Objective To compare the effect of carvedilol and motoprolol on high altitude chronic congestive heart failure (CHF). Methods Ninety patients with high altitude chronic CHF were divided into three groups randomly:Twenty patients in the regular treatment group treated with angiotensin-converting enzyme inhibitor (ACEI) ,diuretics and digoxin; motoprolol (50 mg twice daily) was given in the motoprolol group( 34cases) additional to regular treatment; carvedilol (25 mg twice daily) was given in the carvedilol group(36cases ) additional to regular treatment. All the patients were followed up for six months and measured the changes of cardiac function by echocardiography. Results Left ventricular end-diastolic dimension (LVEDD) was ( 57. 3 ± 6. 5 ) mm and (57.2 ± 6. 9) mm in the carvedilol group and the motoprolol group respectively, and left ventricular end-systolic dimension (LVESD) was (46. 6 ± 7.0) mm and (44. 0 ± 6. 9 ) mm in the carvedilol group and the motoprolol group respectively, which were all significantly smaller than that in the regular treatment group ([64.7 ±9. 1]mm and [53.4 ±9.8]mm for LVEDD and LVESD,respectively) (Ps ＜0.05). Left ventricular ejection fraction (LVEF) in the carvedilol group and the motoprolol group ( [47.5 ± 8. 1] % and [52. 9 ±8.5] % ,respectively) was higher than that in regular treatment group( [42. 8 ±9. 2]% ) (Ps ＜0. 05).The improvement of LVEF in the carvedilol group was better than that in the motoprolol group (P ＜ 0. 05 ). One case died in the motoprolol group and no death in the carvedilol group,4 cases died in the regular treatment group,the mortality in the motoprolol group and the carvedilol group was significantly lower than that in the regular treatment group. Conclusion Carvedilol and motoprolol significantly improved cardiac function in high latitude CHF patients,and the effect of Carvedilol is slightly better than that of motoprolol.

Objective To assess the clinical feature of older-onset systemic lupus erythematosus.Methods A retrospective study was carried out.Clinical and laboratory findings were collected from 48 patients with older-onset (＞ or =50 years) SLE as well as 424 patients with younger-onset (＜ 50 years) SLE hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2008 to January 2011.Results Among the 472 hospitalized patients with SLE,the ratio of male to female was 1 ∶ 8.08,and older-onset SLE accounted for 10.17％.No significant difference was observed in the incidence of fever,arthritis,decrease in hemoglobin level,increase in erythrocyte sedimentation rate and reduction in complement C4 level,or the positivity rate of anti-ribonucleoprotein (RNP) or anti-Sm autoantibodies (all P ＞ 0.05) between the older-onset and younger-onset SLE patients.The patients with older-onset SLE showed a statistically higher incidence of myalgia,myasthenia,serositis,heart damage and lung damage,decrease in white blood cell count and platelet count,but a significantly lower incidence of butterfly rash,alopecia,renal damage,Raynaud's phenomenon,photosensitivity,decrease in complement C3 level,as well as the positivity rate of anti-dsDNA and anti-nucleosome antibodies in comparison with those with youngeronset SLE (all P ＜ 0.05).Conclusions It is likely that older-onset SLE has mild and atypical clinical manifestations,with a relatively low positivity rate of specific immunological indices.Hence,clinicians should pay more attention to older-onset SLE so as to avoid the misdiagnosis or missed diagnosis of it.

