Objective:To explore and observe therapeutic effect of nursing exercise rehabilitation on home patients with chronic heart disease (CHF) .Methods :A total of 122 CHF patients ,who performed home‐rehabilitation in community from Jan 2012 to Feb 2015 ,were selected .According to sealed envelope extraction method ,patients were randomly and equally divided into routine nursing group (received routine nursing intervention ) and exercise intervention group (received early exercise intervention based on routine nursing group ) ,the intervention period was eight weeks for both groups .The 6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) ,scores of Minnesota living with heart failure questionnaire (MLHFQ) and self‐behavior management scale were measured and compared between two groups before and after nursing .Results:Compared with before nursing ,after nursing , there were significant rise in 6MWD ,LVEF and score of self‐behavior management in both groups , P<0.01 all . Compared with routine nursing group after nursing ,there were significant rise in 6MWD [ (482.44 ± 65.29) m vs . (546.24 ± 76.13) m] ,LVEF [ (35.69 ± 7.22)% vs .(38.83 ± 6.92)% ] and score of self‐behavior management [(89.19 ± 25.14) scores vs .(103.49 ± 22.44) scores] ,significant reductions in physical [(62.12 ± 17.97) scores vs . (42.32 ± 17.67) scores] ,emotional [ (67.76 ± 17.17) scores vs .(51.32 ± 16.41) scores] and social dimension score [ (72.43 ± 10.31) scores vs .(62.44 ± 10.45) scores] of MLHFQ in exercise intervention group ,P<0.01 all .Con‐clusion:Nursing exercise can significantly enhance heart function and athletic ability ,improve self‐care capacity , help to improve quality of life in home patients with chronic heart failure .

?Dry eye ( DE) is a multifactorial disease of tear film and ocular surface. Inflammation in the ocular surface plays a main role in the pathogenesis of DE. Accordingly, inflammation and therapies that inhibit immune response may become topic for DE in recent years. Unfortunately, there are few studies about signaling pathway that has changed in ocular surface of DE. It is novel and there are few researches on how inflammation active signaling pathway and how it was regulated by signaling pathway on DE. This paper presents a review about inflammation active signaling pathway and its regulation on signaling pathway of DE.

Objective To analyze the effect of intravenous dripping of 3% sodium chloride solution on prevention of diluted hyponatremia during transurethral vaporization of the prostate (TUVP). Methods Eighty-five cases with benign prostatic hyperplasia (BPH) accompanied with typical lower urinary tract symptoms (LUTS) were divided into two groups during undergoing TUVP operation: the control group(n=38) given Ringer's solution dripping (3ml/min) and the concentrated sodium chloride injection group(n= 47) given 3% sodium chloride solution dripping (2～4ml/min). All of the operations were taken via Wolf electric resection system, and the operation time was≥60 min. The complete blood count and serum electrolyte were determined before operation and 60 minutes after operation beginning, and the data were compared between the two groups. Results The decrease amplitude of serum sodium was obviously smaller in concentrated sodium chloride injection group[(1.45±5.14)mmol/L] than that in the control group[(7.79±6.64) mmol/L] 60 minutes after operation beginning (P<0.05). Conclusions Giving 3% sodium chloride solution by intravenous drip during TUVP may reduce the severity of diluted hyponatremia and postpone the occurrence of hyponatremia, and thereby decrease the risk of transurethral resection syndrome.

