Objective To investigate the effect of chain management on education among hypertensive patients of the community. Methods A total of 144 cases of hypertension patients in community were selected as the research objects, they were divided into the control group(72 cases, from February to July 2015) and the countryside group (72 cases, from September 2015 to February 2016).The control group was given routine education, and the countryside group received education with chain management. The treatment compliance and blood pressure values were compared between the two groups before and after intervention. Results The score of patients behavior of drug compliance, adverse drug, self life management and cigarettes-alcohol addiction management after intervention in the countryside group were (20.32±4.41), (34.62±5.08), (41.27±3.54), (10.02±1.79) points, while they were (13.41±3.07), (26.23 ± 5.12), (39.78 ± 2.47), (7.94 ± 1.83) points in the control group. And the scores of the countryside group were significantly higher than those of the control group (t=2.930-9.864, P<0.05). There were no significant differences in the systolic blood pressure, diastolic blood pressure and mean arterial pressure before the intervention between the two groups (P > 0.05). The systolic blood pressure, diastolic blood pressure and mean arterial pressure after intervention in the countryside group were (129.63 ± 8.07), (80.12 ± 7.62), (87.43 ± 9.35) mmHg(1 mmHg=0.133 kPa), while they were (135.42 ± 8.13), (87.56 ± 7.79), (99.31 ± 8.72) mmHg in the control group, and there were significant differences(t=4.295, 3.800, 9.201, P<0.01). Conclusions The chain management mode of community hypertension patients with education, can effectively improve the control of blood pressure in patients, improve the treatment compliance of patients.

Objective:To investigate the efficacy of compound carbidopa tablets combined with Bunao Xifeng Zhijing soup in the treatment of Parkinson’s disease(PD)and the influence on the levels of IL-6,IL-1β,MDA,SOD and serum cystatin C. Methods:Totally 68 patients with PD were divided into the observation group and the control group with 34 cases in each. The course of treatment was 3 months. The control group was treated with compound carbidopa tablets,and the observation group was treated with Bunao Xifeng Zhijing soup additionally. The Parkinson's disease quantitation table(UPDRS),quality of life,TCM symptoms,self-rating depression scale(SDS),self-rating anxiety scale(SAS)and changes of inflammatory factors before and after the treatment were compared between the two groups. Results:After the treatment,UPDRS-1,UPDRS-2,UPDRS-3, UPDRS-4,PDQ-39 SI,SDS,SAS and TCM symptom scores were all decreased in both groups(P < 0. 05),and the decrease was more notable in the observation group(P < 0. 05). Observation group UPDRS-4 score also significantly lower than the control group(P < 0. 05). After treatment,two groups of patients of interleukin(IL)6,IL-1 beta,malondialdehyde(MDA),serum(C level was a significant reduction in the inhibition(P < 0. 05),superoxide dismutase(SOD)levels,compared with the previous significantly increased(P < 0. 05). And the observation group of patients with IL-6,IL-1 beta,MDA,urinary inhibition C level significantly lower than the control group,serum SOD levels are significantly higher than control group(P < 0. 05). Observation group total effectiveness 91. 18% ,significantly higher than that of control group 64. 70%(P < 0. 05). Conclusion:compound carbidopa tablets combined with Bunao Xifeng Zhijing soup in the treatment of PD can significantly improve the movements and non-motor symptoms of the patients with high safety and good clinical efficacy.

Objeetive To evaluate the diagnostic value of axially loaded MR imaging with supine position in patients with degenerative disorders of lumbar spine.Methods Thirty asymptomatic volunteers and 89 patients were examined in psoas-relaxed position(PRP)and axially compressed supine position(ACE)of the lumbar spine.Sixty-one patients with low back pain,19 with sciatica and 9 with neurogenic claudication were included in the symptomatic study group.The disc levels from L3 to S1 were examined.Results In 30 asymptomatie volunteers,a significant decrease in dural sac cross-sectional area(DSCA)was found at 14 disc levels(15.6%)in 10 individuals(33.3%)during ACE(>15 mm2).In 89 patients.a significant decrease in DSCA was found at 55 disc levels(20.6%)in 38 patients(42.7%)during ACE(>15 mm2),and the mean decrease was 28 mm2.During ACE,32 disc levels with an increasing severity of disc herniation were noted in 26 patients.16 disc levels with neural foramen stenosis were found in 12 patients,11 disc levels with ligamentum flavum thickening were observed in 10 patients,3 cases facet dislocation and 3 cases lumbar spondylolisthesis were also seen.In 22 of the 89 patients(24.7%).additional valuable information(AVI)was found during ACE,including 7 patients(7/9)with neurogenic claudication,8 patients(8/19)with sciatica,and 11.5%(7/61)of the patients with low back pain.Conclusion As compared with conventional imaging methods,axially loaded imaging provides AVI,and more occult lesions can be found during ACE.ACE MRI is a valuable tool in diagnosing degenerative disorders of lumbar spine.

