Objective To know the quality of life-related factors in patients with asthma, and then carry out certain effective counter nursing measures. Methods Investigated 137 patients with severe asthma, to know their nursing requirement and factors which can influence their quality of life, and then counert nursing measures were carried out for patients according to the results of investigation. Compared the quality of life of patients with asthma before and after the research. Results There was a negative correlation between the quality of life for patients with asthma and their smoking habit, sleeping station, disease course and complica-tions respectively, while a positive correlation between the quality of life for patients with asthma and their edu-caiton background, asthma-related knowledge and incomes. The nursing requirement about health education, psychological interview, treatment services were the main requirements. After the nursing intervention, the quali-ty of life for patients with asthma was significant better than before. Conchlsions There were several factors which can influence the quality of life for patients with asthma, analysis,carry out certain strategy and eval-uation a kind of proper mode for adult patients with asthma.

Objective To investigate the causes and characterization of hepatic encephalopathy after transjugular intrahepatic portosystemic shunts(TIPSS).Methods 32 cases of patients with recepted TIPSS operation were enrolled in retrospective study.Results 9 of 32 patients suffered from hepatic encephalopathy were detected out after TIPSS. The present of hepatic encephalopathy was associated with the flow direction of blood in portvein after the operation(P

Objective To analyze the clinical distribution and drug resistance of clinically isolated strains of Acinetobacter Bau-mannii(ABA)in our hospital from January 2007 to December 2012 so as to provide the basis for the rational use of antibacterial drugs in clinic.Methods The API microbiological culture and identification system was adopted to conduct the ABA culture,identi-fication and drug susceptibility analysis on the clinical specimens submitted by various clinical department and the drug resistance of the strains was analyzed by using WHONET5.6 software.Results 791 strains of ABA were isolated in the recent 6 years,and the isolating rate of ABA in the pathogenic bacteria was 7.8%;The ABA detection was dominated by the sputum (80.4%)and the throat swab(10.9%)specimens;the distribution of isolated ABA strains were relatively widespread;the infection rates of the pa-tients were higher in ICU (18.8%),cadre wards(17.6%),respiratory medicine department(13.3%)and neurosurgery department (12.3%).During these 6 years,the drug resistance rate of less than 50% included imipenem(IPM)and cefoperazone sodium/sul-bactam,and the resistance rate in most of commonly used antibacterial drugs showed an increasing trend,especially IPM.Conclusion The drug resistance of ABA is more serious and the resistance rate of clinically isolated strains to most of antibacterial drugs in our hospital during 2007- 2012 showed an increasing trend.Dynamically monitoring the ABA distribution and the drug resistance changes conduces to guide the rational use of antibacterial drugs in clinic,prevent the nosocomial infection and reduce the generation of pan-drug resistant strains.

Objective To investigate the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital. Methods The first-time qualification rate of cleaning,packaging and sterility test and incidence rate of nosocomial infection before and after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital.The application effect was comprehensively evaluated. Results The first-time qualification rate of cleaning,packaging and sterility test after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center were significantly increased.The incidence rate of nosocomial infection was 1.5％ before and 5.5％ after the application of cleaning packaging of surgical medical apparatus and instruments,the difference was significant. Conclusions Application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center can effectively control the cleaning and packaging quality,guarantee the thoroughness of subsequent disinfection and sterilization,decrease the incidence rate of nosocomial infection caused by poor quality of surgical medical apparatus and instruments.It creates reliable medical environment for patients and obtain good social and economic benefit,which is worthy of wide application.

Objective To investigate the association between the presence of cerebral microbleeds and chronic kidney disease in patients with ischemic stroke.Methods Patients with ischemic stroke within 1-6 months were consecutively recruited.Cranial MRI was taken within two weeks after recruitment.Cerebral microbleeds were assessed using Microbleed Anatomical Rating Scale on gradient echo MRI.Demographics including sex,age and risk factors were obtained.Chronic kidney disease was defined and classified according to National Kidney Fundation-Kidney Disease Outcome Quality Initiative Guideline.Glomerular filtration rate (GFR) was estimated by using the abbreviated Modification of Diet in Renal Disease equation.Results Of the 636 patients included,mean age was (59.8 ± 10.1) years,435 (68.4％) were male.Sixty-six had decreased estimated GFR (eGFR; ＜ 60 ml · min-1 · 1.73 m-2).Two hundred and one (31.6％) patients had cerebral microbleeds,which were most commonly located in deep or infratentorial location (133/201,66.2％).The presence of cerebral microbleeds was much higher in patients with decreased eGFR than the others (48.5％ (32/66) vs 29.6％ (169/570),x2 =9.709,P =0.002).Age,history of hypertension and decreased eGFR were associated with the presence of cerebral microbleeds in univariate analysis.In multivariate analysis,decreased eGFR was independently associated with the presence of cerebral microbleeds in deep or infratentorial location (OR =1.457,95％ CI 1.044-2.034,P =0.027),but not associated with the presence of cerebral microbleeds in pure lobe.Conclusion Impaired kidney function is associated with the presence of cerebral microbleeds in deep or infratentorial regions in patients with ischemic stroke.

