Objective Psychological intervention combined with carboprost ammonia butyl alcohol three for pregnancy clinical effect in the treatment of postpartum hemorrhage and its impact on quality of life. Methods According to the different nursing methods from January 2015 to December2016 in our hospital with high risk of postpartum hemorrhage patients were divided into 50 groups: control group with routine nursing care plus carboprost ammonia butyl alcohol three treatment, the observation group with psychological intervention plus carboprost ammonia butyl alcohol three treatment; comprehensive observation of the two groups of 2h and 24h in patients with postpartum hemorrhage, bleeding time, quality of life and other aspects, and the related data were analyzed. Results The psychological intervention plus carboprost ammonia Butyl alcohol three (observation group) carboprost ammonia butyl alcohol three with better effect than the treatment of postpartum hemorrhage pregnancy (control group) treatment, 2h and 24h in patients with postpartum bleeding was less than the control group, the bleeding time was shorter than the control group, the quality of life is better than the control group, the difference was statistically significant (P<0.05). Conclusion Postpartum hemorrhage: Patients with psychological intervention plus carboprost ammonia butyl alcohol three treatment effect of pregnancy, can decrease the 2h and 24h in patients with postpartum hemorrhage, bleeding time is short, the quality of life of patients, is worthy of clinical widely used to treat patients with postpartum hemorrhage pregnancy.

Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.

Objective To investigate the value of the joint detection of Troponin T(TnT),highsensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) for the clinical diagnosis of acute coronary syndrome(ACS) in elderly patients.Methods The adequate serum samples were collected in each group:unstable angina (UA) (49 cases),non-ST segment elevations myocardial infarction(NSTEMI) (48 cases),acute myocardial infarction(AMI) (37 cases)and healthy control (45 cases).The levels of TnT and NT-proBNP were measured by electrochemiluminescent double antibody sandwich method,and hs CRP by immune transmission turbidity.The roles of individual and joint detection of the three indicators were analyzed by ROC curve and Logistic regression model.Results Except for TnT in UA group,the serum TnT,NT-proBNP and hs-CRP levels were significantly higher in three ACS groups than in healthy control group (P＜0.05).The largest areas under the ROC curve (AUC) of individual TnT,NT-proBNP,hs-CRP testing and the joint detection for UA were 0.583±0.059,0.786±0.047,0.620±0.058 and 0.787±0.046,for NSTEMI were 0.967±0.022,0.978±0.015,0.897±0.032 and 0.991 ±0.009,for AMI were 0.971 ± 0.024,0.961 ± 0.021,0.874 ± 0.043 and 0.999 ± 0.002,therefore,the area under the ROC curve of the joint detection was increased to some degree as compared with individual TnT,NT-proBNP,hs-CRP testing.Similarly,the best sensitivity and specificity of individual TnT,NT-proBNP,hs-CRP testing and the joint detection for UA were 16.7％ and 100.0％,54.2％ and 91.1％,54.2％ and 75.6％,50％ and 95.6％; for NSTEMI were 93.5％ and 100.0％,95.7％ and 97.8％,67.4％ and 97.8％,95.7％ and 100.0％; for AMI were 94.1％ and 100.0％,91.2％ and 97.8％,67.8％ and 97.8％,100.0％ and 97.8％,respectively.Conclusions Joint detection of TnT,NT-proBNP,hs-CRP can significantly improve the diagnosis of UA; for NSTEMI and other AMI,it can be achieved the optimism of sensitivity and specificity,but its effect of distinguishing NSTEMI and AMI is little.

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.