Objective To explore the value of somatostatin receptor scintigraphy(SRS) in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.Methods Twenty-five patients with orbital inflammatory pseudotumor associated with systemic vasculitis (10 males,15 females,average age:(51.2± 14.2) years) underwent SRS.The uptake ratio (UR) of orbital inflammatory pseudotumor was obtained.(1) Patients were divided into group A (with immune activity) and group B (without immune activity) according to Birmingham vasculitis activity score (BVAS).The difference of UR between the 2 groups was compared by two-sample t test.The difference of UR before and after treatment in 12 patients was also compared.(2) Based on the results by BVAS,ROC curve was used to obtain the cut-off value of UR,as well as the diagnostic efficiency and Youden index.The consistency between SRS and BVAS was calculated.(3)Patients were divided into two groups according to the cut-off value of UR and the prognosis difference between them was compared by Fisher exact test.(4)The expression of SSTR2 and SSTR5 was observed by immunohistochemistry.Results (1) UR in group A was significantly higher than that in group B (2.09±0.44 vs 1.32±0.46,t =5.94,P＜0.01).After glucocorticoids treatment,the UR in group A reduced significantly (t=4.07,P＜0.01),but not in group B (t=1.76,P＞0.05).(2)ROC curve analysis identified UR cut-off value as 1.66,with the sensitivity of 87.5％,specificity of 95.7％,positive predictive value of 95.2％,negative predictive value of 88.0％,accuracy of 91.3％ and Youden index of 83.2％.The consistency between SRS and BVAS was strong (Kappa =0.840).(3) The prognosis was significantly different between patients with UR≥ 1.66 and UR＜1.66 (P＜0.05).(4) The immunohistochemical results revealed high expression of SSTR2 and SSTR5 in inflammatory cells in patients with immune activity.Conclusion SRS has potential value in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.

Objective To know the effects of living with the elderly on nursing students' willingness engaging in aged nursing and attitude towards the elderly so as to provide references for nurturing professionals for caring for the aged.Methods 231 nursing students were surveyed.The questionnaire included four parts,general information,life experience with the elderly,willingness engaging in aged nursing,attitude towards the elderly and cognition of aging.Results 45.9 percent of the nursing students were willing to engage in aged nursing.Living with elderly and relationship with the elderly affected their willingness.Conclusions Creating more opportunities for nursing students in touch with the elderly can help nursing students to have a good impression of the elderly and stimulate them to choose aged nursing.

Objective To know the nursing students' willingness engaging in geriatric nursing and analyze affecting factors so as to provide references for nurturing professionals for caring for the aged.Methods 231 nursing students were surveyed.The questionnaire included general information,life experience with the elderly,willingness engaging in geriatric nursing,attitude towards the elderly and cognition of aging.The investigation results underwent analysis.Results Single factor analysis showed that whether ever living with the elderly (x2=6.027),time living with the elderly and relationship with the elderly (x2=4.928) influeced the nursing students' willingness engaging in geriatric nursing.Multiple correspondence analysis indicated that nursing students living with elderly more than one year and having good relationship with the elderly had positive willingness.Conclusions Geriatric nursing curriculum should be optimized and more opportunities should be created for nursing students to be in touch with the elderly.At the same time,we must pay attention to occupation guide and moral education about how to respect and care for the elderly.

Objective To study efficacy and safety of large dose of pamidronate disodium in treatment for patients with painful bone metastasis of prostate cancer. Methods A total of 100 patients with painful bone metastasis of prostate cancer were randomized into large dose group and conventional dose group, with 50 cases each. Pamidronate disodium was administered by intravenous infusion, 90 mg on the first day and 60 mg on the second day for large dose group, and 60 mg on the first day and 30 mg on the second day for conventional dose group, respectively, every 4 weeks for two courses. Changes of pain,mobility, quality of life and adverse effect in patients before and after treatment were observed. Results After treatment, pain was relieved in 43 of 50 patients ( 86% ) in large dose group, significantly more than that in conventional dose group (21/50, 42% ) (χ2 = 22.79, P ＜ 0. 01 ). Both mobility and quality of life were improved in 39 and 33 patients ( 87% and 66% ), respectively in large dose group and 21 and 18 (46% and 36% ), respectively in conventional dose group (χ2 = 17.04 and 9. 00, P ＜0. 01 ). No severe adverse effect in both groups was observed. Conclusions Pain in patients with bone metastasis of prostate cancer can be significantly relieved with large dose of pamidronate disodium, as well as their quality of life improved.