Objective To investigate the effects of adrenocorticotropic hormone (ACTH)combined with Huaiqihuang on hypothalamic pituitary adrenal (HPA) in rats. Methods Fifty rats were randomly divided into five groups according to the random number table method:normal control group (group A), prednisone group (group B), Huaiqihuang group (group C), ACTH group (group D) and combined treatment group (group E) with 10 rats in each group. Rats in group B, C, D and E were gavaged by acetic acid prednisone water solution 12.5 mg/(kg · d) for 4 weeks to establish HPA axis suppression model. Group A was given distilled water 10 mL/(kg·d) as control. Rats in group C and E were gavaged with Huaiqihuang 5 g/(kg·d) 30 minutes after intragastric administration of prednisone acetate. At the third week of the experiment, group D and E were subcutaneous injected with ACTH 200 μg/(kg·d). The serum cortisol levels were measured respectively at the start of the ex?periment, 2 weeks and 4 weeks of experiment. Animals were sacrificed at the end of the experiment, and then weights of the pituitary, adrenal glands and the viscera index were calculated. The pathological changes of the pituitary and adrenal glands were observed by HE stainning. Results After 2 weeks, the serum cortisol levels were significantly lower in group B, C, D and E than those of group A (P<0.05), suggesting that the model was successful. After 4 weeks, the serum cortisol levels were significantly higher in group C, D and E than those of group B (P<0.05), and between the treatment group the value was group E>group D>group C (P<0.05). At the same time, the weights of pituitary and adrenal gland and the viscera in?dex were higher in the three groups than those of B group (P<0.05). The HE staining showed that there were no significant changes in the distal part of the pituitary gland in five groups. The adrenal cortex zona was thinning and the structure was dis?ordered in group B. There were different degrees of hyperplasia in group C, group D, and group E, which was the most obvi?ous in group E. Conclusion ACTH combined with Huaiqihuang can promote adrenal cortex zona hyperplasia and cortisol secretion, which reduces the glucocorticoid induced inhibition of HPA axis in rats.

Objective To investigate the incidence and risk factors of cerebral microbleeds(CMB) in ischemic stroke patients.Methods Patients with cerebral infarction for 1～6 months were recruited.Clinical data were recorded.MRI was reviewed blindly to determine the number of CMB and lacunar infarcts and the white matter lesions(WML).The independent risk factors of CMB were analyzed with the Logistic multivariable regression.Results 636 subjects were included.CMB were found in 250 cases(39.3%).The incidence of CMB in patients of ≤50,50～65 and >65 years old were 27.2%,38.1% and 47.6% respectively(P<0.05).CMB was more frequent in patients with more lacunar infarcts(P<0.05).The incidence of CMB in patients with negative,mild,moderate and severe WML were 21.9%,33.8%,46.9%and 63.1% respectively(P<0.05).Logistic regression analysis showed that history of hypertension(OR=1.523,95% CI 1.019～2.276),severity of WML(OR=1.535,95% CI 1.258～1.874) and lacunar infarcts(OR=1.517,95% CI 1.087～2.118) were the independent risk factors for presence of CMB.Conclusion CMB was frequent in ischemic stroke.The frequency of CMB increased with aging,grade of lacunar infarcts and WML.History of hypertension,severity of WML and lacunar infarcts were the independent risk factors for CMB presence.

