This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model.

Objective To sum up effective measures to prevent complications of peripherally inserted central catheter (PICC) by applying evidence-based nursing in patients after PICC insertion.Methods From January 2011 to January 2013,1490 patients inserted with PICC in Hunan Provincial Tumor Hospital were selected by convenience sampling,whom were divided into control group (n =758) and observation group (n =732) with random number table.The control group received routine care,while the observation group received evidence-based nursing.Nursing program for the observation group was formed based on literature regarding the causes of and solutions for phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage of insertion sites.Results The incidences of postoperative phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage at insertion sites in the observation group were significantly lower than those in the control group (3.14％ vs.8.97％,P=0.023;4.23％ vs.11.74％,P=0.021;3.96％ vs.8.44％,P=0.001;4.92％vs.12.66％,P =0.011).Conclusions The application of evidence-based nursing in patients with PICC insertion could effectively reduce the complication,and improve the quality of clinical nursing care.

Objective To explore the clinical effect and lung CT change of long-term used of low-dose roxithromycin in treatment for bronchial expansion patients in stable phase. Methods 94 cases collected in the Department of Respiration, The Second Hospital Affiliated to Suzhou University from February 2011 to December 2012 were diagnosed as bronchiectasis, 34 cases in control group were given oral treatment for ambroxol 30 mg, three times one day, 60 cases in treatment group were added roxithromycin 75 mg on basis of control group, two times one day. Patients in two groups were both treated for 6 months. The therapeutic effect and the score of life quality and dyspnea scores in two groups were observed, and the changes of CT data were compared before and after treatment. Results After treatment, the life quality score and dyspnea score of two groups were all improved, but the treatment group was signiifcantly higher than the control group (P<0.05). The effective rate in treatment group was 86.67%, which was signiifcantly higher than 70.59%in the control group (P<0.05). After treatment, chest CT imaging score of patients in treatment group were improved, signiifcantly better than that in the control group (P<0.05). Conclusion Long-term low dose administration of roxithromycin can control and stable bronchiectasis symptoms, and improve signs and symptoms .

OBJECTIVE:To study the effect of irbesartan and losartan on pharmacokinetics of cyclosporin A(CsA)in rabbits. METHODS: 12 rabbits were randomly divided into two groups(n=6). In self-controlled study,plasma concentration of CsA in rabbits of two groups before and after treating with combination of irbesartan and losartan were determined and pharmacokinetics parameters were examined. RESULTS: After combination of irbesartan or losartan,the Cmax and AUC0～24 of CsA were significantly increased(P

Objective To compare the effects of telmisartan and (or) amlodipine on the reversal left ventricular re-modeling in two-kidney one clip hypertensive rats. Methods A total of 50 healthy male SD rats were randomly divided into 5 groups (n=10):two-kidney one clip renal hypertensive (2KIC) model group, sham group, telmisartan (10 mg/kg) group, am-lodipine (2.5 mg/kg) group and telmisartan (10 mg/kg)+amlodipine(2.5 mg/kg) group. The model of two-kidney one clip re-nal hypertensive rats was established. The tail arterial blood pressure was detected once a week. After 20 weeks, rats were sacrificed and specimens were collected. The left ventricular mass index (LVMI) was assessed. The myocardial ultrastructur-al changes were observed by electron microscope. Values of plasma renin activity (PRA), angiotensionⅡ(AngⅡ) and atrial natriuretic peptide (ANP) were measured by enzyme linked immunosorbent assay (ELISA).Results Compared with sham group, the levels of systolic blood pressure (SBP), LVMI, PRA, AngⅡand ANP were significantly higher in 2KIC group (P＜0.01). Compared with 2KIC group, values of SBP, LVMI, PRA and ANP were significantly lower in telmisartan group and am-lodipine group (P＜0.01), but the value of AngⅡwas significantly higher (P＜0.01). The levels of SBP, LVMI, AngⅡand ANP were significantly lower in combined medication group than those of single drug medication group (P＜0.01). There was no significant difference in the plasma PRA level between those groups (P>0.05). Results of myocardial electron microsco-py showed that the left ventricular remodeling was significantly improved in combined treatment group. Conclusion Telmisartan and amlodipine can effectively improve the left ventricular remodeling induced by hypertension. There was more effective therapy using both medications together.

