0.05).Conclusion Levofloxacin treating community-acquired pneumonia than gatifloxacin have more medicine economics advantage and it is in the prior choice.

Objective To explore the factors affecting blood level of elderly hypertensive patients, using a multilevel analysis model. Methods 927 elderly hypertensive patients from 23 communities were studied, through a multi-stage random sampling method. The influencing factors on systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed through a two-level linear multilevel model, respectively. Results The average blood pressure of subjects appeared as: SBP (139.2±11.7) mm Hg ( 1 mm Hg=0.133 kPa), DBP (85.6±8.6) mm Hg. Ratio of physician versus patients was the factor affecting blood level of subjects from the community level. SBP and DBP of the subjects from the higher physician/patient ratio communities were 3.86 mm Hg and 2.51 mm Hg, lower than the subjects in the lower ratio communities, after controlling the other related factors. Age, gender,overweight/obesity were the individual risk factors of hypertension, while factors as regularl medicine taking, reducing salt intake and related self-efficacy to manage disease could reduce the blood pressure.Reducing salt intake could lower the SBP for 2.44 mm Hg and DBP for 2.03 mm Hg, after controlling the other factors. Conclusion Multilevel analysis model could effectively analyze the hierarchically structured data while both factors from the community and individual levels could affect the blood level among elderly patients with hypertension.

AIM:To observe the image features of Vogt-Koyanagi-Harada disease (VKH) and multiple central serous chorioretinopathy (CSC) by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT).METHODS:Thirty-two eyes of 17 patients with VKH and thirty-five eyes of 30 patients with multiple CSC were collected from 2009 to 2016 in my hospital.RESULTS:All the eyes with VKH were found small and dense fluorescein leakage in the early stage.The 17 eyes (53%) with VKH were found fluorescein accumulation in the final stage;24 eyes (75%) with VKH were found high fluorescence of optic disc.All of eyes with multiple CSC were found multifocal leakage in the early stage.And 2 eyes (6%) with multiple CSC were found high fluorescence of optic disc.There were 28 eyes (14 patients) with VKH and 25 eyes (22 patients) with multiple CSC had been done OCT in my hospital.Retinal pigment epithelial fold was only found in VKH.Fluctuation of internal limiting membrane (ILM) and membrane structure had higher sensitivity to diagnostic VKH from to multiple CSC, with sensitivity of 54% and 68% respectively.CONCLUSION:There are some similarities as well as differences between FFA and OCT in diagnosis of VKH and multiple CSC.A combination usage of FFA and OCT can be more effective in distinguishing VKH from multiple CSC.

Objective To analyze the characteristics of tuberculosis (TB) in renal-transplant recipients from our hospital, and summarize the corresponding experiences in diagnosis and management.Methods A retrospective study was performed on 61 documented post-transplant TB cases out of the 2842 patients who received kidney transplantation in the First Affiliated Hospital of Sun Yat-sen University between Jan.1991 and Dec.2010.Results TB in the post-renal-transplant population in our hospital displayed the following characteristics:(1) High incidence (2.1％ ).54.1％ recipients were diagnosed within the first year post-transplant; (2) Lung was the most common site (77.0 ％).There was high prevalence (60.7 ％) of extra-pulmonary TB (lymphatic TB,23.0 ％; pleuritis,13.1 ％; graft,11.5％); (3) Fever (83.6 ％),cough (55.7 ％),sputum (41.0 ％) were the most common clinical manifestations.There were also emaciation (3.3 ％) and enlargement of lymph nodes (18.0 ％); (4) Chest X-ray and CT were of great value during TB diagnosis while purified protein derivative of tuberculin (PPD) skin test had little diagnostic value with a negative result in 56 cases (91.8 ％) ; (5) Liver function damage ( 16.4 ％),kidney function injury (39.3 ％) and peripheral nerve toxicity (3.3 ％) were the main adverse reactions of anti-tuberculosis chemotherapy,also the major cause of anti-TB failure; (6) Pre-transplant TB (17 cases) increased the probability of TB recurrence (4 cases,23.5 ％) post-transplantation; (7) The post-transplant TB patients were accompanied with cellular immune deficiency,resulting in overlapping infection of bacteria,viruses and fungi (19.7 ％); (8) 1- and 3-year patient/graft survival rate of patients with post-transplant TB was 85.2 ％/78.7 ％ and 85.2 ％/75.4 ％ respectively. The accumulative mortality rate reached to 14.8％,while overlapping infection was the major cause of death (66.7 ％).Conclusion Chinese renal transplant recipients still face a high risk of TB because of their immunecompromised state and epidemiological prevalence of the disease. For the high mortality rate and associated serious complications,rapid diagnosis and effective anti-TB chemotherapy are of great value for TB population.

OBJECTIVETo observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.

METHODSFifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.

RESULTSCompared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).

CONCLUSIONThe Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.

Acupuncture Therapy ; Aged ; Female ; Hand ; physiopathology ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Movement ; Recovery of Function ; Stroke ; complications ; physiopathology

