Objective To investigate the feasibility of magnetic resonance diffusion tensor imaging (DTI) as a noninvasive way for assessment of kidney transplant function in the early posttransplantation period.Method Fifty-one kidney transplant recipients less than 1 month after kidney transplantation and 26 age-matched healthy volunteers were included and examined using a fatsaturated echo-planar DTI sequence in oblique-coronal orientation at 3.0 Tesla magnetic resonance (MR) imager (diffusion directions=6,b =0,300 s/mm2).According to the estimated glomerular filtration rate (eGFR) recorded and calculated on the examined day,all subjects were divided into four groups:group 1,healthy volunteers (n =26) ; group 2,eGFR≥60 mL/min/1.73 m2 (n =24) ; group 3,30≤eGFR＜60 mL/min/1.73 m2 (n =19) ; group 4,eGFR＜30 mL/min/1.73 m2 (n =8).Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were determined separately for the cortex and the medulla.The paired Students t test was used to compare ADC and FA between cortex and medulla within each group.ADC and FA between groups were compared by using the one-way analysis of variance test.Relationship between ADC and FA with eGFR of the transplants was assessed by using Pearson correlation analysis.Result Mean cortical FA was significantly higher in group 1 than in other three groups (P＜0.01 for all),while differences among groups of allograft recipients were not significant (P＞0.05 for all).There was a gradually decreasing trend of medullary FA and ADC,and cortical ADC from group 2 to group 4,and the differences among groups were all pronounced (P＜0.05 for all).In renal allografts,there was a significant positive correlation between eGFR and medullary FA,medullary ADC as well as cortical ADC (r =0.812,0.756,0.757,respectively,P＜0.01).The cortical-medullary discrimination of FA-map and ADC-map in group 3 and group 4 apparently decreased.Meanwhile,DTI revealed that the radial diffusion tracts in the medulla of group 3 and group 4 obviously broke off and reduced,especially in group 4.Conclusion DTI is a promising way to evaluate kidney transplant function early after transplantion,and can quantitatively and visually distinguish transplants with different functions.

Objective? To explore the reasons of hypertensive patients' uncontrolled blood pressure before onset of ischemic stroke so as to provide clinical evidence for stroke prevention. Methods? The phenomenological analysis method in qualitative research was applied. From February to June 2016, 15 hypertensive ischemic stroke patients with hypertensive cerebral infarction and low medication adherence admitted to the department of neurology of three tertiary hospitals in Guangdong province were selected and participated in qualitative interviews. Results? By Colaizzi phenomenological analysis method, the medication misconception of patients were summarized into 4 themes: estimating physical condition by self-feeling, holding the opinion that there was few relation between "whether monitoring blood pressure", "forgetting medication","stopping medication because of various reasons" and cerebral infarction. Conclusions? There are some misunderstandings in the cognition of taking medicine before the onset of hypertensive cerebral infarction. It suggests that we should strengthen blood pressure monitoring and health education of drug compliance in hypertensive patients and hypertensive cerebral infarction patients, so as to improve the effect of primary prevention and secondary prevention of stroke.

Objective To analyze the status of information release and the ability to identify public needs for hypertension prevention and control information in Shanxi and Hebei areas. Methods A systematic data collection method was used to obtain various information about hypertension prevention and control published in Shanxi and Hebei provinces. Based on the Delphi method, sensitive and evaluation indicators for the tertiary prevention of hypertension were determined. To evaluate the degree to which public needs were met in the two areas, the authority, timeliness, continuity, systematicness, and credibility of identifying public needs were calculated. Results The release of information on hypertension prevention and control in Shanxi and Hebei lagged behind that in World Health Organization (WHO) for 2 and 27 years, respectively, and this was mainly carried out by research institutes, with no response from professional associations and government agencies. Information on primary and secondary prevention was first released in 1980 in Shanxi province, while primary prevention information was first released in 2005 in Hebei province. Regarding hypertension prevention and treatment, Shanxi province could meet 6.11% of the public need, and Hebei province could meet 3.57% of it. The five dimensions of authority, timeliness, continuity, systematicness, and credibility of identifying the public need were 11.34%, 25.29%, 0, 50.31%, and 0 in Shanxi province, and 6.86%, 14.54%, 0, 50.00%, and 0 in Hebei province, respectively. Conclusions The ability to identify the public need for information on hypertension prevention and control in Shanxi and Hebei provinces is relatively low. Relevant departments should take measures to enhance the two‐way communication of information and improve the public's knowledge and participation.

