Although osteoporosis is often considered asilent disease,it is highly prevalent.It will definately affect the health of elderly people and bring heavy burden to the society.Studies of osteoporosis will also draw great attention in the field of geriatrics.The diagnosis,treatment,and monitoring of osteoporosis have not yet been standardized.Multidisciplinary medical staff should work together along with the cooperation of the patients.

Objective To analyze inhibitions and working memory impairments in children with different subtypes of attention deficit hyperactivity disorder (ADHD) with saccade tasks. Methods Participants,aged 10～ 13 years with ADHD-combined ( n= 19) ,ADHD-inattentive ( n= 11 ) and control subjects ( n= 18) ,were selected according to DSM-Ⅳ diagnosis,Conners teacher rating scale and parent symptom questionnaire from 1500pupils from 2 primary schools in Jinhua city by stratified cluster sampling method. Participants performed 3 different saccade tasks: 1 prosaccade and 2 antisaccades executed in a single-task and a dual-task situation. One of the antisaccade tasks was performed under the verbal secondary task condition to investigate verbal working memory.Saccades were registered by Eyelink Ⅱ Tracker. Errors and correct rate were analyzed. One-way ANOVA and repeated measures ANOVA were used to analyze the data. Results (1) Each group showed more response suppression errors on antisaccade task without load than on prosaccade task, ADHD-combined and ADHD-inattentive exhibited more errors than non-ADHD (P＜0.01) ,and errors was lower in ADHD-inattentive than in ADHD-combined ( ( 70.90 ± 15.78 ) % vs ( 84.04 ± 12.84 ) %, P ＜ 0.05 ). (2) The interactions between group and load were not significant in error rate on antisaccade tasks (P ＞ 0.05 ), but in correct rate (P ＜ 0. 05 ). The two subtypes of ADHD were affected more than non-ADHD, their correct rates tended to decrease under verbal working memory load. Conclusion An integrative view of deficits in inhibition and verbal working memory in two subtypes of ADHD is proposed, and ADHD-inattentive has a better response suppression than ADHD-combined.

In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.

BACKGROUND:Treatment methods of pterygium mainly include pterygium excision,pterygium excision combined with local application of mitomycin,pterygium excision combined with conjunctival flap transfusion and pterygium excision combined with autologous corneal limbus stem cell transplantation.Dry eye commonly occurred in many patients following pterygium excision.OBJECTIVE:To evaluate the effects of stem cell transplantation of limbus cornea and simple excision of pterygium on tear film stability.METHODS:Eighty patients(eighty eyes)with pterygium were involved in this clinical experiment.All patients were randomly divided into 2 groups:Group A accepted simple excision of pterygium in 40 patients with 40 eyes under a 10-fold microscope,and Group B accepted excision of pterygium with stem cell transplantation of limbus cornea in 40 patients with 40 eyes under a 10-fold microscope,in which a free transplantation of the superotemporal limbus stem with an adjacent piece of conjunctiva was transplanted in the excision area.Slit-lamp examination,tear film break-up time and questionnaire on dry eye were performed before operation,at one week post-operation,and at three months post-operation.RESULTS AND CONCLUSION:In both groups,following surgery,some patients affected dryness,foreign body sensation,burning sensation.These symptoms were more in the group A compared with group B(P ＜ 0.05).Implant was red 1 week following surgery in the group B,and confluence was found,without infection or rejection.The tear film break-up time was prolonged in the group B compared with the group A at 1 week following surgery,and no significant difference was determined at 3 months.Results indicated that compared with simple excision of pterygium,combined excision of pterygium with stem cell transplantation of limbus cornea obtained better outcomes,and could decrease the manifestations of dry eye and maintain better tear film stability in patients with pterygium.

