ObjectiveTo investigate current status of community health management for hypertensive patients.Methods A total of 59 communities from 5 provinces of China were selected by cluster sampling methods,and 55 communities responded.The detailed health management for hypertensive patients was collected through structured interviews. Results (1) Self-management support in health education:the rates of diet control,physical exercise and medication guide were 100.0％ (55/55),96.4％(53/55) and 98.2％ (54/55),respectively,and the rates of home blood pressure monitoring,patientdoctor cooperation,and social mental guidance were 83.6％ (46/55),85.5％ (47/55) and 85.5％ (47/55),respectively.(2) Delivery system redesign:the rates of doctor training,branch cooperation,routine follow-up study and health promotion were 100.0％ ( 55/55 ),67.3％ ( 37/55 ),72.7％ (40/55) and 74.5 ％ (41/55),respectively.(3) Decision support:the rates of embedding evidence-based guidelines on daily clinical practice,expert consultation and health maintenance were 72.7％ (40/55),67.3％ (37/55)and 92.7％ (51/55),respectively.(4) Clinical information systems:the usage rates of long-term followup or monitoring system were 80.0％( 44/55 ) and 89.1％ ( 49/55 ),respectively. ( 5 ) Community resources and policies:the rates of health promotion,environment supporting and community action were 96.4％ (53/55),72.7％ (40/55) and 85.5％ (47/55),respectively.(6) Health system support:the rates of using effective evaluation indexes,senior leader supporting,continuous policy making and increased reimbursement of medical insurance in health-care organizations were 81.8％ (45/55),85.5％ (47/55),74.5％ (41/55) and 61.8％ (34/55),respectively.The rates of providing incentives,increasing staff in community,encouraging general practitioner to participate in policy making and increasing the salary of general practitioner were 58.2％ (32/55), 50.9％ ( 28/55 ), 54.5％ ( 30/55 )and34.5％ ( 19/55 ),respectively.ConclusionThe community hypertension management in some areas of China considers the principles of chronic disease models,and may play an important role in the prevention and control of high blood pressure in communities.

Objective To investigate the observation and nursing for patients with atria] fibrillation (AF)after left atrial linear ablation surrounding ipeilateral pulmonary veins (PVs). Methods Thirty patients with persistent AF underwent left atrial linear ablation surrounding ipsilateral PVs guided by CARTO electroanatomic mapping system and double Lasso catheters technique. The end point of ablation was defined as absence of all PV spikes after isolation and bidirectional conduction block between left atrial and PVs. Results After a median of (245±65)days of follow-up, twenty-one patients were free of AF. Eight patients subjected recurrent atrial tachyarrhymias, including 5 typical AFL, 2 atrial taehycardia and 1 paroxysmal AF. Two patients with persistent AF remaining PV spikes in left superior PV failed to be translated to sinus rhythm. Nine patients underwent repeated ablation and 8 of them were free of atrial taehyarrhythmia after (192±92) days follow-up. Total success rate after two procedures was 92.8%. Conclusions Nurses should perform effective care according to the symptom of patients before, during and after ablation procedure and relieve the patients from pain.

Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

Adaptor Proteins, Signal Transducing ; chemistry ; metabolism ; Animals ; Apoptosis ; Cell Differentiation ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Neoplasms ; pathology ; Phosphorylation ; Protein Isoforms ; RNA-Binding Proteins ; chemistry ; metabolism ; Transcription Factors ; antagonists & inhibitors

Objective To investigate the level of alpha-synuclein (α-syn) oligomers in peripheral blood plasma and red blood cells (RBC) in patients with Parkinson's disease (PD), and the value of it for diagnosis and evaluation of PD. Methods From March, 2013 to De-cember, 2014, peripheral blood samples were collected from 30 PD patients and 30 healthy coutrols, and the level ofα-syn oligomers in plas-ma and RBC was detected with enzyme linked immunosorbent assay. Results The level of α-syn oligomers was less in both plasma and RBC in the controls than in the patients (t>2.346, P<0.05), and was more in RBC than in plasma in both the controls and the patients (t>2.242, P<0.05). The level ofα-syn oligomers of patients did not correlate with their course, Hoehn-Yahr Stage, the scores of Unified Parkin-son Disease Rating Scale Part 3, Non-Motor Symptom Quest and Mini-Mental State Examinatlon, both in plasma and RBC (P>0.05). Con-clusion The level ofα-syn oligomers in peripheral RBC and plasma may be helpful for diagnosis of PD, but less for the evaluation of the ill-ness.

Liver transplantation is one of the main treatments for acute and chronic liver failure currently.In recent years,with the lack of donor liver transplantation and the in creasing number of patients,the major donator of liver transplant is brain dead patients.In brain-dead state,organ functions de cline gradually.Changes in hemodynamics and immunity could lead to inflammation and alter hormone release.Organ survival and patients'prognosis can be unpredictable.The study of the above phenomenal mechanisms is still at an early stage.This article summarized the current liver transplant treatments by explai ning the pathophysiology of donor organ damage and reviewing the prognosis.The aim of this article was to provide a perspective for future study on this topic.

