Objective To observe the effects of aging on liver and heat shock protein (HSP)70 expression in rats,and explore the role of HSP 70 in the changes of aging liver. Methods 24 healthy Sprague Dawley rats were divided into 4 groups according to age:21-day-old group,3-monthold group,12-month-old group and 18-month-old group (n=6 per group).Routine blood tests and biochemical tests were tested. Liver tissues were observed under light microscopy. The mRNA expression of HSP70 was detected by real-time PCR. Results The ratios of liver weight to body weight were decreased gradually with aging in 4 groups (0.073,0.050,0.025,0.019,respectively,t=78.016,P =0.000).Compared with those of young rats (21-day-old and 3-month-old),serum albumin levels of aged rats (12-months and 18-months) were declined [(35.0±2.7) g/L and (39.8±3.5) g/L vs.(27.3±9.3) g/L and (20.6± 1.7) g/L,t=12.233,P=0.000].Nevertheless serum alkaline phosphatase (ALP) levels were increased with aging [(68.8± 23.3) U/L,(71.6 ± 19.2)U/L,( 185.9 ± 41.5) U/L,(418.6 ± 140.6) U/L,respectively,t =35.454,P=0.000].The differences in other routine biochemical indexes were not found among the age groups (P＞0.05).Liver histological changes including hepatocytes disordered and vacuolization or fatty changes were detected with aging,especially in 18 month-old rats. Real-time PCR results indicated that the expression level of HSP70 mRNA was much lower in 18-month-old rats than in 12-month-old and 3-month-old rats (0.218 vs.0.220 and 0.230,P=0.000). Conclusions HSP70,as a stress protein,may play an important role in the procedure of injury and senescence of liver cell,and then can serve liver aging as one of the influential markers.

Objective To observe the influence of the short effect antihypertension drugs- nifedipine and medial effect antihypertension drugs- extended release nifedipine on the blood pressure variability (BPV) in essential hypertension(EH). Methods Twenty-five EH patients were underwent 24-hour noninvasive ambulatory blood pressure monitoring (ABPM) and observed their BPV respectively before taking drugs, after taking nifedipine and extended release nifedipine. Meantime,25 normotensive controls (NC) were observed. Results (1)BPV in EH group was higher than that in controlled group and the severer the rise of blood pressure, the more obvious the increase of BPV (P 0.05). Conclusions Nifedipine could increase BPV but extended release nifedipine did not change BPV while they decreased blood pressure. Effect of extended release nifedipine was better than nifedipine in decreasing blood pressure.

Objective To explore the prognosis of endoscopic tissue adhesives injection in treating liver cirrhosis patients with esophageal gastric varices (GOV),and to evaluate the effects of various factors on bleeding after treatment.Methods A total of 157 liver cirrhosis patients with GOV treated by endoscopic tissue adhesives injection with or without ligation therapy were retrospectively analyzed.The basic information,liver function and blood biochemical values of patients at enrollment were investigated.The analysis of bleeding after treatment was conducted by Kaplan-Meier.The survival curves comparison was conducted by Log-rank test.Logistic regression model was used for multivariate analysis.The prognosis predictors were evaluated by receiver operating characteristics (ROC) curves and the area under the curve (AUC).Results Rebleeding happened in 26 of 157 patients.The median rebleeding time was 3.4 months.The results of univariate analysis indicated that there were statistical differences in FIB4 scores (Z=-1.282,P=0.100) and the inner diameter of the right portal vein (Z=-1.812,P=0.035) between bleeding group and no bleeding group.The results of multivariate analysis showed that the inner diameter of the right portal vein was independent prognostic factor of rebleeding (OR =1.733,95％ CI:1.045 to 2.874,P =0.033).Optimal diagnostic threshold was 8.5 mm (AUC=0.724,95 ％CI:0.537 to 0.910),sensitivity and specificity was 77.8％ and 66.6％ respectively.Conclusions The inner diameter of the right portal vein was one of the important factors that affected the efficacy of tissue adhesives injection in preventing bleeding and the prognosis.FIB4 score had certain reference value in predicting recurrence or bleeding after treatment.

Objective To investigate the correlation between self-management level and survival quality among stroke patients in community. Methods A total of 100 stroke patients in community were recruited from three communities in Shanghai from January to April 2014. They were investigated with the stroke patients self-management scale and SIS life quality scale. The SPSS 19. 0 software was used for statistical analysis. Results The total scores of self-management level and survival quality were (174. 97 ± 36. 69) and (213. 94 ± 52. 84),respectively, which were at the level of better than average. The scores of the total scale and the factors of self-management level and survival quality were positively correlated (r =0. 139 -0. 661,P <0. 01). Conclusions Positive correlation exists between self-management level and survival quality among stroke patients in community. The medical staff should pay more attention to improve the level of self-management in patients, and improve their quality of life.

