Objective: To understand and solve the problems in health education in intravenous infusion among elderly patients with cardiovascular disease.Methods: An investigation was conducted with a self-designed questionnaire among 127 elderly cardiovascular disease patients receiving intravenous infusion,with the purpose of finding out specific problems concerning the education so as to adopt effective countermeasures.Results: Among the patients investigated,88.9% considered the contents of the health education to be too simple,50% thought of the nurses as lacking in initiative,19.8% deemed the nurses short of expertise,and 41.3% thought that supervision had to be emphasized in the management of health education.Conclusion: Systematic,comprehensive and scientific health education in intravenous infusion plays an important role in ensuring the safety and improving the satisfaction rate of intravenous infusion among elderly patients with cardiovascular disease.

Objective To determine the appropriate concentration of ropivacaine for differential sensory and motor block of brachial plexus.Methods Ninety ASA Ⅰ - Ⅲ patients aged 16-75 yr weighing 40-85 kg undergoing upper extremity operation under axillary brachial plexus block were randomly divided into 3 groups according to the concentration of ropivacaine used for the block(n = 30 each): group A 0.15% ropivacaine;group B 0.10% ropivacaine and group C 0.05% ropivacaine.Axillary brachial plexus block was performed using ultrasound guidance and electric nerve stimulation.Sensory and motor block were assessed and recorded at 10,30,60and 240 min after local anesthetic injection(T1-4).The rate of adequate sensory block,the rate of differential sensory and motor block(the areas innervated by radial,median and ulnar nerves were numb but the patients could still move their elbow,wrist and fingers)and effectiveness of the block(excellent - completely no pain;good slight pain,iv fentanyl was needed;poor -rescue brachial plexus block was needed or general anesthesia was induced).Operation time and duration of analgesia and success rate of the block were recorded.Results 0.15%ropivacaine produced excellent or good block and no failure in group A.The rate of differential sensory and motor block was significantly higher in group B(0.10% ropivacaine)than in group A.The effect of block with 0.05% ropivacaine was unsatisfactory in group C.Conclusion Axillary brachial plexus block with 0.10% ropivacaine can induce differential sensory and motor block in the majority of patients.

Objective To evaluate the clinical efficacy and effect of benazepril treat with diabetic nephropathy on Plasma NO and ET-1. Methods 100 cases of DN patients were divided into two groups by random number table (50cases), group A with basic treatment, group B increased benazepril. Selected another 50 cases of simple diabetic patients as control group, observed the plasma NO (nitric oxide) and ET-1 (ET-1) levels changes of three groups,and compared the clinical efficacy. Results The levels of NO, ET-1 and Ang II in A group and B group were significantly lower than those in control group (P<0.05); the level of NO in B group was higher than that in group A, and the level of ET-1 and Ang II was lower than that of group A(P<0.05). The total effective rate of B group was 86.00％, which was significantly higher than that of control group 58.00％(P<0.05). Conclusion The clinical application benazepril treat with DN can effectively regulated plasma NO and ET-1 levels, protect the kidneys, and improve the therapeutic effect.

Objective To investigate the effect of the gene polymorphism of cholesterol ester transfer protein (CETP) on the serum lipid levels in renal transplant patients.Methods Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL),high density lipoprotein cholesterol (HDLC),apolipoproteins (Apo A1,B,E) and lipoprotein(a) [Lp(a)] were measured. Polymerase chain reaction-restriction fragment length polymophism (PCR-RFLP) was used to detect CETP gene polymorphism in renal transplant recipients.Results Serum levels of TC,TG,HDLC,LDLC,ApoB,ApoE in the renal transplant recipients were increased significantly after transplantation. The allele frequency and the distribution of the TaqⅠ(intron 1) and MSPⅠ(intron 8) genotypes showed no significant difference between the controls and the renal transplant recipients. The serum TG level was significantly higher in renal transplant recipients with the genotype TaqⅠB1/B1 than those in the patients with genotype TaqⅠ B1/B2 and B2/B2. But there was no statistical difference among the serum lipid levels in renal transplant recipients with different MSPⅠgenotypes.Conclusion The serum lipid levels were increased significantly in transplant after transplantation,and the patients with CETP genotype TaqⅠB1/B1 liable to develop hypertrglyceridemia.