Objective To investigate the effects of the low-dose ketamine on the minimum alveolar concentration (MAC) of sevoflurane in patients undergoing gynecological abdominal surgery.Methods Fifty-one ASA Ⅰ or Ⅱ patients aged 36-49 yr with body mass index ≤ 30 kg/m2 scheduled for gynecological abdominal surgery were randomly divided into control group (group C, n = 29) and ketamine group (group K, n = 22) . The paitents were unpremedicated. In group K, a loading dose of ketamine 0.2 mg/kg was injected intravenously followed by infusion at a rate of 14 μg·kg-1 ·min-1 , while equal volume of normal saline was given in group C. Anesthesia was induced with inhalation of sevoflurane (end-tidal concentration 4%-5%, maintaining for 5 min) in both groups. Endotracheal intubation was performed. The patients breathed sevoflurane until the predetermined target end-tidal sevoflurane concentration was reached for at least 15 min before skin incision. Occurrence of body movement was determined by any visible contraction of the muscle bundle of trunk, limbs, head and neck during skin incision and/or within 60 s after skin incision. The initial end-tidal concentration of sevoflurane was set at 1.8 % .If body movement occurred, the end-tidal concentration of sevoflurane was increased by 0.2% , while if not, decreased by 0.2% . MACs of sevoflurane were calculated. Results The MAC of sevoflurane was 1.51% (95% confidence interval 1.45%-1.58%) in group K, and 2.49% (95% confidence interval 2.40%-2.57%) in group C, and there was significant difference between the two groups ( P < 0.05) . Conclusion Intravenous infusion of the low-dose ketamine can enhance the anesthetic effect of sevoflurane in patients undergoing gynecological abdominal surgery.

Objective To evaluate the efficacy of aerosol inhalation ofXiyanpingversus ribavirin for the treatment of respiratory tract infections in children.MethodsPubMed, Embase, Cochrane database of Systematic Reviews, CNKI, cqvip and wanfangdata were searched. The randomized controlled trials(RCTs) of aerosol inhalation ofXiyanpingversus ribavirin injections for the treatment of respiratory tract infections in children were incuded. The quality of trials was evaluated and data analyses were performed with the Cochrane Collaboration’s software RevMan 5.0.Results A total of 7 trials were included, involving 857 patients(437 treated withXiyanping, 420 treated with ribavirin). Both of the clinical cure rate(50.11%vs. 40.71%) and clinical effective rate(91.08%vs. 75.95%) in theXiyanping group were significantly higher than those in the ribavirin group, withOR(95%CI) 1.49(1.13 to 1.97) and 3.54(1.87 to 6.71), respectively.Conclusions Aerosol inhalation ofXiyanping superior to aerosol inhalation of ribavirin for the treatment of respiratory tract infections in children. Owing to the poor quality and the small sample size of included trials, more larger good quality CRTs are required to confirm this conclusion.

Objective To investigate the role of recombinant Vibrio vulnificus cytolysin (rVvhA) in inducing THP-1 cells damage and study the pathway of associated calcium influx .Methods Inverted mi-croscope, CCK-8 cell proliferation kit, Fluo3/AM staining and caspase activity detection were performed to analyze the damage of THP-1 cells induced by rVvhA and the pathway of calcium influx .Results rVvhA had cytotoxic effects on THP-1 cells in a dose-dependent manner .The concentrations of extracellular K +and LDH were respectively up-regulated after 1 h and 6 h of 12 μg/ml rVvhA intervention .Verapamil , Mibe-fradil and SKF-96365 could not prevent the influx of free Ca 2+induced by rVvhA .The activities of caspase-3 and caspase-9 were singanificantly enhanced by rVvhA in a time-dependant manner .Conclusion rVvhA can induce THP-1 cells damage through triggering extracellular calcium influx via porous channel on cell membrane.Moreover, rVvhA might induce THP-1 cell apoptosis through activating caspase-9/3-dependent pathway .

