Objeclive To investigate the relationship between carotid atheroselemtic(CAS)plaque and homocysteine(HCY),C-reactive protein(CRP)and ischemie eerebrovasclar desease(ICVD).Methods 468 patients with ICVD and 456 patients without eerebrovaseular disease(control group)were detected by carotid color duplex in IMI,number,size and character of carotid atherosclerosis(CAS) plaque and thelevels of HCY and CRP were evaluated,and compared with normal control group.Results(1)Compare with control group,the IMT,prevalence of CAS plaque,the rates of soft plaque in ICVD group were significantly higher(all P＜0.05).(2)The levels of HCY and CRP in ICVD were significantly higher than those in control group(P＜0.05),and in ICVD with plaque subgroup were significantly higher than those in ICVD without plaque subgroup(P＜0.05).(3)The prevalence of CAS plaque and IMT were positively correlated with the levels of HCY and CRP(r=0.32,0.30 repectively,P＜0.05).Condusion ICVD patients show increased IMT and hJish prevalence of CAS plaque.CAS plaque and hyperhomocystoinemia is an independent risk factor for ICVD.The level of CRP is an important biological marker to evaluate the severity and prognosis of ICVD.

0.05).The degree of angiostegnosis:1-grade stenosis in MSCTA was higher than that in DSA.The 2-grade,3-grade and 4-grade stenosis in DSA were higher than that in MSCTA(all P

Objective:To compare the clinical efficacy of Du's heat-reinforcing method and Western medication in treating diarrhea-predominant irritable bowel syndrome (IBS-D).Methods:Sixty-five IBS-D patients were randomized into two groups by the random number table.Thirty-three cases in the treatment group were intervened by acupuncture with Du's heat-reinforcing method,while thirty-two cases in the control group were given oral administration of pinaverium bromide tablets.The intervention lasted 4 weeks for both groups.The IBS symptom severity score (IBS-SSS),IBS-quality of life (IBS-QOL) and hospital anxiety and depression scale (HAD) were adopted to evaluate the therapeutic efficacy.Results:The two groups each had two dropout cases.The clinical recovery rate was 38.7％ and the total effective rate was 90.3％ in the treatment group versus 13.3％ and 66.7％ in the control group.The treatment group was superior to the control group in both clinical recovery rate and total effective rate (both P＜0.05).After 1-week and 4-week treatment,respectively,the IBS-SSS scores were lower compared with the baseline in both groups,and the intra-group differences were statistically significant (both P＜0.05);the score in the treatment group was lower than that in the control group,and the between-group difference was statistically significant (both P＜0.05).After 4-week treatment,the component scores of IBS-QOL showed improvements in both groups,and the treatment group was superior to the control group in the improvements of dysphoria,interference with activity,health worry and food avoidance (all P＜0.05).The anxiety and depression scales of HAD (HAD-a,HAD-d) in the treatment group and the HAD-a in the control group obtained significant improvements (all P＜0.05);the scores of HAD-a and HAD-d in the treatment group were significantly better than those in the control group (both P＜0.05).Conclusion:Acupuncture with Du's heat-reinforcing method can effectively ease the symptoms of IBS-D,improve the quality of life and the state of anxiety and depression.It can produce a more significant efficacy than oral administration of pinaverium bromide tablets.

Objective To understand the job burnout conditions of nurses with different education levels in Ningyang county,analyze the influence of education level on job burnout,in order to find strategies to relieve the job burnout,reduce burnout,increase working enthusiasm,then further lower nurse turnover rate and stabilize of the nurse team.Methods A total of 150 nurses in the first hospital of Ningyang county participated in the investigation using Maslach Burnout Inventory (MBI) in December 2012.The survey data underwent statistical analysis.Results The results show that in the dimension of emotional exhaustion,education level showed main effect.While in the dimension of depersonalization and personal accomplishment,the education level showed no main effect.Conclusions Education levels have a significant impact on job burnout of nurses,mainly in the emotional exhaustion dimension.Hospital managers should pay attention to job burnout of nurses with college degree,reduce their occupational burnout through positive changes in personal and organizational factors.

Objective This work aimed at study the rel ationship between the pathologicomorphological change of gastrocneminus muscle cells and deep venous insufficiency (DVI).Methods Patients with DVI in three different stage of developing process are grouped into early t eam?middle team and late team group ,each group consists of 9 cases.HE stain , special ATPase histoenzymic methds was quantitatively employed to study histo chemical cytomorphology of gastrocneminus and musculus sartorius specimens in th ose subjects.Results There is no significant difference of the pathologicomorphological change,either between early-stage group and mid-sta ge group or between early-stage group & mid-stage and control group.But there is significant difference comparing advanced stage group and early-stage group & m id-stage group or between advanced-stage and control group.Conclusion As the process of DVI develops,marked morphological degeneration can be found in gastrocneminus muscle cells.It could be regarded as the pathogenic fundament of impairment of calf muscle pump and development of DVI.

