To investigate the influence of the teaching model based on the synergy of medical education on the objective structured clinical examination (OSCE) scores and critical thinking ability of interns in emergency department.Methods:A total of 84 students who studied as interns in Emergency Department of our hospital from January 2020 to 2021 were selected as research subjects, and they were divided into observation group and control group using a random number table, with 42 students in each group. The students in the control group were taught using traditional methods, while those in the observation group were taught based on the synergy of medical education. Both groups received an OSCE examination, and the two groups were compared in terms of OSCE score, critical thinking ability, and evaluation of teaching. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had significantly higher scores of theoretical assessment, disease assessment, first aid measures, special skills, use of medical instruments, communication skills with SP, and medical record writing and a significantly higher total score of OSCE assessment ( P<0.05). After teaching, both groups had a significant increase in the score of critical thinking ability, and the observation group had a significantly higher score than the control group [(306.38±25.76) vs. (280.39±20.17)]. The observation group had a significantly higher degree of satisfaction with teaching than the control group ( P<0.05). Conclusion:The teaching model based on the synergy of medical education can improve the OSCE score of interns in emergency department and cultivate their critical thinking ability, and there is a relatively high degree of satisfaction with this teaching model.

Objective:To discuss the correlation between the immune instability of Th17/Treg and the pathogenesis of the Henoch-Schonlein purpura(HSP)with Mpcoplasma pneumoniae(MP)infection.Methods:From June 2018 to December 2019, children who had been diagnosed as HSP in the Department of Pediatrics at Qinhuangdao First Hospital and Qinhuangdao Maternal and Child Health Care Hospital, as well as in-patients with MP infection and outpatients, who had health check-up were collected.The subjects were divided into HSP group(41 cases), MP group(25 cases), HSP-MP group(19 cases) and control group(20 cases) according to the diagnosis of HSP and MP infection.The percentage of Th17 and Treg cells in peripheral venous blood of four groups were determined by flow cytometry, and the levels of interleukin(IL)-17, IL-6 and transforming growth factor-β(TGF-β)in peripheral venous serum of four groups were detected by ELISA.Results:There were no statistically significant differences regarding age and gender distribution among four groups( P>0.05). The percentages of Th17 cells, IL-17 and IL-6 levels in peripheral blood of the HSP-MP group was significantly higher than those in the other three groups( P<0.05), which in HSP group and MP group were higher than that in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). The percentage of Treg cells in peripheral blood was significantly lower in HSP-MP group than those in the other three groups( P<0.05), which in the HSP group and MP group were lower than those in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). There were no statistically significant differences of TGF-β among the four groups( P>0.05). Conclusion:High levels of IL-17 and IL-6 may be an important factor causing severe Th17/Treg immune disorders in children with HSP combined with MP infection, which may play an important role in the pathogenesis of HSP combined with MP infection.

Objective:To explore the clinical effect of endoscopic assisted or microscopical transsphenoidal surgery in the treatment of different grades of invasive pituitary tumors and the measures to reduce complications.Methods:From January 2016 to June 2019, 87 patients with pituitary tumor admitted to the neurosurgery of Tangshan People′s Hospital of Hebei Province were selected as the study objects for retrospective analysis. Among them, 42 patients were included in the endoscopic group and 45 patients were included in the endoscopic group. To compare the related indexes and clinical effects of two different surgical methods, and to analyze the treatment strategies to reduce the common postoperative complications.Results:The amount of intraoperative bleeding, the time needed for operation and the hospital stay of patients in endoscopic group were significantly less or shorter than those in microscopical group(intraoperative bleeding volume: (66.19±9.55) ml and (79.78±11.68) ml; operation time: (93.93±9.53) min and (103.33±9.23) min; hospitalization time: (7.71±1.53) d and (10.16±1.33) d). The difference was statistically significant (T values were 5.92, 4.67, 7.94, all P< 0.01). There was no significant difference between the two groups ( P= 0.577). There were 2 cases (4.8%) of cerebrospinal fluid leakage in endoscopic group and 12 cases (26.7%) in microscopical group. The difference between the two groups was statistically significant(χ 2=5.67, P< 0.05). There were 7 cases (16.7%) of diabetes insipidus in endoscopic group and 22 cases (48.9%) in microscopical group. The difference between the two groups was statistically significant (χ 2=5.19, P< 0.05). Conclusion:The curative effect of endoscopic transsphenoidal resection of pituitary tumor is similar to that of microscopical resection of pituitary tumor. The patients recover quickly, have fewer complications, and have a short hospital stay.

