ObjectiveTo explore the influence of L-carnitine on the effect of erythropoietin in treatment of patients with renal anemia during hemodialysis treatment.Methods40 uremic patients with chronic renal failure underwent bemodialysis(HD) in were randomly divided into treatment group and control group,20 cases each.Control group was given EPO 9000u/week subcutaneous injection in the blood after dialysis,while regular oral iron,folic acid.Treatment group on the basis of the control group to 1.0g L-carnitine added 20ml 0.9％ sodium chloride injection intravenously 3 ～ 5 min,2 times per week.Both groups were treated for 3 months.Before treatment and after 4 weeks and 3 months treatment.The hemoglobin(Hb),hematocrit (Hct),serum ferritin (SF),serum thyroxine(iPHT) and compared.ResultsAfter 4 weeks of treatment,Hb,Hct levels increased compared with before treatment( all P ＜0.05).Hb after 3 months compared with the two groups before treatment were significantly higher(all P ＜0.05),and Hb increase of the treatment group significantly higher than the control group ( P ＜ 0.01).ConclusionL-carnitine could improve the treatment of erythropoietin in hemodialysis patients with renal anemia.

Objective To study the effect of apolipoprotein E (ApoE) polymorphism on serum lipids and the relationship between apolipoprotein E polymorphism and coronary heart disease (CHD).Methods Polymerize chain reaction (PCR) and HhaI digestion were used for the detection of apolipoprotein E genotype on 71 patients with CHD and 69 control subjects.Results The frequencies of apolipoprotein E4 allele and E3/4 genotype were obviously increased in CHD group than in control group (P<0.01,P<0.05). Conclusion The apolipoprotein E polymorphism is related to the occurrence of coronary heart disease; apolipoprotein E4 allele is one of the most important hereditary factor for the occurrence of CHD.

Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment.

After the concept of symptoms in traditional Chinese medicine was defined, the classification of symp-toms in traditional Chinese medicine and the characteristics of clinical diagnosis and treatment in traditional Chinese medicine were described .It was suggested that the symptoms in traditional Chinese medicine should be classified into 3 kinds, namely symptoms and signs according to the 4 diagnostic methods, symptoms and signs according to the diagnostic devices, symptoms and signs according to the physical constitutions of patients in order to lay a foun-dation for improving the classification in clinical term system of traditional Chinese medicine.

Objective To evaluate the nursing outcomes of patients with chronic diseases discharged from various fields,and to analyze the related factors,and provide the basis for the nursing of patients with chronic diseases.Methods A total of 640 patients with chronic diseases discharged from hospital were investigated by the general information questionnaire and the Chronic Disease Patients Nursing Outcomes Classification Evaluation Form.Results In nursing outcome classification evaluation of patients with different diseases,the score of patients with cardiovascular disease was (250.27 ± 38.82) points,the score of patients with chronic obstructive pulmonary disease was (267.27± 32.46) points,the score of patients with cerebral apoplexy was (238.69 ± 38.80) points,and the score of patients with diabetes was (287.71 ± 21.86) points,the differences were statistically significant (F=40.062,P＜ 0.01).Evaluation in each dimension,physiological,functional outcome scores higher,cognitive,behavioral health outcome scores lower;,in addition,education,place of residence,average annual family income,types of illness,mentality,the whether hospitalized for the first time become discharged patient care of the main factors.Conclusions Nursing care should be guided by the classification of nursing outcome,and individual nursing intervention for the differences between the types of illness and individual factors.

ObjectiveTo improve nursing quality by paying attention to management of nurses' psychology and behavior and changing individual and collective behavior.MethodsGuided by dynamic field theory,giving nursing staff continuous periodic training and counseling,establishing a staff interview system,giving systematic support and enhancement to develop a high-performance team.A case-control study was carried out in eight wards to evaluate implementation effect by comparison study.ResultsBefore and after introducing dynamic field theory,there were significant differences in job satisfaction of nurse staff (P<0.01),in patients' satisfaction(P<0.05),in evaluation of nursing staff management efficiency(P<0.05).ConclusionsApplication of dynamic field theory in nursing management can improve job satisfaction of nurse staff,patients' satisfaction and nurses' post suitability,and obtain continuous nursing quality improvement.