Objective:To explore the diagnostic value of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/MR multiparameter multimodal functional imaging in the diagnosis of naive prostate cancer (PCa), and to analyze its efficacy in the early stages of PCa. Methods:From July to September 2019, 45 suspected or pathologically confirmed PCa patients (average age: 69 years) who met the inclusion criteria were collected to perform 68Ga-PSMA-11 PET/MR examination in Nanjing First Hospital. After the scanning was completed, the method of region of interest (ROI) was used to semi-quantitatively calculate the tumor radioactive uptake in the fusion image, including the maximum standardized uptake value (SUV max), tumor metabolic volume (MTV) and mean standardized uptake value (SUV mean), and PSMA expression load was calculated(SUV mean×MTV). Apparent diffusion coefficient (ADC) values of ROI were measured in ADC images ( b=1 500 s/mm 2). The efficacy of 68Ga-PSMA-11 PET/MR in the preoperative diagnosis of PCa and the effect on clinical staging were evaluated with the pathological results. The correlation between prostate specific antigen (PSA) and radiation uptake in PCa tissues, PSMA expression load and ADC values was analyzed by Pearson correlation. Independent-sample t test was used to analyze the data. Results:Pathologically, 38 of the 45 patients were with PCa and 7 patients had benign prostatic hypertrophy (BPH), and metastasis occurred in 12 of the 38 PCa patients. 68Ga-PSMA-11 PET/MR detected 39 cases of PCa with one of which was false-positive. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 68Ga-PSMA-11 PET/MR were 100%(38/38), 6/7, 97.4%(38/39), 6/6 and 97.8%(44/45), respectively. The tumor tissues of PCa often showed focal radioactive uptake, and the T 2 weighted imaging (WI) showed focal low signal and limited dispersion. BPH showed slightly uneven uptake, and T 2WI and diffusion weighted imaging (DWI) showed uneven diffuse signals. SUV max of PCa was significantly higher than that of BPH (24.66±19.21 vs 4.97±2.13; t=5.208, P<0.001). ADC values of PCa were significantly lower than that of BPH ((0.91±0.37)×10 -3vs (1.08±0.24)×10 -3 mm/s 2; t=2.816, P<0.05). SUV max and the expression loads of PSMA in PCa were positively correlated with PSA ( r values: 0.42 and 0.71, both P<0.05). ADC values of tumor tissues in PCa were negatively correlated with PSA ( r=-0.37, P=0.013). Conclusion:68Ga-PSMA-11 PET/MR has great merits in the early diagnosis and staging of PCa.

Objective To investigate the effects of pioglitazone on osteoblast proliferation and apoptosis.Methods MC3T3-E1 mouse osteoblastic cells were treated with 0, 5, 10, 20, 30, and 40 μmol/L pioglitazone for 24 h. Cell viability was measured by MTT, cell cycle and apoptosis were inspected with flow cytometry, the expressions of Bcl-2 and Bax proteins were examined via immuno-chemical staining. Results Survival of osteoblasts decreased in a dose-dependent manner. Compared with the control group, the cells in the G0/G1 and G2/M stages increased, while the cells in S stage decreased significantly. The percentage of apoptosis at 5 and 10 μmol/L were lower than that of the control group(P ＜ 0.05), While it was increased significantly at 30 and 40 μmol/L(P ＜0.01). Bax expression was attenuated at 10 μmol/L(P＜0. 01), returned to normal by 20 μmol/L, and was increased by 30 and 40 μmol/L(P ＜ 0. 01). Bcl-2 expression was enhanced at the dose ≤ 20 μmol/L(P ＜0.01). Positive correlation was found between the death rate and the expression intensity of Bax/Bcl-2(n = 15, r=0.796, P＜0.01). Conclusions Pioglitazone inhibits apoptosis of osteoblasts at low concentrations and protects the cells, but promotes their apoptosis at higher concentration, Bax/Bcl-2 may play an important role in mediating the piglitazone-induced apoptosis of osteoblasts. It inhibits DNA synthesis and cell proliferation.

Objective To compare changes in dental arch and soft and hard tissue produced by the Damon Q self-ligating bracket and 3M metal bracket with non-extraction treatment in maxillary mild-to-moderate crowding cases. Meth-ods Eighty seven patients were selected in our study, who were assigned to 4 groups by the crowding degree of maxillary and appliance type:ⅠandⅡcrowding degree using Damon Q self-ligating bracket groups (41 cases);ⅠandⅡcrowding de-gree 3M metal bracket groups (46 cases). We measured lateral cephalometric radiographs and dental casts at both beginning and end of treatment. Paired t-tests and group t-tests were used in statistical analysis to compare the alteration in dental arch and soft and hard tissue. Results There was significant increase in width and length of maxillary dental arch by non-extraction treatment withⅠandⅡcrowding degree maxillary, but the results of both groups were not of statistical difference. To compare hard and soft tissue in two groups withⅡcrowding degree maxillary, the reduction of nasolabial angle, angle of inclination of upper lip, angle of upper lip and lower lip had obvious statistical significance and it is more prominent in self-ligating bracket group than in conventional bracket group. Conclusion Using non-extraction treatment, when maxillary crowding is moderate, ,Damon Q self-ligation bracket group result in more prominent changes of upper lip protrusion than 3M bracket with more marked crowding . Therefore, clinical doctors should pay more attention to choose bracket and treat-ment system for patients with marked crowding of maxillary dentition.

