Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

Objective To investigate the observation and nursing for patients with atria] fibrillation (AF)after left atrial linear ablation surrounding ipeilateral pulmonary veins (PVs). Methods Thirty patients with persistent AF underwent left atrial linear ablation surrounding ipsilateral PVs guided by CARTO electroanatomic mapping system and double Lasso catheters technique. The end point of ablation was defined as absence of all PV spikes after isolation and bidirectional conduction block between left atrial and PVs. Results After a median of (245±65)days of follow-up, twenty-one patients were free of AF. Eight patients subjected recurrent atrial tachyarrhymias, including 5 typical AFL, 2 atrial taehycardia and 1 paroxysmal AF. Two patients with persistent AF remaining PV spikes in left superior PV failed to be translated to sinus rhythm. Nine patients underwent repeated ablation and 8 of them were free of atrial taehyarrhythmia after (192±92) days follow-up. Total success rate after two procedures was 92.8%. Conclusions Nurses should perform effective care according to the symptom of patients before, during and after ablation procedure and relieve the patients from pain.

ObjectiveTo investigate current status of community health management for hypertensive patients.Methods A total of 59 communities from 5 provinces of China were selected by cluster sampling methods,and 55 communities responded.The detailed health management for hypertensive patients was collected through structured interviews. Results (1) Self-management support in health education:the rates of diet control,physical exercise and medication guide were 100.0％ (55/55),96.4％(53/55) and 98.2％ (54/55),respectively,and the rates of home blood pressure monitoring,patientdoctor cooperation,and social mental guidance were 83.6％ (46/55),85.5％ (47/55) and 85.5％ (47/55),respectively.(2) Delivery system redesign:the rates of doctor training,branch cooperation,routine follow-up study and health promotion were 100.0％ ( 55/55 ),67.3％ ( 37/55 ),72.7％ (40/55) and 74.5 ％ (41/55),respectively.(3) Decision support:the rates of embedding evidence-based guidelines on daily clinical practice,expert consultation and health maintenance were 72.7％ (40/55),67.3％ (37/55)and 92.7％ (51/55),respectively.(4) Clinical information systems:the usage rates of long-term followup or monitoring system were 80.0％( 44/55 ) and 89.1％ ( 49/55 ),respectively. ( 5 ) Community resources and policies:the rates of health promotion,environment supporting and community action were 96.4％ (53/55),72.7％ (40/55) and 85.5％ (47/55),respectively.(6) Health system support:the rates of using effective evaluation indexes,senior leader supporting,continuous policy making and increased reimbursement of medical insurance in health-care organizations were 81.8％ (45/55),85.5％ (47/55),74.5％ (41/55) and 61.8％ (34/55),respectively.The rates of providing incentives,increasing staff in community,encouraging general practitioner to participate in policy making and increasing the salary of general practitioner were 58.2％ (32/55), 50.9％ ( 28/55 ), 54.5％ ( 30/55 )and34.5％ ( 19/55 ),respectively.ConclusionThe community hypertension management in some areas of China considers the principles of chronic disease models,and may play an important role in the prevention and control of high blood pressure in communities.

Adaptor Proteins, Signal Transducing ; chemistry ; metabolism ; Animals ; Apoptosis ; Cell Differentiation ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Neoplasms ; pathology ; Phosphorylation ; Protein Isoforms ; RNA-Binding Proteins ; chemistry ; metabolism ; Transcription Factors ; antagonists & inhibitors

OBJECTIVETo observe the difference of the clinical effects of different needle retention times for acute lumbar sprain treated with float needle.

METHODSOne hundred and twenty patients with acute lumbar sprain were randomly divided into a 6 h group, a 12 h group, a 24 h group and a western medication group, 30 cases in each one. In the three float needle groups, plastic hose was detained near the pressure pain point on the lumbar after subcutaneous scattering with float needle. The needle retention time was 6 h, 12 h and 24 h respectively. In the western medication group, 75 mg voltaren tablet was adopted orally every day and the treatment was given for four days. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) about low back pain were observed before and after treatment. Also, the comprehensive effect was assessed after treatment.

RESULTSAfter treatment, the VAS scores and the ODI scores were improved obviously than those before treatment in all groups (all P< 0. 05). In the three float needle groups, the VAS scores and the ODI scores were superior to those in the western medication group (all P<0. 05). The differences in VAS scores and ODI scores among the three float needle groups were not statistically significant after treatment (all P>0. 05). The effective rate in the 6 h, 12 h and 24 h group was 93. 3% (28/30), 90. 0% (27/30) and 93. 3% (28/30) respectively, which were better than 73. 3% (22/30) in the western medication group (all P<0. 05).

