Objective To investigate the effect of applying the evidence-based nursing in elderly hypertensive cerebral hemorrhage patients with minimally invasive therapy.Methods 78 cases of hypertensive cerebral hemorrhage patients with minimally invasive treatment were recruited from May 2010 to May 2011.According to the conventional method of random numbers,they were divided into the evidencebased group and the conventional group with 39 cases in each group.The evidence-based group received evidence-based nursing,while the conventional group received conventional clinical nursing.The nursing effect of the two groups was observed.Results The satisfaction degree of the evidence-based group and conventional nursing group was respectively 94.9％ and 79.5 ％.There was statistically significant differences.The score of SDS,SAS and BI before treatment between two groups showed no significant difference,while it showed statistically significant differences after treatment between two groups.The complication rate of the evidence-based group and the conventional nursing group was respectively 10.2％ and 35.9％.There was statistically significant differences.Conclusions It is feasible to implement evidence-based nursing in the elderly hypertensive cerebral hemorrhage patients with minimally invasive therapy.It can effectively improve the patients' negative emotions,enhance daily living and quality of life.It is simple and can effectively reduce the incidence of complications.Thus,it is worthy of clinical application.

Objective To investigate the expression and significance of ERα (estrogen receptorα),ERβ(estrogen receptorβ),PR,and Bcl-2 of endometrial polyps.Methods 50 cases of endometrial polyp patients were studied.And 45 cases of endometrial normal subjects were selected as the control group.The enzyme-linked immunosorbent assay was used to detected the FSH,LH,E2,P,T and PRL six levels of the two groups.And endometrial ERα two groups of patients,ERβ,PR and Bcl-2 expression was studied.Results The FSH,LH,E2,P,T and PRL six levels of the two groups were no significant difference(P ＞0.05).Polyps in patients with proliferative phase of ERα,ERβ expression levels of the normal group had no significant difference (P ＞ 0.05),the expression level of PR(0.47 ± 0.02) point was significantly lower than that of the normal group(0.53 ± 0.02) point (t =10.383,P =0.000),Bcl-2 expression levels(0.53 ± 0.04) point was significantly higher than that of the normal group (0.49 ± 0.02) point (t =4.322,P =0.000).Polyps in patients with secretory phase of ERα,Bcl-2 expression levels (0.46 ± 0.07;0.43 ±0.04)point were significantly higher than that of the normal group (0.37 ± 0.05 ;0.39 ± 0.03) point (t =5.007,P =0.000; t =3.834,P =0.000),the expression level of PR (0.42 ± 0.02) point was significantly lower than that of the normal group (0.46 ± 0.01)point(t =8.486,P =0.000),there was no significant difference in expression levels between the two groups ERβ(P ＞0.05).Between the two groups displayed,ERα,PR proliferative phase of the normal group and the polyp group,the expression levels of Bcl-2 were significantly higher than that of the secretory phase (P ＜ 0.05).Conclusion The increase of the ERα,Bcl-2 expression levels,and the reduction of the level of PR expression in patients with endometrial polyps are closely related.

Objective To compare the prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine.Methods Ninety-eight cases of hypertensive with paroxysmal atrial fibrillation patients were enrolled and divided into telmisartan group and nifedipine group with 49 cases each by random digits table method.Telmisartan group was given telmisartan 80 mg/d,nifedipine group was given nifedipine 30 mg/d.Dose of the drug needed to be adjusted according to individual condition until achieving the target.Followed-up for 18 months.Observed two groups of recurrence of atrial fibrillation and the recurrence time for the first time,recorded before and after the treatment of cardiac parameters:including left atrial diameter (LAD),left ventricular end diastolic diameter(LVDD),left ventricular posterior wall thickness (LVPWT),interventricular septum thickness (IVST),left atrial volume index(LAVI) and left ventricular mass index(LVMI).Results The blood pressure after treatment in two groups was lower than that before treatment,there was statistically significant difference (P＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).After treatment,the recurrence of atrial fibrillation,atrial fibrillation recurrence time for the first time in two groups had no statistical significance (P ＞ 0.05).But the incidence of persistent atrial fibrillation in telmisartan group was significantly lower than that in nifedipine group [4.1％ (2/49) vs.16.3％ (8/49)],there was statistically significant difference (P =0.045).The cardiac parameters between two groups before treatment had no significant difference (P ＞ 0.05).After treatment,the cardiac parameters in two groups were signifcantly reduced,there were statistically significant differences (P ＜ 0.05).Moreover,the LAD,LVPWT,LAVI and LVMI in telmisartan group after treatment were significantly lower than those in nifedipine group [(37.6 ± 2.9) mm vs.(38.9 ± 2.4) mm,(11.6 ± 1.0) mm vs.(12.0 ± 0.9) mm,(22.0 ± 3.6) ml/m2 vs.(23.9 ± 4.2)ml/m2,(120.4 ± 18.2) g/m2 vs.(129.5 ± 19.2) g/m2],there were statistically significant differences (P ＜ 0.05).Conclusions Nifedipine and telmisartan can effectively lower the blood pressure.But telmisartan is superior to preventing atrial fibrillation recurrences and developing in hypertensive with paroxysmal atrial fibrillation patients,promoting cardiac parameters and postponing myocardial remodeling.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

