Objective To determine the prevalence and clinical characteristics of orthostatic hypotension (OH) and orthostatic hypertension (OHT) in the elderly patients with hypertension.Methods 489 elderly patients with hypertension were enrolled and divided into the OH group,the OHT group and the non-OH-OHT group,which represents no or symptom.The orthostatic blood pressure was measured in supine position after resting for more than 5 minutes and at 3 min standing.Results The prevalence of OH in the 60～79 years old group was lower than that in ≥ 80 years old group.The morbility of coronary heart disease,diabetes and ischemic stroke was significantly higher in the OH and OHT group than that in the non-OH-OHT group.Conclusions OH and OHT are common disease in the elderly patients with hypertension and associated with increased risk of cardiovascular disease and diabetes mellitus.To strengthen nursing and health education for elderly patients with hypertension could prevent the incidence of malignant cardiovascular events due to OH and OHT.

Objective To investigate the frustration-confronting ability training on adversity quotient(AQ)of nursing graduates.Methods One hundred and fifty nursing graduates were received the frustration-confronting ability training.The adversity quotient scale was used in the investigation before and after the training.Result The total scores of AQ and other scores on all factors in AQ after training were significantly higher than before the training(all P<0.01).Conclusion The frustration-confronting ability training may be effective for the improvement of nursing graduates’AQ.

Objective To discuss the influence of nursing intervention on sleep quality and postoperative comfort of patients with percutaneous coronary intervention(PCI). Methods We divided 96 patients who were to receive PCI into the test group and control group with 48 patients in each group.The control group received routine nursing while the test group were given systemic nursing intervention based on routine nursing intervention.The sleep quality and incidence rate of complications were compared. Results The sleep quality in the test group was better than that of the control group (P ＜ 0.01 ).The ineidience of waist-back pain,dysuria,induced emiction,eatheter emietion,anaesthesia of lower limbs,fidget in the test group also decreased compared with the control group(P ＜ 0.05). Conclusions Systemic nursing intervention could improve the sleep quality and postoperative comfort for PCI patients

Objective To evaluate the effects of the project of ditching for drain on Oncomelania hupensis snail control and flood prevention security and explore the optimal engineering design plan in Dongting Lake region. Methods A retrospective study was performed on the previous studies about the project of ditching for drain. The reference values of project indices were determined. The outside levee of Nanhu New Distinct of Yueyang City in Dongting Lake region was selected as the study area , and the cross section of marshland perpendicular to the center line of the levee was extracted to research. According to the situa?tions of various water levels,a dynamic simulation was performed on the effect and security of the project of ditching for drain through the software FLAC3D. Results The retrospective study showed that the project would be effective when the relatively subsoil water level decreased by 0.35 m,and the soil water content decreased correspondingly. The dynamic simulation by FLAC3D showed that the minimum safe distances between transverse ditch 1,vertical ditch and levee toe should be 25 m and 13 m respectively. The digging depth of transverse ditch and vertical ditch should be 1.2 m and 1.0 m respectively. If the width of marshland in drought period was less than 500 m,one transverse ditch was efficient. Otherwise,more transverse ditches should be set with the intervals of 300 m. Conclusions The project of ditching for drain is an effective ecological snail elimination method. Optimizing the digging depth of ditches and distances between transverse ditches,vertical ditch and levee toe will en?sure the effects and security of the project.

Objective To explore the effect of task-driven teaching methodology based on the action research on cardiopulmonary resuscitation training. Methods The 80 nurses recruited in 2011 were assigned in the control, receiving routine training while another 80 nurses recruited in 2012 were in the study group, where task-driven teaching methodology was used based on the action research. The two groups were compared in terms of results of theoretical and operational examinations. Result The study group was significantly better than the control group in the scores of theoretical and operational examinations ( P < 0 . 05 ) . Conclusion The task-driven teaching methodology based on the action research not only increases the examination results, but also improves the effect of teaching.

