Objective To observe the clinical effect of mesalazine combined with bifidobacterium in the treatment of ulcerative colitis and its effect on serum inflammatory cytokines.Methods 80 patients with ulcerative colitis were selected as the subjects.Auording to the digital table,the patients were randomly divided into observation group(40 cases) and control group(40 cases) by random number tables.The control group was treated with oral mesalazine only.The observation group was treated with bifidobacterium on the basis of the control group.Both two groups were treated for 8 weeks.Before and after treatment,the symptoms and microscopic manifestations were observed.The levels of CRP,TNF-α,IL-6 and IL-8 in venous blood were measured before and after treatment in the morning,and the clinical curative effect was evaluated.Results The proportions of diarrhea,abdominal pain and mucus bloody in the control group and the observation group were 20.0％ and 0.0％,22.5％ and 2.5％,20.0％ and 0.0％,respectively,which were significantly lower than those before treatment (x2 =46.036,72.381,26.467,52.379,22.175,48.000,all P ＜ 0.01).The improvement of diarrhea,abdominal pain and mucus bloody of the observation group was better than those of the control group(x2 =8.941,7.895,9.574,all P ＜ 0.05).The percentages of ulcers,erosions and bleeding points in the observation group and the control group were 22.5％ and 5.0％,32.5％and 10.0％,37.5％ and 7.5％,respectively,which were significantly lower than those before treatment (x2 =31.427,48.813,12.832,32.273,29.574,64.962,all P ＜ 0.01).The improvement of ulcer,erosive and bleeding in the observation group was better than those in the control group (x2 =5.084,6.74,10.853,all P ＜ 0.05).The levels of CRP,TNF-αt,IL-6 and IL-8 in the control group and observation group were (13.6 ± 3.6)mg/L and (7.8 ±1.2)mg/L,(28.4 ±9.6)ng/L and (15.6 ±7.1)ng/L,(141.3 ±21.4) ng/L and (90.5 ± 14.7) ng/L,(202.4 ±32.8) ng/L and (155.2 ± 25.4)ng/L,respectively,which were significantly lower than those before treatment (t =15.525 and 20.672,13.851 and 17.524,8.243 and 12.021,9.101 and 11.132,all P＜0.01),the CRP,TNF-α,IL-6 and IL-8 levels in the observation group were significantly lower than those in the control group (t =7.456,6.325,7.543,all P ＜ 0.01).The effective rate in the observation group was 97.5 ％ (39/40),which was significantly higher than that in the control group (77.5 ％,31/40),the difference was statistically significant (x2 =7.680,P ＜0.05).Conclusion Mesalazine combined with bifidobacterium has exact clinical effect in the treatment of ulcerative colitis,it is more effective in improving clinical symptoms and microscopic manifestations,and can reduce the level of serum proinflammatory cytokines.It is worthy to be used.

Objective To investigate the cost-effect of tele-wound treatment platform with cellular phone terminator and traditional outpatient treatment on chronic lower limb ulcers in remote district.Methods Thirty seven cases with chronic lower limb ulcers from the key hospitals in the district of west Hunan Province were collected by cluster sampling,and randomly divided into the intervention group (25 cases)and the control group (12 cases).They chose remote wound treatment platform intervention with cellular phone terminator and traditional dressing change in clinic.All patients received a 1.5-year follow-up,or cure and amputations were set as the endpoint of the study.The cost-effect,including the incidence of complications in the course of treatment,number of switches,treatment time,the cost of treatment,as well as medical human resources consumption was analyzed and compared between the two groups.Results The incidence of complications in the course of treatment in the intervention was (76.0％) significantly lower than the control group(91.7％).There was a significant increase in the dressing times and the duration of treatment; and there was no significant difference in the cost of treatment and medical human resources consumption between two groups.Conclusions Compared to the traditional outpatients wound treatment,the multimedia message-based tele-wound treatment platform unlikely increased medical human resources consumption and the cost of treatment,and may reduce the incidence of complications and the treatment time.

