Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.

Objective: To observe the effect of acupuncture-moxibustion on the expression of insulin-like growth factor-1 (IGF-1) and suppressor of cytokine signaling-2 (SOCS2) in colonic mucosa of rat models of ulcerative colitis (UC), and explore the mechanism of acupuncture- moxibustion therapy in treating UC. Methods: The rats were randomized into a normal control (NC) group, a model control (MC) group, an herb-partitioned moxibustion (HPM) group and an electroacupuncture (EA) group, 8 in each group. The rat models of UC were established by immunological methods combined with local stimulation. The rats in the HPM and EA groups were given herb-partitioned moxibustion and electroacupuncture treatments respectively, once every day, lasting for 14 d. The morphological variations of rat's colonic mucosa were observed under light microscope; the colonic mucosal mucin was detected by PAS-AB and HID-AB staining methods; the expression of IGF-1 and SOCS2 was assayed by the immunohistochemical method. Results: In the rat models of UC, ulceration and inflammation of the colon were revealed by light microscope. The concentration of colonic mucosal mucin was reduced (P<0.01), while the expression of IGF-1 had an increase (P<0.01), and the expression of SOCS2 was reduced (P<0.01). After HPM or EA treatment, the pathological injuries of colonic mucosa had improved, the concentration of mucin increased (P<0.01), the expression of IGF-1 decreased (P<0.01), and the expression of SOCS2 increased (P<0.01). Conclusion: The secretion of mucosal mucin in rat UC decreased, the expression of IGF-1 was significantly higher, while the expression of SOCS2 was remarkably lower; both HPM and EA can help improve the damage of colonic mucosa in rat UC, and modulate the secretion of mucin, as well as regulate the expression of IGF-1 and SOCS2 in the colonic mucosa.

Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.

Objective To evaluate the effectiveness and safety of Botulinum toxin-A (BTX-A) injection into detrusor to treat neurogenic detrusor overactivity in patients with spinal cord injury (SCI).Methods A total of 78 patients with SCI were treated with transurethral injection of BTX-A (300 IU dissolved in 15 ml of saline) into 30 different points of detrusor with 15 ml in every patients. Urodynamic parameters and voiding diary were assessed at baseline and 3 weeks and 3 months after the injections. Adverse events were recorded after the injection if present.Results After the first injection, 78 patients showed that the mean frequencies of incontinence decreased from 13.5 to 2.7 times per day, the mean volume of intermittent catheterization (IC) increased from 131 ml to 389 ml per time, the mean volume of incontinence decreased from 1 690 ml to 281 ml per day, the mean getting effect time was 7.6 days. 10 patients received second injection at 8.9 months after first injection, the results showed that the mean frequencies of incontinence decreased from 9.7 to 3.7 times per day, the mean IC volume increased from 108 ml to 387 ml. 6 patients received third injection at 5.8 months after second injection, the results showed that the mean frequencies of incontinence decreased from 9.2 to 3.9 times per day, the mean IC volume increased from 116 ml to 364 ml. No side effects were observed during the follow-up.Conclusion BTX-A injection into detrusor to treat neurogenic detrusor overactivity in patients with SCI seems to be an effective, safe and miniinvasive solution.

OBJECTIVETo investigate the immunological activity of Streptomyces polysaccharide (SMP) on normal and immunosuppressed mice.

METHODSThe effect of SMP on the proliferating activity of normal mouse splenocytes was tested in the mixed lymphocyte culture, and the changes of peripheral blood T lymphocytes were evaluated with acid a-naphthyl acetate esterase (ANAE) method. The ratio of Lyt2+ and L3T4+ T cell subsets was measured by flow cytometry.

RESULTSSMP stimulated obvious proliferation of mixed lymphocytes, showed protective effects on T lymphocyte and increased the ratio of Lyt2+ and L3T4+ cell subsets to nearly normal level in immunosuppressed mice.

CONCLUSIONSSMP can regulate the immune function in mice.

Animals ; CD4-Positive T-Lymphocytes ; immunology ; Female ; Immunocompromised Host ; immunology ; Lymphocyte Culture Test, Mixed ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Polysaccharides ; immunology ; Spleen ; cytology ; Streptomyces ; chemistry ; immunology ; T-Lymphocytes ; cytology ; immunology

