Objective To investigate the effect of ear massage on blood pressure and sleep quality of hypertensive patients . Methods Two hundred and ninety-eight elderly hypertensive patients were nursed on the basis of conventional therapy. One hundred and forty-eight patients randomly selected were set as the experiment group, where they were given intervention of ear massage. Another one hundred and fifty patients were set as the control group and treated with conventional interventions. The two groups were compared in terms of blood pressure (systolic and diastolic blood pressure) after nursing interventions and the sleep quality (by Pittsburgh sleep quality index, PSQI). Result After intervention, the diastolic and systolic blood pressure values in the experiment group were both significantly decreased than before intervention (P<0.05) and the quality of sleep was significantly lower than that before intervention (P<0.05). Conclusion Ear massage can be effective in regulating blood pressure in elderly hypertensive patients and improving their quality of sleep.

AIM:To investigate the effects of progranulin (PGRN) on the proliferation, apoptosis and inflammatory responses in lipopolysaccharide (LPS)-induced human alveolar epithelial A549 cells and HPAEpiC cells.METHODS:The cells were divided into 4 groups:control group (the normal cultured cells), LPS group [the cells were treated with LPS (10 mg/L)], PGRN+LPS group (the cells were transfected with pcDNA3.1-PGRN plasmids and then treated with LPS), and pcDNA3.1+LPS group (the cells were transfected with pcDNA3.1-EGFP plasmids and then treated with LPS).The cell viability was measured by MTT assay, cell proliferation was measured by BrdU incorporation assay, and cell apoptosis was analyzed by flow cytometry.The expression of PGRN at mRNA and protein levels was detected by RT-qPCR and Western blot.The protein levels of caspase-3, Bcl-2, Bax, IL-1β, IL-6, TNF-α, p65 and p-IκB-α were determined by Western blot.RESULTS:Compared with control group, the cell proliferation rate was decreased (P<0.05), and the apoptotic rate was increased (P<0.05) in LPS group.The protein levels of caspase-3 and Bax were significantly up-regulated (P<0.05), and the expression of Bcl-2 was down-regulated (P<0.05).The protein levels of IL-1β, IL-6 and TNF-α were significantly up-regulated (P<0.05), and the protein levels of p65 and p-IκB-α were enhanced (P<0.05).Compared with LPS group, the cell proliferation rate was increased (P<0.05), and the apoptotic rate was decreased (P<0.05) in PGRN+LPS group.The protein levels of caspase-3 and Bax were significantly down-regulated (P<0.05), and the expression of Bcl-2 was up-regulated (P<0.05).The protein levels of IL-1β, IL-6 and TNF-α were significantly down-regulated (P<0.05), and the protein levels of p65 and p-IκB-α were decreased (P<0.05).CONCLUSION:PGRN over-expression may alleviate LPS-induced abnormal proliferation, apoptosis and inflammatory cytokine production in the A549 cells and HPAEpiC cells, which may be associated with the regulation of NF-κB signaling pathway.

Objective To investigate the clinical effect of tiotropium bromide combined with Seretide in treatment of moderate to severe chronic obstructive pulmonary disease( COPD) patients. Methods From Jan. 2012 to Oct. 2013,76 severe COPD were selected as our subjects and they were randomly divided into the control group(38 cases)and research group(38 cases). Patients in control group were used Seretide(1 time both at morning and night,the does was 50 μg/ 500 μg),and in research group were given tiotropium bromide with thiophene beside Seretide(1 time every day). The two groups were received routine treatment,including anti infection,cough and asthma,according to the change of illness. The pulmonary function,blood gas index, respiratory symptoms and 6 minutes walking distance(6 MWD)were recorded. Results Forced expiratory volume in one second( FEV1),forced vital capacity( FCV),FEV1 / FCV of patients in research group after ftreatment were(2. 22 ± 0. 48)L,(3. 28 ± 0. 32)L,(66. 23 ± 9. 22)% respectively,higher than those in the control group,and the differences were significant((1. 78 ± 0. 35)L,(2. 85 ± 0. 47)L,(56. 83 ± 7. 85)% ;t= 5. 39,4. 66,4. 78;P < 0. 01). Partial pressure oxygen(PaO2 )of patients in research group after treatment was (72. 83 ± 5. 28)mmHg,significantly higher than that of control group((65. 36 ± 3. 22)mmHg). However, partial pressure of carbon dioxide( PaCO2 )was(43. 28 ± 3. 52)mmHg,significantly lower than the control group((48. 76 ± 2. 85)mmHg;t = 7. 44,7. 45,P < 0. 01). Dyspnea( MMRC)score in research group was (1. 38 ± 0. 32),lower than the control group(1. 76 ± 0. 35),and 6 MWD was(428. 36 ± 32. 85)m,higher than that of control group((398. 65 ± 28. 38)m;t = 4. 93,4. 21,P < 0. 01). Conclusion The treatment plan of tiotropium bromide combine with Seretide on moderate and severe COPD patients is proved with the better clinical effect and it can improve the partial pressure of oxygen and then promote repair mechanism of lung injury as well as promote the quality of life of patients with ascension.

