Objective To compare the effects of different methods of blood pressure management in elderly hypertensive patients in the community,so as to explore the effective model for the management of chronic diseases.Methods 302 elderly hypertensive patients in Puhuangyu community health service center were divided into two groups by random number method:(1) receiving conventional antihypertensive drugs (control group,n=152);(2) receiving antihypertensive drugs combined with blood pressure self-measurements at least twice-weekly and real-time adjusting antihypertensive management (blood pressure self-measurements group,n =150).Medication adherence,levels of blood pressure control and blood pressure-targeting rate were compared between groups one year after intervention.Results Medication adherence rate was higher in self-measurements group than in the control group [94.7％ (142 cases) vs.75.7％ (115 cases),P＜ 0.05].After intervention,systolic pressure was decreased from (168.5±37.7) mmHg to (155.3±25.2) mmHg(1 mmHg=0.133 kPa) in the control group and from (168.0±38.1)mmHg to (141.7 ±22.9) mmHg in self-measurements group (all P＜0.05).Diastolic pressure level was similar in the two groups.There was a significant difference in the blood pressure-targeting rate between groups (P ＜0.05).Conclusions Blood pressure self-measurements are more effective in controlling blood pressure and can improve the self-management ability in elderly patients with chronic diseases in the community.

Objective To investigate the clinical characteristics of children with dyspepsia diarrhea and the effect of Clostridium butyricum powder combined with changweikang granules on the treatment of the children with this diseases.MethodsFrom February 2013 to October 2015 in department of pediatrics, Tonglu County the First People's hospital, 76 cases with dyspepsia diarrhea as the research object, were randomly divided into the experimental group and the control group, 38 cases in each group.The two groups were given changweikang granules, at this basis, the observation group were given clostridium butyricum powder.3 days for a course of treatment, the two groups were treated for 2coureses continuously.ResultsBefore treatment, there were no significant differences in clinical symptom scores between the two groups.After treatment, the scores of loss of appetite, abdominal pain, diarrhea, abdominal distension and stool in the experimental group were lower than those in the control group, the difference was statistically significant (P<0.05);Before treatment, the serum motilin, gastrin and somatostatin levels in the two groups were not statistically significant.After treatment, the serum motilin and gastrin levels in the experimental group were lower than those in the control group, and the level of serum somatostatin was higher than that of the control group, the difference was statistically significant;After treatment, the total effective rate in the experimental group was 92.11% higher than that in the control group (73.68%), and the difference was statistically significant (P<0.05).ConclusionPediatric indigestion diarrhea often showed loss of appetite, abdominal pain, diarrhea, abdominal distension and stool.The effect is good which clostridium butyricum powder combined with changweikang granules on the treatment of infantile indigestion diarrhea, it is worthy of clinical application.

0. 05). Conclusions The kidney transplantation without prior dialysis offered comparable patient/graft survival to kidney transplantation with prior dialysis and avoided the dialysis complications and sensitization of transfusion, while reduced the risk of acute rejection. Therefore, uremic patients may be considered to receive the kidney transplantation without prior dialysis in clinic.

Objective To investigate the effect of seretide plus montelukast on clinical symptoms、pulmonary functions and the serum IL-6 and TNF-α of patients with asthma.Methods 73 cases patients with asthma were randomly divided into seretide group and seretide plus montelukast group and were treated respectively for two weeks.The clinical symptoms,lung functions and serum IL-6,TNF-α contents of patients were measured respectively before treatment and after two weeks treatment.Results After two weeks treatment,the clinical symptom scores、FEV1.0、FVC and PEFR of two groups had significantly changed than that before treatment(P<0.05);Each index was further compared after treatment,and it was found that two groups had significant differernces statistically (P<0.05),these showed that combination of seretide and montelukast could significantly enhance the therapeutic effect.After treatment,the TNF-α and IL-6 contents in the peripheral blood of seretide group and seretide plus montelukast group had both significantly reducted (P<0.05 or P<0.01);The TNF-α and IL-6 contents of seretide plus montelukast group had reduced more significantly than that of the seretide group(P<0.05).Conclusion The seretide plus montelukast group could improve the clinical symptoms and pulmonary function of patients with asthma,and the action mechanism might be related to lower the serum IL-6 and TNF-α contents.

Objective To find out the methods for the reconstruction of digestive tract following subtotal gastrectomy. Methods The clinical data of 17 patients with carcinoma of gastric fundus and cardia carcinoma undergoing transabdominal pylorus preserving subtotal gastrectomy for the reconstruction of digestive tract with interposition of jejunum from March 1999 to July 2002 were analyzed retrospectively. Results No death, no stoma fistula, nor constriction were found after operation. All patients were discharged after recovery. Half a year later, patients could eat food of about 200-300 g at each meal (3 or 4 times a day). No burning pain in the postbreast bone, phenomenon of bile reflux, empty disorder, nor dumping syndrome were found after meal. No anemia was found in all patients, and their body weight restored to the preoperative normal level. Conclusion The pylorus reserving transabdominal subtotal gastrectomy for the reconstruction digestive tract with interposition of jejunum can result in satisfactory surgical outcomes if the indications are strictly controlled.

