In order to promote our country's research on transitional care for patients with chronic kidney disease (CKD),the article summarized research progress on transitional care for patients with CKD,analysed the problems existed including lack of evidence-based basis,insugiciency of Intervention staff,one-sided intervention content and effect evaluation,etc,and put forward the corresponding countermeasures.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective · To investigate the effect of metformin on insulin resistance (IR)-related metabolic parameters in olanzapine-bearing rats.Methods · Thirty female SD rats were randomly divided into metformin intervention group, olanzapine group and control group. During the first 6 weeks,5 mg /(kg·d) olanzapine was given to the two test groups . The control group was given the same amount of saline. From the 7th week, the intervention group began to combine with metformin 500 mg / (kg·d), while the olanzapine group combined with the same amount of saline, continuing for 4 weeks.At the end of 6th week and 10th week, intraperitoneal glucose tolerance and homeostasis model assessment IR index were assessed. Results · The area under the glucose tolerance curve (P=0.040) and the IR index (P=0.000) were significantly higher for the intervention group and the olanzapine group than the control group at the end of 6th week. At the 10th weekend, the glucose tolerance (P=0.015) and IR index in the intervention group were significantly lower than those in the olanzapine group (P=0.001). Conclusion · Metformin may rectify the impaired glucose tolerance and improve IR induced by olanzapine partly.

Objective: To establish an HPLC-fluorescence detection method for the determination of thioguanosine-monophosphate (TGMP), thioguanosine-diphosphate (TGDP) and thioguanosine-triphosphate (TGTP) in red blood cells (RBC), as well as quantify the individual thioguanine nucleotides metabolites in kidney transplant recipients with azathioprine (AZA) therapy.Methods: The individual thioguanosine phosphates were extracted from RBC by dichloromethane and subsequently oxidized by potassium permanganate.The separation was achieved on a Nucleosil C18 column (150 mm×4.6 mm,5 μm) with an ion pairing reagent and detected by a fluorescence detector (excitation at 315 nm, emission at 390 nm).The mobile phase consisted of 20 mmol·L-1 potassium phosphate buffer (pH was adjusted to 6.8 by 5 mmol·L-1 tetrabutylammonium hydrogensulfate)-acetonitril (80:20) with the flow rate of 1.0 ml·min-1.Results: TGMP, TGDP and TGTP were quantified from RBC within the range of 50-500, 50-1000 and 100-5 000 pmol·ml-1, respectively.The limit of quantification (LOQ) was 50, 50 and 100 pmol·ml-1 RBC for TGMP, TGDP and TGTP, respectively.The intra-and inter-day RSDs were below 7.0% with the method recovery between 95.0% and 103.6%.The mean extraction recovery was above 90%.The assay was applied in the blood samples of 30 kidney transplant recipients with AZA therapy, and the results indicated that TGTP was the predominant phosphate metabolite in RBC.Conclusion: The method is simple, rapid, sensitive and specific, and it can quantitatively determine the individual thioguanosine phosphates in RBC of kidney transplant recipients with AZA therapy.

Objective To explore the three criteria of Ranson,CT severity index (CTSI) and the bedside index of severity in acute pancreatitis (BISAP) in assessment of severity and prognosis of acute pancreatitis.Methods A total of 503 diagnosed acute pancreatitis patients from January 2008 to April 2011 were studied retrospectively,including 356 mild acute pancreatitis (MAP) cases and 147 severe acute pancreatitis (SAP) cases.The differences of the three criteria of Rason,CTSI and BISAP in assessment of severity and prognosis of acute pancreatitis were compared with receiver operating characteristic (ROC) curve.The SAP group was divided into no organ failure group and organ failure group,and the predictive value of the three criteria in acute pancreatitis with organ failure was compared.Results There was significant differences between MAP group and SAP group with Rason,CTSI and BISAP score (x2 =236.88、126.24 and 101.27,P＜0.01).The sensitivity (97.3％) and AUC value (0.93) of Ranson criterion was highest.In no organ failure group and organ failure group of 147 SAP patients,there was significant difference between Ranson criterion and BISAP criterion (x2 =17.67 and 26.12,P＜0.01),both sensitivity were 100％,the specificity were 96％ and 85％ respectively,and the area under ROC curve (AUC) value of BISAP criterion (0.8) was the highest.In illness improved group and deteriorated group,the difference of score between Ranson criterion and BISAP criterion was significant (x2 ＝ 9.53 and 10.19,P＜0.05),and the AUC value of BISAP criterion (0.74) was the highest.Conclusions All three criteria can be used to determine the severity of acute pancreatitis.In predicting the risk of SAP with organ failure and prognosis,BISAP criterion is better than Ranson criterion.BISAP criterion is simple and easy to practice,which provides an important rule for evaluating the clinical condition of acute pancreatitis.

