Objective To investigate the effects of comprehensive nursing on the depressive emotion and quality of life among patients with congestive heart failure. Methods 58 patients with congestive heart failure were randomly divided into comprehensive nursing group and the control group.The control group was given routine nursing, the comprehensive nursing group was given body care, life care and psychological care based upon routine nursing. The depressive emotion and quality of life (QOL) of two groups was evaluated with Zung self-rating depression scale(SDS) and 36-items short form health survey (SF-36) scale and then underwent subsequent t test. Results compared with the control group, comprehensive nursing could reduce the score of self-rating depression scale and increase the score of QOL. Conclusions The result indicates that comprehensive nursing has an important role in improvement of depressive emotion and quality of life of patients with congestive heart failure.

OBJECTIVE:To compare the cost of Xiangdan injection and Danshen chuanxiongqin injection in the treatment of unstable angina pectoris of coronary heart disease,and to provide reference for rational and economic drug selection. METHODS:42 inpatients with unstable angina pectoris of coronary heart disease were divided into Xiangdan injection group(group A,20 cas-es) and Danshen chuanxiongqin injection group (group B,22 cases). Two groups were given conventional symptomatic treatment according to the specific clinical situation;on this basis,group A was given Xiangdan injection 20 ml intravenously,qd;group B was given Danshen chuanxiongqin injection 10 ml intravenously,qd,for 14 d. Clinical efficacy and the occurrence of ADR were compared between 2 groups,and cost-minimization analysis was conducted. RESULTS:After treatment,total effective rate of group A and B was 95.00% and 95.45%,without statistical significance(P>0.05);there was also no statistical significance in the incidence of ADR (P>0.05). The costs of 2 groups were equal in addition to the cost of drugs. According to cost-minimization analysis,the drug cost of group A was 77.28 yuan and total cost was 705.88 yuan;the drug cost of group B was 1 310.40 yuan and total cost was 1 939.00 yuan;the drug cost and total cost of group A were far more less than that of group B,with statistical significance(P<0.05). The results of sensitivity analysis were consistent with it. CONCLUSIONS:The cost of Xiangdan injection is lower and more economical than that of Danshen chuanxiongqin injection in the treatment of unstable angina pectoris of coronary heart disease.

Objective To study intervention effect of diet habits according to Trans-theoretic Model (TTM) in young and middle-aged patients with asymptomatic hyperuricemia. Methods 120 patients were divided into the intervention group (n=60) and the control group (n=60). The nursing intervention by stages of TTM was implemented to a total of 56 patients in the intervention group in the study. Routine nursing care was taken to 57 patients in the control group. Patients were evaluated by self-designed questionnaire after 1, 3 and 6 months of the intervention in the two groups respectively, including the diets of patients, the change of patients′ eating habit, differences of uric acid, total cholesterol, triglycerides, blood sugar. Results The patients′ intake of beer, seafood, meat, edible oil in the intervention group was lower than the patients′ intake in the control group, while the patients′ intake of fruits and vegetables was higher than the patients′intake in the control group after 1, 3 and 6 months of the intervention, which was statistically significant ( P < 0.01). Compared with 27 cases in the control group, 53 cases in the intervention group were in action phase and maintenance phase after 6-month intervention, the difference was statistically significant (P < 0.01). After six months′intervention, the patients′uric acid, triglycerides in the intervention group was (418.01 ± 24.15)μmol/L and (1.52 ± 0.56) mmol/ L respectively, which was significantly lower than (435.02 ± 26.35) μmol/ L and (2.45 ± 0.74) mmol/L in the control group, t values were-3.47 and 2.20 respectively, P<0.01. Conclusions Diet intervention based on the TTM can effectively promote the change of patients′ unhealthy eating habits, improve self-management skills, and reduce uric acid, which is worthy of generalizing.

