Objective To investigate the effect of perhexiline injection on oxygen free radical in old patients with heart failure(CHF). Methods 32 healthy parsons were taken as controls. 58 old patients with CHF were ran-domly divided into two groups. The treatment group received both basic therapy and perhexiline injection transfusion for 14 days. Malondialdehyde (MDA) ,total antioxygen capacity(TAOC) ,oxidation-low-density-lipoprotein-cholester-ol (OX-LDL-C) and superoxide dismutase(SOD) were measured before the therapy and after the therapy. Results MDA [ (5.59±1.95 )μmol/L and OX-LDL-C [ ( 808.64 ± 156.34) μg/L] were significantly higher in the old patients with CHF] than control group [ (4.04 ± 0.67 μmol/L ) and ( 538.67 ± 125.43 ) μ/L ] ( P < 0.05 ) ; SOD [ (68.69 ± 20.43 )μU/L ] and TAOC [ ( 7.72±2.13 ) kU/L ] were significantly lower in the old patients with heart failure than the matched group [(105.67±13.86 )μU/L and (9.68±1.86 ) kU/L ] ( P <0.05 ), which were posi-tively associated with CHF severity. After the improvement of the cardiac function, MDA, OX-LDL-C;SOD and TAOC recovered significantly. Conclusion The therapeutic action of perhexiline injection in old patients with CHF can re-ly on the promotion of eliminating oxygen free radical inside organism.

OBJECTIVE:To observe clinical efficacy and safety of Tianqi jiangtang capsules combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions. METHODS:A total of 96 elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions were randomly divided into control group(48 cases)and observation group(48 cases). Control group was given Metformin hydrochloride tablets 0.5 g orally,3 times a day. Observation group was additionally given Tianqi jiangtang capsules 1.6 g orally,3 times a day,on the basis of control group. Both groups received treatment for 4 weeks. Clinical efficacies of 2 groups were observed as well as total score of TCM symptoms,the levels of blood glucose(FPG,2 hPG,HbA1c),blood lipid(TC,TG,HDL-C,LDL-C),hs-CRP,ET-1,blood rheology and oxidative stress indexes(MDA,SOD),the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group(89.58% vs. 70.83%),with statistical significance(P<0.05). After treat-ment,total score of TCM symptoms,the levels of blood glucose,hs-CRP,ET-1,TC,TG,LDL-C,blood rheology indexes and MDA in 2 groups were significantly lower than before;total score of TCM symptoms,the levels of FPG,2 hPG,hs-CRP,ET-1, TC,TG,LDL-C,blood rheology indexes and MDA in observation group were significantly lower than control group;the level of SOD in 2 groups were significantly higher than before,and the observation group was significantly higher than control group,and the level of HDL-C in observation group was significantly higher than before treatment and control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Tianqi jiangtang capsules combined with metformin show significant therapeutic efficacy in the treatment of elderly patients with type 2 diabetes mellitus,and can re-duce the levels of blood glucose and lipid,improve blood rheology and oxidative stress reaction,with goud safety.

Objective:To investigate the association between metabolically healthy obesity(MHO) and atherosclerosis risk among Chinese community population aged 40 or older.Methods:A total of 9 525 participants without cardiovascular diseases (3 621 men and 5 904 women) from Jiading community in Shanghai were enrolled to complete questionnaires, undergo extensive physical examination including brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) assessment, and laboratory screening. According to body mass index (BMI) and metabolic status, these participants were categorized into 4 groups including metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), MHO, and metabolically unhealthy obese (MUO). High baPWV was defined as baPWV>1 400 mm/s, and high pulse pressure (PP) was defined as PP above fourth quartile of the population. Multivariate logistic regression model was conducted to explore the relationship between MHO and high baPWV as well as high PP after adjusting for confounders. Results:After multivariable adjustment, such as sex, age, current smoking, current drinking, and education, logistic regression analysis showed that MHO was significantly correlated with high baPWV ( OR=1.18, 95% CI 1.02-1.37) and high PP ( OR=1.72, 95% CI 1.43-2.08) in comparison with MHNO. Otherwise, both MUNO and MUO subjects were at higher risk for suffering from high baPWV (MUNO: OR=3.02, 95% CI 2.60-3.50; MUO: OR=3.26, 95% CI 2.87-3.70) and high PP (MUNO: OR=2.56, 95% CI 2.17-3.02; MUO: OR=3.49, 95% CI 3.01-4.06). Conclusion:On the basis of Chinese community population, there was a pronounced correlation between the MHO phenotype and the increased risk of developing atherosclerosis.