Objective To determine the in vitro antibacterial activity of levornidazole against 375 anaerobic isolates.Methods Agar dilution method was used to determine the minimum inhibitory concentrations (MICs)of levornidazole,3 comparators (metronidazole,ornidazole and dextrornidazole)against 375 anaerobic isolates.Results For anaerobic gram-negative and gram-positive bacilli,and anaerobic gram-positive cocci,levornidazole displayed activity similar to or slightly higher than that of met-ronidazole,ornidazole and dextrornidazole.Levornidazole showed good activity against B.fragilis,Bacteroides thetaiotaomi-cron ,Clostridium difficile ,Clostridium perfringens ,and Peptostreptococcus magnus .The MIC90 value of levornidazole a-gainst the above-mentioned anaerobes was 0.5,1,0.25,2 and 1 mg/L,respectively.However,levornidazole and the compa-rators had poor antibacterial activity against Veillonella spp.among anaerobic gram-negative cocci.Conclusions The in vitro anti-anaerobic activity of levornidazole is similar to or slightly higher than that of metronidazole, ornidazole and dex-trornidazole.Levornidazole has good activity against both gram-negative and gram-positive anaerobic bacilli,and gram-positive anaerobic cocci,suggesting its promising clinical use.

Objective:To develop a method for the detection of 10 single nucleotide polymorphisms(SNPs) of Nm23 gene,and to explore the genotypic and allelic distributions of the 10 SNPs in Chinese Hans population in Wuhan.Methods: Two hundreds healthy subjects ,115 men and 85 women included ,were enrolled as DNA sample donors.The real time TaqMan-MGB genotyping assay was used for the determination of the 10 SNPs selected ,and the results were validated by direct gene sequencing.Results:The method established could accurately and quickly screen the genotypes of the 10 SNPs of Nm23/NDPK gene.Distribution frequencies of the 10 SNPs were similar to these in other researches as well as these of HCB.All the loci follow the Hardy-Weinberg equilibrium.Highly linkage disequilibriums were found between rs 16949649 and rs7207370 , rs16949649 and rs34214448 , rs2159359 and rs2302254 , rs2159359 and rs8075231 ,rs2159359 and rs2041296 ,as well as rs2159359 and rs8071647 ,respectively.Four Tag SNPs:rs34214448 , rs2302254 ,rs11868380 and rs2318785 were initially selected by Heploview software.Conclusion:The method established for SNP gen-otyping can meet the needs for rapid analysis of Nm 23 gene polymorphisms ,and may have great values in investigating the association between gene polymorphisms and diseases as well as adverse drug reactions.

Objective To investigate the clinical characteristics of multiple drug resistant Acinetobacter baumannii infection in respiratory elderly patients.Methods A total of 102 elderly patients infected with multidrug-resistant Acinetobacter baumannii were enrolled in our hospital from January 2014 to December 2015.At the same time,no multiple drug-resistant Acinetobacter baumannii infection elderly patients was selected as a control group.The gender,age,antimicrobial use,white blood cell count,mechanical ventilation time and other differences between the two groups of elderly patients were compared.Results There were significant differences in the days of hospitalization [(18.7±7.5) d vs.(10.0±2.7)d],the time of application of invasive ventilator[(24.6±10.3) d vs.(11.6±6.9)d] and the time of application of antimicrobial agents[(26.2±13.1) d vs.(8.0±2.6)d] (t=19.463、15.436、26.905,all P＜ 0.05).There was no significant difference in immunosuppressant use,white blood cell count,serum protein level and APACHEⅡ score (all P＞0.05).Conclusions Reasonable scientific application of antimicrobial agents,reducing invasive mechanical ventilation time and improving patient immunity can help to reduce the risk of respiratory infection in elderly patients with multiple drug resistance to Acinetobacter baumannii.

Objective To evaluate the use of transfer statements in inhouse transport of critical patients.Methods By means of continuous enrollment,123 critical patients were enrolled as a control group for conventional transport,and 111 such patients were enrolled as an observation group for transport using the transfer statement.Then the incidence of adverse events,transport during and nurse-nurse collaboration level of the two groups were compared.Results In the control group,its incidence of adverse events was 13.8%,the mean transport during was(19.5 ± 8.4)minutes,and the mean score for nurse-nurse collaboration level was ( 101.87 ± 7.13 ).In the observation group,its incidence of adverse events was 5.4%,the mean transport during was(13.5 ± 5.4)minutes,and the mean score for nurse-nurse collaboration level was(106.15 ± 8.86).Implementing the transfer statement has cut back the incidence of adverse events (P<0.05)and the transport duration significantly(t=3.833,P<0.01),while improving the level of nurse-nurse cooperation significantly(t= -4.261,P<0.05).Conclusions The transfer statement can increase the safety of patient transport,promote organization and coordination of nurses,and improve the efficiency of transport.

Objective:To study the association of RAC1 gene polymorphisms with protein expression levels of Rac1-GTP. Methods:A total of 182 healthy Hans population in Hubei were recruited. The 4 tag-SNPs in RAC1 gene were genotyped by Real time TaqMan-MGB genotyping assay. And the Rac1-GTP protein levels in plasma samples from all participants were determined by enzyme linked immunosorbent assays ( ELISA ) . The distribution characteristics of Rac1-GTP expression levels were also analyzed. Furthermore,the expression levels of Rac1-GTP were compared among different genotypes of the 4 tag-SNPs in RAC1 gene. Results:The distribution of Rac1-GTP expression levels was positive skewed in healthy Chinese Hans population. The expression levels were significantly higher in females than in males (P<0. 05),and appeared in decreased trend with age,but without significant differences (P>0. 05). Different expression levels of Rac1-GTP were observed in different genotypes for rs702482 and rs10951982 (P<0. 05). However,no significant difference was found for rs702483 and rs6954996 (P>0. 05). Conclusion:RAC1 genetic polymorphisms can potentially affect the expression levels of Rac1-GTP protein in healthy Chinese Hans population.