Objective To analyze the perioperative conditions and long-term survival of patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods 119 patients with NSCLC underwent thoracoscopic lobectomy from January 2006 to December 2012 were enrolled in the study, then collecting and analyzing their perioperative indicators, pathological results and follow-up data. Results 9 patients converted to thoracotomy with a conversion rate of 7.0 %. The median operation time, the median intraoperative blood loss and off-bed activity time were 170 min (65~440 min), 90 ml (15~3 000 ml) and (32.9 ± 16.3) h after operation respectively. The time and amount of postoperative drainage, the length of hospital stay were (6.7 ± 3.2) d, (1 690.0 ± 410.5) ml, (9.2 ± 4.0) d respectively. The incidence of perioperative mortality and postoperative complications were 0.8 %, 13.4 % respectively. For postoperative pathological type, 96 cases of adenocarcinoma, 19 cases of squamous carcinoma, 2 cases of adenosquamous carcinoma and 2 cases of large cell carcinoma. For discharge patients, the median follow-up time was 34.5 months (0 ~ 102 months). The incidence of local recurrence and distant metastasis in observation group were 5.0 % and 17.6 % respectively. 1-year overall survival (OS) and disease free survival (DFS) were 85.3 % and 79.5 %, 3-year OS and DFS were 69.8 % and 64.8 %, 5-year OS and DFS were 60.8 %and 58.6 % respectively. There was no significant difference in 1-year, 3-year and 5-year OS and DFS between adenocarcinoma and squamous carcinoma (P > 0.05) while there were significant difference in local recurrence and distant metastasis among different stages (P < 0.05). In addition to slightly low OS, DFS of Ⅲ a , Ⅲ b and Ⅳ DFS and OS, the overall living conditions among all stage were similar. Conclusions The long-term survival condition of thoracoscopic lobectomy for NSCLC is ideal, and it’s a safe and effective operation, worthy of clinical promoting.

Objective · To design an immuno-affinity chromatography device for the separation and detection of syphilis specific antibody, then verify its performance of detection and clinical application. Methods · Affinity filler packed by Treponema pallidum (TP) antigen in affinity chromatography can specifically adsorb TP specific antibody (including IgG and IgM) in samples. After balance, elution and desalination, IgG or IgM gold labeled chromatography strip detects the possibly present syphilis specific IgG or IgM antibody. Twenty cases of syphilis antibodynegative samples and 230 cases of syphilis antibody positive clinical specimens were detected by this chromatography device, and 40 cases were also detected by Western blotting.Results ·The standard operation procedure of the affinity chromatography device was optimized, which could effectively detect the specific IgG and IgM antibody of syphilis. The results of 20 syphilis antibody negative samples were all negative. In 230 syphilis antibody positive cases, the detection results were 2 cases with TP-IgG(-) and TP-IgM(-), 210 cases with TP-IgG(+) and TP-IgM(-),10 cases with TP-IgG(-) and TP-IgM(+), and 2 cases with TPIgG(+)and TP-IgM(+). The detection results of 40 cases were compared with the results detected by Western blotting, among which 2 cases detected by affinity chromatography device were TP-IgG(-) and TP-IgM(-), while the results detected by Western blotting were TP-IgG(+) and TP-IgM(-). But the results of the two methods showed no statistically significant difference (P>0.05). Conclusion · The application of the device in separation and detection of IgG and IgM antibodies against TP pathogens is feasible, and it has important value for further application in clinical diagnosis.

Objective To study the effect of magnetic field on serum activity of superoxide dismutase (SOD), content of malon-dialdehyde (MDA)and content of nitric oxide (NO)in patients undergoing operation for pituitary Tumor. Methods Sixteen ASA Ⅰor Ⅱ patients undergoing pituitary tumor surgery under general anesthesia were randomly divided into 2 groups (n=8 each): magnetic field group (M) and control group (C). Patients in magnetic field group were exposed in 150 mT magnetic field during the operation period.Blood samples were taken from radial artery for determination of serum SOD,MAD and NO before induction of anesthesia(T_0, baseline),after induction(T_1),70 min after induction(exposed in magnetic field for 60 min) (T_2)and 130 min after induction (exposed in magnetic field for 120 min) (T_3). Results There was no significant difference between the two groups in age, sex (M/F ratio),body weight,body height,duration of operation and duration of anaesthesia.The serum activity of SOD and content of NO were significantly higher at T_3 in group M than that in group C,and the serum content of MDA was lower at T_3 in group M than that in group C. Conclusions The magnetic field not only increases serum SOD activity and the content of NO in patient undergoing operation for pituitary tumor,but also reduces the content of MDA in them.

Objective To detected the motor cortex reorganization and compared the influence on reorganization process as regard to different transfer modes of contralateral seventh cervical nerve root (C7)in young rats model of total brachial plexus root avulsion. Methods The young Sprague-Dawley rats model of total brachial plexus root avulsion was established. The left radix dorsalis and radix ventralis from the fifth cervical nerve root (C5) to the first thoracic nerve root (T1)were exposed and the roots from C5 to T1 were avulsed from the spinal cord. Then, the contralateral C7 transfer operation was performed. Three different operative modes were applied randomly which included contralateral C7 transference to anterior division of the upper trunk (group A, n=30), to both musculocutaneous and median nerves (group B, n=30), or to median nerve (group C, n=30). The movement evocation of motor cortex was measured by intracortical microstimula-tion in both hemispheres, and functional reorganization was assessed dynamically in 1.5, 3, 6, 9 and 12 months after operation. Results After contralateral C7 transference, the ipsilateral motor cortex initially acti- vated the injured limb at 1.5 month, and subsequently the motor cortex of both hemispheres activated the in-jured limb at the 3rd and 6th month. The injured limb was activated mainly by the contralateral motor cortex in group A at the 9th month. The contralateral motor cortex exclusively controlled the injured limb in all three groups at the 12th month after the operation. Meanwhile, the extent of functional reorganization was better in group B than that of group C. Conclusion After contralateral C7 transfer operation, motor cortex in charging injured limb developed a transhemispheric functional reorganization in young rats with total brachial plexus root avulsion. Different operative modes contributed to the functional reorganization of motor cortex. Transferring contralateral C7 to anterior division of the upper trunk or to both musculocutaneous and median nerves provided better functional reorganization than to median nerve.