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Objective:To observe any effect of repeated transcranial magnetic stimulation (rTMS) in the treatment of diabetic peripheral neuropathic pain (DPNP).Methods:Eighty-six persons with type 2 diabetes mellitus and DPNP were randomly divided into an observation group and a control group, each of 43. Both groups were given basic treatment to control plasma glucose and blood pressure, while the observation group was additionally provided with daily 10Hz rTMS of the primary motor cortex (M1 area) of the non-dominant hand 5 days a week for 4 weeks. Before and after the treatment, pain in both groups was evaluated using a visual analog scale (VAS) and the Patient′s Global Impression Change scale (PGIC). The motor conduction velocity (MCV) and sensory conduction velocity of the median and the common peroneal nerves were also tested.Results:After treatment, the average VAS pain rating and PGIC score of the observation group were significantly lower than the control group′s averages and those before treatment. The observation group′s treatment effectiveness rate (79.07%) was then much better than that of the control group (23.26%). After the treatment, the average MCV of the median and common peroneal nerves of the observation group (47.65±1.94 m/s and 46.98±3.26 m/s, respectively) were significantly faster than before treatment, and those of the control group.Conclusions:rTMS based on routine intervention can significantly relieve DPNP and promote the recovery of injured nerves, bettering diabetics′ physical condition and life quality.
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Objective@#To investigate the effect of Toll-like receptor 9 (TLR9) on high glucose-induced retinal ganglion cells-5 (RGC-5) apoptosis and the inhibitory effects of small interfering RNA-TLR9 (si-TLR9) on apoptosis.@*Methods@#RGC-5 cells were divided into normal control group, high glucose group, high glucose+ negative control group and high glucose+ si-TLR9 group which cells were respectively dealt with normal culture medium, high glucose medium, transfection of non-specific siRNA under high glucose and transfection of siRNA-TLR9 under high glucose.The expression of TLR9 mRNA was detected by real time PCR; the survival rate of the cells was evaluated by MTT assay; the apoptotic rate of the cells was detected by flow cytometry; the caspase-3 activity in the cells was detected by related kit, and the expressions of TLR9, B cell lymphoma (bcl-2), bcl-2 associated X protein (bax), p38 mitogen-activated protein kinases (p38MAPK) and phosphorylated (p)-p38MAPK proteins were detected by Western blot.@*Results@#The expressions of TLR9 mRNA and protein in the high glucose+ si-TLR9 group were significantly decreased in comparison with the high glucose+ negative control group (both at P<0.05). The cell survival rate of the high glucose group and high glucose+ negative control group was (78.36±5.13)% and (75.12±4.25)%, respectively, which was significantly lower than (95.48±7.25)% in the normal control group, and that in the high glucose+ si-TLR9 group was (86.58±5.32)%, which was significantly reduced in comparison with the high glucose+ negative control group (all at P<0.05). The apoptotic rate of the cells in the high glucose group and high glucose+ negative control group was (13.23±1.22)% and (12.52±1.38)%, respectively, which was significantly higher than (2.26±0.15)% of the normal control group, and apoptotic rate in the high glucose+ si-TLR9 group was (7.15±0.24)%, which was significantly lower than that in high glucose+ negative control group (all at P<0.05). The expression of bax in the cells of the high glucose+ si-TLR9 group was significantly decreased, and the expression of bcl-2 in the cells of the high glucose+ si-TLR9 group was significantly increased in comparison with the high glucose+ negative control group (both at P<0.05). Caspase-3 activity in the cells was significantly decreased in the high glucose+ si-TLR9 group compared with the high glucose+ negative control group (P<0.05). The relative expression of p-p38MAPK in the cells was significantly decreased in the high glucose+ si-TLR9 group compared with the high glucose+ negative control group (P<0.05).@*Conclusions@#Down-regulation of TLR9 expression in the RGC-5 cells can inhibit the apoptosis induced by high glucose probablely by suppressing p38MAPK signaling pathway.