CONCLUSIONThe effect of float needle for acute lumbar sprain is better than voltaren, and there is no apparent difference in retention times.

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Low Back Pain ; physiopathology ; therapy ; Lumbar Vertebrae ; injuries ; physiopathology ; Male ; Middle Aged ; Needles ; Sprains and Strains ; physiopathology ; therapy ; Young Adult

0.05).SF-36 data revealed significant postoperative improvement(P0.05).Main complications included deep infection in one case,deterioration of spondylolisthesis in two cases,conjunctional stenosis in one case,and broken pedicle screws in two cases.Six patients received revision surgery.[Conclusion]Surgical treatment of DLSS may result in satisfactory outcome.Transpedicular screw fixation may not improve the clinical outcomes and posterior instrumentation should be adopted cautiously and properly.

AIM To observe the effect of aspirin on a model of Alzheimers disease in rats and its molecular mechanism. METHODS The AD pathological model was made by hippocampal CA 1 lesions with stereotaxic mini-injection of quinolinic acid;the rats learning and memory was observed by Y-maze; the apoptosis of hippocampal cells were detected by using flow cytometry and electronic microscope; the content of calcium in AD rats hippocampus was determined by atomic absortion spectrophotometer. RESULTS Aspirin was shown to improve learning and memory deficiency in rats with bilateral hippocampal lesions induced by quinolinc acid, to decrease apoptosis rate in hippocampal cells significantly and to reduce the concentration of calcium in hippocampus. CONCLUSION The protective effects of aspirin on a model of AD in rats may be involved in antagonism of calcium and inhibition of apoptosis in hippocampal cells induced by quinolinic acid.

Objective To investigate the effect of nerve grafting to enzyme histochemical changes on neurons after brachinal plexus nerve in jury in young rats. Methods Model of C5 resection was set up in 24 18-day-old SD rats. Experimental animals were divided in to two groups, one group for C5 resection, another for nerve grafting in repairing the C5 defection. At 4 weeks postoperatively, cholinesterase (CHE) and acidphosphatase (ACP) histochemical stain of neurons in C5 anterior horn and dorsal root ganglia (DRG) were detected. Results Compared with C5 resection group, bio-activity of CHE of C5 repairing group was statistically higher, and that of ACP was statistically lower. Conclusion Nerve grafting has protective effect on survival of neurons after brachial plexus nerve injury in young rats.

Objective To search for and investigate the relationship between the differently expressed gene and pulmonary thromboembolism.Methods Peripheral blood mononuclear cells were isolated from pulmonary thromboembolism patients who were diagnosed and sex,age matched healthy controls.To screen differently expressed mRNA fragment which was related to pulmonary thromboembolism.Analyze one of the new ESTs.Simultaneity and homology comparison were made.Results First,fifty-five candidate mRNA fragments were chosen.Analysis of ten candidate mRNA fragments among them(up regulation or down regulation more than 3 times)were made by using Homology search,which confirmed that g44 and g48 were new sequence and were registered to GenBank.Making g44 be probe,northern blot was used to analyze one of the new ESTs.Signal of cross was found in controls and patients with pulmonary thromboembolism.It was significantly strong in the patient group compared with the control group.Conclusion These results reveal that new fragments have a strong expression in pulmonary thromboembolism group than control group.It suggests that these two new gene fragments may play an important role in the process of pulmonary thromoembolism as pathogenic gene.

Aim To investigate the effects of curcumin on the adherence between isolated rat brain microvascular endothelial cells(BMECs)and leukocytes induced by TNF-? in vitro.Methods The adherence ofleukocytes to BMECs and the effects of curcumin were determined by myeloperoxidase.The expression of ICAM-1 was detected by RT-PCR and immunoblotting.Results Curcumin inhibited the TNF-? stimulated adherence of leukocytes to BMECs.Pretreament of curcumin also inhibited TNF-?-induced increases in the mRNA and protein levels of ICAM-1 in BMECs.Conclusions Curcumin could protect the endothelial cells against damage caused by TNF-?.The protective effects of curcumin may be mediated through downregulation of the expression of ICAM-1.