Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.

Objective To observe the clinical effect of the Placenta Polypeptides injection combined with paclitaxel plus paraplatin(TC)chemotherapy in the treatment of advanced ovarian cancer.Methods Eighty patients with advanced ovarian cancer receiving tumor cytoreductive surgery were divided into the treatment group and control group,40 cases in each group.The control group accepted single TC chemotherapy,while on this basis the treatment group was added with the Placenta Polypeptides injection.The short-term effect,KPS scores and occurrence of chemotherapeutic toxic reactions were observed in both groups.Results The short-term effective rates in the treatment group and control group were 90.00％ and 87.50 ％ respectively,the difference was not statistically significant (P＞0.05);the living quality KPS score in the treatment group was significantly better than that in the control group,the difference indicated statistical significance(P＜0.05).The occurrence rates of adverse reactions,including leukopenia,nausea and vomiting,liver function damage,heart toxicity,muscle and joint pain were significantly lower than those in the control group (P＜0.05).Conclusion The Placenta Polypeptides injection combined with TC chemotherapeutic regimen in the treatment of advanced ovarian cancer could improve the quality of life of the patients,reduce the toxic and adverse reactions of chemotherapeutic drugs.

Objective To improve the treatment of abnormal calcium-phosphorus metabolism in hemodialysis patients, and observe its influence on the quality of life. Methods Implemented the kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in hemodialysis patients, improved the treatment of abnormal calcium-phesphoms metabolism in hemodialysis patients. After 1 year, the values were compared between before and after application of K/DOQI guidelines, including albumin-adjusted serum calcium, phosphorus, calcium × phosphorus (Ca × P) product, and intact parathyroid hormone (iPTH) and their achieved target range rates. The quality of life were evaluated by using the kidney disease questionnaire (KDQ). Results One year later, the levels of serum calcium, phosphorus, Ca × P product, and iPTH were all decreased (P<0.01 or <0.05) compared with before the application of K/DOQI guidelines. The percentage of patients fell within the guideline range were as follows: 74.42% (32/43), calcium; 62.79%(27/43), phosphorus; 55.81%(24/43), Ca × P product; 60.47%(26/43), iPTH; 25.58%(11/43), all four criteria, higher than before (P<0.01 or <0.05). The scores of KDQ in global indices and symptom scores of physical symptoms, fatigue, depression, relationships with others and frustration dimension were also all increased (P<0.01). Conclusion The state of calcium-phospberns metabolism in hemodialysis patients is improved, the quality of life is also enhanced.

Objective To investigate the effects of SPARC (secreated protein acidic and rich in cysteine) and its peptide on proliferation, apoptosis and cell cycle of human mesangial cells cultured in vitro, and explore the possible mechanism. Methods Mesangial cells were incubated in the media with various concentrations of SPARC and its peptide cultured in vitro. Cell proliferation was assessed by MTT colorimetric assay. Cell cycle and apoptosis index were analyzed by flow cytometry. The expression of cyclinD1 and p21Wafl proteins in response to SPARC and its peptide in HMC was determined by Western blot. Results Various concentrations of SPARC and its peptide could significantly inhibit the proliferation of mesangial cells in dose- and time-dependent manner, regulate the cell cycle at phrase G-0/G1 increased while cells phrase S reduced, and could also induce apoptosis. Under the stimulation of SPARC and its peptide, the expression of cyclinDl in HMC decreased markedly meanwhile the expression of p21Wafl increased significantly. Conclusions SPARC and its peptide can effectively inhibit HMC proliferation and regulate cell cycle progression. The mechanism may be mediated by inhibiting cyclinDl and stimulating p21Wafl expression, subsequently blocking cells passing through G-S check point, which will be useful for treating mesangial proliferative glomerulonephritis.

