Adolescent ; Adult ; Chronic Disease ; Female ; Humans ; Laryngeal Diseases ; etiology ; therapy ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Singing ; Young Adult

Objective To explore effect of clinical pathway in turnout gene therapy's health education,to promote turnout sufferer's acknowledge of gene therapy,thus to better cooperate the treatment.Methods To apply the clinical pathway to the in-patient health education,to explain and evaluate to the turnout gene therapy's sufferer.Resuits The sufferers'acknowledge of tumour gene therapy promoted and their cognition of the therapy's side effect promoted,so they can better regard gene therapy.Simultaneously the relationship of nurse-sufferer improve and the nurse's ability of health education improved.Conclusion Clinical pathway has good using value in the health educadon of promoting turnout gene therapy's sufferer's acknowledge.

Objective To explore the clinical value of radioactive iodum131 in treating hyperthyroidism.Methods 53 patients with hyperthyroid heart disease were treated with radioactive iodum131. The caring measure before and after the iodum131 treatment was introduced,including psychological and dietary caring,follow-up visit. Results After 12 months iodumted131 treatment, 39 cases were clinical healed ( healing rate 73.58% ), 10 cases (18. 87% )were remitted,4 cases (7. 55% )were inefficient, total effective rate was 92. 45%. Conclusion High quality caring has important clinical significance in safely and effectively developing iodum131 treating hyperthyroid.

This study was aimed to investigate the effect of Rheum tanguticum on expression of serum endothelial nitric oxide synthase (eNOS), endothelin (ET) and 6-keto-prostaglandin F1α (6-Keto-PGF1α) in uric acid nephropathy rat model. After 3 weeks of treatment with different extractions of Rheum tanguticum on uric acid nephropathy rat model, levels of serum BUN, Cr and UA were measured by biochemical analyzer. ELISA method was used to measure the expression of serum eNOS, ET and 6-Keto-PGF1α. Meanwhile, pathological changes of renal tissues were observed by light microscope. The results showed that compared with the normal control group, the levels of serum BUN, Cr, UA and renal index were higher in the model group (P< 0.05). Compared with the model group, the concentration of eNOS in the model group was obviously higher in the rhubarb ethanol extraction group, rhubarb water extraction group, and allopurinol group (P< 0.05). Concentration of ET was obviously reduced in the rhubarb water extraction group and allopurinol group (P< 0.05). There was no statistical difference with the rhubarb ethanol extraction group. There was no significant difference in the concentration of 6-Keto-PGF1α among groups. Lots of inflammatory cells and uratic crystallization were observed by light microscope in renal tissues among rats in the model group. Damages of renal tissues in medication groups were alleviated than the model group. It was concluded that Rheum tanguticumcan alleviate the damage of uratic crystallization and inflammatory cell infiltration, increase the concentration of serum eNOS, and decrease the concentration of serum ET. Thus, it can reduce the damage of renal endothelial cells and protect renal functions. The effect of rhubarb ethanol extraction on reducing ET expression was less than the water extraction.

Although coronary heart disease (CHD) and stroke share important risk factors,some associations differ between these two components of cardiovascular diseases.The objective of this study was to compare vascular risk factor profiles and in-hospital outcomes in acute stroke (AS) and acute myocardial infarction (AMI) patients.Methods We evaluated 383 consecutive patients who were admitted to the 94th Hospital of Chinese PLA and the Third Hospital of Nanchang with diagnoses of AS (ischemic stroke or intracerebral hemorrhage;n = 310) or AMI (n = 73) during a 2-year period.The frequency of risk factors and inhospital mortality rates were assessed in both groups.Results AS patients were significantly older than AMI patients ( 68.9 ± 9.1 years vs.62.8 ±11.7 years;P ＜ 0.01).AMI was significantly more common than AS in patients younger than 65 years;51% of this group had AMI and 26% had AS (P ＜ 0.001).Hypertension was more common in AS patients than in AMI patients (69% vs.58%;P = 0.042).Patients who died did not differ significantly in age between the groups.In-hospital mortality rates were significantly higher in AS than AMI cases (31% vs.12%,P ＜ 0.001 for all patients;37% vs.5%,P ＜ 0.001 for men).Women hospitalized for AMI were more likely to die in hospital than men (28% vs.5%;P = 0.002).Conclusions Patients with stroke and with AMI differ in their risk factor profile.Age at the time of presentation was a significant differentiating factor between patients with AS and AMI.We observed significantly higher in-hospital mortality for patients with AS (when adjusted for age) than for patients with AMI.(J Geriatr Cardiol 2008;5:223-226)

After a brief description of standards for HL7 and its application in foreign countries and China, the lo-calization and implementation principles of HL7-based application of integrated medical information system, and its advantages and disadvantages were analyzed with its development trend in China pointed out.

