Objective To explore the application of humanistic nursing model in clinical nursing in psychotic patients. Methods 132 patients from January,2007 to January,2010 were retrospectively analyzed and randomly divided into the research group and the control group with 66 patients in each group.The control group was given routine nursing,the research group was given additional humanistic nursing based upon routine nursing.The nursing effect was compared between the two groups. Results The research group had apparent advantage in hospitalization time,satisfactory degree and treatment compliance comparing with the control group. Conclusions Humanistic nursing can wholly include the physiological,psychological,social,mental and culture factors of patients,so it can satisfy individual nursing care for psychotic patients.

Objective To establish the method of anti-cell membrane associated DNA (mDNA) antibody detection, to evalute its sensitivity and specificity in systemic lupus erythematosus (SLE), and to analyze the relationship between anti-mDNA antibody and the clinical features of SLE. Methods Indirect immunofluorescence assay was used to measure anti-mDNA antibodies in sera of 207 SLE patients, 167 patients with other rheumatic diseases and 82 healthy controls. Using indirect immunofluorescence to detect the expression of mDNA with positive standard serum samples on nine cultured cell lines and pre-treated cells by DNAse, RNAse or trypsin. Results Of the serum samples, 73.3% SLE and 5.4% other rheumatic diseases were positive for anti-mDNA, but negative in 82 blood donors (P0.05). This study also proved that mDNA was expressed on B and T lymphocytes, the strongest staining was expressed on Raji cell line. The mDNA molecule was confirmed by pattern extinction on the cells pre-treated with DNAse but not RNAse or trypsin. Conclusion Anti-mDNA antibody is one of the most valuable marker in the diagnosis of SLE. Anti-mDNA antibody is valuable in diagnosis of SLE with negative anti-dsDNA, Sm, DNP, AHA and AnuA antibodies; but it has no significant with relationship the disease activity of SLE.

Objcetive To evaluate the clinical significance of bone biochemical metabolic markers in osteoporosis( OP),and investigate the clinical application value of the determination.Methods BMD at various skeletal sites was measured by XR-36 dual energy X-ray absorptiometry for 65 patients.Enzyme linked immunosorbent assay (ELISA) were used to determine bone biochemical metabolic markers in sera of 65 patients with osteoporosis and 62healthy controls.Results The levels of serum TRACP5b and 25-OH-VD3/25-OH-VD2 in OP group were higher than that in control group( P ＜0.05),meanwhile the level of BGP,BAP and Ca were varying degrees higher than that in control group,but the level of P was lower than that in control group.Conclusion TRACP5b,BGP,BAP,VD3/2 and other bone metabolic markers can be used as indicators of early detection of osteoporosis,in order to provide valuable data for early treatment of osteoporosis.

10.3969/j.issn.2095-4344.2013.25.025

Objective To observe the effect of inhaled glucocorticoids combined with theophylline in smoking patients with bronchial asthma.Methods Seventy-three patients with bronchial asthma were enrolled in this study and they were divided into observation group (34 cases,smoker) and control group(39 cases,no-smoker).They all accepted inhalation of budesonide 200 μ g/suck,bis in die,plus aminophylline tablet (0.1 g,ter in die,per os) for 3 months.After treatment for 3 months,the basal control rate was compared between two groups.The levels of asthma control test (ACT) score,peak expiratory flow (PEF),the first second forced expiratory volume accounted for the percentage of prediction (FEV1％pred),eosinophil leukocyte (EOS) count and immunoglobulin E(IgE) in two groups before and after treatment for 3 months were compared too.Results After treatment for 3 months,the basal control rate in observation group was 88.24％ (30/34),in control group was 92.31％(36/39),and there was no significant difference(P＞ 0.05).After treatment for 3 months,the levels of ACT score,PEF and FEV1％pred in two groups were increased and the levels of EOS count and IgE were decreased than those before treatment,and there were significant difference (P ＜0.05).After treatment for 3 months,the levels of ACT score,PEF,FEV1％ pred,EOS count and IgE in observation group were (22.43 ± 2.64) scores,(292.52 ± 98.64) L/min,(74.87 ± 4.83)％,(270 ± 180) × 106/L,(68.25 ± 13.89) U/L,in control group were(22.81 ± 2.27) scores,(300.34 ± 100.45) L/min,(75.26 ± 5.04)％,(210 ± 170) × 106/L,(65.47 ± 11.28) U/L,and there were no significant differences (P ＞ 0.05).Conclusions Low dose inhaled glucocorticoids combined with theophylline in treatment smoking and non-smoking asthmatics patients are equal.It can improve asthma symptoms and lung function,improve hormone sensitive and reduce airway inflammation.

Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,P<0.05 or P<0.01〕. The areas under the ROC curve(AUC)made by combinations of Cys C,Cr and Urea for the diagnosis of renal damage were 0.908,0.817 and 0.785. In the four different kinds of combination of the indicators,the AUC were sequentially arranged from large to small area as follows:Cys C+Cr+Urea=Cys C+Cr>Cys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.

Objective To discuss the intervention effect of four oral care model on compliance of atomizing inhalation and mouth and throat complications in outpatient infants and young children patients. Methods A total of 480 cases of children patients using budesonide inhalation for the treatment of respiratory tract infection were divided into the observation group(n=260)and the control group (n=220) according to the time sequence. The control group received conventional nursing, the observation group used quaternity oral care model in nursing care. The compliance and occurrence of complications in the mouth and throat were observed between the two groups. Results In the observation group with nebulae inhalation compliance was 79.2% (206/260), evidently higher than that in the control group the compliance of 58.6%(129/220) (χ2=23.97,P<0.01). The incidence of oral herpes and ulcers in the control group was 2.73%(6/220), and 0.77%(2/260) in the observation group, but no significant difference was seen (χ2=2.79, P>0.05). The incidence of thrushes was 3.64%(8/220) in the control group, and none occurred in the observation group, which showed significant difference (χ2=9.62, P<0.01). Conclusions Using quaternity oral care model in corticosteroid nebulae inhalation patientscan increase compliance and decreasecomplications of oral and throat of outpatient children.

Objective To investigate the diagnostic value of laboratory evaluation of renal injury in early diagnosis index. Methods Eighty-six patients in in-patient and out-patient of the department of urology were tested in serum C (Cys C), serum creatinine (Cr) and serum UREA nitrogen (UREA). According to the diagnostics (sixth edition), we evaluated their values for diagnosis of renal injury by analyzing the characteristics of the work curve (ROC). Results According to the renal function indexes, 3 groups were divided such as group A (normal renal function control Ccr 80 mL/min) or the Cys C, Cr, and UREA in (0.47 ± 0.24) mg/L, (85 ± 14) μmol/L, and (4.55 ± 1.33) mmol/L, group B (a decrease in renal function reserves, and renal insufficiency 20 mL/min or less Ccr < 80 mL/min) of Cys C, Cr, and UREA in (1.59 ± 1.29) mg/L, (214 ± 173) μmol/L, and (11.04 ± 8.24) mmol/L and group C (renal failure and uremia Ccr < 20 mL/min) of Cys C, Cr, and UREA in (3.47 ± 0.75) mg/L, (669 ± 466) μmol/L, and (21.22 ± 13.10) mmol/L respectively. As reducing in Ccr, Cys C, Scr and UREA concentration increased and correlated with Ccr negatively. According to the mazimum Youden index, the critical values of Cys C, Cr, and UREA were 0.90 (mg/L), 115 (μmol/L) and 7.33 (mmol/L) separately, the sensitivity (%), specificity, positive predictive value (%), negative predictive value (%), diagnostic accuracy (%) and the area of the ROC curve (AUC) were Cys C (77.3%, 97.6%, 97.0%, 81.1%, 77.3%, 0.908), Cr (65.9%, 97.6%, 96.5%, 74.1%, 65.9%, 0.817), and UREA (63.6%, 97.6%, 96.4%, 72.8%, 63.6%, 0.785) respectively. The diagnostic accuracy showed that the Cys C > Cr > UREA. Their correspounding ROC curve (AUC) were in the area of 0.908, and 0.785 and 0817. Cys C had the highest AUC (0.908), and achieved a good diagnosis effect. Conclusion Renal damage laboratory indexes of in the early diagnosis, Cys C has a higher sensitivity and specificity to be worth of clinical promotion.