Objective To analyze and evaluate the safety and efficacy of modified Pie-crusting ( PC) technique for releasing medial tightness during primary total knee arthroplasty ( TKA) . Methods We completed primary TKA by the same performer with modified PC technique in 30 patients (34 knees) with genu varus from March 2014 to June 2016.By using a special curved scalpel with width limit of 3 mm and depth limit of 5 mm to poke the tension parts , we released the anterion bondle of superficial medial collateral ligament ( sMCL) and posteromedial corner structures ( PMCS) during tension happened in extension , and we released the posterior bondle of sMCL during tension happened in flexion .According to the gap value measured intraoperatively , we divided these cases into three groups: extension with flexion tension group ( 10 knees ) , extension tension group ( 13 knees ) , and flexion tension group (11 knees).The difference between medial and lateral gap value no more than 1 mm was defined as gap balance.We calculated the gap balance rate of each group .Series of weighted frontal X-ray were conducted at fixed period to evaluate the varus angle of the knee postoperatively.The range of motion (ROM), HSS scores and WOMAC scores were also recorded at the same time . Results Among the 34 knees , 31 knees reached the medial and lateral gap balance at both extension and flexion .There was a difference of 2 mm in medial and lateral gap value at extension in 1 knee and the same difference at flexion in the other 2 knees.The total postoperative gap balance rate was 91.2%( 31/34 ).The constrained inserts were implanted in 3 cases.No technical-related complications happened after the surgery.After the releasing procedure, the flexion gap value had an increase of 1 mm (range, 1-3mm) in the extension tension group , and the extension gap value had an increase of 1 mm ( range, 1-2 mm) in the flexion tension group, without significant difference (Z=-1.118, P=0.264).The ROM was 83.3°±14.7°preoperatively and 100.7°±14.2° postoperatively (t=-7.714, P=0.000).The median alignment of the knee was 11.5°(range, 7°-32°) preoperatively and 1° (range, 0°-4°) postoperatively (Z=-5.092,P=0.000).The HSS scores were (42.7 ±16.3) points preoperatively and (88.1 ± 9.9) points postoperatively (t=-21.868, P=0.000).The WOMAC scores were (76.2 ±8.2) points preoperatively and (11.4 ± 9.7) points postoperatively (t=31.726, P=0.000).All of them were significantly improved in comparison with those before the surgery. Conclusions Using modified PC technique is safe and effective in medial releasing during primary TKA .Both extension and flexion gap value will be affected by releasing tensed fiber at extension or flexion position .

Objective To evaluate the guidance role of the CURB-65 criteria in the management of community-acquired pneumonia(CAP) in adults. Methods The clinical date of 13 patients with CAP from January 2007 to January 2008 were analysed, the diagnosis and treatment of 3 patients were enumerated. Evaluated the effect of CURB-65 criteria on CAP. Results According to the CURB-65 criteria, the scores of 3 patients with CAP were 0, 2, 5 scores respectively.After the proper treatment based on CURB-65 criteria,each patient got a good prognosis. Conclusions The CURB-65 criteria plays an encouraging role in assessing the severity of CAP. But the veracity of identifying severe CAP is poor. In this situation the criteria for severe CAP is needed to make the decision.

The cell-free plasma DNA of the 132 critically ill patients admitted to the emergency intensive care unit ( EICU) was measured by real-time quantitative polymerase chain reaction assay for the humanβ-globin gene. Ac-cording to the prognosis, the patients were divided into survival group (95 cases) and death group (37 cases). Blood samples were collected after EICU admission, 24 hours after admission, 48 hours after admission, and 1 week after admission. 30 age-mached controls were collected from healthy volunteers healthy care centre. Com-pared with control group, at each time point, cell-free plasma DNA concentration was significantly higher in EICU patients (P<0. 05). Cell-free plasma DNA concentrations were higher in hospital non-survivors than in survivors, of which plasma DNA concentration of 24 hours after admission and 48 hours after admission was statistically signifi-cant ( P<0 . 05 ) . The area under the ROC curves ( AUC ) for plasma DNA was bigger than the lactate and A-PACHE IIscore, the maximum of AUC was 0. 847(95% CI 0.648~1.000) at the point of 48 hours after admis-sion.

Objective Methicillin-resistant Staphylococcus aureus (MRSA) is a growing public health concern that has been associated with pediatric fatalities. This study investigated the genotypes of staphylococcal cassette chromosomal mec (SCCmec) and Panton-Valentine Leukocidin (PVL) in MRSA strains isolated from Shanghai Children's Hospital by PCR. Methods A total of 30 strains of MRSA were isolated from various clinical specimens from October 2005 to June 2006. The antimicrobial susceptibility was measured by agar diffusion method. SCCmec typing was conducted using a novel multiplex PCR assay allowing for concomitant detection of methicillin resistance (mecA gene) to facilitate detection and classification of all currently described SCCmec typesⅠ, Ⅱ, Ⅲ, Ⅳa, b, c, d andⅤ. PVL gene was also determined by PCR. Results mecA gene was positive in all the strains. SCCmecⅡ was identified in 6(20.0%) isolates, SCCmecⅢ in 15(50.0%) isolates, SCCmecⅤ in 2 and SCCmecⅣa in 1 isolate. Six MRSA strains were non-typeable. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics. The strains harboring SCCmecⅣa or SCCmecⅤwere susceptible to all antibiotics except β-lactams. Eleven (36.7%) isolates were PVL positive. The genotypes and subgenotypes of staphylococcal chromosomal cassette mec of eleven PVL-positive MRSA were SCCmecⅡ(1 isolates), SCCmecⅢ (5 isolates), SCCmecⅣa (1 isolate), SCCmecⅤ (2 iso-Lates) non-typeable (2 isolates). Conclusions SCCmecⅡ and SCCmecⅢ are the major genotypes of MRSA in our hospital. These isolates are multi-resistant to antibiotics. The prevalence of PVL gene is higher in SCCmecⅡ- or SCCmeⅢ-positive MRSA. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics.