Objective To detect the levels of cytokines in first-episode depressant patients and the influence on the levels of cytokines after the treatment with sertraline and venlafaxin. Methods The levels of IL-2,IL-6,TNF-α and IL-10 were measured in 80 first-episode depressant patients and 40 healthy control subjects. 80first-episode depressant patients were divided into two groups which were treated by sertraline and venlafaxin respectively. The levels of the same items were measured after 6-week treatment with sertraline and venlafaxin. All data were statistically analyzed by SPSS. Results The levels of IL-2,IL-6,TNF-α in 80 first-episode depressant patients were significantly higher than that in control group( IL-2:(6.79 ± 2.89 )pg/ml vs (4.06 ± 2.05 )pg/ml;IL-6:(10.12 ±4.52)pg/ml vs (6.04 ± 1.79) pg/ml;TNF-α: ( 14.81 ±4.38) pg/ml vs ( 10.69±2.54) pg/ml)(P＜0.05). The level of IL-6 after treatment by sertraline and venlafaxin was lower than that before treatment.There were no significant difference of the levels of IL-2,TNF-α, IL-10 before and after treatment. No significant difference of the levels of cytokines were observed between the two groups which were treated by sertraline and venlafaxin. Conclusions There are some changes of the levels of cytokines in first-episode depressant patients, which might be corrected by the treatment with sertraline and venlafaxin. Sertraline and venlafaxin might have the same mechanisms to cytokines.

Factor Analysis, Statistical ; Health Policy ; Leadership ; Occupational Health Services ; organization & administration

Objective To explore the risk factors of the recurrence of ischemic stroke and to supply theoretical basis for secondary prevention.Methods 612 patients with ischemic stroke were enrolled in the study and they were followed-up for 2 years to record the stroke recurrence.According to whether the recurrent stroke occurred,all the patients were divided into the recurrent group and the non-recurrent group.Logistic regression model was used to analyze the risk factors.Results Of 612 patients,90 patients suffered from recurrent stroke and the recurrence rate after 2 years was 14.7％.In the recurrent group,age,smoking,hypertension,diabetes,fibrillation atrial history and homocysteine level were significantly higher than those in non-recurrent group (P ＜ 0.05),compliance of anti-platelet drugs was significantly lower than that in non-recurrent group (P ＜ 0.01).Multivariate analysis suggested that age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs were associated with recurrence of ischemic stroke (OR value =11.14,47.38,53.11,111.12,53.11,40.98,90.12,all P ＜ 0.05).Conclusion Age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs are the independent risk factors of recurrent stroke.To enhance the interference of these risk factors are helpful for preventing the recurrence of stroke.

Objective To investigate the correlation of the plasma homocysteine level and serum B/apolipoprolionAl(ApoB/ApoAl) radio with cerebral vascular stenosis in patients with cerebral infarction.Methods 184 patients with cerebral infarction experienced cerebral digital substraction angiography (DSA) were selected.Among them,158 patients with cerebrovascular stenesis and 26 patients without stenosis were included.Three groups were categorized by distribution of artery lesion sites:isolated intracranial artery stenesis ( n =48 ),isolated extracranial artery stenosis( n =60) co-existing of intracranial and extracranial artery stenosis( n =50).The correlation analysis was made between the levels of Hcy and ApoB/ApoAl with cerebral vascular stenosis in patients with cerebral infarction.Results ( 1 ) The proportion of subjects with high level of plasma homocysteine was significantly higher in patients with cerebrovascular stenosis than those without[( 16.9 ±8.1 ) μmol/L vs (8.6 ±4.6) μmol/L,P ＜0.001 ;40％ vs 0,P ＜0.01].The proportion of subjects with high level of ApoB and ApoB/ApoA1 ratio was significantly higher in patients with cerebrovascular stenosis than those without ApoB [( 1.02 ± 0.25 ) vs ( 0.86 ± 0.22 ) g/L,P ＜ 0.01],ApoB/ApoAl ratio [( 0.94 ± 0.50) vs ( 0.64 ± 0.21,P ＜ 0.01 )].(2) For the different groups of artery lesion sites,the proportion of subjects with high level of plasma homocysteine was not significantly different[( 16.1 ± 8.5 )mml/L、( 17.0 ± 8.9 ) mmol/L、( 16.7 ± 8.7 ) mmol/L,P ＞ 0.05],the proportion of subjects with ApoB/ApoAl ratio was not significantly different [0.98 ± 0.45,0.93 ± 0.48,0.96 + 0.50,P ＞ 0.05].(3) Based on multivariable stepwise Logistic regression model,the increased level of Hcy( OR =1.146,95％ CI:1.021 ～ 1.287 ;P =0.021 ),the increased level of ApoB/ApoAl ( OR =4.71,95 ％ CI:1.70 ～ 14.20,P =0.005 ),the increased level of ApoB ( OR =4.50,95 ％ CI 为 1.62 ～ 12.80,P =0.007),the increased level of Cho ( OR =2.406 ;95％ CI:1.145 ～ 5.055 ; P =0.023 ),the decresed level of HDL( OR =0.089,95％ CI:0.014 ～ 0.551,P =0.017 ) were all risk factors.Conclusion High level of plasma homocysteine and ApoB/ApoAl were both independent risk factors for cerebral vascular stenosis.