Objective To study the optimized process for effective components in Danggui-Buxue pill by orthogona design,and provide the basis for the establishment of quality standard.Methods Ferulie acid and ligustilide were used as examining index,the extraction time,solvent volume and extraction times were used as factors.L9(34) orthogonal test table was used to determine the optimum extraction process.HPLC method was used to establish methodology for ferulie acid and ligustilide.Results According to the result of orthogonal design,comprehensive consider determining the extraction efficiency of ferulic acid and ligustilide the optimal extraction technology as follows:1.0 g Danggui-Buxue pill was extracted by 30 ml of methanol for 60 min,extraction times for 2 times.Conclusions This method is simple with high efficiency.Its HPLC method has high precision and good reproducibility,which can be used for analysis Danggui-Buxue pill.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) singling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by zinc sulfate preconditioning in rats.Methods SPF healthy male Sprague-Dawley rats,weighing 250-280 g,aged 16-20 weeks,were used in this study.After the animals were anesthetized,their hearts were immediately removed and retrogradely perfused with an oxygenated K-H solution at 37 ℃ in a Langendorff apparatus.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each):control group (group C),I/R group,zinc sulfate preconditioning group (group Zn) and zinc sulfate preconditioning plus Nrf2/ARE singling pathway blocker luteolin group (group Zn+Lut).After 20 min of equilibration,the hearts were continuously perfused for 100 min in group C,the hearts were perfused with 4 ℃ St.Thomas′ cardioplegic solution before ischemia and then subjected to 40 min global ischemia followed by 60 min reperfusion to establish the model of I/R in group I/R,200 μmol/L zinc sulfate 1.5 ml/kg was injected intraperitoneally,and 24 h later the model of I/R was established in group Zn,and in group Zn+Lut,the hearts were perfused for 3 min with K-H solution containing luteolin 50 μmol/L starting from the time point immediately before ischemia,and the other treatments were similar to those previously described in group Zn.Heart rate (HR),left ventricular end diabetic pressure (LVEDP),left ventricular developed pressure (LVDP) and the maximum rate of increase of left ventricular pressure (+dp/dtmax) were recorded at the end of equilibration and reperfusion.Coronary effluent was collected at the end of reperfusion to measure the levels of lactate dehydrogenase (LDH) and malondialdehyde (MDA).The expression of heme oxygenase-1 (HO-1),quinone oxidoreductase (NQO1),superoxide dismutase 1 (SOD1) and Nrf2 in myocardial tissues was detected by Western blot.Results Compared with group C,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion in I/R and Zn+Lut groups,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in I/R,Zn and Zn+Lut groups (P<0.05).Compared with group I/R,the HR,+dp/dtmax and LVDP were significantly increased,LVEDP was decreased,and the levels of LDH and MDA in coronary effluent were decreased at the end of reperfusion,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in group Zn (P<0.05).Compared with group Zn,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion,and the expression of NQO1,HO-1 and SOD1 was down-regulated(P<0.05),and no significant change was found in Nrf2 expression in group Zn+Lut (P>0.05).Conclusion The mechanism by which zinc sulfate preconditioning reduces myocardial I/R injury is related to activation of Nrf2/ARE singling pathway in rats.