Objective To investigate the application of PDCA circulation in the patients undergoing liver transplantation.Methods Apart from 1 of experiment and 3 of control group failed to be followed up,116 cases undergoing liver transplantation in our liver transplant center from April 2009 to May 2011 were divided into the experiment group (n =59) and control group (n =57) by registration order.PDCA circulation was used in the experiment group,but in the control group,routine management mode was used.A self-designed questionnaire about the compliance of liver transplantation and the Satisfaction Degree of Patients to the Nursing Work and Quality of Life Index (QL-Index) were used to investigate at the first follow-up time.Results There was a significant difference between two groups in the aspects of habits and customs,drug-taking compliance,reasonable physical training,self-monitoring and the satisfaction degree of patients to the nursing work [57 vs 44,52 vs 39,51 vs 40,52 vs 40 ; 94.92％ vs 82.46％ ; x2 =6.3096,6.6646,4.5365,5.6991,4.5225,respectively;P ＜ 0.05].Overall life quality score of experimental group (6.52 ± 0.53) was higher than that in control group (4.36 ± 0.78),and the difference was statistically significant (t =17.498,P ＜ 0.05).All the items of QL-Index showed a significantly statistical difference between two groups (P ＜ 0.05).Conclusions Applying PDCA circulation can enhance the compliance and quality of life of patients undergoing liver transplantation and improve their satisfaction degree to the nursing work.

Objective To explore the associations of depressive symptoms with functional status and frailty in elderly outpatients.Methods A total of 297 geriatric outpatients(aged 65 years and over) from Zhejiang Hospital were recruited in the cross-sectional study from January 2014 to December 2015.We gathered general information,and evaluated depressive symptoms by Geriatric Depression Scale-15 (GDS-15),cognitive function by mini-mental state examination(M MSE),frailty by clinical frailty scale(CFS),activities of daily living (ADL)by Barthel index,instrumental activities of daily living (IADL),balance,POMA and gait by Tinetti-performance oriented mobility assessment (Tinetti-POMA),grip strength and 4m gait speed by 4-meter walk gait speed test.According to the GDS-15 scores,297 geriatric outpatients were divided into a depression symptom group(n=35,GDS-15 ≥6)and a nomdepressive symptom group(n=262,GDS-15＜6).The frailty and functional status were compared between two groups by SPSS 23.0.Results As compared with non-depressive symptoms,the depressive symptoms group had higher clinical frailty scale(CFS),lower body mass index(BMI),lower cognitive function and poorer grip strength and balance(all P＜0.05).There were significantly negative correlations of Geriatric Depression Scale-15 (GDS-15) with ADL,IADL,gait,balance,POMA and grip strength(r=-0.165、-0.154、-0.216、-0.291、-0.305、-0.314,All P＜ 0.05),while there were significantly positive correlations with CFS score,gait speed(r=0.256、0.198,both P＜0.05).The more severe the frailty was,the higher the risk of depressive symptoms was(OR=3.650,95％ CI 1.611-8.271).Conclusions The cognitive and physical functions in the elderly with depression symptoms are poorer as compared with the elderly without depression symptoms.Elderly outpatients with more severe frailty have a higher risk for depressive symptoms.

Objective: To construct the dynamic assessment system for practice base of professional master's degree in clinical medicine. Methods: The teaching managers, clinical experts, postgraduate tutors and postgraduates of seven tertiary general hospitals with standardized training qualifications for residents in Hunan province were selected. Using the literature review and site investigation, we drafted the framework and score-factor of the dynamic assessment indicator system and adopted the percentage system to construct the assessment system. Results: We interviewed and discussed with 28 teaching managers, 21 clinical experts, 35 graduate tutors and 112 graduate students; the response rate of all interviewees was 100%. The dynamic assessment system was composed of 4 first-level indicators and 20 second-level indicators; the score-factor of the primary indicator was 25%, and the score-factor of the secondary indicator was 5%. Conclusion The established dynamic assessment system has reasonable indicators and strong operability, and can provide useful reference.

