Objective To investigate the effect of Omaha system intervention on social psychology of the elderly,and to provide evidence for effective intervention in elderly with homebound state.Methods 218 cases with homebound conditions were divided into intervention group and control group by random digits table with each group 109 cases.The intervention group accepted intervention including health education,treatment procedures,case management,supervision of the four aspects of 1-3 times a week according to Omaha intervention system for a period of 3 months.The control group was the blank control.And Omaha evaluation form was used to evaluate social psychological and physical effect before and after the intervention.Results 3 months after the intervention,except physiology in the field of neuromusculo-skeletal function of two groups had no significant difference (t=2.03,P＞0.05),scores in the intervention group in the field of physiology (like the circulation) were higher than the control group,the difference was statistically significant [(1 1.20±2.03) vs.(8.72±1.36),P＜0.05].As for psychology (like mental health),scores of intervention group were higher than that of the control group [(12.53±1.42) vs.(8.63±1.33),t=20.12,P＜ 0.05].Conclusions Omaha system can effectively improve the quality of life of elderly with homebound state and maintain their physiological,social and psychological function.

Objective To observe and compare the antiemetic effectiveness and adverse effects of magnetotherapy plus the 5 -hydroxytryptamine (5-HT3 ) receptor inhibitor granisetron hydrochloride with that of granisetron hydrochloride alone with chemotherapy patients. Methods Sixty-four patients were randomized to receive either granisetron hydrochloride alone ( control group: granisetron hydrochloride 3 mg intravenous infusion before chemotherapy, from the 1st day of chemotherapy until the day after the chemotherapy course was completed) or magnetotherapy plus granisetron hydrochloride ( treatment group: the same granisetron hydrochloride regimen plus rotatory magnetotherapy of 1 h/time every day after chemotherapy). The baseline characteristics of the two groups were similar. The patients' emesia was evaluated according to the WHO's criteria. The density of 5-HT, in serum was detected by enzyme-linked immunosorbent assay ( ELISA). Results In terms of acute vomiting, there was no significant difference between the two groups, but in terms of tardive vomiting, the effectiveness in the treatment group was significantly better than in the control group. The densities of S-HT, in serum in the treatment and the control group were (225.32±57.29 ) ng/ml vs (213.00±53.29 ) ng/ml before chemotherapy and (273.88±5.42) ng/ml vs ( 313.17±76.36 ) ng/ml after chemotherapy, a significant difference. The rates of adverse events were 36.36% and 48.39% respectively in the treatment group and control group, a difference which was not significant. Conclusions Magnetotherapy plus granisetron hydrochloride is more effective than granisetron hydrochloride alone, and the two therapies have a synergistic effect. Adverse events didn't rise in the treatment group.

Objective To investigate the changes and clinical significance of the plasma growth differentiation factor-15 (GDF-15) in patients with chronic congestive heart failure (CHF). Methods A total of 100 patients with CHF were in?cluded in this study (CHF group), and 30 healthy persons were used as control group. CHF group was divided into heart func? tionⅡgrade (n=35),Ⅲgrade (n=32),Ⅳgrade (n=33) groups in accordance with New York Heart Association (NYHA). And CHF group was also divided into left ventricular ejection fraction (LVEF)<0.4 grade (n=52) and LVEF≥0.4 grade (n=48) groups in accordance with LVEF of patients. The plasma GDF-15 and brain natriuretic peptide (BNP) levels were detected by ELISA. The values of LVEF, left ventricular end-diastolic diameter (LVDd), left ventricular systolic diameter (LVDs) and left ventricular fractional shortening (LVFS) were detected by echocardiography. The correlation of GDF-15, NYHA classifi?cation, BNP and index of echocardiography was analyzed between groups. Results Compared with control group, the levels of BNP, GDF-15, LVDd and LVDs were significantly higher in heart failure group, and values of LVEF and LVFS were sig?nificantly lower (P<0.05). The plasma levels of BNP, GDF-15, LVDd and LVDs were in turn increased in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group. The plasma levels of LVFS were in turn decreased, in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group (P<0.05). There were positive correlations between the plasma levels of GDF-15 and BNP, NYHA, LVDd and LVDs (r=0.524, 0.286, 0.453 and 0.531, P<0.05). The plasma level of GDF-15 was negatively correlated with LVEF and LVFS (r=-0.592,-0.587,P<0.05). Conclusion The plasma level of GDF-15 can be used as a new marker for diagnosis, treatment and prognosis in patients with chronic congestive heart failure.

