Objective To investigate the relationship between Serum BNP and heart failure in patients un-dergoing maintenance peritoneal dialysis ( MPD) .Methods 80 uremia patients who underwent MPD and 40 healthy volunteers were enrolled in the study.In the morning of treatment, we assessed their cardiac function according to in-terrogation, physical examination, chest X-ray and echocardiography while detecting BNP, Scr, BUN levels in the fasting venous serum of upper extremity.Results 80 MPD patients were divided into 2 groups:a heart failure group (Group A, n=42) and a normal cardiac function group (Group B, n=38).40 healthy volunteers served as a con-trol group ( Group C ) .There were no significant differences in age, weight and sex ratio among 3 groups ( P>0.05).The time period of maintenance peritoneal dialysis in Group A and B was similar (P>0.05).Compared with Group C, the levels of Serum BNP, Scr and BUN were significantly higher in Group A and B( P<0.05) .There were no significant differences of Scr and BUN between Groups A and B ( P>0.05) .The level of Serum BNP was signifi-cantly higher in Group A than that in Group B (P<0.05).Conclusion The level of Serum BNP may be closely re-lated to the cardiac function and it may be used as a predictor for heart failure in MPD patients.

Objective To expolre the clinical characteristic of hospital acquired acute renal failure(HA-ARF).Methods To retrospectively analyse the clinical datas of 103 patients who were suffered from acute renal failure in the duration of hospital stay within 5 years,which was compared with the homeochronous community-acquired acute renal failure(CA-ARF).Results In the 103 cases of HA-ARF,the incidence rate was 32.04% in the major age range from 60 to 74 years old,infection was the most important factor(33.01%),then other factors were cardial and cerebrovascular diseases(17.48%),acute hypovolemia(14.56%) and operation(9.71%);The complicating other organ nonfunction(34.95%),and the mortality rate was 39.80%,all the factors in HA-ARF were higher than that in CA-ARF.Conclusion The main factors of origin in HA-ARF are infection,cardial and cerebrovascular disease,acute hypovolemia and operation.The mortality rate of this disease is higher.Etilogical treatment promptly and dialysis regimen are the main means to rescue these patients.

Objective To study the distribution of the G/A variant at position -30 of the glucokinase gene promoter in southern Chinese subjects with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT) and to investigate the association between different genotypes and indices of glucose metabolism. Methods Four hundred and fourty four unrelated Chinese subjects 〔aged (50.8?12.2)years〕 without diabetics were studied, among them 222 subjects with NGT and 222 with IGT. The G to A substitution at position -30 of the glucokinase promoter, resulting in the loss of a BsiHKA Ⅰ cut site, was detected after BsiHKA Ⅰ digestion of PCR amplified genomic DNA. Results Allele frequency of the A variant was 18.2% in NGT (similar to finding in native Japanese) and 19.8% in IGT subjects. Fasting plasma glucose level was significantly higher in subjects with the A allele (n=153; GA:AA=137:16), when compared to the GG subjects (n=291), 〔(5.35?0.59 vs 5.19?0.53) mmol/L, P=0.006〕. Higherfastingglucoselevelwasalsofound when only IGT subjects with the A variant and GG allele were analyzed 〔(5.54?0.58 vs 5.35?0.52) mmol/L, P=0.02〕. In subjects with NGT, there was no significant difference in fasting plasma glucose levels between different GCK genotypes. Conclusion GCK gene promoter -30 G/A variant is associated with higher fasting plasma glucose levels, and may contributes to the development of IGT in Southern Chinese.