Objective To explore the practice effect of network platform for health education in inpatients with diabetes mellitus.Methods A total of 56 inpatients with type 2 diabetes mellitus (T2DM) were selected as control group with routine health education from July 2014 to June 2015. A total of 58 inpatients with T2DM were chosen as observation group with education through network platform from July 2015 to June 2016. The treatment compliance, self efficacy and quality of life of patients was compared between two groups after nursing care.Results The treatment compliance of patients in observation group was higher than that in control group after nursing care with a significant difference (P＜0.01). Besides, the improvement of self efficacy and quality of life of patients in observation group was better than those in control group after nursing care with significant differences (P＜0.01).Conclusions Health education through network platform for inpatients with diabetes mellitus can obviously improve treatment compliance, self efficacy and quality of life of patients.

With the increasing number of adolescents with chronic diseases surviving into adulthood, various problems have arisen in the transition from a sheltered pediatric environment to an adult medical independent environment. In this context, transitional care has emerged, which plays an important role in increasing disease knowledge, enhancing self-management abilities, reducing admission and visit rates, and improving the quality of life for adolescents with chronic diseases. This paper reviews the overview, implementation methods, strategies, and suggestions for transitional care for adolescents with chronic diseases, so as to provide reference and guidance for standardizing and promoting transitional care for adolescents with chronic diseases.

Objective:To explore the impact of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department.Methods:A total of 40 nurses who were on duty in the Emergency Department of Tangshan Gongren Hospital from February 2018 to May 2020 were selected for the study. Our hospital performed routine management of emergency department nurses from February 2018 to February 2019. After a 3-month wash-out period, nurses were managed hierarchically from May 2019 to May 2020. According to the practical experience and educational background of nurses, they were divided into 5 levels, namely N0 level assistant nurse ( n=12), N1 level registered nurse ( n=9), N2 level responsible nurse ( n=10), N3 level specialist nurse ( n=5), N4 expert level ( n=4). Before and after the hierarchical management of nurses in the emergency department, the Quality of Nursing Work Life (QNWL) scale was used to evaluate the nurse′s quality of life, and the nursing quality was assessed by the Nursing Service Quality Questionnaire. Analyze the incidence of errors in the nursing process to assess the nursing risk. Results:The scores of work environment, work family balance, social environment, workload score and QNWL total score before the implementation of hierarchical management were 46.33 ± 8.52, 30.01 ± 6.07, 21.45 ± 4.60, 94.52 ± 8.06, 192.31 ± 12.46, respectively. After implementation, the scores were 51.29 ± 4.75,34.62 ± 4.68, 25.89 ± 3.58, 109.43 ± 6.15 and 221.23 ± 10.03, respectively. The scores after implementation were higher than those before ( t value was 3.216-11.435, P<0.05). The scores of human resource allocation, ward management, operating procedures, basic nursing, nurse training, nursing efficiency, nursing record writing, and first-aid goods management were 84.29 ± 9.75, 80.39 ± 12.46, 83.02 ± 5.63, 80.93 ± 9.84, 87.14 ± 6.12, 85.91 ± 8.46, 88.20 ± 6.76 and 83.51 ± 7.18, respectively. After the implementation, the scores were 92.38 ± 4.66, 94.67 ± 3.89, 91.25 ± 6.37, 94.78 ± 3.56, 95.01 ± 3.78, 93.81 ± 4.11, 95.13 ± 3.07, 93.57 ± 4.62, respectively. The scores after implementation were higher than those before ( t value was 4.735-8.371, P<0.05). After the implementation of nurses' hierarchical management, the nursing error rate was 4.44% (8/180), which was significantly lower than 10.00% (18/180) before implementation ( χ2 value was 4.146, P<0.05). Conclusions:The application of hierarchical management of nurses in emergency department can improve nurses' professional life quality, improve nursing quality, and reduce the incidence of nursing errors. It is worthy of popularization and application in emergency department.

In order to reveal the intestinal absorption mechanism of saikosaponin d (SSd) in vitro and in vivo, the current research investigated the effects of different experimental conditions (time, concentration, temperature, pH, intestinal segments), transporter inhibitors, paracellular pathway enhancer, metabolic enzyme inhibitors on the intestinal absorption of SSd, in Caco-2 monolayers and a single pass perfusion model in rats.The results showed that the apparent permeability coefficient (Papp) and effective permeability coefficient (Peff) of SSd were 4.75 × 10-7 - 6.38 × 10-7 cm/s and 0.19 × 10-4- 0.27 × 10-4 cm/s, respectively, indicating that it was a low permeability compound, and that the transmembrane transport of SSd was concentration-dependent (0.5-5 μmol/L) and time-dependent (0-180 min).Ileum was the main absorption site for SSd. Experimental results based on Caco-2 monolayers showed that the P-gp inhibitor and paracellular permeability enhancer significantly increased the absorption of SSd (P < 0.05), which was consistent with the results obtained in rats. Inhibitors of OATPs and OCTs showed different results in vitro and in vivo, which may be related to the lower expression of them in jejunum.In summary, the intestinal absorption of SSd occurs through a carrier-mediated and energy-dependent transport, as well as passive diffusion, and P-glycoprotein plays an important role in the active transport of SSd.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.