Objective To investigate the effect of psychologic nursing on the rehabilitation for post-stroke depression(PSD) patients. Method 62 patients of 98 PSD patients were divided into 31couples. According to age, sex, course of illness and statge of illness, the patients were divided into rehabilitation nursing ( interference group) and routine nursing ( control group) with CES - D ( Center of epidemi ological survey - depression Scale ) and CNFD ( Criterion of nervous function defect). Every couple was compared with each other. Result The score of two groups before treatment was not obviously different(p＞ 0. 05). Two scores in two groups after treatment were obviously better than those of before treatment. Two scores of interference group were significantly higher compared with control group ( p ＜ 0. 05). Conclusion Interference of psychologic nursing is effective in treating post - stroke depression.

OBJECTIVE:To provide reference for further development of Internet drug transaction services in China. METH-ODS:The data of online drugstores with top 20 approvals data and sales amount were collected bu the Internet,the normative man-agement was evaluated. Meanwhile,questionnaire was conducted to survey and analyze the cognition,buying drugs and correspond-ing requirements of some Shanghai citizens for Internet drug retail. RESULTS:By Jun. 12,2015,totally 307 retail chain drug-stores(online drugstores)had got the License of Internet Drugs Transaction,only 62 online drugstores(20.2%)were in full compli-ance with the normative management;the top 19 online drugstores supplied averagely 1 072±815 OTC medicines,including 259± 165 chemical drugs and 813 ± 650 Chinese traditional medicines,and the top 3 were jianke.com (3 658 species),J1.com (2 071 species)and 360 kad.com(1 523 species). Totally 216 questionnaires were sent out,and 183 were effectively received with effec-tive recovery of 84.7%. The 183 surveyed citizens showed high cognition in distinguishing the authenticity of online drugstores (75.4%) and the authenticity of drugs (67.1%),but low cognition in online drugstore opening qualifications and Internet selling drugs;only 22.4% had the experience of buying drugs online,the degree of satisfaction towards online shopping,from the highest to the lowest,were drug price(62.5%),professional consultation of pharmacists(50.0%),variety of drugs(45.0%),quality of drugs(37.5%),delivery time(35.0%),etc.;the most probably purchased medicine category were vitamins and minerals(63.9%) and medicines for common diseases(40.4%). CONCLUSIONS:Currently the demands and confidence of online drugs shopping of Shanghai citizens are still scarce. Though the access of retailing prescription drugs would spur the Internet drug business,the condi-tion is still immature. It is suggested to sell prescription drugs in a limited way and improve their access threshold,promote Medi-care settlement to multi-faceted promote the orderly development of Internet drug transaction services.

Objective To investigate the clinical characteristics of twice-weekly hemodialysis patients.Methods Data were collected from Shanghai Renal Registry.A total of 1288 patients undergoing regular hemodialysis (HD) with dialysis adequacy index and other biochemical parameters in Shanghai in January 2007 were enrolled into the cohort study with 2 years follow-up.Clinical characteristics and outcome of twice-weekly HD patients were analyzed as compared with thrice-weekly HD patients.Results Compared with patients on thrice-weekly HD,the twice-weekly HD patients were significantly younger and had significantly shorter HD vintage,smaller body surface area,longer HD session time,higher single-pool Kt/V (spKt/V) and serum albumin but lower weekly Kt/V (P＜0.05).There was no statistical difference in ultrafiltration volume between two groups.Kaplan-Meier survival analysis indicated that both groups had similar two-year survival.Multivariate Cox regression analysis showed that age,body mass index,serum albumin and weekly Kt/V were predictors of patient mortality.Conclusion It is acceptable for some hemodialys patients with twice-weekly HD,and close monitor of dialysis adequacy and volume status is necessary for this therapy model.