Objective To explore the relationship between serum uric acid(SUA) levels and metabolic syndrome(MS) in middle-aged and elderly people,and to investigate the impacts of age and gender on the relationship between SUA and MS.Methods A cross-sectional study was carried out in general population aged over 35 years in rural area of Yiling District,Yichang City in 2007.All subjects were investigated by using the standardized questionnaire,physical and biochemical examinations.MS was defined according to the diagnostic criteria of the latest Chinese guidelines.All subjects were divided into different subgroups based on quartiles of SUA levels and age(35-44 years old,45-59 years old,over 60 years old).The relationship of MS with age and SUA levels were investigated.Results 9354 subjects consisted of 3883 males and 5471 females were included in this study.The percentage of subjects aged over 60 years was 21.1％ in men and 17.4％ in women.The prevalence of MS from the first quartile to the fourth quartile were 3.8％,5.5％,7.9％,15.2％ in males,and 3.1％,5.5％,7.9％,16.7％ in females,respectively.The SUA levels was positively correlated with MS in both sexes after adjusting for other confounding factors.By analyzing associated-subgroups based on age and SUA levels,logistic regression analysis showed that the risk of MS was significantly increased with aging and SUA levels in female subjects.The association between age and MS was significantly weaker in men than in women.Conclusions There is a positive correlation between SUA levels and MS.The associations of MS with age and SUA levels are more closely in women than in men.The risk of MS may be highest in middle-aged and elderly women with high level of SUA.

Objective: To explore the correlation between the expression of C-terminal tensin-like protein (CTEN) and the prognosis of hepatocellular carcinoma (HCC). Methods: Using immunohistochemistry, we detected CTEN protein level in samples of primary lesion and adjacent non-tumor lesion collected from 240 patients with HCC. The relationship between CTEN expression and clinicopathology, 5 year recurrent-free survival, or overall survival was evaluated by Chi-square test, Kaplan-Meier, or Cox regression analysis. Results: High CTEN expression was detected in 55% of hepatocellular carcinoma tissues and 20%of adjacent carcinoma tissues (P<0.001). CTEN expression was positively correlated with tumor diameter (P=0.022), venous invasion (P=0.007) or TNM stages (P=0.022). Five-year recurrence-free survival time (P<0.001) and overall survival time (P<0.001) in patients with high CTEN expression were signiifcantly less than those in patients with low CTEN expression. Multivariate Cox regression analysis revealed that the CTEN expression was an independent prognostic marker for HCC (all P<0.05). Conclusion: CTEN protein may play a role in the genesis and development of HCC, and it can function as a prognostic marker.

Objective To explore the effect of cluster nursing intervention in elderly patients with swallowing dysfunction. Methods A total of 105 elderly patients with a Water Swallowing Test (WST) score of ≥3 and a Fried Frailty Phenotype (FP) score of ≥33 admitted to the department of geriatrics in our hospital from August 2022 to December 2023 were selected as research subjects and randomly divided into study group (n=55) and control group (n=50). The control group received routine nursing care for swallowing dysfunction, while the study group received cluster nursing care. The frailty status, swallowing disorders, and quality of life were compared between the two groups after 1 month of intervention. Results Due to changes in the condition, 2 cases dropped out from the control group and 3 cases from the study group, leaving 52 cases in the study group and 48 cases in the control group. There was no statistically significant difference in general information between the two groups (P>0.05). Before the intervention, there was no statistically significant difference in the proportion of patients with different WST grades between the two groups (P>0.05). After 1 month of intervention, there was a statistically significant difference in the proportion of patients with WST grades 3, 4, and 5 compared to before the intervention (P < 0.05). After 1 month of intervention, there was a statistically significant difference in the proportion of patients with different WST grades between the two groups (P < 0.05). Before the intervention, the Swallowing-Quality of Life(SWAL-QOL) score of the study group was (108.47±19.99) points, and was (109.17±20.34) points in the control group. There was no statistically significant difference in SWAL-QOL scores between the two groups before the intervention (P>0.05). After 1 month of intervention, the SWAL-QOL score of the study group was (143.07±16.55) points, and was (133.52±21.06) points in the control group. The SWAL-QOL scores of both groups improved compared to before the intervention, and the study group had a higher score than the control group (P < 0.05). Conclusion Cluster nursing for elderly patients with swallowing disorders and frailty can effectively improve their frailty status, swallowing function, and quality of life.