Objective To explore the prevalence of diabetes and hyperlipidemia in cerebral infraction patients with hypertension and look into the rates of awareness, treatment and control. Methods Blood pressure, blood glucose and blood lipids were measured in 238 cerebral infraction patients with hypertension. Meanwhile, the rate of awareness, treatment and control of hypertension, diabetes and hyperlipidemia were investigated by questionnaire. Results Among 79.41％of the patients had abnormal blood pressure and cerebral infaction on admission, the rates of awareness , treatment and control of hypertension were 74.79％, 67.23％, 20.59％. 10.11％of them never took antihypertensive drugs in spite of their awareness of hypertension. 32.35％ of the patients were combined with diabetes, the rates of awareness, treatment and control were 79.22％, 62.34％, 12.99％respectively, and among them 21.31％never tookantidiabetic drugs in spite of awareness of diabetes. 81.51％ of the patients were combined with hyperlipidemia, the rates of awareness, treatment and control were 23.20％, 6.70％, 1.55％respectively, and among them 71.11％never took lipid-lowering drugs with awareness of high blood lipid. Conclusions 79.41％ of the incidence of cerebral infraction was related to abnormal blood pressure. 32.35％cerebral infarction patients with hyperlipdemioa are complicated with hypertension diabetes;81.51％are complicated with 28.57％cerebral infraction patients with hypertension were complicated with diabetes and hyperlipidemia as well, but the rate of awareness, treatment and control were relatively low. In order to improve the secondary prevention, we should pay more attention to the stroke risk factors, and help make the individualized medicine-taking plan to improve the control rate.

Background::Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s dementia. Mitochondrial dysfunction is involved in the pathology of PD. Coiled-coil-helix-coiled-coil-helix domain-containing 2 (CHCHD2) was identified as associated with autosomal dominant PD. However, the mechanism of CHCHD2 in PD remains unclear.Methods::Short hairpin RNA (ShRNA)-mediated CHCHD2 knockdown or lentivirus-mediated CHCHD2 overexpression was performed to investigate the impact of CHCHD2 on mitochondrial morphology and function in neuronal tumor cell lines represented with human neuroblastoma (SHSY5Y) and HeLa cells. Blue-native polyacrylamide gel electrophoresis (PAGE) and two-dimensional sodium dodecyl sulfate-PAGE analysis were used to illustrate the role of CHCHD2 in mitochondrial contact site and cristae organizing system (MICOS). Co-immunoprecipitation and immunoblotting were used to address the interaction between CHCHD2 and Mic10. Serotype injection of adeno-associated vector-mediated CHCHD2 and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration were used to examine the influence of CHCHD2 in vivo.Results::We found that the overexpression of CHCHD2 can protect against methyl-4-phenylpyridinium (MPP+)-induced mitochondrial dysfunction and inhibit the loss of dopaminergic neurons in the MPTP-induced mouse model. Furthermore, we identified that CHCHD2 interacted with Mic10, and overexpression of CHCHD2 can protect against MPP +-induced MICOS impairment, while knockdown of CHCHD2 impaired the stability of MICOS. Conclusion::This study indicated that CHCHD2 could interact with Mic10 and maintain the stability of the MICOS complex, which contributes to protecting mitochondrial function in PD.

Objective:To investigate the status of core competency of newly recruited nurses in Traditional Chinese Medicine (TCM) hospitals during the standardized training period and explore its influencing factors.Methods:From March to April 2018, new recruits of nurses from various levels of TCM hospitals in 11 provinces or municipalities directly under the central government were selected to conduct a questionnaire survey, and the results of the survey were statistically analyzed.Results:728 questionnaires were actually recovered, including 723 valid questionnaires. The total score of the core competency of newly recruited nurses in the standardized training period of the TCM hospital is (160.42±37.25) . The results of single factor analysis showed that the differences in core competency scores of nurses with different educational backgrounds, graduated colleges and working stages were statistically significant ( P<0.05) . Correlation analysis showed that the scores of occupational identity of newly recruited nurses in TCM hospitals were positively correlated with the scores of core competency ( P<0.05) . Multiple linear regression analysis showed that the types of colleges, academic qualifications, working stages, and the sense of selfdetermination, self-efficacy, Sense of organizational influence, consistency in the occupational identity were the influencing factors of nurses' core competency ( P<0.05) . Conclusions:The core competency of newly recruited nurses in TCM hospitals is affected by the types of colleges, academic qualifications, working stages, and the sense of self determination, self-efficacy, sense of organizational influence, consistency in the occupational identity. Targeted measures should be taken to improve the core competency and professional identity of newly recruited nurses, so that can enhance the cohesion of the nursing team and improve the overall level of nursing.

Objective: To develop a comprehensive services system of integrated home care for the elderly based on Omaha System. Methods: The Omaha system was used to determine relevant indicators of the content of integrated home care services for the elderly, and identified through the Delphi expert consultation. Results: After two rounds of expert correspondence consultation, the effective recovery rate of the questionnaire was 100.00%, the authoritative coefficient of the experts was 0.872 and 0.851, the variation coefficient of the first and second indexes in the second round of expert correspondence consultation was 0.00 to 0.28, The mean importance ratings ranged from 3.80 to 5.00 on a 5-point scale, and the full score was 33.33% to 100.00%. Finally, four first-level indicators including physiological field, social-psychological field, health-related behavior field, environmental field and other fields were established, as well as 43 second-level indicators. Conclusions The indicators related to the services system of integrated home care services for the elderly based on Omaha system are reliable and scientific, which can provide reference basis for further understanding the needs of the elderly of integrated home care services, improving the quality of medical care and old-age care services for the elderly.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.