Objective To assess the surgical effectiveness of pelvic endometriosis (EMS) by Laparoscopic. Methods Retrospective analysis was performed in 1272 pelvic EMS patients underwent laparoscopic surgical treatment. All patients were classified into four groups according to the R-AFS,63 patients of Ⅰ stage,44 patients of Ⅱ stage,475 patients of Ⅲ stage and 690 patients of Ⅳ stage. Symptoms of EMS,surgical effect and follow-up outcomes were compared. Results In all stages, there were no significant differences on moderate to severe dysmenorrhea,increase in CA125 and infertility (Ps ＞ 0. 05 ). In the EMS patients combined with AM or/and DIE, the rates of the moderate to severe dysmenorrhea, CA125 increase and infertility were 84.6% (11/13 ) ,92.3 %(12/13) and 53.8% (7/13)in stage Ⅰ ,81.8% (9/11) ,90. 9% ( 10/11 )and 54.5% (6/11) in stage Ⅱ ,84.8%(173/204) ,93. 1% (190/204) and 47.1% (96/204) in stage Ⅲ ,and 81.6% (213/261) ,91.2% (238/261) and 46.4% ( 121/261 ) in stage Ⅳ, respectively. The rates in non-consolidated AM or/and DIE patients were 46.0%(23/50),62.0% (31/50) and 22.0% ( 1 1/50) in stage Ⅰ ,45.5 % ( 15/33 ),54.5% ( 18/33 ) and 18.2% (6/33)in stage Ⅱ ,41.7% ( 113/271 ) ,62.7% ( 165/271 ) and 23.6% (64/271) in stage Ⅲ ,and 47.3% (203/429),60.1% (248/429) and 21.7% (93/429). The difference between the two groups with and without consolidated AM or/and DIE had statistical significance( P ＜ 0.05 or P ＜ 0.01 ). After the treatment, the scores of life's energy, ache,emotion,sleep,social activity and body movement of NHP were significantly superior than those before treatment in all patients ( P ＜ 0.01 ). The surgery time-consuming of Ⅲ and Ⅳ stage patients were (64.5 ± 18.4) min and (61.7 ± 17.1 ) min respectively, which were significantly higher than that of Ⅰ and Ⅱ stage ( ( 31.9 ± 12.3 ) min and (40.3 ± 10. 6) main ] ( t = 20.25, P ＜ 0.01 ). The massive hemorrhages and the internal damage organs occurred in Ⅲ and Ⅳ stage surgery [2.9% and 3.5% ,respectively] ,whereas much less in Ⅰ and Ⅱ stage (0.8% and 1.4% ) ,with no significant difference(P ＞0. 05). After treatment,the rate of symptoms recurrence of Ⅲ and Ⅳ stage patients respectively were 21.4% ,which were higher than that of Ⅰ and Ⅱ stage patients ( 2.3% ) (P ＜ 0.05 )The rate of pregnancy in Ⅲ and Ⅳ stage patients ( 15.4% ) were lower than that of Ⅰ and Ⅱ stage patients (69. 6% ) ( P ＜ 0. 01 ). Conclusions Pelvic EMS decreased the quality of life. EMS patients combined with adenomyosis or/and deep infiltrating EMS have more severe pelvic pain symptoms, less surgical effectiveness and more serious complications. Ⅲ and Ⅳ stage patients are more liable to symptoms recurrence and lower pregnancy rate.

Regional saturation technique has been applied in MR scaning widely. It is possible to obtain MRA or MRV by putting the REST slab on one side of slice or another. REST eliminates artifacts caused by motion or blood flow and minimizers wrap artifacts along the phase encoding and high quality of images can be provided.

Objective To investigate the role of tumor necrosis factor (TNF)-alpha-induced protein 8-like 2 (TIPE2) for regulating the macrophage polarization in systemic lupus erythematosus and its curative effects on experimental SLE mice.Methods The mice were treated with activated lymphocytes derived DNA (ALD-DNA) for inducing mice model,randomly divided into AAV-scr control group and AAV-TIPE2 experimental group,and injected with AAV-TIPE2 or AAV-scr virus solution from the tail vein of mice.The expression of TIPE2 mRNA and protein in polarized macrophages,serum dsDNA antibody titer,urine protein and renal pathological index were detected.Results (1) The TIPE2 expression level of TIPE2 mRNA and protein in AAV-TIPE2-transfected cells was 13.5±1.6 times and 10.8±1.6 times of AAV-scr control group respectively.(2) M2 macrophage specific molecule MGL+ was 59.6% in AAV-TIPE2 group and MGL + cells in the AAV-scr group was 8.4%.M2/M1 odds ratio of AAV-TIPE2 experimental group to AAV-scr control group was 16.(3) The recombinant TIPE2 adenovirus related vector could stably expressed in transfected HEK-293.In vitro and in vivo experiments confirmed that AAV-TIPE2 was able to induce M2 polarization of macrophages in ALD-DNA-induced lupus mice.(4) The serum anti-dsDNA antibody,urinary protein and renal pathology in the AAV-TIPE2 group were significantly lower than those in the AAV-scr group(P<0.01).Conclusion TIPE2 alleviates the disease condition of ALD-DNA induced SLE mice through induction of macrophage polarization to M2 phenotype,which may be used as a promising therapeutic method for ALD-DNA induced SLE mice.

Objective To investigate the changes of pulsatile tinnitus on HRCT and MRI CE 3D-SPGR image.Methods CT and MRI images of 1 5 pulsatile tinnitus patients were retrospective analysis.All 1 5 patients underwent temporal bone HRCT and MRI CE 3D-SPGR scan.Abnormal changes on CT and MRI image,which caused the pulsatile tinnitus,were compared.Results In 1 5 patients,9 sides (8 cases)showed abnormal sigmoid sinuses including 4 sides of sigmoid sinuses diverticulum,5 sides sigmoid sinu-ses uncovering,8 sides dominant sigmoid sinuses.The high jugular bulb was showed in 10 sides (8 cases),the thick emissaria mas-toidea in 5 sides (4 cases),bilateral semicircular canal dehiscence in one case,glomus tympanicum tumor in one case and the cochle-ar nerve was constricted by small vessel in one case.Conclusion Cranial base vessel abnormity can be visualized more precisely on MRI CE 3D-SPGR image than that on HRCT.On the contrary,the detection of temporal bone abnormalities is superior on HRCT.