10.3969/j.issn.2095-4344.2013.24.003

AIM: To investigate the comparison of different types of catheter treatment of anastomotic ring canalicular effect.
METHODS:Retrospective analysis. A total of 114 cases 114 eyes were randomly selected between May 2013 to May 2015 jointly admitted to Huizhou Huizhou City People's Hospital and the Central People's Hospital of canalicular patients in accordance with the agreement of the annular catheterization divided into three groups, group A of annular nasal lacrimal duct catheterization in 36 eyes, group B for the whole nasal lacrimal annular catheterization in 33 eyes, group C between the upper annular tears point catheterization 45 eyes. Through the A, B, C three groups after 1, 3wk, 1, 3mo and 1y follow-up were analyzed to compare.
RESULTS:Group A of 31 eyes were cured, improved in 2 eyes, 3 eyes, the effective rate was 91. 7%;group B, 27 cases were cured, improved in 3 eyes, 3 eyes, the effective rate was 90. 9%;group C, 40 cases were cured, improved in 2 eyes, 3 eyes, the effective rate was 93. 3%. A, B, C three groups efficiency pointless difference (P=0. 124). Eye Effect: A, B, C meaningful difference among the three groups(F=36. 578; P=0.002), Group A scored the highest score of a minimum group C, respectively( 3. 5±0. 8 ) and ( 2. 3±0. 7 ); comparison meaningless difference between group a and group B( t=0. 086, P>0. 05 ); Group A and C and comparison of differences between group C and group B have the significance ( t = 15. 241, t = 17. 472; P<0. 05 ). Nasal influence: A, B, C meaningful difference among the three groups(F=778. 581;P=0. 001), the highest score in group B, group C minimum scores were(6. 6±0.8) and ( 0. 9 ± 0. 7 ); A, B, C three groups comparison of differences twenty-two have significance(t=17. 262; t=18.247; t = 16. 647; P<0. 05). Shape Effect: A, B, C difference among the three groups of meaningful ( F=481. 113;P=0. 002), Group A scored the highest score of a minimum group C, respectively(5. 8±0. 9) and(1. 2±0.6);Compare the difference between Groups B and C meaningless ( t = 0. 087, P > 0. 05 ); comparing the differences between the Groups A and B and between Group A and C were significance(t=26. 362, t=27. 532; P<0. 05 ). Unplug risk: A, B, C meaningful difference among the three groups(F=751. 121;P=0. 003), Group A scored the highest score of a minimum group C, respectively(6. 5±0. 7 ) and ( 1. 5±0. 7 ); A, B, C three groups comparison of differences twenty - two have significance(t=19. 642; t=20. 153; t=18. 345; P<0. 05). Group A had 8 patients had lower eyelid eversion, 5 cases of inferior lacrimal point expansion, 13 cases of sneezing, itchy nose, runny nose syndrome. Group B had 20 cases of varying degrees of now sneezing, itchy nose, runny nose syndrome. Group C had no serious complications.
CONCLUSION: Similar to A, B, C three groups of treatment efficacy, patient lacrimal functional recovery is safe and effective, which the group C treatment, during treatment and less material and fewer postoperative complications in patients, it is worth promotion.

Objective To explore the influence of intestinal trefoil factor (ITF) on interleukin-6(IL-6) in neonatal rat with necrotizing enterocolitis(NEC) ,and to discuss the protective machanism of ITF on NEC.Methods Thirty-two neonatal rats were divided randomly into four groups,group A as control group,group B as NEC group,group C as NEC+NS 0.2 mL group,group D as NEC+ITF 0.2 mg group.NEC model of neonatal rats were established.On the 4th day,all the subjects were put to death.Intestinal tissue within the boundary of ileum and cecum was obtained to observe histological changes.Other intestinal tissue was treated into homogenate.After the homogenate was centrifuged,supernates were used to test the density of IL-6.Results The density of IL-6 significantly decreased in group A,D than those in group B and C (Pa0.05).The pathological lesions indicated that intestinal tissue necrosis was severe in group B and C,which was graded as 3 points,but obviously lessen in group D,which was graded as 1 point,with ITF interfering.Conclusions Intestinal inflammation is ameliorated after ITF are injected hypodermically or intraperitoneally.ITF may provide a brand-new way for the therapy of NEC in neonatal rats.