Objective To evaluate the effect of health education on lung function,quality of life,awareness degree and treatment compliance in chronic obstructive pulmonary disease (COPD) patients during stationary phase.Methods 106 COPD patients during stationary phase were randomly divided into 4 groups,25 patients in group Ⅰ,26 patients in group Ⅱ,20 patients in group Ⅲ,35 patients in group Ⅳ.Group Ⅰ did not accepted the health education,and group Ⅱ,Ⅲ,Ⅳ accepted two,four and eight (or＞eight) weeks health education in file.The lung function,quality of life,awareness degree and inerratic treatment rate were compared before and 6 months after health education by questionnaire and follow-up survey.Results Health education could be successful in delaying the decline of FEV1,FVC and FEV1/FVC and was effective in decreasing the SGRQ score among the COPD patients during stationary phase.The results showed that group Ⅱ,Ⅲ,Ⅳ were superior to group Ⅰ,while group Ⅲ,Ⅳ were superior to group Ⅰ,Ⅱ.Health education could remarkably increase awareness degree and inerratic treatment in COPD patients during stationary phase,and the effect on inerratic treatment was connected with the health education number of times.There were distinct different results among 4 groups.Conclusions Health education could remarkably increase awareness and inerratic treatment rate,and have positive effect to delay lung function decline and to promote quality of life in COPD patients during stationary phase.

Objective To analyze the clinical and pathological data of the minimal deviation adenocarcinoma (MDA) of the cervix, and to provide evidence based medicine for diagnosis and treatment. Methods Clinical case reports about MDA or malignant adenoma during 1980-2014 published on CNKI, WanFang, CBM, WeiPu and Medline were retrieved and combined with 2 case with the same diagnosis and treatment. Results Age of onset was 20-86 years old, and the average age was 44.8 years, with median age of 44.5 years. Clinical symptoms of MDA showed massive vaginal apocenosis or irregular bleeding. Gynecological examination common showed cervical hypertrophic and harden. The positive rate of cervical cytology examination was 9.73% (11/113). MDA diagnosed by cervical biopsy and conization accounted for 58.38% (108/185). Immunohistochemical showed that the positive rates of carcinoembryonic antigen, P53 and Ki-67 were 93.91%(108/115), 75.44%(43/57)and 100.00% (42/42). Main operation assisted with postoperative radiotherapy and chemotherapy, early diagnosis, clinical stage and operation methods played important roles in the prognosis. Conclusions The clinical symptoms and physical signs are not obvious for MDA which is difficult to diagnose, so it is easy to diagnose mistakenly and misdiagnose also. The positive rate of cervical cytology is usually lower, repeated and deep cervical biopsy or conization combined with immunohistochemistry can improve the accuracy of diagnosis. The individualized treatment should be selected according to clinical stage for the patients who were confirmed preoperatively.

Objective To evaluate the role of myocardial contrast echocardiography (MCE) to select target vessel, to monitor the opacification zone and to avoid complications during transcoronary ablation of septal hypertrophy(TASH) for hypertrophic obstructive cardiomyopathy(HOCM). Methods In 37 HOCM patients cardiac apex four chamber view, parasternal left ventricular long axis view and left ventricular short axis view were recorded after injection of the myocardial agents and absolute ethanol 5 minutes later respectively. And the opacification zones of the myocardial agents and absolute ethanol were observed. Results Among 37 patients,2 patients gave up treatment because of no appropriate vessel to provide ablation by coronary Doppler flow imaging.Two of 37 patients gave up treatments and did not undergo myocardial contrast echocardiography because of diffused coronary arteries in coronary angiography. Among 33 patients who underwent MCE, 5 patients gave up TASH including one of the opacification of left ventricular mammary muscles, one of the opacification of right ventricular and right ventricular mammary muscles, one for the opacification zone out of the target area and two for the large opacification zone. Other 28 patients underwent TASH successfully. Just after operations and 7 days, left ventricular outflow tract pressure gradient decreased at no less than 50%. Distribution zone of absolute ethanol was smaller than that of myocardial opacification zone in some patients. Conclusions MCE is a credible reference for selection of target vessels in TASH for HOCM.

Objective To investigate the cardioprotective effect of losartan o n subtotal nephrectomy renal failure rats. Methods Renal failure rats were estab lished by subtotal nephrectomy, and then divided into RF group with subtotal nep hrectomy,RF+Los group with additional losartan(10 mg?kg-1?d-1) gavage. Rats underwent sham operation(sham group) with normal saline gavage as control. Hear t changes of experimental rats were observed 12 weeks after operation. Results T he RF group developed hypertension of arterial systolic blood pressure(SBP) and myocardiac myocytes hypertrophy. The levels of collagen type Ⅰ,type Ⅲ,and fi bronectin in endocardium and surrounding intracardial coronary arteries adventit ia of the RF group were significantly increased as compared to those of the sham group. The SBP and the levels of collagen type Ⅰ,Ⅲand fibronectin were marked ly decreased in the RF+Los group as compared to those of the RF group.Expressio n of angiotensin Ⅱsubtype 1 receptor (AT1R) mRNA in the myocardium of the RF+L os group was significantly down regulated as compared to that of RF group. Concl usions Losartan can prevent the cardiac ventricular remodeling with left ventric ular hypertrophy (LVH) and myocardial interstitial fibrosis by the depression of renin-angiotensin system through the down-regulation of myocardiac AT1R mRNA.