Objective To assess the risk factors of postphlebitic syndrome(PS)after deep vein thrombosis of the lower extremities. Method In this study,102 DVT patients managed by conservative therapy were recruited.Data including age,sex,etiopathogenesis,anticoagulation,pathogenesis, elasticstocking therapy,degree of lower extremity exercise,INR,WBC,PT%and FIB were analyzed by single factor analysis and COX analysis. Result PS developed in 67.60%cases,single factor analysis shows:sex(P=0.025),anticoagulation(P=0.000),elastic-stocking therapy(P=0.000),degree of lower extremity exercises(P=0.000),INR(P=0.033),WBC(P=0.012),PT%(P=0.000),FIB(P=0.002)are related to the occurrence of PS.COX regression shows that anticoagulation(P=0.011),the degree of lower extremity exercise(P=0.019),elastic-stocking therapy(P=0.000)are related to PS.Age (P=0.299),etiopathogenisis(P=0.838)and pathogenesis(P=0.2 17)are not statistically PS related.Conclusion DVT is a multi-factors related disease.Multivariant analysis revealed that elastic-stocking (P=0.000),anticoagulation(P=0.011)and the degree of lower extremity exercises(P=0.019)are related to the development of PS.

Objective To investigate the application potentiality of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of hepatic tumors.Methods Total of 65 hepatic tumors were examined with two-dimensional contrast-enhanced ultrasound (2D-CEUS) and dynamic 3D-CEUS and make statistical comparison between two imaging modes in aspects of enhancement patterns,spatial relationships of tumors and vascularity of different hepatic tumors.Results Dynamic 3D-CEUS showed the same enhancement patterns with 2D-CEUS.However,Dynamic 3D-CEUS was superior to 2D-CEUS in the display of spatial relationships of hepatic tumors and vascularity(P ＜0.05).The vascularity between benign and malignant hepatic tumors was statistically significant (P ＜ 0.05).Conclusions Dynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and comprehensively,which provides additional beneficial information for the diagnosis and therapy of hepatic tumors.

Objective To prepare Integrin αvβ3/CCR2 dual targeted microbubble,test physical-chemical properties,enhancement effect and targeting ability in vitro.Methods The dual targeted microbubbles (MBdual-target )with FITC labled iRGD and PE labled CCR2 were prapared,and non-target microbubbles as control (MBcontrol ) were prapered.Physical and chemical properties of two groups of microbubbles were tested,connectivity of peptides/antibodies and microbubbles were detected by fluorescence microscope and flow cytometry instrument.Enhancement effect and the stability of two groups of microbubbles was observed and compared in vitro.The affinity of MBdual-target and MBcontrol for bEnd.3 cells was investigated with light and fluorescent microscope.Results ①The particle size of MBdual-target was (0.93±0.23)μm,with no statistically significant difference compared with MBcontrol (P >0.05).②MBcontrol showed no fluorescent,while MBdual-target showed both clear green and red light,under fluorescent microscope.③There was no significant difference of gray scale of enhancement between MBdual-target and MBcontrol in vitro.④ It was showed that MBdual-target adhered to bEnd.3 cells in vitro experiment.Conclusions Integrinαvβ3/CCR2 dual targeted targeted microbubbles was successfully prepared and proved having good enhancement effect and targeting ability in vitro.

Objectives To explore the differences in therapeutic efficacy between decitabine combined with low dose HAG(D+ HAG)and CAG in elderly patients with acute myeloid leukemia (AML).Methods Totally 32 elderly patients with AML in our department from July 2012 to July 2015 were retrospectively analyzed.15 patients were on a therapy of decitabine combined with low dose HAG,and 17 patients with CAG.Efficacy and side effects were compared between the two groups.Results In(D+HAG)versus CAG groups,the complete remission(CR)was 10 cases(66.7％)vs.6 cases (35.3 ％),partial remission(PR) was 2 cases (13.3％) vs.1 case(5.9 ％),non-remission(NR) was 3 cases(20％)vs.10 cases(58.8％),and the total efficacy rate(CR+PR)was 80％vs.41.2％ (P＜0.05).The side effects in two groups mainly included bone marrow depression,respiratory tract infection,gastrointestinal reaction,which were all alleviated after symptomatic treatments.The incidence rate of side effects had no statistical difference (P ＞ 0.05).Conclusions The treatment of decitabine combined with low dose of HAG is prior to CAG,and the side effects are all tolerated.So decitabine combined with low dose of HAG can be served as the first-line therapy for elderly AML patients.