Objective To explore the effects of postdischarge follow-up continuous nursing intervention on the psychological quality and compliance of immunosuppressants treatment in patients with kidney transplantation.Methods 157 patients with kidney transplantation post-operation were recruited,81 cases in the study group and 76 cases in the control group randomly.The control group received routine hospital discharge care and immunosuppressants treatment.The study group received postdischarge followup nursing intervention and immunosuppressants treatment.After 6 months of postdischarge intervention,the psychological quality of patients in two groups was assessed by the emotion application measure scale separately.The Morisky Medication Adherence Scale 8-item version (MMAS 8-item version) was used for the assessment of the immunosuppressants treatment compliance of the two groups of patients.Results After 6-month intervention,the patients in the study group showed better psychological quality than the patients in the control groups.There were significant differences in the various items of assessments of the psychological quality between the two groups.The high compliance percentage of immunosuppressants treatment of the study group was 45.7％,whereas the high compliance percentage of the control group was 22.4％.The differences between the two groups were significant.Conclusions Post-discharge follow-up nursing intervention to patients with kidney tranplantantion is effective for improving the psychological quality and the immunosuppressants treatment compliance and may be helpful to improve the life quality of the patients.

Objective To establish and optimize a method to extract and determine rhynchophylline in a traditional Chinese herb,Ramulus Uncariae cum Uncis. Methods Cold maceration with methanol and supersonic extraction was used to treat the medical material. Chromatography was performed on a Diamonsil C18 column (250 mm?4.6 mm,5 ?m). Gradient elution was employed with a mobile phase consisting of methanol (solution A) and ammonium acetate buffer (0.01 mol/L,pH 6.0 adjusted by ammoniae aqua,solution B) as follows: A∶B from 25∶75 to 50∶50 from 0 to 20 min. The flow rate of the mobile phase was 1.0 ml/min and the column was maintained at 20 ℃. The detector was monitored at 245 nm. Results The calibration curve was linear among the concentration range of 0.25 to 64.0 ?g/ml (y=3.64?104x-2.13?104,r=0.999 5) and the relative recovery ranged from 95.95% to 114.4%. The relative standard deviation (RSD) of the reproducibility test was 6.50% and of the stability test was 4.62%,2.65% and 4.58% from the high density to the low. Conclusion Our method is accurate,reliable and with good reproducibility,and it can be used for determining rhynchophylline in Ramulus Uncariae cum Uncis.

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.

Objective To evaluate the value and security of the use of medical thoracoscopy in the diagnosis of elderly patients with un‐known pleural effusion and to analyze the finally pathological results .Methods STORZ medical thoracoscopy was used to retrospectively study the 68 patients with unknown pleural effusion .Multiple punch biopsy was taken in the questionable diseased regions under direct vi‐sion .The changes of patients′condition in intraoperative and postoperative ,and the causes of pleural effusion were observed .Results Sixty‐three cases were confirmed in 68 cases of patients with unexplained pleural effusion ,the diagnostic rate was 92 .6% .In all cases ,26 cases (38 .2% ) were tuberculosis ,31 cases (45 .6% ) were malignant tumor ,3 cases (4 .4% ) were chronic pus chest and Aspergillus infection in 1 case(1 .5% ) ,a large number of aspergillus hyphae were found in biopsy tissue .Non‐specific inflammatory changed in 7 cases (10 .3% ) ,in which 2 patients were eventually diagnosed with pleural effusion caused by pulmonary schistosomiasis ,and the rest cases were still un‐known .All cases had no serious complications .Conclusion Medical thoracoscopy have a good effect in diagnosing elderly patients with un‐explained pleural effusion ,which could be easily and safely performed .The primary cause of unexplained pleural effusion in elder patients may be malignant tumor ,followed by tuberculosis .

Objective To evaluate the efficacy of dezocine for prevention of postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.Methods Sixty-eight patients of both sexes, aged 65-85 yr, weighing 48-78 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral total knee arthroplasty under general anesthesia, were randomly divided into 2 groups (n =34 each) using a random number table: control group (group C) and dezocine group (group D).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 0.05-0.06 mg · kg-1 · min-1 and remifentanil 0.05-0.10 μg · kg-1 · min-1, and intermittent iv boluses of vecuronium 0.04 mg/kg.Dezocine 0.1 mg/kg was injected intravenously at 30 min before skin incision in group D.At 1 day before operation (T0) , and 1, 3, 5, 7 days after operation (T1 , T2, T3 , T4) , the blood samples from the central vein were collected for determination of serum cortisol (Cor), neuron specific enolase (NSE) and S-100β protein concentrations.Before operation, and 5 and 7 days after operation, the patients' cognitive function was assessed using Mini-Mental State Examination, and the occurrence of POCD was recorded.Results Compared with the baseline value at T0, the serum Cor, NSE and S-100β protein concentrations were significantly increased at T1-3, and MMSE scores were decreased at T3,4 in the two groups.Compared with group C, the serum Cot, NSE and S-100β protein concentrations were significantly decreased at T1-4, and Mini-Mental State Examination scores were increased at 5 and 7 days after operation, and the incidence of POCD was decreased in group D.Conclusion Dezocine 0.1 mg/kg intravenously injected at 30 min before skin incision can prevent the occurrence of POCD in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.

