General practitioners from community health service institutions in Shijingshan,Mentougou,Haidian,Chaoyang,Fengtai and Dongcheng Districts of Beijing were selected to take the examination of chronic wounds management.Questionnaire survey was also performed on the status of community chronic wounds management,medical service motivation,influencing factors and their demand for training.Among 204 general practitioners,55 (27.0％) had mastered basic knowledge,98 (48.0％) passed the examination and 51 (25.0％) failed.The results showed that 179 (87.7％) had changing dressing service,36.8％ offered out-patient consulting service,17.6％ performed surgical debridement,only 10 (4.9％) provided home chronic wounds care service and 2 (0.9％) of them carried out long-term follow-up.According to the motivation survey,all the practitioners expressed the willingness to help the patients and win their trust.Most of the practitioners claimed no supporting from their institutions(91.7％) and chronic wounds management was excluded from daily routine.Furthermore,heavy work load(82.8％) and lack of professional knowledge(80.9％)were also considered to be main obstructive factors.The survey showed that the majority of physicians required classroom teaching (90.1％),case analysis (86.8％),operating video (92.6％) and other teaching forms.More low level doctors(97.1％)had the desire to pursue further specialist training than higher level physicians (56.7％).The results of our investigation indicate that general practitioners in community heath service institutions have strong learning motivation for chronic wounds management and systematic training of knowledge and practical skills in this field should be provided.

Objective Through active intervention of nursing care to improve the cognitive rate of hy-pertension, rate of blood pressure control and treatment compliance for hypertensive patients to reach the aim of alleviation of prognosis and reduction of disability and mortality. Methods Free physical examinations were carried out in population groups of above 30 years old in a certain community in Xinjiang Uygur Autonomous Region and family health files were set up. Totally 108 patients were screened and standardized management was applied in them,besides their conditions before and after the application of the management were investi-gated and analyzed by self-designed "prevention and treatment of hypertension as a chronic disease" and "in-vestigation questionnaire of KAP of patients with hypertension". Results The cognitive rate and rate of con-trol of high blood pressure were more higher after intervention than that before. Conclusions Through a planned health education instruction, popularizing prevention and treatment knowledge of primary hypertension to residents, we can increase the cognitive rate and rate of control of high blood pressure for patients with hyper-tension.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Bulbar Palsy, Progressive ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

Objective To analyze the clinical features of 385 postoperative thyroid nodules patients,and to compare the correlation affected by different factors between benign and malignant thyroid nodules.Methods Total 385 patients underwent thyroid operation in general surgery department of our hospital were enrolled.Their clinical data,ultrasonic scanning of thyroid,and pathological results were compared between benign and malignant thyroid nodules.Results (1)264 cases with benign nodules (68.57％) and 121 cases with malignant nodules (31.43 ％)were found among 385 cases.The average age of benign group was (48.1 ± 13.4) years old,while malignant nodules group was (45.6 ± 12.5) years old.(2) No gender difference was found between benign and malignant nodules group (P＞0.05).(3) According to body mass index (BMI),the highest prevalence of malignant nodules was in overweight group,followed by obesity group.(4) Fasting blood glucose was (5.61 ± 1.07) mmol/L in benign group and (5.86±1.21) mmol/L in malignant group(P＜0.05).(5) Thyroid-stimulating hormone (TSH) in benign nodules group was (1.62 ± 1.30) mIU/L,while in malignant nodules group,which was (2.02 ±2.59) mIU/L(P＜0.05).(6) Irregular shape,unclear boundary,calcification,and lymph node metastasis were more frequent in malignant group than those in benign group under ultrasonic scanning (P＜0.05).(7) Logistic regression analysis revealed that the existence of thyroid cancer was significantly associated with age,fasting blood glucose,ultrasonic images(lymph node metastasis,irregular shape,and calcification).Conclusion (1) Fasting blood glucose levels and TSH in the malignant nodules group are higher than those in the benign group.(2) A negative correlation exists between age and thyroid cancer prevalence.(3) Ultrasonic images,including lymph node metastasis,irregular nodule shape,and calcification,may suggest the high possibility of thyroid cancer.

Objective To evaluate the left ventricular diastolic function in coronary artery disease (CAD)patients without regional wall motion abnormality by real-time three-dimensional specke tracking imaging(RT3D-STI),and to investigate the value of RT3D-STI in detecting CAD.Methods According on coronary angiography,92 patients without regional wall motion abnormality were divided into two groups:control group(n = 21 ),without coronary artery stenosis;case group (n = 50 ),coronary stenosis group. Two dimensional images and the three-dimensional full volume dynamic images of left ventricle were collected.Routine parameters and end-systolic left ventricular globle longitudinal strain (GLS),globle circumferential strain (GCS),globle area strain (GAS),globle radial strain (GRS)and corresponding strain imaging diastolic index (SI-DI)were aquired,respectively.The parameters by RT3D-STI were analyzed to diagnose coronary artery stenosis.Results Compared with control group,there were no significant difference in routine parameters,GLS,GRS,GAS and GCS(P >0.05 ).Longitudinal SI-DI(L-SI-DI),area SI-DI(A-SI-DI),radial SI-DI (R-SI-DI),circumferential SI-DI (C-SI-DI)in case group were significantly reduced compared with control group (P <0.05).The sensitivity of L-SI-DI,A-SI-DI,R-SI-DI and C-SI-DI were 90.5%,81 .0%,85.7%,81 .0%,and the specificity of them were 82.0%,78.0%,68%,56%, respectively,L-SI-DI was the best in sensitivity and specificity.L-SI-DI,A-SI-DI,R-SI-DI were significantly correlated with Gensini score (r = -0.706,-0.547,-0.410 P < 0.05 ).Conclusions RT3D-STI can quantitatively assess the early changes of left ventricular diastolic function,which has important significance for early diagnosis of coronary artery stenosis.

