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.

Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Gene Expression Profiling ; Humans ; Oligonucleotide Array Sequence Analysis ; Pancreatic Neoplasms ; drug therapy ; metabolism

AIM:To investigate the effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell.METHODS:Totally 140 cataract patients (152 eyes) treated in our hospital from August 2013 to March 2016 were selected.All of the patients underwent small incision non-phacoemulsification cataract surgery.Before surgery and at 1wk, 1mo and 3mo after surgery, we measured the corneal endothelium of upper cornea, the central cornea and the lower part of cornea.The proportion and density of hexagonal cells, loss rate and cell area in corneal endothelial cells were calculated and compared.RESULTS:Postoperatively 36 eyes had posterior elastic layer folds, aqueous flare, which disappeared after treatment.After surgery, corneal incision was found to have mild corneal edema.No other complications were found.A total of 128 patients (137 eyes) were followed up for a total of up to 3mo, with a loss of follow-up in 12 patients (15 eyes).After surgery, corneal endothelial cell density of the upper part of the cornea, the central cornea and the lower part of cornea, was statistically significantly different with each other (F=3.526, P=0.031), the difference in different time points was statistically significant (F=4.111, P=0.018).The postoperative corneal endothelial cell loss rate was statistically significant different between the three groups (F=3.526, P=0.031), at different time pionts (F=4.111, P=0.018).There was statistical significance of percentage of hexagonal cells between the three groups (F=4.348, P=0.014), the difference was significantly different between different time points (F=4.964, P=0.008).There was statistical significance of corneal endothelial cell area between the three groups (F=3.180, P=0.044), the difference was significantly different between the time points (F=3.511, P=0.032).CONCLUSION:After small incision non-phacoemulsification cataract surgery, corneal endothelial cell density decreased, hexagonal cell proportion decreased, corneal cell area expanded.

Objective To evaluate efficacy and safety of hormone combined mycophenolate mofetil (MMF) and tacrolimus (FK506) multiple targets treatment ,hormone combined intravenous cyclophosphamide pulse (IVC ) in the induction treatment of lupus nephritis .Methods The RCTs of MMF plus FK506 versus IVC in LN were searched from PubMed ,EMbase ,the Cochrane , CBM ,and CNKI .The literature were screened according to include and exclude standards ,evaluated the quality of the included stud-ies ,and performed meta-analyses using Revman 5 .1 software .Results It was identified 44 domestic RCTs papers including 331 pa-tients .Meta-analysis showed that multiple target therapy group had significantly superiority to IVC group in the induction treatment of Ⅴ + Ⅳ LN (RR=3 .94 ,95% CI 2 .10-7 .38 ,P<0 .01) ,while with no significant advantage for other pathological types of LN patients .Gastrointestinal reaction ,abnormal liver function ,the incidence of leukopenia ,menstrual disorders in multiple target thera-py group were significantly lower than that of IVC group for LN ,while the incidence of new hypertension group was significantly higher than the IVC group .Moreover ,multiple target therapy group could significantly reduce urine protein ,increase serum albumin and had a significantly higher anti-dsDNA negative conversion rate compared with IVC group .Conclusion Multiple target therapy is more effective than IVC for Ⅴ + Ⅳ LN in Chinese patients and with better security .Further large-scale RCTs are needed to con-firm these results .

Objective To study the differential expression of matrix metalloproteinase-9(MMP-9) and tissue inhibitors of metalloproteinase-1(TIMP-1) in serum and decidua tissue from missed abortion and normal first trimester pregnancy,and to explore their function in early pregnancy .Methods The expression of MMP-9,TIMP-1 in serum was determined using enzyme-linked immunosorbent assay ( ELISA) ,and in decidua by immunohistochemical method . Results The MMP-9 serum level from missed abortion women was higher than that from normal first trimester preg -nancy women [(154.60 ±28.69)ng/mL vs.(135.75 ±18.35)ng/mL,t=3.50,P=0.001].The TIMP-1 serum level from missed abortion women was lower than that from normal first trimester pregnancy women [(253.03 ± 29.90)ng/mL vs.(323.15 ±33.62) ng/mL,t=9.86,P=0.000].The MMP-9 positive expression rate in decidua tissue was higher in missed abortion women than that in normal first trimester pregnancy women (82.5%vs.42.5%,χ2 =13.65,P=0.000).The TIMP-1 positive expression rate in decidua tissue was lower in missed abortion women than that in normal first trimester pregnancy women (87.5%vs.62.5%,χ2 =6.67,P=0.010).Conclusion The expression of MMP-9 and TIMP-1 in serum and decidua may be assosiated with missed abortion .