Objective To investigate the effects and mechanisms of sulindac, a non-selective cyclooxygenase(COX)inhibitor, on the proliferation and apoptosis of colorectal cancer cell line HT-29.Methods HT-29 cells were treated with sulindac. MTT assay and flow cytometry were used to measure the proliferation and apoptosis respectively. The laser scanning microscope(LSM)and the fluorescence microscope were used to observe apoptosis of the cells, and the flow cytometry (FCM)analysis was used to observe the cell apoptosis and cell cycle. Results Sulindac inhibited the cells proliferation and induced apoptosis in a dose-and time-dependent manner. With the TUNEL staining and fluorescence microscope, we found that the apoptosis cell became brown. After the Annexin V/PI staining, we observed that the membrane of apoptosis cells became green with LSM; the nucleosidase became red or crocus. FCM showed that sulindac promoted apoptosis of the cells, made the stage of G0/G1 ceils significantly reduced. Conclusions Our results showed that sulindac may inhibit the proliferation and induced the apoptosis of colon cancer cell HT-29,and the mechanism may probably be related to cell cycle arrest.

Objective To analyze the risk factors and pathogen drug resistance of senile stroke-associated pneumonia (SAP), and to provide references for early clinical intervention. Methods A total of 859 elderly patients with cerebral stroke admitted to our hospital from June 2018 to June 2020 were selected and divided into the study group (SAP, n=375) and the control group (no SAP, n=484) according to the occurrence of stroke associated pneumonia. Clinical data of age, gender, and other complications of the two groups were analyzed. The sputum culture and drug sensitivity test of senile SAP patients were analyzed. Results A total of 313 pathogens were detected in 375 SAP patients, including 211 strains of gram-negative bacteria (67.41%), mainly consisting of 92 Acinetobacter baumannii (29.39%), 54 Pseudomonas aeruginosa (17.25%), and 42 Klebsiella pneumoniae (13.42%), and 73 strains (23.32%) of gram-positive bacteria, mainly 62 strains of Staphylococcus aureus (19.81%). In addition, there were 29 strains of fungi (9.27%). Pseudomonas aeruginosa was highly sensitive to piperacillin/tazobactam and ceftazidime. Acinetobacter baumannii and Klebsiella pneumoniae were highly sensitive to imipenem, meropenem, and cefoperazone sodium and sulbactam sodium. Staphylococcus aureus and Enterococcus were highly sensitive to teicolanin, linezolid and vancomycin. The proportion of patients aged ≥80 years old, mechanical ventilation, bed rest and use of prophylactic antibiotics in the experimental group was significantly higher than that in the control group (P<0.05). Logistic regression analysis showed that age ≥80 years, mechanical ventilation, hypoproteinemia and use of prophylactic antibiotics were independent risk factors for SAP (P<0.05). Conclusion The main pathogens of stroke-associated pneumonia in the elderly are Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. It is necessary to rationally choose antibiotics according to the results of drug sensitivity. The risk factors are patients' age ≥ 80 years old, mechanical ventilation, and bed rest. Clinicians should attach great importance to the prevention of stroke-related pneumonia in the elderly.

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea