Objective To explore the effect of mindfulness- based stress reduction on coping style and quality of life in liver cirrhosis ascites patients. Methods Seventy- nine patients with liver cirrhosis ascites from March 2012 to May 2013 were selected as the control group with conventional treatment; 77 patients with liver cirrhosis ascites from October 2013 to December 2014 were selected as the observation group and were given mindfulness based stress reduction based on the control group. The coping style, the hope level and the quality of life between the two groups were compared by Simplified Coping Style Questionnaire, Herth Hope Scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ- c30). Results Before the treatment, two groups of positive and negative coping had no statistically significant difference (P>0.05). After the treatment of the observation group actively respond to score as follows: (25.44 ±2.61) points,significantly higher than the control group:(19.42±3.33) points, negative coping scores as follows: (9.76±1.89) points,significantly lower than the control group:(11.99±2.43) points, the differences between the two groups were significant (t=-10.468, 7.572, both P<0.01).Before the treatment, two groups of hope level had no statistically significant difference (P>0.05). The scores of the reality and the future of positive attitude, positive action, keep close relationship with others were (14.5±2.6), (15.1±2.4), (15.6±2.1) points after the treatment in the observation group, and (10.1±2.7), (10.5±2.3), (11.6±2.5) points in the control group, and there were significant differences (t=4.965, 5.569, 3.659, all P<0.01). After the treatment, observation group and control group patients in nausea and vomiting, constipation, diarrhea three dimension score difference had no statistical significance(P>0.05). The scores of physical function, role function, emotional function, cognitive function, social function, fatigue, pain, general health questionnaire, shortness of breath, insomnia, loss of appetite and the economic difficulties were (69.3±15.5), (74.1±22.6), (68.3±21.5), (79.7±23.4), (72.6±25.2), (42.1±26.1), (30.1±26.2), (55.6±15.6), (35.2±27.4), (36.2±28.7), (33.6±28.3), (25.6±24.3) points after the treatment in the observation group, and (58.6±21.2), (61.4±26.2), (75.6±20.4), (65.4±22.3), (55.4±28.7), (48.5±25.3), (37.6±29.2), (30.2±11.3), (41.6±28.7), (44.6±31.3), (40.2±30.4), (59.6±32.4) points in the control group, and there were significant differences (t=-39.369-15.621, P<0.01 or 0.05). Conclusions The mindfulness- based stress reduction can significantly improve the coping style in patients with liver cirrhosis and ascites, the level of hope and improve quality of life of patients, it is worth clinical promotion.

OBJECTIVE To investigate the occurrence and the genotype character of AmpC ?-lactamases-producing Escherichia coli isolated from the Second Hospital affiliated to Harbin Medical University.METHODS K-B disk diffusion test and FOX(≤17mm) test were used as initial screen tests to detect the clinical isolates;AmpC ?-lactamases were confirmed by three-dimentional extract tests;multiple-PCR was used for detecting plasmid-mediated AmpC gene and their genotypes were determined by DNA sequencing;the regulator genes of high producing AmpC isolates of E.coli were cloned to pUCm vectors and sequenced,the difference among them was analyzed by blast method.RESULTS Among total 586 E.coli clinical isolates,10 isolates(1.70%) resisted to cefoxitin;three-dimensional extract tests were positive for all 10 isolates;4 isolates of E.coli were plasmid-mediated DHA-1 type AmpC ?-lactamases by using multiplex PCR and DNA sequencing;6 isolates of chromosomal high level AmpC ?-lactamases-producing E.coli were sequenced and contrasted to that of E.coli K12,showed that they were gene polymorphism.CONCLUSIONS E.coli clinical isolates producing high level AmpC ?-lactamases not only acquire plasmid-mediated DHA-1 AmpC ?-lactamases but also cause by chromosomal ampC promotor or attenuator gene mutations in our hostiptal.