The content of the asarone submicro emulsion injection was determind by HPLC method, and thereby a quality evaluation method was established based on indexes of pH value, particle size, peroxide value, methoxy aniline values, free fatty acid, lysophosphatidylcholine, visible foreign substances, insoluble particle, sterility, bacterial endotoxin and impurities, etc. The results showed that the injection exhibited uniform physical appearance and all the products were in milkwhite liquid. The content of the three batches products were respectively 102.9%, 100.8%, 97.70% of the labeled amount, with mean particle size of 210-250 nm, and other indexes all met with the standards. The reserved samples showed no obvious change in terms of detection indexes and indicated good stability after the accelerated stability test and long-term stability for 12 months. The quality evaluation method established in this study could be applied to quality control and stability investigation of asarone submicron emulsion injection, which laid a basis for further clinical research and application.
Anisoles ; chemistry ; Chromatography, High Pressure Liquid ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Emulsions ; chemistry ; Particle Size ; Quality Control

OBJECTIVETo explore the effect of Buyang Huanwu Decoction (BYHWD) and its disassembled recipes on rats' neurogenesis after focal cerebral ischemia and to investigate its underlying molecular mechanisms.

METHODSFocal cerebral ischemia model was induced by occlusion of the right middle cerebral artery for 90 min using the intraluminal filament model. Rats were divided into the sham-operation group, the model group, the BYHWD group, the qi supplementing group, and the blood activating group. Medication was performed by gastrogavage 24 h after ischemia for 14 successive days. 5-bromodeoxyuridine (BrdU) (at 50 mg/kg) was intraperitoneally injected, once per day for 14 successive days. The neurological function was assessed using modified neurological severity score (mNSS) and the corner test at day 1, 7, and 14 after ischemia. BrdU/Nestin, BrdU/NeuN, and BrdU/GFAP positive cells were examined by double immunofluorescence at day 14 after ischemia. The protein expression of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) were detected by Western blot at day 14 after ischemia.

RESULTSCompared with the model group, the score of mNSS and the frequency of turning right significantly decreased in the BYHWD group and the qi supplementing group (P < 0.01), the number of BrdU/Nestin in the subventricular zone of the lateral ventricle, and BrdU/ NeuN and BrdU/GFAP positive cells in the peripheral ischemic cortex increased (P < 0.05, P < 0.01), protein expression of BDNF and VEGF increased (P < 0.05, P < 0.01). In the qi supplementing group, there was no statistical difference in BrdU/GFAP. But there was no statistical difference in each index of the blood activating group (P > 0.05). Compared with BYHWD group, the number of BrdU/Nestin, BrdU/ NeuN, and BrdU/GFAP positive cells significantly decreased (P < 0.01), and the protein expression of BDNF and VEGF were significantly reduced in the qi supplementing group and the blood activating group (P < 0.01).

CONCLUSIONSBYHWD could significantly improve neurogenesis and neurological function recovery after focal cerebral ischemia in rats. Its mechanisms might be related to up-regulating protein expression of BDNF and VEGF. Drugs for qi supplementing and drugs for blood activating had synergistic effects.

Animals ; Brain Ischemia ; drug therapy ; metabolism ; Brain-Derived Neurotrophic Factor ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Male ; Neurogenesis ; drug effects ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism

Objective:To explore the correlation between hypersomnia and anhedonia in patients with major depressive disorder.Methods:From November 2018 to May 2019, patients hospitalized with major depressive disorder who met the ICD-10 diagnostic criteria were selected.According to the Epworth Sleepiness Scale (ESS), 46 patients were divided into daytime sleepiness group with ESS ≥ 7, and 171 patients were divided into non-sleepiness group with ESS < 7.The Chinese Revised Social Anhedonia Scale (RSAS) and the Chinese Revised Physical Anhedonia Scale (RPAS) were used to evaluate the patients' anhedonia symptoms.Two-way ANOVA and Pearson correlation analysis were used for data processing.Results:(1)There was no interaction between the hypersomnia and gender on the score of physical anhedonia ( F=0.274, P=0.601). The main effect analysis showed that there was significant difference in the influence of gender on physical anhedonia ( F=10.948, P<0.05). (2)There was interaction between the hypersomnia and age on the score of physical anhedonia ( F=4.396, P=0.013). Further simple effect analysis showed that the score of physical anhedonia in 40-49 age(21.54±12.37) was lower than that in 50-64 age(34.13±12.53) in daytime sleepiness group( P<0.05). (3) There was interaction between hypersomnia and sitting and lying on the score of social anhedonia ( F=4.247, P=0.041). Further simple effect analysis showed that the score of social anhedonia in patients with sitting and lying time less than 2 hours (13.71±5.18) was lower than that in patients with sitting and lying time more than 2 hours (19.75±6.39) in daytime sleepiness group( P<0.05). (4)Pearson correlation analysis showed that the total sleepiness score of depression patients was positively correlated with the social anhedonia score ( r=0.206, P<0.01). After adjusting for gender, age and sitting and lying time, the total sleepiness score was still positively correlated with the social anhedonia score( r=0.225, P<0.01). Conclusion:Hypersomnia may be associated with anhedonia in patients with major depressive disorder.