Objective To study the effect of apigen on articular cartilage repair involving chondrocytes transfected with bone morphogenic protein-7 (BMP-7).Methods lnterleukin (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) were induced by IL-1 β in rabbit chondrocytes.After apigen at different concentrations (10 μmol/L,25 μmol/L,and 50 μmol/L) was added into the culture system,the effect of apigen on IL8 and sICAM-1 production was observed using enzyme linked immunosorbent assay.Then chondrocytes were seeded on improved matrigel gel bracket and culturedin vitro to construct the compound,which was then transplanted into the rabbit model of articular cartilage defection.The rabbits were randomly divided into sham group (n =4),trans-BMP-7 group (n =4),and trans-BMP-7 + apigen group (n =4).Histological observation was conducted and Wakitani score calculated after 5 weeks.Results The concentrations of IL-8 and sICAM-1 in the chondrocytes supernatant in vitro significantly decreased after apigen treatment at 10 μmol/L,25 μmol/L,and 50 μmol/L [(6803.63 ±162.31) ng/g,(6005.74 ±201.49) ng/g,and (5202.34 ±271.67) ng/gvs.(10011.84±239.29) ng/g ; P =0.00].Five weeks after the cartilage cells on matrigel gel bracket were transplanted into rabbit models,the Wakitani scores of the trans-BMP-7 group and the trans-BMP-7 + apigen group were significantly lower than that of the sham group [(3.68 ± 0.86) vs.(8.25 ± 0.90),P =0.00 ; (3.21 ± 0.78) vs.(8.25 ±=0.90),P =0.00].In addition,no inflammatory reaction was noted during the repair in the trans-BMP-7 + apigen group.Conclusion Apigen can promote the construction of compound and repair of articular cartilage defects by trans-BMP-7 chondrocyte.

Objective To investigate the critical value of TSH-stimulated Tg(sTg) in the diagnosis of metastasis from DTC, and to evaluate the diagnostic value of the ratio of sTg to suppressed Tg (sTg/suppressed Tg).Methods A total of 330 post-operative DTC patients(87 males, 243 females, age range: 12-70 years)who underwent thyroid remnant ablation from August 2008 to December 2014 were retrospectively reviewed.Their serum TgAb levels were normal.The patients were divided into non-metastasis group(147 cases)and metastasis group(183 cases) according to results of ultrasonography, CT and WBS.The difference of sTg between the two groups were compared by Mann-Whitney rank sum test.ROC curve was used to analyze the relationship between sTg, sTg/suppressed Tg ratio and metastasis, the cutoff value was calculated.Results The sTg was significantly different between the non-metastasis group and metastasis group: 1.0 (0.1, 2.0) μg/L vs 36.5 (3.9, 126.7) μg/L;u=-6.642, P<0.05.The AUC for ROC curve in metastasis group was 0.85, and the cutoff value was 2.05 μg/L, with the sensitivity 85.2%, specificity 67.3%, and accuracy 82.3%.While sTg<2.05 μg/L, the AUC of sTg/suppressed Tg ratio was 0.941, and the cutoff value was 4.3, with the sensitivity 93.3%, specificity 88.2%, and accuracy 92.3%.Conclusions The sTg has a specific value for the diagnosis of metastasis from DTC after operation and the cutoff value is 2.05 μg/L in this set of patients.The ratio of sTg/suppressed Tg could be used to correct the sTg and to improve the diagnostic sensitivity.

