Objective To explore the correlative factors of hypotension among hemodialysis patients and to come up with nursing interventions.Methods The histories of 49 maintenance hemodialysis patients were retrospectively reviewed to find out the correlative factors of hypotension and summarize the nursing strategies.Results The major factors for hypotension included large volume of dehydration and fast speed of dehydration in 22 cases,malnutrition and hypoproteinemia in 8 cases,severe anemia in 6 cases,dysfunction of the autonomic nervous system in 5 cases,low concentration of sodium or high temperature of dialysate in 4 case and medication errors and eating too much before or during dialysis in 4 cases.Conclusion The nursing strategies including control of weight,correct assessment of dry weight,right performance of low temperature hemodialysis and sodiun profile hemodialysis as well as mental care to those with depression are critical for prevention of hypotension development in patients undergoing maintenance hemodialysis.

Objective:To study the functional status of the monocytes-derived dendritic cells (DCs) plused with HBsAg from patients with chronic hepatitis B and their capacity of inducing the HBV- special cytotoxic T lymphocytes (CTLs),and explore a new method of inducing the special anti-HBV cell-mediated immunity.Methods:Monocytes of patients were isolated from peripheral blood and incubated with GM-CSF+IL-4+TNF-? to induce DCs generation. Those DCs were pulsed with HBsAg to induce HBV- special DCs. The phenotype of DCs including CD1a,CD80,CD83,CD86,CD40 and HLA-DR was characterized by FCM and the stimulating reaction of allogenic T lymphocytes was detected by MTT assay. The concentration of cytokines such as IL-12 and IL-6 in supernate was tested by ELISA and the cytotoxicity of CTLs inducing by the DCs against HepG2 2.2.15 cells,HepG2 cells and K562 cells were detected by LDH assay.Results:The expression of CD1a, CD80, CD83,CD86, CD40, HLA-DR molecules on the DCs pulsed with HBsAg was higher than those of the control group (P

Objective:To study the radiotherapy sensitization of recombinant human endostatin in patients with cervical cancer.Methods:Sixty patients with advanced cervical cancer (stage ⅡB to ⅣA) from July 2017 to November 2018 in the Second Affiliated Hospital of Dalian Medical University were selected. The patients were divided into experimental group and control group according to random number table with 30 cases each. The patients in experimental group were treated with recombinant human endostatin combined with concurrent chemoradiotherapy, while the patients in control group only received chemoradiotherapy. The serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured 1 week before treatment and 1 week after treatment, and short-term efficacy was evaluated 3 months after treatment.Results:The objective remission rate (ORR) and disease control rate (DCR) in experimental group were higher than those in control group: 93% (28/30) vs. 87% (26/30) and 97% (29/30) vs. 93% (28/30), but there were no statistical differences between 2 groups ( P>0.05). There was no statistically significant difference in the occurrence of adverse reactions between 2 groups ( P>0.05). Compared with that before treatment, the serum VEGF and bFGF after treatment were significantly lower, experimental group: (88.07 ± 37.53) ng/L vs. (227.27 ± 142.61) ng/L and (21.03 ± 5.75) ng/L vs. (38.34 ± 18.17) ng/L, control: (120.04 ± 81.22) ng/L vs. (197.34 ± 142.41) ng/L and (24.04 ± 7.29) ng/L vs. (39.78 ± 13.35) ng/L, and there were statistical differences ( P<0.01); after treatment, the serum VEGF and bFGF in experimental group were lower than those in control group, but there were no statistical difference between 2 groups ( P>0.05). Conclusions:For patients with advanced cervical cancer, recombinant human endostatin combined with concurrent chemoradiotherapy can further decrease the serum levels of VEGF and bFGF, improve the sensitivity of chemoradiotherapy, and enhance the short-term efficacy.

Objective To study the value and feasibility of temporary emergency bedside cardiac pacing. Method Two hundred patients with severe witnessed bradycardia were treated with temporary emergency cardiac pacing. We treated 130 patients with emergency bedside pacing and 70 patients with x-ray-guided pacing. Results Emergency bedside pacing was successful in 127 patients except three patients and no postoperative complications occurred. X-ray-guided pacing was successful in all 70 patients but three patients experienced complications: one deep venous thrombosis and two cardiac tamponades due to myocardial perforation. The pacing electrodes were more likely to be displaced in X-ray-guided pacing than in emergency bedside pacing (six cases versus three cases) . The door-to-operation time was 30-90 min for x-ray-guided cardiac pacing and 5-15 min for emergency bedside pacing. Needle-to-pacing times were similar for both procedures (3.5 ± 1.5 min for x-ray guided pacing versus 4± 2.5 min for bedside pacing). Conclusions Temporary emergency bedside cardiac pacing is a rapid, efficient and safe procedure for treating severe witnessed bradycardia. The technique is easily mastered and may prove lifesaving in an emergency.