Objective To compare the clinical efficacy of three kinds of replacement fluid for continuous hemofiltration in severe sepsis,and to develop a more rational composition.Methods Fifty severe sepsis patients with continuous hemofiltration were divided into four groups randomly.The configuration of the replacement fluid in accordance with the random number table,randomly selected from four different formulations:group A (13 cases):Ports composition provided by Nanjing general hospital;group B (12 cases):Zhongshan hospital composition; group C (11 cases):an improved composition; group D (14 cases):an improved composition by Donghua hospital affiliated to SUN Yat-sen university.Blood electrolytes,blood gas analysis,renal function,blood glucose(highest and lowest serum glucose in treatment period),high sensitive C-reactive protein(hs-CRP) concentration,calcium concentration in filter were tested before and after every treatment period.Results The concentration of blood electrolytes during treatment had no significant change (P ＞ 0.05).Renal function were improved significantly after treatment among four groups (P ＜ 0.05).The level of hs-CRP decreased significantly after treatment (P ＜ 0.05) and there was no significant difference among four groups (P ＞ 0.05).The change of serum glucose during treatment was the smallest in group D than that in group A,B,C [(3.0 + 0.9) mmol/L vs.(11.2 + 2.0),(3.8 + 1.1),(5.5 +1.3) mmol/L](P ＜ 0.05).Calcium concentration in filter was the lowest in group D than that in group A,B,C [(1.5 + 0.5) mmol/L vs.(2.0 + 0.7),(2.3 + 0.5),(2.1 + 0.4) mmol/L] (P ＜ 0.05).The dosage of heparin was the least during treatment in group D than that in group A,B,C[(6.5 ± 2.8) U/(kg·h) vs.(8.9 ± 3.4),(7.9 ± 3.0),(8.7 ± 3.1) U/ (kg· h)] (P ＜ 0.05).Conclusions Improved composition by Donghua hospital affiliated to SUN Yat-sen university hospital compared to other compositions can better maintain a stable blood glucose levels,have a better anticoagulant effect,reducing the application of heparin,maintain a stable homeostasis.It is worthy of using in clinic.

Objective To construct lentivirus vector expressing antigene RNA and ferritin gene.Methods Intermediate plasmid pGC-FU-HF was constructed by transfecting lentivirus vector pGC-FU with heavy chain ferritin subunit gene.The target plasmid pGC-agRNA-HF was subsequently constructed by transfecting the intermediate plasmid with β-arrestin 2 antigene RNA.The NG108-15 cells were transfected with the target plasmid.The titre of lentivirus vector was measured by RT-PCR.The expression of antigene RNA and ferritin gene was determined by Western blot and RT-PCR.Results Lentivirus vector was successfully transfected with antigene RNA and ferritin gene.The titre of lentivirus vector was 2.00 × 109 TU/ml.The expression of β-arrestin2 protein was down-regulated and the expression of ferritin protein up-regulated in the NG108-15 cells after being transfected with the lentivirus vector.Conclusion Lentivirus vector expressing antigene RNA and ferritin gene has been successfully constructed.

Purpose: In this article, we aimed to investigate the influences of luteolin on inflammatory injury to cardiomyocytes induced by lipopolysaccharide (LPS). Materials and Methods: H9c2 cells were pretreated with different concentrations of luteolin (10, 20, and 50 μM) for 12 h and then stimulated with 10 μg/mL LPS or no LPS for 6 h. Cell viability was detected by CCK-8 assay. Cell apoptosis was determined by flow cytometry. QRT-PCR and Western blotting were utilized to examine mRNA and protein levels. ELISA was used to determine the levels of monocyte chemoattractant protein-1, tumor necrosis factor-alpha, interleukin (IL)-6, IL-1β, and IL-18 in cell supernatants among different groups of H9c2 cells. Immunofluorescence was applied to evaluate reactive oxygen species formation in H9c2 cells. M-mode images of echocardiography, the ejection fraction test, fractional shortening test, end-systolic volume test, and end-diastolic volume test of mouse heart function were obtained by ultrasonic electrocardiogram. Results: Luteolin could alleviate inflammatory damage and inflammatory factor expression among LPS-induced H9c2 cells. Additionally, we found that luteolin decreased LPS-stimulated inflammatory damage in H9c2 cells by down-regulating NOD-like receptor family pyrin domain containing 3 (Nlrp3). Luteolin also improved myocardial function in mice treated with LPS and reduced myocardial relaxation. Luteolin reversed myocardial histological abnormalities in mice and reduced inflammation and cardiomyocyte apoptosis. Additionally, luteolin inhibited oxidative stress-mediated myocardial and systemic tissue damage in mice. Finally, luteolin reduced LPS-induced inflammatory damage in mouse cardiomyocytes by down-regulating Nlrp3. Conclusion We found that luteolin could reduce inflammatory damage to cardiomyocytes induced by LPS by down-regulating Nlrp3.