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Objective:To investigate the predictive value of peripheral blood platelet to lymphocyte ratio(PLR)for the survival of elderly type 2 diabetes mellitus(T2DM)patients with diabetic ketoacidosis(DKA).Methods:Clinical data of 137 elderly T2DM patients with DKA admitted to our hospital between January 2014 and December 2018 were divided into the survival group(n=109)and the death group(n=28)and retrospectively analyzed.Another 137 elderly T2DM inpatients without DKA during the same period were enrolled as the control group.Clinical data of all patients were recorded to analyze predisposing factors of DKA.Multivariate Logistic regression analysis was used to analyze the related factors for the death in elderly T2DM patients with DKA.The best cut-off value for PLR to predict the survival status of patients was determined.Results:The main predisposing factors for DKA were pulmonary infections and insufficient insulin. Logistic multivariate analysis showed that diastolic blood pressure, Glasgow coma score, the coexisted other organ failure, PLR( OR: 3.576, 95% CI2.225~5.472)and mechanical ventilation were risk factors for the survival in elderly T2DM patients with DKA( P<0.05). ROC curve analysis indicated that the area under the curve(AUC)of PLR was 0.803( P=0.002, 95% CI: 0.758-0.886). The optimal cut-off value of PLR for prognosis(survival/death)was 224.29, with a sensitivity of 81.7% and a specificity of 70.1%. Conclusions:PLR is easy to obtain and can be used as a sensitive indicator to predict the survival of elderly T2DM patients with DKA.
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Objective To investigate the effect of Toll-like receptor 9 (TLR9) on high glucose-induced retinal ganglion cells-5 (RGC-5) apoptosis and the inhibitory effects of small interfering RNA-TLR9 (si-TLR9) on apoptosis.Methods RGC-5 cells were divided into normal control group,high glucose group,high glucose+ negative control group and high glucose + si-TLR9 group which cells were respectively dealt with normal culture medium,high glucose medium,transfection of non-specific siRNA under high glucose and transfection of siRNA-TLR9 under high glucose.The expression of TLR9 mRNA was detected by real time PCR;the survival rate of the cells was evaluated by MTT assay;the apoptotic rate of the cells was detected by flow cytometry;the caspase-3 activity in the cells was detected by related kit,and the expressions of TLR9,B cell lymphoma (bcl-2),bcl-2 associated X protein (bax),p38 mitogen-activated protein kinases (p38MAPK) and phosphorylated (p)-p38MAPK proteins were detected by Western blot.Results The expressions of TLR9 mRNA and protein in the high glucose+si-TLR9 group were significantly decreased in comparison with the high glucose+negative control group (both at P＜0.05).The cell survival rate of the high glucose group and high glucose+negative control group was (78.36±5.13)％ and (75.12± 4.25) ％,respectively,which was significantly lower than (95.48± 7.25) ％ in the normal control group,and that in the high glucose+si-TLR9 group was (86.58±5.32)％,which was significantly reduced in comparison with the high glucose+negative control group (all at P＜0.05).The apoptotic rate of the cells in the high glucose group and high glucose+negative control group was (13.23 ± 1.22) ％ and (12.52± 1.38) ％,respectively,which was significantly higher than (2.26±0.15)％ of the normal control group,and apoptotic rate in the high glucose+si-TLR9 group was (7.15±0.24) ％,which was significantly lower than that in high glucose+negative control group (all at P＜0.05).The expression of bax in the cells of the high glucose+si-TLR9 group was significantly decreased,and the expression of bcl-2 in the cells of the high glucose+si-TLR9 group was significantly increased in comparison with the high glucose+ negative control group (both at P＜ 0.05).Caspase-3 activity in the cells was significantly decreased in the high glucose+si-TLR9 group compared with the high glucose+negative control group (P＜0.05).The relative expression of p-p38MAPK in the cells was significantly decreased in the high glucose+ si-TLR9 group compared with the high glucose+negative control group (P＜0.05).Conclusions Down-regulation of TLR9 expression in the RGC-5 cells can inhibit the apoptosis induced by high glucose probablely by suppressing p38MAPK signaling pathway.
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Objective:To investigate the nursing care of acute leukemia granulocyte deficiency patients with scrotal and perianal infection.Methods:Individualized care plans were developed for acute leukemia granulocyte deficiency patients with scrotal and perianal infection. Nursing measures were conducted from wound care, high fever care, pain care, and psychological care.Results:The infected area of scrotum was reduced from 5 cm×5 cm to 3 cm×3 cm. The new granulation tissue was at the same height of skin. The skin around anus was fully-recovery.Conclusions:Evaluating this patient′s condition and observing the state of the illness, then applied corresponding nursing managements at different period of scrotum infection could reduce the occurrence and development of acute leukemia granulocyte deficiency-related infection and assure the successful chemotherapy.
