Objective To explore clinical characteristics and treatment of the thrombotic microangiopathy (TMA) induced by malignant hypertension, and provide a better understanding of the disease. Methods The clinical manifestations, laboratory examinations, therapeutic methods and prognosis of 15 TMA patients induced by malignant hypertension were analyzed retrospectively. Results The clinical manifestations were characterized by microangiopathic hemolytic anemia, thrombocytopenia and kidney injury. None of the patients required plasma exchange therapy. After antihypertensive treatment, all of 15 patients were discharged with improved clinical condition, remoglobin levels and platelet count. Conclusions The TMA induced by malignant hypertension is different from the classic TMA. Improving the understanding of TMA induced by malignant hypertension will contribute to early diagnosis and targeted treatment.

In 54 cases of pulmonary hypertension, the PaCO2 was markedly lowered, PaO2 and SaO2 elevated, HR, CO and mPAP, PVR all lowered in the treatment group (P0. 05), but SBP was significantly different (P

0.05).It was revealed by ROC curve analysis that P-LAP≤38.12 U/L and IL-6≥3.40 pg/mL could be adopted as criteria to predict the inevitable preterm labor,and the Youden's index of the combination use of the parameters of P-LAP and IL-6 was significantly higher than that of the single use of each parameter(P

AIM: To study the antiproliferation of vitamin E succinate (VES) on pterygium fibroblasts in vitro and to find a potential agent for prevention and treatment of primary and recurrence pterygium.METHODS: Primary culture and subculture of pterygium fibroblasts were established in vitro ,and different concentrations of VES (0, 10 and 20mg/L) were added to subcultured fibroblasts, respectively. Influence of VES on the growth curve of fibroblast was observed at day 2, 4 and 7 after treatment of VES. 3- [4,5-Dimethylthiazolzyl]-2,5-Diphenyl Tetrazolium Bromide (MTT) assay at 490nm was used to evaluate the effect of the cells proliferation.RESULTS: The addition of VES to culture caused the marked descent of growth curve in comparison with the control group, and the inhibiting rate of 10 and 20mg/L of VES was 33.2% and 46.7%, 67.9%, and 76.8%, 81.7% at day 2,4 and 7, respectively. VES could obviously inhibit the fibroblast proliferation in dose-dependent manner by MTT assay.CONCLUSION: VES can significantly inhibit the proliferation of pterygium fibroblast in vitro.

Objective To explore the method of treatment of sunken cheek deformity.Methods The longitudinal platysma-faseial flap was overturned 180 degree upward,the flap's pedicle located in the margin of mandible,and then combined with abdominal dermis fat graft to form as a sandwich,which filled in the sunken area of face.Results Five patients were treated with this method from 2003 to 2007,and satisfactory results were gained but only mild absorption was found in the transplanted tissue area during followed up for 3 months to 3 years.Conclusion Platysma-fascial flaps survive easily with rich blood supply and strong anti-infection,and are also easy to incise and operate as well,which,together with free abdominal dermis fat flap,could increase the amount of the needed tissue.It is a better approach to repair the sunken cheek deformity and in particular suitable for the more serious deformity in patients with sunken cheek.

The article describes the current situation of training mode of community nurses in community health service institutions in Hubei province from several aspects,including training object,training target,training base,teaching staff,training organization and government,training method and time,training curriculum,training effect evaluation and certification.The article suggests a multitude of factors influencing the training quality,such as formal training,dominant job training,and monotonous community training content and less training time.Overall,the government should be done something to increase government support and funding and accelerate the community nursing services and community nursing education.It is also essential to establish community nursing personnel training mechanism,improve and perfect the community health personnel training system,increase the construction of community nursing practice base and facilities and strengthen clinical practice skills.