Objective To investigate association between postural changes of blood pressure and carotid atherosclerosis in the elderly.Methods Standardized questionnaires,physical examination and biochemical blood tests were performed to acquire clinical characteristics of the participants.Presences of carotid plaques were identified by carotid ultrasound examination.Orthostatic hypotension (OH) and orthostatic hypertension (OHT) were defined according to the international consensus.Multivariable logistic regression analysis was performed to analyze the associations of carotid plaques with OH and OHT.Results 377 old people were finally included,of which 101 had OH and 33 had OHT.After full adjustment for possible confounders,old people with carotid plaques had significantly increased risk for OH as compared with those without carotid plaques (OR=2.27,95％ CI:1.32-3.90,P=0.003).Participants with bilateral carotid plaques were associated with significantly increased risk for OH (OR=3.45,95％CI:1.74 6.84,P=0.001),while the association between unilateral carotid plaques and OH was not significant (OR=1.71,95％ CI:0.88-3.32,P=0.112).No significant association was identified between carotid plaques (bilateral or unilateral) and OHT.Conclusions Presence of carotid plaques,particularly bilateral plaques,may be an independent risk factor for OH.

Objective To study the genetic diversity of different geographical populations of Houttuynia cordata in China.Methods The genetic diversity of 15 geographical populations of H.cordata from 13 provinces in China was estimated using amplified fragment length polymorphism(AFLP) markers.The data of amplified bands were analyzed by the software POPGENE and MEGA.Results The ten AFLP primers employed produced a total of 110 discernable and reproduceable amplified fragments.The percentage of polymorphic bands within different populations was 70.51%.Genetic diversity analysis showed that effective number of alleles(Ne) was 1.210,Nei′s gene diversity(H) was 0.119,and Shannon′s genetic diversity index(I) was 0.186.The coefficient of genetic distance was 0.008 9—0.181 8 among populations.A UPGMA dendrogram based on Nei′s(1972) genetic distance visualized that the 15 populations were grouped into three different clusters,Emei population was one individual cluster group and the other populations were grouped into two different clusters corresponding to the different geographical areas.Conclusion The genetic diversity within different geographical populations of H.cordata in China is plentiful.

Objective To investigate the role of activated cylic AMP(cAMP) signaling in chemical-induced podocyte injury.Methods Eight-weeks-old male BalB/C mice were randomly divided into three groups:control group,Adriamycin (ADR) group and Forskolin+ADR group.ADR nephropathy models were established by tail intravenous injection,and part of them were injected Forskolin,an agonist of adenylate cyclase,intraperitoneally.Phosphorylation of cAMP response element binding protein (CREB) was detected by laser confocal microscopy,morphology of foot processes were determined with transmission electron microscope,and WT-1 expression in glomeruli were detected by immunohistochemistry.Conditionally immortalized podocytes were treated with puromycin aminonucleoside (PAN),Exchange protein directly activated by cAMP (Epac) agonist 8-pCPT-2-O-Me-cAMP (2Me),protein kinase A (PKA) antagonist H89 and its agonist pCPT-cAMP(pCPT).Western blot was used to detect the expression levels of Epac,caspase3 and cleaved caspase3.PKA activity was assayed using cAMP-dependent protein kinase detection system.Cell viability was determined by a cell count kit and podocyte apoptosis was estimated by TUNEL staining.Mitochondrial membrane potential was evaluated by JC-1 staining.Results (1)Compared with ADR group,the urine albumin decreased significantly (P ＜ 0.05) among Forskolin + ADR group and the WT-1 positive cells per glomerulus increased obviously (P ＜ 0.05).(2)PAN decreased podocyte number in a time-dependent manner (P ＜ 0.05),pre-treatment with pCPT obviously inhibited PAN induced podocyte decrease (P ＜0.05),but H89 prevented the effect of pCPT in a dose-dependent manner (P ＜ 0.05).(3)JC-1 staining showed that the percentage of podocyte with green fluorescence for control,PAN and pCPT+PAN group were (12.67±2.15)％,(31.35±4.60)％ and (16.96 ± 2.51)％ respectively (P ＜ 0.05),and pretreatment with H89 inhibited the effect of pCPT (P ＜ 0.05).(4) PAN promoted podocyte apoptosis and cleaved caspase3 expression (P ＜ 0.05),and pretreatment with pCPT significantly prevented PAN-induced podocyte apoptosis and cleaved caspase3 expression (P ＜ 0.05).Conclusions cAMP signaling activation ameliorated podocyte injury in ADR nice and PAN-induced podocyte apoptosis,and cAMP/ PKA pathway may mediate these processes.

