Objective To investigate the service requirements and health and safety problems in home care among senile cerebrovascular disease patients above 65 years old and provide the direction and basis for the home care.Methods 78 cases of elderly patients with cerebrovascular sequela 2 years after discharge were selected as the research objects.One-on-one interviews with patients and their families,the self-made questionnaire were sent out,the patients' service item requirements and the main health and safety problems were reorganized,then the corresponding nursing intervention was implemented.One year later,patients were revisited and investigated again.Results In elderly patients,there were many health and safety issues in home care,their nursing service demand was high.After giving corresponding nursing intervention of health guidance,the incidence of aspiration,fall,falling out of bed,bedsore,sleep disorders,urinary tract infection was effectively reduced.Conclusions The mode of family care should be established on the basis of demand of home care by elderly cerebrovascular disease patients,which conforms to the ac-tual situation of our country,in order to improve patients' self-care ability and life quality.

In order to investigate the effect of nuclear factor-kappaB (NF-kappaB) on airway remodeling in asthmatic rats, 18 Wistar rats were divided into three groups: asthmatic group; pyrrolidine dithiocarbamate (PDTC) group, in which rats were injected intraperitoneally with NF-kappaB specific inhibitor PDTC (100 mg/kg) before ovalbumin (OVA) challenge; control group. The NF-kappaB activity and the expression of inhibitory protein kappaBalpha (I-kappaBalpha) in airway were detected by electrophoretic mobility shift assay (EMSA), Western blot and immunohistochemistry respectively. The infiltration of inflammatory cells, the number of Goblet cells, the area of collagen and smooth muscle in airway were measured by means of image analysis system. The results showed that with the up-regulation of airway NF-kappaB activity in asthmatic group, the number of goblet cells (3.084 +/- 0.86/100 microm basement membrane (BM)), the area of collagen (24.71 +/- 4.24 microm2/microm BM) and smooth muscle (13.81 +/- 2.11 microm2/microm BM) in airway were significantly increased (P<0.05) as compared with control group (0.14 +/- 0.05/100 microm BM, 14.31 +/- 3.16 microm2/microm BM and 7.67 +/- 2.35 microm2/microm BM respectively) and PDTC group (0.33 +/- 0.14/100 microm BM, 18.16 +/- 2.85 microm/microm BM and 8.95 +/- 2.16 microm2/microm BM respectively). However, there was no significant difference between PDTC group and control group (P>0.05). It was concluded that the activity of NF-kappaB is increased in airway of asthmatic rats. Inhibition of NF-kappaB activation can attenuate constructional changes in asthma airway, suggesting NF-kappaB may contribute to asthmatic airway remodeling.
Animals ; Asthma ; metabolism ; physiopathology ; Epithelium ; metabolism ; physiopathology ; I-kappa B Proteins ; metabolism ; Lung ; pathology ; physiopathology ; Mice ; NF-kappa B ; metabolism ; Ovalbumin ; Pyrrolidines ; Rabbits ; Rats ; Rats, Wistar ; Respiratory System ; metabolism ; physiopathology ; Thiocarbamates ; Transcription Factor RelA

In order to investigate the effect of nuclear factor-kappa B (NF-kappaB) on vascular endothelial growth factor (VEGF) mRNA expression of human pulmonary artery smooth muscle cells (HPASMCs) in hypoxia, the cultured HPASMCs in vitro were stimulated with pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-kappaB. The NF-kappaB p65 nuclei positive expression was detected by immunocytochemical technique. The IkappaBalpha protein expression was measured by Western blot. RT-PCR was used to detect the VEGF mRNA expression of HPASMCs. The results showed that no significant change was observed in the NF-kappaB p65 nuclei positive expression of cultured HPASMCs during 6 h-24 h in normoxia, but the levels of NF-kappaB p65 nuclei positive expression of cultured HPASMCs were significantly increased in hypoxia groups as compared with those in all normoxia groups (P<0.05). The IkappaBalpha protein expression of cultured HPASMCs showed no significant change during 6 h-24 h in normoxia, but significantly decreased in hypoxia as comapred with that in normoxia groups (P<0.05). PDTC (1 to 100 micromol/L) could inhibit the VEGF mRNA expression of HPASMCs in a concentration-dependent manner in hypoxia. In conclusion, NF-kappaB can be partly translocation activated from cytoplasm into nuclei in the cultured HPASMCs under hypoxia. The inhibition of NF-kappaB activation can decrease the VEGF mRNA expression. It is suggested that the activation of NF-kappaB is involved in the VEGF mRNA expression of HPASMCs under hypoxia.
Cell Hypoxia ; Cells, Cultured ; Humans ; I-kappa B Proteins ; metabolism ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Myocytes, Smooth Muscle ; cytology ; metabolism ; NF-kappa B ; metabolism ; Pulmonary Artery ; cytology ; Pyrrolidines ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Thiocarbamates ; pharmacology ; Transcription Factor RelA ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

OBJECTIVETo evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.

METHODSFive hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.

RESULTSBoth leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).

CONCLUSIONSLeflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.

Antirheumatic Agents ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Female ; Growth Inhibitors ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Isoxazoles ; adverse effects ; therapeutic use ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Middle Aged