Objective To explore the effects of the multidisciplinary cooperative continue nursing on the quality of life of patients with chronic obstructive pulmonary disease (COPD). Methods From December 2012 to December 2014, hospitalized COPD patients who were in the stable stage of disease and would soon be discharged and met the criteria standards were chosen. Convenient extraction of 64 patients were set as the experimental group in one ward and 50 patients as the control group in the other ward. The conventional discharge guidance was employed in the control group. While the continuation of care before discharge and 1, 3, 6 months after discharge was employed in the experimental group. The indexes such as the quality of life and 6 min walking test distance (6MWD) were observed and compared. Results The total scores and symptoms, activities, influence scores of the quality of life were 48.53±15.78, 35.38± 18.61, 57.95 ±23.69, 52.28 ±15.27 after 6 months intervention in the experimental group and 60.24 ±10.14, 52.76 ±12.36, 68.34 ±15.59, 58.55 ±11.79 in the control group, and there were significant differences (t=-5.69--2.38, P<0.05). 6MWD was (267.46 ±64.64) m after 6 months intervention in the experimental group,which was more than that before intervention (169.42±48.46) m, and there was significant difference (t=-9.71, P<0.01). 6MWD was (201.32±53.93) m after 6 months intervention in the control group, which was not significantly better than that in the experimental group (t=5.82, P<0.01). Conclusions The quality of life of patients with COPD can be significantly improved by the multidisciplinary cooperative continue nursing education after discharge.

BACKGROUND:Cartilage is an avascular tissue and has a limited capacity for self-repair after injury. There are various methods for the treatment of articular cartilage injury ranging from conservation therapy to invasive surgery. With the development of tissue engineering technology, it provides a new way for treating articular cartilage injury. OBJECTIVE:To review the new development of tissue engineering technology for repairing articular cartilage injury. METHODS:The PubMed database and CNKI database were retrieved for articles from 2000 to 2013 by the first author with computer in May 2013. The key words were“cartilage tissue engineering, cartilage defect, stem cell, scaffold, growth factor”in English and Chinese. A total of 64 articles were included which related to cartilage regeneration and cartilage tissue engineering. For the articles in the same field, those published recently or in authorized journals were selected. RESULTS AND CONCLUSION:The three elements of cartilage tissue engineering, seed cells, scaffolds and cytokines, must be coordinated and mutual y beneficial development. At present, the research of tissue engineering for repairing articular cartilage injury has made a great progress. But the application in clinic has not enforced yet which is limited in experimental exploration stage. With the continuous development of new materials, the new tissue engineering cartilage repair materials should meet the requirement of material science and biological science, thus making the materials closely meet the biological characteristics of the self tissues. The animal studies wil turn to clinical experiments with the support of new technique, which make a breakthrough in the treatment of articular cartilage injury.

Objective:To study the expression of IQ motif containing GTPase activating protein 1 (IQGAP1 )in oral squamous cell cancer(OSCC)tissue,and to explore the effects of IQGAP1 on cell proliferation and invasion as well as its underlying mechanism. Methods:Expression levels of IQGAP1 in tumor and adjacent normal tissues were examined by western blot and RT-PCR.OSCC cell line SCC-4 cells was transfected with the recombinant plasmid-pcDNA3.1 -IQGAP1 by lipofectamine,and then treated with an Akt in-hibitor.The phosphorylation of Akt,cell proliferation and invasion were detected by western blot,MTT assay and Transwell invasion as-say respectively.Results:Protein and mRNA expression levels of IQGAP1 were higher in cancer tissue than in adjacent normal tissue (P <0.05).Transfection of pcDNA3.1 -IQGAP1 increased IQGAP1 expression,enhanced the capability of cell proliferation and inva-sion (P <0.05),increased p Akt level in the cells.Preconditioning with an Akt inhibitor reduced p Akt level.Furthermore,silencing Akt pathway blocked the increase of cell proliferation and invasion induced by IQGAP1 overexpression(P <0.05).Conclusion:IQ-GAP1 overexprission can mediate the ability of proliferation and invasion of OSCC cells by regulating the activation of Akt pathway.