Objective　To investigate the biological characteristics of the serine protease inhibitor 15 (RmS-15) protein of Rhipicephalus microplus, and to perform molecular cloning and prokaryotic expression. Methods RmS-15 gene was amplified and sequenced to construct a phylogenetic tree to understand its evolutionary relationships. Bioinformatic tools were used to analyze the physicochemical properties, signal peptide, secondary and tertiary structure of the RmS-15 protein. In addition, DNA star and ABCpred were used to predict potential B-lymphocyte antigenic epitopes of RmS-15 protein, and potential T-lymphocyte antigenic epitopes were predicted by SYF-PEITHI and IEDB. Finally, the RmS-15 recombinant protein of Rhipicephalus microplus was obtained using the E.coli prokaryotic expression system and purified. Results The RmS-15 gene with 1 212 bp was successfully amplified, encoding a protein comprising 403 amino acids. Phylogenetic tree results indicated high conservation of the RmS-15 protein among different tick amino acid sequences, with the closest phylogenetic relationships to the Rhipicephalus haemaphysaloides and the Rhipicephalus sanguineus. The results of physicochemical property analysis showed a 20-amino acid signal peptide at the N-terminus of the RmS-15 protein, with a relative molecular weight and theoretical isoelectric point of 44 000 and 6.68, respectively. The protein showed an average hydrophilicity of 0.001, classifying it as a stably hydrophilic protein. The results of antigenicity analysis showed that the dominant fragments of B-cell antigenic epitopes of RmS-15 protein were 102-112 aa,147-152 aa and 207-215 aa, and the dominant fragments of T-cell antigenic epitopes were 3-11 aa, 6-14 aa, 27-33 aa, 34-37 aa. Protein expression results showed that RmS-15 protein exhibited high expression levels in the supernatant after induction with 0.8 mmol/L IPTG at 16 ℃ for 24 hours and reached a successful purification with a single band of the protein molecular weight of 44 000. Conclusions The method of prokaryotic expression and purification of RmS-15 protein from Rhipicephalus microplus was successfully established. Bioinformatics analysis demonstrated its strong antigenicity, suggesting its potential to develop as a candidate vaccine for ticks.

Objective To explore the case mixed method in diagnosis-related groups ( DRGs ) of patients with cervical cancer in Nantong and to provide references for standard hospitalization expense of cervical cancer. Methods 8610 patients with cervical cancer from Nantong Tumor Hospital from 2006 to 2013 were selected for the study. The influencing factors of hospitalization expenses were screened by multiple liner regression. DRGs case mix scheme was established by Chi-squared automatic interaction dtector in the decision tree model. Results The mean hospitalization expense was 11363 yuan and the median was 9325 yuan. The influencing factors included admitting pathways, complications, therapeutic methods and prognosis of diseases. The cases of 8610 formed 11 DRGs combinations, with the corresponding hospitalization expense standards. Conclusions Case-mix diagnosis related groups are reasonable. The standards and related weights of hospitalization expenses could serve references for hospitals and medical insurance institutions.

ObjectiveTo analyze the outcome of psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city.MethodsThe variables of supervision rate,improvement rate,society participation rate,disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate,etc.were observed in psychiatric patients pre-and post initiation of the program as the model of socialization,complexity,accessibility.Results3 years after carrying out the program in Huicheng District of Huizhou city,the supervision rate,improvement rate,society participation rate of psychiatric patients have significantly increased,and the disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate have substantially decreased.ConclusionThe psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city has been shown to be an effective way for psychiatric intervention.

ObjectiveTo investigate the morbidity rate, states of distribution and therapy of psychosis, and the influence of the patients with psychosis to society. MethodsClue exploration was used mainly, assisted with filling vacancy.ResultsTotal of the patients with psychosis was 4253,the time-spot rate of every psychosis was 4.59‰, the all-life rate was 6.24‰. ConclusionSome data of psychosis in Huicheng District have been obtained.

Objective To discuss influence and curative effect observation of sodium hyaluronate on serum matrix metalloproteinase-9,12 and 13 (MMP-9, 12 and 13) levels of patients with knee osteoarthritis (OA). Methods Selected 70 cases of patients with knee OA, and divided into observation group (n=35 cases) and control group (n=35 cases) in accordance at random. The patients in two groups were given oral 75 mg diclofenac sodium enteric capsules , once a day for 5 weeks. The patients in observation group were additionally given 2 mL sodium hyaluronate , injected into in-tra-articular, once a week, for 5 weeks. Excepted for sodium hyaluronate injection fluid, the patients in control group were given the same medical treatment as that in observation group. The changes of serum MMP-9 , 12 and 13 levels between the two groups before and after medical treatment were observed , and the clinical curative effect and untoward effect was compared as well. Results After 5 weeks’ treatment, the serum MMP-9, 12 and 13 levels of patients in two groups were declined more significantly than before with different degrees (P<0.05 or P<0.01), and the declining rate of patients in observation group was much higher than that in control group (P<0.05). The clinical good and excellent rate with in observation group(85.71%) was much higher than that in control group (62.86%)(χ2=4.79,P<0.05). 9 and 11 cases of untoward effect were appeared between control group and observation group respectively with light symp-tom, and after comparing the occurrence rates of untoward effect of patients in two groups, with no statistical differ-ences (χ2=0.28,P>0.05). Conclusion Sodium hyaluronate has favorable curative effect on patients with knee OA, whose mechanism of action has close effect on reducing serum MMP-9 ,12 and 13 levels.