Objective To observe the effect of beraprost sodium on elderly patients with type 2 diabetic nephropathy (DN) and to observe the change of the plasma vascular endothelial growth factor(VEGF) and endothelin(ET-1) level.Methods The levels of plasma VEGF and ET-1 in the 27 cases of type 2 diabetes without nephropathy and 48 cases with type 2 diabetic nephropathy were measured.The possible role of VEGF and ET-1 in diabetic nephropathy was explored.48 cases of type 2 diabetic nephropathy patients were randomly divided into 2 groups:the conventional treatment group and beraprost sodium treatment group.The changes of VEGF and ET-1 level in the 2 groups before and after the treatment were measured.Results The plasma VEGF and ET-1 levels were significantly higher in type 2 diabetic nephropathy patients than in type 2 diabetes patients without nephropathy(P ＜0.01).Compared with the control group,beraprost sodium significantly reduced the plasma VEGF and ET-1 levels in patients with diabetic nephropathy(P ＜ 0.05),and also reduced urinary albumin excretion rates (UAER) significantly (P ＜ 0.05).Conclusions The increasing level of VEGF and ET-1 plays an important role in the onset of diabetic nephropathy.Beraprost sodium can correct the balance of the plasma VEGF and ET-1 in treatment of patients with diabetic nephropathy,improves the endothelial function in diabetic nephropathy,decreases urine protein,and plays a protective role in diabetic nephropathy.

Objective To explore the effects of Taiji exercise on the psychology and the functions of the autonomic nervous systems of middle aged and elderly people. Methods Two hundred and seven middle aged and elderly Taiji exercisers and 166 age matched non Taiji exercisers were sampled. The Zung Self rating Anxiety Scale(SAS), Zung Self rating Depression Scale (SDS) and autonomic nervous system equilibrium index (ANSEI)were adopted to assess the subjects. Results Compared with those of the control group, the scores of SAS and SDS in Taiji group were significantly higher, and the equilibrium of autonomic nervous systems in Taiji group was also superior. There was no significant difference between the male and the female with regard to SAS, SDS and the equilibrium of autonomic nervous systems within Taiji group. The longer the exercise, the better the equilibrium of autonomic nervous systems. Conclusion Taiji exercise has positive effects on the psychology and the autonomic nervous system of the middle aged and the elderly.

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.

Objective To observe the effect of tripterygium glycosides combined with prednisone in treatment of purpura nephritis.Methods 51 patients with purpura nephritis were selected and treated by tripterygium glycosides (1.5～2.0mg/kg) combined with prednisone(1.5～2.0mg/kg) ,three times every day.The total course was 6 to 9 months.Before and after the treatment, the five indicators of bleeding and coagulation, urine protein, occult blood changes and drug side effects and recurrence after drug withdrawal were observed.Results The high coagulation of the blood was improved,and the renal function of 94.1%children recovered.Only 6 cases had little complication and only 1 case had recrudescence 1 year after leaving hospital.Conclusion Tripterygium glycosides combined with prednisone was effective in treating children with purpura nephritis.

Objective:To develop a quality assessment scale of ICU transitional care based on patient-reported outcomes and test its performance.Methods:According to the guidelines of patient-reported outcomes development process, the item pool was established combining with analysis of relevant literatures and patients′ experience and needs in ICU transitional period based on the grounded theory about ICU transitional care. Cognitive test of patients and Delphi expert correspondence were utilized to amend the initial scale before pretest. One hundred and seventy-seven patients who had been transferred from ICU to general ward from March to August 2019 in Tianjin Third Central Hospital were recruited by convenience sampling method for project analysis.Results:The active coefficient and authority degree of expert were above 0.90 and 0.785 respectively for the two rounds of expert enquiry. The final scale consisted of 28 items, from which 4 principal factors, which were preparation for self-care, communication and coordination, psychological support and health belief, respectively, were extracted by exploratory factor analysis, explaining 78.307% of total variance. The content validity index of each item was 0.769-1.000, and the scale-level content validity was 0.896. The Cronbach α coefficients of the 4 factors and the scale were 0.844, 0.793, 0.897, 0.681 and 0.807, respectively.Conclusions:The patient-reported outcomes scale measuring ICU transitional care quality has good reliability and validity and can be used as an auxiliary tool measuring ICU transitional care quality in clinic.

Objective To analyze the influence of the cesarean section and vaginal delivery at term pregnancy when fetal distress in labor conditions on maternal and neonatal outcomes .Methods 238 cases of fetal distress in labor when full-term pregnant were selected ,and they were randomly divided into the observation group and control group,119 cases in each group .The control group was given midwifery vaginal delivery ,while the observation group was given cesarean section .The maternal and neonatal outcomes were compared between the two groups . Results 78 cases(65.55%) of neonatal score above 7 or more points and 7 or more points of the control group were 58 cases(48.74%),the difference was significant (P<0.05).The incidence rate of neonatal complications in the observation group was 5.88%, which was significantly lower than 20.16% of the control group ( P <0.05 ). Conclusion Fetal distress in full-term pregnancy in labor , the use of cesarean section has higher neonatal score compared with vaginal delivery ,and it has low incidence rate of neonatal complications ,it is worth to be applied in clinical.

