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 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 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 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.

Objective To investigate the genotype distribution of hepatitis C virus (HCV) in Guangdong Province by linear probe assay (LiPA) and core,non-structural protein 5B (NS5B) sequence analysis,and to evaluate the accuracy of LiPA for genotyping.MethodsOne hundred and ten HCV specimens from chronic hepatitis C (CHC) patients in Guangdong Province were genotyped by both core,NS5B sequence analysis and INNO-LiPA 2.0.The data were then analyzed with SPSS 10.0 software.ResultsAmong the 110 specimens,core and NS5B fragment could be amplified from 97 and 62 specimens,respectively,while both fragments were obtained from 57 specimens. The results of genotyping by core sequence analysis were completely consistent with the results of NS5B sequencing.One hundred and two specimens were classified into five subtypes,i.e.genotype 1a,2a,3a,3b,6a,with frequencies of 61.8％ (64),9.8％ (10),3.9％ (4),3.9％ (4),20.6％ (21),respectively.All but genotype 6 strains can be genotyped correctly by using INNO-LiPA 2.0.However,only subtype 1b and 3b could be genotyped accurately.81.5％ genotype 6a strains were genotyped as 1b by mistake. Conclusions Genotype 6a has become the second most prevalent genotype in Guangdong Province.The LiPA cannot distinguish genotype 6a from 1b strains accurately which needs further investigation.

Objective To evaluate the procedure of diagnosis and treatment for cystitis glandularis in female. Methods Forty-seven patients were classified into 3 groups randomly after being operated by tuansurethral resection:15 cases without any other therapy(A group), 16 cases with bladder instillation of pirarubicin afterward (B group), 16 cases with bladder instillation of mitomycin afterward (C group). Symptomatic reliof and recurrence were investigated in 1-year follow-up visit. Results Forty-four cases had fulfilled the entire follow-up visit. The effective rates of the three groups were 38.5%,87.5% and 86.7% respectively (X2=13.80,P＜0.01 ), the recurrence rate was 30.8% ,0,13.3% respectively (X2=4.86,P＞0.05).Conclusions The clinical situation of cystitis glandularis has no specificity. Cystisis glandularis has diversification of the clinical symptoms, urodynamics. Transurethral resection with bladder instillation is more effective than transttrethral resection simply, the recurrence rate is lower.

Objective To investigate the effect of angiotenisn ⅡI (Ang Ⅱ) on RIN-m β-cell,and to explore the mechanism of β-cell function impairment caused by Ang Ⅱ.Methods RIN-m cells were cultured with various concentrations of AngⅡ (0.1,1,10,100 nmol/L).After incubation for 24 hours,the basal(3.3 mmol/L) and glucose-stimulated(16.7 mmol/L) insulin secretion(GSIS)were detected by radioimmunoassay,mRNA and protein expressions of uncoupling protein 2(UCP2)were determined by RT-PCR and Western blot,respectively.The intracellular ATP content was measured by luciferase bioluminescence.The mitochondrial membrane potential and cellular Ca~(2+) concentration were detected by flow cytometry.Results (1) Various concentrations of Ang Ⅱ had no significant influence on the basal insulin secrection of RIN-m cell(F=0.644,P = 0.634).Except for 0.1 nmol/L AngⅡ,the other concentrations of Ang Ⅱ markedly reduced GSIS of RIN-m cells(F= 118.528,P = 0.000).(2) Compared with the control group,Ang Ⅱ significantly increased mRNA and protein expression of UCP2(F= 1 370,P = 0.000;F=675.175,P = 0.000).(3)Except for 0.1 nmol/L Ang Ⅱ,the other concentrations of Ang Ⅱ significantly decreased the mitochondrial membrane potential,cellular ATP content,and cellular Ca2+ concentration of RIN-m cell(F=4.035,P=0.008;F=3.353,P = 0.013;F=5.867,P = 0.001).Conclusion Ang Ⅱ impairs GSIS of p-cell,the mechanism of impairment may be interpreted that Ang Ⅱ can increase the expression of UCP2,furthermore,it can reduce mitochondrial membrane potential,decrease the content of cellular ATP and the concentration of cellular Ca~(2+),can finally impair the function of β-cell.