Objective:Continuous glucose monitoring (CGM) technology is used to compare the advantages of insulin degludec (IDeg) as a basal insulin regimen compared with insulin glargine (IGlar) in the treatment of adult type 1 diabetes mellitus.Methods:30 adult patients with T1DM admitted to Heji Hospital Affiliated to Changzhi Medical College from September 2019 to December 2020 were screened. According to the random number table method, the patients were randomly divided into two groups (insulin degludec group and insulin glargine group) at a ratio of 1∶1, respectively treated with IDeg, IGlar and aspartate insulin for 12 weeks. The main outcome measures were the coefficient of variation of blood glucose (CV), mean amplitude of glycemic excursions (MAGE), time in range (TIR), time above range (TAR) and time below range (TBR). The secondary outcome measures were mean blood glucose (MBG), standard deviation of blood glucose (SD), fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h BG), hemoglobin A1c (HbA 1c), means of daily differences (MOOD), and the frequency of hypoglycemic events. Results:At 12 weeks of treatment, the HbA 1c, FPG, 2 h BG, MBG, SD, CV and MAGE of insulin degludec group were lower than those of insulin glargine group, with statistically significant difference (all P<0.05). The TIR in the insulin degludec group was significantly higher than that in the insulin glargine group [73(63, 75)% vs 43(28, 63)%, P<0.001], and the TAR was lower than that in the glycerine group [25(17, 23)% vs 35(33, 64)%, P=0.003]. From the curve spectrum of blood glucose level of the two groups, the stability of blood glucose in the insulin degludec group was better than that in the insulin glargine group. After 12 weeks of treatment, 8 cases (8/15) in insulin degludec group had HbA 1c<7.0%, and 4 cases (4/15) in insulin glargine group had HbA 1c<7.0%, without statistically significant difference ( P=0.264). There were 7 cases (7/15) in the insulin degludec group and 1 case (1/15) in the insulin glargine group who achieved high quality blood glucose control, with statistically significant difference ( P=0.035). At the 12th week of outpatient follow-up, the incidence of nocturnal hypoglycemic events in insulin degludec group was significantly lower than that in insulin glargine group (4/15 vs 11/15, P=0.027). Conclusions:Compared with insulin glargine, insulin degludec can achieve higher blood glucose compliance rate, lower blood glucose level and reduce blood glucose fluctuations in patients with type 1 diabetes.

【Objective】 To explore the application effect of traditional teaching combined with problem based learning (PBL) in the teaching of transfusion medicine taking the chapter of Human Leukocyte Antigen System and Testing in Clinical Blood Transfusion Testing Technique as an example. 【Methods】 Firstly, practical problems in chapter Human Leukocyte Antigen System and Testing were analyzed. Then, in response to the key and difficult points in the teaching of this chapter, examples were given to illustrate the practical application of traditional teaching combined with PBL in the teaching of Clinical Blood Transfusion Testing Technique from the aspects of teaching objectives, teaching processes, course implementation and implementation effects. The teaching effectiveness was evaluated through a questionnaire. 【Results】 Traditional teaching combined with PBL helped students grasp important knowledge and techniques, break down thinking barriers, grasp internal connections and characteristics, simplify the learning process, stimulate interest in learning and enhance team collaboration. Meanwhile, students' exploration and innovation abilities could be further cultivated through extracurricular expansion by teachers, thus achieving ideal teaching effect. The questionnaire showed that over 90% of the students consider that combining traditional teaching with PBL was beneficial for improving teaching effect. 【Conclusion】 In the teaching of transfusion medicine, adopting traditional teaching combined with PBL according to the textbook content can improve the teaching effect, which is beneficial for the cultivation of comprehensive talents.

Objective:To determine the effect of pelvic floor electrical stimulation combined with conventional treatment on neurogenic bladder dysfunction after spinal cord injury.Methods:The Pubmed/Medline, Embase, Cochrane, CINAHL, China National Knowledge Infrastructure, CQVIP and Wanfang databases were electronically searched for reports published before April 2019 of randomized and controlled trials testing the effect of electrical stimulation of the pelvic floor on neurogenic bladder after spinal cord injury. Meta-analysis of all the reports collected was performed.Results:Seven randomized and controlled trials with 319 patients were identified. Together they showed that compared with conventional treatment, pelvic floor muscle stimulation better increased bladder capacity and reduced the volume of residual urine. Average single urination output was increased, while the frequency of urination decreased along with episodes of urinary incontinence. Average lower urinary tract symptoms scores were also significantly better.Conclusions:Electrical stimulation of the pelvic floor combined with conventional therapy may be more effective than conventional therapy alone in alleviating the symptoms of neurogenic bladder.