PurposeConventional gastric CT provides poor contrast for gastric cancer lesions, the purpose of this study is to investigate the application value of dual energy CT image fusion technology in the improvement of lesion contrast in gastric cancer.Materials and Methods Abdominal dual energy contrast-enhanced CT images of 30 gastric cancer patients were retrospectively analyzed, dual-energy images were reconstructed with different linear and nonlinear fusion settings, contrast between lesions and normal gastric wall, lesion contrast to noise ratio (CNR) were compared among 100 kVp, 140 kVp and different fusion groups, and image quality was evaluated subjectively.Results There were statistically significant differences among the gastric cancer contrast and CNR of 100 kVp, 140 kVp and three linear blending images (F=29.6 and 26.1,P<0.001), with M=0.7 linear fusion group showing the highest CNR. The gastric cancer contrast and CNR was signiifcantly higher with a bandwidth (BW) of 0 HU when compared among the three groups of nonlinear blending images (F=268.5 and 49.5,P<0.001). Moreover, the nonlinear group with a width of 0 HU had a 36% and 47% increase in lesion contrast and CNR over that of a linear blending image. In the subjective evaluation of images, the BW=0 HU nonlinear fusion image was most frequently estimated as the most preferred images for lesion observation of gastric cancer.Conclusion Nonlinear blending with a BW of 0 HU improves display of gastric cancer, and has the potential clinical value to increase the accuracy of staging.

Objective By analyzing the epidemiological characteristics and trends of brucellosis in Ji'nan City,to provide a scientific basis for further prevention and control of the disease.Methods Serum samples of suspected brucellosis patients were collected from every county (city,district) of Ji'nan City from 2008 to 2014,and these samples were screened by Rose-bengal plate agglutination test (RBPT).Then positive samples were confirmed by Standard tube agglutination test (SAT),and experimental data and results were analyzed by statistics.Results Totally 2713 serum samples of suspected brucellosis patients were tested,and 200 were positive by SAT.Temporal distribution:the serum antibody positive specimens were detected each month throughout the year,and the results showed clear seasonal prevalence by concentrating from March to September (82.07％,151/184).Population distribution:the serum antibody positive rate of males was higher than that of females,the ratio was 2.08:1.00,and the cases were found among 15 to 75 years old,while concentrated from 30 to 65 (67.00％,134/200).Spatial distribution:except Huaiyin District,positive samples were detected in all other 10 counties (cities,districts) of Ji'nan City,most of them (92.5％,185/200) in Shanghe,Zhangqiu,Changqing,Shizhong and Licheng counties (cities,districts).Conclusions Brucellosis epidemic in Ji'nan is serious,and cases have occurred mostly in spring,summer and autumn.It is recommended that health propaganda and education should be strengthened in order to enhance selfprotection awareness of the exposed population,and then improve the physical examination for early discovery,early reporting and early treatment.At the same time,it is important to cooperate with the Department of Livestock to prevent and control brucellosis.

Objective To evaluate different measurement methods in histogram for the diffusion and perfusion parameters from intravoxel incoherent motion (IVIM) MR imaging of different types of uterine fibroids.Methods 63 patients with confirmed uterine fibroids (80 in total) were examined with MR imaging.3D T2WI and IVIM imaging were performed for those patients.The fibroids were classified into three types (type 1, 2, 3) on the basis of different signal intensities on T2WI according to Funaki's theory.Real diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were calculated using IVIM analysis.25%,50% and 75% of those parameters (D25,D50,D75,D*25,D*50,D*75,f25,f50 and f75) as well as mean values (Dmean,D*mean and fmean) were calculated using histogram method.ANOVA was used to compare the IVIM parameters among the three types of fibroids.Results There were 44 type 1,24 type 2 and 12 type 3 fibroids in the total of 80 fibroids.There was significant difference among all the diffusion parameters from histogram and mean values of different types of fibroids, and only one perfusion parameter D*75 value showed significant difference (P<0.05).There was no significant difference among all the f values from histogram and mean values.Conclusion Different measurements of parameters from IVIM histogram showed no added value for diffusion features in different types of fibroids compared to mean value.While the perfusion parameter D*75 value from histogram can distinguish the features of perfusion within different types of fibroids compared to mean value.