Objective To study the effect of uremic serum on the calcification and osteogenic transition of cultured human umhilical artery smooth muscle cells(HUASMC).Methods Sera from 40 healthy controls(control group),40 nondialysis uremic patients(nondialysis group)and 45 uremic patients on dialysis(dialysis group)were detected fi)r biochemical indexes concerned and used to treat the cultured HUASMC.Alizarin red S stain was applied to examined calcium deposition in the cell layer.Calcium concentration was determined calorimetrically by the Ocresolphtha]ein complexone method,and corrected by total cell proteins.The mRNA expression of bone specific alkaline phosphatase(BAP),osteopontin(OPN)and bone morphogenelic protein 2(BMP2)was estimated by realtime PCR.OPN and BMP2 protein expression was assessed by Western blotting and fluorometry method was used to check the BAP concentration. Results Serum biochemical detection revealed thai both uremic groups had higher levels of phosphate,triglyseride,iPTH,C-reactive protein(CRP)and IL-6,and lower level of fetuin-A than healthy control(P＜0.05).Furthermore,dialysis serum had higher levels of triglyseride,CRP and IL-6 than nondialysis serum(P＜0.05).Compared with control group,both uremic scra induced more cell layer calcium deposition and higher mRNA and protein expression levels of BMP2,BAP and OPN(P＜0.05).Higher mRNA and protein expression levels of above factors were found in dialysis group as compared to nondialysis group(P＜0.05). Conclusions Uremic serum can induce HUASMC calcification and osteogenic transition in vitro,which may be one of the mechanisms involved in vascular calcification of ESRD patients.Microinflammatory state may promote the osteogenic transition and vascular calcification in dialysis patients.

OBJECTIVE: To study the expression of angiopoietin receptor Tie-2 in the renal tissue of diabetic rats and the effects of Astragalus. METHODS: SD rats were randomly divided into normal control group, diabetes group and Astragalus-treated group. The expression of receptor Tie-2 in the renal tissue was assessed by using real-time quantitative polymerase chain reaction and immunohistochemical method. RESULTS: Glomerule Tie-2 protein expression was significantly elevated in the diabetes group as compared with the normal control group (P<0.01). Glomerule Tie-2 protein expression in the Astragalus-treated group was decreased as compared with the diabetes group (P<0.01). CONCLUSION: Tie-2 may play an important role in the pathogenesis of the early stage diabetic renal injury. The reno-protection effect of Astragalus may be mediated by down-regulating the expression of Tie-2 in the kidney tissue of diabetic rats.

Objective To clarify the association between non-dipping circadian blood pressure (BP) rhythm and left ventrieular hypertrophy (LVH) in chronic kidney disease (CKD) patients. Methods A total of 257 CKD patients of stage 1 to 5 were enrolled in the study. The parameters of BP and circadian rhythm were measured by ambulatory BP monitoring (ABPM) and the cardiac structure was examined by echocardiography. The association between circadian BP rhythm and echocardiographic parameters was studied. Results The prevalence of abnormal circadian BP rhythm (non-dipping rhythm) was quite high (75.4%) in CKD patients and increased with the deterioration of renal function. Even if in the normal BP group, the prevalence of non-dipping rhythm was 71.3%. The change of cardiac structure such as LVH in non-dipping patients was more obvious than the dipping patients. The left ventrieular mass index (LVMI) was positively correlated with BP, non-dipping rhythm. Multiple regression analysis showed that 24 h-SBP (β=0.417, P<0.01), triglyceride (TG) (β=-0.132, P=O.007), Hb (β=-0.394, P=0.016) and gender(β=0.158, P=0.039) were independent risk factors of LVMI. Conclusions The prevalence of non-dipping rhythm is quite high in CKD patients and increases with the deterioration of renal function. The change of cardiac structure such as LVH is obvious in CKD patients, especially in non-dipping group. The non-dipping rhythm is related with LVMI.

Objective To clarify the role of pentraxin 3 (PTX3) in the development of peripheral arterial disease (PAD) in maintenance hemodialysis (MHD) patients. Methods One hundred and sixteen patients undergone MHD therapy in our center for more than 3 months were enrolled in the study. Clinical data were collected for analysis. Ankle-brachial index (ABI) was used to estimate the presence of PAD. Patients were divided into PAD group (ABI<0.9) and nonestimate the association of PAD with PTX3 as well as other potential risk factors. Results The incidence of PAD was 18.1% (21/116). Plasma level of PTX3 was significantly higher in PAD patients than that in non-PAD patients [(5.55 ±2.63) μg/L vs (2.32 ±1.29)μg/L, P<0.01].Univariate analysis showed ABI values were negatively correlated with plasma PTX3 levels (r =-0.548, P<0.01), high-sensitivity C-reactive protein (hsCRP), age, blood glucose and triglyceride. ROC curve of PAD revealed that area under curve (AUC) of PTX3 was 0.901 (P<0.01). With the cut-off value of PTX3 as 4.06 μg/L, the diagnostic sensitivity and specificity in PAD were 81.0% and 91.5%. ROC curve of PAD showed that AUC of hsCRP was 0.640 (P<0.05). With the cut-off value of hsCRP as 3.33 mg/L, the diagnostic sensitivity and specificity in PAD were 57.1% and 56.8%. Using Logistic regression, plasma PTX3 was found to be associated with PAD (0R=9.755, 95%CI:2.359-19.354, P=0.001). Conclusions The PAD incidence of MHD patients in our center is 18.1%. Plasma PTX3 level is significantly correlated with the presence of PAD in MHD patients. The sensitivity and specificity of PTX3 are higher than those of hsCRP for PAD diagnosis.

