Objective:To improve hypertension management in peritoneal dialysis patients through CQI process. Methods: Using the 4 step problem solving framework called the PDCA cycle-plan, do, check and act, we conducted a CQI program. Results: One hundred and forty five peritoneal dialysis patients dialyzed for more than 3 months participated in the study. In 49 prevalent patients, the incidence of uncontrolled hypertension (BP≥140/90 mm Hg, 1 mm Hg=0.133 kPa) decreased from 49% to 16.3% although there were no significant changes in antihypertensive medication and total fluid removal. The incidence of uncontrolled hypertension in incident patients decreased from 61.3% to 28%. Height normalized extracellular water decreased significantly. In males it was from (10.8?1.4) kg/m to (10.3? 1.7) kg/m and in females (9.6?1.2) kg/m to (8.6?1.2) kg/m. Conclusion:CQI is a useful method in the management of hypertension in peritoneal dialysis patients.

Animals ; Female ; Hypertension, Pregnancy-Induced ; metabolism ; pathology ; Kidney ; metabolism ; pathology ; Pregnancy ; Protein Kinase C-alpha ; genetics ; metabolism ; Rats ; Rats, Wistar ; Transcription, Genetic

Objective To investigate the changes of plasma vascular endothelial growth factor( VEGF) of patients of advanced primary liver cancer before and after interventional treatment and its clinical Significance. Methods Forty-six patients with advanced primary liver cancer were performed the hepatic arterial chemoembolization and served as observation group. Sixty healthy people were served as control group and measured their level of serum VEGF. The level of serum VEGF of patients in observation group before treatment and intervention 1 month were measured. Results Before interventional treatment,the serum VEGF level of observation group were(510. 0 ± 310. 0)ng/L,significantly higher than that of control group((27. 0 ± 23. 0) ng/L,P﹤0. 001). After interventional treatment,he serum VEGF level decreased to(316. 4 ± 240. 7)ng/L and the difference was statistically significant( P=0. 036 ). After one month interventional treatment,4 cases were complete remission(8. 70%),34 cases were partial remission(73. 91%),6 cases were in stable(13. 04%),and 2 cases were progress( 4. 35%),and the total effective rate were 82. 61%( 38/46 ). The 38 cases who were complete remission and partial remission were been served as effective group,the other 8 cases were served as invalid group. The serum VEGF level in effective group were( 260. 6 ± 70. 5 )ng/L,lower than that in invalid group(( 346. 7 ± 61. 3 )ng/L,P = 0. 046 ). Conclusion Hepatic arterial chemoembolization treatment on primary liver cancer curative effect is a better approach. VEGF involves in the development of primary liver cancer,and the high serum VEGF level with poor prognosis can be the reference of efficacy.

Objective To investigate the influence of seawater immersion of open abdominal wound on function and pathological changes in liver in dog.Methods Twenty healthy dogs were divided randomly into two groups.A perforating abdominal wound was was made in each animal of both groups.Animals in control group(n=10)only abdominal wound was made,while abdominal wound was followed by seawater immersion in the animals of seawater immersion group(n=10).Blood samples were taken before the trauma(0 hour)and at 4,8,12,16 and 20 hours after the trauma and water immersion for both groups.Total bilirubin(TB),alanine transaminase(ALT),aspartate transaminase(AST),lactate dehydrogenase(LDH),blood ammonia(NH3),prothrombin time(PT),tumor necrosis factor-?(TNF-?),interleukin-6(IL-6)and endotoxin(ETX)were assayed.Experimental animals were sacrificed 24 hours after trauma,and the pathological changes in hepatic tissue were studied.Results TB,ALT,AST and PT were higher in seawater immersion group,than those in control group,with a marked elevation at 16 hours.In seawater immersion group,LDH was significantly higher than those in control group at 4 and 12 hours,and NH3 was increased significantly at 4 hours in experimental group(P

Objective:To obverse the therapeutic effect of superficial needling with different frequencies for intractable facial paralysis. Methods: A total of 120 patients with intractable peripheral facial paralysis were allocated into a superficial needling with high frequency group (150 times/min), a moderate frequency group (100 times/min) and a low frequency group (50 times/min) according to the random number table method. The Toronto facial grading system (TFGS) was used to evaluate facial nerve functions before treatment and after 2 weeks and 4 weeks of treatment respectively. The electromyography (EMG) test of the mandibular branch of facial nerve was used to compare the motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV) and monophasic action potential (MAP) among different groups, and was done before treatment and after 4 weeks of treatment. The clinical efficacy was also compared. Results: After 2 weeks and 4 weeks of treatment, the changes of TFGS scores in the three groups all showed statistical significance (all P＜0.05), and the TFGS score in the low frequency group was substantially higher than that in the other two groups. After treatment, the changes of the MCV and SCV in the three groups all showed statistical significance (all P＜0.05), and the results in the low frequency group were higher than those in the other two groups; the change of MAP in the three groups showed no statistical significance (P＞0.05). The total effective rate was 65.0%, 80.0% and 95.0% in the high frequency group, moderate frequency group and low frequency group respectively, and the between-group differences showed statistical significance (P＜0.05). Conclusion: Compared with the superficial needling with high and moderate frequencies, superficial needling with low frequency can produce more significant clinical efficacy for intractable facial paralysis.

