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 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 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 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 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 effects of different metastatic sites on the prognosis of extensive?stage small cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive?stage SCLC ( stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer) who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non?regional lymph node metastasis;261 had single?organ metastasis and 61 multi?organ metastases. Survival rates were calculated using the Kaplan?Meier method. Between?group comparison of the survival was made by the log?rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time ( MST) was 11. 7 months;1?and 2?year overall survival ( OS) rates were 47. 9% and 19. 5%, respectively. The patients with single?organ metastasis had significantly longer MST and significantly higher 1?and 2?year OS rates than the patients with multi?organ metastases ( 12. 4 vs. 8. 9 months;52. 5% vs. 30. 5%;21. 9% vs. 11. 2%;P=0. 014) . In the patients with single?organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8. 5 months, while those with non?regional lymph node metastasis had the best prognosis with a MST of 14. 5 months ( P= 0. 001 );there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver ( P=0. 139) . In the patients with multi?organ metastases, those with liver metastasis and bone metastasis had the worst prognosis ( P=0. 016,0. 006);there was no significant relationship between brain metastasis and the prognosis of extensive?stage SCLC with multi?organ metastases ( P=0. 995) . There was no significantdifference in the prognosis between those with liver metastasis only and multi?organ metastases ( P=0. 862) . Conclusions Liver metastasis predicts the worst prognosis in patients initially diagnosed with extensive?stage SCLC and single?organ metastasis. Liver metastasis and bone metastasis predict the worst prognosis in patients with multi?organ metastases. Brain metastasis has no significant effect on the prognosis. There is no significant difference in the prognosis of extensive?stage SCLC between patients with single?and multi?organ metastases once liver metastasis occurs.

Objective To investigate the effects of different chemoradiotherapy ( CRT) schemes on the prognosis of extensive?stage small?cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed in 322 patients with extensive?stage SCLC who were admitted to our hospital from 2011 to 2015.All patients received standard EP/CE ( etoposide+cisplatin/carboplatin) chemotherapy. According to RECIST criteria, the efficacy of chemotherapy was divided into complete response, partial response, stable disease, and progressive disease ( PD). A total of 232 patients without PD after chemotherapy were enrolled as subjects and divided into radiotherapy group (n=187) and non?radiotherapy group (n=45).The patients undergoing radiotherapy were further divided into early radiotherapy group ( before 3 cycles of chemotherapy, n=65) and late radiotherapy group (after 3 cycles of chemotherapy, n=122),or concurrent CRT group ( n=45 ) and sequential CRT group ( n=142 ) . The survival rates were analyzed using the Kaplan?Meier method. Between?group comparison was made by log?rank test. The Cox regression model was used for multivariate prognostic analysis. Results In all the patients, the median overall survival ( OS ) , progression?free survival (PFS),and local recurrence?free survival (LRFS) time was 13?2,8?7,and 14?6 months, respectively. The non?radiotherapy group had significantly shorter median OS, PFS, and LRFS time than the radiotherapy group ( 8?7 vs. 15?0 months, P=0?00;5?6 vs. 9?8 months, P=0?00;5?9 vs. 19?2 months, P=0?00).There were no significant differences in median OS, PFS, or LRFS time between the early radiotherapy group and the late radiotherapy group ( 15?4 vs. 14?6 months, P=0?720;8?0 vs. 10?8 months, P=0?426;19?2 vs. 18?1 months, P=0?981) . The concurrent CRT group had significantly longer median OS time than the sequential CRT group (19?4 vs. 13?8 months, P=0?036),while there were no significant differences in median PFS or LRFS time between the two groups ( 10?8 vs. 9?8 months, P=0?656;19?8 vs. 17?8 months, P= 0?768 ) . Generally, patients undergoing radiotherapy had increased incidence rates of adverse reactions than those without radiotherapy (P=0?038).However, the incidence rates of grade ≥3 adverse reactions were similar between the two groups ( P=0?126) . Conclusions In the treatment of extensive?stage SCLC, thoracic radiotherapy improves the treatment outcomes without increasing the incidence rates of severe adverse reactions. When to receive radiotherapy has nothing to do with the prognosis. Concurrent CRT may further improve the treatment outcomes, which still needs further studies.

Objective To explore the levels of IL-1β,IL-6 and tumor necrosis factor α (TNF α) in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage and their relationship with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).Methods The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and TNF α in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were measured with enzyme-linked immunosorbent assay (ELISA).Results The levels of IL-1β,IL-6,and TNFα in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were significantly higher than those of control group (P ＜ 0.05),but the increased time of these cytokines was different.Three cytokines in serum and the cerebrospinal fluid levels of IL-1β and IL-6 but not TNFα were significantly related to SIRS and MODS.Condusions The increased cytokine levels in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage may be related to SIRS and MODS,and the measurement of IL-1β,IL-6,and TNFαin serum,and IL-1β and IL-6 in cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage can be useful to predict and treat SIRS and MODS.