Objective To describe the clinical features and surgical treatment outcomes of patients with moyamoya disease (MMD) in Jiangxi Province of China.Methods Clinical features of a total of 1223 patients with MMD accepted treatment in our hospital from January 2005 to December 2015 were retrospectively analyzed.Totally,228 patients with MMD accepted revascularization from November 2011 to November 2015;the surgical treatment outcomes were retrospectively analyzed.Results The ratio of male to female was 1:1.1 (580/643).The mean age was 45.1±12.2 years (ranged 3-79 years).Two definite peaks in age distribution were found (aged 4-10 and aged 38-51).High incidence was noted in Nanchang,Fuzhou,Yichun,and Shangrao.Ischemic symptoms appeared in children and intracranial hemorrhage appeared in adults;the majority of ischemic patients presented with transient ischemic attack,and in patients with hemorrhagic MMD,intraventricular hemorrhage was the most common type.Familial history was observed in only one patient.Totally 16 indirect and 232 combined revascularizations were performed in 248 hemispheres of 49 patients with hemorrlogic type MMD and 179 patients with ischemic type MMD.Perioperative complication was noted in 18 patients (7.9％).Follow-up showed that most patients had good prognosis.Conclusions There is no difference in the gender distribution of patients with MMD in Jiangxi province.Though two definite peaks in age distribution are found,the number of adult patients is larger than that of children,and primarily experiencing intracranial hemorrhage.There are few familial histories and regional concentration distribution.Individualized treatment with extra-intracranial revascularization is an effective treatment strategy for MMD.

OBJECTIVETo study effects of three pentacyclic triterpenoids, oleanolic acid (OA), ursolic acid (UA) and asiatic acid (AA) on Ca(2+)-induced liver mitochondrial permeability transition (MPT).

METHODEffects of three compounds on liver MPT induced by Ca2+ were assessed by measuring the change in mitochondrial swelling, mitochondrial membrane potential and release of matrix Ca2+ in vitro.

RESULTObvious mitochondrial swelling, loss of mitochondrial membrane potential and release of matrix Ca2+ occurred after the addition of 50 micromol x L(-1) Ca2+. However, preincubation with 50 mg x L(-1) OA, UA or AA significantly blocked the above changes. In addition, it was also found that there are differences in the inhibitions of three compounds on liver MPT induced by Ca2+.

CONCLUSIONThree pentacyclic triterpenoids, OA, UA and AA, have significant mitochondrial protection through blocking on liver MPT and the inhibition on liver MPT of AA is stronger than that of UA and OA.

Animals ; Calcium ; metabolism ; pharmacology ; Membrane Potential, Mitochondrial ; drug effects ; Mice ; Mice, Inbred ICR ; Mitochondria, Liver ; drug effects ; metabolism ; Mitochondrial Membrane Transport Proteins ; drug effects ; Mitochondrial Swelling ; drug effects ; Pentacyclic Triterpenes ; pharmacology

OBJECTIVE: To observe the clinical treatment effectiveness of clarithromycin for naso-sinusitis after nasopharyngeal carcinoma radiotherapy. METHOD: Twenty-four cases of naso-sinusitis after one year nasopharyngeal carcinoma radiotherapy were treated with the oral clarithromycin of small dosage (250 mg everyday). The course of treatment were for 12 to 20 weeks. The treatment effectiveness were evaluated with the chronic naso-sinusitis visual analog quality table mark system (VAS) and Lund-Mackay nasal sinuses CT image mark system before and after treatment. RESULT: The VAS mark and CT image mark have significant deviation (P < 0.01) among pretherapy, post-treatment and 6 months after drug withdrawal. No significant deviation was found(P > 0.05) between post treatment and 6 months after drug withdrawal. The treatment effectiveness was judged for very good is 9 cases, for the good is 11 cases and for the bad is 4 cases. CONCLUSION The clarithromycin of small dosage for long-term treatment of naso-sinusitis after nasopharyngeal carcinoma radiotherapy has positive clinical treatment effectiveness, which is a better treatment method.
Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; Clarithromycin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiography ; Sinusitis ; drug therapy ; etiology ; Treatment Outcome