Objective To evaluate the impact of hypertension self-management on self efficacy of community residents.Methods November 2011 to February 2012,twenty-eight medium-sized and better adherence to community was selected from fourteen districts and counties in Beijing.In this community-based randomized controlled trial,323 hypertensive patients were randomly assigned to the treatment group (n =159,receiving hypertension self-management) and the control group (n=164,receiving standard hypertension management).A questionary survey was completed at baseline and 6 weeks.Rank sum test or Chi-square test was used for data analysis.Results The average age of the treatment group or the control group was (61.9 ±9.1) vs (61.8 ±9.0) years old,respectively.No significant difference in mean age,gender and education level was found between the two groups (F =0.164,x2 values were 0.782 and 2.093,respectively ; all P ＞ 0.05).In the treatment group,the scores of fatigue,headache and shortness of breath were declined (when compared with the controlled females,Z =-5.198,-3.873,-2.781 ; P ＜ 0.05).Self-efficacy score of the treatment group was increased after the intervention.Women's symptom management self-efficacy and common disease management self-efficacy were significantly higher (Z=-2.958,-2.582; P ＜ 0.05).In comparison with the control group,before and after self-management,the added scores of communication ability with doctors were increased.But the difference was not statistically significant (P ＞ 0.05).Conclusion Six-week self-management program may improve self efficacy among hypertensive patients.

Objective To compare Vecchietti′s and Davydov′s laparoscopic techniques for vagino-plasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Methods From January 2010 to December 2013, 13 patients underwent the Vecchietti′s laparoscopic procedure (Vecchietti group), and 15 patients underwent the Davydov′s laparoscopic procedure (Davydov group). Intraoperative parameters and postoperative results were compared. Results Both of the two groups were successfully treated. The neovagina in both groups were wide with good elasticity, softness and smoothness. The operation time [(39± 7) versus (73 ± 11) minutes], the intraoperative blood loss [(21 ± 6) versus (63 ± 10) ml], the anal exsufflation time after surgery [(19 ± 5) versus (28 ± 6) hours] and the recovery period of body temperature after surgery [(35 ± 10) versus (46 ± 10) hours] of the Vecchietti group were less than those of the Davydov group (all P<0.05). But the neovagina length [(8.8±0.5) versus (9.6±0.5) cm] was shorter and the Female Sexual Function Index scale score [26.8 ± 2.0 versus 28.5 ± 1.7] was lower in the Vecchietti group than those in the Davydov group (all P<0.05). The postoperation hospital duration didn′t reached statistical difference between the two groups [(7.5 ± 0.9) versus (7.1 ± 0.7) days, P>0.05]. No intraoperative complication occurred. After surgery, 2 patients were found vaginal polyps and 8 patients were suffered from pain in the Davydov group, while all patients were suffered from pain in the Vecchietti group. Conclusions Both Vecchietti′s and Davydov′s laparoscopic techniques are simple, safe and effective surgical methods for vaginal reconstruction. In contrast, the Vecchietti′s procedure is more time efficient and minimally invasive, while the Davydov′s procedure can get less pain, longer vagina and higher sexual satisfaction.

[Abstratc] Objective The function of cIAP1 in the progression of ovarian cancer has not been clarified . This study is to explore the involvement of cIAP 1 in regulating biological behaviors of ovarian cancer cells by u-sing RNA interference(RNAi)technology.Mte hods The short hairpin RNA plasmid targeting cIAP1 was con-structed and transfected into Skov 3 cells.The levels of cIAP1 mRNA and protein were investigated by RT -PCR and Western Blot respectively .MTT assay and flow cytometry were used to evaluate cell proliferation and apopto-sis.R esults The rate of cIAP1 transfection was 74.7%performed by flow cytometric analysis .cIAP1 expression was significantly down -regulated at both mRNA and protein levels ,which resulted in a decrease of cell prolifera-tion and invasion capability in vitro .Conclusion This study implies that cIAP 1 might play an important role in the progression of ovarian cancer ,and it could be a potential target for therapeutic anti -cancer drugs .

