Ambulatory blood pressure monitoring (ABPM), which can reflect the 24h mean blood pressure, precisely characterize changes in blood pressure throughout daily activities and circadian rhythm, has been found to be superior to traditional blood pressure monitoring. ABPM is in more widespread use in recognition of children's white coat hypertension and masked hypertension, predicting target-organ damage, assessing the efficacy of antihypertentive drug treatment and distinguishing primary hypertension from secondary hypertension.The article summarizes the clinical applications of ABPM in pediatrics.

Objective To analyze nursing risk factors in digesting internal medicine nurses,looking for effective prevention measures and observe the nursing effect. Methods Nursing risk factors were analyzed from November 2009 to October 2010,and effective preventive measures were explored and applied from November 2010 to October 2011.The incidence rate of nursing accidents,the degree of satisfaction and approval,and basic nursing quality were compared before and after the implementation of nursing risk preventive measures. Results Nursing accident before and after the implementation was 0.98％ and 0.12％,the degree of satisfaction and approval before and after the implementation was 78％ and 75％,the basic nursing quality score before and after the implementation was (93.87 ±1.26)points,(99.68 ±0.54)points,the results before and after the implementation showed significant difference. Conclusions To adopt effective nursing risk preventive measures can significantly reduce the incidence of nursing risk,improve nursing service quality and satisfaction degree of patients.

Objective To explore the clinical value of intravenous thrombolysis in the treatment of patients with acute myocardial infarction (AMI) and cardiac arrest after cardiopulmonary resuscitation.Methods 120 patients with AMI and cardiac arrest admitted in our hospital from Mar 2009 to Mar 2013 were divided into thrombolytic group (n=50) and control group (n=70) according to the voluntary principle.The recanalization rate,return time of spontaneous circulation,left ventricular ejection fraction (LVEF) and creatine kinase-MB (CK-MB),complications and hospital mortality rate were compared between two groups.Results The recanalization rate was significantly higher in thrombolytic group than in control group (76％ vs.11.4％,x2 =84.81,P＜ 0.05).Restoration of spontaneous circulation was significantly shorter and LVEF after one week of treatment and CK-MB peak were significantly higher in thrombolytic group than in the control group (t=6.796,4.342,2.923,respectively,P＜0.001 or 0.05).The incidences of heart failure,angina,arrhythmia,and re-infarction were significantly lower in thrombolytic group than in control group (x2 =6.10,20.95,8.52,11.10,respectively,all P＜0.05).There were no significant differences in the incidences of intracranial hemorrhage and upper gastrointestinal bleeding between thrombolytic group and control group (x2 =2.19,3.74,both P＞0.05).Hospital mortality rate was significantly lower in thrombolytic group than in control group (10 ％ vs.25.7 ％,x2 =4.65,P＜0.05).Conclusions Intravenous thrombolysis has a higher recanalization rate,faster recovery time of spontaneous circulation,fewer complications and higher hospital survival rate for the treatment of cardiac arrest in patients with acute myocardial infarction after cardiopulmonary resuscitation.

Objective To investigate the effect of enteral nutrition on the improvement of the nutritional status and prevention of complications in elderly stroke patients with eating difficulties,and provide theoretical guidance for clinical treatment.Methods Eighty-two cases of elderly stroke patients with eating difficulties after stroke were randomly divided into two groups by the time of admission,41 cases in control group were given with parenteral alimentation,and 41 cases in treatment group were given with enteral nutrition.Before treatment and 3 weeks after treatment triceps skinfold (TSF),arm muscle circumference (AMC),serum hemoglobin (Hb),albumin (ALB),serum total protein (TP),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),total cholesterol (TC) and fasting plasma glucose (FPG) was measured,and the incidence of complications was observed.Results The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in control group was significantly lower than that before treatment (P ＜ 0.05),but in treatment group compared with that before treatment there was no significant difference (P ＞ 0.05).The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in treatment group was significantly higher than that in control group (P ＜ 0.05).The incidence of complications in treatment group was signifcanfly lower than that in control group [36.6％ (15/41) vs.78.0％ (32/41)] (P ＜ 0.05).Conclusions Enteral nutrition is conducive to the nutritional status of elderly stroke patients with dysphagia improvement,and can greatly reduce the incidence of complications,and improve survival rate.It is worthy of promotion.