Objective To investigate the pathogenesis,diagnosis and therapy of intranasal contact point headache.Method The clinical data of 73 patients with contact point headache between the septum and the lateral nasal wall were retrospectively reviewed and the anatomical abnormality of nasal carity was determined by CT scanning of the sinuses and endoscopy.All the patients underwent surgical intervention for correcting the abnormal anatomical conditions of nasal cavity.Results The headache disappeared in 67 of the 73 patients after topical anesthesia,and in the 6 remainders after maxillary sinus puncture.Among the anatomic variations in all the cases,endoscopy revealed that 31 sides there was hypertrophy of ethmoidal bulla,hypertrophy and medial deriation of processus uncinatus in 59 cases,abnormality of middle turbinate in 91 sides,and upper nasal septal deviation in 51 cases.Among the 73 cases,there was confact of two or mose sites of mucosa of the abnormalities in 57 cases.The headache disappeared in 64 patients(87.7%) one week after operation,and it was reduced in 9 cases(12.3%).12-month follow-up showed recovery in 59 cases(80.8%),in 12 cases(16.4%) it was partially relieved,and in 2 cases(2.7%) there was no effect.Conclusions Abnormal nasal septa,enlarged turbinates and other anatomic abnormalities are the most common findings in contact point headache.Pressure due to mucosal contact between the septum and lateral nasal wall mucosa,and maxillary sinus orifice occlusion are the major causes of contact point headaches.Endoscopy,CT scanning,and topical anesthesia are ideal in diagnosis of intranasal contact point headache.

Objective To investigate the reconstruction procedures of digestive tract following total gastrectomy.Methods The clinical data of pylorus ring preserving and jejunum interposition for the reconstruction of digestive tract following total gastrectomy in 17 cases of fundus and/or cardia carcinoma in past 3 years in our hospital were reviewed. Results There was no operative death,and no stomach fistula or constriction occurred in this series.All the 17 patients were discharged with recovery. Half a year after the operation, all the patients can eat about 200-300g each time, and 3-4 times a day. Patients′ subject feeling was good; no retrosternal burning pain occurred after meal; no symptoms of bile reflux or empty disorder happened. Conclusions The reconstruction of digestive tract following total gastrectomy using pylorus ring preservation and jejunum interposition should be effective if strict indications are adopted.

Objective To investigate the effect of berberine anti macrophages apoptosis, initially to determine the concentration of anti-apoptosis and to explore its mechanisms of treatment in atherosclerosis (AS). Methods Apoptosis of RAW264.7 macrophages is induced by 0.5 μmol/L Tg and 50 μg/ml Fuc. The cell survival rate and apoptosis rate was detected by MIT and flow cytometry, respectively. Results There was statistical significance between the berberine group of 800 μg/ml and normal group in the cell sur-vival rate(P<0.01). With the decline in concentration of berberine, the cell apoptosis rate showed a down-ward trend, berberine (0.02-0.63 μg/ml) effectively inhibited the cell apoptosis induced by Tg and Fuc. Conclusion Berberine group has little impact on the cell proliferation. Berberine can effectively inhibit the cell apoptosis induced by Tg and Fuc.

BACKGROUND: It is a hot investigation to many scholars that how to cure and prevent renal ischemic reperfusion injury in a utility way, but the mechanism is unclear at present. The investigation indicates that aquaporiin-1 plays an important role during this process. OBJECTIVE: To research the correlation between aquaporin-1 expression and renal function change following renal ischemic reperfusion injury. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at Histology and Embryology Laboratory of Dalian Medical University from June 2007 to December 2008. MATERIALS: A total of 80 healthy female adult Wister rats were randomly divided into control group and ischemia-reperfusion group. Rats in each group were observed at days 1, 2, 3, 5, and 7 after operation, with 8 rats for each group. The ischemia-reperfusion injury was established on the left kidney. METHODS: Right kidney was removed. The left renal pedicle was freed and occlused to establish ischemia-reperfusion injury model. After 40 minutes, the blood was re-flowed. If the kidney colored from dark red to bright red within 2-5 minutes, the ischemia-reperfusion injury models were successfully established, and the thrombus was not formed in the kidney vessels. If the kidney was still dark red after 5 minutes, the thrombus was formed, and the rats were excluded from the ischemia-reperfusion group. The abdomen was sutured after 40 minutes.MAIN OUTCOME MEASURES: Rats were sacrificed at days 1, 2, 3, 5, and 7 after ischemia-reperfusion injury. Samples of urine, serum, and kidney were performed with the examinations of urine, renal function, renal pathology and morphology, immunohistological assay of aquaporiin-1, and RT-PCR assay. RESULTS: After ischemia-reperfusion injury, the rats had hydrouria, urine osmotic pressure depress, symptoms of carnine and urea nitrogen increasing. HE staining demonstrated that renal tubular epithelial cells were swelling, necrosis, and desquamate. Aquaporin-1 expression and its mRNA level was decreased; in particular, the expression and level were the lowest at day 1 after ischemia-reperfusion injury and recovered to normal value at day 5 after ischemia-reperfusion injury. CONCLUNSION: The down expression of aquaporin-1 maybe one of the important indicators to reflect renal functional changes of acute renal failure following renal ischemia-reperfusion injury.

Objective To evaluate the role of endorectal ultrasonography with coupling gel intrarectal filling in preoperative T stage of rectal cancer. Methods One hundred and fifteen patients with rectal cancer underwent endorectal ultrasonography with coupling gel intrarectal filling. The preoperative T stage according to ultrasonic manifestations was compared with histological findings. Results The total diagnostic accordance rate of preoperative T stage by endorectal ultrasonography with coupling gel intrarectal filling was 89.57%. The sensitivity of ultrasonography for T1, T2, T3 and T4 was 93.10%, 61.11%, 96.61%, 88.89%, while the specificity was 97.67%, 96.91%, 89.29%, 99.06%, respectively. The overstaging rate of ultrasonography was 6.96% (8/115), and the understaging rate was 3.48% (4/115). Conclusion Endorectal ultrasonography with coupling gel intrarectal filling is a valuable diagnostic method for T stage of rectal cancer.