Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.

Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.

Dental anxiety (DA) is the psychology obstacle of the dental patients in the dental treatment. Recently, dental anxiety becomes prevalent in the world and it greatly impacts physical health and the quality of life. The text discussed the relationship between doctors and patients in the treatment of DA

Objective To sdudy the effects of Melatonin(MT)on cognition and tau hyperphosphorylation in hippocampus of Alzheimer's disease(AD)model rats.Methods A?25-35 was injected into the hippocampus to make AD model rat.MT was injected intraperitoneully into rats of MT group 7 days before and 19 days after modeling.Normal saline(NS)was injected intraperitoneully into rats of AD group after modeling.The cognition was tested by Morris water maze.The pathological changes of hippocampus was observed by Bielschowsky staining and the tau hyperphosphorylation was detected by immunohistochemistry staining.The results were compared with normal control group.Results In MT group,the results of Morris water maze were significant better than those in AD group(all P

Objective To investigate the clinical and pathological characteristics of carcinoid tumor in rectum and its treatment. Methods The clinical and pathological data of 38 rectal carcinoid patients from Wuhan Center Hospital and Wuhan the Eighth Hospital from January 2005 to December 2009 and reviewed were analyzed retrospectively. Results All 38 cases were typical carcinoid, located in the rectum within 10 centimeters to the lower border of the anal canal.The classic characters were submuscosal tumor with yellow color and rigid or tough texture and always were lack of mobility. Carcinoid tumor of rectum often expressed markers of neuroendocrine differentiation on immunohistochemical staining.Among 38 cases, 34 cases were less than or equal to 2.0 cm in diameter and located in lamina propria (n=30) or invased submucosal layer (n=4), these patients were cured by endoscopic mucosal resection (EMR).Four cases were larger than 2.0 cm in diameter with muscularis externa invasion, treated by curative resection.All tumors <2.0 cm in diameter had a very lower Ki-67 labeling index (<3% ).34 patients survived at the latest follow-up. Conclusions The diagnosis of rectal carcinoid relies on histopathology and immunohistochemistry. The behavior of the rectal carcinoid shows low degree of malignant potentia. They rarely invade the muscularis externa or metastases. Most of them can be cured by endoscopic mucosal resection(EMR).

Objective To analyze the endoscopic and pathological characteristics of rectum neuroendocrine neoplasm (NEN).Methods From January 2005 to May 2012,the endoscopic and pathological data of 66 patients with rectum NEN were collected and graded according to historistic grade of gastroenteropancreatic-neuroendocrine neoplasm (GEP-NEN) by World Health Organization (WHO).The factors related with the metastasis of neuroendocrine tumor (NET) and neuroendocrine cancer (NEC) were analyzed by Chi square test and Fisher exact probability method.Results The locations of 66 NEN cases were between three and 15 cm from the anus.The diameters of 54 cases were less than 1 cm and under endoscopy the appearance of most tumors was submucosal hemispherical polypoid bulge.The diameters of nine cases were over 1 cm but less than 2 cm,of which the appearance of five cases was submucosal thickening or sessile polypoid bulge.The diameter of three cases was over 2 cm and the appearance was cauliflower-like or polypoid tumor which caused annular lumen stenosis.Sixty-one cases were NET (grade G1),three cases were NEC (grade G3) and two cases were mixed adenoendocrine carcinoma with both NEC and adenocarcinoma components.The metastasis of NET and NEC was not related with gender (x2 =0.158,P＞0.05) and age (Fisher exact probability method,P＞ 0.05),however was related with the diameter of tumor (Fisher exact probability method,P＜0.05).Conclusions NEN is a tumor with variety endoscopic characteristics and pathological features.The metastasis of NET and NEC seems not related with gender and age,but related with diameter.

