Objective To investigate the correlation of lacune of presumed vascular origin and microalbu-minuria in elderly inpatients. Methods 237 elderly patients (184 males and 53 females) at Guangzhou First People's Hospitalwho aged from 70 to 94 years old with a median age of 83.92 ± 5.32 were included in this study. We collected data on age,gender,medical history,smoking history,renal function test,blood lipid test,C-reactive protein,microalbuminuria,cerebral MR. Logistic regression was conducted to analyze all the data. Based on the MR findings ,the patients were divided into two groups:a group with lacune of presumed vascular origin (132 patients)and a control group(105 patients). Results The group with lacune of presumed vascular origin had higher mean systolic blood pressure than the control group. Median MAU was higher in the groupwith lacune of presumed vascular origin.Single factor or multiple factors logistic regression showed that increased systolic blood pressure and positive rates of MAU and MAU were independent risk factors for lacune of presumed vascular origin and were also significantly associated with the severity of lacune of presumed vascular origin. Conclusion Microalbuminuria is significantly associated with lacune of presumed vascular origin in elderly patients.

Objective To analyze the effect and the problems of the comprehensive application of quality management tools in order to improve nursing quality and ensure patient safety.Methods To summarize the implementation of Plan,Do,Check,Action(PDCA),quality control circle(QCC),root cause analysis(RCA),healthcare failure mode and effect analysis(HFMEA) in the nursing quality improvement.Aiming at problems arising in application process,the measures such as systematic training of quality management knowledge,case demonstration,standardized evaluation throughout the whole process,holding competition activities,inviting experts to give immediate guidance were applied.Results Among 1 798 PDCA and QCC programs,the result of 1 795 programs reached the target value,3 substandard programs reached the expected outcome finally after cause analysis,procedure break down and adjust of improvement contents.No nursing error or adverse events occurred.The indicators of nursing quality improved and patient satisfaction was 98.58％,which got the third position among all national hospitals.Conclusions The comprehensive application of four quality management tools was helpful in enhancing the effect of nursing quality improvement.

Objective To Summarize experiences in the treatment of serious injury of pancreas using damage control laparotomy. Methods Retrospectively analyze the choice of surgical method and follow-up treatments on 38 patients cured by DCL,who were in serious injury of pancreas. Results 12 cases(32%) were stanched, surgical debrided and drainage quickly,6 cases(16%) were treated with improved Cogbill operation,and 20 cases(S3% ) were treated with pancreateduodenectomy without reconstruction of enteron. After recovery in SICU, all patients were treated with deterministic operation again. Totally 4 cases(11%) died,with no relation with surgical operation,and 34 cases (89%) were cured. Pancreatic fistula occurred in 4 patients(11% ) ,all of which have been cured with conservative treatment. Conclusion Patients with serious injury of pancreas in accordance with DCL, should choose proper method and take fractionated operation,based on different places and extent of the injury of pancreas.

Objective To observe the prophylactic effects of a HSV-2gD2DNA vaccine in guinea pigs challenged with HSV-2strains.Methods Female guinea pigs were divided into3groups with10each,which was immunized intramuscularly with100?g of pc-gD plasmids(recombinant HSV-2DNA vac-cine),or with pcDNA3blank plasmids,with normal saline as control,respectively.Two booster injections were given on day7and day21.Sera were collected for virus neutralization test on day0,day28,and day56.The animals were challenged with HSV-2strain sav intravaginally,and lesions induced on the external genital skin were scored between day1and day21after challenge.Results The titer of neutralizing anti-body to HSV-2was much higher in the sera from animals immunized by pc-gD plasmids than that from ani-mals immunized by pcDNA3blank plasmids or normal saline.Furthermore,the lesion scores on external genital skin were significantly decreased in pc-gD group than those in other two groups with either primary or recurrent infections.Conclusion The constructed gD2vaccine can efficiently protect guinea pigs from genital infection and reduce recurrent infection induced by latent herpes simplex virus.