Objective:To explore blood pressure variability (BPV)characteristics in patients with sustained,masked hypertension (MH)and white coat hypertension (WCH).Methods:A total of 527 cases undergoing physical exami-nation in our hospital from Dec 2010 to Dec 2012 were treated as subjects.According to characteristics of blood pressure (BP),they were divided into sustained hypertension group (SH group,n= 143),MH group (n= 93), WCH group (n=86)and normal control group (NC group,n=205).CV (coefficient of variation)=BPV/mean BP.Results:BP-CV of MH group and SH group were significantly higher than that of NC group [24h systolic blood pressure (SBP)-CV: (27.73±5.36)% vs.(29.83±5.95)% vs.(17.93±4.85)%,24h diastolic blood pressure (DBP)-CV: (23.02±4.63)% vs.(22.69 ± 4.63)% vs.(14.32 ± 4.21)%,daytime (d)SBP-CV: (25.12 ± 4.79)% vs.(25.98±4.73)% vs.(14.97±4.29)%,dDBP-CV:(21.03±4.59)% vs.(20.92±4.53)% vs.(11.79 ±4.43)%,nighttime (n)SBP-CV: (21.52±4.93)% vs.(22.37±4.98)% vs.(11.57±4.19)%,nDBP-CV:(18.79±4.83)% vs.(20.09 ± 5.19)% vs.(6.98 ± 3.69)%],P < 0.01 all;however,there was no significant difference in BP-CV between WCH group and NC group,SH group and MH group (P >0.05).Conclusion:Blood pressure variability significantly rises in patients with sustained and masked hypertension,which may be one of main causes for severe target organ damage in these patients.

Recently,much interest has been focused on the clinical application and biology of tumor-derived DNA in the plasma/serum of cancer patients.Such interest has resulted in the demonstration of human papillomavirus(HPV) DNA in the plasma/serum of patients with cervical cancer(CC).The studies used different materials(plasma /serum),different DNA extraction methods and different primers to detect circulating free HPV DNA,so the positive rates varied from(6.9%) to 50%.The HPV DNA in the plasma/serum of patients suffering from CC most likely originates from the tumor itself,which will probably provide us with a new tool for CC monitoring after primary treatment,especially in patients in advanced stages.It is expected that this promising molecular tumor marker would soon be put into routine clinical use.

Objective To introduce and evaluate arthroscopic release technique for treatment of knee stiffness due to arthrofibrosis after total knee arthroplasty (TKA). Methods Five patients with mean age of 56 years (41－ 70 years) underwent knee arthroscopy for a history of arthrofibrosis following TKA. There was no painful stiff total knee or infected total knee in this series. All of 5 cases had good range of motion in the operation room after total knee replaced. The arthroscopy was performed at 6 months (3－ 12 months) after the TKA, and at this time the flexion was limited to 70 degrees (60－ 85 degrees).In 2 cases,the extension was limited to 10 degrees and 30 degrees. With 3 standard portals, we examined the knee joint and found the adhesions and fibrous band formed in the suprapatellar pouch and two gutters. By resection of those fibro- band and passive flexion of the knee, the satisfactory range of motion(ROM)could be achieved. For the 2 cases of extension limited, CR prothesis was replaced. We released the posterior cruciate ligaments through the anterior portals. Continuous passive motion was started immediately postoperatively at the first day. The patients were evaluated at an average time of 20 months (8－ 46 months) after the arthroscopy. Results The mean knee ROM was 116 degrees (100－ 130 degrees) at the end of arthroscopy and was 105 degrees (90－ 115 degrees)at the last review.The mean ROM was improved by 35 degrees (15－ 50 degrees). There were no complications in this series. Conclusion Arthroscopic release for the treatment of knee stiffness due to arthrofibrosis without pain and infection following TKA is a useful, reliable and safe technique, compared with closed or open procedure. The arthrolysis should be done at 3 to 6 months after the TKA in order to obtain better results.

ObjectiveTo study B-cell activating factor(BAFF)/a proliferation inducing ligand (APRIL)protein and mRNA expression levels in patients with primary Sj(o)gren's syndrome(pSS)and its contribution to the pathogenesis of pSS.Methotis The levels of serum BAFF and APRIL were tested by ELISA method in 32 pSS patients and compared with 23 healthy control sabjects.BAFF/APRIL protein levels of labial salivary glands were examined in 17 pSS patients by immunohistochemical staining and compared with 8 healthy controls.BAFF/APRIL mRNA expression relative levels to GAPDH of PBMC were also detected in 18 pSS patients by real time RT-PCR and compared with 20 healthy controls.The relationship between BAFF/APRIL levels and several clinical manifestations in pSS patients were analyzed.Results The median level of serum BAFF in pSS were markedly higher than that in healthy controls[(7.4±3.9)ng/ml vs(3.7±1.1)ng/ml,P＜0.01].Serum APRIL levels were also significantly elevated compared to healthy controls[(26±15)ng/ml vs(16±15)ng/ml,P=0.039].The higher levels of BAFF were associated with higher levels of IgG,ESR.total globulin and the titer of ANA(P＜0.05).There was a positive correlation between serum APRIL levels and ESR and labial salivary gland lymphocyte focus scores(P＜0.05).The two cytokines levels inversely correlated with the count of peripheral white blood cells and platelets in pSS(P＜0.05).When comparing serum Ievels of APRIL and BAFF in patients with pSS,a positive correlation could be found(r=0.534,P=0.002).The BAFF/APRIL protein levels were higher in infiltrating lymphocytes of labial salivary glands from pSS patients than from the controls(P＜0.05).The BAFF mRNA[(0.023±0.024)vs(0.245±0.188),P＜0.01]and APRIL mRNA[(0.047±0.035)vs(0.130±0.097),P=0.002]levels of PBMC were significantly lower in pSS patients than in the normal controls.Conclusion The BAFF/APRIL levels of serum and labial salivary glands are significantly elevated in patients with pSS and correlate with clinical parameters.These indicate that BAFF and APRIL may be involved in the pathogenesis of pSS.The low BAFF mRNA and APRIL mRNA levels of PBMC in pSS may reveal that the production and regulation of this system is complicated.