Objective To observe the efficacy, safety and feasibility of the four kinds of anticoagulation method in hemodialysis patients with high risk of hemorrhage. Methods 128 patients with high risk of hemorrhage who had undergone hemodialysis were randomly divided into four groups. In group A, 68patients were resorted with 30% regional sodium citrate anticoagulation(RCA). In group B, 60 patients were treated with local heparin anticoagulation. In group C, 64 patients were treated with low molecular weight heparin (LMWH). In group D, 66 patients received no heparinization hemodialysis. The changes of bleeding, clotting function, adverse effect and nursing strategies were studied. Results All patients of group A completed regular hemodialysis with satisfactory indices, 6 cases with bleeding and primary bleeding aggravated in group B, 8 cases with bleeding and primary bleeding aggravated in group C, 8 cases occurred grade three coagulation and finished dialysis in group D. 3 cases in group A and 2 cases in group B occurred adverse reaction, but no adverse reaction was seen in group C and D. Conclusions RCA is safe,effective and can be easily handled in regular hemodialysis. It is an ideal dialysate for hemodialysis in patients with high risk of hemorrhage.

Objective To investigate the expression of interleukin 18 (IL-18) in liver tissues of patients with chronic hepatitis B (CHB) and its clinical significance.Methods Totally 172 CHB patients admitted in the Second Affiliated Hospital of Anhui Medical University from January 2012 to December 2012 were enrolled.The tissue specimens were obtained by liver biopsy from all patients,and 22 normal liver specimens were also collected as controls.Liver function,serum markers of HBV and HBV DNA load were measured and liver inflammation grades and fibrosis stages were assessed.Immunohistochemical method was used to detect the expression of IL-18 in liver tissues.Spearman rank correlation was used to analyze the correlations between IL-18 expression and the above indicators.Results IL-18 was mainly expressed in cytoplasm of liver cells.It was positive or strong positive in liver cells of healthy people,but weakly positive in liver cells of CHB patients.The difference of IL-18 expression between CHB patients and healthy people was of statistical significance (x2 =42.124,P ＜ 0.05).In CHB patients,the expression of IL-18 was gradually enhanced with the increasing of ALT,inflammation grades and fibrosis stages (r =0.182,0.173 and 0.068,P ＜0.05),but it was not correlated with HBV DNA load and HBeAg (r =-0.05 and 0.041,P ＞0.05).Conclusion In CHB patients,the expression of IL-18 may be involved in liver injury and fibrosis formation.

As one of the important factors that impact the life of quality to the elderly,visual impairment has become a research highlight in developed countries.And some related results have been found out.It is in the primary stage of establishing the elderly community extending service system in China.Based on this background,literature about the impact of visual impairment on quality of life of the residential setting elderly and related interventions were reviewed.By drawing the experience from developed countries,we aim to innovate perfect interventions,improve the quality of life,avoid unexpected events such as fall and medication mistakes.

With the public hospitals expanding,the nurses at age of marriage or bearing are enrolled and account for large part of all health care workers in China.A significant percentage of nurses in the period of pregnancy or lactation,especially abortion and sterility,deteriorate the shortage of nursing human resources and the nurses' health.It is essential to cope with the matter in order to maintain the nurses and contribute to the professional development.In this paper,we review the human resource management of the nurses during the periods at home and abroad from the human resources,occupational protection and management approaches,which is contributed to supplement the human resource.

Objective To discuss significance of carcinoembryonic antigen level changes be-fore and after the treatment of gefinitib in patients with non-small cell lung cancer(NSCLC). Methods 40 patients with advanced NSCLC in Ⅲ~Ⅳ period were enrolled and given routine local chemotherapy and gEfitinib,and the therapy was which until the patients were intolerant to it.All the patients were given carcinoembryonic antigen (CEA)test before and after treatment and were divided into high CEA group and low CEA group according to CEA level before treatment.Follow-up lasted until December 2013,adverse reactions and PFS in 2 groups were observed.Results Before treatment,the difference was not significant in CEA levels in control group and uncontrolled group (P >0.05).After treatment,CEA levels in 2 groups were obviously lower than the treat-ment before (P <0.01)and CEA level in control group was obviously lower than that in the uncon-trolled group(P <0.01).Occurrence rate of adverse reactions in high CEA group was higher than low CEA group but the difference were not significant (P >0.05).Survival rates of 9 and 12 months in high CEA group were markedly higher than that in thee low CEA group (P <0.05). Conclusion CEA level can be considered as a biochemical index of assessing prognosis of gefitinib in treatment of advanced NSCLC.