Objective To investigate the correlation between histone deacetylase 9 gene ( HDAC9 ) single nucleotide polymorphisms and ischemic stroke ( IS) subtypes. Methods A total of 202 patients with IS were enrolled prospectively. According to the Trial of Org 10172 in Acute Stroke Treatment ( TOAST) classification,the patients with IS were divided into large artery atherosclerotic stroke group (LAA,n=149) and the small-artery occlusive stroke group (SAO,n=53). A total of 201 age- and sex-matched healthy subjects over the same period were enrolled as the control group. Polymerase chain reaction-ligase detection reaction ( PCR-LDR ) was used to perform genotyping for HDAC9 gene rs11984041 and rs2107595 loci in all subjects. The correlation between genotype and IS was analyzed with multivariate logistic regression analysis. Results ( 1 ) In all the subjects detected, the genotype detected from rs11984041 loci was type CC,and 3 genotypes including CC,CT,and TT were detected from rs2107595 loci. (2) There were significant differences in dominance model (CT+TT,CC) genotypes and allele frequencies among the LAA, SAO, and control group dominance model ( CT +TT, CC ) and (χ2 =8. 635,P=0. 013, χ2 =10. 309,P=0. 006);and there were no significant differences in dominance model (CT+TT,CC) and allele frequencies among the 3 groups (after adjustment all P>0. 017). Compared with the control group,there were significant differences in the CC,CT,and TT genotypes and allele frequencies in the LAA group (χ2 =7. 446;P=0. 006). In the dominance models (CT+TT),there was significant difference in genotype frequencies between the LAA group ( 65. 1%,97/149 ) and the control group (52. 2%,105/201) (χ2 =5. 800;P=0. 016). (3) Multivariate logistic regression analysis showed that in addition to gender,hypertension,smoking,and high level of low-density lipoprotein,the dominance model CT+TT genotype was associated with the LAA type IS ( CT+TT genotype:OR,1. 909,95% CI 1. 055-3. 454,P =0. 033). Conclusion In addition to the risk factors for cerebrovascular disease such as gender,hypertension,smoking,and high level of low-density lipoprotein,HDAC9 gene polymorphisms may be associated with the LAA type IS. rs2107595 locus CT + TT genotype may be an independent risk factor for LAA type IS.

Objective The purpose of this study was to investigate the chemical constituents of Pierre. Methods The chemical compositions were isolated by silica gel column chromatography, semi-preparative HPLC,Sephadex LH-20, and MPLC packed with MCI gel, and their structures were identified on the basis of chemical and spectroscopic evidence (NMR and MS) . Results Eight compounds were obtained and determined as fibraurin (1),makisterone A (2),cycloartenol (3),feruloylphenethylamine (4),trans- -feruloyltyramine(5),β-sitosterol(6),1-monopalmitin(7),1-sinapoyl-β-D-glucopyranoside(8). Conclusion Compounds 2-8 were isolated from this plant for the first time.

Objective To observe plasma resistin levels in patients with essential hypertension (HT) of Xinjiang Kazakans and Han nationalities, and explore its association with insulin resistance (IR), blood glucose, blood lipids, blood pressure and obesity. Methods Total 127 Kazakan cases and 131 Han cases were selected as the subjects. According to their blood pressure, they were divided into HT group of Kazakans, control group of Kazakans, HT group of Hans and control group of Hans. Blood pressure, height, weight, waist circum-ference (WC) and hip were measured. Plasma resistin, fasting insulin(FINS), fasting plasma glucose (FPG), total cholesterol (TC), tri-glyceride (TG), high-density lipoprotein cholesterol ( HDL-C), low-density lipoprotein cholesterol ( LDL-C), apoprotein-A1( Apo-A1)and apoprotein-B(Apo-B) were determined. Body mass index (BMI), waist-hip ratio ( WHR), body fat percentage ( BF% )and homeostasis model assessment of insulin resistance index ( HOMA-IR) were calculated. Results Plasma resistin levels in the HT groups of Kazakans and Hans were significantly higher than those in their control groups ( P<0.01 ). There were no significant difference in the comparison of plasma resistin levels in HT groups or control groups between Kazakans and Hans ( P>0.05). Plasma resistin was posi-tively and significandy correlated with age, systolic blood pressure (SBP), WC, BMI, WHR, BF%, FlaG, FINS, HOMA-IR, TG in HT groups of Kazakans and Hans ( HT group of Kazakans, r=0.492,0.296,0.281,0.648,0.263,0.515,0.742,0.759,0.797,0.595; HT group of Hans, r=0.417,0.275,0.391,0.483,0.278,0.318,0.453,0.560,0.641,0.310; P<0.05). After the influential factors such as age, blood glucose, blood lipids and obesity were adjusted, plasma resistin level in four groups were still positively and significantly corre-lated with FINS and HOMA-IR ( HT group of Kazakans, r=0.432,0.410 ; control group of Kazakans, r=0.327,0.305 ; HT group of Hans, r=0.426,0.425 ; control group of Hans, r=0.377,0.392 ; P<0.05), but not correlated with SBP or DBP( P>0.05 ). HOMA-IR, FPG and BMI were independent factors for plasma resistin level in HT group of Kazakans, while HOMA-IR, FlaG and BF% were inde-pendent factors for plasma resistin level in HT group of Hans. Conclusion Plasma resistin level was increased in patients with HT of Kaza-karts and Hans. Close correlations between resistin and obesity, blood glucose and IR were found, and there may be indirect correlation be-tween resistin and blood pressure.

