ObjectiveTo explore the changes of the levels of cytokines in patients with first-episode depression and the effect on the levels of cytokines after the treatment with duloxetine.MethodsThe serum levels of interleukin 1 ( IL-1 ),interleukin 6 ( IL-6 ),tumor necrosis factor-alpha ( TNF-αt ),interleukin4 ( IL-4 ),interleukin10(IL-10) were measured in 38 patients with depression before and after duloxetine treatment by enzyme linked immunosorbent assay(ELISA).HAMD score were assessed at pre- treatment and post-treatment to assess curative effect.The control group was 30 healthy individuals.All data were statisticaly analyzed by SPSS.ResultsBefore treatment,the HAMD score and the levels of serum IL-6,TNF-α,IL-1 in first-episode depressant patients were remarkablely higher than those in the control group( IL-6:( 10.66 ± 3.12 ) pg/ml vs (2.72 ± 0.91 ) pg/ml ;TNF-α:(77.49 ±3.12) pg/ml vs (37.48 ±5.87) pg/ml; IL-1:(39.09 ± 3.77 ) pg/ml vs ( 10.31 ± 1.05 ) pg/ml ),the levels of serum IL-4 and IL-10 in first-episode depressant patients were remarkablely lower than those in the control group(P＜0.05,P＜0.01 ).The HAMD score and the levels of serum IL-6,TNF-α,IL-1 in post-treatment were remarkablely lower than pre-treatment (P ＜ 0.05 ),but which were still higher than the control group(P＜ 0.05 ).The levels of serum IL-4 and IL-10 in post-treatment were remarkablely increased than pre-treatment(P＜0.05).The levels of serum IL-6,TNF-α,IL-1 were positively correlated with the HAMD score( r =0.667,0.486,0.727,P ＜0.01 ),but the levels of serum IL-4 and IL-10 were negatively correlated with the HAMD scorae ( r=-0.433,-0.269,P＜0.05,P＜ 0.01 ).ConclusionsThe first-episode depressant patients show immune disorder induced by cytokines.Anti-depressant activity of duloxetine may participate in the regulation of cytokines and Th1/Th2 unbalance.

In order to promote our country's research on transitional care for patients with chronic kidney disease (CKD),the article summarized research progress on transitional care for patients with CKD,analysed the problems existed including lack of evidence-based basis,insugiciency of Intervention staff,one-sided intervention content and effect evaluation,etc,and put forward the corresponding countermeasures.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective To investigate the diagnostic value of one-stop liver magnetic resonance dynamic enhanced MRA for esophageal and gastric varces.Methods 82 patients with liver cirrhosis portal hypertension who were diagnosed by clinical and laboratory detect were taken,conducting liver horizontal scanning and multitemporal three dimensional dynamic enhanced scanning using Philips Achieva 1.5T MRI scanner,and then make maximum intensity projection(MIP) at work station to draw up portal vein image,observing the form and distribution of portal vein and its branches,meanwhile refer to cross sectional image to carefully observe whether there was cirsoid vein in esophagus and stomach,and further the source,degree and depth of cirsoid vein were compared,and whether there was cirsoid vein in other parts,and the pathological situation of liver.Compared with the result of gastroscope inspection,whether there is cirsoid vein in esophagus and stomach.Results The trunk and class-Ⅲ branches of portal vein of all patients had been clearly shown.In this team,there were esophageal and gastric varces in 78 patients,specifically including varices of fundus of stomach & esophageal varices in 27 patients,and varices of fundus of stomach and varices of body of stomach in 19 patients.Meanwhile,it diagnose 6 patients with liver cirrhosis and liver cancer and indicate 8 patients with liver cirrhosis nodule cancerization.The endoscope found out esophageal varices and varices of fundus of stomach in 68 patients,specifically including gastric varicesa and esophageal varices in 25 patients,sole gastric varicesa in 8 patients,and sole esophageal varices in 35 patients.Conclusion The one-stop liver three dimensional dynamic enhanced MRA is with great value in diagnosing the location and degree of esophageal varices and varices of fundus of stomach of patients with portal hypertension.The overall effect is better than endoscope.