Objective To investigate the effect of high glucose on the expression of liver X receptors (LXRs) and ATP-binding cassette transporter A1 (ABCA1) in human macrophages (THP-1 cell line). Methods THP-1 monocytes were differentiated into macrophages by induction of phorbol 12, 13-dibutyrate (PMA). Surface markers of macrophages were identified by CD68 immunohistochemistry. The macrophages were cultured with different concentration (5.6, 11.1, 22.2 and 33.3 mmol/L) of glucose and different time (0, 0.5, 2, 6, 12, 24, 48, 72 h). Real time PCR and Western blotting methods were used to examine the mRNA and protein expression of LXRs and ABCA1. Results As compared to 5.6 mmol/L glucose, macrophage LXRβ and ABCA1 were decreased significantly at both mRNA and protein levels in dose-and time-dependent manner (P<0.05). Conclusion Hyperglycemia may play a role in the pathogenesis of arteriosclerosis through the inhibition of LXRs and ABCA1 expression in diabetic patients.

The appearance and degree of damage caused by metallic mercury injection at different sites were disparate, and different from common mercury poisoning. This study reviewed literature on poisoning caused by injection of metallic mercury in different body parts, summarized the health impairments and corresponding treatment principles. The causes of such accidents were mostly intentional injury or suicide, self-harm, with a minority due to feudal superstition, tattoos, and improper treatment. Subcutaneous or deep intramuscular injection of mercury primarily caused local inflammation reactions in the early stages. Intraocular injection might lead to inflammation, tissue necrosis, and blindness. Intravenous injection might lead to local or systemic acute reactions. The injection at local sites might cause harms to respiratory, nervous, urinary, and circulatory systems and reproductive health if individuals fail to boost mercury excretion promptly. For mercury treatment, the vacuum sealing drainage and extensive removal of deposits were preferred for mercury subcutaneous, muscular, or deep tissue injected individuals. For mercury intraocular injected individuals, the prompt surgical removal of mercury drops and, if necessary, enucleation of the eyeball were preferred. For mercury intravenous injected individuals, in addition to debridement surgery, treatment such as plasma exchange, hemoperfusion, hemodialysis, and bronchoalveolar lavage could be used. For mercury poisoning caused by injection in different body parts, mercury expulsion and symptomatic treatment are recommended, in addition to psychological therapy.

Objective To validate the effect of Renji acute kidney injury score (RAKIS) on predicting patients with acute kidney injury (AKI) after cardiac surgeries,and make comparison with Cleveland score,simplified renal index (SRI) and acute kidney injury following cardiac surgery (AKICS).Methods Patients undergoing open heart surgery from 2008/01/01 to 2010/10/31 in Renji hospital were enrolled,and their scores of those four scoring models were calculated.AKI patients were diagnosed by KDIGO,and those scores of AKI patients and non-AKI patients were compared.Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to decide the predictive values of those models.Results A total of 1126 patients were chosen in this cohort,with the average age of (58.43±14.88) years (rang from 18 to 88).The male to female ratio was 1.47:1.And 355(31.5％) patients were developed AKI.AKI stage Ⅰ,Ⅱ and Ⅲ were 65.4％,23.7％ and 11.0％ respectively.RAKIS was significantly higher in AKI patients than in non-AKI patients (17.5 vs 9.0,P ＜ 0.001).The AUCs of RAKIS to predict AKI,AKI Ⅱ-Ⅲ stages,renal replacement therapy (RRT)and in-hospital death were 0.818,0.819,0.800 and 0.784 respectively.The AUCs of Cleveland score and SRI were 0.659 to 0.710,lower than those of RAKIS and AKICS.AKICS had lower value for predicting AKI and AKI Ⅱ-Ⅲ stages (AUC 0.766 and 0.793),but good value in predicting RRT and inhospital death after surgery (AUC 0.804 and 0.835) as compared with RAKIS.Conclusions RAKIS is valid and accurate in the discrimination of KDIGO defined AKI patients,while for predicting the composite end point,AKICS may be more useful.