Objective:To establish an intelligent management system and explore its application in the management of high-value consumables in Interventional Operating Room.Methods:Supply and processing and distribution (SPD) combined with the intelligent management system was applied in the Intervention Center at Ningbo First Hospital of Zhejiang Province in October 2019. High-value consumables managed with traditional information management between October 2018 and September 2019 were included into the control group, while those managed with SPD combined with the intelligent management system from October 2019 to September 2020 were included into the observation group. The high-value consumable system and inventory compliance rate, average daily inspection time, average daily claim time, timely supply of consumables, return rate of unused consumables, and nurse satisfaction under the two different management modes were compared.Results:The coincidence rates of the high-value consumable system inventory and actual inventory in the observation group and the control group were 98.26% (226/230) and 85.21% (196/230) , respectively; the average daily inspection time, (67.44±1.42) min in the observation group was less than (108.00±2.51) min in the control group, and the average daily claim time, (53.41±5.24) min was less than (118.22±4.68) min in the control group; the total rate of untimely supply of consumables and unreturned unused consumables in the observation and control groups were 3.46% (138/3 986) and 20.86% (881/4 224) , respectively; and the satisfaction of nurses in the two groups were 93.75% (135/144) and 63.89% (92/144) . The differences between the two groups were all statistically significant ( P<0.05) . Conclusions:The construction and application of the intelligent consumable management system can effectively improve the standardization and refinement of the management of high-value consumables in the Interventional Operating Room, and reduce the operating cost of the department.

Objective:To explore the application effect of multidisciplinary teamwork mode in patients with laparoscopic partial nephrectomy of renal carcinoma.Methods:A total of 86 patients with renal cancer who received laparoscopic partial nephrectomy in Ningbo First Hospital of Zhejiang Province from February to December 2019 were selected by the convenient sampling method. According to admission time, the patients were divided into the control group and the observation group, with 43 cases in each group. The control group implemented urological nursing routines and various measures recommended in the accelerated rehabilitation surgery guidelines, while the observation group adopted a multidisciplinary team collaboration model based on evidence-based nursing on the basis of the control group. The Kolcaba General Comfort Questionnaire (GCQ) and Numerical Pain Rating Scale (NPRS) were used to evaluate the comfort and low back pain of the two groups at 1, 3, and 5 days after surgery. Hamilton Anxiety Scale was used to evaluate anxiety of patients in both groups 5 days after surgery, and postoperative rehabilitation indicators (postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time, postoperative hospital stay) were collected in both groups.Results:The total score of GCQ of observation group was higher than that of control group on 1, 3, and 5 days after operation, and lower back pain score was lower than that of control group. The postoperative anxiety score, postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time and postoperative hospitalization days in the observation group were lower than those in the control group. There were statistically significant differences between the two groups ( P< 0.05) . There was no postoperative bleeding or deep venous thrombosis (DVT) in the lower limbs of patients of the two groups. Conclusions:The multidisciplinary teamwork model can alleviate the postoperative anxiety of patients with partial nephrectomy, improve their overall comfort, shorten the postoperative hospital stay and promote postoperative recovery.

The outbreak of viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China poses a major threat to public health. SARS-CoV-2 is highly homologous to severe acute respiratory syndrome-associated coronavirus and Middle East respiratory syndrome-associated coronavirus, all of which may cause severe respiratory symptoms. In addition to respiratory symptoms, a considerable proportion of patients with SARS and SARS-CoV-2 infection have varying degrees of liver injury, but their epidemiological features and pathogenesis remains unclear. This article summarizes the epidemiology of SARS-CoV-2 and elaborates on the current status of the research on SARS-CoV-2, possible mechanism of liver injury caused by SARS-CoV-2, and effective treatment regimens, so as to provide a reference and new research ideas for the prevention and treatment of liver injury in patients with SARS-CoV-2 infection.

Objective To explore the role of impulsivity in manic episodes of bipolar I disorder and cognitive impairment. Methods Sixty-one patients with bipolar I manic-episode ( study group) and 43 healthy volunteers (control group) were included in the study,and the cognitive function and impulsivity of the subjects were assessed using the MATRICS consensus cognitive battery (MCCB) and BIS-11 impulsivity scale (BIS-11). The differences in impulsivity and cognitive function between the study group and control group were compared. Partial correlation analysis was used to analyze the correlation between impulsivity and cognitive function in patients with bipolar I manic episode. Results ( 1) The scores of several cognitive function in study group,were significantly lower than those in healthy control group including information pro-cessing speed,attention alertness,word learning,visual learning,working memory,reasoning and problem sol-ving (all P<0. 01). (2)The total score,motor factor score and cognitive factor score of BIS-11 impulse scale in study group were significantly higher than those in control group (58. 39±15. 77 vs 48. 02±11. 16,62. 09± 19. 01 vs 44. 24±21. 09,56. 97±16. 57 vs 50. 06±13. 87,all P<0. 05). Increased overall scores on the bis-11 impulse inventory may be a risk factor for bipolar I episodes( OR=1. 204,95% CI=1. 032-1. 404). (3) In study group,the total score of BIS-11 was negatively correlated with the speed of information processing, working memory,word learning,reasoning and problem solving,and the total score of MCCB(r=-0. 417,-0. 360,-0. 294,-0. 348,-0. 348,P<0. 05). The score of unplanned factor was negatively correlated with the speed of information processing,word learning,the total score of MCCB(r=-0. 397,-0. 302,-0. 358,P<0. 05). The score of cognitive factor was negatively correlated with the speed of information processing,work-ing memory,word learning,reasoning and problem solving,and the total score of MCCB(r=-0. 327,-0. 351,-0. 374,-0. 391,-0. 463,P<0. 05). The score of motor factor was negatively correlated with working memo-ry and the total score of MCCB(r=0. 370,r=0. 389,P<0. 05). Conclusion High impulsivity is a risk factor for manic episodes of bipolar I disorder and may be associated with cognitive impairment in patients with ma-nic episodes of bipolar I disorder.