AIM:To investigate the inhibitory effect of rabbit lens epithelial cell(RLEC)survival and growth by propylene glycol mannate sulfate(PGMS)on the rabbit capsular bag in vitro.METHODS;Capsular bags were prepared from rabbit eyes after extracapsular cataract extraction(ECCE)and incubated in 0.2,0.4,0.8g/L PGMS in 2,5,10 minutes incubation periods.After treatment,the capsular bags were cultured for 7 days in Dulbecco minimum essential medium(DMEM)supplemented with 50mL/L fetal calf serum(FCS).The specimens were examined with light microscopy and transmission electron microscopy(TEM).Capsular bags without receiving PGMS only served as controls.RESULTS:PGMS inhibited the proliferation of RLEC in the manner of concentration and time dependentment.At the threshold protocol of incubation in PGMS at 0.8g/L for 5 or 10 minutes,proliferative activity of cells were largely arrested and nearly no RLEC was seen on the posterior capsule(P＜0.05).Control group had no effect on structure and proliferative activity of RLEC,and the growth proceeded rapidly so that the posterior capsule were totally covered by a confluent monolayer of cell by the end of 7 days.Under TEM,the cells in the control group were tightly arrayed with clearly defined cellular boundary and structure;while cellular deformity and undefined intracellular structure could be seen in the 0.4g/L and 0.8g/L experimental groups.CONCLUSION:PGMS can effectively inhibit the proliferation of RLEC.

Background Choroidal neovascularization(CNV)has been descrihed as a main reason of visual loss in a lot of ocular diseases.Researches showed that local hypoxia and retinal pigment epithelial(RPE) cells play an important role in the formation of CNV.A closely relationship of angiopoietin-2 (Ang-2) and angiogenesis has been proved.However,whether the expression of Aog-2 in hypoxic cultured human RPE cells is associated with the pathogenesis of CNV is still below understood.Objective This study was to investigate the effects of hypoxia on expression of Ang-2 in cultured human RPE cells in vitro,and discuss the possible effects of Ang-2 in the formation of CNV.Methods Human RPE cells were cultured and passaged,and 4-7 generation of cells were used in the experiment.The cells were incubated in cultural plate at the density of 5×107 cells/L.The culture medium containing 200 μmol/L CoCl2 was used to establish the hypoxia model of human RPE cells culturecd in vitro for 0.5,1,2,4,6,12and 24 hours,and the RPE cells cultured under normoxia were as controls.Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expression of Ang-2 mRNA in cultured human RPE cells,and enzymelinked immunosorbnent assay(ELISA) was used to assay the content of Ang-2 protein in supernatant of cultured human RPE cells.Results The survival rate of human RPE cells was 90％ after resoscitation.The fourth generation of cells showed the fusiform with the less pigment in them.The Ang-2 mRNA/β-actin mRNA value in human RPE cells was significantly different among various groups(F=1086.30,P=0.00),The Ang-2 mRN A/β-actin mRNA value in hypoxia cultured for 0.5 hours group began to increase and peaked in hypoxia culture for 4-6 hours group,with the significant differences in comparison with normoxia control group(P＜0.05).The Ang-2 mRNA/β-actin mRNA value decreased to the baseline level at hypoxia for 24 hours.The ELISA analysis showed that the concentration of Ang-2 protein in supernatant of RPE cells showed significant difference among groups(F=1034.00,P=0.00).The concentration of Ang-2 protein increased at hypoxia culture for 0.5 hours and peaked at 6 hours,showing significant differences in comparison with the control group (P＜0.05).Conclusions Hypoxia could significantly up-regulate the expression of Ang-2 in human RPE cells cultured in vitro.Ang-2 expresses highly in the early stage of hypoxia,implying that Ang-2 participates in the formation of CNV.

In liver transplantation,hepatic sinusoidal obstruction syndrome (HSOS) is rare,which results in misdiagnosis and mistreatment.The prognosis of HSOS after liver transplantation is related to the implementation of early specific treatment.No systematic review has been reported on HSOS after liver transplantation.To raise awareness of HSOS after liver transplantation,this review summarizes the aetiology,pathology,clinical manifestations,laboratory findings,imaging features,diagnosis,differential diagnosis,treatment and prognosis of the condition.

We built a new platform based on teaching experiences and difficulties of applied psychology in Hunan University of Chinese Medicine.The new platform was built aiming at improving curriculum,establishing practice platform,reforming assessment methods and constructing supervising mode between teaching and studying.The new multi-leveled and multi-layered practice platform,starting from the mental health screening of freshmen,was consisted of levels of practice operations including mental health record-mental health assessment-psychological consult and therapy.

Objective To study the effect of motor imagery therapy combined with conventional physical training on hemiplegia lower extremity function in stroke patients with hemiplegia.Methods Thirty hemiplegic patients meeting the eligible criterions were randomly divided into two groups: a treatment group (n = 13 ) and a control group ( n = 17).All subjects accepted conventional rehabilitative treatment.Patients in treatment group were treated with motor imagery therapy after physical training, while the patients in control group were treated with physical training only.Motor function was measured by the percentages of changes in maximum loading on affected lower limb (PL%), Barthel index (BI), 5m maximum back and forth walking speed (5m MBFWS), Berg balance scale ( BBS), Fugl-Meyer motor assessment ( lower limb) (FMA-L) before the beginning of training and at the end of sixweek training.Results In both groups, all measurements at the end of training improved significantly ( P < 0.01 )compared to that at the beginning of training.After the whole training course, PL% and 5m MBFWS (m/s) in treatment group were significantly better compared to those in control group( P < 0.05 ), and the other measurements were not statistically significant between two groups( P > 0.05 ).Conclusion Motor imagery therapy had positive effect on hemiplegia lower extremity function of sub-acute stroke patients.