Objective To investigate the role of transforming growth factor-β1 (TGF-β1), Smad2/3 and Smad7 expressions in carotid artery remodeling in renovascular hypertensive rats, and also the therapeutic effect of Enalapril and Amlodipine. Methods The renovascular hypertensive rat (RHR) models with two-kidney and one-clip were established, including model group (n = 6), sham-operated group (n = 6), Enalapril group (10 mg/kg per day, n = 6), Amlodipine group (5 mg/kg per day, n = 6) and combination group (Amlodipine 2.5 mg/kg per day + Enalapril 5mg/kg per day, n = 6). The medication were continuous administrated for six weeks. Carotid artery morphological and structural changes in the media were observed by HE staining, Masson staining and immuno histochemical staining. Media thickness (MT), MT and lumen diameter ratio (MT/LD), and the expression levels of media α-smooth muscle actin (α-actin), proliferating cell nuclear antigen (PCNA), TGF-β1, phosphorylated Smad2/3 (p-Smad2/3) and Smad7 in carotid arteries were measured. Results The media of carotid arteries in RHR model group was significantly thickened, the volume of smooth muscle cell was increased, and the array was in disorder; MT, MT/LD, the proliferation index of smooth muscle cell and collagen fiber area percentage of carotid arteries in the model group were significantly higher than those in the sham-operated group (P < 0.01). Compared to sham-operated group, the model group had significantly higher expressions of TGF-β1 and p-Smad2/3 (P < 0.05) and lower Smad7 expression. Both Enalapril and Amlodipine improved smooth muscle hypertrophy and collagen deposition, reduced RHR carotid MT, MT/LD, proliferation index of smooth muscle cell, collagen fiber area percentage and the expressions of TGF-β1 and p-Smad2/3 (P < 0.05), increased Smad7 expression (P < 0.05). Moreover, the combination treatment of Enalapril and Amlodipine had significantly better effects than single Amlodipine group (P < 0.05), but not single Enalapril group. Conclusions TGF-β1/Smads pathway may participate in the mechanism of carotid artery remodeling in RHR; the role of Amlodipine and Enalapril in inversing carotid artery remodeling may be related to the change of TGF-β1/Smads pathway, the combination treatment of Amlodipine and Enalapril had better effects than single administration of Amlodipine.

Endoscopy ; Humans ; Myosarcoma ; diagnosis ; surgery ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; Skull Base ; Skull Base Neoplasms ; diagnosis ; surgery

OBJECTIVE: To investigate the therapeutic effect of pAdKDR-tk suicide gene system on tumor vessel endothelium cells (VEC) of human NPC in nude mice. METHOD: Sixteen nude mice with transplantation tumor were randomized into AdKDR tk/GCV group and AdKDR-tk/PBS group, with 8 in each group. The tumor size changes and histomorphology were observed before and after treatment. Immunohistochemistry was used to detect the tumor microvessel density and VEGF expression. RESULT: There's significant difference among the gross tumor volume of groups after experiment. The tumor volume in control group grew continuously and rapidly, while for the AdKDR-tk/GCV treatment group, tumor grew slowly at the first 6 days, and the tumor growth was inhibited after the 6th day, then the transplantation tumor volume gradually grew smaller. Tumor volume in treatment group was significantly smaller than that of control group after the 6th day, the 9th day and the 14th day (P<0.01). HE staining morphological observation that there's no significant difference in cell morphology of NPC between the two groups, but large amount of necrobiosis focus were found among tumor tissue. The MVD mean value of CD34 in control group was 6.63+/-1.41, with 3.50+/-0.93 of the treatment group. The statistics results demonstrated significant difference of vessel density around tumors between groups (P<0.05). The VEGF positive expression in control group was higher than that in treatment group, with significant difference of VEGF expression between two groups. CONCLUSION Adenovirus (ADV) mediated KDR promoter single herpes simplex virus thymidine kinase (AdKDR-tk)/GCV system could effectively inhibit vascular proliferation in tumors, thus inhibit the tumor growth in nude mice with NPC.
Adenoviridae ; genetics ; Animals ; Cell Line, Tumor ; Endothelial Cells ; metabolism ; Ganciclovir ; Genes, Transgenic, Suicide ; Genetic Therapy ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Nasopharyngeal Neoplasms ; genetics ; therapy ; Simplexvirus ; genetics ; Thymidine Kinase ; genetics ; Transfection

By the end of 2017, the Supreme People's Court issue a judical interpretation called Tort law of China·Medical damage liability. It formulates some new rules about identification. It stipulates qualification of new appraiser; clears requirement of medical fault judgment; clears the requirement of causal relationship; defines procedure of medical damage identification and so on. However, there exist the dual identification model. Under the new rules, medical damage identification will face new challenges, especially some stipulates about qualification of appraisers, and expert assistants' views become the basis of the verdict. Those will effect medical examiners' working directly in China. So, I put forward following suggestions: ①Medical identification must be scientific, public welfare, normative.②It is trend for medical damage identification back to peer review. ③A unified library of clinical expert appraisers should be establised. ④We should reasearch the theorys, principles and methods of medical damege identification.

The Standardization Law carried out almost 30 years, and it is amended recently. The amended Standardization Law mainly focus on following aspects: enlarge the range of application into social undertakings;define the compulsory standards strictly in case of they are overmuch; add the supply effectively to meet the social needs; establish a well-organized and unified standardization system and make sure each standards can be linked up and matched. Also, the Standardization Law requires the development of standards; compulsory standards and with the enforcement of standards must be carried out; relevant organizations should disclose their standards; and some organizations shouldn't utilize their advantage to do unfair competition and so on. Those regulations may effect the forensic appraisal activities. At present, accrediting bodies in China exist many problems. For example, the standards are not scientific and not updated in time. They are unfamiliar with standards, low sense of executing identification standards,not disclose their standards. And their standards are lower with government's standards. Thus, this essay aim to analyze those problems and put forward related solutions.