Objective To discuss significance of carcinoembryonic antigen level changes be-fore and after the treatment of gefinitib in patients with non-small cell lung cancer(NSCLC). Methods 40 patients with advanced NSCLC in Ⅲ~Ⅳ period were enrolled and given routine local chemotherapy and gEfitinib,and the therapy was which until the patients were intolerant to it.All the patients were given carcinoembryonic antigen (CEA)test before and after treatment and were divided into high CEA group and low CEA group according to CEA level before treatment.Follow-up lasted until December 2013,adverse reactions and PFS in 2 groups were observed.Results Before treatment,the difference was not significant in CEA levels in control group and uncontrolled group (P >0.05).After treatment,CEA levels in 2 groups were obviously lower than the treat-ment before (P <0.01)and CEA level in control group was obviously lower than that in the uncon-trolled group(P <0.01).Occurrence rate of adverse reactions in high CEA group was higher than low CEA group but the difference were not significant (P >0.05).Survival rates of 9 and 12 months in high CEA group were markedly higher than that in thee low CEA group (P <0.05). Conclusion CEA level can be considered as a biochemical index of assessing prognosis of gefitinib in treatment of advanced NSCLC.

OBJECTIVETo evaluate the feasibility of developing brain-targeted nasal delivery system of scutellarin by the passage between nase and brain in nasal olfactory area.

METHODThe samples of cerebrospinal fluid (CSF) and blood were prepared by cranial puncture and femoral artery catheterization methods respectively according to the certain sampling time after drug administered. The scuteIlarin concentration of samples were determined by 125 marked method. Pharmacokinetic parameters were calculated by trapezoidal rule. The brain-targeted trendence were evaluated by the value of the index AUC(brain)/AUC(plasma).

RESULTThe distribution of scutellarin in brain following intranasal administration was different between tissues. Drug concentration in olfactory bulb achieved to peak at 5-15 min after intranasal administration, while in brain tissue was 30-60 min. Above all, peak concentration in olfactory bulb and olfactory region respectively were (574.8 +/- 205.), (323.4 +/- 128.3) ng x g(-10, both are higher than CSF, which is (123.2 +/- 29.3) ng x g(-1). Moreover, the distribution of scutellarin given by intranasally in brain was: olfactory bulb (OB) > olfactory region (OR) > cerebrospinal fluid (CSF) > cerebellum(CB) > medulla oblongata (MO) > cerebrum (CR); AUC(0-240) of olfactory bulb, olfactory region and CSF after scutellarin intranasal administration were 5.54, 5.07 and 5.51 times of that after intravenous injection, respectively. And the AUC(0-240) of other brain tissues after intranasal administration were also higher than that after intravenous injection. AUC(brain tissue)/ AUC(plasma) of every brain tissues by intranasally are all higher than that by intravenously remarkably. For instance, 5 min after intranasal administration, the value of AUC(CSF)/ AUC(plasma), AUC(OB)/AUC(plasma), and AUC(CR)/AUC(plasma) were 30.34, 56.93, and 6.14 times of that by intravenously.

CONCLUSIONPart of scutellarin could be straightly transported into brain by the intranasal administration. Its absorption pathway was: the molecule of Scutellarin throughed olfactory mucosa in nasal cavity into olfactory bulb in arachno-hypostegal cavity, and then entered into olfactory region, CSF, cerebrum and cerebellum gradually. It showed that olfactory bulb was the only way for drug molecule to go through nasal cavity into brain. It had a significant trendence of brain-targeted when compared to oral administration and intravenous injection, which indicated a certain feasibility to develop a brain-targeted nasal delivery system for scutellarin.