Objective:To investigate the clinicopathological significance of the CyclinB1 and CDK1 expression in stomach carcinogenesis.Methods:The expression of CyclinB1 and CDK1 was examined by immunohistochemistry method in normal epithelium(15 cases),low-differentiated adenocarcinoma (15 cases)and moderate-well-differentiated adenocarcinoma (20 cases).Results:Immunoreaction to Cyclin B1 and CDK1 was mainly localized in the cytoplasm of cells.In stomach carcinogenesis,the positive immunostaining rate of CyclinB1 protein in normal epithelium and adenocarcinoma was 13.3%(2/15),94.3%(33/35) respectively (P

OBJECTIVE:To study the species and drug resistance of the bacteria isolated from sputum specimens of the inpatients in our hospital.METHODS:The drug susceptibility of 2 255 strains of pathogenic bacteria cultured from 6 052 qualified sputum specimens that collected from inpatients of our hospital between Jan.2005 and July 2007 were analyzed retrospectively.RESULTS:Of the 2 255 strains of pathogenic bacteria,1 210(53.7%)were gram negative bacillus,with Pseudomonas aeruginesa,Escherichia cob,Klebsiella pneumoniae and Acinetobacter showing the highest proportion,accounting for 19.5%,13.9%,8.2% and 6.4%,respectively;429(19.0%)were gram positive coccus,with CN-S and Staphylococcus aureus showing the highest proportion;and the 519(23.0%)were fungus with Candida albicans showing the highest proportion.CON-CLUSION:The result of drug susceptibility test showed that both gram negative bacilli and gram positive coccus were highly resistant to quite a few of antibiotics.

OBJECTIVE:To evaluate the efficacy of esomeprazole vs.lansoprazole in the treatment of patients with reflux esophagitis (RE).METHODS:A total of 120 patients with RE were randomly assigned to receive either esomeprazole (20 mg n&m,treatment group) or lansoprazole (30 mg n&m,control group) for 8 weeks.The symptomatic scores including heartburn,retrosternal pain and acid regurgitation,and gastroscopic curative efficacy at 4 and 8 weeks were obtained for the evaluation of clinical efficacy.RESULTS:In the treatment group at 4 and 8 weeks after treatment,the total effective rates in improvement of clinical symptoms were 78.1% and 87.5%,respectively,and the total effective rates of gastroscopic curative efficacy were 87.5% and 93.8%,respectively;while in the control group at 4 and 8 weeks,the total effective rates in improvement of clinical symptoms were 60.7% and 73.2%,respectively,and the total effective rates in gastroscopic curative efficacy were 73.2% and 80.4%,respectively,showing statistical differences in total effective rates between esomeprazole and lansoprazole(P

OBJECTIVE: To investigate the protective effects of tea polyphenol (TP) on lung injury caused by global cerebral ischemic-reperfusion and its mechanism. METHODS: Improved Pulsinelli-brierley method was applied to induce damage model by global cerebral ischemia model for 15 min and global cerebral ischemia-perfusion for 3 h. Some indexes were observed, including morphology change of cerebral and lung tissue, activity of superoxide dismutase (SOD), concentration of malondialdehyde (MDA) and expression of lipopolysaccharide receptor CD14. Healthy rats were divided into sham group, model group and nimodipine group. RESULTS: As compared with sham group, there were pathologic damage of lung and brain and the positive expression of CD14 cell of lung in model group. As compared with model group, the activity of SOD were increased significantly (P

Objective To explore the prevention and treatment principles of different types of iodine contrast agents.Methods 240 patients with CT enhancement were divided into two groups according to the contrast agent type: 80 patients with ionic contrast agent (control group), 160 cases with non-ionic contrast agent (observation group).The allergic reaction was evaluated according to the ADR classification.The constituent ratio of the allergic reaction was observed in the two groups.The contrast ratio of the hypersensitive reaction was observed.The clinical manifestations of the allergic reaction were observed.Results In the control group, there were 8 cases of mild allergic patients,7 cases of mild allergic patients in the observation group,7 cases of moderate allergic patients in the control group,6 cases of moderate allergic patients in the observation group,4 cases of severe allergic patients.There were 2 cases of severe allergic patients in the observation group.In the observation group, there were 15 cases of total allergies and 19 cases of total allergies in the control group.The number of allergies in the observation group was lower than that in the control group (x2=9.063,P<0.05).80 cases of contrast agent induced 19 cases of allergic reaction;non-ionic contrast agent iodopromide 79 cases, induced 9 cases of allergic reactions;non-ionic contrast agent iodohydrin contrast 81 cases.Allergy symptoms such as skin rash, malaise, chills and fever, eyelid edema, throat discomfort and voice, such as nausea and vomiting, dizziness, chest tightness, cardiovascular symptoms such as shock, blood pressure changes and so on.Conclusion Non-ionic iodine contrast agent is superior to ionic contrast agent in the incidence of allergic reaction.However, it is an important measure to reduce the patients' injury caused by different types of hypersensitivity reaction.It is worth the attention of clinicians.

Problems in pathology teaching requires the introduction of PBL pedagogy.Teaching experiments show that PBL teaching has a positive impact on the improvement of clinical medical students'ability and quality and can be conditionally applied and promoted. And at the same time, it is a challenge to traditional teaching mode of pathology and therefore the reform of medical education needs to be deepened.