BACKGROUND:Isoflurane is an anesthesia drug that has a certain effect on the nervous system. It possibly causes neurologic disorders through impacting nerve stem cel function or morphology. OBJECTIVE:To investigate the effects of isoflurane on the proliferation and differentiation of neural stem cels in the hippocampus of rats. METHODS:Neural stem cels from the hippocampus of neonatal Sprague-Dawley rats, aged 7 days, were induced and differentiated. Passage 3 cels were obtained and divided into two groups: isoflurane group (a mixture gas of 2.8% isoflurane, 5% CO2 and 95% O2) and control group (a mixture of 5% CO2 and 95% O2).
After intervention of 6 hours folowed by 2 hours of routine culture, anti-BrdU monoclonal antibody immunofluorescent staining was used to detect cel proliferation, and western blot assay to detect the expression of β3-tubulin and glial fibrilary acidic protein. RESULTS AND CONCLUSION:Compared with the control group, the number of BrdU positive cels in the isoflurane group reduced significantly, indicating that isoflurane inhibits the proliferation of neural stem cels. Compared with the control group, the expression of glial fibrilary acidic protein in the isoflurane group up-regulated, but the expression of β3-tubulin had no changes, indicating isoflurane promotes the differentiation of neural stem cels into astrocytes. Cite this article:Min N, Hu QF, Li XP, Nie XH, Yang LL.Isoflurane effects on the proliferation and differentiation of neural stem cels in the hippocampus of neonatal rats. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):118-122.

Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa,and to guide clinical treatment.Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled.The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa.According to the wound healing time,they were divided into wound healing group (26 cases,healing time ≤ 3 months) and wound un-healing group (23 cases,healing time ＞ 3 months).The general information,clinical indicators and treatment between two groups were compared,and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis.Results Compared with those in wound un-healing group,the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher:(43.59 ± 2.71) ml/min vs.(23.14 ± 5.39) ml/min,76.9％ (20/26) vs 47.8％(11/23),and the urinary micro-albumin was lower:(67.01 ± 3.32) mg/L vs.(234.03 ± 6.71) mg/L.There were significant differences (P ＜ 0.05 or ＜ 0.01).Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was-5.551,P =0.001),urinary micro-albumin (regression coefficient was 0.127,P =0.007) and negative pressure attraction (regression coefficient was-2.244,P =0.042).Conclusion The blood flow volume of dorsal artery of affected foot,urinary micro-albumin,negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa.

Objective To investigate the perinatal outcome for pregnancies complicated with chronic renal diseases,and the risk factors for the adverse outcome.Methods Retrospectively analyze the clinical data of 48 patients with chronic renal diseases complicating pregnancy admitted in Peking University People's Hospital between January 1998 and August 2010,record the pregnancy outcome and explore the risk factors for the poor outcome using multivariate regression analysis.Results Thirty-eight patients had known chronic renal disease before conception,and ten were diagnosed during pregnancy.Seven patients (15％,7/48 ) presented with obvious renal impairment [ serum creatinine (sCr) ≥ 125 μmol/L] prepregnancy,and nine (19％,9/48 ) were recorded with chronic hypertension.Thirty-three patients received regular prenatal care.Twenty-one cases ( 44％,21/48 ) developed preeclampsia.During the gestation,normal renal function (defined as sCr ＜71 μmol/L) was seen in nineteen cases (40％,19/48),mild dysfunction (sCr ranged 71 - 132 μmol/L) in twenty (42％,20/48) and moderate to severe dysfunction ( sCr ≥ 132 μmol/L) in nine cases ( 19％,9/48 ).Twenty patients had negative or mild proteinuria (24 hour urine protein ＜2000 mg),19 had moderate (24 hour urine protein ranged 2000 -5000 mg) and nine had severe proteinuria (24 hour urine protein ≥ 5000 mg).The gestational age at delivery ranged from 24 to 41 weeks and the neonatal birth weight ranged from 890 to 4150 g.A total of twenty patients (42％,20/48 ) suffered adverse perinatal outcome,including one case with late spontaneous abortion,fifteen with preterm delivery,eleven with small for gestational age,two with neonatal respiratory distress syndrome and four with perinatal death.Declined maternal renal function was seen in eight patients,and two patients progressed toward the end-stage renal failure ( the stage of uremia).Multivariate regression analysis identified that preeclampsia (OR =24.72, P =0.002 ) and the degree of proteinuria ( OR =4.24,P =0.032) were the independent risk factors for the adverse perinatal outcome. Conclusions Pregnancies complicated with chronic renal diseases have significantly high incidence of preeclampsia and adverse perinatal outcome.Preeclampsia and the degree of proteinuria are perhaps the independent risk factors for the adverse outcome.

Objective To evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.