Objective To observe the vasodilation effect of extract of Jasminum samba (EJs), a kind of traditional Chinese medicine, on ex vivo rat thoracic aortic rings, and to investigate its mechanism. Methods On ex vivo aortic ring perfusion device, influence of EJs on contraction of the aorta induced by phenylephrine (PE) or potassium chloride (KCl) was observed. Influence of N-nitro-L-arginine-methylester ( L-NAME ), barium chloride ( BaCl2 ), glibenclamide ( Gli ) on vasodilating effect of EJs (0. 5, 1, 2, 4, 8 g·L-1 ) was detected. Effect of EJs on the contraction of calcium chloride (CaCl2 ) and PE in Ca2+-free medium was detected. [ Ca2+ ] i in vascular smooth muscle cells was determined by using laser scanning confocal microscope (LSCM). Results In blood vessels with intact endothelium, EJs concentration-dependently decreased PE- or KCl-induced vasoconstriction, the maximum dilating effect being (105. 0±3. 2)% and (78. 0±6. 5)% , respectively; L-NAME affected the vasodilatory effect of EJs on thoracic aorta rings ( P<0. 01), the maximum dilatory effect being (58. 0 ± 6. 9)% . BaCl2 and Gli had significant influence on vasodilation of EJs, and the contraction was obviously attenuated (P<0. 01), the maximum dilatory effect being (37. 0±5. 2)% and (78. 0±10. 0)% , respectively. EJs significantly inhibited contracting effect of PE on thoracic aorta rings in Ca2+-free medium (P<0. 01). The maximum contraction effect was (70. 0±6. 3)% . EJs inhibited CaCl2-induced vasoconstriction (0. 5-8 mmol·L-1 ), and vasoconstriction was decreased by (65. 0±3. 2)% . LSCM recorded that Fmax / F0 of 4 and 8 g·L-1 EJs was (2. 0±0. 2) and (1. 5±0. 2), respectively. Conclusion EJs exerted a dose-dependent vasodilating effect on rat isolated aorta rings. The mechanism might be related to promoting NO release, activating K+channels and decreasing the concentration of cytoplasmic Ca2+.

Objective:To investigate the prevalence,and the factors that influence depressive symptoms among chronic respiratory disease patients in tertiary hospital.Methods:A total of 1713 outpatients and inpatients with chronic respiratory disease were selected from 8 tertiary hospitals in Jiangsu Province from July to September,2014 and screened according to the Hospital Anxiety Depression Scale-D (HADS-D).A questionnaire developed by this research group,was used to collect demographic and clinical information.Logistic regression was used to identify factors that were associated with depressive symptoms.Results:The overall rate of depressive symptoms was 46.0％.Multiple logistic analysis showed that spinsterhood (OR ＝ 0.45),higher education level (middle school /high school/technical school OR ＝0.65;college degree or aboveOR ＝0.28),BMI ≥24 (OR ＝0.71) were associated with decreased risk of depressive symptoms (P ＜ 0.05).B MI ＜ 18.5 (OR ＝ 1.52,),average income of family ≥10000 RMB (OR ＝ 1.37-1.96),limited daily activities (OR ＝ 1.72),poorer sleep quality (OR ＝ 1.45),and negative life events (OR ＝ 1.62) were associated with increased risk of depressive symptoms (P ＜ 0.05).Conclusion:The prevalence of depressive symptoms among chronic respiratory disease patients in tertiary hospitals in Jiangsu Province was higher.Marital status,education level,income,BMI,limited daily activities,subjective sleep quality,negative life events may be the related factors of depressive symptoms of chronic respiratory diseases patients.

Objective To explore the changes on autonomic nervous function of the patients with different Traditional Chinese medicine syndrome types.Methods The cases of anxiety or depressive diseases were divided into different types according to traditional Chinese medicine syndrome types,and then heart rate variability(HRV) were tested and compared with normal controls.Results Indicators of time or frequency of heart rate variability(HRV) in anxiety or depressive disease patients with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng were lower than those of controls group,especially in parasympathetic nervous.The abever disorders of the patients with Gan-Yu-Tan-Zu Zheng or Gan-Yu-Qi-Zhi Zheng was more significant than those in patients with Xin-Pi-Liang-Xu Zheng.Conclusions The autonomic nervous function of anxiety or depressive diseases with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng is disordered and their HRV of was lower than that of control(P

Objective To investigate the relationship between the biochemical markers of bone turnover and renal osteodystrophy (ROD) in patients with primary nephrotic syndrome (PNS).Methods A total of 30 patients with PNS and 50 healthy subjects (controls) were included in the study.The BMD of lumbar vertebrae and femur was measured by dual-energy X-ray absorptiometry.The levels of total procollagen type Ⅰ amino-terminal propeptide (TP Ⅰ NP),β-isomerized carboxyterminal propeptide (β-CTx),intact PTH (iPTH),serum calcium,serum phosphorus,ALP,25-OH-Vitamin D3 (25-OH-VD3),β2-micro-globulin(β2-MG),and ratio of urinary to creatinine (UA/Cr) were measured and calculated.The risk factors related to ROD in PNS patients were analyzed.Two-sample t test,multiple linear regression and partial correlation analysis were used to analyze data.Results The BMD values of lumbar vertebrae and femur in the PNS group were significantly decreased compared with those in controls (t =6.162,5.583,3.891 (＜40 years),5.923,5.324,3.129 (≥40 years),all P＜0.05) and the serum levels of TPⅠNP,β-CTx,iPTH,ALP,β2-MG and UA/Cr in the PNS group were significantly higher than those in controls (t:2.738-10.129(＜40 years),3.226-12.581 (≥40 years),all P＜0.05),and the levels of serum calcium and 25-OH-VD3 in the PNS group were significantly lower than those in controls (t =3.624,7.223 (＜40 years),2.011,2.564 (≥40 years),all P＜0.05).But there was no significant difference for serum phosphorus between the 2 groups (t=0.811,0.513,both P＞0.05).TP Ⅰ NP was positively correlated with β-CTx,iPTH,ALP,UA/Cr,β2-MG(r:0.512-0.682,all P＜0.01),and TP Ⅰ NP was negatively correlated with serum calcium and 25-OH-VD3(r=-0.314,-0.562,both P＜0.01)in the PNS group.β-CTx was positively correlated with iPTH,ALP,UA./Cr,β2-MG(r:0.459-0.618,all P＜0.01),and negatively correlated with serum calcium and 25-OH-VD3(r=-0.212,-0.589,both P＜0.01).The iPTH was positively correlated with ALP,UA/Cr and β2-MG (r =0.410,0.606,0.508,all P＜0.05),and negatively correlated with serum calcium and 25-OH-VD3(r=-0.315,-0.516,both P＜0.05).Conclusions The BMD in PNS patients is lower than that in healthy subjects.Combined measurement of TP Ⅰ NP,β-CTx and the BMD is helpful for the diagnosis of ROD in PNS patients.

Objective:To evaluate the effectiveness and safety of endovascular treatment in solving symptomatic cerebral artery tandem lesions.Methods:From June 201 2 to February 201 4,1 2 cases (24 lesions)with symptomatic cerebral artery tandem lesions were accepted for the endovascular treatment. The distributions of the tandem lesions were as follows:the common carotid artery and internal carotid ar-tery (1 case),the internal carotid artery and the proximal of the carotid cavernous sinus segment (3 ca-ses),the internal carotid artery and the distal of the carotid cavernous sinus segment (4 cases),the in-tracranial segment of internal carotid artery and middle cerebral artery M1 segment (2 cases),the first segment of vertebral artery and intracranial segment of vertebral artery (2 cases).All of these cases were treated from distal lesions to proximal lesions except for tandem lesions in the internal carotid artery and the distal of the carotid cavernous sinus segment in order to obtain better support.Tandem lesions were treated in the same operation with local anesthesia or general anesthesia.The procedures of the 1 2 cases retrospectively were analyzed and the peri-operation complications and responsibility region recurrent is-chemic stroke incidents observed.Results:All tandem lesions were solved successfully all at once.There were no peri-operation complications or recurrent ischemic stroke incidents.There were no recurrent is-chemic stroke incidents or stent restenosis cases in the follow-up.Conclusion:It is safe and effective for selective endovascular treatment in solving symptomatic cerebral artery tandem lesions at the same time, but we should take careful preoperative evaluation and improve the operation plan.

Objective To summary the echocardiographie features of the patients with dissection into interventricular septum (IVS) and to analyze the etiology.Methods The data of 13 cases with the dissection into the interventricular septum diagnosed by echocardiography were reviewed to summarize the echocardiographic features and the analysis of etiology.Results Among the 13 patients with dissection into IVS,11 patients were dissected into IVS from the right sinus of Valsalva (SOV),in which 5 patients were from single aneurysm of the right SOV,one patient was from a combination of a bicuspid aortic valve and right SOV,4 patients were from aortic valve infection of infective endocarditis,and one patient was induced by severe paravalvular leak after mechanical aortic valve prosthetic replacement was complicated by annular detachment.In all 11 patients,eehocardiography showed a dissecting cystic-like mass in the IVS from the base to mid septum or confined to the septal base.The path of the dissection in all these patients was traced to the right SOV.In the other 2 patients,IVS dissection followed septum rupture due to a myocardial infarction.Conclusions Echocardiography could accurately diagnose dissections of the IVS and to analyze the etiology,which is very helpful to make the clinical medical strategy.