Acute respiratory distress syndrome is a serious disease and has a high mortality rate.Protective ventilation strategy and conservative fluid management is the mainstay of treatment and there is no effective pharmacological treatment yet.Recent studies found that beta-2 adrenergic receptor agonists in the treatment of acute respiratory distress syndrome could inhibit the inflammatory response,protect the functions of alveolar capillary barrier,improve pulmonary edema fluid removal,promote the secretion of surfactant and enhance the impaired lung repair,and so on.This review aimed for the pathogenesis,mechanism of action and treatment mechanism of the recent studies.

Prevalence rates of paediatric allergic diseases have been gradually increasing worldwide,which cannot be ignored.The theory of atopic march of paediatric allergic diseases has been verified as early in 1985.The atopic march refers to that allergic symptoms in infancy or early childhood often predate development of other allergic diseases later in life.A number of longitudinal epidemiological studies support this theory,mainly from Europe and North America.However,there are some challenges to this theory.Allergic disease in children is influenced by various factors such as early wheezing,gender and a parental history of allergic diseases.This article reviews the latest progress on the atopic march of paediatric allergic diseases,which may provide clues to the early recognition and management of children at high risk of these diseases.

ObjectiveTo observe the effect ofTong Guan Li Qiao(opening orifices) needling method on the swallowing function in patients with post-stroke deglutition disorders.MethodNinety-one patients were randomized into an acupuncture group of 46 cases and a control group of 45 cases. The acupuncture group was intervened byTong Guan Li Qiaoneedling method, while the control group was by rehabilitation training. The Standard Swallowing Assessment (SSA), Modified Barthel Index (MBI), Swallowing-related Quality of Life (SWAL-QOL) and Hamilton Depression Scale (HAMD) were adopted for evaluation before and after intervention.ResultAfter intervention, the SSA, MBI, SWAL-QOL, and HAMD scores were significantly improved in the two groups (P<0.05); there were significant differences in comparing the scores between the two groups after intervention (P<0.05), and the improvements in the acupuncture group were more significant than that in the control group (P<0.05).Conclusion Tong Guan Li Qiaoneedling method can produce a more significant efficacy than conventional rehabilitation, by more effectively improving the swallowing function, activities of daily life, quality of life, and depression state in patients with post-stroke deglutition disorders.

Objective:To observe the clinical efficacy of nape cluster acupuncture in treating migraine. Methods:Fifty patients with confirmed diagnosis of migraine were intervened by using nape cluster acupuncture, and were evaluated at the outset and after 2-month treatment by the short-form of McGill pain questionnaire (SP-MPQ) and self-rating depression scale (SDS). Results:After treatment, the number of positive words, sensory pain rating index (S-PRI), affective pain rating index (A-PRI), total pain rating index (T-PRI), visual analogue scale (VAS), and present pain intensity (PPI) were significantly changed (P<0.01); the SDS score was (56.42±8.12) points before treatment versus (41.08±5.73) points after treatment, and the difference was statistically significant (P<0.01). The total effective rate was 86.0%; the therapeutic efficacy of the patients with a shorter disease duration was superior to that of the patients with a longer one (P<0.05); the efficacy of mild-moderate migraine was superior to that of severe one (P<0.01); the total effective rate of patients without depression was higher than that with depression, but without a significant difference in comparing the therapeutic efficacy (P>0.05). Conclusion:Nape cluster acupuncture is effective in treating migraine, significantly improving headache and depression.

The relationship between immuno-suppression and poor prognosis of sepsis causes widely concern.Immuno-modulatory therapy is one of the research hotspots in critical medical care.Some studies have shown that to enhance the function of lymphocyte might improve the prognosis of septic patients.This paper will review the immune dysfunction and explore the value of immuno-modulatory therapy in process of sepsis.