Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.

Dental anxiety (DA) is the psychology obstacle of the dental patients in the dental treatment. Recently, dental anxiety becomes prevalent in the world and it greatly impacts physical health and the quality of life. The text discussed the relationship between doctors and patients in the treatment of DA

Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.

Objective To sdudy the effects of Melatonin(MT)on cognition and tau hyperphosphorylation in hippocampus of Alzheimer's disease(AD)model rats.Methods A?25-35 was injected into the hippocampus to make AD model rat.MT was injected intraperitoneully into rats of MT group 7 days before and 19 days after modeling.Normal saline(NS)was injected intraperitoneully into rats of AD group after modeling.The cognition was tested by Morris water maze.The pathological changes of hippocampus was observed by Bielschowsky staining and the tau hyperphosphorylation was detected by immunohistochemistry staining.The results were compared with normal control group.Results In MT group,the results of Morris water maze were significant better than those in AD group(all P

Objective To analyze the endoscopic and pathological characteristics of rectum neuroendocrine neoplasm (NEN).Methods From January 2005 to May 2012,the endoscopic and pathological data of 66 patients with rectum NEN were collected and graded according to historistic grade of gastroenteropancreatic-neuroendocrine neoplasm (GEP-NEN) by World Health Organization (WHO).The factors related with the metastasis of neuroendocrine tumor (NET) and neuroendocrine cancer (NEC) were analyzed by Chi square test and Fisher exact probability method.Results The locations of 66 NEN cases were between three and 15 cm from the anus.The diameters of 54 cases were less than 1 cm and under endoscopy the appearance of most tumors was submucosal hemispherical polypoid bulge.The diameters of nine cases were over 1 cm but less than 2 cm,of which the appearance of five cases was submucosal thickening or sessile polypoid bulge.The diameter of three cases was over 2 cm and the appearance was cauliflower-like or polypoid tumor which caused annular lumen stenosis.Sixty-one cases were NET (grade G1),three cases were NEC (grade G3) and two cases were mixed adenoendocrine carcinoma with both NEC and adenocarcinoma components.The metastasis of NET and NEC was not related with gender (x2 =0.158,P＞0.05) and age (Fisher exact probability method,P＞ 0.05),however was related with the diameter of tumor (Fisher exact probability method,P＜0.05).Conclusions NEN is a tumor with variety endoscopic characteristics and pathological features.The metastasis of NET and NEC seems not related with gender and age,but related with diameter.

Objective To investigate the anti-inflammatory impacts of in the progression of Alzheimer' s disease (AD) in the rat model induced by β-amyloid 1-42 (Aβ1-42 ). Methods Sixty healthy male Wistar rats (weight 250--300 g) were randomly divided into 4 groups: control group, model group, statins control group and statins treatment group, 15 in each group. Rats model were established via intracerebroventricular injection of A13, and then atorvastatin (5 mg·kg-1·d-1) were given to the treatment group for 3 weeks, saline to the control group. Water Maze was used to observe learning and memory ability changes in rats, and expression of inflammatory eytokines IL-1β, IL-6 and TNF-α in the hippocampus were repectively detected by immunohistochemical technique. Furthermore, HE staining patterns, hippoeampns neurons and glial cells in the small ultra structural changes were observed under light microscope and electron microscope respectively. Results The model rats resulted in decreased learning and memory abihties ( the escaping latency: 12. 0 ± 1.2, 41.3 ± 3.4, t = 18. 0363, P < 0. 01 ) and increased secretion of the brain inflammatory factor compared with the controls with statistically significant difference (IL-1β:53.5 ± 2.4, 101.0 ± 3. 8, t = 23. 8246, P < 0. 01 ). Atorvastatin treatment group improved learning and memory performance ( the escaping latency: 25. 7 ± 1.6, 41.3 ± 3.4, t = 9. 1076, P < 0. 01 ), reduced the secretion of inflammatory factors in the hippocampus, compared with the model rats (IL-1β:60.0±3.4,101.0±3.8, t = 18.0231, P <0.01). There were less injured nerve cells and proliferated glial cells in the atorvastatin treatment group than in the model group. Conclusions Atorvastatin plays an anti-inflammatory role in the progression of Alzheimer's disease, reducing the nerve cell damage and improving learning and memory ability.

Objective To investigate the performance of surgical management in facial skin malignancies.Methods From January 2000 to December 2006,65 patients with facial skin malignancies,including47 cases of basal cell carcinoma.10 cases of squamous cell carcinoma,3 cases of dermatofibrosarocoma protuberans,2 cases of malignant melanomas,and one case of malignant acanthoma,hemangioendotheliosar-coma and sebaceous carcinoma,respectively,were collected and managed with wide resection followed by reconstruction.In order to achieve a thorough resection,frozen sections were prepared and subjected to pathological examination during the operation process to ensure the margins of resection were free of malignancy.Reconstruction was carried out by direct closure,or with local random flaps,extended flaps,free skin grafts.Resuits All defects were managed by one-stage reconstruction.The survival rate of skin flaps/grafts was 100%,and a satisfactory appearance and function was achieved.During the follow-up from 6 months to 5 years,local relapse was observed in one patient with basal cell carcinoma and one with squamous eell carcinoma,lymphatic metastasis in one with squamous cell carcinoma.Distant metastasis occurred in a patient with malignant melanoma.who died consequently.Conclusions Thorough resection is the key to prevent relapse of facial skin malignancies after surgery.Appropriate reconstruction may favor the restoration of facial appearance,and local random flaps appear to be the best reconstruction strategy.

Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa,and to guide clinical treatment.Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled.The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa.According to the wound healing time,they were divided into wound healing group (26 cases,healing time ≤ 3 months) and wound un-healing group (23 cases,healing time ＞ 3 months).The general information,clinical indicators and treatment between two groups were compared,and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis.Results Compared with those in wound un-healing group,the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher:(43.59 ± 2.71) ml/min vs.(23.14 ± 5.39) ml/min,76.9％ (20/26) vs 47.8％(11/23),and the urinary micro-albumin was lower:(67.01 ± 3.32) mg/L vs.(234.03 ± 6.71) mg/L.There were significant differences (P ＜ 0.05 or ＜ 0.01).Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was-5.551,P =0.001),urinary micro-albumin (regression coefficient was 0.127,P =0.007) and negative pressure attraction (regression coefficient was-2.244,P =0.042).Conclusion The blood flow volume of dorsal artery of affected foot,urinary micro-albumin,negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI) in patients with multiple soft tissue contusion.Methods A total of 513 patients diagnosed as multiple soft tissue contusion in the First Affiliated Hospital of Xinjiang Medical University from January 1,2008 to January 1,2013 were retrospectively analyzed.Demographics,clinical data and laboratory examinations before and after AKI were collected and analyzed.Results The age of all subjects was 31.30 (12-78) years old with the male to female ratio of 2.1∶ 1.AKI occurred in 74 cases with an incidence rate of 14.4％.No AKI was observed in patients with assault injuries,while AKI was found in 27 cases (36.5％) with car accident injuries and 4 cases (5.4％) with other injuries.AKI showed in 1 case(1.4％) with damaged area under 1％,in 4 cases(5.4％) with damaged area ranged from 1％ to ＜ 3％,10 cases (13.5％) with damaged area ranged from 3％ to 5％ and 19 cases (25.7％) with damaged area over 5％ with significant difference among the groups (P ＜ 0.01).Incidence rate of AKI was significantly higher in patients with chronic kidney disease (CKD) than those without CKD (54.5％ vs 20.3％,P ＜ 0.01).Two of the AKI cases died,with a mortality rate of 2.7％.Multivariate logistic regression analysis showed that the followings were the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injuries:age (OR =1.996),basic serum creatinine (OR =0.976),basic evaluated GFR (eGFR) (OR =0.964),serum potassium (OR =2.117),myoglobin (OR =0.950) and damaged area (OR =1.811).Conclusions Incidence rate of AKI is quite high in multiple soft tissue contusion.Age,basic serum creatinine,basic eGFR,serum potassium,myoglobin and damaged area are the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injury.

BACKGROUND:Isoflurane is an anesthesia drug that has a certain effect on the nervous system. It possibly causes neurologic disorders through impacting nerve stem cel function or morphology. OBJECTIVE:To investigate the effects of isoflurane on the proliferation and differentiation of neural stem cels in the hippocampus of rats. METHODS:Neural stem cels from the hippocampus of neonatal Sprague-Dawley rats, aged 7 days, were induced and differentiated. Passage 3 cels were obtained and divided into two groups: isoflurane group (a mixture gas of 2.8% isoflurane, 5% CO2 and 95% O2) and control group (a mixture of 5% CO2 and 95% O2).
After intervention of 6 hours folowed by 2 hours of routine culture, anti-BrdU monoclonal antibody immunofluorescent staining was used to detect cel proliferation, and western blot assay to detect the expression of β3-tubulin and glial fibrilary acidic protein. RESULTS AND CONCLUSION:Compared with the control group, the number of BrdU positive cels in the isoflurane group reduced significantly, indicating that isoflurane inhibits the proliferation of neural stem cels. Compared with the control group, the expression of glial fibrilary acidic protein in the isoflurane group up-regulated, but the expression of β3-tubulin had no changes, indicating isoflurane promotes the differentiation of neural stem cels into astrocytes. Cite this article:Min N, Hu QF, Li XP, Nie XH, Yang LL.Isoflurane effects on the proliferation and differentiation of neural stem cels in the hippocampus of neonatal rats. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):118-122.