Objective To illustrate the semiological characteristics of the three sub-types within the broad bilateral asymmetric tonic seizures (BATS),summarize their predictive values on lateralization and localization of seizure onset zone (SOZ),and analyze the difference between BATS and asymmetrical tonic limb posturing (ATLP).Methods A retrospective review of 385 patients who underwent stereotactic electrode implantation in the Sanbo Brain Hospital,Capital Medical University from September 2011 to May 2018 was performed.As long as there was a clinical epileptic seizure in the presence of BATS or ATLP,the patients were classified into the corresponding groups.Postoperative prognosis was assessed using Engel's grading criteria for a follow-up of no less than six months.Seizure descriptions were based on the classification of epileptic seizures introduced by Lüiders,which used arrows to connect the symptoms in chronological order.Results There was no statistically significant difference between the classic BATS and bilateral proximal tonic seizure in terms of whether it could be an independent seizure,as the onset and end of the seizure,with version and generalized tonic-clonic seizure (P＞0.05).Compared with the ATLP,except for whether it could be an independent seizure (P=1.000) and onset before versive seizure (P=0.068),the BATS showed significantly different semiological features (P＜0.05).The classic BATS and secondary motor area epilepsy had a 100.0％ predictive accuracy on the lateralization of SOZ.In the patients with broad BATS,the SOZ distribution was more extensive,but it was rare in the orbitofrontal gyrus,frontal pole and mesial temporal lobe.Compared with the bilateral proximal tonic seizures from the other regions,those originated from supplementary somatosensory motor area and its adjacent areas were rare and showed no statistically significant difference (0/8 vs 40.0％ (18/45),x2=3.226,P=0.072) but a low trend.The predictive value of BATS on lateralization of SOZ was higher than that of ATLP (84.9％ (45/53) vs 57.1％ (24/42),x2=9.086,P=0.003),and BATS was less originated from temporal lobe than ATLP (3.8％ (2/53) vs 23.8％ (10/42),x2=8.523,P=0.004).Conclusion Different from ATLP,the broad BATS are characterized by tonic proximal upper limb posturing,and have a higher predictive value on lateralization and localization of SOZ.

Objective: To explore the research status of rhinovirus (RV) through analysis of rhinovirus literature using GoPubMed. Methods: "Rhinovirus" was used as the major subject word and the rhinovirus literature was collected at PubMed database (from Jan 1, 1970 to April 16, 2018). The high frequency subject words of rhinovirus related literature and the distribution of countries, cities, and journals were analyzed through a bibliometrical analysis method . Results: A total of 5 367 reports were retrieved from PubMed. The quantity of rhinovirus papers increased overall year by year. The highest number of papers were mainly published in developed countries. The highest number of papers on RV were mainly published in J Virol among all journals related with rhinovirus and Tyrrell D published the highest number of papers in all authors contributed to articles on rhinovirus. The rhinovirus, human, virus, respiratory tract infection were the high frequency subject words in the rhinovirus research. Conclusions Rhinovirus research is becoming one of research hotspots according to the statistical analysis of the research literature on rhinoviruses by GoPubMed.

Methotrexate (MTX)has dual effects of anti-inflam-matory and immune suppression,and its pharmacological mecha-nism is complex,diverse and synergistic.This paper summari-zes the main anti-inflammatory mechanism of low-dose MTX,in-cluding inhibition of JAK/STAT pathway,inhibition of inflam-matory reaction and immune response,increasing the accumula-tion of adenosine and the function of intracellular metabolites (methotrexate polyglutamate).In addition,low-dose MTX can inhibit oxidation by decreasing the level of lipid peroxidation, suppress the inflammatory response to secondary spinal cord in-jury,reduce spinal cord ischemia reperfusion injury and neuro-pathic pain,thus playing a neuroprotective role by a series of pharmacological mechanism.The anti-inflammatory mechanism of low-dose MTX and its application in spinal cord injury were reviewed,to guide the further research on the anti-inflammatory effect of MTX,and provide a theoretical basis for new drugs for clinical treatment of spinal cord injury.