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Objective To investigate the diagnostic value of fine needle aspiration biopsy combined with BRAFV600E gene mutation detection in elderly patients with thyroid nodules.Methods A total of 168 elderly patients with thyroid nodules suspicious for malignancy on ultrasound from January 2017 to December 2017 at our hospital were enrolled in this study.Using color Doppler ultrasound,185 thyroid nodules were found.Fine needle aspiration cytology(FNAC)and BRAFV600E gene mutation detection were performed before surgery and the findings were compared with postoperative pathological results.The diagnostic value of single and combined detection of FNAC and BRAFV600E gene mutation was evaluated.Results Among 185 thyroid nodules,there were 146 malignant lesions including 137 papillary carcinomas and 9 follicular carcinomas,and 39 benign lesions including 31 cases of nodular goiter,5 cases of Hashimoto's thyroiditis and 3 cases of adenoma.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of FNAC were 79.5％,59.0％,75.1％,75.2％,and 45.6％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of BRAFV600E gene mutation detection were 78.1％,51.3 ％,72.4 ％,84.4 ％ and 51.2 ％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the combined detection were 93.4％,77.5％,86.2％,90.8％ and 53.4％,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the combined detection were higher than those of either method used alone (all P＜0.05).Conclusions For some thyroid nodules that cannot be unequivocally diagnosed as benign or malignant by FNAC,the combined detection of FNAC and BRAFV600E gene mutation can significantly improve the sensitivity,specificity and accuracy of malignancy detection,differentiate between benign and malignant nodules,and help formulate operation plans and subsequent treatment.
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Objective To compare the efficacy of lung ultrasound and chest X-ray for diagnosis of neonatal transient respiration syndrome (TTN) and respiratory distress syndrome (RDS).Methods Totally 120 infants with respiratory distress underwent lung ultrasound and chest X-ray within 6 h after birth.Taking clinical diagnosis as the standard,the sensitivity,specificity and accuracy of lung ultrasound and X-ray for diagnosis of TTN and RDS were calculated.Results According to clinical diagnosis,there were 75 infants of TTN and 34 of RDS.The sensitivity,specificity and accuracy of lung ultrasound in diagnosis of TTN was 96.00％ (72/75),88.89％ (40/45) and 93.33％ (112/120),respectively,higher than those of chest X-ray (85.33％ [64/75],84.44％ [38/45] and 85.00％ [102/120]).Lung ultrasound showed 85.29％ (29/34) of sensitivity,95.35％ (82/86) of specificity and 92.50％ (111/120) of accuracy for diagnosis of RDS,whereas chest X-ray showed 88.23％ (30/34) of sensitivity,89.53％ (77/86) of specificity and 89.17％ (107/120) of accuracy.Conclusion Lung ultrasound is accurate for the diagnosis of TTN and RDS.
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Objective To explore the clinical effect of cognitive rehabilitation therapy combined with repetitive transcranial magnetic stimulation (rTMS) on diabetes mellitus patients complicated with early cognitive impairment.Methods Eighty patients with type 2 diabetes mellitus complicated with early cognitive impairment admitted to our hospital between February 2016 and February 2018 were randomly divided into a control group and an observation group.Patients in both groups were treated with conventional medications and comprehensive rehabilitation training,while the observation group was additionally treated with rTMS for 4 weeks.The fasting blood glucose (FBG) was detected before and after the treatment.The cognitive status,as well as the latency and amplitude of P300 were evaluated using Montreal cognitive assessment (MoCA),NTS-2000 Instrument for electromyography and evoked potentials before and after the treatment.Results After the treatment,significant decrease was observed within both groups in terms of FBG compared to before the treatment,but no significant differences between the two groups were revealed (P＞0.05).After the treatment,the sub-scores and total scores of the MoCA scale of the two groups were significantly higher than those before treatment,with those of the observation group significantly higher than the control group.After the treatment,the latency of P300 decreased significantly,while the amplitude of P300 increased significantly in both group,with significantly higher improvement in the observation group than the control group (P＜0.05).Conclusion rTMS,in addition to cognitive function rehabilitation,significantly improved cognitive function status in patients with type 2 diabetes mellitus complicated with early cognitive impairment.Such combination is worthy of clinical promotion with its safety,reliability and patient compliance.
