Objective To explore the effects of the multidisciplinary cooperative continue nursing on the quality of life of patients with chronic obstructive pulmonary disease (COPD). Methods From December 2012 to December 2014, hospitalized COPD patients who were in the stable stage of disease and would soon be discharged and met the criteria standards were chosen. Convenient extraction of 64 patients were set as the experimental group in one ward and 50 patients as the control group in the other ward. The conventional discharge guidance was employed in the control group. While the continuation of care before discharge and 1, 3, 6 months after discharge was employed in the experimental group. The indexes such as the quality of life and 6 min walking test distance (6MWD) were observed and compared. Results The total scores and symptoms, activities, influence scores of the quality of life were 48.53±15.78, 35.38± 18.61, 57.95 ±23.69, 52.28 ±15.27 after 6 months intervention in the experimental group and 60.24 ±10.14, 52.76 ±12.36, 68.34 ±15.59, 58.55 ±11.79 in the control group, and there were significant differences (t=-5.69--2.38, P<0.05). 6MWD was (267.46 ±64.64) m after 6 months intervention in the experimental group,which was more than that before intervention (169.42±48.46) m, and there was significant difference (t=-9.71, P<0.01). 6MWD was (201.32±53.93) m after 6 months intervention in the control group, which was not significantly better than that in the experimental group (t=5.82, P<0.01). Conclusions The quality of life of patients with COPD can be significantly improved by the multidisciplinary cooperative continue nursing education after discharge.

In this review, the author analyzed the challenges in modern research and development of Traditional Chinese Medicine (TCM) products. Chinese traditional and herb drugs have gained interest from the international medical, biomedical and pharmaceutical institutions as potential source of valuable medicinal agents. For the researches and development of TCMs, the first challenge is to evaluate the efficacy, pharmacological properties, action mechanism and active chemical constituents. The second one is to summarize the issues for developing safety research methodologies, to improve the quality and enhance the value of research in TCM and to provide appropriate evaluation methods to facilitate the regulation and registration of TCM products, and the third is to study drug metabolism and pharmacokinetics, and the fourth is to apply new "-omics" techniques and tools in new revolution in drug discovery-development and to impact on modern research of TCM products. This interest is needed to apply modern research on the development and exploration of the promising medical potential resources of Chinese traditional and herbal drugs, especially from medicinal plants.

Objective To investigate the effect of alanyl-glutamine (Ala-Gln) on acute lung injury (ALI) in rats induced by sepsis and its mechanisms. Methods Forty healthy adult Wistar rats were randomly divided into a control group, a lipopolysaccharide (LPS)-induced shock group, an Ala-Gln treated group, and a glutamine (Gin) treated group. The control group received an intravenous infusion of 28 mL/kg lactated Ringer's solution(LR). The LPS-induced shock group received an intravenous administration of 25 mL/kg LR, and then 3 mL/kg (6 mg/kg) LPS (L-2880, Sigma, America). The AlaGin treated group received 4.5% Dipeptiven (25 mL/kg, equaling 0.75 g/kg Gin) immediately before 3 mL/kg (6 mg/kg) LPS. The Gin treated group received 3% glutamine (25 mL/kg, 0.75g/kg) immediately before 3 mL/kg (6 mg/kg) LPS. Serum (1 mL) was drawn via the femoral vein or cardiac puncture before LPS injection (T0) and 6 h after the administration of LPS (T1), respectively. All rats were killed 6 h after LPS infusion. The samples of pulmonary tissue and lung lavage fluid were collected after experiments. Tumor necrosis factor-α (TNF-α), interleukin-1β( IL-1β), and interleukin-8(IL-8) in the serum at T0 and T1 were detected by ELISA. Apoptosis in the lung epithelial cells was detected with TUNEL assays. The lung wet/dry(W/D) weight ratio and total protein in the bronchoalveolar lavage fluid (BALF) were measured. Results Six hours after the infusion of LPS (T1), the plasma concentrations of TNF-α, IL-1β, and IL-8 were much lower in the Ah-Gln treated group and the Gin treated group than those in the LPS-induced shock group (P < 0.05). Compared with the LPS-induced shock group, AlaGin and Gin significantly reduced the increase in the lung wet/dry weight ratio (P<0.05) and attenuated the morphological lung damage. Conclusion Intravenous administration of Ala-Gha can effectively protect the lung from sepsis induced injury.

Objective To study the mutants of pre C/C gene and the base core premotor (BCP) in chronic hepatitis B patients carrying or not carrying hepatitis B e antigen (HBeAg). Method The HBV DNA of BCP and PreC/C ware amplified by PCR from serum samples of patients with chronic hepatitis B, and the products were cloned into T vector and sequenced. Results Of BCP variants, the double mutations of T1762/ A1764 were found in 20 of 42 patients with chronic hepatitis, and the prevalence was significantly lower in HBeAg positive patients (7/20) than in HBeAg negative patients (13/22) (P

