Dyslipidemia is a well-established risk factor for atherosclerosis. Treating dyslipidemia in elderly patients requires specific knowledge and understanding of common dyslipidemias and the relative safety of various pharmacologic agents in the presence of possible multiple comorbidities. Lifestyle modification remains the first step in the treatment of dyslipidemia; however, it can be difficult to sustain and achieve acceptable compliance in the elderly and it is best used in combination with drug therapy. Statins are widely accepted as the first-line therapy. Several recent studies have demonstrated that statins are safe and effective in the elderly. However, it is important to note that there is very limited data regarding the effects of dyslipidemia treatment on morbidity and mortality in patients over 85 years of age. In summary, the clinicians must recognize that the presence of dyslipidemia in the elderly poses substantial risk of coronary events and stroke. The available evidence has demonstrated that in most elderly patients who are at increased risk for cardiovascular morbidity and mortality, treatment of dyslipidemia with appropriate therapy reduces the risk, and when used carefully with close monitoring for safety, the treatment is generally well tolerated. With increasing life expectancy, it is critical for physicians to recognize the importance of detection and treatment of dyslipidemia in the elderly.

Objective We aimed to discuss the influence of establishment of a hospital which makes people satisfied on nursing management. Methods We improved our nursing work by establishing quality-control groups, training staff, checking once a week and making feedback once a month through decomposing and subdividing the standard of building a hospital which makes people satisfied from March 2002 to December 2006. Results The qualified rate of nursing management increased from 69.3% to 97.6% every year, which has statistical difference (P<0.01). Conclusions Establishment of a hospital which makes people satisfied improved the general level of nursing management quality and nursing staff. We acquired good social and economic befenit.

Anti-Inflammatory Agents ; pharmacology ; Brain ; drug effects ; metabolism ; Humans ; NF-kappa B ; metabolism ; Neurons ; drug effects ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; alpha-MSH ; pharmacology

As a kind of nervous system disease,migraine is more common in female,and has the clinical characteristics of repeated attacks,it is of great significance with standardized treatment in the control of the attacks.Yong female patients with migraine during pregnancy and lactation stage will face lots of special problems because they must first consider the impact of treatment on the mother and fetus.Generally,non-drug therapy is recommended as a first-line treatment,if it is not sufficiently effective,paracetamol is recommended during the pregnancy or sporadic use of sumatriptan,NSAIDs is not recommended during the first or third trimester of pregnancy.Preventive therapy should only be considered in the most severe cases.This review summarized recent documents of the safety of the most used antimigraine medications during pregnancy and breastfeeding,in order to provide treatment recommendations in clinical practice.

AIM:To investigate the distribution of protein Z intron FG79A polymorphisms in Chinese and the associations with coronary artery disease(CAD).METHODS:148 patients were performed selected coronary angiography and more than one major coronary vessel with at least 50% stenosis was defined as CAD.The control group consisted of 147 subjects.The protein Z intron FG79A polymorphisms were studied by polymerase chain reaction and restriction fragment length polymorphism and parts of PCR products were sequenced.RESULTS:Protein Z intron FG79A polymorphisms were first recovered in Chinese,and the frequencies of G and A alleles were 44.24% and 55.76%,respectively.The frequencies of two alleles were not significantly different between patients and controls.There was no significant difference in protein Z intron FG79A genotype distribution among patients with one,two or three stenosed vessels.No significant difference was found among the frequencies of the three genotypes between both acute coronary syndrome(ACS)and non-ACS.CONCLUSION:Protein Z intron FG79A polymorphisms are present in Chinese.Protein Z intron FG79A polymorphisms were not associated with CAD and ACS.

OBJECTIVE:To evaluate evidence foundation of phamracogenetics personalized medication,and to provide refer-ence for clinical application. METHODS:Using“phamracogenetics”“pharmacogenomics”and“gene polymorphism”as key words,related literatures and clinical guideline were retrieved from PubMed,CNKI,Wanfang database,and analyzed in respects of involved gene,site and drug types,etc. Evidences of package inserts of phamracogenetics biomarker were evaluated by using phamracogenetics practice and prevention evaluation guideline. RESULTS:8 276 papers,25 guidelines and 166 drug package in-serts are available for analysis. The phamracogenetics literatures mostly focus on the relationship between some one gene and differ-ent drugs. In guidelines,some one specific gene can guide clinical application of multiple drugs in different fields. In drug package inserts,general level of clinical evidence is not high;detectable biomarkers is inadequate in category,and detection rate is only 38.06% besides targeting preparation. CONCLUSIONS:Under the condition of low clinical evidence level the detection of pharma-cogenetics biomarker should be conducted carefully,and basic study should be further strengthened.

Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; Diagnostic Imaging ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; Middle Aged ; Retrospective Studies

Two isomers of nitrochlorobenzene (o-, and p-NCB) were treated by a Pd/Fe catalyst in aqueous solutions through catalytic amination and dechlorination. Nitrochlorobenzenes are rapidly converted to form chloroanilines (CAN) first through an amination process, and then rapidly dechlorinated to become aniline (AN) and Cl(-), without the involvement of any other intermediate reaction products. The amination and dechlorination reaction are believed to take place predominantly on the surface site of the Pd/Fe catalysts. The dechlorination rate of the reductive degradation of the two isomers of nitrochlorobenzene (o-, and p-NCB) in the presence of Pd/Fe as a catalyst was measured experimentally. In all cases, the reaction rate constants were found to increase with the decrease in the Gibbs free energy (correlation with the activation energy) of NCBs formation; the activation energy of each dechlorination reaction was measured to be 95.83 and 77.05 kJ/mol, respectively for o- and p-NCB. The results demonstrated that p-NCBs were reduced more easily than o-NCBs.
Catalysis ; Industrial Waste ; prevention & control ; Iron ; chemistry ; Isomerism ; Kinetics ; Metals ; chemistry ; Nitrobenzenes ; chemistry ; Palladium ; chemistry ; Structure-Activity Relationship ; Waste Disposal, Fluid ; methods ; Water ; chemistry ; Water Purification ; methods

Objective To investigate the clinical significance of fiberoptic ductoscopy-guided intraductal biopsy in diagnosing nipple discharge.Methods From May 2006 to April 2007,screening fiberoptic ductoscopy was performed for intraductal papillary lesions in 53 ducts among 51 patients.Fiberoptic ductoscopy-guided intraductal biopsy was carried out followed by open microdochectomy. Results Except for a failure in 5 ducts,biopsy found papilloma in 29 cases,ductal hyperplasia in 15 cases,severe ductal hyperplasia in 2 and carcinoma in 2.Microdochectomy revealed 43 benign diseases (12 solitary intraductal papillomas,12 multiple intraductal papillomas,and 25 ductal hyperplasia)and 4 malignancies (3 ductal carcinoma in situ,1 invasive ductal carcinoma).Surgeries performed for the 5 ducts failing a biopsy attempt revealed papilloma in one and adenosis in 4.Compared with conventional microdochectomy,fiberoptic ductoscopy-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma(40.7% vs. 92.6%,P＜0.05).It might also underestimate multiple intraductal papilloma and breast cancer. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive,safe,convenient with a high success rate,and could be as a routine procedure after intraductal lesion found by screening fiberoptic ductoscopy.

Objective To describe and analyze the misdiagnosis and mistreatment status of pulmonary alveolar proteinosis (PAP), especially cases with combination of severe infection. Method The misdiagnosis and mistreatment of 84 PAP patients and 6 cases with combination of severe infection before admitting to PUMCH was analyzed retrospectively. Results 66.7%(56/84) had experienced misdiagnosis before admission. 32.1% (27/84) were misdiagnosed with idiopathic interstitial pneumonia (IIP) and 14.3% (12/84) with pulmonary tuberculosis. 88.1%(74/84) had received anti-infection treatment, 33.3%(28/84) received eortieosteroids, and 19.0%(16/84) received anti-tuberculosis treatment. The percentage of the pa-tients who had taken the bronchoscopic examination outside the PUMCH was 53.6%(45/84). The PAP pa-tients diagnosis was established through bronchoscopic examination (including BAL and TBLB) in 86.9% (73/84) patients. There were 6 patients who had severe infection when PAP established. All of these 6 cases had been misdiagnosed with IIP and received corticosteroids treatment, 2 of whom died. Conclusions The misdiagnosis and mistreatment happens commonly in PAP patients. The misuse of corticosteroids makes some PAP cases get the severe infection. The image feature and the examination of bronchoscopy, BAL and TBLB are the key point in avoiding misdiagnosis. The administration of corticosteroids in uncertain patients should be avoided.