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.

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.

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 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 study the effects of diabetes on hippocampal synaptic plasticity in perforant path-dentate gyrus pathway (PP-DG) in rats. Methods 70 SD rats( 180±20) g were divided into 3 groups at random: control group, type1 diabetes group (DM1)and type2 diabetes group (DM2). After Morris water maze test, 15 rats that showed worse spatial memory ability were selected in each model group to investigate the variation of paired-pulse facilitation (PPF) and the range of synaptic plasticity. Field potentials were recorded in the dentate gyrus of the dorsal hippocampus by stimulating the perforant path. Results Contrast to the control group, diabetic rats' hippocampal LTP were depressed (P<0.05), and type1 diabetic rats' LTP reduced much more. Diabetic rats' PPF ratio was reduced contrast to the control group (P<0.05). Conclusion Type1 and type2 diabetes impaired synaptic plasticity of hippocampal PP-DG pathway in rats, which conformed the results of water maze test.

Objective To analyze and summarize the characteristics of thyroid diseases on the MR diffusion-weighted imaging.Methods Forty-two patients with thyroid lesions,including 10 males and 32 females [age range 20-72 years,mean age (42 + 13) years] underwent MR DWI before surgery and biopsy.The diagnoses of thyroid lesions were confirmed by pathological results.ADC values of benign and malignant nodules,with different b values (b values was 300,500 and 800 s/mm2),were generated by using post-processing software Functool of GE company(USA).The independent-samples t test was used and ROC curve was made to evaluate the diagnostic efficiency of the ADC values by using statistical software SPSS 12.0.Results Histologically,there were 28 benign lesions and 14 malignant lesions.Benign lesions included 20 cases of thyroid adenoma,6 cases of nodular goiter and 2 cases of Hashimoto's thyroiditis respectively.Malignant lesions consisted of 11cases of thyroid papillary carcinoma,2 cases of follicular thyroid cancer,and 1case of dysplasia.mean ADC value of benign thyroid lesions was (2.39 ±0.38) ×10 -3 mm2/s and mean ADC value of malignant thyroid lesions was ( 1.60 ± 0.56) × 10 -3 mm2/s with b value of 300 s/mm2.The statistical difference was significant between them( t =5.35,P ＜ 0.05 ).The statistical difference of mean A DC values,between benign and malignant nodules with b value of 500 s/mm2 [ (1.85 +0.33 ) × 10 -3 mm2/s and ( 1.65 ± 0.42 ) × 10 -3 mm2/s ],was insignificant ( t =1.70,P ＞ 0.05 ).The statistical difference of mean ADC values,between benign and malignant nodules with b value of 800 s/mm2 [ ( 1.61± 0.30) × 10 -3mm2/s and( 1.44 +0.29) × 10 -3mm2/s],was insignificant (t =1.76,P ＞0.05 ).ROC curve indicated that the ADC value of 1.98 × 10-3 mm2/s or higher was the cut-off value for differentiating benign from malignant cold thyroid nodules,with a sensitivity of 85.7％,and a specificity of 78.6％.Conclusions The image quality is best with b value of 300 s/mm2.Mean ADC value of benign lesions was significantly higher than mean ADC value of malignant lesions with b value of 300 s/mm2.

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 To investigate the effects of hydrogen-rich saline on postoperative cognitive dysfunction (POCD) in aged mice and the possible mechanism.Methods Seventy-two male C57BL/6 mice,aged 18 months,weighing 45-55 g,were randomly divided into 4 groups (n =18 each):control group (group C),hydrogen-rich saline group (group H),POCD group and POCD + hydrogen-rich saline group (group PH).POCD was induced by open tibial fracture.Hydrogen-rich saline 10 ml/kg was injected intraperitoneally twice a day for 7 days before surgery.Six mice were chosen at day 1,3 and 7 after surgery and cognitive function was assessed by Morris water maze test.The mice were then sacrificed and hippocampus was isolated for determination of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) contents (by ELISA) and nuclear factor-κB (NF-κB) activity.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased at 3 and 7 days after surgery,and the contents of NF-α and IL-1β and NF-κB activity were increased during 1,3 and 7 days after surgery in group POCD (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group H (P ＞ 0.05).Compared with group POCD,the escape latency was significantly shortened,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased at 3 and 7 days after surgery,and the contents of NF-α and IL-1β and NF-κB activity were decreased at 1,3 and 7 days after surgery.Conclusion Hydrogen-rich saline can alleviate POCD via inhibiting NK-κB activity in hippocampus and reducing inflammatory response.

Objective To study the risk factors for dose wearing off (WO)in PD patients .Methods One hundred and thirty-three PD patients were recruited in this study according to the UKPDBB criteria .Their dose WO was diagnosed according to the Wo questionnaire 9 (WOQ-9) .The pa-tients were divided into WOQ-9 (+ ) group (n=111) and WOQ-9 (-) group (n=22) .The pa-tients in WOQ-9 (+) group were further divided int WO (+ ) group (n=59) and WO (-) group (n=52) .The difference in their clinical and therapeutic parameters was compared .Results The dose WO was observed in 83 .5% of the 133 PD patients ,53 .2% of which accorded with the dose WO clinical definition .T he disease onset age ,disease course ,maximal levodopa daily dose and ac-cumulated levodopa dose differed greatly in WOQ-9 (+ ) group and WOQ-9 (-) group (P<005) . The disease course ,H-Y stage ,UPDRS score ,tetany score ,maximal levodopa daily dose ,levodopa dose per body weight and accumulated drug use time differed greatly in WOQ-9 (+ ) group and WOQ-9 (-) group (P< 0 .01) .The major risk of dose WO was the levodopa dose per body weight (OR=1.364 ,P<0 .05) .Conclusion Dose WO is related with the progress of disease and the use of levodopa .Levodopa dose per body weight is an independent risk factor for dose WO .

Objective To investigate the relationship among the activity of protein kinase C (PKC) in platelets of maternal vein and umbilical blood , the pathophysiological changes of pregnancy induced hypertension (PIH) and fetal growth restriction (FGR) in PIH patients. Methods Activities of PKC in membrane and plasma of platelets from maternal vein and umbilical blood taken from 35 PIH patients and 20 normal pregnant women were measured with substrate phosphorylation method. Results No difference was shown in the PKC activities between the mild PIH patients and normal pregnant women in both maternal and cord blood.The PKC activities in moderate and severe PIH patients were significantly higher than those of the normal pregnant group.In normal pregnant women, the PKC activity in membrane and plasm of the platelets had no significant difference. In the moderate and severe PIH group, PKC activity in membrane was far more higher than the plasm 46?6 vs 37?4 pmol/(min?mg protein), P