Objective To investigate the clinical value of high frequency ultrasound in discovering secondary pathological changes in infant with developmental dysplasia of the hip (DDH).Methods Thirtyfour infants with 36 dislocation hips were involved.Among them,32 were with unilateral dislocation of hip joint,2 were with bilateral dislocation of hip joint.High frequency ultrasound were used to observe the morphological changes of hip glenoid labrum,adipose hyperplasia in acetabulum,thickness variation of articular capsule,and development of the ossification center of the femoral head.Besides,the morphological changes of hip glenoid labrum and adipose hyperplasia in acetabul were compared with those from MRI.Results The sensitivity and specificity of ultrasound in diagnosing glenoid labral introversion were 82 ％ and 100％ respectively.The coincidence rate of diagnosing glenoid labral introversion and glenoid labral extroversion were both 83％.Adipose hyperplasias in acetabul were clearly seen in 31 hips using ultrasound.The thickness of articular capsule in the affected hip and in the healthy hip was (2.8 ± 0.6)mm versus (1.7 ± 0.4) mm,and the difference was obviously significant (P ＜0.01).The ossification center of the femoral head in the 34 infants were classified as the following four types:① which was smaller in the affected side than in the healthy side (22/34);②which was shown in the healthy side (7/34) but not in the affected side;③ which in both sides were not shown (4/34);④ which in both sides were small (1/34).Conclusions Ultrasound is a method of simple,rapid,non-invasive in diagnosing DDH,and it can be used to discover secondary pathological changes in infant with DDH,which provide important reference for clinical diagnosis and treatment.

Aim To optimize extraction of polysaccha-rides from Dendrobium officinale ( DOP ) and investi-gate the effects of DOP on the expression of Bax and Bcl-2 in vascular endothelial cell of human umbilical vein ( HUVEC) by the induction of high sugar. Meth-ods Response surface methodology ( RSM ) was em-ployed to optimize the conditions for extraction of DOP on the basis of single factor experiment. The HUVEC cells were divided into the blank control group, the normal blood sugar group, the high sugar stimulation group and different drug concentration group plus the high sugar stimulation group. The growth condition of cells was examined by methyl thiazolyl tetrazolium ( MTT) , and RT-PCR was used to detect the expres-sion of Bcl-2 Assaciated X protein ( Bax ) and B-cell lymphoma-2 ( Bcl-2 ) in vascular endothelial cells after 24 and 48 hours. Results The optimal extraction time was 2 h and the optimal liquid-solid ratio was 15. 75∶1 ( mL/g ) , and the optimal extraction frequency was 2. 8. Under these optimized conditions, the extraction rate of polysaccharides was 25. 1%, while the experi-mental extraction rate was 24. 9%, which was highly fit with the regression model. Compared with normal sugar group, high sugar group reduced the growth of cells and enhanced the expression of Bax, and inhibi-ted the expression of Bcl-2 . DOP promoted the growth of cells in high sugar induction, inhibited the expres-sion of Bax, and enhanced the expression of Bcl-2. Conclusions The process optimized through RSM has the extraction effect, and has certain practical signifi-cance. Through the down-regulation of the expression of Bax in vascular endothelial cells and the up-regula-tion of the expression of Bcl-2 by the induction of high sugar, DOP can restrain HUVEC, which could prevent and cure diabetic angiopathy to some extent.

Objective To investigate the expression of glucose-regulated protein 78(GRP78)and cysteine aspartic acid protease 12(Caspase-12) and evaluate the endoplasmic reticulum stress (ERS) in rats with contrast-induced nephropathy (CIN),and observe the protective effects of hydroxytyrosol on CIN rats.Methods Eighty-four Wistar rats,(220±20) g,were randomly divided into control group,CIN group,hydroxytyrosol treated group (group C+H).At 12th,24th,48th,72th day after the rats model were established,BUN and Scr were detected.ELISA were used to detect the expression of methane dicarboxylic aldehyde (MDA),superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px).HE staining were used to evaluate the pathological change of kidney.TUNEL were used to detect the apoptosis of tubular ceils.Real-time PCR were used to detect the expression of GRP78 mRNA and Caspase-12 mRNA in tubular cells.Immunohistochemistry and Western blotting were used to detect the expression of GRP78 and Caspase-12 protein in tubular cells.Results BUN,Scr,the mRNA and protein expression of GRP78,Caspase-12 in hydroxytyrosol treated group were higher than that in control group(P ＜ 0.05),but were significantly lower than that in CIN group (P ＜ 0.05).Pathological changes and the apoptosis of tubular cells in CIN group were more serious than that in hydroxytyrosol treated group (P ＜ 0.05).Conclusions Endoplasmic reticulum stress may be associated with contrast-induced nephropathy.Hydroxytyrosol can protect kidney from contrast medium via reducing the endoplasmic reticulum stress.