Background and purpose:Paclitaxel is believed to be efficient in treating malignant ascites in gastric cancer. However, researches are still needed to get more evidence. The aim of this study was to discuss the efficacy and safety of the treatment of malignant ascites in gastric cancer with paclitaxel. Methods:Six cases of late phase gastric cancer patients were enrolled into the study, paclitaxel 60 mg/m2 and 1 500-2 000 mL natural solution were administered via intraperitoneal injection, qw, for a of total 2-4 weeks. Efficacy and toxicity were determined according to WHO criteria. Results:Five (5/6) had complete response, and one (1/6) with partial response. The malignant ascites recession time was 0.5-10 months, overall survival time 2-10 months, 4 cases suffered grade Ⅰ-Ⅲ abdominal pain, 4 cases grade Ⅰ leucopenia, 3 cases grade Ⅰ hair loss, 1 case gradeⅠ liver injury (with past history of hepatitis). Conclusion:Paclitaxel is effective and relatively safe to treat malignant ascites of gastric cancer.

Objective To investigate the expression and clinical significance of tumor-associated macrophages (TAMs) in invasive micropapillary carcinoma (IMPC) of breast.Methods Immunohistochemical streptavidin-biotin method(LSAB) method for CD68 and CD163 were performed on 68 cases of IMPC and 72 cases of invasive ductal carcinoma,not otherwise specified(IDC-NOS).Results CD68 and CD163 were mainly expressed in IMPC interstitial macrophages in the cytoplasm or on the membrane,and occasionally expressed in tumor nest.CD68 positive rate in tumor stroma in IMPC (47/68,69.1％) was higher than in IDC-NOS group (37/72,51.5％),and the difference between the two groups was statistically significant (P =0.022).CD163 positive rate in tumor stroma between the two groups was not statistically significant(P =0.682).CD68 + macrophages in IMPC stroma were positively correlated with pathological stage,histological grade,lymph node metastasis,vascular invasion,and Ki67 expression(P ＜ 0.05),and inversely correlated with the expression of ER(P =0.037).Univariate analysis showed that CD68 + macrophages in the stroma of IMPC were significantly associated with progression-free survival(P =0.027),Conclusion The expression of TAMs was different in different types of breast carcinoma and widely expressed in IMPC,which may play a significant role in high invasion and metastasis behavior of IMPC.

Objective To study the clinical features and spirometry of children with chronic cough and positive findings by bronchial provocation test.Methods Four hundred and fifty children with chronic cough from 3 hospitals of Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong Medical University School of Medicine,Gong Li Hospital of Pudong New Area,Pudong Hospital,were enrolled in this study from December 2012 to December 2014,and among them,373 cases completed the questionnaires,spirometry and bronchial provocation test.The differences in clinical features and spirometry between the bronchial provocation test positive group and negative group were compared.And the further evaluation of their clinical value was performed.Results Two hundred and thirty-six cases of children with bronchial provocation tests positive showed much higher rate of dry [72.03％ (170/236 cases)] and night cough[58.90％ (139/236 cases)] than those in the negative group[27.00％ (37/137 cases),22.63％ (31/137cases)],and the differences were significant (x2 =71.154,45.973,all P ＜0.01).Children in positive group also had higher morbidity of eczema[52.12％ (123/236 cases)],allergic conjunctivitis [24.15％ (57/236 cases)] and inhaled allergy history[40.25％ (95/236 cases)] than those in negative group[32.85％ (45/137 cases),10.95％ (15/137cases),18.98％ (26/137 cases)],and there existed significant differences (x2 =13.006,9.701,17.904,all P ＜0.01).And they also had higher asthma heredity [18.22％ (43/236 cases)] than that in negative group [9.49％(13/137 cases)],and the difference was significant (x2 =5.179,P =0.023);with worse small airway function [50.85％ (120/137 cases) vs 36.50％ (50/137 cases)] (x2 =7.197,P =0.007).For further study,the sensitivity and specificity for dry cough were both high(72.03％ and 72.99％).For specificity,family history was the most highest one (90.51％),and night cough and allergic conjunctivitis were also high.Conclusions Pulmonary function tests to reflect small airway function abnormalities,combined with a family history of asthma and chronic cough in children related to eczema,allergic conjunctivitis,and inhalation allergy history clinical features,can better predict airway hyperresponsiveness.