Objective To evaluate the impact of hypertension self-management on self efficacy of community residents.Methods November 2011 to February 2012,twenty-eight medium-sized and better adherence to community was selected from fourteen districts and counties in Beijing.In this community-based randomized controlled trial,323 hypertensive patients were randomly assigned to the treatment group (n =159,receiving hypertension self-management) and the control group (n=164,receiving standard hypertension management).A questionary survey was completed at baseline and 6 weeks.Rank sum test or Chi-square test was used for data analysis.Results The average age of the treatment group or the control group was (61.9 ±9.1) vs (61.8 ±9.0) years old,respectively.No significant difference in mean age,gender and education level was found between the two groups (F =0.164,x2 values were 0.782 and 2.093,respectively ; all P ＞ 0.05).In the treatment group,the scores of fatigue,headache and shortness of breath were declined (when compared with the controlled females,Z =-5.198,-3.873,-2.781 ; P ＜ 0.05).Self-efficacy score of the treatment group was increased after the intervention.Women's symptom management self-efficacy and common disease management self-efficacy were significantly higher (Z=-2.958,-2.582; P ＜ 0.05).In comparison with the control group,before and after self-management,the added scores of communication ability with doctors were increased.But the difference was not statistically significant (P ＞ 0.05).Conclusion Six-week self-management program may improve self efficacy among hypertensive patients.

Objective To study the safety and efficacy of the combination of rituximab and DHAP chemotherapy in patients with relapsed non-Hodgkin lymphoma(NHL). Methods To choose 16 patients with relapsed B-cell NHL as research objects, they were divided into two groups: treatment and control group. The treatment group(8 cases) received the combination of rituximab and DHAP chemotherapy; the control group (8 cases) received combination chemotherapy. The treatment was first infused a dose of rituximab (375 mg/m2) the day before receiving the DHAP chemotherapy, and such treatment being repeated for 4 ~ 6 times every other week. The DHAP chemotherapy lasts 4 ~ 6 cycles and twenty-one days in each cycle. The control group was primitively administrated 4 ~ 6 cycles of CHOP chemotherapy, methotrexate, Ara-C and etoposide as additional drug. Results The complete response and overall response rate were 75 % and 100 % while in the control group were 37.5 % and 62.5 %. The progression-free and overall survival was (18.3?5.4) months significantly higher than that of the control group [(4.7?2.8) months, P

Objective To investigate the myocardial protective effect of isehemic post-conditioning in total repair for tetralogy of fallot,in order to improve short-term prognosis of infant patients.Methods 64 cases of TOF infant patients were randomly divided into two groups,32 cases in the control group:conventional surgery without ischemic post-conditioning,and other 32 cases in the experimental group:given three cycles of ischemic post-conditioning.Then the clinical indieators:cardiopulmonary bypass time,aortic cross-clamping time,automatic re-jump rate,the latter parallel to the off-line time,the off-line blood pressure,the offline dopamine usage,extubation time,ICU stay time,postoperative complications,and the testing laboratory indicators:the cTnI and CK-MB levels in plasma after anesthesia induction,10min after aortic cross-clamping,10min after aortic opening,ICU1h,1d after surgery,and 2d after surgery were observed.Results Two patients were died and,mortality rate was 3.1%.The remaining patients were discharged from hospital.Laboratory indicators of the control group and the experimental group had significant differences (all P＜0.05),while the clinical indicators of the two groups had no significant differences(all P＞0.05).But for the sub-group which the aortic cross-clamping time were more than 60min,the clinical indicators were significantly different(all P＜0.05).Conclusion Ischemic post-conditioning could enhance myocardial protection in total repair for tetralogy,of fallot.for the cases aortic cross-clamping time was more than 60min,their clinical meanings were more obvious.

Objective To explore the experience of diagnosis and treatment of laparoscopic abdominal inci-sion hernia repair.Methods The clinical data of 15 patients treated with laparoscopic incision hernia repair were ret-rospectively analyzed.Results All 15 cases were successful in operation by laparoscopy.The operation time was 60~180 mins,and the mean operation time was (117 ±30.46) mins,the post-operation aerofluxus time was 1~2 days and the mean time of post-operation hospital stay was (16.53 ±3.46) days.During the operation no association with serosal layer damage or massive hemorrhage occurred;no postoperative seroma infection,intestinal fistula,infec-tion of incision,patches or deaths occurred.Ten patients(66.67%) had abdominal wall nail regional pain to different degree.2~11 months′postoperative follow-up indicated no recurrent cases.Conclusion Laparoscopic adoption of stapler or stapler with sutures through abdominal wall to repair incisional hernia is safe and effective.Compared with the open surgery,laparoscopic incisional hernia repair has the advantage of minor injury,quicker recovery,and lower recurrence rate.

Objective To evaluate the efficacy of laparoscopic operations in the treatment of ectopic pregnancy.Methods A total of 148 cases of tubal pregnancy from January 2002 to January 2005 were studied.Laparoscopic operations included 106 cases of oviduct-sparing operation(79 cases of oviduct fenestration and 27 cases of lesion clearance),37 cases of salpingectomy,and 5 cases of lesion clearance.Results The diagnosis and operation were laparoscopically completed in all the 148 cases.Persistent ectopic pregnancy occurred in 2 cases.Postoperative monitoring of serum ?-hCG levels showed the shortest recovery time to normal levels after the treatment of salpingectomy(8?1 d),and the longest one after lesion clearance (15?2 d).Regular menstruation resumed at((31?)2 d) after salpingectomy and at(43?3 d) after lesion clearance.Follow-up checkups with uterotubography in 84 cases for 1~3 months(mean,2.3 months) found a patent rate of both oviducts of 82.1%(69/84).Conclusions Laparoscopic operations is a safe and effective option in the treatment of ectopic pregnancy.