Objective To investigate the relation between macrophage infiltration and degree of calcific aortic stenosis (CAVS)in elder patients.Methods The aortic valve specimens were collected from 2012 September to 2014 March in Depart‐ment of Cardiac Surgery of Hainan General Hospital ,for operation removal ,from 80 cases[40 males and 40 females ,age:(58 ± 6)years old];normal aortic valve specimens were collected from 7 patients undergoing surgical removal of the normal aortic valve because of aneurysm[4 males ,3 female patients ,aged(41 ± 8)years] ,and 80 healthy adults served as control group.The clinical data of patients were collected ,and CAVS valve and normal valve were observed by HE staining.Expression feature of macrophages was studied by immunohistochemical(IHC)staining.IPP(Image‐Pro Plus)software was used to measure the densi‐ty of macrophages ,and Pearson relation analysis was employed to study the correlation between the density of macrophages and the degree of valve stenosis.Results As compared with healthy adults ,cholesterol and C reactive protein in patients with CAVS were significantly elevated.There were infiltration of inflammatory cells ,new blood capillaries and calcification in the valves of CAVS lesions observed by HE staining.No positive expression of macrophage marker CD68 was found in normal aortic valves , but CD68 positive expression was observed in the valves of CAVS by IHC staining ,and mainly concentrated in the peripheral calcification and osteoid tissues.Simple linear regression analysis showed the density of macrophages was positively correlated with the large pressure gradient(r=0.75 ,P<0.05) ,the average differential pressure(r=0.75 ,P<0.05) ,and the maximum aortic jet velocity(r=0.72 ,P<0.05) ,however ,was negatively correlated(r= -0.71 ,P<0.05)with the valve orifice area .Con‐clusion Compared with healthy adult volunteers ,the concentration of cholesterol and C reactive protein were elevated in blood of the patients with CAVS.Compared with the normal valve ,the macrophages were infiltrated in CAVS valves ;the density of macrophage was positively correlated with the degree of CAVS.

Objective To investigate the relationship of body mass index (BMI), blood glucose, and blood calcium with se-verity of acute pancreatitis .Methods A total of 127 cases of patients with acute pancreatitis was divided into 10 cases of severe acute pancreatitis group (SAP group), and 52 cases of mild acute pancreatitis group (MAP group), according to the severity.BMI, levels of blood sugar and blood calcium of two groups were compared , respectively .Correlation analysis was carried out among those parame-ters.Results The differences in BMI, blood sugar, and blood calcium between SAP and MAP groups were statistically significant , respectively ( P <0.05).The differences in BMI, blood sugar, and blood calcium between patients [Ranson score≥3, Balthazar computed tomography(CT) grade D or E, and computed tomography severity index (CTSI)≥3)] and patients [Ranson score<3, Balthazar CT grade A , B, or C, and CTSI<3 ( P <0.05 ) ] were statistically significant ( P <0.05 ) , respectively .Pearson correla-tion coefficient analysis showed significantly positive correlations among BMI , blood glucose , blood calcium , Ranson score , Balthazar CT grade, and CTSI ( P <0.05).Conclusions Severity of acute pancreatitis patients was related to BMI , blood sugar, and blood calcium.All of them can be used as evaluation index of disease progression and prognosis in patients .

Objective To study the gene expression on the inhibitory effect of endostatin on choroidal neovascularization in C57BL/6J mice and the mechanisms.Methods Photocoagulation using 532 nm diode laser was performed to establish a CNV model in mice’s eye.The mice were randomly divided into three groups:blank group (model group);endostatin group (experimental group),in which endostatin of 0.01 mg/2μL was given intravitreally;and saline group (control group),which received intravitreal injection of 2μL of 0.9 g/L saline.Four samples selected respectively from experimental group and control group were used to complete the gene expression profiling analysis.By comparing the differences of gene expression between the two groups,we selected the genes with expression difference ≥ 1.5 times and P ≤ 0.05. Results CD105 marking showed that choroidal neovascularization was significantly lower in endostatin group than in control group.The gene expression analysis showed that 1 1 6 genes were up-regulated and 1 0 6 genes were down-regulated in endostatin group compared with control group.GO analysis indicated that endostatin could inhibit cell activity and growth,but did not initiate the activity of the immune system,and even suppress it.Conclusion Endostatin can inhibit the activity and locomotion of endothelial cells and synergically inhibits the immune system,thus suppressing choroidal neovascular-ization.

Once umbilical cord ligation,neonatal kidney will be responsible for maintaining the whole-body homeostasis and the excretory requirements of the newborn. Meanwhile,there is a significant physiologic changes that occurs during the transition from intrauterine to extrauterine life. Neonatal renal reserve is less than adults,for the structure and function of the kidney still undergo a maturation process. Under the normal condi-tion,the adaptive changes of the renal function,with neonatal growth and development,can keep a delicate bal-ance of the internal environment. If they are exposed to a variety of external stressors,their immature kidney is especially vulnerable,which will not only cause fluid,electrolyte and acid-base imbalances and the adverse prog-nosis,but effect kidney structure and function further mature and increase the long-term risk of chronic kidney disease as well.

