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Ultra-fine 2,2’,4,4’,6,6’- Hexanitrostilbene (HNS-IV) was obtained by HNS-II by vibration cavity comminute. This method uses only alcohol and deionized water, which can be viewed as a green technology. The morphology, particle size, specific surface area, thermal decomposition property and the threshold energy for slapper detonator were compared between HNS-IV and HNS-II in this paper. Results show that after HNS pulverizing, the particle size decreased from 27.18μm to 1.44μm, the specific surface area increased from 0.73m 2• g −1 to 9.10m 2• g −1 . DSC analysis shows that the decomposition peak temperature T d decreases and the melting temperature T m increases after pulverizing. It is speculated that in the explosive reaction with very high heating rate, the enthalpy of decomposition will be increased by pulverizing, which will be more conducive to detonation growth and explosive reaction. According to the calculation of thermal decomposition kinetics, the decomposition and activation energy Ea of HNS decreases after pulverizing, and the thermal decomposition reaction rate of HNS-IV increases when the temperature is less than 409.6°C. The initiation threshold test of the impact plate shows that the 50% initiation threshold energy of HNS- II is 1.242J, and the 50% initiation threshold energy of HNS-IV is 0.558J, and the initiation threshold for slapper detonatorer is significantly reduced by 55%. This means that the ultra-fine HNS-IV is very suitable as the main ingredient in the booster in the EFI initiation.

Regarding long-term home care needs, nurses need to communicate effectively and reasonably when teaching home caregivers. Designers can assist medical staff and develop pictorial tools to enhance communication. The purpose of this study is to explore a theoretical basis from the perspective of designers, patients’ home caregivers, and medical staff to construct a theoretical framework that can jointly develop pictorial health education tools and healthcare system. The qualitative methods, including in-depth interview and observation, are applied to this study; ground theory sets out to construct a framework from the verbatim transcript of the interviews. Based on interview results, six axial codes were extracted: (1) the method of interdisciplinary cooperation; (2) medical research ethics; (3) communication methods; (4) forms of health education tools; (5) development of health education tools; (6) home care intubation procedure. Eight groups of home caregivers offered suggestions from their experiences. The designers need to assist medical staff to solve real problems, pay attention to professional norms, and forms of cooperation. Health education tools need to meet the needs of medical staff and home caregivers and designers should pay attention to the processes of communication. This study can also assist in interdisciplinary cooperation to explore the theoretical basis of pictorial health education tools for nurses in the context of long-term care at home.

The present study evaluated the efficacy of switching from premixed insulin or an insulin analogue to insulin glargine plus oral antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM). The feasibility and suitability of the regimen to the patients was examined based on islet function. Patients with T2DM (n=30) treated with stable doses of premixed insulin or an insulin analogue for eight weeks were divided into two groups according to islet function. Group A had a 2 h of C peptide (2hCP)/fasting C peptide (FCP) ratio ≤3, whereas group B had a 2hCP/FCP ratio >3. Eight weeks following the switch to insulin glargine plus OADs, a significant decrease in fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG) and glycosylated-haemoglobin (HbA1c) were observed in the two groups, with effective rates of 75, 42.9 and 39.3%, respectively. A distinct reduction in the insulin dose was particularly evident in group B. There was a marked decrease in FBG in group A, more so than that observed in group B. By contrast, the decrease in HbA1c was more evident in group B following the switch. A larger number of patients in group B had HbA1c≤7.0%, compared with group A. No difference in the incidence of hypoglycaemia and change of body weight were observed. Following the switch to insulin glargine plus OADs, patients with T2DM demonstrated improved blood glucose control and reduced insulin dosage. The results revealed that this switch in regimen is more suitable for patients with T2DM with 2hCP/FCP>3 and that administration of insulin glargine plus OADs is more efficacious for patients with T2DM with increased FBG levels.

Medical institutions provide guidance on caring skills for home caregivers. Oral teaching is combined with graphical tools in a method that has been proved to be an effective way of quickly mastering home caring skills and promotes effective learning for home caregivers. The graphic design and operation contents of this method are constantly revised through interviews and observations, and by carrying out home care application graphics it forms a spiral structure of Plan–Do–Study–Act (PDSA) participatory action research (PAR). In the three cycles of the operation of PDSA PAR, the designers accurately create graphics of the caring details based on the nurses’ demonstrations and develop health education tools that are suitable to provide continuous assistance and services in real-life situations. PAR combined with PDSA, in each of the three cycles of the operation—design personnel, medical personnel and home caregiver personnel, respectively—as the lead roles, guide the planning decisions for PAR. This study is a reference for the improvement and development of medical graphics for health education tools to improve accuracy.

Background Selenoprotein S (SelS) is an important endoplasmic reticulum and plasma membrane-located selenoprotein implicated in inflammatory responses and insulin resistance. However, the effects of SelS on endothelial cells (ECs) have not been reported. In the present study, the role of SelS in oxidative stress and the underlying mechanism were investigated in human ECs. Methods A SelS over-expression plasmid (pc-SelS) and a SelS-siRNA plasmid were transfected into human umbilical vein endothelial cells (American Type Culture Collection, USA). The cells were divided into four groups: control, SelS over-expression (transfected with pc-SelS), vector control, and SelS knockdown (transfected with siRNA-SelS). After treating the cells with H 2 O 2 , the effects of oxidative stress and the expression of caveolin-1 (Cav-1) and protein kinase Cα (PKCα) were investigated. Results Following treatment with H 2 O 2 , over-expression of SelS significantly increased cell viability and superoxide dismutase (SOD) activity, and decreased malondialdehyde (MDA) production and Cav-1 gene and protein expression. However, no effects on PKCα were observed. In contrast, knockdown of SelS significantly decreased cell viability, SOD activity, and PKCα gene and protein expression, and increased MDA production and Cav-1 gene and protein expression. Conclusions SelS protects ECs from oxidative stress by inhibiting the expression of Cav-1 and PKCα.