Objective To observe the clinical effect of xerophthalmia of meibomian glands dysfunction treated with meibomian glands massage and tobramycin dexamethasone in the northeast area.Methods The clinical data of 403 patients (767 eyes) with xerophthalmia of meibomian glands dysfunction in the northeast area in January to November 2013 were analyzed retrospectively.The patients were divided into 3 groups.Patients of treatment goup 1 were combined modality therapy by meibomian glands massage and tobramycin dexamethasone and artificial tears (carbomer eye ophthalmic gel).Patients of treatment goup 2 were treated with tobramycin dexamethasone and artificial tears.Patients of control group were only used by artificial tears.Tear film break-uptime (BUT),tear secretion test (Schirmer Ⅱ),corneal staining score and symptom score were measured before treatment and after treatment for 1,3 months.Results There was no significant difference in the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score before treatment among three groups (P ＞ 0.05).Compared with that before treatment,the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score after treatment for 1 month was improved in treatment group 1 and treatment group 2 (P ＜ 0.01),but there was no significant difference in control group (P ＞ 0.05).After treatment for 3 months,the effective power in treatment group 1 [87.1％(122/140)] and treatment group 2 [60.8％(79/130)] was higher than that in control group [48.9％(65/133)],and there was significant difference (P ＜ 0.05).And there was significant difference between treatment group 1 and treatment group 2 (P ＜ 0.05).Conclusions Xerophthalmia of meibomian glands dysfunction in the northeast area due to speciality in the geographical environment and food habits.Combined modality therapy (applied heating,meibomian glands massage and tobradex) can provide a new direction of xerophthalmia of meibomian glands dysfunction,retrieve in the lipids component of the tear film and eliminate the inflammation.But,dependence of the out-patients are very important in the therapeutic process.

Objective To explore the clinical application of Narcotrene Ineex( NI)on guieing the usage of propofol combinee with eifferent analgesic erugs at colonoscopy examination,in oreer to evaluate the application ane clinical safety of the eifferent analgesic erugs. Basee on NI guieance,propofol effect-site concentration was aejustee euring colonoscopy. Methods Two huneree ane forty patients with colonoscopy were selectee as our subjects. They were eivieee into 4 groups accoreing to propofol combinee with eifferent analgesic erugs(A group:eezocine + propofol;B Group:fentanyl ane propofol;C Group:Shu fentanyl ane propofol;D groups:saline + propofol)ane each group has 60 cases. At eifferent stages of surgery,NI was control within 56- 65 or 66 - 75 in terms of anesthesia eegree. The life ineices( mean arterial pressure( MAP),heart rate, respiratory rate(RR)ane oxygen saturation( SpO2 )),ineuction time,insert the mirror ane surgical time ane recovery time ane cases with boey movement,the cases of respiratory eepression were recoreee. The analysis of each group of patients with VAS scores ane the total amount of propofol the patients were recoreee at 5 time points(before anesthesia(T1)ane eyelash reflex time(T2),insertee through the anus mirror(T3),when insertee mirror up to the ileocecal(T4)ane the back mirror finish(T5)). Results MAP,heart rate,respiratory rate of patients in four groups at T2,T3 ane T4 time point were eecreasee than that in T1. Comparee with D group, MAP,heart rate,respiratory rate of patients in A,B ane C groups eecreasee at eifferent eegrees(MAP:F within group = 26. 793,P < 0. 05;F interaction = 6. 532,P < 0. 05;F between group = 7. 574,P < 0. 05;Heart rate:F within group = 21. 428,P < 0. 05;F interaction = 6. 316,P < 0. 05;F between group = 5. 431,P < 0. 05;Respiratory rate:F within group = 14. 226,P < 0. 05;F interaction = 5. 531,P < 0. 05;F between group= 7. 986,P < 0. 05). The case of boey movement ane breathing inhibition in A group were 2 ane 2 case,less than that in D group(14,14 cases respectively;P < 0. 01). VAS score ane the total amount of propofol in A,B, C groups were(1. 20 ± 0. 72)points ane(148. 40 ± 10. 53)mg;(1. 88 ± 0. 88)points ane(178. 85 ± 18. 59) mg;(1. 65 ± 0. 74)points ane(166. 68 ± 16. 22)mg,less than that in D group((2. 35 ± 1. 10)points ane (227. 33 ± 28. 66)mg),ane the eifferences was statistically significant( F = 18. 038,177. 399;P < 0. 05).Conclusion During colonoscopy,Narcotrene real-time monitoring of propofol combinee with eifferent analgesics can significantly reeuce the amount of narcotic erugs,shortee recovery time,reeuce the incieence of complications in patients,ane thus enhancing patient comfort .

AIM: To observe and compare the improvement of glomerul- osclerosis in rats with 5/6 nephrectomy by valsartan and benazepril. METHODS: Thirty Sprague-Dawley male rats were selected and performed five-sixths nephrectomy to produce chronic renal failure model. Two weeks after the surgery, the rats were randomly divided into model group, valsartan group and benazepril group, and established a shame group serving as normal control. The weight, blood pressure, blood uria nitrogen (BUN) and serum creatinine were measured on the sixth week after operation, then the rats were killed to take the kidneys for pathological histological observation. Immunohistochemistry was used to examine the expression of TGF-? 1 protein and fibronectin (FN) and collagen IV in glomeruli. RESULTS: As compared with model group, systolic pressure decreased (P