目的评价护理干预在社区老年慢性病患者健康管理中的效果。方法对本管辖社区内171例60岁以上社区老年慢性病患者实施护理干预，包括健康教育、端正治疗的态度和信念、合理搭配膳食、调节情绪、适量运动、每周对病情的跟踪随访等。结果2年后社区老年慢性病患者在参加体育锻炼、低盐摄入、身体不适就医、保持心情舒畅、遵医服药方面有显著性差异（P<0.05）。结论社区护理干预改变了社区老年慢性病患者不良的生活方式，增强了患者的自我管理能力。

To screen potential hamster chymase 2 inhibitors, a high-throughput screening (HTS) model was established. Recombinant hamster chymase 2 with active form was cloned and expressed in E. coli. The HTS model with total volume of 50 microL in 384-well microplate was based on fluorescence analysis and was proved sensitive as well as specific (Z' = 0.84). A total of 40 080 samples (including 28 060 compounds and 12 020 natural products) were screened, and 613 samples with inhibition greater than 90% were selected for further rescreening. Finally, compounds J16647 and J16648 were identified with high inhibitory activity on chymase 2, and whose IC50 values were 0.823 and 0.690 micromol x L(-1), respectively.

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is an effective method for treating multiple malignant hematological diseases and hereditary diseases.However,systematic internal organs disorders,especially pulmonary complications,are commonly following allo-HSCT,How to correctly diagnose and treat the coexistence of pulmonary infectious complications and pulmonary noninfectious complications has great importance.OBJECTIVE: To report a case suffered from pulmonary Aspergillus infection coexisted with obliterative bronchiolitis at 1 year following allo-HSCT,and to discuss the prevention,clinical manifestation and treating method by reviewing related literature.METHODS: At 373 days after allo-HSCT,the patient developed fever,dry cough,shortness of breath and dyspnea on exertion A high-resolution computed tomography of chest demonstrated that there were alveolar infiltrating in the upper,middle and lower lobe of the right lung,and the focus of infection was performed further biopsy.RESULTS AND CONCLUSION: The histopathological examination of the sample showed alveolus dilatation,epithelial cells hyperplasia,fibrinous obliteration in alveolar space and peribronchiolar lymphocytes inflammation,which were CD3(+),CD45RO(+),CD20(-),CD79a(-),MPO(-),CD34(-).Aspergillus fumigatus could be seen in the cultured biopsied tissue specimen.Pulmonary function test showed that,air flow obstruction with reduction of forced expiratory volume in one second was 59.27%.The patient was diagnosed as invasive pulmonary Aspergillus infection combined with bronchiolitis obliterans and was treated by caspofungin combined with intravenous voriconazole for invasive aspergillosis,methylprednisolone,azathioprine,intravenous immunoglobulin and azithromycin for bronchiolitis obliterans.At 40 days after treatment,the CT examination showed the focus was absorbed completely.

Objective To prospectively evaluate the sensitivity and specificity of ankle brachial index (ABI) in the diagnosis of lower extremity arterial disease(LEAD)by using conventional digital subtraction angiography (DSA) as the reference standard, and to research the threshold value of ABI screening test for diagnosis. Methods A total of 383 consecutive patients (245 men and 138 women, mean age (64.1±11.7) years] underwent conventional DSA and ABI measurement. Receiver operator characteristics (ROC) analysis was performed to assess possible threshold values for predicting the LEAD in these patients. Results Conventional DSA was used as the gold standard in defining≥50% luminal stenosis for the diagnosis of LEAD. 0. 95 was the overall cutoff of ABI which was associatcd with 93.0% sensitivity, 85.0% specificity, 8.81 positive likelihood ratio(+LR) and 0. 23 negative likelihood ratio(-LR) for detection of hemodynamically significant stenosis (lesions>≥50%) in all 383 subjects (P<0.01). The area under the ROC curve was 0. 953(95%CI 0.920～0.985). Conclusions ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the diagnosis of lower extremity arterial disease. And the cut-off 0.95 is the threshold ABI value for detecting LEAD in Chinese population.

Objective To analyse distribution and antibacterial resistance status of pathogenic bacteria isolated from blood cul‐tures of hospitalized infants ,in order to provide references for rational use of antimicrobial agents in the treatment of bloodstream infection .Methods A total of 299 strains of pathogenic bacteria isolated from positive blood culture specimens from infants(3 or less than 3 months of age) suspected with bloodstream infections in this hospital from January 2011 to May 2015 were collected ,the bacteria identification and drug sensitivity test were carried out by using the VITEK 2 Compact automatic microorganism analyzer . The composition and antibacterial resistance of these isolates were analyzed .Results Among the 299 strains of pathogenic bacteria , there were 169 strains of gram‐positive cocci(accounted for 56 .5% ) ,including 95 strains of coagulase negative Staphylococcus (ac‐counted for 31 .8% ) which was the main isolates ,and followed by 28 strains of Staphylococcus aureus(accounted for 9 .4% );there were 120 strains of gram‐negative bacilli (accounted for 40 .1% ) and mainly were Escherichia coli (53 strains ,accounted for 17 .7% );otherwise ,there were 8 strains of fungi (accounted for 2 .7% ) and 2 strains of gram‐positive bacillus (accounted for 0 .7% ) .The results of drug susceptibility test indicated that the gram‐positive cocci had multiple drug resistance to antibacterial a‐gents except for vancomycin and linezolid;the gram‐negative bacilli shown multiple drug resistance except for amikacin ,imipenem and meropenem .The fungus ,however ,displayed high sensitivty to all antifungal drugs .Conclusion Gram‐positive and gram‐nega‐tive bacteria are the main pathogens of hospitalized infants with bloodstream infection ,and are severely resistant to antibacterial a‐gents .Rational use of antimicrobial agents should be recommend for improving clinical efficacy and prohibiting the emergence of drug‐resistant strains .

