Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

Objective To provide basis for the formulation of policies and measures that will reduce the work pressure on nurses and to provide them with a better working environment. Methods An investigation was made via questionnaires into 942 nurses working in designated SARS hospitals and a comprehensive analysis was conducted by means of multivariant stepwise regression. Results The major factors affecting the pressure on nurses include: lack of support from and communications with families, arduousness of tasks to an unbearable point, extreme strictness in management, and unsoundness of treatment and living conditions. Conclusion Good communications with families are of great significance to nurses working in isolated areas. It is imperative to rationally allocate the human resources of nurses, show more concern for them, encourage them to participate in management, and strengthen scientific prevention so as to create a better working environment.

Objective To investigate the association of AcrAB-tolC efflux pump and marA-soxS-rob regulon with ciprofloxacin-resistance in Shigella flexneri isolates.Methods Forty five strains of Shigella flexneri were isolated in stool samples collected from outpatient diarrhea clinics in Tianjin from 2009 to 2013.The antimicrobial susceptibility of bacteria was analyzed by Kirby-Bauer disk diffusion method.Ten ciprofloxacin-resistant Shigella flexneri isolates and 10 ciprofloxacin-sensitive isolates were randomly selected.The gyrA and parC genes,plasmid mediated quinolone resistant (PMQR) determinants,efflux pump genes (acrA,acrB) and regulation genes (marA,soxS,rob) were screened and sequenced.Minimum inhibition concentrations (MICs) of the strains were determined before and after efflux pump inhibitor carbonyl cyanide m-chlorophenylhydrazone (CCCP) was added.The expression of acrA,acrB,marA,soxS and rob genes in ciprofloxacin-resistant and ciprofloxacin-sensitive strains was detected by realtime fluorescence quantitative RCR (RT-PCR),and the differences of expression were evaluated using t test.Results Both gyrA and parC mutations were detected in all ciprofloxacin-resistant strains; qnrS1 was positive in ciprofloxacin-resistant strain CR2 and aac(6')-Ib-cr was positive in ciprofloxacin-resistant strain CR5.Efflux pump genes and regulation genes were not detected in ciprofloxacin-sensitive strains,while soxRS mutation was detected in all ciprofloxacin-resistant strains except CR10.MICs of quinolones in ciprofloxacin-resistant strains decreased to one-fourth or one-eighth when CCCP added,while not changed or only decreased to one-half in ciprofloxacin-sensitive strains.Expressions of acrA,acrB,marA and soxS were significantly higher in ciprofloxacin-resistant strains than those in ciprofloxacin-sensitive strains (P ＜ 0.05 or P ＜ 0.01).Conclusion Efflux pump may involve in the high-level ciprofloxacin resistance in Shigella flexneri through activating transcription of efflux pump genes by marA-soxS-rob regulon,in which soxRS mutation may play an important role.

BACKGROUND:Many previous experiments have confirmed that transforming growth factor?1(TGF-?1) plasmids can inhibit or decrease the injection in nerve transplantation,but there has rare report about their effects on vein transplantation.OBJECTIVE:To investigate the action pathway of immune tolerance of allogenic femoral vein transplantation in rats induced by local injection of TGF-?1.DESIGN,TIME AND SETTING:A randomized block animal observational experiment was performed at Animal Experimental Center of Harbin Medical University from March 2007 to April 2008.MATERIALS:A total of 18 Wistar rats were selected to assign as donors.A total of 48 Sprague Dawley rats were selected to assign as recipients and randomly divided into four groups with 12 rats in each group:autograft,allograft,immunosuppressant,and TGF-?1 groups.METHODS:The rats in the immunosuppressant group were administated(i.p.) cyclosporin A(10 mg/kg) one time per day from three days before transplantation till they were sacrificed.Each rat in the TGF-?1 group was injected 40 ?g TGF-?1 plasmids into two ends of femoral vein.Vein transplantation was performed in the autograft and allograft groups.MAIN OUTCOME MEASURES:Imaging,histology and immunological assays of these groups were conducted at two weeks after transplantation.RESULTS:In the autograft group,the endothelial cells of vein were flat,and nuclear membrane thickened.In the allograft group,the exfoliated endothelial cells and fragments,as well as subendothelium were observed.In the immunosuppressant group,the nuclear membrane of endothelial cells thickened,and rough endoplasmic reticulum expanded widely.In the TGF-?1 group,the expand of rough endoplasmic reticulum and mitochondrial vacuolation were observed.Tight junction could be seen between adjacent cells.Histologic and immunologic parameters in the TGF-?1 group were better than those in the immunosuppressant and allograft groups.The absorbance value of lymphocyte culture in the autograft,allograft,immunosuppressant,and TGF-?1 groups were 1.07?0.14,4.15?0.67,1.77?0.23 and 1.38?0.23,respectively.The absorbance value of lymphocyte culture in the TGF-?1 group was significantly lower than that in the immunosuppressant and allograft groups(P

Objective To analyze and explore the clinical characterizations, treatment and prognosis of central neurocytoma (CNC).Methods The data of 62 cases of CNC from Jan 1995 to Jan 2008 confirmed by pathological examinations and underwent surgical treatment were analyzed retrospectively.Results CNC appeared some radiological figures.Conclusion Surgical resection with the help of post-operative radiotherapy can result in satisfied outcomes.

