ObjectiveTo discuss the effect of health education pathways in old patients undergoing laparoscopic cholecystectomy. Methods62 old patients undergoing iaparoscopic cholecystectomy were divided into the control group and the observation group, each group included 31 patients. The control group used the traditional method of health education, and the observation group adopted health education pathways. The satisfaction degree of patients with nursing and incidence of postoperative complication were compared between the two groups using χ2 test and t test. ResultsThe satisfaction degree of patients with nursing was higher and incidence of postoperative complication was lower in the observation group com-pared with those of the control group. ConclusionsHealth education clinical pathway can raise the edu-cation ability of nurses, increase the satisfaction degree of patients, reduce the complications and improve the serf- guard ability of the old people.

Objective To discuss the perioperative nursing experience of patients with primary venous reflux disease(PVRD)of lower extremity undergoing external valvuloplasty of superficial femoral vein.Methods Patients(146 cases)with PVRD of lower extremity were given psychological nursing,observation of postoperative complications and rehabilitation exercise instruction.Results Five limbs appeared short lymphatic seepage and other limbs recovered completely.No thrombus Was seen.Venous claudication,swelling and pain disappeared in 90.4% patients.Limbs symptom alleviated in 9.6% patients.All varicos evein disappeared.The function of deep vein valve recovered in 92% patients by color doppler ultra sonoscope re-examination.Conclusions General evaluation before operation,good perioperative psycho logical nursing and attention to the complication and rehabilitation exercise instruction are significant for reduction of postoperative complication and improvement of success rate of operation.

Objective To compare the therapeutic effects of two different intervention methods in the treatment of Navelbine leakage.Methods 40 cases with Navelbine leakage were collected and randomly divided into the control group and the observation group in equal number.Local block therapy in earlier period was used in the control group,and non-local block therapy was adopted in the observation group.Then the therapeutic effects of the two methods were compared.Results The differences of effect between the observation group and the control group were significant.Conclusions Local medicine injection in earlier period,wet compress and microwave physiotherapy after 24 hours is more effective than the local block in earlier period in the treatment of Navelbine leakage.It may shorten the time of pain and detumesccnce obviously,so it is worth popularizing clinically.

[Objective]To analyze the MRI and CT characteristics of the pathological changes of ligamentum flavum.[Method]Clinical data of MRI and CT characteristics of 48 cases of lagamentum flavum pathological changes were analyzed and compared retrospectively.[Result]MRI showed"\"signal in sagital position and"V"signal from the vertebral canal in stalk postition.CT showed two sides of soft tissue signal of vertebral canal and some part presented bone substance density.[Conclusion]The MRI,CT images of the ligamentum flavum pathological changes have both advantages and disadvantages.It would benefit the clinical therapy only with the combination of them.

Objective To investigate the effects of adrenomedullin (ADM) on the expression of nuclear transcription factor-?B (NF-?B) in cultured human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells were exposed to ADM with the concentration of 10 -7mol/L or lipopolysaccharide (LPS) with the concentration of 10 ?g/ml for 60 minutes. Nuclear translocation of NF-?B was determined by immunofluorescence staining. Western blotting analysis was used to check the expression of NF-?B protein. Results In cultured human RPE cells that were not stimulated, weak NF-?B positive green flurescence was localized in the cytoplasm. After exposed to ADM or LPS for 60 minutes, there was bright NF-?B nuclear staining in cultured human RPE cells. The results of Western blotting analysis demonstrated that in cultured human RPE cells that were not stimulated, a single weak protein strip with the relative molecular weight of 36?103 identified as immunoreative NF-?B could be observed. Both ADM and LPS could markedly increase the expression of NF-?B protein in cytoplasm. Conclusions NF-?B-dependent signal transduction pathway can be activated in cultured human RPE cells by ADM. ADM could induce NF-?B nuclear translocation and increase the expression of the protein in cytoplasm. NF-?B-dependent signal transduction pathway may play an importantrole in the function of ADM.

Objective To investigate the reverse effect and mechanism of the extracted solution of chinese medicine MBC on the drug-resistance of K562/ADM in vitro. Methods MTT assay was used to determine the IC50 of ADM on K562/ADM cell line and the reverse multiples of the drug-resistance before and after MBC treatment. Flow cytometry(FCM) was applied to assess the intracellular concentration of Rh123. Results 8?10 -1 ?g/ml MBC increased cytotoxic effect of ADM on 562/ADM cells, the reverse multiple was 6 28, and MBC could increase the intracellular concentration of Rh123. Conclusion MBC could increase killing effect of ADM on the drug-resistant K562/ADM cell and partly reverse the drug-resistance of K562/ADM cell.

