We investigated health condition and evaluate the viability of Barthel's measuring scale for 1297 elder patients at 17 nursing homes.We nursed all patients by standards and performed a comparison study.The nursing percentages of highest and lowest levels were higher than the previous ones ( P ＜ 0.01 ),while the nursing percentage of normal level was lower than the previous one ( P ＜ 0.01 ).The cooperation between doctors and nurses became optimized through progressive patient care.Ideal nursing standard should be based upon the doctors' judgment and nurses' evaluation.The new standard will be more suitable for patients and easier to control for nurses.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

Objective To evaluate the effect of CT temporal subtraction(TS) for detection of lung nodules.Methods 80 cases of CT images (current and previous CT images) and corresponding CT TS images were presented, which included 30 cases with nodules(75 nodules) and 50 controls.4 observers, including 2 radiologists and 2 residents, indicated their confidence level regarding the presence of a new emerging or larger or solid component than before,which first used standard CT images, then with the addition of CT TS images.Receiver operating characteristic(ROC) curve analysis was used to evaluate the observers'' performance.Results The mean value of the area under the ROC curve (AUC) were 0.860 and 0.925 for four observers without and with TS images,respectively(P<0.01).Average sensitivity for detection of lung nodules was improved from 77.3%(58/75) to 89.3%(67/75) by using CT TS images.Conclusion The use of CT TS images can significantly improve radiologists'' performance for detection of lung nodules,especially when a small size solid or subsolid nodule presents near the pulmonary hilum.CT TS is more helpful for residents.

Animals ; Gene Expression Profiling ; Mitochondria, Heart ; genetics ; metabolism ; Myocardial Reperfusion Injury ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To investigate the left ventricular (LV) performance in patients with essential hypertension(EH) by global performance index (GPI) based on three-dimensional speckle tracking imaging (3D-STI).Methods A total of 164 EH patients were enrolled and divided into four subgroups according to LV configuration:LV normal group (LVN,n =67),concentric cardiac remodeling group (CCR,n =49),concentric cardiac hypertrophy group (CCH,n =28) and eccentric cardiac hypertrophy group (ECH,n =20).Thirty age and sex matched healthy volunteers were enrolled as controls.3D-STI was performed to assess LV 3D global strain and LV torsion,then LV systolic dyssynchrony index (SDI) and global performance index (GPI) were calculated.Global strain parameters were investigated among the groups,and correlations with GPI were studied.Results GPI,global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS) and global 3D strain(G3DS) in EH groups were respectively lower than those in the normal controls,and there were statistical differences among the respective parameters (P ＜0.05,respectively).SDI in group CCH and ECH were significantly higher than that in normal controls (P ＜ 0.05,respectively).In multivariate stepwise regression analysis,GAS was the most influential to GPI.Conclusions GPI based on 3D-STI may accurately reflect LV performance in patients with EH,and has potential applications in clinical practice.

AIMTo synthesize poly(N-isopropylacrylamide)/cyclodextrin conjugate (PNIPA-beta-CD) as thermosensitive drug carrier, incorporate indomethacin into the conjugate and evaluate the drug release from the carrier in vitro.

METHODSPNIPA-beta-CD was synthesized by introducing carboxyl terminated PNIPA into the primary hydroxy group of beta-CD. The obtained conjugate was characterized by FTIR, 1H NMR and DSC. The indomethacin/PNIPA-beta-CD complex was prepared by lyophilization. In vitro drug release from the complex was carried out at 25 degrees C and 37 degrees C respectively.

RESULTSThermosensitive PNIPA-beta-CD was synthesized successfully. The LCST is 35 degrees C, as measured by turbidity method. The drug release from indomethacin/PNIPA-beta-CD complex was slower at 37 degrees C than that at 25 degrees C.

CONCLUSIONThermosensitive PNIPA-beta-CD with molecular inclusion capacity is a potential carrier for drug sustained release.