Objective To evaluate the effect on the reversal of left ventricular aneurysm (LVA) and on heart function of percutaneous coronary intervention (PCI) therapy at different time of acute myocardial infarction (AMI). Methods A total of 326 patients with primary anterior AMI-accompanied LVA diagnosed by left ventriculography (LVG) from January 2001 to July 2004 were enrolled in this study. They were randomized into 4 groups according to the time of accepting PCI:≤3 h group, 4-6 h group, 7-12 h group and one week group. At the baseline and 6 months after AMI, the parameters of left ventricular diastolic volume index (LVEDVI), left ventricular systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score (LVWMS) and left ventricular end diastolic pressure (LVEDP) were measured by LVG. The paradox volume index (PVI) was measured by equilibrium radionuclide at one week and 6 months after AMI.At 3 year following up to, the major adverse cardiac events (MACE) were recorded. Results At 6 months after PCI, the LVESVI, LVEDVI, WMS and LVEDP were all decreased while LVEF was increased in the four groups as compared with pre-PCl (P<0.05, respectively). Those parameters changed most obviously in ≤3 h group. At the 6th month after PCI, the PVI was lower in ≤3 h group (12.1±2.1)% than in 4-6 h, 7-12 h and one week group [(15.4±2.4)%, (16.5±2.5)% and (20.4±3.7)%, all P<0.05]. Within the 3 years follow-up, the MACE was significantly lower in 3 h, 4-6 h and 7-12 h groups than in one week group, and the mortality was lower too [(2.8%, 3.0% and 3.1% vs. 17.9%, all P<0.05]. Conclusions The early, fully and permanent open of the infraction-related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve LV function and prognosis.

Objective To evaluate the effect of Diver CE aspiration thrombus catheter used in patients during the recovery of acute myocardial infarction (AMI) with percutaneous coronary intervention (PCI). Methods A total of 50 AMI patients were enrolled from January 2010 to December 2011. Twenty-ifve patients received PCI and used the Diver CE aspiration thrombus catheter (aspiration group);and the other 25 patients received routine PCI (routine PCI group). The basic characteristics, PCI characteristics, myocardial perfusion indexes and clinical data were compared and analyzed. Results There was no statistically difference between two groups in basic characteristics. Compared with the routine PCI group, higher rate of myocardial blush grade 3 but lower thrombus scores were found in the aspiration group. The incidence of no-lfow or slow-lfow were also lower in aspiration group (all P<0.05). The LVEF after 6 and 12 months were higher in the aspiration group (both P<0.05), no difference in MACE between the two groups. Conclusions Using the Diver CE thrombus aspiration in PCI is a simple and safe by method for treatment of acute myocardial infarction with high thrombosis burden. It can improve reperfusion decrease the rates of no-relfow on slow-relfow and can improve the long-term left ventricular function.

Objective To explore the application of repeated measurement‘analysis of variance'(ANOVA)in evaluating the effectiveness of 'community-based hypertension self-management program'.Methods A community-based parallel controlled trial was conducted among 3 communities.169 patients in intervention group took part in the course on hypertension self-management program once a week and 204 patients in control group received routine hypertension management services.Data collected through questionnaire at baseline and 6 months,12 months after intervention and were compared through repeated ANOVA measurement.Results Subjects in the intervention group showed statistical significance and linear trends in health self-evaluation,distress,in lOW spirit,self-efficacy in managing symptoms(SEMS),self-efficacy to managing diseases in general(SEMDG),systolic blood pressure(SBP)and diastolic blood pressure(DBP)over time by univariate test of repeated measurement ANOVA.The score of SEMS increased from 6.84±2.53 at baseline to 8.20±1.44 at 12 months after intervention while SEMDG from 7.28±2.45 to 8.89±1.05,and SBP decreased from 137.66±7.30 inln Hg(1 mm Hg=0.133 kPa)to 130.41±7.71 mm Hg.DBP decreased from 84.13±6.70 mm Hg to 81.04±5.98 mm Hg respectively.Only tow spirit and SBP changed over time were seen in the control group.Self-evaluation,distress,in low spirit,caused by diseases,SEMS,SEMDG and SBP were statistically different between control and intervention groups,and the effect of interaction between groups and time span were statmtically significanton indicators as self-evaluation,low spirit,self-efficacy in managing symptoms,seLf-efficacy tO manage diseases and sBP etc,by multivariate test of repeated measurement ANOVA. Conclusion Repeated measurement ANOVA not only could be used to analyze group-effect,but could also explain the effect and the interaction among groups and time,to make the results more reliable.The self-management approach could improve the health status and self-efficacy of the patients,so as to reduce the blood pressure.Our result showed that it was effective for hypertensive patients to be on the chronic diseases selfmanagement program.

Liver fibrosis is a common pathological process for chronic liver injury caused by multiple etiological factors and an inevitable phase leading to liver cirrhosis. According to the previous studies, hesperidin (HDN) shows a very good protective effect on CCl4-induced chemical hepatic fibrosis in rats. In this experiment, based on the findings of the previous studies, a platelet-derived growth factor (PDGF)-induced HSC-T6 model was established to observe the inhibitory effect of HDN on HSC-T6 proliferation. The ELISA method was adopted to detect the content of collagen I in HSC-T6 supernatant. Transforming growth factor (TGF)-beta1, Smad2, Smad3, Smad7 and connective tissue growth factor (CTGF) mRNA expressions were measured by RT-PCR; TGF-beta1 and CT-GF protein expressions in HSC-T6 were determined by Western blot, in order to study HDN's effect on TGF-beta1 signaling pathway in HSC and its potential action mechanism. The results demonstrated that HDN could notably improve HSC-T6 proliferation, Collagen I growth and TGF-beta1, Smad2, Smad3 and CTGF mRNA.expressions. After being intervened with HDN, it could notably inhibit HSC-T6 proliferation and Collagen I growth, reduce TGF-beta1, Smad2, Smad3 and CTGF mRNA and TGF-beta1, CTGF protein expressions and increase Smad7 mRNA expression. HDN's antihepatic fibrosis effect may be related to the inhibition of HSC proliferation and activation by modulating TGF-beta/Smad signaling pathway.
Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Connective Tissue Growth Factor ; physiology ; Hesperidin ; pharmacology ; Platelet-Derived Growth Factor ; pharmacology ; Rats ; Signal Transduction ; drug effects ; Smad Proteins ; physiology ; Transforming Growth Factor beta1 ; physiology