Prosthesis revision and service life after artificial joint replacement is highly correlated with the biocompatible responses among prosthesis per se, host, and manipulating technique. Artificial prosthesis consists of two parts: metal part and rigid plastic components. Many metals such as stainless steel, cobalt-chrome-molybdenum alloy and titanium alloy can be used as prosthesis materials. The plastic materials mainly include wear-resisting polythene, plastic bone cement that is used to embed the prosthesis into osseous substance. Host defines as the patients with various joint injury, mainly the elderly. Anesthesia is a key step in replacement. Artificial joint replacement is performed in patients under anesthesia. Different anesthesia methods bring variable influences on biocompatibility after surgery. In addition, complications of anesthesia may aggravate tissue lesions around operation sites in the early stage after replacement, leading to joint loosening or inadequate joint range of motion. Appropriate anesthesia, modified artificial joint design and joint replacement technique can prolong the serve life of artificial joint.

Myocardial fibrosis is a predominant pathological change of radiation-induced heart disease (RIHD) in late stage.It often occurs several or more than ten years after radiotherapy and can lead to myocardial remodeling, impaired cardiac function, and heart failure.At present there is no effective method to prevent or reverse the development of radiation-induced myocardial fibrosis.Many cells, cytokines, and other factors are involved in the development and progression of myocardial fibrosis in RIHD and some of them have been validated.But most investigators focused on the pathological changes and related mechanisms in early stage, and myocardial fibrosis was just regarded as an endpoint event.The definitive mechanisms of myocardial fibrosis in late stage remain unclear.This paper reveiws the studies about general mechanisms of myocardial fibrosis in RIHD and summarizes the roles of microcirculation dysfunction, mast cells, several cytokines, hypoxia, oxidative stress, and renin-angiotensin system, and points out the future research direction of the pathogenesis of myocardial fibrosis in RIHD.It provides new ideas for discovering the potential targets for clinical intervention of myocardial fibrosis in RIHD.

Chlorogenic acid (5-CQA) is one of the major components in some Chinese herbal injections. However, the metabolism of 5-CQA in rats after intravenous injection has not been determined. An ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF MS) method was applied to identify the metabolites in bile, urine, feces and plasma after a single intravenous administration of 10 mg x kg(-1) 5-CQA to rats. Using MSE and mass defect filter techniques, a total of 35 metabolites were detected in bile, urine, feces and plasma. The predominant metabolites in bile were glutathione conjugates of O-methyl-5-CQA, accounting for approximately 80% of the metabolites excreted in bile. The major components in urine were parent drug, O-methyl-5-CQA, hydrolyzed metabolites and glucuronide conjugates. The major components in feces were O-methyl-5-CQA and its cysteine conjugates. The major component in plasma was the parent drug. The urinary and fecal excretion pathways were equally important to 5-CQA in rats. These results demonstrate that 5-CQA undergoes extensively metabolism in rats and are highly reactive to nucleophiles such as GSH. This finding indicates that attention should be paid on the injections containing 5-CQA, which may covalently bind to proteins, leading to allergenic drug reactions.

Objective To investigate the infection status and drug resistance of imipenem‐resistant Pseudomonas aeruginosa (PAE) isolated from the submitted specimens from children patients in our hospital between October 2012 to September 2013 for mastering the antimicrobial resistance status of Pseudomonas aeruginosa infection among children in Guangzhou and the occurrence situation of imipenem resistant strains .Methods The detection situation of Pseudomonas aeruginosa from infected children during this period was analyzed and the VITEK 2 Compact analyzer produced by the France bioMerieux company was used to identify the bacteria .The minimal inhibitory concentration(MIC) of imipenem resistant Pseudomonas aeruginosa to 11 kinds of antibiotics was detected .Results 161 strains of Pseudomonas aeruginosa were detected from 36 600 specimens ,including 24 strains(14 .9% ) of imipenem resistant Pseudomonas aeruginosa ,the positive strains were mainly originated from phlegmy (50 .3% ) ,the isolation was highest in ICU (27 .4% ) and NICU(21 .8% ) .The drug resistance rate of imipenem‐resistant P .aeruginosa was higher to ceftriax‐one sodium(91 .7% ) ,cefoperazone(29 .0% ) ,ceftazidime(29 .0% ) ,cefoperazone /shubatan(29 .0% ) and aztreonam (25 .0% ) .Con‐clusion Imipenem‐resistant Pseudomonas aeruginosa has the higher detection rate among children in this area and usually has re‐sistance to multiple antibiotics ,which should be paid more attention to and antibiotics should be rationally used .

Objective To improve the skills of pharmacists in pharmaceutical care and to provide patients with better individualized pharmaceutical care.Methods A total of 785 traditional Chinese medicine (TCM) counseling outpatient cases, consultation modes, objectives, consulting drugs, consulting problems were analyzed.Results Office counseling was the dominant method for TCM counseling (85.10%), followed by telephone counseling (14.90%). Of all the counselings, patients and their relatives accounted for 80.63%, where females was 60.25% and males 39.75%; and patients over 40 years of age accounted for 81.91%. Of all the pharmacy counseling, heart system disorder were the major (14.79%), followed by drugs for Qi, blood and body fluid disorder (12.61%); the contents of counseling were diversity, which included dosage and administration amounts (29.04%), experience for drug use (14.14%), drug interactions (10.39%) and adverse reactions (9.55%). Conclusion TCM counseling could offer an effective platform of communication between pharmacists and patients, improve patients' medication compliance, and ensure patients' safe, rational, economical and effective.