BACKGROUND:At present, there is no relevant systematic research about the effects of ankle-foot orthoses on lower limb muscles. OBJECTIVE:To extract the main features of the surface electromyography signals of the lower limbs from normal people with ankle-foot orthoses and to analyze the effects of the fixed ankle-foot orthoses on lower limb muscle fatigue. METHODS:Each of five male healthy young adults was respectively required to walk with and without special ankle-foot orthoses for three times. (1) Group 1, walking in a nature gait without orthoses. (2) Group 2, walking in a natural gait with ankle-foot orthoses (the ankle center was packaged over 1.0 cm by the orthoses that was recorded 1.0 cm); wearing the same orthoses but 1.0 cm in the ankle was removed and the ankle plastic edge was just through the ankle center to colect the data (recorded as 0 cm); after 1.0 cm was removed again in the ankle, walking in a natural gait (recorded as-1.0 cm). (3) Group 3, wearing 1.5 cm heel-height ankle-foot orthoses and walking in a natural gait; wearing the same orthoses but with 1.0 cm and 2.0 cm heel-height and walking in a natural gait. During walking, surface electromyography signals were colected from the biceps femoris muscle, rectus femoris muscle, tibialis anterior muscle, and gastrocnemius of the lower limbs. RESULTS AND CONCLUSION: (1) Without orthoses, the surface electromyography signals were the weakest. (2) For any muscle, the electrical activity of subjects without orthoses was weaker than that of subjects wearing orthoses at different hardness. (3) For the biceps femoris muscle, the integral electrical value without orthoses was very close to that wearing orthoses with normal heel height. Meanwhile, these two values were lower than that wearing orthoses with abnormal heel height. These findings indicate that the fixed plastic ankle-foot orthoses could cause the fatigue of the biceps femoris muscle, rectus femoris muscle, tibialis anterior muscle, and gastrocnemius; and the orthoses with abnormal heel height can further increase the fatigue of the biceps femoris muscle.

The medical education has long paid great attention to students' specialized knowledge education and neglected the humanities education for all-around development excessively. Diagnostics is a bridge curriculum between basic medicine and clinical medicine. Enhancing the quality education by fully combining the process of diagnostics teaching plays an important role in qualified medical talents training.

ObjectiveTo evaluate the effect of lifestyle intervention on high-risk individuals for hypertension. MethodsOne hundred and four prehypertensive adults who received physical examination during October 2005 and October 2007 and showed at least 2 hypertension risk factors were randomly assigned to the experimental or control group.A muhicomponent behavioral intervention,including health education(e.g.awareness of disease),metary gmdance,physical.exercise,and psychologtcat improvement,Was conducted for 2 years.The awareness of disease,blood pressure,bedy weight,and the change of risk factors were compared.ResultsAt 2 years,the awareness of disease in the experimental group wag significantly improved,and the blood pressure,body weight,and risk factors were obviously reduced.Although the awareness of disease and the risk factors in the control group were improved,the blood pressure and body weight were increased.The difference in average systolic blood pressure,average diastolic blood pressure,body weight,and the awareness of disease between the two groups were 13 mm Hg(1 mm Hg=0.133 kPa),7.9 nlnl Hg,3.7 kg,and 37.6%,respectively(all P<0.05).ConclusionThe lifestyle intervention among high-risk individuals for hypertension could effectively reduce blood pressure and body weight. Improved lifestyle would result in less risk factors.

Objective To discuss clinical results of self-made anatomical dynamic hip lock plate (ADHLP) in treatment of intertrochanteric fractures. Methods ADHLP was applied in 73 patients in-eluding 52 males and 21 females at age range of 19-92 years ( mean 54.7 years). Fractures were caused by traffic accidents in 32 patients, sllp in 21, fall from height in nine and other factors in 11. According to the Evans' s classification system, there were 42 patients with type Ⅰ fractures, 17 with type Ⅱ, nine with type Ⅲ and five with type Ⅳ. Self-made ADHLP was applied to manage various fractures with differ-ent operation strategies. The curative effect of ADHLP was observed for evaluation of ADHLP. Results The operation lasted for mean 60 minutes (40-90 minutes). The volume of blood loss was mean 200 ml (100-400 ml). All patients were followed up for 6-48 months (average 36 months), which showed that the function of hips was satisfactory, with excellence rate of 99%. There were no complications like coxa yam, femoral head eoncis, rotation displacement, iatrogenic fracture, infection or internal fixation break and loosening. Conclusions ADHLP takes advantages of reasonable vitodynamics, wide operation in-dicatioas, convenient operation, minor trauma, fast recovery, stable fixation and few complications for in-tertrochantefie fractures, especial]y osteoporotie and gemntal patients.