Objective To investigate the effect of alprostadil in the treatment of interventional angiography in elderly patients with coronary heart disease after contrast nephropathy prevention.Methods From February 1,2014 to January 31,2017,60 elderly patients with coronary heart disease with interventional therapy in Yuncheng Central Hospital of Shanxi Province were divided into two groups,with 30 cases in each group.The control group received hydration therapy,the observation group was given alprostadil combined with hydration therapy.The biochemical index changes before surgery and three days after surgery and incidence of contrast nephropathy were compared between the two groups.Results Before surgery and three days after surgery,the tumor necrosis factor alpha,beta 2 microglobulin, urea and creatinine in the two groups were not changed significantly.Three days after surgery,24h urine protein, superoxide dismutase,glutathione peroxidase,interleukin －6 and C reactive protein levels in the two groups were increased,the increase amplitude of the observation group was smaller.Three days after surgery,the five indicators of the observation group were (185.54 ±86.47)mg,(2.01±1.32)mg/L,(6.18 ±2.13)g/L,(135.56 ±41.58)ng/L, (1.21±1.05 )mg/L,respectively,the differences were ststistically significant between the two groups (t ＝1.21, 1.24,1.50,1.26,1.22;P＝0.03,0.03,0.04,0.03,0.04).Three days after surgery,the creatinine clearance rate of the observation group was (98.67 ±21.56)mL/min,which was higher than that of the control group(t＝2.71,P＝0.01).The incidence rate of contrast induced nephropathy in the observation group (3.33%)was lower than that in the control group(χ2＝5.19,P＝0.02).Conclusion Alprostadil can effectively prevent contrast nephropathy in elderly patients with coronary heart disease after interventional therapy.

Objective To explore the application effect of fast track surgery concept in terrible triad of the elbow to improve the nursing quality and promote the rehabilitation of patients.Methods Patients with terrible triad of the elbow in Orthopedics Department were selected using convenient sampling method. The control group included 26 cases who adopted traditional recovery treatment in 2014;the experimental group contained 30 cases who received fast track surgery in 2015. The Mayo elbow-performance score and patients′ satisfaction were compared between two groups.Results After the implementation of fast track surgery mode,the Mayo elbow-performance score was (86.15±8.16) in the experimental group and (72.67±12.51) in the control group;the difference was statistically significant (t=4.697,P<0.01). The patients′ satisfaction was 96.7% in the experimental group and 92.3% in the control group,with statistically significant difference between two groups (χ2=6.897,P<0.01).Conclusions Fast track surgery concept,which can help the function recovery of patients with terrible triad of the elbow and improve patients′ satisfaction,is an important innovation and perfection of traditional recovery concept.

Objective To investigate the change of antimicrobial resistance among gram-positive cocci from 1999 to 2006 in Beijing Chaoyang Hospital. Methods Antimicrobial susceptibility test was car-ried out by MIC method, data were analyzed by WHONET 5.3 software. Results A total of 6192 clinical isolates were collected. The top four pathogens were Staphylococcus coagulase-negative, Staphylococcus au-reus, Enterococcus faecalis and Enterococcus faecium. The prevalence of methicillin-resistant S. aureas and coagulase-negative were identified in 88.4% and 86.9%, respectively. The resistance rates of S. aureus to penicillin G and ampicillin were more than 90.0% during 1999-2006. Neither strains of S. aureus nor strains of coagulase-negative Staphylococcus were found resistant to vancomycin. Vancomyein-resistant Enterococci (VRE) strains were firstly isolated in 2003, thirteen vancomycin-resistant E.faecalis isolates were identified as VanB genotype by PCR and sequencing. The VanA gene was confirmed by PCR and sequencing in seven-teen vancomycin-resistant E.faecium, vancomycin-resistance E.faecium rate increased sharply. The most ac-tive antibiotics against E. faecalis were vancomycin, ampicillin, penicillin with the susceptible rates of 98.7%, 95.7% and 85.6%, however, the susceptibility rate of E. faecalis to penicillin decreased from 94.3%-84.6%. The resistance rates of E.faecalis to clindamycin was 99.0%. The resistance rates of E. faecium to erythromycin and clindamycin were more than 95.0%. The resistance rates of E.faecium to ampi-cillin, penicillin, ciprofloxacin were more than 90.0%. The most active antibiotics against E. faecium was vancomycin. The susceptibility rate of E.faecium to tetracycline increased from 27.8% to 82.6%. Conclu-sion Vancomycin remains highly active against gram-positive cocci. A total of 30 Enterococci isolates were found resistant to vancomycin.