ObjectiveTo investigate the effect of different reference vessel groups on CT perfusion in patients with nasopharyngeal carcinoma (NPC) after radiation therapy,and explore the feasibility of substitution of reference vessel.MethodsThirty patients with NPC after radiation therapy were divide into two groups,recurrence group ( n =19) and fibrosis group ( n =11 ).All patients underwent CT perfusion scans,and the CT parameters were calculated with different arterial input and vein output in order to study their differences.The vessels were internal carotid artery-internal jugular vein( ICA-IJV group),external carotid artery-retomandibular vein (ECA-RTV group)and external carotid artery-internal jugular vein( ECAIJV group) respectively.The differences of the CT parameters between local recurrence group and fibrosis group were compared among the various vessel groups by rank sum test.With the help of receiver operating characteristic curve (ROC),the diagnostic efficiencies were compared by the area under the ROC curve (AUC).ResultsIn ICA-IJV group,ECA-RTV group and ECA-IJV group,bloood flow(BF) of local recurrence group were 201.88,439.59,252.23 ml · min-1 · 100 g-1,while BF of fibrosis group were 98.96,180.50,106.55 ml · min-1 · 100 g-1.Blood volume (BV) of local recurrence group were 6.71,12.39,6.70 ml/l00 g,while BV of fibrosis group were 2.35,4.76,2.95 ml/100 g.Mean transit time (MTT) of local recurrence group were 1.66,1.50,1.56 s,while MTT of fibrosis group were 2.13,1.96,1.79 s.Permeability surface (PS) of local recurrence group were 19.31,36.39,15.22 ml · min- 1 ·100 g-1,while they were 16.58,29.08 ,16.63 ml · min-1 · 100 g-1 in the fibrosis group.The differencesof BF and BV between the local recurrence group and fibrosis group were statistically significant in each vessel group (P ＜ 0.05 ) but MTT and PS showed no significant difference( P ＞ 0.05 ).In ICA-IJV group,the AUC of BF,BV,MTT,PS were 0.909,0.947,0.677,0.703,respectively.BF,BV,MTT,PS in ECA-RTV group were 0.938,0.967,0.648,0.679 respectively,and those in ECA-IJV group were 0.861,0.890,0.641,0.656 respectively.However,AUC of BF and BV of three groups all had significant difference ( P ＜ 0.01 ).ConclusionsBoth BF and BV values calculated by three pairs of reference vessels had enough diagnosis efficiency for local recurrence and fibrosis,so all of the three groups of vessels may substitute each other in CT perfusion.

Objective To investigate the protective effect of genistein on endotoxin-induced acute lung injury in rats,and explore the underlying mechanisms.Methods Thirty-two male Sprague-Dawley rats were randomly divided into four experimental groups: saline control(S), genistein alone(G),lipopolysaccaride(LPS) alone(L),and genistein pretreatment(G+L).Each treatment group consisted of eight animals.Animals were observed for 6h after LPS challenge,and the wet/dry(W/D) weight ratio of the lung and the protein contents of the bronchoalveolar lavage fluid(BALF) were used as indexes of lung injury.Neutrophil recruitment and activation were evaluated by BALF cellularity and myeloperoxidase(MPO) activity.RT-PCR analysis was performed with lung tissue to assess the gene expression of ICAM-1.The histopathologic changes were also observed using the H&E stains of lung tissue.Results Lung injury parameters,including the wet/dry weight ratio and protein content in BALF,were significantly higher in the L group than in the S group(P

Objective To study the value of CT perfusion in differential diagnosis of local recur and local radiofibrosis of nasopharyngeal carcinoma(NPC) at pre-and post-radiotherapy.Methods Dynamic CT scan was performed in 71 objectives: 14 in local recur group,22 in radiofibrosis group,15 in pre-radiotherapy NPC group and 20 in control group,the time-density curve(TDC) and the data of perfusion parameters were recorded and analyzed statistically.Results The TDC feature between local recur group,pre-radiotherapy NPC group and radiofibrosis group,control group had difference.The average of blood flow(BF) had significant differences by two by two comparison in four groups(P

OBJECTIVETo discuss the changes in Wnt pathway inhibiting factors in esophageal precancerosis lesions induced by methyl benzyl nitrosamine (MBNA) and the effect of Gexia Zhuyu decoction.

METHODWistar rats were subcutaneously injected with MBNA (3.5 mg x kg(-1) for twice per week to establish the model. Since the 1st day after the model establishment, they were orally administered with Gexia Zhuyu decoction (16, 8 mg x kg(-1)). At the 10th week, esophageal tissues were collected to observe the pathological changes of esophageal mucosa, detect SFRP1, sFRP4, Axin1, Axin2 and GSK-3β mRNA levels.by fluorescent quantitation PCR analysis and β-catenin protein level by Western blotting.

RESULTBeing induced by MBNA, rats in the model group showed slight atypical hyperplasia in the histopathological examination. Compared with the normal group, Gexia Zhuyu decoction dose high and low groups showed no significant pathomorphological and histological changes. The model group showed lower gene transcription levels of esophageal tissues sFRP1, sFRP4, Axin1 and Axin2 (P < 0.05 or P < 0.01) and higher β-catenin protein expression level (P < 0.01) than the normal control group. The Gexia Zhuyu decoction low dose group showed higher gene transcription levels of esophageal tissues sFRP1, sFRP4, Axin1 and Axin2 (P < 0.05 or P < 0.01) and lower β-catenin protein expression level (P < 0.01) than the normal control group.

CONCLUSIONUp-regulated β-catenin protein level and down-regulated Wnt pathway could enhance Wnt pathway activity of MBNA-induced esophageal precancerous lesions. Gexia Zhuyu decoction could down-regulate the β-catenin protein level and up-regulate the transcription level of Wnt pathway inhibiting factors, but could not block MBNA-induced esophageal precancerosis lesions.