This paper summarizes the main content, application effect, application characteristics and limitations of the colostomy complication assessment tool, analyzes the problems of the existing assessment tools, and proposes practical solutions, so as to provide a reference for the evaluation and management of colostomy complications.

Objective:To explore the effect of a new teaching mode, which includes bridge-in, outcome, pre-test, participation, post-test and summary (BOPPPS), on the online teaching of radiobiology related knowledge for cancer radiotherapy practitioners.Methods:Taking the cell survival curve, cell cycle and radiosensitivity as examples, the radiotherapy practitioners in multiple university-affiliated hospitals were organized to carry out a multicenter prospective randomized control study. All practitioners were randomly divided into BOPPPS group and control group. The courses for BOPPPS group were designed as an online classroom, consisting of pre-class preparation, online teaching and post-class stages. The online teaching stage included video viewing, basic knowledge learning, literature discussion, group discussion and others. The control group employed the traditional teaching mode. The χ2 test was used to compare the consistency of general conditions between the two groups, and nonparametric test was used to compare the differences in scores between two or more groups. Results:The score of the pre-class test was 58.56 ± 0.99. Post-class average score for BOPPPS group was 85.48±0.85 and for control group 77.79±1.10, with the former being higher 7.69 ( Z=5.31, P<0.001) than the latter. The average answer time was (296.62±15.40) s for BOPPPS group and (386.41±21.27) s for control group, with the former being shorter 89.79 s ( Z=3.34, P=0.001) than latter. Subgroup analysis shown that the scores of BOPPPS group were significantly rising, regardless of whether or not the students had studied radiobiology courses. Among the students who have not studied these courses, the scores were rising greatly. Moreover, From the analysis of different positions, it was found that both the scores of BOPPPS group and control group have risen, especially for doctors, deputy chief doctors, physicists and technicians. There were also statistically differences between different degrees, with significantly rise in scores for undergraduate and doctoral students ( Z=3.64, 4.18, P<0.001). Conclusions:The flexible application of BOPPPS teaching mode to the online education of such boring disciplines, like radiobiology, is of great significance to raise the theoretical basis of radiotherapy practitioners.

Objective:To understand the influencing factors of the maintenance and promotion of peripherally inserted central catheter (PICC) in the community under the medical alliance model, and provide a basis for realizing the full coverage of PICC maintenance clinics at each site in the medical community.Methods:Using the cluster sampling method, a total of 79 patients with PICC in 10 communities participating in the medical alliance model in Hangzhou and 67 community nurses participating in PICC maintenance were selected as the research objects from January to February 2021. The patients and nurses were surveyed by using the patient questionnaire and the nurse questionnaire, respectively. Univariate analysis and Logistic regression were used to analyze the influencing factors of community PICC maintenance and promotion under the medical alliance model, and the theoretical knowledge and operation of PICC maintenance for community nurses were assessed. According to the 8-month promotion of communities, 3 communities with more than or equal to 40 PICC maintenance patients were selected as the promotion advantage communities, and the remaining 7 communities were selected as the promotion disadvantage communities. And the influencing factors of promotion results among the superior and inferior communities were compared and analyzed.Results:In the univariate analysis of the patient survey, payment method, mobility, transportation mode, transportation cost, receiving follow-up, satisfaction with community consultation process and maintenance technology were the influencing factors of community PICC maintenance and promotion under the medical alliance model ( P<0.05) . In the univariate analysis of the nurse survey, publicity channel, performance distribution, shift arrangement, family doctor team and door-to-door maintenance were the influencing factors of community PICC maintenance and promotion under the medical alliance model ( P<0.05) . There were statistically significant differences in knowledge and operation skills of PICC complications among superior and inferior community nurses ( P<0.05) . Logistic regression analysis showed that patients' behavior ability and whether they were followed up were the influencing factors of community PICC maintenance and promotion ( P<0.01) . Conclusions:Based on the medical community model, the homogenization training and management of PICC maintenance should be carried out in the community, the family doctor team should be used to carry out regular follow-up for patients with catheterization, the maintenance process of PICC in the community should be simplified, the publicity of various ways should be strengthened, the ability of community nurses to deal with PICC complications should be continuously improved and the performance allocation scheme should be adjusted to improve the initiative of nurses. And strengthening the two-way referral linkage mechanism between the general hospital and the community, providing consultation support to the community and solving the reimbursement channels for diseases specified in the maintenance of community PICC can promote the promotion and maintenance of PICC in community.