Administration, Intranasal ; Animals ; Apigenin ; administration & dosage ; pharmacokinetics ; Brain ; drug effects ; metabolism ; Drug Delivery Systems ; methods ; Glucuronates ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley

Background/Aims: Metabolic risk factors could accelerate hepatitis B virus (HBV)-related mortality; however, their impacts on disease severity in HBV-related acute on chronic liver failure (HBV-ACLF) patients remain unexplored. In this study, we assessed the effects of metabolic risk factors on the outcome of HBV-ACLF patients. Methods: This study retrospectively enrolled antiviral therapy naïve HBV-ACLF patients from a single center in China. Patients were evaluated according to Child-Turcotte-Pugh score, Model for End-Stage Liver Disease (MELD) score, 30-day, 90-day mortality and survival rate to estimate the prognosis of HBV-ACLF. The impacts of different metabolic risk factors were further analyzed. Results: A total of 233 patients, including 158 (67.8%) with metabolic risk factors and 75 (32.2%) without metabolic risk factors, were finally analyzed. Patients with metabolic risk factors had significantly higher MELD score (22.6±6.1 vs 19.8±3.8, p<0.001), 90-day mortality rate (56.3% vs 38.7%, p=0.017), and shorter median survival time (58 days vs 75 days: hazard ratio, 1.553; 95% confidence interval, 1.061 to 2.274; p=0.036) than patients without them. Moreover, metabolic risk factors were independently associated with patients’ 90-day mortality (hazard ratio, 1.621; 95% confidence interval, 1.016 to 2.585; p=0.043). Prediabetes/diabetes and hypertension were related to higher rates of infection and worse renal function in HBV-ACLF patients. Conclusions HBV-ACLF patients with metabolic risk factors, especially prediabetes/diabetes or hypertension, could have more severe disease and lower survival rates. In addition, the existence of metabolic disorder is an independent risk factor for HBV-ACLF patients’ 90-day mortality.

Objective To investigate the effect of different concentration of povidone-iodine solution on preoperative irrigation of the conjunctival sac .Methods A total of 150 patients were randomly divided into Group A, B and C, each group had 50 cases.All patients were performed with conventional intraocular surgery's preparation.First, 0.5%iodine solution was used to disinfect all patients'eyelid, surrounding skin and limbi palpebralis after entering operation room .Second, irrigation of the conjunctival sac was performed ( three different concentration separately ) before operation.1 minute later, bacterial culture of conjunctiva sac and immediately corneal fluorescein staining was done .The degree of conjunctival hyperemia and corneal epithelial damage under slit lamp were compared among groups .Results The negative rate of bacterial culture of conjunctiva sac of the groups using 0.025% iodine solution and 0.05% iodine solution were 92.0% and 94.0%.The effects were better than 78.0%of 0.01%iodine solution group.There were significant differences between groups (χ2 =7.197,P<0.05).0.05% iodine solution had a more serious effects and worse corneal epithelial damage compared with the other groups .There were significant differences between groups (χ2 =20.257,18.656, respectively;P<0.05).Conclusions 0.025% iodine solution has better bactericidal effect and higher efficiency , and has little damage to the cornea and conjunctiva , so it is more suitable to preoperative disinfection of conjunctival sac in operation in ophthalmology .

Objective:To investigate the intention to participate in health care in transitional children and adolescents with diabetes and analyze its influencing factors.Methods:This was a cross-sectional survey study. From March to October 2021, 185 children and adolescents with diabetes were selected as research subjects by convenience sampling method from People′s Hospital Affiliated to Jiangsu University. General data questionnaire, Participation in Health Care Intention Questionnaire, Health Literacy Scale and Diabetes Self-management Scale were used to investigate, and multiple linear regression was used to analyze the influencing factors of the population′s intention to participate in health care.Results:The transitional children and adolescents with diabetes participation in health care intention total score was (124.87 ± 16.31) points, the health literacy total score was (33.70 ± 4.38) points, diabetes self-management total score was (35.11 ± 5.19) points. The regression analysis found that age, course of the disease, diabetes type, family structure modes, health literacy, and self-management ability were the main factors influencing adolescents involved in health care intention ( t values were -1.99-2.66, all P<0.05), including health literacy ability and disease management ability was positively correlated with the disease ( r = 0.250, 0.232, both P<0.01). Conclusions:The transitional children and adolenscents with diabetes have a medium level of intention to participate in health care. The transitional children and adolenscents with older age, longer disease course and nuclear family structure had higher levels of health care intention. The higher the level of health literacy and self-management, the higher the level of intention to participate in health care, medical staff should take targeted measures to improve the intention to participate in health care, promote this group to improve disease management ability and quality of life.