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Objective To investigate the relationship between occult pancreaticobiliary reflux (OPR) and biliary diseases.Methods Forty-four patients with primary biliary diseases was enrolled,and serum amylase level was determined,and the bile in common bile duct (CBD) was collected to measure the amylase level,then the △ amylase was calculated,which equals bile amylase level minus serum amylase level.OPR was confirmed if bile amylase level was higher than serum amylase level,otherwise it would be defined as the control group.Results Among the 44 patients with primary biliary diseases,the incidence of OPR was 72.7％ (n =32).The bile and serum amylase activity of patients with OPR were (1 513 ± 2 725),(44 ± 21)U/L;and they were (18 ± 14) and (38 ± 17) U/L in the control group.The bile amylase level in OPR group was significantly higher than that in the control group,and the difference was statistically significant (P ＜ 0.05),while there was no significant difference in serum amylase activity between the two groups.The incidence of OPR in patients with CBD stones was 100％,and the bile amylase activity was (1 048 ± 1 317) IU/L,and the △ bile amylase activity was (996 ± 1 322) U/L;the incidence of OPR in patients with choledocholithiasis and cholecystolithiasis was 75％,and the bile amylase activity was (2 457 ± 3 312),the △ amylase activity was (2 412 ± 3 320)IU/L;and the corresponding values in patients with gallbladder stones were 80％,(95 ± 82),(57 ± 76)IU/L;and the corresponding values in patients with bile duct cancer were 50％,(73 ± 51),(40 ± 37)U/L.Conclusions The occurrence of OPR is closely related to CBD stones only,CBD stones and gallbladder stones,and it may be one of the main pathogenic factors of bile duct stones.
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Objective To investigate the effect of blood glucose level on pulmonary diffusion capacity in elderly patients with type 2 diabetes and its clinical significance.Methods Totally 132 older adults with type 2 diabetes were enrolled in this study.According to blood glucose level,the patients were divided into well-controlled group (n =57) and poor controlled group (n =75).Additionally,52 age-matched non-diabetic healthy subjects were selected as control group.Levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) and 2-hour postprandial glucose (2h PG) in the diabetic patients were detected,and homeostasis model assessment of insulin resistance (HOMA IR) was calculated.The patients with type 2 diabetes underwent urinary albumin excretion rate (UAER) detection,fundus examination and nerve conduction velocity test.pulmonary ventilation,diffusion of the lungs for carbon monoxide (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were examined in all subjects.Results Levels of FBG,2h PG,HbA1c and HOMA-IR were higher in poor-controlled group than in good glycemicwell-controlled group (all P＜0.05).Compared with the control group,body mass index (BMI) was increased in diabetic groups (both P＜0.05).The pulmonary ventilation function in the three groups had no significant differences (P＞0.05).DLCO and DLCO/VA were lower in diabetic groups than in the control group(all P＜0.05).DLCO and DLCO/VA in poor-controlled group were lower than those in well controlled group (both P＜0.05).DLCO and DLCO/VA were lower in patients with microangiopathy score ≥ 2 than those without microangiopathy (both P ＜ 0.05).Multiple liner regression analysis showed that DCLO and DLCO/VA were negatively correlated with HbA1c,HOMA-IR,duration of diabetes and microangiopathy (r=-2.51,-2.35,-2.42,-2.37,-2.41,-2.52,-2.47,-2.36,all P＜0.05).Conclusions The pulmonary diffusion capacity is significantly impaired in elderly patients with type 2 diabetes.Pulmonary diffusion capacity is negatively correlated with the blood glucose level.The lung may be one of the target organs of type 2 diabetes mellitus.
