Objective To observe the effectiveness of alprostedil in treatment of diabetic nephropathy and the mechanism of the renal protection of the drug. Methods One hundred patients with diabetic nephropathy due to diabetes mellitus were randomly divided into 2 groups ,50 in treatment group ,and 50 as controls, alprostadil was used intravenously in the Treatment Group for 12 day while routine management of diabetes such as food intake control,physical exercises and oral drugs or injection of insulin was conducted in both of the 2 groups. Urinary albumin were employed for evaluation as well as the side-effects. Results By the end of the trial, urinary albumin was decreased significantly compared with those before intravenous alprostadil treatment or with those in the control group (P<0.05). Conclusion Urinary albumin was decreased significantly after intravenous alprostadil. Therefore,it is a safe and effective drug in the treatment of diabetic nephropathy.

Objective To evaluate the efficacy of cold preservation solution containing desferrioxamine (DFO) in protecting the rat hearts.Methods Pathogen-free male Sprague-Dawley rats,weighing 300-350 g,were used in the study.Thirty-two isolated rat hearts were equally and randomly divided into control group (C group) and DFO group using a random number table.Hearts of rats were stored for 6 h in 4 ℃ histidine-tryptophan-ketoglutarate (HTK) solution in group C.DFO was added to HTK solution (DFO concentration 100 μmol/L),and hearts of rats were stored for 6 h in 4 ℃ HTK solution in group DFO.At 6 h of cold storage,creatine kinase and lactate dehydrogenase activities in the cold preservation solution were determined.Myocardial specimens were obtained from the apex,cut into sections which were stained with haematoxylin and eosin,and examined under a microscope.The pathological changes of myocardial tissues were scored.The content of malondialdehydc in myocardial tissues was determined using thiobarbitnric acid method,and hypoxia-inducible factor-1α protein and mRNA expression in myocardial tissues was detected by real-time reverse transcriptase polymerase chain reaction and Western blot.Results Compared with group C,the creatine kinase and lactate dehydrogenase activities in the cold preservation solution,malondialdehyde content in myocardial tissues,and pathological scores were significantly decreased,and the expression of hypoxia-inducible factor-1α protein and mRNA expression in myocardial tissues was significantly up-regulated in group DFO (P＜ 0.05).Conclusion Cold preservation solution containing DFO can protect the rat hearts effectively,and the mechanism is related to up-regulation of the expression of hypoxia-inducible factor-1α.

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.
Stroke

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.