Objective To investigate the level and impact factors of stigma in people living with stroke patients in community. Methods A total of 189 stroke patients in community were investigated by general information questionnaire, Stigma Scale for Chronic Illness, Medical Moping Questionnaire, Self-Rating Depression Scale and Social Support Rating Scale. Results The total score of stigma was (44.96± 16.71) points, score of self-stigma was (27.70±10.91) points, score of enacted-stigma was (17.26±7.00) points. Multiple regression analysis showed that stroke patients′ depression, avoiding coping, subjective support and activity of daily living were impact factors of stigma, which explained 57.5% of the variance. Conclusions Community nurses should pay attention to the stigma of stroke patients in community, especially focus on those with higher degree of depression and lower activity of daily living, guiding them to adopt positive coping strategies and enhance subjective support. Oriented by influencing factors, proper intervention should be provided to lower the level of stigma, promote psychosomatic rehabilitation.

Objectives To investigate the association between health belief and medication adherence in hypertensive patients.Methods A total of 232 hypertensive patients who visited Outpatient Department of Huashan Hospital between October 2013 and May 2014 were recruited in this cross-section study.The degree of medication adherence was measured with Morisky scale and health belief was evaluated with questionnaires of Health Belief Model (HBM).Results Of the 232 participants,61 (26.3％),51 (22.0％) and 120 (51.7％) showed low,medium and high medication adherence in Morisky scale,respectively.Logistic analysis showed that the perceived susceptibility (P ＜ 0.001),and cues to action (P =0.004) were positively correlated,and perceived barriers (P ＜ 0.001) was negatively correlated with medication adherence of patients.Conclusion Effective interventions to improve antihypertensive medication adherence should increase perceived susceptibility,cues to action,and reduce the barriers to medication adherence of patients.

Background The incidence of dry eye is growing.However,the early diagnosis of dry eye is still difficult up to now.Keratograph 5M analyzer,a novel noninvasive ocular surface analyzer for dry eye may offer important parameters.Objective This study was to evaluate the clinical value of Keratograph 5M analyzer for clinical diagnosis of dry eye.Methods An observational study was proceeded with 88 cases who accepted myopia diagnosis in Tianjin Medical University Eye Hospital from October to December 2013.A series of conventional dry eye-related examinations were performed on the patients,including tear film break-up time (TBUT),corneal fluorescein staining scoring,Schirmer Ⅰ test (S Ⅰ t),and then Keratograph 5M analyzer-related examinations were subsequently carried out,including noninvasive tear film break-up time (NITBUT) and conjunctival hyperemia scoring.The correlations between conventional dry eye-related examinations and Keratograph 5M analyzer-related examinations were assessed by using Spearman rank correlation analysis.Results A total of 88 patients were recruited with male 32 and female 56.No significant difference in age was found between different genders (P =O.34).In 88 patients,Keratograph 5M analyzer showed the non-dry eyes in 15 patients,suspicious 44 patients (50.0％) and dry eyes in 29 patients (33.0％).However,the non-dry eyes were checked out in 39 patients and dry eyes were in 49 (55.7％) based on China Dry Eye Clinical Diagnosis and Treatment Consensus.The first NITBUT (NITBUTf) was less than the average NITBUT (NITBUTav) (P =0.00),and a positive correlation was seen between them (rs =0.62,P =0.00).Dry eye grade was significantly correlated with NITBUTf or NITBUTav or conjunctival hyperemia scoring (rs =-0.60,P =0.00 ; r,=-0.89,P =0.00 ; rs =0.24,P =0.02).A negative correlation was found between the conjunctival hyperemia scoring and NITBUTav (rs =-0.24,P =0.02).However,no significant correlation was seen between conjunctival hyperemia scoring and NITBUTf,TBUT,S Ⅰ t or corneal fluorescein staining scoring (rs=-0.13,P=0.22;rs=0.16,P=0.14;rs =-0.16,P=0.13;rs=-0.08,P=0.44).No significant difference was found between TBUT and NITBUTf (P =0.71).And TBUT was correlated with NITBUTf (rs =0.23,P =0.03),but not NITBUTav (rs =0.18,P =0.09).In addition,no significant correlations were seen between S Ⅰ t and NITBUTf or NITBUTav (rs=0.20,P=0.07;rs=0.05,P=0.66).Conclusions NITBUTav has an important significance in assessing overall ocular surface conditions.The conjunctival hyperemia score is one of refrent indicators to judge ocular surface status.

AIM:To investigate the expression and the significance of VEGF-C/D in rat cornea after alkali burning as well as the role of lymphangiogenesis in the high-risk corneal transplantation rejection.
●METHODS:The model of alkali burn corneal was made. Different times corneas were taken to electron microscope for vascularization, and examined the expression of VEGF-C/D and VEGFR-3 in l, 3, 5, 7, 14, 28d. The other rat cornea after alkali burn were divided into four parts to penetrate keratoplasty, containing only blood vessels in the cornea ( group A ) , angiogenesis and lymphangiogenesis ( group B ) , lymphangiogenesis degenerating period ( group C ) , angiogenesis degenerating period ( group D ) . ln addition, there are also normal groups ( group N ) to compare the Rl values and survival time of corneal graft.
●RESULTS: Electron microscopy showed that, when the first 7d rat cornea appeared neovascularization after alkali burn, but not lymphangiogenesis. The occurrence of new blood vessels and lymphatic in 2wk. There were no obvious lymphangiogenesis in 5wk and the angiogenesis gradually subside in 8 wk. The expression of VEGF-C/D and VEGFR-3 in the corneas of rats were up-regulated in the third days after the injury, and reached its peaks at 5d. The average survival time of group N, A, B, C, D were (14.25±0.62)d, (9.35±1.02)d, (5.06±1.13)d, (8.71±0.83) d, (9. 44±1. 05)d after transplant cornea. Compared to the rest of the group, group B plant average survival time significantly shortened (P<0. 05), while compared with group B, the survival time of A, C, D groups were significantly longer (P<0. 05).
● CONCLUSION: VEGF - C/D and VEGFR - 3 are expressed significantly after corneal alkali burn. New lymphatic vessels can accelerate high - risk corneal transplantation immune rejection.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Fingers ; Humans ; Male ; Middle Aged ; Neuralgia ; therapy ; Young Adult

BACKGROUND:Since cannulated screw has been applied to femoral neck fracture, it is not uncommon that the screw wear penetrates or refunds. What factors affect the stability of cannulated screw for treatment of femoral neck fractures in adults remains unclear. ＜br> OBJECTIVE:To explore factors related to internal fixation failure by cannulated screws in treatment of adult femoral neck fracture and improve the stability of the adult femoral neck fracture by cannulated screws. ＜br> METHODS:A total of 92 adult patients of femoral neck fracture were treated by cannulated screws in our department between June 2007 and June 2011. Their data were retrospectively analyzed. According to clinical information and fol ow-ups, we selected factors such as age, gender, Garden type of fracture, preoperative skeletal traction, timing of surgery, Garden index, standards of pedicle screws, pedicle screw shapes, partial weight bearing time and postoperative complications, which may affect the success rate of cannulated screws for ＜br> treating femoral neck fracture. The selected factors were then grouped and assigned, after unrelated factors were excluded by one-way χ2 analysis, multiariable Logistic regression analysis was performed. ＜br> RESULTS AND CONCLUSION:The involved 92 patients were fol owed up for 18-72 months. According to Harris assessment criteria, hip function was excellent in 28 cases, good in 25 cases, fair in 17 cases, and poor in 22 cases at the final fol ow-up, the excellent and good rate was 58%. Radiographic results showed that, the patients were divided into two groups according to the presence of the displacement, GardenⅠ (n=22) and GardenⅡ (n=29) as a group, and Garden Ⅲ (n=25) and Garden Ⅳ (n=16) as the other group, the fixation failure rate was 12%and 39%, respectively. In normol and abnormal Garden Index groups, the fixation failure rate was 16%and 59%, respectively. In nail position standards and non-attainment standards groups, the fixation failure rate was 19%and 70%, respectively. In the complication and non-complication groups, the fixation failure rate was 14%and 55%, respectively. These factor groups showed significant differences (P＜0.05). Multiariable Logistic regression analysis showed that, Garden type of fracture, Garden index, standards of pedicle screws, and postoperative complications are the risk factors for internal fixation failure using cannulated screws in treatment of the adult femoral neck fracture.

