Objective To investigate effect of levocarnitine on maintainance hemodialysis in patients with hypotension.Methods 64 cases with continuous hemodialysis hypotension were randomly divided into control group and treatment group, 32 cases in each group.Patients in the control group were treated with erythropoietin treatment after regular hemodialysis, and the treatment group based on the control group with levocarnitine.Blood pressure, hemoglobin, urea clearance rate, hypotension and changes of C-reactive protein (CRP), arteriovenous fistula occlusion and cardiovascular events incidence were compared after the treatment.Results Compared with before treatment, the incidence of two groups of blood pressure and hemoglobin levels were significantly increased ( P <0.05 ) and CRP levels decreased ( P <0.05 ) , hypotension, arteriovenous fistula occlusion and cardiovascular events rate were decreased (P<0.05); compared with the control group, systolic blood pressure and minimum systolic blood pressure and hemoglobin levels of treatment group were higher (P<0.05) and CRP levels were lower (P<0.05), the incidence of hypotension, arteriovenous fistula occlusion and cardiovascular events were lower (P<0.05), the clinical curative effect was higher (P<0.05).Conclusion Levocarnitine can effectively reduce the occurrence of hypotension in hemodialysis patients continuously, with good clinical efficacy and safety.

OBJECTIVE:To establish the quality standards for Fufang ningshen granule. METHODS:TLC was used for the qualitative identification of Radix angelicae and White paenoy;HPLC was adopted for the contents determination of spinosin and verbascoside:the column was Kromasil C18 with the mobile phase of acetonitrile-0.1% acetic acid(16∶84,V/V)at a flow rate of 1.0 ml/min,detection wavelength was 330 nm,column temerpature was 30 ℃. RESULTS:The TLC spots of R. angelicae and W. pae-noy were clear with good separation,negative control without interference. The linear range was 0.055 44-0.277 2μg for spinosin(r=0.999 4)and 0.055 98-0.279 9 μg for verbascoside(r=0.999 5);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recoveries were 95.62%-100.53%(RSD=1.77%,n=9) and 95.63%-102.57%(RSD=2.74%,n=9). CONCLU-SIONS:The standard can be used for the quality control of Fufang ningshen granule.

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.

Objective To establish a method for simultaneous determination of HPLC fingerprint and multi-target ingredients in Atractylodis Macrocephalae Rhizoma(AMR),in order to provide reference for its quality control.Methods HPLC-DAD multi-wavelength switching method was used to establish fingerprint of AMR,similarity evaluation combined with hierarchical clustering analysis(HCA),principal components analysis(PCA)and discriminant analysis of partial least squares(PLS-DA)were used to carry out chemometric study.The contents of differential component such as atractylenolide Ⅰ,Ⅱ,Ⅲ and atractylon were determined simultaneously.Results The HPLC fingerprint of 37 batches of AMR was established.Nine common peaks were marked,and 4 of them were identified as atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ.The similarity degrees were between 0.539 and 0.996,the quality of AMR from different origin and different batches varies greatly.Atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ and one unknown component(peak 9)are the important factors affecting the quality of AMR.Conclusion The combination methods of HPLC fingerprint and simultaneous determinations of multiple components are simple,stable,accurate and reliable,which can provide reference for the quality evaluation of AMR and the improvement of quality standard,as well as lay a foundation for the basic research of its pharmacodynamic substances and related compound.

Objective To investigate if improving or slowing the progression of glucose intolerance might be linked with the reduction of cardiovascular disease(CVD)events and mortality in a Da Qing population with prediabetes.Methods In 1986,577 subjects with impaired glucose tolerance in 33 clinics in Daqing city were randomly assigned to either the control group or one of three lifestyle intervention groups(diet,exercise,or diet plus exercise)to receive a 6 year lifestyle intervention.All the participants were followed for 14 years(1993-2006)after completion of the 6 year active interventions to assess the long-term effect of the interventions.In this post-hoc analysis,the participants were stratified into four subgroups(quartiles)based on their 2 h plasma glucose(2hPG)level after glucose loading at the end of the active intervention,in order to analyze the impact of plasma glucose level on CVD events and mortality.Results During the 20-year follow-up,there were a total of 142 deaths(68 of which were attributed to CVD)and 211 first CVD events(145 strokes and 66 myocardial infarctions).From the highest to the lowest levels of 2hPG in the 4 quartiles,the all-cause mortality(17.8,12.7,10.9,and 9.7/1 000 personyears),CVD mortality(9.1,5.9,6.1,and 4.9/1 1300 person-years)and the incidence of first CVD events(30.4.24.0,18.8,and 19.7/1 000 person-years)showed a clear trend of decline.In multivariate analyses,controlled for age,sex,body mass index,smoking habit,blood pressure,and intervention methods at baseline,the results showed that the 5 mmol/L elevation of 2hPG level after glucose loading in 1992 significantly increased the all-cause mortality(HR 1.335.P=0.005),the incidences offirst CVD events(HR 1.227,P=0.012)and stroke(HR 1.213,P=0.026).Conclusion In pre-diabetes population.if the lifestyle intenrentions are substantially efficacious in improving glucose intolerance,the CVD risk and mortality will be reduced.