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Objective To explore the correlation of bone mineral density (BMD) with levels of N-terminal osteocalcin (N-MID),total collagen type 1 amino-terminal extension peptide,β-collagen special sequence (β-CTX),25-hydroxy vitamin D [25 (OH) D3] and insulin-like growth factor-1 (IGF-1) in postmenopausal women with type 2 diabetes.Methods 116 elderly postmenopausal women with type 2 diabetes were divided into 3 groups according to BMD level:normal group (n=29),osteopenic group (n=49) and osteoporosis group (n=38).Body height,weight,body mass index (BMI) were measured.Fasting blood glucose (FBG),2-hour postprandial glucose (PPG),glycated hemoglobin (HbAlc),24-hour urinary protein (UPro) and levels of N-MID,T-P1NP,β-CTX,25(OH)D3 and IGF-1 were determined.General informations and bone metabolic markers were statistically analyzed and compared between the 3 groups.Results There were no significant differences in levels of FBG,PPG,HbA1c,25(OH)D3 and duration between the 3 groups (all P＞0.05).For the comparison of normal group with osteopenic and osteoporosis groups,BMI and IGF-1 levels were decreased (both P＜0.05) ; T-P1NP and N-MID levels were decreased [(19.85 ± 2.83)μg/Lvs.(12.23±2.75) μg/L,(9.16±2.86) μg/L; (7.12±2.05) μg/Lvs.(5.06±2.38) μg/L,(4.92±2.12) μg/L,all P＜0.05]; 24 h urine protein was increased (P＜0.05); β-CTX level was increased [(1.32±0.38) μg/Lvs.(1.97±0.58) μg/L,(2.14±0.73) μg/L,P＜0.05].Logistic regression analysis showed that BMD was positively correlated with total collagen type 1 aminoterminal extension peptide,IGF-1,25(OH)D3,N MID and BMI (r=0.351,0.217,0.213,0.273,0.203,respectively,P＜0.01 or 0.05),and BMD was negatively correlated with β-CTX and urinary protein levels (r =-0.236 and-0.216,P ＜ 0.05).Conclusions Osteopenia or osteoporosis occurs more often in postmenopausal women with type 2 diabetes.The change of BMD is closely related with bone metabolism markers and IGF 1 level.Routine tests and early prevention can avoid fracture in postmenopausal women with type 2 diabetes.
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Objective:To improve the sensitivity and the linear range of electrochemical immunosensor to detect Schistosoma japonicum (S.japonicum) antibody.Methods:Carbon inks and silver/silver chloride inks were printed on a polyethylene terephthalate (PET) board to make a two-electrode test strip,where carbon was the working electrode and S.japonicum soluble egg antigen (SEA) was fixed at one end of working electrode by different methods; silver/silver chloride electrode was used as control.We tested the valency of the antibody by cyclic voltammetry (CV) and differential pulse voltammetry (DPV) in an electrochemistry workstation,and conducted comparison with the results of ELISA.Two new immunosensing electrodes have been developed,based on glutaraldehyde cross-linked (GA) or chitosan-glutaraldehyde cross-linked (Chit-GA) transducer fixing S.japonicum antigen.We tested the titer of the antibody by means of CV and DPV.Results:Our experimental S.japonicum antigen (50 μg/L) is the optimal test concentration for the GA sensor,and 10 μg/L for Chit-GA sensors.The immune reaction time of both electrodes is all essentially complete in 1 minute.The linear range for S.japonicura antibody in human positive serum sample detection by the glutaraldehyde cross-linked immunosensor is 1∶1000 to 1∶400,and by the chitosan-glutaraldehyde cross-linked immunosensor is 1∶1000 to 1∶500.As the concentration of dilution ratio of S.japonicum antibody in human positive serum sample increased,the test value of DPV increased proportionally.Conclusion:GA sensor and Chit-GA cross-linked S.japonicum sensors have high sensitivity and broad linear range response,and both exhibited a good linear relationship between the DPV signal and the test antibody titer.
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Objective To investigate the inhibition rate of cell proliferation, cell apoptosis rate and their effects on the cell cycle proceeding of the SSMC7721 cell line when 5-FU combined with thermotherapy is induced into the cells, and then provide theoretical bases to the combined therapy of hepatocellular carcinoma. Methods The inhibition rate of cell proliferation was detected by the MTT under different conditions, the cell cycle proceeding and the cell apoptosis rate was detected by flow cytometry and the subcellular structure was detected by the electronmicroscope. Results The cell inhibition rate of the thermotherapy group, 5-FU group and the combinedgroup were 18.4% ,28. 3% and 52. 7% ,respectively. The inhibition rates in the latter two groups were significantly different to the thermotherapy group. The results of flow cytometry showed that the cell numbers increased in G1 stage decreased in S stage,and increased in G2/M stage;the cell apoptosis rate increased. There was significant difference between different groups(P ＜ 0.01 or P ＜0.05). The results of the electronmicroscop showed that the nuclear chromatins agglutinated in the borderline and the mitochondriums became swelled. Conclusions The 5-FU combined with thermotherapy could significantly improve the inhibition rate of cell proliferation, inhibit the cell cycle proceeding from G1 stage to S stage, and induce cells apoptosis and change the subcellular structures in the SSMC7721 cell line.