Objective To investigate the correlation between fatigue and coping strategies among peritoneal dialysis patients,to improve their health consciousness and reduce the fatigue.Methods A total 107 patients were surveyed with general data questionnaire,Multidimensional Fatigue Symptom Inventory-Short Form( MFSI-SF) ,and Medical Coping Modes Questionnaire,MCMQ.Results The score of fatigue was (83.32 ±1.54) points,which indicated the fatigue remained in high level.Scores from high to low were dialysis≥5years,dialysis<1year and 1year≤dialysis<5years.Patients mainly took the coping style with positive face.Pearson correlation analysis showed that fatigue was negatively correlated withface(r=-0.300,P<0.05),while it was positively correlated with withdrawand yield(r=0.227,0.300,all P<0.05).Conclusion Patiens should be encouraged to actively face the disease,pay more attention to their own state of dialysis and improve the effect of drain,reduce fatigue,then to reply for both mind and body health.

BACKGROUND:The umbilical cord blood is rich of mesenchymal stem cells, which can be used as a new source of seed cells in tissue engineering. OBJECTIVE:To compare two methods for culturing, expanding and purifying the mesenchymal stem cells in vitro isolated from the human umbilical cord blood. METHODS:The ful-term birth cord blood of 40 cases was col ected under sterile conditions with heparin anticoagulation. Ficol density gradient centrifugation was used to isolate the mononuclear cells from the umbilical cord blood. The cases were randomly divided into two groups according to the different culture media. Twenty cases of umbilical cord blood were cultured in MesenGro human mesenchymal stem cells culture medium (group A), and the remaining 20 cases of umbilical cord blood were cultured in Dulbecco’s modified Eagle’s medium (group B). The occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and the number of primary cells in the two groups were compared. Cells which grew well were selected to detect the surface markers by flow cytometry. RESULTS AND CONCLUSION: The mean occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and number of primary cells in group A were better than those in group B (P < 0.01). The strong expression of the surface markers of mesenchymal stem cells (CD73 and CD105) was found by flow cytometry, of which the positive rate was 99.1%. No expression of the surface markers of hematopoietic stem cells (CD45 and CD34) was seen, of which the negative rate was 99.3%. The number, morphology, growth rate and culture time of umbilical cord blood mesenchymal stem cells cultured in MesenGro human mesenchymal stem cells culture medium were better than those cultured in Dulbecco’s modified Eagle’s medium. Cells cultured in MesenGro human mesenchymal stem cell culture medium can better express surface markers of mesenchymal stem cells.

This study was aimed to establish a quantitative method for the determination of agarotetrol in agarwood to control its quality. The HPLC analysis was performed on a Diamonsil C18 column (4.6 mm í 250 mm, 5 μm), eluted with a mobile phase of water with 0.1% formic acid and acetonitrile in gradient mode with the flow rate of 0.7 mL·min-1. The detection wavelength was set at 252 nm. The column temperature was 30oC. The results showed that the separation of agarotetrol and adjacent peaks were more than 1.5, which achieved a baseline separation. A good lin-earity (r = 0.999 8) was observed in the range of 2.0-125.0 μg·mL-1, with the average recovery of 102.75%. The a-garotetrol cannot be less than 0.15% based on the data of Agarwood samples. It was concluded that the method was accurate and reliable to determine the content of agarotetrol, which can be used for the quality control of agarwood.

ObjectiveTo investigate and compare the prevalence,awareness and risk factors of chronic kidney disease (CKD) between urban and rural population in Guangxi province in order to provide information for prevention and treatment of CKD.MethodsBy a stratified multistage random sampling method,18 to 74 years old residents in Guangxi province were surveyed. They wereevaluatedbyquestionnaire,urinaryalbumin/creatinineratio, hematuria (microscopic examination of centrifuged urine sediment),kidney B-mode ultrasound,and abnormal results were reviewed 3 months later.Estimated glomerular filtration rate(eGFR) was calculated with the simplified MDRD equation modified by a Chinese coefficient.The risk factors associated with CKD were also investigated.Results There were no significant differences between urban and rural residents in the prevalence of albuminuria (5.22％ vs 5.47％) and hematuria (1.07％ vs 1.11％)(all P＞0.05).The prevalence of renal lithiasis in rural residents was significantly higher than that in the town(10.54％ vs 6.95％)(P＜0.05).The decreased renal function between urban and rural residents(3.87％ vs 4.04％,P＞0.05) had no significant difference.The prevalence of CKD was 9.58％ in urban and 9.42％ in rural(P＞0.05).The prevalence of albuminuria according to the age distribution was different between urban and rural,which increased along with the age in urban but showed two peaks(30-40 years old and 60-74 years old) in rural.Based on logistic regression analysis,the risk factors for albuminuria were diabetes,hyperuricemia,the history of cardiovascular disease,chronic tonsillitis and HBsAg positive.The risk factors for kidney function decline were age,hyperuricemia,hypertension,diabetes,renal lithiasis and history of cardiovascular disease.The awareness rate of CKD in urban was significantly higher than that in rural (14.45％ vs 6.27％,P＜0.05).Conclusions The prevalenceof CKD has no significant difference between urban and rural in Guangxi province.The awareness rate of CKD in urban is significantly higher than that in rural.It is needed to enhance the prevention and treatment of CKD in rural.