Objective To explore self-emulsifying particle size characterization methods and compare the regularity of various methods. Methods By setting the clarity level of turbidity standard solution, with two less soluble drugs-diterpene lactone compounds Chuanhuning and dihydropyridine drug nifedipine as model drugs, 10-12 clarity level prescriptions were selected from six different ternary phase diagram. Laser particle size scanner was used to determine the particle size, and UV-visible spectrophotometry to determine its absorbance. Three methods of particle size characterization rules were compared by drawing charts. Results There was a positive correlationship among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in the same phase diagram. But, there was no regularity among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in different phase diagram. Conclusion The droplet particle size of emulsion formed by prescription containing the same drugs and excipients in different proportions can be compared by clarity with visual method or absorbance with UV-visible spectrophotometer.

Objective To explore the effect of Baihe Zhimu Tang(百合知母汤,BZT) on the airway inflammation in bronchial asthma rats.Methods Forty Wistar rats were randomized into control group,asthma model group,BZT group and dexamethasone (DX) group with 10 rats in each group.The bronchial asthma rat model was built by intraperitoneal injection of 10％ ovalbumin (OVA) and ultrasonic atomizing inhalation of 2％ OVA except for the control group.Thirty minutes before every ultrasonic atomizing inhalation,the BZT group was given BZT 3.68 g/(kg · d) by gastric perfusion;the DX group was administered DX injection 1.2 mg/(kg · d) by gastric perfusion;as for the control group and asthma model group,they were given normal saline of the same volume;all groups were intervened for 14 days.After that,HE staining was used to observe the pathological changes of lung tissue,the levels of interleukin-2 (IL-2) and interleukin-4 (IL-4) were measured,and the cell cycle and calcineurin (CaN) activity were observed in separated peripheral blood lymphocytes.Results For the asthma model group,there was a lot of inflammatory cell infiltration in the bronchial wall under light microscope,the content of IL-4 in the plasma was higher than that in the control group,while the content of IL-2 decreased,the proportion of G0/G1 phase lymphocytes decreased,the proportion of S phase and G2/M increased,and the CaN activity of lymphocytes increased significantly (P ＜ 0.05).For the BZT group,there was only a small amount of inflammatory cell infiltration in the lung tissue under light microscope,the IL-4 level in the plasma was lower than that in the asthma model group,while the IL-2 content increased,the proportion of G0/G1 phase lymphocytes increased,the proportion of S phase and G2/M decreased significantly,and the CaN activity of lymphocytes decreased significantly (P ＜ 0.05).Conclusion BZT could reduce lymphocyte proliferation,decrease IL-4 level and reduce airway inflammation by reducing CaN activity in peripheral blood lymphocytes of bronchial asthma rats.

Objective To explore the inter-fraction setup errors and affecting factors from data of daily fan-beam megavoltage computed tomography(MVCT). Methods A total of 37consecutive NPC patients treated with tomotherapy were hospitalized during the period of February 2015 to September 2015. For each patient,one MVCT scan was obtained after conventional positioning ,online correction and tomotherapy delivery daily ,and the scans were put into the planning computed tomography to determine inter-fraction setup errors. The MPTV was calculated with the equation:MPTV=2.5∑+0.7σ(∑:systematic error;σ:random error). Results The average absolute errors of the inter-fraction were(2.102 ± 0.0406)mm,(1.490 ± 0.0348)mm,(1.306 ± 0.335)mm and(1.392 ± 0.0384)° at three dimensions. The total MPTV accounting for inter-error was 3.4675 mm,2.9795 mm,and 2.8885 mm. Gradual increases in both inter-fraction three-dimensional displacement were observed with time and treatment(P < 0.05). Univariate analysis revealed that weight loss and retraction of neck lymph nodes were affecting factors of set-up errors. Conclusions 3 mm margins uniformly expended from clinical target volume to planning target volume may not be suitable. The personalized margin should be adopted for the design of IMRT planning. Displacement increases as a treatment course is prolonged.