objective To evaluate the relationship between the pulse pressure and the cardiac geometric structure in patients with essential hypertension. Methods Three hundred and ninety-five patients,age ranging from 20 to 77 years,were enrolled into the study. Their clinical systolic and diastolic blood pressure (SBP/DBP) were all above 140/90mmHg. All the patients either were initially diagnosed as having essential hypertension,or confirmed after taking a the placebo for 2 weeks after stopping anti-hypertensive drugs. The cardiac geometric structure was determined by the echocardiography at the same time when the patients untook the 24 hours ambulatory blood pressure monitoring. Results The clinical pulse pressure was significantly different among the groups as divided by the age ( P

The study aims to improve the level of fine management of medical equipments, give full play to the functions and roles for better patient service, and explore methods for evaluating the benefits of medical equipment that can take into account and reflect the needs of multiple parties. Based on objectives and key results(OKR) methods and concepts, a benefit evaluation system was developed with the goal of giving full play to the functions and roles of medical equipments, with corresponding evaluation indexes and supervision and evaluation mechanisms formulated as well. This index system could take into account the needs and concerns of hospitals, the departments in use, the management authorities and patients at large, while contributing to process supervision and continuous improvement. In the OKR practice of large medical equipments(CT, MR) from 2018 to 2019, they had performed significantly better in inspections, inspection positive coincident rates, clinical service capabilities, maintenance assurance levels, patient satisfaction, scientific research and academics among others. The use of a medical equipment benefit evaluation system based on OKR concepts and methods can provide effective evaluation indicators for the operation and management of medical equipments. In addition, the system can maintain internal improvement momentum leveraging process supervision and continuous improvement methods, in order to assure the elevation of fine management level of medical equipments of modern hospitals, thus offering better medical services for patients at large.

Denys-Drash Syndrome ; diagnosis ; Humans ; Infant ; Male

Objective To investigate the effects of different therapeutic strategies on recurrence of postoperative Crohn's disease (CD) patients.Methods From September 2009 to September 2014,85 CD patients with intestinal resection were enrolled.The clinical features and maintenance therapeutic medication were retrospectively analyzed.The patients were divided into non-treatment group (induding continuously or cumulatively taking medicine less than three months),5-aminosalicylic acid (5-ASA) group and immunosuppressant agents group (including azathioprine,methotrexate and thalidomide).Kaplan-Meier method was performed to compare the recurrence rate in postoperative CD with different therapeutic medication and the risk factors of postoperative recurrence were also analyzed.Results Among 85 CD patients,there were 32,21 and 32 patients in non-treatment group,5-ASA group and immunosuppressive agents group,respectively.After surgery,the one year accumulated clinical recurrence rate of immunosuppressant agents group was 12.5％ (4/32),which was significantly lower than that of non-treatment group (56.3％,18/32) and 5-ASA group (38.1％,8/21),and the differences were statistically significant (x2 =12.250,P＜0.01;x2 =4.102,P =0.043).After surgery,the two years accumulated clinical recurrence rate of immunosuppressant agents group was 12.9 ％ (4/31),which was significantly lower than that of non-treatment group (75.9％,22/29) and 5-ASA group (47.6％,10/21),and the differences were statisitcally significant (x2 =17.840,P＜0.01;x2 =6.597,P=0.010).After operation,the one year accumulated endoscopic recurrences rates of non-treatment group,5-ASA group and immunosuppressant agents group were 39.1％ (9/23),5/16 and 34.6％ (9/26),respectively;while the two year accumulated endoscopic recurrence rates were 59.1％ (13/22),6/16 and 44.0％ (11/25),respectively.However,there was no statistically significant difference among the groups (all P＞0.05).Penetrating lesion was an risk factor of postoperative clinical recurrence in CD patients (x2 =4.963,P=0.026,oddsratio (OR) =2.221,95 ％ confidence interval (CI) 1.121 to 5.775).Conclusions Immunosuppressive agents rather than 5-ASA have remarkable effects in preventing postoperative clinical recurrence in CD patients.Postoperative clinical recurrence is more likely to happen in patients with penetrating lesions.

AIM: To observe the effects of dexamethasone and interleukin-10 (IL-10) on the release of proinflammatory cytokines, tumor necrosis factor-?(TNF-?), IL-6 and activation of transcriptional factors, nuclear factor-?B(NF-?B), activator protein-1 (AP-1) and cAMP response element binding protein (CREB) in cultrued human peripheral blood mononuclear cells (hPBMC). METHODS: The hPBMC were divided into control group, lipopolysaccharide (LPS) stimulated group, dexamethasone and IL-10 treated group. The contents of TNF-? and IL-6 in supernatant were mensured by ELISA. The activity of NF-?B, AP-1 and CREB of nuclear abstract were analyzed by electrophoretic morbility shift assay (EMSA). RESULTS: The content of TNF-? was significantly increased 1 hour after LPS stimulation, and it was significantly inhibition by dexamethasone and IL-10. The contents of IL-6 and IL-10 were significantly increased after LPS stimulation for 12 hours. The production of IL-6 was still inhibited by dexamethasone and IL-10, but the production of IL-10 was not affected by dexamethasone. The activities of NF-?B, AP-1 and CREB were significantly increased 1 hour after LPS stimulation. Dexamethasone and IL-10 significantly ihibited their activities, but the effects of dexamethasone was stronger than that of IL-10. CONCLUSIONS: LPS induces the release of several pro and anti- inflammatory cytokines and induces the activation of several transcriptional factors in hPBMC. Dexamethasone and IL-10 can inhibite the production of proinflammatory cytokines TNF-?, IL-6 and the activation of NF-?B, AP-1 and CREB. Dexamthasone has more significant inhibitory effect on AP-1 and CREB than IL-10.