Objective To observe the effect ofprostaglandin E1 intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria.Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks,according to random number table method were divided into treatment group and control group,with 30 cases in each group.Original antihypertensive drugs were used continuously in treatment group and control group,and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment,with losartan and other antihypertensive drugs routinely.Using self-contrast before and after treatment and contrast with control group,the change of urinary level of microalbumin (mALB),osmotic pressure,β2-microglodulin (β 2-MG) and N-acetyl-β-D-glucosaminidase (NAG) were compared.Results The blood pressure after treatment in both groups were decreased,but there was no statistically significant difference compared with that before treatment (P ＞ 0.05).After treatment of 12 weeks,urinary levels of mALB,β 2-MG and NAG in treatment group were lower than those in control group [(88.6 ± 14.2)μg/min vs.(123.9 ± 14.8) μg/min,(0.84 ±0.41) mg/L vs.(1.61 ±0.49) mg/L,(30.2 ± 10.5) U/L vs.(75.7 ± 12.8) U/L],and osmotic pressure was higher than that in control group [(591 ± 71) mmol/L vs.(454 ± 67) mmol/L],the difference had statistical significance (P ＜ 0.01).Conclusion Prostaglandin E1can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.

Objective To explore the curative effects of endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage. Methods 76 patients with hepatic cirrhosis complicated with upper gastrointestinal hemorrhage were divided into 2 groups by random double blind method, with 38 cases in each group. The control group were treated by conservative regimen alone while the experimental group were treated by endoscopic band ligation combined with drug injection, based on the control group. The clinical curative effects, adverse reactions, hemostasis time, hospitalization time , rebleeding , haemodynamics and other indexes before and after the treatment in the 2 groups were compared. Results The total effective rate, rebleeding rate and the incidence of fever in the experimental group were 2.6% and 10.5%, respectively. Compared with those in the control group (71.1%, 21.1%, 28.9%), the differences were statistically significant (P < 0.05). The differences in volume of blood transfusion, hemostasis time , time of improvement of symptoms and hospitalization time between the experimental group and the control group were significant (P < 0.01). The blood flow of portal vein(550.2 ± 143.4)mL and splenic vein (284.3 ± 96.4)mLin the experimental group was significantly less than that in the control group [(628.1 ± 156.0)mL, (332.6 ± 100.3)mL] (P < 0.05). Condusions Endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage is effective and can significantly improve the varicose hemodynamics in patients. The rate of rebleeding is low.

Objective To summarize the nursing key points of one patient of external ankle foot of gout patients with purulent infection which caused by gout stone burst in order to provide reference for the similar case. Methods Using silver dressing for local treatment of gout during wound, on the basis of control the basic diseases, local wound treatment focus was mainly reflected in: infection control, fluid management and wound debridement. Results After 86 days of treatment. The wound had already healed. Conclusions Rational use of silver dressing gout can promote wound healing and relieve the pain of patients.

Objective To investigate the consistency of gene amplification and its expression at protein level of human epidermal growth factor receptor 2 (HER2) in gastric carcinoma.Methods From 2010 to 2012,120 gastric cancer specimens of patients with gastric cancer were collected,of which 100 were surgical specimens and 20 were specimens from biopsy under gastroscope.The protein expression of HER2 in 120 specimens was detected by immunohistochemistry (IHC).According to the results of IHC,the positive parts of HER2 expression of IHC slices were developed into tissue microarrays for fluorescence in situ hybridization (FISH) to test the gene amplification of HER2.The different parts with different color intensity of focal (+ + +) (≤ 10％ tumor cell strongly staining) specimens detected by IHC detection were compared with the results of FISH.Kappa test was performed for statistical analysis.Results Among 120 gastric cancer specimens,the results of IHC indicated that 77 specimens were positive with different staining intensity including 16 strong positive (+++),six focal positive (+++),37 moderate positive (++) and 18 weak positive (+).The positive rate of HER2 protein expression detected by IHC was 18.3％ (22/120).The results of FISH showed 41 specimens were positive and the rate of gene amplification was 34.2％.Among which,21 were moderate positive (++) detected by IHC,15 were strong positive (+ + +) and five were focal positive (+ ++).The positive rate of HER2 was 35.0％ (42/120) with IHC and FISH combined detection.The consistent rate of IHC and FISH was 91.6 ％ (76/83).Kappa coefficient was 0.960 (P＜0.01).In five positive specimens detected by FISH and which were focal positive (+ + +) by IHC,the different parts with different color intensity were compared with the results of FISH and gene amplification was found in all specimens.Conclusion Tissue microarray technology is consistent with IHC in HER2 detection in gastric cancer specimens and could help to improve the detection rate.