Objective To investigate the application of reality cross-sectional assessment ( RCA) in the ability evaluation of young nurses .Methods 32 young nurses, who had worked for 3-10 years, were enrolled in the study.Each month, we randomly selected 10 nurses to finish the RCA.The clinical ability, quality ofcare and patients ’ satisfaction were compared before and after the assessment .Results The score of clinical ability was (80.41 ±10.76) before the application of RCA .After applied the RCA for 6 and 12 month, the scores of clinical ability were (90.78 ±5.71) and (89.25 ±6.36), the difference was significant ( F=15.932,P<0.01).After applied the RCA for 6 and 12 month, the scores of quality of care were (88.03 ±6.05) and (88.22 ±5.98), the difference was significant (F=3.179,P<0.05).The patients’ satisfaction improved from 90.38%to 100.00%, which was significant different (χ2 =18.152,P<0.05).Conclusions RCA combine with practical work can reflect the state of real work of nurses and their true level , which promotes the overall quality of care and clinical practice of working ability .

Objective To investigate the correlation between self-management level and survival quality among stroke patients in community. Methods A total of 100 stroke patients in community were recruited from three communities in Shanghai from January to April 2014. They were investigated with the stroke patients self-management scale and SIS life quality scale. The SPSS 19. 0 software was used for statistical analysis. Results The total scores of self-management level and survival quality were (174. 97 ± 36. 69) and (213. 94 ± 52. 84),respectively, which were at the level of better than average. The scores of the total scale and the factors of self-management level and survival quality were positively correlated (r =0. 139 -0. 661,P <0. 01). Conclusions Positive correlation exists between self-management level and survival quality among stroke patients in community. The medical staff should pay more attention to improve the level of self-management in patients, and improve their quality of life.

Objective:To screen the differentially expressed genes(DEGs)under high phosphate-induced calcification in the vascular smooth muscle cells(VSMCs)by mRNA high-throughput sequencing technology,and to analyze the key genes and signaling pathways involved in the VSMCs calcification.Methods:The human VSMCs were divided into control group and model group.The cells in model group was exposed to the high-phosphate medium,while the cells in control group were cultured in DMEM supplemented with 10%fetal bovine serum under the same conditions.The VSMCs in two groups,stably transfected,were cultured for 12 d.The morphology of the cells in two groups were observed and photographed under inverted microscope.The DEGs were selected by Hisat2 software,and Gene Ontology(GO)functional and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were performed by Stringtie software from three aspects,such as biological processes(BP),molecular functions(MF),and cellular components(CC).The calcification of the cells in two groups was observed by Von Kossa staining method.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to analyze the expression levels of alkaline phosphatase(ALP),bone morphogenetic protein 2(BMP2),alpha-smooth muscle actin(α-SMA),tumor protein 53(Tp53),glutathione peroxidase 4(GPX4),ferritin light chain 1(Ftl1),and glycosylphosphatidylinositol-specific phospholipase D1(GPLD1)mRNA in the cells in two groups.Results:Compared with control group,there were 2 524 DEGs in the cells in model group,and there were 1 368 upregulated DEGs and 1 156 downregulated DEGs.Clustering of DEGs between the cells in two groups was distinct.The GO functional and KEGG pathway enrichment analysis results showed that the upregulated DEGs were primarily involved in regulating the microtubule cytoskeleton,cell polarity,protein localization,and cell cycle regulation among BPs;in constructing cell membrane,microtubule organization,chromosomes,and kinetochore among CCs;and functioning in phosphatidylinositol phosphate,Rho GTPase protein binding,transmembrane transport,and protein kinase regulatory activity among MFs.Downregulated DEGs were mainly involved in cytoplasmic translation,protein membrane localization,mRNA metabolism,and protein endoplasmic reticulum localization among BPs;in forming ribosome subunits,cell membrane,and autophagy among CCs;and functioning in single-stranded DNA,ribonucleoprotein complex,growth factor binding,regulating protein kinase activity,and catalytic activity among MFs.Seven signaling pathways were significantly enriched in upregulated genes,most notably in the biosynthesis of glycosylphosphatidylinositol(GPI)anchors;whereas 18 signaling pathways were significantly enriched in the downregulated genes,most notably in ferroptosis.The RT-qPCR results showed that compared with control group,the expression levels of GPX4,Ftl1,and Tp53 mRNA in the cells in model group were significantly decreased(P<0.01),while the expression level of GPLD1 mRNA was significantly increased(P<0.01);compared with control group,the expression level of α-SMA mRNA in the cells in model group was significantly decreased(P<0.01),and the expression levels of ALP and BMP2 mRNA were significantly increased(P<0.01).Conclusion:The VSMCs underwent calcification and normal cells exhibit the DEGs.The key signaling pathways in the calcification induced by high phosphate in the VSMCs include ferroptosis and GPI anchor biosynthesis,mediated primarily through GPX4,Ftl1,Tp53,and GPLD1.