AIM: To evaluate the therapeutic effect of the PVEP-CD comprehensive therapy \〖a multimedia visual training system uses the individualized PVEP(pattern visual evoked potential)sensitive spatial frequency parameters\〗 in children with amblyopia by comparing the differences in visual acuity and stereo acuity enhancement between the PVEP-CD comprehensive therapy and traditional therapy.

METHODS: A total of 38 children(54 eyes)with amblyopia who were treated in our hospital from April 2018 to January 2019 were randomly divided into two groups. Traditional therapy group(19 cases, 27 eyes; therapeutic methods contain refractive correction, patching/optical or drug suppress and precision eyesight training); PVEP-CD comprehensive therapy group(19 cases, 27 eyes; therapeutic methods contain refractive correction, patching/optical or drug suppress and a multimedia visual training using the individualized P-VEP sensitive spatial frequency parameters). To study the clinic therapeutic effect, the best distance corrected visual acuity(BCVA)and near stereo acuity were measured at the enrollment visit and the final visit after 6mo treatment.

RESULTS: After 6mo treatment, both groups had an apparent BCVA improvement(both therapy effective rate≥85%). PVEP-CD comprehensive therapy group were significantly better than traditional therapy group in BCVA lines improvement \〖3(2, 3)lines\〗, near stereo acuity therapy effective rate(89%)and near stereo acuity level improvement \〖2(1, 4)levels\〗(all P<0.05). In amblyopic children older than 6y, PVEP-CD comprehensive therapy group showed a significantly greater BCVA lines improvement(P=0.018). In mild amblyopia cases, PVEP-CD comprehensive therapy group showed a significantly better clinical efficacy in near stereo acuity(P=0.048)and greater improvement in near stereo acuity level(P=0.029). In moderate amblyopia cases,the BCVA lines improvement(P=0.003)was significantly greater in PVEP-CD comprehensive therapy group.

CONCLUSION:Both PVEP-CD comprehensive and traditional therapy can improve the BCVA in children with amblyopia and have a good clinical efficacy. Furthermore, the PVEP-CD comprehensive therapy could improve the BCVA and near stereo acuity level more obviously and help amblyopic children get a better binocular vision.

[Objective]Taking the course of"Geriatric Nursing"in traditional Chinese medicine colleges as an example,to actively explore a new model of integrating traditional Chinese medicine culture into ideological and political education teaching reform.[Methods]Through literature research and other methods,focusing on the essence of nursing education,it constructed an ideological and political plan and evaluation system for the course of traditional Chinese medicine culture in geriatric nursing.[Results]A teaching model for traditional Chinese medicine course ideological and political education was constructed through the four dimensions of"understanding,practice,perception and innovation"in elderly care.A comprehensive evaluation system for course ideological and political education was formed based on different dimensions,promoting the effective implementation of course ideological and political education.[Conclusion]Integrating traditional Chinese medicine culture into the ideological and political education curriculum has solved the problem of the two sides of medical professional education and ideological and political education,and made beneficial explorations and contributions to the inheritance and development of traditional Chinese medicine culture and the cultivation of high-quality talents in modern traditional Chinese medicine.