Objective To study the cardioprotection effects of heme oxygenase-1(HO-1)on cardiopulmonary resuscitation(CPR).Method Male Sprague-Dawley rats were asphyxiated for 9 minutes and resuscitated.Rats wefe randomly divided into 4 groups,namely,sham asphysiation group,CPR group,Hemin group and Heroin +ZnPP group(zinc protoporyphyrin IX).Resuscitated groups were further divided into two subgroups according to various intervals:6 hours and 24 hours after resuscitation.Hemodynamic was observed.Serum creatine phosphokinase-MB(CPK-MB)and lactate dehydrogenase were determined.HO-1 in heart tissue homogenates was assayed.Ultrastructure of rats hearts was examined.Statical evaluation was performed with analysis of variance.Results The mean blood pressure(MBP)in resuscitated groups was significantly reduced after resuscitation,hadn't any difference between supgroups.The scores of dp/dt 40 and-dp/dt were significantly decreased in CPR group and Hemin+ZnPP group after resuscitation(all P＜0.05),but dP/dt40 in Heroin group did nol differ significantly after resuscitation.and-dp/dt decreased only 0.5 hours and one hour after resuscitation and returned to baseline values two hours after resuscitation.The scores of dp/dt 40and-dp/dt in Heroin group at different intervals after resuscitation were significantly higher than those in CPR group and Hemin+ZnPP group(all P＜0.05).Serum CPK-MB and LDH in CPR group and Hemin+ZnPP group at 6 hours and 24 hours after resuscitation were significantly higher than those in Hemin group(all P＜0.05).The cardiac tissue ultrastructure of rats in Hemin group was more intact than that of CPB group and Hemin+ZnPP goup.HO-1 levels in heart tissue homogenates of Hemin group at 6 hours and 24 hours after resuscitation were significantly higher than those in CPR group and Heroin+ZnPP group(all P＜0.05).Conclusions HO-1 expression induced by Heroin can effectively improve post-resuscitation myocardial dysfunction,alleviate cardiac injury,keep the ultrassructure integrity of cardiac myocytes.It may be a new approach to treat myocardial dysfunction after resuscitation.

Objective : To investigate the AIDS-related knowledge and behaviors and health service demand among secondary vocational school students in Shanghai Municipality, so as to provide the evidence for formulating the HIV/AIDS health education and behavioral interventions among secondary vocational school students. Methods : Three secondary vocational schools were randomly sampled in Shanghai Municipality using a stratified cluster sampling method from September to November in 2019, and grade was stratified in each school. Then, a class was sampled from each grade, and all students in this class were sampled. Participants' demographics, AIDS-related knowledge, sexual behaviors, and health service needs for AIDS control were collected using questionnaires and descriptively analyzed. Results : Totally 2 078 questionnaires were allocated, and 2 022 questionnaires were recovered, including 2 013 valid questionnaires (99.55%). The respondents had a median age of 16 years (interquartile range, 2 years), and included 1 366 men (67.86%). A low awareness rate was found for “Self-testing may understand HIV/AIDS infection status” (40.83%) and “Mosquito bites fail to transmit HIV” (37.95%). There were 182 respondents with sexual behaviors (9.04%), including 47 respondents with use of condoms during each sexual behaviors (25.82%), 20 respondents with multiple sexual partner behaviors simultaneously (10.99%), and 21 respondents that had received HIV testing (11.54%). There were 807 respondents with questions about sex and reproductive health (40.09%), and 852 respondents that wished to acquire answers from professional network platforms and professionals (42.32%). Conclusions The awareness of HIV/AIDS transmission route and use of condoms is low among secondary vocational students in Shanghai Municipality, and there are high-risk behaviors for HIV/AIDS among students. The secondary vocational school students are most eager to obtain the answers from professional institutions and professionals if there are questions about sex and reproductive health.