Patients with hypoxia pulmonary hypertension (HPH) are often accompanied by dyspnea, fatigue, and headache. With the development of the disease, the right ventricle gradually collapses and eventually leads to death. Hypoxic pulmonary vascular remodeling is an important pathological basis of HPH, and the remodeled pulmonary vessels will form permanent thickening. The mechanism of hypoxic pulmonary vascular remodeling is relatively complex. At present, there are few studies on drugs for pulmonary vascular remodeling on the market, mainly focusing on the alleviation of pulmonary vasoconstriction. It was found that hypoxia induces calcium overload in pulmonary artery smooth muscle cells (PASMCs), resulting in the proliferation of PASMCs. The main mechanisms include: ① abnormal expression of calcium pumps; ② abnormal calcium channels in the plasma membrane of pulmonary artery smooth muscle cells; ③ overexpression of calcium-sensitive receptors in cells; ④ the expression of Na⁺/Ca²⁺ exchanger type-1 was abnormal. This review summarized several mechanisms of hypoxia induced calcium overload leading to pulmonary artery remodeling, hoping to provide a new idea for the treatment of HPH.

Objective:By applying moxibustion to the eight confluent points in different periods of time,to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa.Methods:A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time,i.e.Chen (7:00-9:00),Wu (11:00-13:00) and Xu (19:00-21:00).The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions (different periods of time,different genders,different acupoints and different states of the acupoints) based on Fei Teng Ba Fa.Results:Finally,thirty subjects dropped out and 438 subjects were included.The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa:latencies of the closing points and adjunct points were significantly different in different periods of time (P＜0.05);the latencies of the males were significantly longer than those of the females (P＜0.05);there was no significant difference in the latency between the left and right sides (P＞0.05);in the female group,there was a significant difference in the latency between the lower-limb points and the upper-limb points (P＜0.05).The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state:in the period of Wu (11:00-13:00),the latencies of the opening points were significantly longer than those of the closing points and adjunct points (P＜0.05);for men,their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points (P＜0.05);despite the gender,the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points (P＜0.05);in the female group,the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points (P＜0.05).Conclusion:Based on Fei Teng Ba Fa,the pain thresholds of the eight confluent points vary in different periods of time,gender,acupoint location and opening/closing state,which can be taken as the evidence of making time-based acupuncture-moxibustion prescriptions.

Objective To investigate the effects ofWenyujinessential oil on tau protein phosphorylation in mice with Alzheimer Disease (AD); To discuss the relevant mechanism of action.MethodsSixty Kunming mice were divided into six groups randomly: sham-operation group, model group,Wenyujin essential oil low- and high-dose group, donepezil group andShenzhiling group.β-Amyloid protein (Aβ25-35) was infused into the hippocampal of mice. Mice in each group were given relevant medicine for gavage for 15 d. After the last administration, immunohistochemistry was used to detect the expressions of tau protein phosphorylation points (Ser 404 and Thr 231). Western blot was used to detect tau protein phosphorylation points and the expression of PI3K/Akt protein. Results Compared with sham-operation group, tau protein phosphorylation points in the model group increased (P<0.05), but the phosphorylation levels of PI3K and Akt decreased significantly (P<0.05). Compared with the model group, tau protein phosphorylation (Thr231 and Ser404) inWenyujin essential oil high-dose group decreased significantly (P<0.05), and the phosphorylation levels of PI3K and Akt increased(P<0.01). ConclusionWenyujinessential oil can inhibit tau protein phosphorylation in mice. The possible mechanism may be related to the PI3K/Akt signal pathway.

Objective To evaluate the current status of aspirin for primary prevention in hypertensive outpatients in China,and the gap between aspirin use and guidelines.Methods This was a multi-center cross-sectional study and carried out in hypertensive patients from 46 hospitals of twenty two cities in China from June to December in 2009.At least 100 essential hypertensive outpatients were consecutively recruited from each participant hospitals according to the consistent inclusion criteria.The patients underwent physical examinations and biochemical analyses,and answered questionnaires.Based on the relevant guidelines,the risk assessment of cardiovascular disease (CVD) is a prerequisite for the proper use of aspirin in primary prevention.Results A total of 5 206 hypertensive outpatients were included.Among them,1 324 (25.4％) were with a history of CVD.Among those with no history of CVD,2 705 patients (69.7％) were at high risk of CVD,and the aspirin utilization rate for primary prevention was 29.2％,with 32.2％ patients at high risk and 22.4％ patients at low-medium risk of CVD,respectively.In the application of aspirin for CVD primary prevention,the inappropriate aspirin use rate in patients at lowmedium risk was 23.3％.Conclusions The proportion of subjects at high risk for CVD is high in hypertensive outpatients suggesting a wide range of application space for aspirin.There exists underutilization for high risk and overutilization for low-medium risk patients in current aspirin primary prevention application.