Objective To investigate the roles and significances of MMP-2 and MMP-9 in diffuse proliferative lupus nephritis by repeated renal biopsy.Methods Seventeen patients diagnosed by renal biopsy as WHO typeⅣlupus nephritis were analyzed by immunohistochemistry staining for MMP-2 and MMP-9. Double staining for MMP-2 and MT1-MMP,MMP-9 and CD68 were also performed.Patients had repeated renal biopsy after followed up for 2.5 years.The relationship between expressions of gelatinases and pathological activity index and clinical data were studied.Results MMP-2 immunoreactivity was detected in normal controls and was increased in diffuse proliferative lupus nephritis.MMP-9 staining,which was almost negative in normal giomeruli,was increased much more significantly in diffuse proliferative lupus nephritis. The immunoreactivity of MMP-2 and MMP-9 was positive in MT1-MMP staining and CD68-positive macrophages, respectively.The expression of MMP-2 and MMP-9 was reduced by 70% and 62% in 10 patients whose clinical condition was partially alleviated,while the expressions in 7 patients whose clinical condition was not alleviated,were only reduced by 27% and 32%.The staining for MMP-2 and MMP-9 were correlated with activity index of lupus nephritis and proteinuria.Conclusion Up-regulation of gelatinases expression in diffuse proliferate lupus nephritis is correlated to activity index of the disease.

ObjectiveTo investigate the effect of simvastatin on severe complications and prognosis of subarachnoid heamorrhage (SAH).Methods98 cases with SAH were randomly divided into the treatment groups and control group (finally, there were 32 cases in treatment group, 48 cases in control group). Patients in treatment group were given simvastatin 20 mg/day, and those in control group were treated with routine therapy. The incidences of cerebral vasospasm, hydrocephalus, rebleeding and mortality between the two groups were compared.ResultsThe incidence of hydrocephalus of treatment group was 3.13%; that of control group was 18.7%, there was a significantly difference between two groups (P<0.05). There were no significant differences for incidences of cerebral vasospasm, rebleeding and mortality between two groups (P>0.05).ConclusionSimvastatin can reduce the occurrence of hydrocephalus after SAH.

Objective To investigate the effect of Holmium laser urethrotomy under ureteroscopy on urethral stricture.Methods 30 men with urethral stricture who accepted urethrotomy with Holmium laser under ureteroscopy were observed.Results Operation was performed successfully in 21 cases;7 cases underwent 2～3 endoscopic surgical treatments.Endoscopic surgical treatment failed in 2 cases,and open surgery were performed on them.21 cases were followed up for 3～37 months,and 8 of them need urethral dilatation termly.Conclusion Endoscopic surgery with ureteroscopy and Holmium laser may be effective on urethral stricture with slight trauma.

These active components and monomes inhibit thrombosis aimed directly at activation, adhesiveness and aggregation of platelet, thus preventing and curing ischemic cardiovascular and cerebrovascular diseases. Here we summarized the effect of active components and monomes of the traditional Chinese medicine targeted platelet on ischemic cardiovascular and cerebrovascular diseases, to provide references for drug investigation and clinical application.
Alkaloids ; isolation & purification ; pharmacology ; Animals ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Flavones ; isolation & purification ; pharmacology ; Humans ; Plants, Medicinal ; chemistry ; Platelet Activation ; drug effects ; Platelet Adhesiveness ; drug effects ; Platelet Aggregation ; drug effects ; Terpenes ; isolation & purification ; pharmacology

Objective To assess clinical and urodynamic results of augmentation enterocystoplasty (AE) in patients with ncurogcnic hladdcr dysfunction (NBD).Methods Retrospectively reviewed our database between 2005-2011 to identify 77 patients who underwent AE ( sigmoid 74 patients,ileum 3 patients).Postoperativc complications,renal function,urodynamics parameters and quality of daily life were evaluated.Results The mean follow-up length was 24 months.Compared with pre-operative condition,the mean bladder capacity significantly increased from (160.6 ± 128.3) to (468.5 ± 60.6) ml (P ＜0.001 ) and the maximum detrusor pressure decreased from ( 31.1 ± 26.4) to ( 10.9 ± 4.5 ) cm H2O ( P =0.002 ).Serum creatinine level decreased from (270.3 ± 113.6 ) to ( 174.4 ± 81.3 ) μmol/(l) ( P =0.00 1 ).There were significant decrease on mean number of incontinence episodes and pads used per day ( P ＜0.01 ).Post-operative complications included metabolic acidosis in two patients (2.6％),adhesive intestinal obstruction in four patients (5.2％),deteriorating renal function in one patients ( 1.2％ ) and recurrence of vesicoureteral reflux in three patients (3.9％).Conclusions The results suggest that AE is safe and effective in treating patients with NBD.Concomitant URI is considerèd on patients with long illness history,vesicoureteral reflux at low intravesical pressures and upper urinary tract dilation.Patients with moderate and severe upper urinary tract deteriorations benefit from this procedure and the benefit can maintain a long time.