Objective To analyze and compare the differences in application of 24-hour dietary recall and dietary balance index (DBI) in dietary survey and evaluation of patients with type 2 diabetes mellitus,meanwhile investigate their nutrition status.Method This was a cross-sectional study.A total of 100 type 2 diabetes inpatients at the age of 19-59 were recruited from Shanghai Jiaotong University Affiliated Sixth People's Hospital from December 2013 to February 2014.They were surveyed and evaluated by 24-hour dietary recall and DBI respectively.Result The micronutrient intake in patients with type 2 diabetes was not sufficient.Compared with RNI,the intake of vitamin B1,B2,and calcium was less than 50％.The average of DBI lower bound score (DBI-LBS) of the 100 patients was 32.1±6.1,65％; the patients were in moderate or severe deficit of food intake.DBI higher bound score (DBI-HBS) was 4.4±2.8.No significant excess intake problem was found.Dietary quality distance was 36.4±6.9.Eighty-seven percent of them had a dietary patterns of mode B.Conclusion Dietary patterns in type 2 diabetes patients were not reasonable.Nutrition education and nutrition intervention for type 2 diabetes should be emphasized.The two methods can be used to evaluate dietary quality independently,but it would be better to evaluate the quality of the patients' diet using two dietary survey methods together.

Objective To observe the efficacy of a rotating magnetic field and granisetron hydrochloride in preventing nausea and vomiting caused by a eisplatin regimen, and any side effects. Methods Sixty-eight patients receiving cisplatin regimen chemotherapy were randomly assigned to two groups: a magnetic treatment group and a drug treatment group. The patients in the two groups were exposed to a rotating magnetic field or received granisetron hydrochloride, respectively. The effects of the treatments were observed. Results Both treatments could effectively prevent and treat the vomiting caused by chemotherapy. The rate of response to the rotating magnetic field was 88.2% and to the drug 91.2%. However, tardive vomiting was significantly better controlled in the rotating magnetic field group. The incidence of side effects in the magnetic field group was 20.6% , and in the drug treatment group it was 45.6%. Conclusion The efficacy of a rotating magnetic field and granisetron in treating acute vomiting were simi- lar. The rotating magnetic field was more effective in preventing tardive vomiting and had fewer side effects. Magnetic therapy should be more generally applied in clinical practice.

Objective To measure the setup errors of patients with esophageal carcinoma during the treatment of three dimensional conformal radiotherapy (3DCRT), and to analyze the impact of setup errors on dose distribution of GTV,CTV and normal tissues around. Methods Forty-two patients with esophageal cancer treated by 3DCRT were included. The setup errors of each patient were measured once a week for 6 times by electronic portal imaging device (EPID). The setup errors were integrated into the treatment plan-ning system by moving the isocenter. Then the dose distribution of GTV, CTV and normal tissues were recal-culated. Results The systematic setup errors of the 42 patients were - 2.31 mm, - 0.55 mm and - 0.16 mm, and the random errors were 4.42 mm, 4.35 mm and 4.48 mm in the directions of lef-fight, anterior-posterior,and superior-inferior, respectively. The dose covered 95% GTV( D95 ) was reduced by 32 cGy and by 88 cGy for CTV D95. The lung V20 in the original plan and the integrated plan was 22.49% and 22.02%, respectively. The average dose of the heart in the two plans was 2077.62 cGy and 2036.23 cGy, respectively. In the original plan, no patient had maximum dose of spinal cord over 4500 cGy; While in the intergrated plan there were 18 patients had the spinal cord dose more than 4500 cGy, with a maximum dose of 5503.90 cGy. Conclusions The setup errors cause significant dose reduction of GTV and CTV, but not of the lung and heart . The maximum dose of the spinal cord may exceed 4500 cGy due to the setup errors.