AIM: In order to explore the role of activator protein-1 (AP-1) and cAMP response element binding protein (CREB) in acute lung injury and anti-inflammatory mechanism of glucocorticoid. METHODS: Using the acute lung injury (ALI) model of rats by intravenous lipopolysaccharide (LPS, 5 mg/kg), the activities of AP-1 and CREB by electrophoretic mobility shift assay (EMSA) in lung tissue and effects of dexamethasone on the activities were observed. RESULTS: After injection of LPS, the peak activity of AP-1 was observed at 2 hours and it returned to normal in 12 hours. CREB peak activity was at 1 hours but it did not return to normal in 12 hours. Dexamethasone significantly inhibited the activities of AP-1 and CREB. CONCLUSIONS: AP-1 and CREB may play important roles in ALI in rats. One of the important anti-inflammatory mechanisms of glucocorticoid is its transcription al modification. [

Grid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.

Objective To explore the changes of S - 100? protein in cerebrospinal fluid and serum of children with viral encephalitis and its clinical significance. Methods The levels of S - 100? protein of cerebrospinal fluid and serum of 36 children with viral encephalitis and 20 lumbar anesthesia children without central nervous system diseases were measured by enzyme - linked immunosor bent assay. Differences in the levels of cerebrospinal fluid and serum S-100? protein between children with and without coma, with and without convulsion, with and without sequelae in the case group were compared. Results S-100? protein levels of cerebrospinal fluid in the case group and control group were (0.641?0.390) and (0.037 ? 0.014) ?g/L( P

Objective The protective effect of hydrogen sulfide (H2 S) against myocardial ischemia/reperfusion ( IR) injury via anti-apoptotic signaling is well established , but the underlying mechanism remains unclear .This study was to investigate whether H 2 S could protect cardiomyocytes from endoplasmic reticulum stress ( ERS)-mediated apoptosis in hypoxia/reoxygenation ( HR) injury by regulating the expression of microRNA-455 ( miR-455 ) . Methods Cardiomyocytes from neonatal SD rats were primarily cultured and the model of HR injury was established .The cardiomyocytes were divided into a control group (normally cultured for 27 hours), an HR group (subjected to HR injury), and an H2S protection group (pretreated with the precursor of H2S NaHS at 40 μmol/L at 30 min before HR treatment followed by the same procedure as in the HR group ) .The cell viability was monitored by MTT , the release of lactate de-hydrogenase ( LDH) in the culture supernatant measured by full-automatic chemical analysis , and the apoptosis rate of the cardiomyo-cytes detected by flow cytometry .The mRNA and protein expressions of Grp 78 and caspase-12 were determined by real-time RT-PCR and Western bot .To verify whether miR-455 was involved in the ERS-mediated apoptosis of the cardiomyocytes , the cells were subjec-ted to HR after transfected with miR-455 mimic or anti-miR-455 oligonucleotide (AMO) for 24 hours, followed by detection of the ex-pressions of Grp78 and caspase-12. Results After HR injury, the H2 S protection group showed an enhanced viability of the cardio-myocytes in comparison with the control group ([67.02 ±6.90] vs [29.27 ±5.66] %), an decreased LDH release ([91.33 ± 10.63] vs [168.17 ±15.38] U/L), and a reduced rate of cell apoptosis ([13.98 ±1.90] vs [24.31 ±2.79] %).H2 S pretreat-ment significantly downregulated the mRNA and protein expressions of Grp 78 and caspase-12 (1.66 ±0.39 vs 2.56 ±0.34;1.75 ± 0.32 vs 2.54 ±0.48;2.01 ±0.45 vs 3.26 ±0.34;1.85 ±0.52 vs 3.21 ±0.84, P<0.05).The mRNA and protein expressions of Grp78 and caspase-12 were evidently increased after transfection with miR-455 mimic (3.56 ±0.37 vs 1.00 ±0.00;3.61 ±0.41 vs 1.00 ±0.00;2.87 ±0.38 vs 1.00 ±0.00;2.98 ±0.49 vs 1.00 ±0.00), but remarkably decreased after transfection with miR-455 AMO (0.62 ±0.16 vs 1.00 ±0.00;0.65 ±0.13 vs 1.00 ±0.00;0.54 ±0.13 vs 1.00 ±0.00;0.62 ±0.16 vs 1.00 ±0.00, P<0.05). Conclusion H2S could protect cardiomyocytes from HR injury by regulating the expression of miR-455 and reducing ERS-mediated cell apoptosis .

0.05).The percentage of CD40 positive cells in CBMC-derived DC was lower than that in PBMC-derived DC[(34.80?7.77)% vs(54.37?9.57)%,P