Objective To evaluate the prevalence of aspirin resistance in old-aged patients with cerebral infarction and to analyze the mechanisms and clinical predictors of aspirin resistance. Methods 300 old-aged patients with cerebra] infarction were selected and the platelet aggregation ratio was determined by nephelometry with CHRONO-LOG PA-meter. And some information of these patients, such as age, sex, smoking, taking non-steroid anti-inflammatory drug (NSAD)or proton pump inhibitor (PPI), obesity, coronary artery disease (CAD), peripheral vascular disease, hyperpiesia, diabetes and hyperlipemia were recorded. Results 112 cases (37.33%) were aspirin sensitiveness, 108 cases(36.0%) were aspirin semi-resistance and 80 cases (26.67%) were aspirin resistance. These cases were divided into two groups. One was aspirin sensitive (AS) group, which included 112 patients of aspirin sensitiveness. The other was aspirin resistant (AR) group, which consisted of 188 patients of aspirin semi-resistance and aspirin resistance. The prevalence of CAD, hypercho]esteremia and RBC count in AR group was higher than that in AS group The percentage of patients who took NSAD, PPI and smoke in AR group was also higher than that in AS group. Conclusion Aspirin resistance existed in old-aged patients with cerebral infarction to great extent, and which was correlated with CAD, hypercholesteremia, smoking, RBC count, taking NSAD and PPI.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ ) and angiotensin Ⅱ type 1 receptor antagonist (AT1RA) on the transforming growth factor-β1 (TGF-β1) synthesis and tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA expression of in vitro cultured hepatic stellate cells (HSCs). Methods HSC-T6 rat hepatic stellate cell line was selected as the study model of the activated hepatic stellate cells. Cultured HSCs were randomized into control group, Ang Ⅱ group, AT1RA group and Ang Ⅱ AT1RA group. Cell culture medium was used to detect the TGF-β1 level by ELISA method. HSCs were harvested to measure the TIMP-1 mRNA expression by RT-PCR. Results TGF-β1 level of control group, Ang Ⅱ group and AngⅡ AT1RA group in cell culture medium was (7.531 ±0. 654) pg/mL, (9. 855± 1. 485)pg/mL and (7.719 ± 0.329) pg/mL respectively, Ang Ⅱ group higher than control group (P ＜ 0.05 ), Ang Ⅱ AT1RA group lower than Ang Ⅱ group (P ＜ 0. 05 ). TIMP-1 mRNA expression level of control group, Ang Ⅱ group and Ang Ⅱ AT1RA group in HSCs was 3. 387 ± 0. 042, 4.870 ± 0.061 and 3. 837 ± 0. 042 respectively, Ang Ⅱ group higher than control group ( P ＜ 0. 05 ), Ang Ⅱ AT1RA group lower than Ang Ⅱ group (P ＜ 0. 05). Conclusion AngiotensinⅡ can increase the TGF-β1 synthesis and TIMP-1 mRNA expression of hepatic stellate cells, while all these effects are inhibited by angiotensinⅡ type 1 receptor antagonist.

Objective To evaluate the clinical application value of amniotic membrane transplantation in the treatment of intrauterine adhesions.Methods Totally 48 intrauterine adhesions patients of infertility were treated with amniotic membrane transplantation from January to December 2013 in our hospital.They were divided into mild adhesion in 11 cases (group A),moderate adhesion in 17 cases (group B),and severe adhesive group in 20cases (group C) by American Fertility Association.They were treated with amniotic membrane transplantation and estrogen/progesterone sequential treatment after operation.Clinical effect and feasibility of each group were analyzed.Results There was statistical significance in the endometrium thickness after 3 months (P ＜ 0.05).The menstruation of all patients with mild and moderate intrauterine adhesion (IUA) was improved,and the menstrual improvement rate in patients with severe intrauterine adhesions was 90％.IUA cure rate of groups A,B,and C were different after 3 months of surgery,[groupA100％ (11/11),group B 94.1％ (16/17),group C70％ (14/20),x2 =6.73,P ＜0.01],The cure rate of group A was significantly higher than that of group C (x2 =4.00,P ＜ 0.05),although the cure rate of group B was higher than that of group A,but the difference was not statistically significant (P ＞ 0.05).Conclusions The cure rate of amniotic membrane transplantation combined with estrogen in the treatment of intrauterine adhesions was high.It could promote the recovery of the endometrium and improve the recovery of menstruation.There was no transplantation rejection and safety.It also had the advantages of easy drawing materials,simple operation,and can be applied to clinical application and promotion.

OBJECTIVE To introduce process management to procedure and standardization of infection management in common ward.METHODS Establishing and applying hospital infection control process,to use it in internal medicine and surgery wards(eight wards).Retrospective investigation was conducted to analyze the data.RESULTS Before and after using infection control process,there were significant differences between incidence of hospital infection in inpatients(P