BACKGROUND: There is still recrudescent risk in the convalescence stage of the acute myocardial infarction and the living condition is relatively poor. The study proved that it has relation to that the patients haven't mastered the scientific conformable life style for the myocardial infarction recovery.OBJECTIVE: Take the rehabilitation education to help the patients set up conformable life style so as to improve the quality of life.DESIGN: The patients in the convalescence stage of the acute myocardial infarction were chosen for the control study.SETTING: Nursing Institute of Beijing Medical University and two university hospitals.PARTICIPANTS: The cases were taken from the Cardiology Departm ents of the Second and Third Affiliated Hospital of Beijing Medical University from April 1999 to November 1999. Inclusive standard: the first onset of the acute myocardial infarction and voluntary for this study. Exclusive standard: not the first onset of the acute myocardial infarction. The control group contained 35 patients hospitalized from April 1999 to June 1999 conforming to the including standard. The experimental group contained 40 patients hospitalized from August 1999 to November 1999 conforming to the including standard. After eliminating the special unmatched cases and missed follow-up cases in the experimental group, the final 30 cases were respectively involved in the both groups. There were 23 male cases and 7 female cases in the control group with the mean age of(60 ± 14), and 22 male cases and 8 female cases in the experimental group with the mean age of(62 ± 10) . There was no significant difference in the age and sex in these two groups.METHODS: The Neuman health care system pattern was taken as the theoretical frame for the rehabilitation education of the patients in the convalescent stage of the acute myocardial infarction. That is the conver genceteaching and personal illustration accompanied the rehabilitation education hand books were adopted for the rehabilitation education in the experimental group before their leaving. Then the telephone education was taken for further direction and consultation during the first three months after being discharged. The evaluation information was obtained through the follow-up after the first three months.MAIN OUTCOME MEASURES: The quality of life and dimensions in the two groups.RESULTS: Compared with the control group, the scores of the quality of life, the dimensions of the body, the psychology, the duty role and the health consciousness in the experimental group were all significantly higher(t= 11.03,3.26,3.62,2.05,15.48, P < 0. 05), while there was no significant difference in the social degree( P > 0.05) .CONCLUSION: The rehabilitation education can significantly improve the quality of life of the patients in the convalescence stage of the acute myocardial infarction.

Objective To investigate the situation of admission nursing evaluation on elderly patients of geriatrics departments in several Shanghai comprehensive hospitals, and the results will be the base for designing elderly patient′s comprehensive admission nursing evaluation form. Methods 41 nurse managers of geriatrics department in Shanghai comprehensive hospitals were selected as research object. Self-designed questionnaire included general data, elderly patient admission nursing evaluation content and the importance of each item. Results The effective recovery rate was 97.56%(40/41). 98%(39/40) hospitals considered that elderly patients need to have a comprehensive assessment according to the elderly characteristics, only 18%(7/40) hospitals used the special nursing evaluation form for elderly patients. The score of importance of five dimensions were as follows: geriatric syndromes or problems scored (4.64 ± 0.38), physical function assessment scored (4.60 ± 0.46), physiological function assessment scored (4.53 ± 0.45), mental and psychological assessment scored (4.10 ± 0.57) and social assessment scored (4.07±0.52). The score of importance of 29 items were as follows:fall assessment scored (4.90±0.30), pressure ulcer assessment scored (4.85 ± 0.36), activities of daily living scored (4.75 ± 0.44), urinary incontinence assessment scored (4.70 ± 0.52), pain assessment scored (4.70 ± 0.46). Conclusions It is of great significance to carry on the comprehensive admission nursing evaluation for the elderly patients, which needs to be valued and strengthened.

Objective To investigate the curative effect of modified Yanghe decoction on pulmonary interstitial fibrosis.Methods In this study,62 patients suffering fiom pulmonary interstitial fibrosis were randomly divided into 2 groups with the use of the Random Number Table method.31 cases in the treatment group were treated with modified Yanghe decoction,while 31 cases in the control group were treated with prednisone,40 mg/d (produced by Zhejiang Xianju Pharmaceutical Factory).The dosages of prednisone were gradually reduced a month later.The changes and improvement in symptoms,pulmonary function,chest CT,etc were observed and analyzed after three month.Results The study showed that the total?effective?rates of the treatment group and control group were 83.9％ (26/31) and 58.1％ (18/31) respectively,and the difference had statistical significance (P=0.031,P＜0.05).The integrals of gasping,breathlessness,cough and Velcros Rale of the treatment group before the treatment were (3.1 ± 2.61),(4.1 ± 1.53),(1.38 ± 1.02),(1.56 ±2.34)respectively while those of the control group were (2.83±2.34),(3.90±1.67),(1.28±1.24),(1.61±2.14) respectively.The after-treatment integrals of the treatment group were (1.1 ± 1.06),(1.52± 1.40),(0.36±0.71),(0.65±0.67)respectively while those of the control group were(1.2± 1.33),(2.15±1.31),(0.41±0.70),(0.78 ± 0.30)respectively.Compwered with their symptoms before the treatment,there was obviousimprovement in the symptoms of both groups after the treatment,(P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Before the treatment,the total lung capacity,vital capacity,diffusion function,arterial oxygen pressure of the treatment group were (69.80±21.7) ％,(73.16±16.38) ％,(51.46± 16.42) ％,(69.70± 10.74) mm Hg (1 mm Hg=0.133 kPa) respectively while those of the control group were(77.52 ± 15.96)％,(74.57 ± 20.73)％,(55.68 ± 17.27)％,(64.86 ± 11.40)mm Hg respectively.After the treatment,the total lung capacity,vital capacity,mass function,arterial oxygen pressure of the treatment group were (82.31±21.65)％,(83.66±17.32)％,(62.34±17.96)％,(83.51±9.37)mm Hg respectively while those of the control group were (85.06± 16.10) ％,(85.72± 20.40) ％,(68.32± 20.16) ％,(79.61 ±9.41)mm Hg respectively.Compwered with their symptoms before the treatment,there was obvious improvement in the symptoms of both groups after the treatment (P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Conclusion Modified Yanghe decoction can be effectively applied in the prevention and treatment of pulmonary interstitial fibrosis.