Objective To observe the effect of midazolam plus propofol administered for colonoscopy on cognitive function in middle-aged and aged patients. Methods One hundred and thirty six patients, ASA I and II, aged 40~75 years and undergoing colonoscopy were randomized to propofol group (group P, n=68) and propofol plus midazolam group (group PM, n=68). Baseline cognitive function was measured using Mini mental state exami-nation (MMSE) before anesthesia and the cognitive testing was repeated 10 minutes after emerging from anesthesia. BP, HR, SpO2, analgesic effect and sedative drug doses in both groups were recorded. Procedure time, recovery time and Rasmay sedation score were both recorded. Results Recovery time was significantly longer in group PM than that in group P (P<0.05). The total dose of propofol was significantly smaller in group PM than that in group P (P<0.05). MMSE score of both groups decreased, but the incidence of cognitive decline and the level of cognition in group PM were more notable than those of group P (P<0.05). Conclusions Midazolam plus propofol and propo-fol alone administered for colonoscopy could both increase the incidence of cognitive decline, and the effect of the former is more notable, but midazolam added to propofol could reduce the dosage of propofol.

OBJECTIVE To investigate the effect of jujuboside A on glomerular cell apoptosis in diabetic rats, and to explore the possible mechanisms. METHODS SD rats were administered with streptozotocin 100 mg · kg-1 to estabilish the diabetic model. Diabetic SD rats received jujuboside A 10 and 20 mg · kg-1 daily for 4 weeks by lavage administration, respectively. The level of glycosylated hemoglobin (GHb) in the blood of each group was measured by fructosamine method. The morphological changes in glomerular cells were observed by PAS staining. Glomerular cell apoptosis was determined by TUNEL staining. The protein expression of Bcl-2 and Bax was detected by immunohistochemistry. The protein expression of cleaved caspase 9 and cleaved caspase 3 was detected by Western blotting. Trans?forming growth factor β1 (TGF-β1) mRNA expression was analyzed by qPCR. RESULTS Compared with model group, jujuboside A 10 and 20 mg·kg-1 treatment significantly reduced the level of GHb in blood (mmol · L- 1: 10.9 ± 0.8 vs 17.5 ± 1.5, P<0.05; 7.6 ± 0.5 vs 17.5 ± 1.5, P<0.05), PAS positive score of glomerular cells (26.8 ± 3.2 vs 36.4 ± 3.8, P<0.05; 18.4 ± 2.1 vs 36.4 ± 3.8, P<0.05) and the apoptosis of glomerular cells〔(8.2±0.8)%vs (17.6±1.8)%, P<0.05;(5.1±0.5)%vs (17.6±1.8)%, P<0.05〕. Moreover, Bcl-2 protein expression in kidney tissues was elevated (P<0.05), whereas Bax (P<0.05), cleaved caspase 9 (P<0.05) and cleaved caspase 3 (P<0.05) protein expression and TGF-β1 mRNA (P<0.05) expression were reduced after jujuboside A administration. CONCLUSION Jujuboside A can prevent glomerular cell apoptosis in diabetic rats, which may be associated with the regulation of mitochondrial apoptotic pathways and TGF-β1 expression.

0.05),that there was negative expression of PP2Ac protein in the cytoplasm of the human lung squamous carcer and small cell lung cancer while positive expression of PP2Ac protein in intercellular substance,and that there were negtive expression of PP2A in human lung adencarcinoma and overexpression of p-AKT protein in human lung adencarcinoma.Western blot technique analysis showed that there was nomal expression of PP2A protein in normal human lung tissue,and lower expression in YTLMC-90 cell than in nomal human lung tissue.While sharp low expression GLC-82 cell.Adding okadaic acid(OA),an inhibitor of PP2A,the expressiong of p-AKT in GLC-82 cells was sharply higher than in normal lung tissue at 6 h,12 h and 24 h,indicating that inverse correlation between PP2A and p-AKT protein expression.Conclusions PP2A is involved in human lung carcinomar,its expression level is related to histological type of human lung carcer.Activition of AKT(p-AKT)is related tightly to human lung carcer.