Objective To establish an assessment model of financial risk exposure for the county-levelpublic hospitals in Inner Mongolia Autonomous Region,which can be used to assess the risk exposure of the hospital in question,and as decision making reference for their financial management and risk prevention and control.Methods Using indicators standardized methods and entropy method to process 1 5 financial indicators (quantitative indicators and qualitative indicators )for the 20 public hospitals,and using the gray clustering method to assess financial risk exposure.Results 70% of the county-level public hospitals are faced with less financial risks,while four of them need to pay close attention,and two have large loopholes pending solution.Conclusions Entropy-Gray clustering methods can complement each other,as found in the study.This study proves its significance,and health authorities should establish their long-term financial risk control mechanisms.

Objective To explore the clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect.Methods Totally 186 patients with threatened abortion caused by uteal phase defect accepted in The First Affiliated Hospital of Henan from April 2015 to April 2016 were selected and randomly divided into groups A,B,and C with 62 cases in each group.Patients in group A were given dydrogesterone,those in group B were given progestin,and those in group C were given dydrogesterone combined with progestin.Then the clinical effect,expression of hormones,treatment outcome,and adverse reaction were observed and compared.Results The total effective rates of groups A and B were 72.58％ and 66.13％,respectively,which were obviously lower than 90.32％ of group C with statistically significance (P ＜0.05).The expression levels of P,E2,and hCG of three groups after treatment were higher than those before,those in group C were the highest among them (P ＜ 0.05).The successful treatment rates of groups A,B,and C were 83.87％,82.26％,and 95.16％,respectively,which had no great difference.Conclusion Combination use of dydrogesterone and progestin has better effective rate in treatment of threatened abortion caused by uteal phase defect compared to single use of these two drugs,which has good safety and worth of clinical application.

Objective To study the protective effect of(-)clausenamide on the damage of PC12 cells induced by serum deprivation and to explore its related mechanism. Methods The cell viability was detected by MTT assay and morphological observation. The effect of(-)clausenamide on the PC12 cell apoptosis was analyzed by flow cytometry. Then western blotting and confocal microscope was used for the further study of effect of(-)clausenamide on the protein expression of GSK-3?,Bax and Bcl-2. Results(-)Clausenamide remarkably increased PC12 cell survival rate through inhibiting the PC12 cell apoptosis induced by serum deprivation at the concentration of 1 or 10 ? mol/L(P

ING1 family is a candidate for tumor suppressor,which has three splicing isoforms named p47ING1a,p33ING1b,and p24ING1c. Study of the effect of different isoforms of ING1 on HeLa cells proliferation and its molecular mechanism would help further identifying the functional relationship of ING1 isoforms,and finding important genes regulated by ING1. Cell growth curve and cell cycle analysis were used to observe the effect of ING1a,ING1b,and ING1c on HeLa cells growth,and the result indicated that they could all inhibit HeLa cells growth by arresting cell cycle at G0/G1 phase. PCR method was used to construct the PHD domain deletions of ING1a and ING1b. ING1a,ING1b,ING1c and the PHD domain deletions 1a?C and 1b?C were then overexpressed in HeLa cells. p16INK4a,PTEN/p27Kip1 and p53/p21Waf1 protein levels were detected by Western blot. The result showed that ING1a,ING1b,ING1c,and 1a?C except for 1b?C induced p16INK4a protein expression,in which ING1c had the most powerful effect. Luciferase assay identified that overexpression of pcDNA3.1(+)-1a?C facilitated p16INK4a transcription through enhancing p16INK4a promoter activity,while pcDNA3.1(+)-1b?C repressed the p16INK4a promoter activity . In a word,it was found for the first time that except for the p53/p21Waf1 pathway,three splicing isoforms of ING1 family could also inhibit HeLa cells proliferation though upregulation of p16INK4a and PTEN,and the PHD domain deletion of ING1a enhanced p16INK4a transcription. These findings provide new clews to further study on the mechanisms of ING1 family suppressing cancer cells growth.

This experiment was designed to investigate the expression profile of miRNAs (microRNA) in human gastric cancer tissues.Methods The expression profiles of miRNAs were compared between 3 pairs of GC and adjacent normal tissues using an Exiqon miRNA array,following which quantitative PCR (qPCR) was employed to confirm the results of the miRNA array,and 10 miRNAs were selected.Bioinformatics was used to analyze the biological function of the differentially expressed miRNAs and its target genes in gastric cancer.Results Compared with adjacent mucosal tissues,95 miRNAs were up-regulated and 16 miRNAs were down-regulated in GC (＞ 2 folds,P ＜ 0.05).The qPCR results were consistent with microarray-based expression analysis (P =0.049).Furthermore,the online GO and pathway analysis revealed that miRNAs might involve RNA transcription,RNA metabolism,gene expression,gene silencing,and other biological functions in GC.Conclusion There is abnormal expression of miRNAs in gastric cancer,and the abnormal expression of miRNAs may be related to GC tumorigenesis.