Objective To discuss the clinical characteristics, treatment and prognosis of pseudotumor forms of demyelinating diseases. Methods 21 patients with pseudotumor forms of demyelinating diseases diagnosed pathologically were analyzed retrospectively. Results 16 cases were operated on. The lesions were established through biopsy in other 5 patients. All the patients improved significantly after corticosteroid therapy. 4 patients relapsed after treatment, and 1 patient died. Conclusion The feature of pseudotumor forms of demyelinating disease is similar to some kinds of intracranial tumors, however it presents some radiological characteristics. Diagnostic corticoid therapy may be helpful to draw a diagnosis.

Objective To investigate the characteristics,treatment and prognosis of supratentorial parenchymal ependymomas(SPEs).Methods 16 cases with SPEs determined with pathology were reported.Results and Conclusion SPEs appears some figures different from other cerebral tumors.Surgery and radiotherapy can result in satisfied outcome.

OBJECTIVE To explore the efficacy of the systemic sanitary monitoring of nosocomial infection(NI) disinfection and sterilization in NI management and performance of related NI standards of Ministry of Health in hospital.METHODS To review and treat statistically spot sampling results in 12 seasons from 2004 to 2006,and to observe performance of continued improvement after taking measures.RESULTS The qualified rate of 1647 samples including autoclave sterilizer,sterilized pack,sterilized endoscope and attachment,solution for dialysis and 2% glutaraldehyde solution was 100% from 2004 to 2006;3411 bacteriological monitoring samples of air,surface of object,hands etc and 1284 samples of all kinds of disinfectants were monitored.The annual statistical results of above mentioned samples were significantly different(?2=4.11-27.37,P

Objective To analyze the effect of conductive education combined with massage on activity of children with severe cerebral palsy. Methods 11 children (7 males and 4 females) with cerebral palsy receiving rehabilitation therapies in CereCare Wellness Centre of Xuhui, Shanghai from April to October 2010 were enrolled in this study. The type of cerebral palsy was as follows: 7 tetraplegia, 1 diplegia,2 athetoid, and 1 dystonia. The average age was 7.47 years, ranging from 4.7～11.9 years. The participants were divided randomly into 2groups. 5 children in group A accepted conductive education and massage therapy in the first 3 months, and then accepted routine rehabilitation therapies in the next 3 months. 6 children in group B accepted routine rehabilitation therapies in the first 3 months, and then accepted conductive education and massage therapy in the next 3 months. The phase of conductive education combined with massage was called intervention period, and the phase of routine rehabilitation therapies was called contrast period. The gross motor function was assessed with Gross Motor Function Measure Scale (GMFM), while the fine motor function was assessed with Fine Motor Function Measure Scale (FMFM).Pediatric Evaluation of Disability Inventory (PEDI) was used to assess activities of daily living. The different effects between conductive education combined with massage and routine rehabilitation therapies were compared. Results The scores of GMFM and FMFM both increased in intervention period, while both decreased in contrast period. The score of FMFM increased significantly (P<0.05). The scores of PEDI changed without statistical significance. Conclusion Conductive education combined with massage may increase the fine motor function of children with severe cerebral palsy compared with routine rehabilitation therapies.

Objective:To understand the status and association of health literacy and self-management ability of hypertensive patients in the community and to provide reference for further intervention research.Methods:From June 2019 to October 2019, a random number table method was used to randomly select multiple streets or towns/townships, and then 401 residents in the community or village aged above 18 years of age diagnosed as hypertension were selected as the subjects of this study. The general data questionnaire, high blood pressure-health literacy scale into Chinese(C-HBP-HLS) and hypertension patients self-management behavior rating scale(HPSMBRS)were used to conduct one-to-one field survey. SPSS 24.0 was used to analyze the scores of health literacy and self-management behavior of patients with hypertension. SAS 9.4 was used to analyze the canonical correlation between health literacy and self-management behavior of patients with hypertension.Results:The score of health literacy and self-management ability were (38.94±17.56) points and (129.45±16.53) points, respectively.The results of canonical correlation analysis showed that the canonical correlation coefficient between health literacy and self-management behavior reached 0.57, which was mainly reflected in the great correlation between " drug label" and " diet management" .Conclusion:Attention should be paid to the positive effect of health literacy on self-management ability, and further intervention research should take the " drug label" and " written health literacy" dimensions of health literacy as entry points to effectively improve the self-management ability of hypertension patients in the community.