Objective To investigate the relationship of self-management skills and the quality of life among solitary elderly patients with hypertension.Methods 110 cases of solitary elderly patients with hypertension were measured with self-designed Self-management of Hypertension Scale and Short Form Health Survey (SF-36) and the correlation of them was analyzed.Results The levels of self-management skills of elderly hypertensive patients was at a middle level,and the mean score of self-management skills was (78.6 ± 5.2) points.The total score of SF-36 of patients with good self-management skills was higher than those with bad self-management skills.The therapy management,catering management,psychosocial management,sports management and overall quality of self-management of elderly patients with hypertension were positively correlated with survival quality.The factors influencing self-management ability of patients incuded education,gender,social resource utilization,psychological conditions.Conclusions Community health nurses should pay attention to self-management skills such as diet,exercise,therapy,social and psychological aspects in elderly hypertensive patients in order to improve their quality of life.Furthermore community nurses should strengthen intervention for solitary eldedy males with lower education level,poor utilization of social resources to improve their self-management skills.

Recurrent respiratory tract infection (RRTI) is a common chronic respiratory disease of children.The pathogenesis is complex,etiology and treatment methods are varied.Probiotics are immune modulators with extensive clinical application.This paper reviewed the changes of intestinal microflora in children with recurrent respiratory tract infection and the mechanisms of probiotic treatment including intestinal flora regulation,intestinal mucosal barrier,stimulation of the growth of intestinal mucosa and immune regulation.

Objective To investigate the clinical effect of honghua injection on hemorrheology in the prevention of deep venous thrombosis ( DVT) after operation of lower limbs fractures.Methods 100 cases with operation of lower limb fracture meeting the inclusion critera were randomly divided into two groups equally.Besides conventional treatment, the control group was treated with rivaroxaban, while the observation group was treated with honghua injection and rivaroxaban.The incidence of DVT, pro-inflammatory factors, hemorheology indices and adverse reactions were observed and compared. Results The observation group had a total DVT incidence of 10.0%, which was statistically lower than that of 28.0% in the control group(P<0.05). Three days after the operation, pro-inflammatory factors of TNF-α, IL-6 and IL-8 in the observation group was respectively statistically lower than that in the control group(P<0.05).As to hemorheology indices, in comparison with the control group, hematocrit, whole blood viscosity and fibrinogen in the observation group were statistically lower (P<0.05).During the treatment, there were no case of severe adverse reactions, and the incidence of adverse reactions in the two groups were statistically same.Conclusion Treatment of honghua injection in combination with rivaroxaban in the prevention of DVT is reliable, which could significantly reduce the incidence of DVT, alleviate inflammatory reaction and improve blood hypercoagulable state with minor adverse reactions.

Objective To evaluate the mental health of medical workers, and develop an EAP suitable for heahhcare sector. Methods A 1-year EAP was implemented in a hospital in Beijing, in which SF-36 and JSS scales were used to study the health-related quality of life and job satisfaction of these workers. Results Work pressure is found to be the main source of pressure for medical workers, accounting for 63.7%. Scores of the group receiving EAP service are found to be significantly higher (P<0.01) in all dimensions (excepting work nature and supervisor dimension) of both SF-36 and JSS. Conclusions Medical workers are exposed to high pressure of work, having strong need for EAP service as result. EAP is an effective means to maintain mental health and improve quality of life and job performance, if applied widely.

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Beverages ; Exercise ; Female ; Glycyrrhizic Acid ; pharmacology ; Humans ; Physical Endurance ; Students

Objective To study CT features of thymoma,so that to improve the accuracy of CT diagnosis and differential diagnosis.Methods 31 cases of thymomas proved by surgery and pathology were examined with conventional CT scans.CT findings of thymoma were analyzed.Results The lesions in 27 cases(87.1%)were located in the anterior upper and middle mediastinum.There were benign lesion in 11,including mass-cardiovascular interface(MCI) with convex type(8 cases),flatness type(1 cases) and concave type(2 cases).20 cases were malignant lesion,including MCI with cast type(18 cases) and concave type(2 cases).Irregular invasion to adjacent organs was found in 11 cases,others included pericardiac effusion(n=6),pericardial and mediastinal invasion(n=2),pleural effusion(n=4),pneumonia(n=2),lung,bone,mediastinal lymphadens metastasis(n=2) and liver,pancreas metastasis(n=1).Conclusion CT scans is of significant value in diagnosis and differential diagnosis of thymoma.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.

Objective To study the effect of low-dose dexamethasone after acute and subacute cerebral infarct.Methods One hundred and forty patients with acute ischemic stroke were randomly divided into acute ischemic stroke group (acute stage group),subacute ischemic stroke group (subacute stage group),placebo and control groups.Subjects in acute stage groups received conventional therapy and 1 mL (5 mg) dexamethasone injection from 1 day to 3 day after admission and in subacute stage group,received the same treatment as acute stage group from 4 day to 6 day after admission.In control and placebo groups,subjects received conventional therapy and conventional therapy + 1 mL normal saline for injection respectively.One week after treatments,complete blood count and erythrocyte sedimentation rate were tested.One month and three month after treatments,neurological function were evaluated by Barthel Index and modified Rankin Scale (mRS).Results The valuate of erythrocyte sedimentation rate in acute stage group were significantly different from it of placebo and control groups (P ＜ 0.05).Moreover,neurological function of subjects in acute stage group was significantly improved than that in placebo and control groups in by Barthel Index and mRS (P ＜ 0.05).However that in subacute stage group was not different from that placebo and control groups (P ＞ 0.05).Conclusion Low-dose dexamethasone plays a neuroprotection role after acutc cerebral ischemia.