Objective:To study the surgical approach to the orbital floor and infraorbital rim.Method:15 cases of fractures of the orbital floor and infraorbital rim were treated with the transconjunctival approach.Result:All fractures of the orbital floor and infraorbital rim were repositioned and fixed through transconjunctival approach. Except for 1 case with mild canthal malposition, no other complication was observed.Conclusion:The transconjunctival approach can provide adequate exposure of the infraorbital rim and orbital floor without scar formation in the face.

Objective To observe levosimendan-induced hemodynamic improvement of chronic decompensated heart failure patients and adverse effects,and sum up the nursing experience of Levosimendan.Methods Sixty-three patients with decompensated heart failure were treated with Levosimendan,based on optimized conventional treatment for heart failure.Aminoterminal pro-brain natriuretic peptide (NT-proBNP) and left ventricle ejective fraction (LVEF) were measured at baseline and one week after Levosimendan administration.In addition,we summarized the clinical observation,adverse effects and nursing experiences of treatment with Levosimendan in decompensated heart failure patients.Results Levosimendan increased 24-hour urine output in patients at the first day after treatment.This effect of levosimendan persisted for 7 days at least.We observed an improvement in LVEF and a reduction of NT-pro-BNP at 7 days after the initiation of levosimendan treatment.Clinical efficiency of levosimendan in patients was 84.1％ in this study.Twenty two patients(34.9％) experienced different adverse events.Conclusions Levosimendan therapy can improve cardiac function and reduce BNP in patients with decompensated heart failure.The rate of adverse effects of Levosimendan is high.It is important to enhance therapy effect by careful nursing and observing variety state during treatment with Levosimendan.These data will be useful for the nursing care of Levosimendan in clinical practice.

Objective To retrospectively review the efficacy and side effects of intense pulsed light (IPL) and red light emitting diode (LED) in the treatment of steroid-dependent dermatitis.Methods Seventy patients with steroid-dependent dermatitis mainly manifesting as facial telangiectasis were treated with IPL for an average of 3.49 sessions with a 4-week interval.The energy density of IPL varied from 20 to 23 J/cm2,pulse width from 2.6 to 5.0 ms,and delay from 15 to 20 ms.Meantime,197 patients with steroid-dependent dermatitis,who mainly presented with facial skin sensitivity,were treated with red LED (633 ± 3 nm wave length) twice a week for an average of 4.23 sessions.The energy density of red LED was 128 J/cm2,and the irradiation lasted 20 minutes at each treatment.The efficacy and adverse reactions were assessed and recorded for each treatment.Results The total response rate was 88.57％ for IPL,and 83.76％ for red LED.There was a significant difference in the clinical efficacy between triple-pulse and double-pulse IPL (x2 =8.14,P ＜ 0.05).No severe adverse reaction was observed in any of the patients.Conclusion IPL and red LED are both effective in treating steroid-dependent dermatitis.

Objective To build three-dimensional (3-D) finite element models for local advancement skin flap, by which the post-operative local strain and local stress of skin were figured out to assist in the design of skin flap in clinic. Methods The biomechanical parameters of human forehead skin were obtained in vitro from biomechanical experiments. The 3-D finite element model of local advancement skin flap was set up by MSC Marc/Mentat 2005 (3-D finite element software). Six models were built with the same flap but different skin defects, to simulate post-operative local strain of skin and local stress of skin in different models. Results Post-operative local stress of skin increased with the skin flaps stretching, but the relationship between increase and stretching did not meet the linear rule. Skin flap was able to stretch to 40 % of its initial length in theory if we did not consider blood supply of it. When the skin flap stretched over 40 % of its initial length, the maximal stress could exceed the yield limit. Conclusion It is an effective and workable way to simulate local advancement skin flap using 3-Dfinite element model and biomechanical parameters of human skin. The stretch ratio of local advancement skin flap should be not over 40% for safety.

BACKGROUND: It is discovered that trace elements in Chinese patent medicine play an important role in pharmaceutical efficacy and structural analysis. A new topic has been formed gradually in a further research on pharmaceutical efficacy and effective components of Chinese patent medicine in the view of inorganic trace elements. The fuzzy classified study on the interrelationship between trace and constant elements of Chinese herbs and therapeutic effects is to discuss the trace-element action of drugs in the holistic aspect of trace elenent and research rather scientifically the holistic coordination among trace elements in Chinese herbs.OBJECTIVE: To determine the contents of 21 kinds of trace and constant elements in Chinese patent medicines in the treatment of cardio-cerebral vascular disease. To study with fuzzy classified method the interdependence between trace, constant elements of drugs and therapeutic effects so as to provide a new approach for the quality evaluation of Chinese patent medicine.DESIGN: Testified observed study based on various Chinese patent medicines.SETTING: Chemistry teaching-research room in a university and department of cardiology in a general hospital of a chemical industrial group corporation.MATERIALS: Twenty-one kinds of common Chinese patent medicines for the treatment of cardio-cerebral vascular diseases in clinic, namely di' ao xinxuekang capsule(DXK), xueshuan xinmaining capsule(XMN), shan haidan capsule(SHD), buchang naoxintong capsule(NXT), linaoxin capsule(LNX), xinnaosu capsule(XNS), lixin wan(LXW), suxiao jiuxin wan (SJX), xinbao wan(XBW), yinxingye pian(YXY), fufang danshen pian (DSP), niuhuang jiangya wan(NHJY), naosaitong pian(NST), qiangli tianma duzhong wan ( TD W ) , tongsaimai pian ( TSM ) , tongmai ningxin infusion(TMNX), maitong capsule(MTC), fufang yinxing wan ( YXW ) , da huoluo dan(DHL), guanxin suhe capsule(GXSH) and xiaoshuan tongluo capsule (XSTL).METHODS: Wet digestion was used to manage samples, atomic absorption spectrophotometric method(AAS) method was used to determine the contents of 10 kinds of trace and constant elements in 21 Chinese patent medicines,namely Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn. Data range method was applied for the standardized management of statistical indexes of various element contents in relevant drugs, dotprod(U, V) method was used to measure correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. The interrelationship was analyzed between the contents of trace elements of various Chinese medicines and pharmaceutical efficacy. By the analysis of fuzzy matrixes in universe, it was to evaluate firmly on the efficacy similarity of various kinds of Chinese patent medicines with quantitative indexes.MAIN OUTCOME MEASURES: ① Results of element contents; ② Results of fuzzy cluster analysis on elements.RESULTS: The standardized management of statistical indexes was carried on the contents of Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn in various drugs to determine correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. When(r) = 0.55, there were 9 kinds of drugs similar in cluster, namely xueshuan xinmaining capsule, buchang naoxintong capsule, lixin wan, xin bao wan, qiangli tianmai duzhong wan,tongsaimai pian, maitong capsule, da h uoluo dan and xiaoshuan tongluo capsu le. When(r) =0. 65, there were 6 kinds of drugs similar in cluster,namely buchang naoxintong capsule, xin bao wan, qiangli tianmai duzhong wan, tongsaimai pian, maitong capsule and xiaoshuan tongluo capsule. When(r) =0. 87, there were 2 kinds of drugs similar in cluster, namely buchang naoxintong capsule and xin bao wan.CONCLUSION: It is indicated in the research that the drugs are in rich of trace and constant elements. The larger the correlation coefficient of drugs is,the more similar the pharmaceutical efficacy is. It is discovered the close interrelationship of the trace and constant elements in drugs with their pharmaceutical efficacy. In this research, fuzzy classified method is used to discuss, in the view of trace elements, the similarity of quantitative indexes in efficacy of Chinese patent medicine commonly administrated in the treatment of cardio-cerebral vascular disease, which has provided a new approach for the quality evaluation of Chinese patent medicine.