OBJECTIVE ToobservetheprotectiveeffectandmechanismofCompoundGinkgo biloba(CGB)againstalcohol-inducedliverinjury.METHODS MiceweregivenCGB0.125,0.25and 0.75 g·kg -1 ,Ginkgo biloba extract (GBE)0.1 25 g·kg -1 and bifendate(Bif)0.1 5 g·kg -1 for 8 weeks, respectively.At the end of 4th week the mice were given wine by gavage (56% V/V,0.01 L·kg -1 ), and (56% V/V,0.016 L·kg -1 )at the end of the 8th week.The serum was obtained to measure alanine transaminase (GPT),aspartate aminotransaminase (GOT),mitochondrial aspartate aminotransferase (mGOT)and tumor necrosis factor-α(TNF-α).Liver histopathology was revealed by HE staining.The protein expression of cytochrome P450 (CYP)2E1 ,NF-E2-related factor 2 (Nrf2)and TNF-αin the liverwasanalyzedbyWesternblotting.RESULTS Comparedwithnormalcontrolgroup,theactivitiesof GOT and mGOT were increased in model group (P<0.01 ).Compared with model group,CGB 0.25 and 0.75 g·kg -1 groups and Bif 0.1 5 g·kg -1 group significantly decreased the activity of GOT and mGOT in serum (P<0.05,P<0.01 ),while there was no significant difference between these groups in serum GPT activity (P>0.05).Fatty degeneration and neutrophil infiltration were significantly ameliora-ted in CGB 0.25 and 0.75 g·kg -1 groups.Preliminary mechanism research showed CGB not only increased the protein expression of Nrf2 with a positive dose-effect relationship (r=0.942,P<0.01 ), but reduced the protein expression of hepatic CYP2 E1 and the level of TNF-αin hepatic tissue with a negative dose-effect relationship (r=-0.987,P<0.05;r=-0.940,P<0.05).In addition.The level ofTNF-αwasalsosignificantlydecreasedintheserum(P<0.05,P<0.01).CONCLUSION CGB may protect the liver fro m acute alcoholic injury and the mechanis m may be that it increases the protein expression of Nrf2,restrains the protein expression of hepatic CYP2E1 and TNF-αand reduces the TNF-αlevel in the serum.

Objective To evaluate the use of transfer statements in inhouse transport of critical patients.Methods By means of continuous enrollment,123 critical patients were enrolled as a control group for conventional transport,and 111 such patients were enrolled as an observation group for transport using the transfer statement.Then the incidence of adverse events,transport during and nurse-nurse collaboration level of the two groups were compared.Results In the control group,its incidence of adverse events was 13.8%,the mean transport during was(19.5 ± 8.4)minutes,and the mean score for nurse-nurse collaboration level was ( 101.87 ± 7.13 ).In the observation group,its incidence of adverse events was 5.4%,the mean transport during was(13.5 ± 5.4)minutes,and the mean score for nurse-nurse collaboration level was(106.15 ± 8.86).Implementing the transfer statement has cut back the incidence of adverse events (P<0.05)and the transport duration significantly(t=3.833,P<0.01),while improving the level of nurse-nurse cooperation significantly(t= -4.261,P<0.05).Conclusions The transfer statement can increase the safety of patient transport,promote organization and coordination of nurses,and improve the efficiency of transport.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objeetive To investigate the relationship among social avoidance and acceptance of disability in burn patients.Methods Totally 127 patients were investigated using Social Avoidance and Distress Scale (SADS),Acceptance of Disability Scale (AODS),demographic information questionnaire and disease related information sheet.Results The points of burn patients' SADS was (21.38±6.75),One-way ANOVA showed that gender,marital status,special parts burns,amputation affected social avoidance significantly.The total score and factors scores of acceptance of disability were all negatively related to the score of social avoidance.Regression analysis showed that acceptance of disability,head burns,gender were the independent risk factors of depression.Conclusions Acceptance of disability were negatively related to social avoidance; Nurse can help them accept the reality of disability,develop the confidence to partici-pate in social communication,and improve the social adaptability.

Objective To detect the serum levels of tumor necrosis factor-alpha (TNF-α) and interferengamma (IFN-γ) in brucellosis patients and to study the Th1 immune response in acute and chronic patients.Method Serum levels of TNF-alpha and IFN-gamma of 110 brucellosis patients,including 58 acute brucellosis patients and 52 chronic brucellosis patients,were measured by enzyme linked immunosorbent assay (ELISA) from 2014 to 2015 in Zhangjiakou Infectious Disease Hospital.Results The serum levels of TNF-alpha and IFN-gamma of 58 acute brucellosis patients were (38.2± 3.6) pg/L and (31.3 ± 3.7) ng/L,respectively;the serum levels of TNF-alpha and IFN-gamma of 52 chronic brucellosis patients were (12.4 ± 2.6) pg/L and (8.8 ± 3.4) ng/L,respectively.The differences were statistically significant between acute and chronic patients (t =43.216,33.809,all P ＜ 0.05).The early cure rate,early base cure rate,improvement rate and inefficiency rate were 36.2％ (21/58),32.7％ (19/58),25.9％ (15/58)and 5.2％ (3/58),respectively in acute patients.Inversely,they were 17.3％ (9/52),13.5％ (7/52),15.4％ (8/52)and 53.8％ (28/52),respectively in chronic patients.The therapeutic effect was better in acutepatients than chronic patients (x2 =4.937,5.657,all P ＜ 0.05).Conclusion It seems that acute brucellosis patients have a higher serum levels of TNF-alpha and IFN-gamma and a better prognosis due to effective Th1 immune response,and chronic brucellosis patients are associated with poor outcome due to deficiency of Th1 immune response.