OBJECTIVE To investigate the change in antibiotic resistance of Burkholderia cepacia in hospital for reference of clinical antimicrobial strategy.METHODS Data were collected of the 859 bacteria strains isolated from clinical specimens from Jan 2004 to Dec 2006.Drug sensitivity tests were made for 22 antimicrobial agents.RESULTS All of the drug-resistance rates were higher than 90.00% including ampicillin,ampicillin/sulbactam,amoxicillin/clavulanic acid,cefazolin,gentamicin,tobramycin,amikacin,imipenem and nitrofurantoin.but that of the others such as ceftazidime(23.57%),cefepime(26.95%),ciprofloxacin(31.73%),cefoperazone/sulbactam(33.33%),and piperacillin/tazobactam(21.45%) were lower.The resistance rate to sulfamethoxazole/trimethoprim was 5.73% which was the lowest.CONCLUSIONS The isolation rate as well as the resistance to most of the antibiotics are increasing in clinical specimens.Antimicrobial treatment should be guided by drug sensitivity test.

OBJECTIVE To investigate the distribution of acute appendicitis pathogens and their drug resistance,and to guide clinically the selection of reasonable antibiotics.METHODS Germicultures and drug sensitivity tests were conducted for the pus specimens from the 116 patients with acute appendicitis by ATB Expression bacteria(identifier).RESULTS Pathogens in 75 cases of 116 were found,with a positive rate of 64.7%,totally 85 strains of bacteria were isolated from clinical samples.Gram-negative bacilli had 72 strains,accounted for 84.7% and Gram-positives had 13 strains,(accounted) for 15.3%.The first three were Escherichia coli(54.1%),Pseudomonas aeruginosa(4.7%),and Klebsiella pneumoniae(4.7%).Sensitivity tests showed that resistance rates of E.coli to cefapirin,imipenem,compound(piperacillin),cefoxitin,and amikacin were 0,2.2%,10.9%,17.4%, and(23.9%).CONCLUSIONS Dominant pathogens in patients with acute(appendicitis) are intestinal bacilli,with(predominance) of E.coli;more emphasis should be placed on pathogen detections and drug sensitivity tests so that effective antibiotics could be selected and resistant bacteria be reduced and nosocomial infections be prevented.

To study whether the late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival and proliferation of T cells through the survivin pathway, ICOS signals deficient T-cells were infected with adenovirus carried survivin gene, other T-cells were given ICOS co-stimulatory signals, then infected with adenovirus carried dominant-negative mutant survivin gene. Apoptosis and proliferation were determined by TUNEL and CCK-8 respectively. The results show that engagement of ICOS signal increased the expression level of survivin significantly. Survivin can sustain co-stimulatory deficient T cells survival and suppress the apoptosis. Mutant survivin inhibits ICOS signal positive T cells survival and increase its apoptosis. Late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival of T cells through the survivin pathway.

Objective To investigate the application effect of FMEA(failure mode and effect analysis) in prevention of aspiration after stroke.Methods From October 2011 to April 2012 48 stroke patients in our department without implementation of the FMEA management mode were set as the control group.From May 2012 to November 2012,another 48 cases were set as the observation group,in addition to the routine neurological nursing care,we also used FMEA to find forward-looking reason of the failure mode of aspiration and operation process analysis,evaluation,calculation and identify the risk factors of aspiration in patients with cerebral apoplexy and high-risk operation steps,prevention priority action plan and improvement measures.The incidence of aspiration,RPN value of six high risk factors,and satisfaction degree and mastering degree of aspiration related knowledge by patients and their families were compared.Results In the observation group,the crisis values of 6 high risk factors was significantly lower than those of the control group.Significant differences existed in satisfaction degree and mastering degree of aspiration related knowledge by patients and their families as well as hospitalization time.There was no aspiration cases during hospitalization in the observation group while 3 aspiration cases in the control group.Conclusions Application of FMEA to evaluate patients with swallowing disorder after stroke,analyzing and taking relevant measures can effectively prevent risks,reduce the occurrence of aspiration,improve the quality of nursing and promote patients' recovery.