Objective　To explore the development of endogenous CO and its mechanisms in asthma.Methods　50 guinea pigs were equally separated 5 groups.After the models of asthmatic guinea pigs were established in 4 groups,3 groups of them were treated with dexamethasone,the specific stimulator(hemin)and inhibitor(Sn-PP)of HO-1 respectively.The rest of groups were asthmatic one and normal control one(NCG).From all tested animals,the COHb in blood and lung HO-1 activity were examined,the lung tissues were pathologically observed and immunohistochemically stained.Results　In asthmatic and hemin stimulated groups,the levels of COHb with enhanced expression of lung HO-1 and their activity were significantly increased compared with NCG(t=4.43～9.97,P＜0.01).For example,the lung HO-1 activities in asthmatic group were (881±361)pmol/(mg*pro*h),COHb (4.94±2.15)% respectively.In dexamethason prevented and Sn-PP inhibited groups,however,all determined levels were markedly reduced compared with asthmatic group(P＜0.01).Conclusion　The increased HO-1 had resulted in the growth of endogenous CO in asthma.

Objective To study the clinical value of serum FL-6 detection in patients with Graves. Methods The level of IL-6 was detected in 75 Graves patients and controls with ELISA, the correlation between IL-6, other function parameter (T3, T4, etc.) and immune indicators (TRAb) were analyzed. Results The level of IL-6 in Graves patients was(1. 84 ±1. 58) ng/L, which was significantly higher than the healthy controls(l. 28 ±0.46)ng/L (t=2.55,P<0.05).IL-6 was positive correlation with T3(r =0. 55) ,T4(r =0. 40) ,FT4(r =0. 36) , FT3(r = 0. 35)and TRAb(r = 0. 47) (P <0. 05)and was negative correlation with TSH(r= -0. 58, P < 0. 05). Conclusions IL-6 can be used as a good index of immune derangement and thyroid function disorders in Grave patients.

Objective To investigate the value of urinary calprotectin in differential diagnosis between prerenal and intrinsic pediatric acute renal injury(AKI).Methods A total of 68 cases with AKI were enrolled in this study,and they were divided into prerenal AKI group(25 cases) and intrinsic AKI group(43 cases) according to their tissue perfusion.The general data was collected,and the blood urea nitrogen(BUN),serum creatinie(Scr),BUN/Scr,potassium,fractional excretion of filtrated sodium(FENa),urine osmotic pressure,B-type natriuretic peptide (BNP),urinary calprotectin,neutrophil gelatinase-associated lipocalin (NGAL),kidney injury molecule 1 (Kim-1) were recorded and compared between the 2 groups.Results There were significant differences between prerenal AKI group and intrinsic AKI group in Scr[(439.0 ± 278.0) μmol/L vs.(603.0 ± 286.0) μmol/L,t =2.30,P ＜ 0.05],BUN/Scr (20.58 ±5.62 vs.14.93 ±4.32,t =4.65,P＜0.05),FENa[(1.5 ±0.6)％ vs.(8.1 ±2.6)％,t =12.46,P＜ 0.05],BNP[95.6(54.0,109.4) ng/L vs.512.3(320.1,520.3) ng/L,Z =2.21,P ＜0.05],urinary calprotectin [20.7(4.3,42.4) μg/L vs.402.4(60.1,498.7) μg/L,Z=3.13,P＜0.05] and NGAL[74.9(14.5,365.5) μg/L vs.684.2(56.2,1 502.5) μg/L,Z =2.35,P ＜0.05].Receiver operating characteristic curve analysis showed that urinary calprotectin[area under the curve(AUC) =0.940] and BNP(AUC =0.909) both had higher value in differential diagnosis.When the cut off value of calprotectin was 240.6 μg/L,its specificity was 96.0％ and the sensitivity was 86.0％.When the cut off value of BNP was 120.6 ng/L,its specificity was 92.0％ and the sensitivity was 90.7％.The diagnostic accuracy was low in Scr,but moderate in BUN,Scr,FENa and NGAL.BUN,potassium,urine osmotic pressure and Kim-1 had no diagnostic value.Conclusions Urinary calprotectin may have higher diagnostic value in the differential diagnosis between prerenal and intrinsic pediatric AKT.It can be used in the clinical diagnosis as a reference index.