Animals ; Axin Protein ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Esophageal Diseases ; drug therapy ; genetics ; metabolism ; pathology ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Male ; Necrosis ; Nitrosamines ; adverse effects ; Proteins ; genetics ; metabolism ; Rats ; Rats, Wistar ; Wnt Proteins ; genetics ; metabolism ; Wnt Signaling Pathway ; drug effects

OBJECTIVE To discuss the surgical methods and their long term efficacy of management of the parotid tumor.METHODS The clinical data of 86 cases with parotid tumor underwent operation between 1997 and 2004 in our hospital were retrospectively analyzed.There were 53 male and 33 female with their age from 23 to 84 years(mean 57 years old). All the patients underwent superficial parotidectomy or extensive superficial parotidectomyenl or total parotidectomy.Selective or functional neck dissection was carried out in some cases.The function of facial nerve was evaluated after operation in all patients. Postoperative radiotherapy was performed in all malignant cases with a dose of 50 to 70 Gy.The patients were followed-up for 36 to 120 months.RESULTS There were 73 benign cases and 13 malignant cases. Five of 8 malignant tumors were found in deep lobe gland.Only one benign tumor locally recurred.The local- regional control rate of the benign tumor was 98.3%. The 3-year survival rate and local-regional control rate in malignant neoplasm were 69.2 % and 84.6 % respectively.The cervical lymph nodes metastasis rate was 23.1% in postoperative pathologic study.The facial nerve preservation rates were 97.3 % and 69.2 % in benign and malignant cases respectively.CONCLUSION The superficial parotidectomy is the basic surgical method.Extensive superficial parotidectomy or total parotidectomy can be used if necessary.The facial nerve and its branches should be preserved during operation. The malignant tumor is more frequently found in deep lobe of the parotid gland.

Objective To explore the diagnostic performance of susceptibility weighted imaging (SWI) in distinguishing malignant from benign parotid lesions.Methods We prospectively evaluated preoperative SWI findings of 41 patients with 12 malignant and 29 benign parotid lesions by surgical pathology, and explore the intravenous distribution, the largest diameter of veins (dv-max), the number of veins per unit area (N/Svein) and the graduation of intratumoral susceptibility signal intensity (ITSS).The parameters was analyzed by Chi-square test, Independent t-test, Mann-Whitney U rank test and receiver operating characteristics (ROC) curves with SPSS 16.0 software.Results (1) For intravenous distribution, the benign ones mainly distributed around peripheral areas, accounting for 89.7％ (26/29), while the malignant ones were centrally distributed, making up 10/12.There were significant difference (x2=20.882, P=0.000) between benign and malignant ones.(2) The largest diameter of veins (dv-max) of benign and malignant lesions were (1.1±0.5) mm and (2.5 ± 1.0)mm respectively.There were significant difference (t=4.633, P=0.000) between benign and malignant ones.(3) The N/Svein of benign lesions were (0.80±0.92) per cm2, while that of malignant ones are (1.07±0.69) per cm2.The N/Svein (t=0.9143, P=0.367) was statistically insignificant.(4) For the graduation of ITSS,among benign lesions, there were 3 cases of grade 0, 22 cases of grade 1, 2 cases of grade 2 and 2 cases of grade 3.Meanwhile, there were 2 cases of grade 1, 5 cases of grade 2 and 5 cases of grade 3 among malignant lesions.When the Youden index reached the highest point, the optimal diagnostic threshold of dv-max and ITSS values were 1.75 mm and 1.5 mm, the corresponding area under the ROC curve (AUC) were 0.924 and 0.856 respectively.The sensitivity of d and ITSS ondiagnosis were 10/12 and 10/12, and the specificity of that were 96.6％ and 86.2％ respectively.The table shows that the sensitivity and specificity of intravenous distribution in diagnosis of malignant lesions are 10/12 and 89.7％.Conclusions The results provided evidence that SWI may be helpful in distinguishing malignant from benign parotid lesions, and it is worth to be generalized in clinical medicine.

Objective To investigate the effectiveness of Varenicline combined with MEDCHART application software for health education and follow-up in patients at smoking cessation clinic.Methods A total of 104 cases who had smoking cessation counseling and intervention at smoking cessation clinic from February 2014 to January 2015 were divided randomly into MEDCHART APP group (n=51) and conventional group (n=53).Both groups were intervened by brief admonishment and given Varenicline.The 9-12 weeks and 26th week protracted continuous abstinence rates were observed.Results There were no significant difference in 9-12 week protracted withdrawal rate between 26th week APP and conventional groups (56.9％ vs.45.3％),the 26th week abstinence rates in group MEDCHART APP (41.2％) were significantly higher than the conventional group (20.8％)(x2=5.088,P＜0.05).There was significant difference in full course completion rates between the two groups;15 cases (29.4％) completed the course in group MEDCHART APP,whereas 5 cases (9.4％) did so in conventional group (x2=4.405,P＜0.05).Conclusion MEDCHART APP can strengthen health education and follow-up,which helps extend the time for Varenicline,increase 26th week smoking cessation withdrawal rate.It is a useful tool for smoking cessation education and follow-up.