Objective To explore the clinical and pathological features of primary IgA nephrology in patients of different gender.Methods The clinical manifestations,laboratory examination and renal pathology results were compared in 192 IgA nephrology patients.Results Not only the onset age of the male patients was older than that of the female ones (P<0 .05 ),but also the course of disease before the kidney biopsy of male patients was longer than that of the female ones (P<0.05).Besides,the proportion of edema in the male patients was lower (P<0.05).The mean arterial pressure,hemoglobin and 24 h urine protein levels were higher in the male patients at the time of kidney biopsy.Besides,the proportions of high blood pressure,hyperuricemia and hypertriglyceridemia were all higher in the male patients.Furthermore,eGFR of the male patients was lower than that of the female ones (P<0 .05 ).There was a significant difference in the gender distribution of clinical and pathological types (χ2=12.666,P<0.05),and the male and female patients also significantly differed in the 24 h urine protein and CKD grouping (Z=-3.118,Z=-3.246,P<0.05).However,there was no significant sex difference in Lee pathology grading or immunofluorescence type (Z=-1.881,χ2 =-0.187,P>0.05 ).Patients of different gender significantly differed in the renal-interstitial lesions grading (Z=-3.0432,P<0.05);to be more specific,the scores of glomerulosclerosis and renal tubule interstitia were higher in the male patients (P<0.05).Conclusion Patients of different gender differ in the clinical and pathological features of primary IgA nephrology.And clinical pathology of male patients is worse than that of female ones.

Objective To investigate the myocardium protective effect of immunoinflammatory response induced by preinfarction angina. Methods Eighty-eight patients of acute myocardial infarction were divided into preinfarction angina group (48 subjects) and sudden onset group (40 subjects). The incidence of severe arrhythmia,heart failure,cardiac shock and in-hospital mortality were assessed in the two groups. The myocardial infarction size,ventricular function,coronary angiography were compared between the two groups. Some immunoinflammatory markers levels were detected. Results In preinfarction angina group,the incidences of severe arrhythmia,heart failure,and in-hospital mortality were lower (P

Objective This study was conducted to investigate the clinical outcomes and safety of percutaneous coronary intervention (PCI) to the single-opened vessel lesion among patients with severe left ventricular systolic dysfunction. Methods Twenty-seven patients with severe left ventricular systolic dysfunction (ejection fraction≤35%) undergoing PCI were included. All the patients received PCI only to the single-opened vessel lesion under the conditions of: (1) There were limitations to open chronic total occlusion (CTO);(2) Single-opened vessel lesion was not calcified and tortuous. Clinical outcomes, including success rate of PCI, changes of symptoms in-hospital, brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) pre-and one week post-PCI, the major adverse cardiac events (MACE, including death, myocardial infarction and target vessel revascularization) at 30-days after discharged were observed. Results The success rate of PCI was obtained in all 27 patients(100%), and all the patients received drug eluting stent implantation. The symptoms improvement occurred in all patients and the NYHA class improved from grade Ⅳto grade Ⅲin 22 patients(81.5%) in-hospital. Significant differences were noted in the mean BNP and LVEF between pre-PCI and one week post-PCI, BNP[(2699.6±1104.7) pg/ml vs. (737.0 ± 261.7) pg/ml, P<0.05],LVEF[(26.9±5.7)%vs. (36.0±3.41)%, P<0.05)]. No MACE happened in-hospital and at 30-days follow up. Conclusions PCI only to the single-opened vessel lesion among patients with severe left ventricular systolic dysfunction under the condition of limitations to open CTO is safe and can significantly improve clinical outcomes in-hospital and at 30-days follow up, but it must be emphasized that single-opened vessel lesion not with obvious calcification and tortuosity.

Objective To discuss the treatment action and mechanism of Wenjing Tongluo Formula on oxaliplatin-induced perpheral neurotoxicity in rats. Methods Intraperitoneal injection was used to inject oxaliplatin 4 mg/kg to establish oxaliplatin-induced peripheral neurotoxicity rat models. Female Wistar rats were randomly divided into normal group, model group, and TCM group. TCM group was given Wenjing Tongluo Formula to soak rats’ limbs and tails. Rats in the model group were soaked with deionized water for comparison. Rats in the normal group received intraperitoneal injection with 5%glucose. Algesia hypersensitivity and anaphylaxis were detected under the mechanical stimulation and temperature. Immunohistochemical method was used to detect the expression of GFAP in L4-L6 spinal dorsal horn of rats. Explore the level of GLT-1 in L4-L6 dorsal root ganglia by RT-PCR. Results Rats in model group showed obvious behavioral changes compared with normal group (P<0.05);Rats in the TCM group improved in behavioristics compared with model group (P<0.01);number of positive cells in GFAP of rats in the model group increased compared with normal group (P<0.05);the increase in the TCM group was not obvious. Compared with normal group, astrocytes in spinal dorsal horn of model group were enlarged, protuberances increased, became coarse, and GLT-1 mRNA is decreased (P<0.05, P<0.01). Compared with model group, active cells and protuberances in the TCM group decreased (P<0.01), GLT-1 mRNA is increased (P<0.01). Conclusion Wenjing Tongluo Formula can improve behavioral changes of model rats under temperature and mechanical stimulation, probably related to harmful signal transmission induced by inhibition of astrocyte in spinal dorsal horn.

Objective To investigate the expression of DcR3 mRNA in cells of acute leukemia(AL) and its clinical significance.Methods The DcR3 mRNA of bone marrow mononuclear cells(BMNC) in the patients with AL was detected by RTPCR.There were 28 AML cases,and 18 ALL cases.27 cases of non-malignant hematopathy were used as control group.The expression level of DcR3 mRNA in BMNC was detected with RT-PCR.Results The positive rate of DcR3 mRNA was 67.4% and gene expression level was 0.56?0.09 in AL group,while they were 40.7% and 0.39?0.19 in control group,there were significant differences(P0.05).The positive expression level of DcR3 mRNA increased when the white blood cell count was ≥30?109?L-1.Conclusion DcR3 gene might play a role by suppressing apoptosis in leukemogenesis.

Objective To monitor and analyze the antigenicity of Streptococcus pneumonia polysac-charide, its derivatives and conjugates by three immunological assays .Methods Inhibition ELISA and rate nephelometry(RN) were established for this study.Antigenicity of serotype 23F pneumococcal conjugates and their intermediates were analyzed by double immunodiffusion assay , inhibition ELISA and RN .The re-sults derived from three assays were comparatively analyzed to evaluate the changes of antigenicity during the preparing process of serotype 23F conjugate.Results Double immunodiffusion assay, inhibition ELISA and RN were all applicable to antigenicity analysis during the process of conjugate preparation .Inhibition ELISA could quantitatively detect a slight difference of polysaccharide antigenicity during the preparing process . Conclusion The antigenicity of polysaccharide during the preparing process of pneumococcal conjugates could be analytically monitored by using three immunological assays .This study provided evidence for suc-cessfully using immunological assays as the quality control means during the preparing process of pneumococ -cal conjugates .

Objective To dynamically analyze the antibodies with regard to in vitro serum bacteri-cidal activity and the quantity of IgG in healthy adults received one dose of immunization with ACYW 135 me-ningococcal polysaccharide vaccine .To investigate the term of protection with polysaccharide vaccine and the correlation between bactericidal titer and IgG concentration .Methods Twenty healthy adults were given one dose of immunization with quadrivalent meningococcal polysaccharide vaccine .Serum samples were col-lected before and after vaccination at specific time points .Test for serum bactericidal activity ( SBA ) and quantitative ELISA were performed to detect bactericidal titers and IgG concentrations in serum samples .Re-sults Certain levels of antibodies against capsular polysaccharides of serogroup A , C, Y and W135 strains had already existed prior to immunization .Moreover, bactericidal titers against serogroup A , Y and W135 strains except serogroup C strain were relatively high .Specific IgG concentrations and bactericidal titers for all serogroup stains were significantly increased on day 15 after vaccination (P<0.05), and then sustained at a high level during a time period from day 30 to day 160.Both IgG concentrations and bactericidal titers dropped to the levels similar to that before preimmunization in about 3 years.No significant correlation was observed between bactericidal titers and IgG concentrations (r<0.3, P>0.05).However, a close correla-tion was demonstrated between GMTs and GMCs of serum samples (r>0.7, P<0.05).Conclusion The geometric mean titers ( GMTs) and geometric mean concentrations ( GMCs) of serum samples collected be-fore and after vaccination at different time points were reliable and consistent parameters for the evaluation of vaccine .The term of protection of quadivalent meningococcal polysaccharide vaccine was about 3 years upon a single dose of immunization .