Objective Investigation of the clearance rate of RBC in cerebral spinal fluid(CSF)after lumber subarachnoid space continuous drainage following subarachnoid hemorrhage(SAH)and the relationship with cerebral vasospasm(CVS) were carried out. Methods An experimental SAH was achieved in dogs by twice injecting fresh autologous arterial blood into cisterna magna of each animal.RBC counts in CSF were measured in the drainage group, puncture group and control group respectively.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diameter,%RBAD). Results Comparing with puncture group and control group, the drainage group showed a significantly higher clearance rate of RBC with lesser occurrance and degree of CVS. Conclusions RBC and its degeneratives in CSF may be involed in the process of CVS following experimental SAH. Continuous lumber subarachnoid space drainage may prevent CVS.

Objective To investigate the relationship between endothelin-1(ET-1)and NO in cerebral spinal fluid(CSF) and cerebral vasospasm(CVS) following experimental subarachnoid hemorrhage(SAH).Methods An experimental CVS model was achieved by twice injections of fresh autologous arterial blood into the cisterna magna of each animal. The contents of ET-1 and NO in CSF were measured by radioimmunological analysis and activated cadmium reduction method respectively.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diamiter,%RBAD). Results The contents of ET-1 in CSF increased significantly than that before injection after SAH(P

Objective To investigate the effect of lumbar subarachnoid space continuous drainage on cerebral vasospasm(CVS) prevention and treatment following experimental subarachnoid hemorrhage(SAH), and further explore the mechanism of CVS prevention and treatment.Methods An experimental SAH was achieved by twice injections of fresh autologous arterial blood into cisterna magna of each dog. The dogs were randomly divided into drainage group and control group and it was just after the second injection of fresh blood that the drainage group began to drain blood cerebral spinal fluid(CSF).The contents of red blood cell(RBC), endothelin-1(ET-1) and nitric oxygen(NO) in CSF were measured respectively. The degree of CVS was analyzed through angiography (%reduction of basilar artery diamiter,%RBAD). The angiographic results of CVS were analyzed and the changes of RBC, ET-1 and NO in CSF at different stages were compared between two groups. Results The drainage group had fewer cases of CVS and the severity of CVS was more slight compared with control group.Drainage group had a significantly higher cleaning rate of RBC.In drainage group,the content of ET-1 was lower and the content of NO was higher significantly than control group.Conclusions Through cleaning the vasogenic substances in subarachnoid space,lumbar subarachnoid space continuous drainage can change the levels of ET-1 and NO in CSF and may prevent and reverse CVS following.

Objective In this study,the authers investigate the effect of lumbar arachnoid space continuous drainage to prevent and reverse cerebral vasospasm (CVS) angiographically following experimental subarachnoid hemorrhage (SAH).Methods SAH model was achieved by cisternal magna twice injections of autolugous blood.Thirty adult mongrel dogs presented with SAH were randomly divided into five groups: early-drainage group,later-drainage group,early-puncture group,later-puncture group and control group. The lumbar puncture two groups started to puncture and exclude blood cerebral spinal fluid(CSF) 2 hours later following the second injection and on day 5 respectively,while the drainage two groups started to drain at the same time.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diamiter,%RBAD). Results ①Compared with early puncture group and control group,early drainage group had less cases of CVS and the degrees of CVS were more slight which relieved within shorter period than other two groups.②Compared with later puncture group and control group,later drainage group had less cases of CVS and the period of CVS was shorter.③Compared with later drainage group,there were less cases of CVS and the degrees of CVS were more slight in early drainage group.Conclusions Lumbar subarachnoid space continuous drainage may prevent and reverse the CVS following SAH.Early lumbar subarachnoid space continuous drainage should be presented with better consequence.

0.05), the ratio of Cm/Cps rose gradually with lowering of rectal temperature and it reached the top value at 28℃; during this period AST, ALT, Cr and BUN decreased with dropping of rectal temperature (P