Objective:To observe the clinical efficacy of electroacupuncture and rehabilitation exercises in the treatment of cerebral infarction.Methods:Seventy-four patients with cerebral infarction were randomized into treatment group and control group in visit sequence.Thirty-seven cases in treatment group were treated with electroacupuncture and rehabilitation exercises,and other 37 cases in control group were treated with electroacupuncture alone.The treatment was given once a day and there was a 2-day interval after any consecutive 5 treatments.After total 30 treatments,Fugl-Meyer scale was used to evaluate motor function and Barthel Index to evaluate the activities of daily living.Results:After treatments,the motor function of paralyzed limb and activities of daily living were obviously improved in both groups,with more significant improvement in treatment group than in control group (P＜0.05).Conclusion:Combination of electroacupuncture and rehabilitation exercises has better effects than simple electroacupuncture in the treatment of cerebral infarction.

Purpose　To judge the value of CT in the diagnosis of acute pancreatitis. Methods　74 cases of acute pancreatitis confirmed by operation were reviewed. All patients underwent CT plain and contrast -enhanced scanning. Oral contrast agents were used. Results　According to clinical diagnosis, they were devided into edematous type(n=53),and necrotic type(n=21). 7 cases were complicated with abscesses, and 5 cases died. According to CT finding, Grade A,n=10; Grade B,n=16; Grade C,n=19; Grade D,n=16; Grade E, n=13. Conclusion　 CT is valuable in the diagnosis of acute pancreatitis, and CT grade is referable.

Objective To establish a method to evoke cerebral potentials by stimulating nociceptive fibers with contact heat evoked potential stimulator,evaluate the state of nociceptive system in patients with multiple sclerosis and assess the value of the potentials in multiple sclerosis(MS).Methods Thirty-six definite MS patients and 40 sex-,height-and aged-matched healthy persons underwent stimulation of contact heat delivered via a circular thermode to excite selectively nociceptors with a rapid rising time at 70℃/s to elicit pain and contact heat evoked potentiaI(CHEP).Thermal stimuli were sent at two intensity levels (47 ℃ and 51℃)to 3 body sites:volar surface of the forearm,the skin of leg 5 cm proximal to the medial malleolus and lumbar part.The CHEP were recorded from Cz.The relationship between the stimulus intensity and pain rating was observed,and the main components of the evoked potential were recorded.Then,somatosensory evoked potential(SEP)was examined in 36 patients with MS.Results CHEP were elicited reliably and stably in all control subjects.In contrast,in 4 patients there were no recordable CHEP on stimulation of the upper limb,and in some cases of lower limb(n=5).Conduction velocity of Aδ fihers was(18.1±7.3)m/s.The 21 MS cases had hypesthesia in upper limb and 29 cases in lower limb.The visual analog scale(VAS)for pain perception was higher in control subjects(upper limb:8.0±0.7;lower limb:7.9±0.7)than MS with hypesthesia(upper limb:6.1±0.9;lower limb:5.6±1.3,Z=-3.249 and -5.272,both P＜0.01).The group of patients (MS) with hypesthesia(upper limb 17 cases,lower limb 24 cases)had markedly reduced N-P amplitudes(upper limb:(30.5±12.8)μV;lower limb:(28.2±16.2)μV,t=-4.612 and -3.144,both P＜0.01)and prolonged N-wave latencies(upper limb:(387.3±34.2)ms;lower limb:(489.9±70.2)ms,t=4.790 and 4.798,both P＜0.01)compared with the control group in CHEP mediated by Aδ fibers.CHEP abnormality was observed more often in the lower(26/36,72.2%)than the upper limb(16/36,44.4%,P=0.031)and SEP(19/36,52.8%,χ~2=4.261,P=0.039).CHEP were abnormal in 3 of 15 skin areas with clinically normal nociception in upper limb,and in some cases of lower limb(2 of 7).Conclusions CHEP provides a clinically practical,non-invasive and objective measure,and can be a useful additional tool for the assessment of nocieptive system.Combined assessment of other Eps can help to document dissemination of demyelinating CNS lesions and detect subclinical lesions thus contribute to the diagnosis of multiple sclerosis.