Objective:The present study aimed to explore the clinical value of neutrophil to lymphocyte and platelet ratio (NLPR) for acute kidney injury (AKI) in elderly patients with sepsis.Methods:This was a retrospective analysis of 360 elderly patients with sepsis or septic shock who were admitted to Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University. They were divided into AKI and non-AKI groups based on the KDIGO-AKI criteria. The independent risk factors of AKI were identified via logistic regression analysis, and the calculation of the receiver-operating characteristic (ROC) curves were used to evaluate the diagnostic capability of NLPR for AKI and the short-term outcome of sepsis patients.Results:Total of 195 (54.2%) patients were attributed to the AKI group, while 165 (45.8%) patients were allocated to the non-AKI group. The median of NLPR was significantly higher in the AKI group compared with the non-AKI group ( Z=8.640, P<0.001). Compared with the non-AKI group, the in-hospital death and the length of ICU stay increased (all P<0.05). Patients with AKI required more vasoactive drugs, mechanical ventilation, and renal replacement therapy (all P<0.05). After adjusting the demographic and clinical variables, multivariate logistic regression analysis showed that NLPR was an independent risk factor of AKI ( OR=1.016, 95% CI 1.002-1.030, P=0.027). The ROC curves showed the excellent clinical value of NLPR and which was significantly higher than the neutrophil to lymphocyte ratio (NLR) and serum creatinine. In addition, the present study revealed that the NLPR was also positively correlated with the stage of AKI ( r=0.525, P<0.001). Conclusions:The NLPR is derived from a complete blood cell count, as a new comprehensive inflammatory parameter that is simple and easily available, it is an independent risk factor for AKI in elderly sepsis patients, and should be paid attention in the clinical practice.

Objective To explore the factors related to the amount of suction under glottis, look for effective nursing counter measures in order to improve the suction effects. Methods A retrospective analysis of the clinical data of 71 patients with subglottic secretion drainage from 1st January 2013 to 1st May 2014 was performed. The secretion viscosity, posture, the endotracheal tube cuff pressure, patients restlessness, suction pressure, and acute physiology and chronic health evaluationⅡscore were set as independent variables. A multiple linear regression analysis was performed to screen factors that may lead to reduction of suction volume of subglottic secretion and nursing counter measures were planned and implemented accordingly. Results Secretion viscosity, supine, endotracheal tube cuff pressure and patient restlessness were the main reasons that influence the amount of suction under glottis(P<0. 05). Multiple linear regression equation:amount of suction of subglottic secretion/2 h(ml) =4. 868 +2. 470 × restlessness-1. 624 × secretion viscosity+0. 874 × endotracheal tube cuff pressure-0. 933 × posture. Conclusions Quantity of suction of subglottic secretion were positively correlated to patients′restlessness, secretion viscosity and endotracheal tube cuff pressure. Subglottic attract amount for the most when take left lateral position. Strengthening the control and intervention of related factors plays a very important role in the care of suction under glottis.

Objective To evaluate the one-year clinical outcomes in patients with the vulnerable plaque sealing with drug-eluting stents for the treatment of intermediate coronary stenosis. Methods 327 patients with an-giographically intermediate lesions(diameter stenosis 50%~70%)with the vulnerable plaque which were detected by 64 slice coronary CT were prospectively enrolled. Patients were divided into medical therapy group (n = 160) and sirolimus-eluting stent group group(n=160). The incidences of one-year major adverse cardiovascular events (MACE)was evaluated(cardiac death,myocardial infarction ,revascularization). Results The MACE tended to be lower in the sirolimus-eluting stent group than medical therapy group(3.13%vs. 10%,log-rankχ2=6.62,P=0.01). The incident of cardiac death and myocardial infarction were lower in the sirolimus-eluting stent group than medical therapy group(1.25%vs. 5.63%,log-rankχ2=4.61,P=0.03). Conclusion The treatment of the siroli-mus-eluting stent can reduce MACE for the paitents with the vulnerable plaque of intermediate coronary stenosis than medical therapy only.