Acrylic Resins ; chemistry ; Delayed-Action Preparations ; chemistry ; Drug Carriers ; Indomethacin ; administration & dosage ; chemistry ; Temperature ; beta-Cyclodextrins ; chemistry

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Anti-Ulcer Agents ; therapeutic use ; Female ; Humans ; Penicillin G Procaine ; therapeutic use ; Stomach Ulcer ; drug therapy ; microbiology ; pathology ; Syphilis ; drug therapy ; microbiology ; pathology ; Syphilis Serodiagnosis ; methods ; Treponema pallidum ; isolation & purification

Objective To evaluate the performance of bone suppression images on the detection of lung nodules in comparison with the radiologists'reading results.Methods There were 141 standard posteroanterior digital chest radiographs,which included 95 patients with a solitary nodule and 46 controls.In this observational study,4 observers,including 2 radiologists and 2 residents,in-dicated their confidence level regarding the presence of a nodule for each lung,first by use of standard images,then with the addition of bone suppression images.Receiver operating characteristic (ROC)curve analysis was used to evaluate the observers'performance. Results Average nodule size was (1.9±1)cm (range from 0.9 cm to 2.9 cm).The mean value of the area under the ROC curve (AUC)was significantly improved from 0.844 with use of standard images alone to 0.873 with use of bone suppression images (P<0.01).Conclusion The use of bone suppression images can improve radiologists'performance on detection of lung nodules on chest radiographs.

Objective To explore the problems in the introducing of complementary food in infants and provide a guidance for cli nical practice.Methods The questionnaire survey was carried out by childhood health doctors in mothers or caregivers on fixed outpatient health care day. The data of survey was entered into computer and analyzed with SPSS 11.5 software.Results 1.Earlier (

Background and purpose:Concurrent radiochemotherapy is the standard modality for locally advanced esophageal squamous cell carcinoma (ESCC) patients. This clinical trial aimed to assess the effectiveness and toxicity of continuous infusion of 5-lfuorouracil (5-FU) and weekly paclitaxel combined with radiotherapy in ESCC patients. Methods:Patients with locally advanced (T2-4N0-1M0-1a) esophageal squamous cell carcinoma were enrolled in a prospective, single-institutional, single-arm study of deifnitive chemoradiotherapy. Patients received 61.2 Gy with IMRT in 34 fractions. Patients had a Karnofsky performance status of 70 or greater, and normal liver, renal, and bone marrow functions. Patients were recommended to receive concurrent 5-FU (300 mg/m2 civ 96 h) for 5 days a week for 5 weeks, plus paclitaxel (50 mg/m2) given during 3 hours every week for 5 weeks. Patients were recommended to receive 2 courses of consolidation chemotherapy after concurrent radio (chemo) therapy (5-FU 1 800 mg/m2 civ 72 h, plus paclitaxel 175 mg/m2 every 28 days). The primary endpoints of the study were 5 year overall survival and acute toxicity. Results:Fifty patients were enrolled in this study, including 38 male patients and 12 female patients;median age:58 years (ranged 26 to 75 years). 72%patients completed all the chemotherapy and 98%patients received the full dose of radiotherapy. 1-, 2-, 3-, and 5-year survival were 75%, 56%, 42%and 28%respectively. Among haematological toxicities, grade 3 leukopenia (16%) was recorded, and no patients experienced any≥grade 2 thrombocytopenia or anaemia. Among non-haematological toxicities, the rates of grade 2 peripheral neurotoxicity, arthralgias and myalgias, nausea, vomiting, and fatigue were 8%, 4%, 4%, 2%and 6%respectively. The rates of≥grade 2 acute radiation-induced esophageal toxicity, radiation pneumonitis and skin toxicity were 32%, 44% and 14% respectively. No treatment-related deaths occurred and no patients experienced any ≥ grade 4 toxicities. Conclusion: Continuous infusion of 5-FU plus paclitaxel given concurrently with radiotherapy may be an effective and tolerable treatment option for ESCC patients.