Objective To observe the expression change of HRG-1 gene between urinary bladder carcinoma and normal tissues,and to investigate the effect of HRG-1-siRNA on the proliferation and apoptosis of human bladder carcinoma cells.Methods Immunohistochemisty was used to detect the expression of HRG-1 in 85 cases of bladder carcinomas and 20 normal bladder tissues.The siRNA of HRG-1 was designed,synthesized,and transfected into bladder cancer cell line T24.Results The HRG-1 gene expression had significant differences between bladder carcinoma and normal bladder tissues (P ＜ 0.05).The positive expression of HRG-1 gene had significant differences between the pathological grades and clinical stages of bladder carcinomas (P ＜0.05).After treated with siRNA,the expression levels of HRG-1 protein and mRNA in T24 cells decreased obviously (P ＜ 0.05).The apoptosis rate of T24 cells transfected with HRG-1-siRNA was significantly different from control-siRNA group and blank group (P ＜ 0.01).Conclusions The high expression of HRG-1 gene may play an important role in bladder carcinoma,and siRNA targeting HRG-1 can suppress HRG-1 protein expression markedly and enhance apoptosis of T24 cells.

OBJECTIVE:To study the effect of ethanol on the pharmacokinetics of phenytoin sodium in rabbits METHODS:The serum concentrations of phenytoin sodium at different points of time were determined by UV-spectrophotometry in eight rabbits after administration of phenytoin sodium(10mg/kg)alone and in combination with ethanol RESULTS:After administration in combination with ethanol,the AUC of phenytoin sodium was significantly decreased from(4 108 64?1 039 98)mg/(min L) to (1 903 65?1 003 40)mg/(min L),Cmax from(29 0?2 94)mg/L to(16 0?5 9)mg/L,T1/2(ke) from(98 45?26 4)min to(82 84?25 5)min;but the apparent distribution volume(Vd)was obviously increased from(0 3 475?0 0 360)L/kg to(0 6 819?0 1 901)L/kg and the clearance rate(CL) from(0 0 026?0 0 008)ml/(kg?min)to(0 0 062?0 0 022)ml/(kg?min) CONCLUSION:The elimination of phenytoin sodium was significantly accelerated after simultaneous administration of ethanol in rabbits

OBJECTIVE: To compare the effects of different factor combinations on diabetic nephropathy(DN)rats model and to determine the preferred plan for the establishment of DN rats model.METHODS:A total of 30 SD rats were randomly divided into 5 group(6 rats in each group):group A was assigned to receive placebo(normal control),group B to receive high-lipids and high-sucrose feeding,group C to receive high-lipids and high-sucrose feeding plus streptozotocin(STZ),group D to receive high-lipids and high-sucrose feeding plus doxorubicin hydrochloride and STZ,group E to receive high-lipids and high-sucrose feeding plus mononephroctomy and STZ 12 weeks later the model rats were put to death for the determination of serum parameters including blood lipid,glycosylated hemoglobin,renal function,aldose reductose(AR),glomerular filtration rate(GFR),SOD and MDA .RESULTS:The rats in group E showed significant increase in blood lipid,in particular the increase of AR,and which also showed significant differences in GFR and oxygen free radical indices as compared with normal group and the other model groups.CONCLUSIONS:The rats model that fed with high-lipids and high-sucrose feeding for 4wk prior to mononephroctomy followed by the postoperative intraperitoneal injection of low dose of STZ 2 weeks later proves to be the optimal one.

Objective To evaluate the deep brain venous blood oxygen content changes in patients with multiple sclerosis(MS) using susceptibility weighted imaging (SWI), and to explore the ability of SWI in reflecting the clinical condition. Methods Forty-four MS patients were prospectively enrolled in the study. All the clinical-proved patients meeting the McDonald standards (2005 revised) underwent conventional MRI, SWI, and 12 cases of them underwent MRI review from 12 to 16 months interval. all the patients' clinical condition were quantified according to the expanded disability status scale(EDSS). The score was 0.5—6.5. Sixty-five age- and gender- matched healthy volunteers underwent conventional MRI and SWI. The blood oxygen content of the deep brain venous were estimated by the veins phase value, and differential phase values of blood vessels and surrounding tissues (Δφ) were processed with SPIN software. The blood vessels consist of bilateral BV, SMCV, ICV, STV and FMV, PMV, OMV. The difference of Δφvalue in different veins between MS patients and the controls was compared using independent sample t-test, and the Δφ value comparison of MS patients in different time were performed by using paired t test; The correlation ofΔφvalue between MS and EDSS was analyzed using Spearman correlation. Results TheΔφvalue of BV, SMCV, ICV, STV were 856.6 ± 246.4, 600.6 ± 155.2, 965.9 ± 205.4, 844.2 ± 149.7 in MS, and 767.6±145.1, 536.2±123.5, 892.8±156.3, 783.1±148.5 in controls, respectively. TheΔφvalue was higher in MS patients than the controls (t=2.157, 2.303, 2.005, 2.103,P<0.05). The twelve patients'Δφvalues of BV, ICV,STV were 729.4±275.1, 906.1±219.2, 737.2±159.1 in the first time, and 923.2±211.6, 1017.3±211.1, 919.3 ± 165.9 in the second time, and all the values increased in the review of the interval of 12 to 16 months (t=-3.092,-6.420,-3.972,P<0.05). The phase value of PMV and OMV had significant positive correlation with EDSS scores(r=0.638, 0.642,P<0.01). Conclusions The state of hypoxia of the brain parenchyma appears in MS patients, and hypoxia may become worse with the extension of course. The extent of hypoxia can reflect the disability of the patients.

Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .