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 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 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 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.

Objective To investigate the perinatal outcome for pregnancies complicated with chronic renal diseases,and the risk factors for the adverse outcome.Methods Retrospectively analyze the clinical data of 48 patients with chronic renal diseases complicating pregnancy admitted in Peking University People's Hospital between January 1998 and August 2010,record the pregnancy outcome and explore the risk factors for the poor outcome using multivariate regression analysis.Results Thirty-eight patients had known chronic renal disease before conception,and ten were diagnosed during pregnancy.Seven patients (15％,7/48 ) presented with obvious renal impairment [ serum creatinine (sCr) ≥ 125 μmol/L] prepregnancy,and nine (19％,9/48 ) were recorded with chronic hypertension.Thirty-three patients received regular prenatal care.Twenty-one cases ( 44％,21/48 ) developed preeclampsia.During the gestation,normal renal function (defined as sCr ＜71 μmol/L) was seen in nineteen cases (40％,19/48),mild dysfunction (sCr ranged 71 - 132 μmol/L) in twenty (42％,20/48) and moderate to severe dysfunction ( sCr ≥ 132 μmol/L) in nine cases ( 19％,9/48 ).Twenty patients had negative or mild proteinuria (24 hour urine protein ＜2000 mg),19 had moderate (24 hour urine protein ranged 2000 -5000 mg) and nine had severe proteinuria (24 hour urine protein ≥ 5000 mg).The gestational age at delivery ranged from 24 to 41 weeks and the neonatal birth weight ranged from 890 to 4150 g.A total of twenty patients (42％,20/48 ) suffered adverse perinatal outcome,including one case with late spontaneous abortion,fifteen with preterm delivery,eleven with small for gestational age,two with neonatal respiratory distress syndrome and four with perinatal death.Declined maternal renal function was seen in eight patients,and two patients progressed toward the end-stage renal failure ( the stage of uremia).Multivariate regression analysis identified that preeclampsia (OR =24.72, P =0.002 ) and the degree of proteinuria ( OR =4.24,P =0.032) were the independent risk factors for the adverse perinatal outcome. Conclusions Pregnancies complicated with chronic renal diseases have significantly high incidence of preeclampsia and adverse perinatal outcome.Preeclampsia and the degree of proteinuria are perhaps the independent risk factors for the adverse outcome.

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.

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 evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.

Objective To investigate the dual-slice spiral computed tomography angiography (DSCTA)in diagnostic value of main renal artery and sub-segment renal artery. Methods 43 patients of renal disease were examined by DSCTA,whole volume to be scanned in one continuous run.Interactive viewing of axial images serves as the basis for making a diagnosis while all kinds of 3D display techniques.Results In the 43 cases,98 renal arteries were visualized by DSCT,all of the main renal arteries were clear.The reveal rate of grade 3 renal artery was 95.3%,grade 4 was 67.1%,grade 5 was 32.9%,only 60%,5%,0% was showed respectively on the sigle slice CT.Conclusion DSCTA can improve the reveal rate of the sub-segment renal arteries than the single-slice CT angiography,so that it can improve the diagnostic value of the sub-segment renal artery stenosis and renal tumor