To explore whether intensified, multifactorial intervention could prevent macrovascular disease in patients with recently diagnosed type 2 diabetes. A total of 150 type 2 diabetic patients, with disease duration of <1 year and without clinical arteriosclerotic disease or subclinical atherosclerotic signs confirmed by ultrasonographic scanning of three conducting arteries, were randomized into an intensive intervention group and a conventional intervention group. They then received intensive, multifactorial intervention or conventional intervention over 7 years of follow-up. The patients' common carotid intima-media thicknesses (CC-IMTs) were measured every year. The primary outcome was the time to the first occurrence of CC-IMTs ≥1.0 mm and/or development of atherosclerosis plaques in the carotid artery. The secondary outcome was clinical evidence of cardiovascular disease. A total of 70 patients in the intensive group and 68 patients in the conventional group completed the 7-year follow-up. Subclinical macrovascular (primary) outcomes occurred in seven cases in the intensive group and 22 cases in the conventional group for a cumulative prevalence of 10.00 and 32.35%, respectively (P < 0.05). No significant differences between the two groups were observed regarding the secondary outcome. Primary prevention of macrovascular diseases can be achieved through intensified, multifactorial intervention in patients with short-duration type 2 diabetes. Type 2 diabetic patients should undergo intensive multifactorial interventions with individual targets for the prevention of macrovascular diseases.

Sulfide and vanadium (V) are pollutants commonly found in wastewaters. A novel approach has been investigated using microbial fuel cell (MFC) technologies by employing sulfide and V(V) as electron donor and acceptor, respectively. This results in oxidizing sulfide and deoxidizing V(V) simultaneously. A series of operating parameters as initial concentration, conductivity, pH, external resistance were carefully examined. The results showed that these factors greatly affected the performance of the MFCs. The average removal rates of about 82.2 and 26.1% were achieved within 72 h operation for sulfide and V(V), respectively, which were accompanied by the maximum power density of about 614.1 mW m⁻² under all tested conditions. The products generated during MFC operation could be deposited, resulting in removing sulfide and V(V) from wastewaters thoroughly.

The aim of the present study was to explore the associations among glycemic excursions, glycated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) in patients with poorly controlled type 2 diabetes mellitus (T2DM) using a continuous glucose monitoring system (CGMS). Sixty-three patients with T2DM whose HbA1c levels were >7% wore a CGMS device for 72 h. According to their HbA1c levels, patients were divided into three groups as follows: Group A (HbA1c ≤9.32%), group B (9.32%< HbA1c ≤11.76%) and group C (HbA1c >11.76%). Patients were also divided into two groups according to the mean amplitude of glycemic excursions (MAGE) as follows: Low glycemic excursion group (MAGE, <3.9 mmol/l) and high glycemic excursion group (MAGE, ≥3.9 mmol/l). Clinical data and the hs-CRP levels in different groups were compared. No significant difference was observed in the MAGE among groups A, B and C (P>0.05). The level of hs-CRP was significantly higher in group C compared with that in groups A and B, and in group B compared with that in group A (P<0.05). Multivariate stepwise regression analysis indicated that HbA1c correlated with hs-CRP (P<0.05). MAGE and HbA1c were independent indices for the assessment of glycemic control. In addition, HbA1c had a considerable effect on the serum hs-CRP level.

Aim： To examine the effects of quercetin, a natural antioxidant, on high glucose （HG）-induced apoptosis of cultured dorsal root ganglion （DRG） neurons of rats. Methods： DRG neurons exposed to HG （45 mmol/L） for 24 h were employed as an in vitro model of diabetic neuropathy. Cell viability, reactive oxygen species （ROS） level and apoptosis were determined. The expression of NF-кB, IкBα, phosphorylated IкBα and Nrf2 was examined using RT PCR and Western blot assay. The expression of hemeoxygenase-1 （HO-1）, IL-6, TNF-α, iNOS, COX-2, and caspase-3 were also examined. Results： HG treatment markedly increased DRG neuron apoptosis via increasing intracellular ROS level and activating the NF-κB signaling pathway. Co-treatment with quercetin （2.5, 5, and 10 mmol/L） dose-dependently decreased HG-induced caspase-3 activation and apoptosis. Quercetin could directly scavenge ROS and significantly increased the expression of Nrf-2 and HO-1 in DRG neurons. Quercetin also dose-dependently inhibited the NF-κB signaling pathway and suppressed the expression of iNOS, COX-2, and proinflammatory cytokines IL-6 and TNF-α. Conclusion： Quercetin protects rat DRG neurons against HG-induced injury in vitro through Nrf-2/HO-1 activation and NF-κB inhibition, thus may be beneficial for the treatment of diabetic neuropathy.