Objective To discuss the optimal radiation dose in the treatment of the late course accelerated hyperfractionation(LCAH) radiotherapy for esophageal carcinoma by using two different treatment doses,focusing on the difference of the short term results,local control rates,treatment tolerance and long term survival rates between the two groups.Methods One hundred patients with esophageal carcinoma were randomly divided by the envelope method into two groups:the 60Gy group and the 75Gy group.Patients in 60Gy group received conventional fraction radiation for the first 3 weeks,and then hyperfractionation radiation(1.5Gy per fraction,two fractions a day with 6 hour interval,10 fractions per week) to the total dose of 60Gy/35 fractions/5 weeks.The radiation schedule of the 75Gy group was the same as the 60Gy group: conventional fractionation of radiation for the first 3 weeks and then hyperfractionation radiation for the rest 3 weeks to the total dose of 75Gy/45 fractions/6 weeks.Results There was no significant difference between the two groups in short term results.The 1-,3-,5-year local control rates were 86%,42%,32% in 60Gy group and 88%,52%,48% in 75Gy group,respectively.The 1-,3-,5-year survival rates were 86%,40%, 28% in 60Gy group and 72%,34%,16% in 75Gy group,with no significant difference(P= 0.283).The median survival time was 25 months for the 60Gy group and 19 months for the 75Gy group.Patients suffered from heavy radiation-induced esophagitis in the 75Gy group were significantly more than those in the 60Gy group(28% vs 10%,P= 0.022).But it was similar for patients who died of side effects in the two groups.Conclusions It is not suitable to pursue high dose in treating esophageal carcinoma with late course accelerated hyperfractionation radiotherapy as high incidence of side effects are unadvoidable if the dose is increased without changing the radiation fields and techniques.When escalating the dose to the esophagus,the radiated lung volume as well as the other normal tissues should be first subjected to meticulous and careful consideration.

AIM: To investigate the effect of probucol on proliferation of rat vascular smooth muscle cells(VSMC) stimulated by basic fibroblast growth factor (bFGF) and/or hydrogen peroxide(H 2O 2). METHODS: Effects of probucol on VSMC proliferation and DNA synthesis stimulated by bFGF and/or H 2O 2 were observed by means of MTT test, cell number count and [ 3H]-TdR incorporation. RESULTS: ①Probucol significantly inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, with dosage-dependent manner. Cell number, A value and [ 3H]-TdR incorporation in group probucol+bFGF and group probucol+H 2O 2 were reduced by 40.0%, 39.1%, 45 5% and 46 9%, 45 0%, 39 5%, respectively, compared with group bFGF and group H 2O 2 ( P 0.05). CONCLUSION: Probucol dramatically inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, but had no inhibitory effect on the cell proliferation prestimulated by bFGF and /or H 2O 2. [

Objective: To investigate the protection roll of rosuvastatin on chronic heart failure (CHF) in rats with its effect on asymmetric dimethylarginine (ADMA) metabolic pathway.
Methods: A total of 36 male SD rats were randomly divided into 3 groups, n=12 in each group. Isoproterenol (ISO) group, the rats received ISO subcutaneous injection (5mg·kg·d) for 7 days to establish CHF model, and then received normal saline gavage administration for 7 days. Rosuvastatin (ROS) treatment group, the rats received ISO with ROS for 7 days, then continuously receiving ROS until 14 days. Normal control group, the rats received saline gavage administration for 7 days. The related serum index and haemodynamic parameters were examined, myocardial pathological changes were observed and the relevant protein expression was measured by Western blot analysis.
Results: Compared with Normal control group, ISO group had obviously increased troponin (cTn I), serum ADMA,-LVdP/dtmin, all P<0.01, and decreased left ventricular systolic pressure (LVSP), heart rate, arterial SP, mean arterial pressure, +LVdP/dtmax, all P<0.01. Compared with ISO group, ROS treatment group showed signiifcantly decreased BNP, cTn I, ADMA , -LVdP/dtmin, all P<0.01, and increased LVSP, heart rate, arterial SP, mean arterial pressure,+LVdP/dtmax, all P<0.01. Compared with Normal control group, ISO group had increased expression of protein arginine methyltransferases 1 (PRMT1), decreased expression of dimethyl- arginine dimethylaminohydrolase 2 (DDHA2), both P<0.01. Compared with ISO group, ROS treatment group showed decreased expression of PRMT1, P<0.01 and similar expression DDHA2, P>0.05.
Conclusion: Rosuvastatin has the protective roll on ISO induced CHF in rats, which might be related to decreased serum levels of cTn I, BNP and ADMA metabolic pathway regulation.

Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.