Objective To observe the MRI findings of normal pancreas in piglets. Methods Eight healthy piglets underwent MR examination, and the morphology, size, signal intensity of pancreas were observed. After MR imaging, all piglets were abdominally incised to observe the anatomy of pancreas and pancreatic adjacent structures. The opening of both common bile duct and pancreatic duct were detected during operation. Two piglets were sacrificed after operation and the whole pancreases were dissected for anatomic research. Results The pancreas of piglets was composed of three parts: right lobe, median lobe and left lobe. All the lobes were displayed clearly on MRI. The signal intensity of pancreas was higher than that of liver and spleen on T1WI, whereas lower than that of liver and spleen on T2WI. On MRCP, pancreatic duct was not presented, whereas the common bile duct could be seen clearly. The opening of common bile duct located at superior part of duodenum (nearby the pylorus) and the opening of pancreatic duct situated at duodenal papilla corresponding to pancreatic right lobe. Conclusion MRI can show the pancreas of piglets very well. The morphology of pancreas and features of common bile duct conjunction with pancreatic duct in piglet are different from those in human.

OBJECTIVETo investigate the effects of 17β-estrogen on expressions of C-reactive protein (CRP) and its mRNA in vascular smooth muscle cells(VSMCs).

METHODSImmunocytochemistry was used to detect CRP level in normal VSMCs. The expressions of C-reactive protein and p-ERK1/2 in Ang-II-stimulated VSMCs were evaluated with Western blot. C-reactive protein mRNA was examined with RT-PCR.

RESULTS17β-estrogen had no effect on cell morphology and C-reactive protein expression in normal VSMCs; however, C-reactive protein and mRNA, as well as p-ERK1/2 were decreased in Ang-II-stimulated VSMCs after 17β-estrogen treatment in a concentration-dependent manner.

CONCLUSION17β-estrogen may inhibit the expression of C-reactive protein and its mRNA in Ang-II-stimulated VSMCs via ERK1/2 signal transduction pathway in a concentration-dependent way.

Animals ; C-Reactive Protein ; genetics ; metabolism ; Cells, Cultured ; Estrogens ; pharmacology ; Male ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; drug effects ; metabolism ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

Objective We aimed to explor the correlation between the serum resistin levels and the collapse process of femoral head necrosis. Methods Eighty-eight patients with osteonecrosis of the femoral head were included in this study (26, 34 and 28 cases at ARCO stage Ⅱ, Ⅲ and Ⅳ, respectively). Fifty healthy controls were enrolled. The serum resistin levels were detected with ELISA method. We compared the serum resistin levels between the patient group and control group. The differences of serum resistin levels between different ARCO stagesand various disease causes were analyzed in the patient group. Results The resistin levels were significantly higher in patients with osteonecrosis of the femoral than healthy control group (P = 0.026). Compared with control group, the resistin levels significantly increased in patients at ARCO stage Ⅲ and ARCO stage Ⅳ respectively (P = 0.001).The resistin levels of procollapse group (ARCO stage Ⅲ and Ⅳ) were significantly higher than that of precollapse group (ARCO stage Ⅱ) (P = 0.000). There was no statistic difference between ARCO stage Ⅲ andⅣ in resistin levels (P> 0.05). No statistical significance was found between different disease causes. ROC curve analysis of resisrin level indicated theertain accuracy (AUC = 0.749) , sensitivity and significant specificity (77.4％, 61.5％, respectively) in the diagnosis of femoral head necrosis. Conclusions Resistin is closely related to the collapse process of femoral head necrosis. The level of resistin was significantly increased after the collapse of femoral head, which could be useful for the clinical diagnosis of the collapse of femoral head necrosis.

Polyamine is an important physiological regulation substance functioning in a wide variety of biological processes, such as plant growth, development, senescence and adversity stress tolerance, which widely exist in all living organisms. Their biosynthetic pathways have already been revealed, and their physiological roles are being elucidated gradually. Previous work on polyamines biosynthetic deficiency mutants and various transgenic plants facilitates improved understanding of the important roles of polyamines and biosynthetic enzymes in plant growth and development. This paper summarizes researches in the biosynthetic pathways of polyamines in plants, focusing on research advances on functions of genes involved in polyamine metabolism. In addition, the potential research directions, especially the application of the genes in the genetic engineering of plant stress tolerance were also discussed.
Biosynthetic Pathways ; physiology ; Gene Expression Regulation, Plant ; Genes, Plant ; genetics ; Plant Physiological Phenomena ; Plants ; metabolism ; Plants, Genetically Modified ; Polyamines ; metabolism ; Stress, Physiological