0.05),but the ratio of fPSA/tPSA in PC group was very lower than that in BPH group(P20.0 ?g/L,the sensitivity and the specificity was 91.6%(22/24) and 87.5%(21/24).Conclusion It can improve the differential diagnosis between PC and BPH to use the ratio of fPSA/tPSA combining with the serum tPSA.It is important for the observation of the differential diagnosis and the therapeutic effects of PC and the preparation of the high risk persons and etc.

Objective Pancreatic duodenal homeobox-1 ( PDX-1) plays an important role in the occurrence and development of diabetes.More importantly,its potential application in insulin resistance (IR) improvement is attracting further attention .Berberine has been shown to improve glucose metabolism and insulin resistance .In this study,rat models of type 2 diabetes mellitus ( T2DM) were established by combination of intraperitoneal injection of low -dose streptozotocin and highg-lucose-high-fat diet induction .The effect of berberine on fasting glucose , fasting serum insulin , homeostasis model assessment of insulin resistance ( HOMAI-R) , and ex-pression of PDX -1 of islet in T2DM rats were analyzed .The present study aimed to evaluate the anti-diabetic efficacy of berberine and study the mechanism of its preliminary therapeutic effects .Methods Twenty healthy adult male Sprague Dawley ( SD) rats were di-vided by random number table into the normal control group ( n =6) feeding with a standard diet ,and the experimental group ( n =14 ) given an intraperitoneal injection of streptozotocin .The rats with fasting blood glucose ( FBG) greater than 13.8 mmol/L were ran-domly divided into diabetes mellitus group feeding high sugar high fat diet for two weeks and then continuing with a standard diet , and the berberine group given berberine [180 mg /(kg· d)] every day.The normal control group and diabetes mellitus group were given physiological saline for every day 6 weeks.At the end of 6th week, the rats were executed , and the levels of fasting glucose, fasting se-rum insulin, HOMA-IR, and expression of PDX-1 in pancreas islet of each group were detected .The expression of PDX1-in pancreas islet was examined by immunohistochemistry .The image pro plus 6.0software was used to calculate the integrated optical density ( IOD) of positive expression .Results Compared with the normal control group , FBG, fasting insulin levels ( FINS) , and HOMA-IR of the diabetes mellitus group and berberine group were significantly increased ( P <0.05 ) .Compared with the diabetes mellitus group, FBG, FINS, and HOMA-IR of the berberine group were statistically significantly decreased [ ( 13.11 ±6.87 ) mmol/L vs (18.45 ±4.69) mmol L/, (2.58 ±0.34) μIU/ml vs (2.98 ±0.40) μIU/ml, 1.60 ±0.91 vs 2.75 ±0.28, P <0.05].Compared with the normal control group , the expression of PDX-1 of the islet in the diabetes mellitus group and berberine group was statistically significantly decreased ( P <0.05).After treatment with berberine, FBG, FINS, HOMA-IR, and IOD of PDX-1 in pancreas islet of berberine treatment rats were significantly increased compared with the diabetes mellitus group ( 9.14 ±1.51 vs 6.79 ±0.98 , P <0.01 ) .Conclusions The increases of PDX-1 in islet may be one of the mechanism in the improvement of hyperglycemia .

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.

Objective To analyze the dialysis adequacy of the maintenance hemodialysis patients under different dialyzate flow.Methods Forty-eight patients under maintenance hemodialysis were divided into four groups according to dialyzate flow:500 ml/min group,600 ml/min group,700 ml/min group and 800 ml/min group,with 12 patients in each group.Each group was treated 6 weeks.The albumin (Alb),hemoglobin(Hb),hematocrit(Hct),blood urea nitrogen (BUN),serum creatinine(SCr) and parathyroid hormone(iPTH) levels before and after treatment were examined,Kt/V and urea reduction ratio(URR) were calculated separately.Results There was no significant difference in Kt/V between 500 ml/min group and 600 ml/min group.Kt/V was no increased when the dialyzate flow rate increased from 500 ml/min to 600 ml/min,that was to say they could not improve the dialysis adequacy.There was statistically significant difference in Kt/V among 500 ml/min group,600 ml/min group,700 ml/min group and 800 ml/min group,and 800 ml/min group on the dialysis adequacy was better.Different dialyzate flow on the impact of the dialysis adequacy was compared in self-control method.Kt/V increased along with the increase of dialyzate flow,and the dialysis adequacy and dialyzate flow showed positive correlation.Conclusion The high dialyzate flow of dialysis treatment can improve Kt/V and has significant effect in enhancing the dialysis adequacy.