Objective To investigate the correlation of preoperative pain threshold and pain tolerance threshold with the intensity of stress reaction induced by endotracheal intubation and skin incision. Methods Fifty ASA Ⅰ or Ⅱ women, aged 20-55 yr, undergoing elective abdominal surgery requiring at least a 10-cm-long skin incision under general anesthesia, were studied. The electricity dolorimeter was used to measure the patients' pain sensitivity, including pain threshold and pain tolerance, and a State Trait Anxiety Inventory (STAI) was also used to examine the mental state the day before surgery. Total intravenous anesthesia was performed in all the patients.Anesthesia was induced with TCI of propofol 4 μg/ml (effect-site concentration). After patients lost consciousness,fentanyl 3 μg/kg and vecuronium 0.1 mg/kg were injected intravenously. Tracheal intubation was performed 3 min later and the patients were mechanically ventilated. MAP and HR were recorded and arterial blood samples were taken for determination of plasma concentrations of norepinephrine (NE) at 10 min after entering operation room (T1), immediately before intubation (T2), 2 min after intubation (T3), immediately before incision (T4) and 2 min after incision (T5). The differences in MAP, HR and plasma concentrations of NE before and after intubation and skin incision were calculated. SPSS 13.0 statistical software was used to analyze the correlation of STAI,pain threshold, and pain tolerance threshold with the differences in MAP, HR and NE before and after intubation and skin incision. Results Pain threshold was not correlated with the differences in MAP, HR and NE (P ＞0.05). Pain tolerance threshold was negatively correlated with the differences in MAP (r= - 0.766, r =-0.688,P＜0.05), HR (r=-0.703, r=-0.638, P ＜ 0.05) and NE (r=-0.781, r=-0.781, P＜0.05). The STAI score was not correlated with pain threshold and pain tolerance threshold (P ＞ 0.05) .Conclusion Preoperative pain tolerance threshold is negatively correlated with the intensity of stress reaction induced by endotracheal intubation and skin incision, but there is no correlation between pain threshold and the intensity of stress reaction.

Fifty-two patients exactly diagnosed as rheumatoid arthritis in the active stage in clinic were treated by acupuncture plus western medicine. Thirty days made up a course of treatment. There were significant differences in clinical symptoms, signs, and immunological indexes between pretreatment and posttreatment (P<0.05, P<0.01). The treatment of rheumatoid arthritis in the active stage by acupuncture plus western medicine could effectively regulate humoral immunity and enhance the clinical therapeutic effect.

Objective Describes the use of homemade simple bedside bracket of children supracondylar fracture closed reduction and percutaneous pin fixed surgical methods and clinical effects.Methods 16 cases of children supracondylar fractures Gartland type Ⅱ cases,15 cases Gartland type Ⅲ,13 males and 3 females,with an average age of 6 years old,all patients used our hospital homemade simple bedside shelf assisted closed reduction,percutaneous pin fixation,and fixed with plaster immobilization.Results 16 patients were followed-up,in addition to the two cases of pin tract infection,fracture all were healed smoothly.Without iatrogenic nerve injury and internal fixation loosening,and also no volkmann contracture,and myositis ossificans etc complications.The average fracture healing time for three weeks,no bone delayed union or nonunion occurred.According to Flynn clinical function evaluation,there were excellent in 7 cases,good in 9 cases.Conclusion Useing homemade simple bedside shelf to children supracondylar fractures closed reduction and percutaneous Kirschner wire fixed can ensure the efficacy,and also simplify the surgical procedure,reduce radiation intake,which is the worthy of clinical practice.

OBJECTIVE:To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemo-therapy alone for non-small lung cancer(NSCLC),and to provide reference for drug payment and clinical treatment. METHODS:By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with che-motherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS:5 dimensions FACT-L score:the patients of Shenqi fuzheng injection combined with chemo-therapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score:the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group (1 632.44 vs. 11 145.30),and incremental cost-effectiveness ratio was 448.69. ZPS score:Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone(-17 398.77 vs. 384 513.00). Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs(1 313 326 yuan vs. 13 374 365 yuan). CONCLUSIONS:Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemo-therapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.

Objective To investigate hepatic histological features and its influencing factors of HBeAg-negative chronic hepatitis B patients. Methods 134 HBeAg-negative chronic hepatitis B (CHB) patients who underwent percutaneous liver biopsy were recruited in this study. The liver biopsy sections were examined after routine haematoxylin-eosin (HE) staining, and silver staining for assessment of fibrosis. The activity of liver disease was assessed by using a modified Knodell numeric histology activity index (HAI). ALT level, HBV DNA load, HBV serological markers, HBV genotype were assessed with appropriate methods. t test or analysis of variance was used to compare means. Non-parametric was done by Kruskal-Wallis test. The correlation between liver pathological change and clinical factors was analyzed by multivariate linear regression. Results Of 134 HBeAg negative CHB patients, percentages of mild (HAI 4 ~ 8), moderate (HAI 9 ~ 12), and severe hepatitis (HAI 13 ~ 18) were 26.9%, 26.1%, and 47.0%, respectively. As for hepatic fibrosis, 18.7% and 81.3% of the patients had fibrosis score < 3 and ≥3, respectively. Multivariate regression analysis showed that ALT level and hepatic fibrosis were correlated to hepatic inflammation (t = 6.687,P < 0.01; t = 3.478, P < 0.01) while age and hepatic inflammation activity were influencing factors of hepatic fibrosis (t = 3.587, P < 0.01; t =7.136, P < 0.01). However, correlation is not significant between hepatic histological change and other factors, including gender, HBVDNA, HBV genotype and HBeAb status. Conclusions In this study, hepatic histological change tend to become worse in majority of HBeAg-negative chronic hepatitis B , especially in older patients and those with high ALT level.

We investigated the baseline brain activity level in patients with major depressive disorder (MDD) by am plitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). We examined 13 patients in the MDD group and 14 healthy volunteers in the control group by resting-state fMRI on GE Signa 3.0T. We calculated and compared the ALFF values of the two groups. In the MDD group, ALFF values in the right medial prefrontal were higher than those in control group, with statistically significant differences (P < 0.001). ALFF values in the left parietal in the MDD group were lower than those in control group with statistically significant differences (P < 0.001). This resting-state fMRI study suggested that the alteration brain activity in the right medial prefrontal and left parietal ALFF contributed to the understanding of the pathophysiological mechanism of MDD patients.
Brain ; physiopathology ; Brain Mapping ; Case-Control Studies ; Depressive Disorder, Major ; physiopathology ; Humans ; Magnetic Resonance Imaging