Objective:To investigate the protective effects of quercetin ( QU) on myocardial ischemia/reperfusion ( MI/R) injury in rats and the underlying mechanisms. Methods:MI/R injury model in rats was prepared by coronary artery ligation for 30 min fol-lowed by 120 min reperfusion. And then the rats were randomly divided into 5 groups, QU (25, 50 and 100 mg·kg-1 ) groups, the model group and the sham group (n=10). QU was orally administered once a day for 7 days before the operation. The CK and LDH activities and TNF-α and IL-1β levels in serum were examined respectively by colorimetric and ELISA method after the reperfusion. Besides, the area of myocardial infarction was calculated and MPO activity in heart homogenate was detected. Results:QU (100 and 50 mg·kg-1 ) could significantly reduced the area of myocardial infarction to 25. 00% and 25. 31%, respectively, and compared with that of 32. 55% in the model group, the difference was significant (P<0. 05). The CK activity in the three QU groups was 779. 82, 793.90 and 870.86 U·L-1, respectively, which was significantly lower than that (1 123.78 U·L-1) in the model group (P<0. 01). The LDH activity in the three QU groups was 2 138. 21, 2 277. 40 and 2 416. 53 U·L-1, respectively, which was significant-ly lower than that (3 105.32 U·L-1) in the model group (P<0.05 or P<0.01). Compared with that (311.72 U·g-1) in the model group, the MPO activity in heart homogenate in the three QU groups was reduced to 185. 70, 190. 66 and 210. 03 U·g-1 , re-spectively (P<0. 05 or P<0. 01). Compared with that (119. 55 pg·ml-1) in the model group, QU (100 and 50 mg·kg-1) signif-icantly reduced the level of TNF-αto 97. 48 and 97. 54 pg·ml-1, respectively (P<0. 05). Compared with that (673. 34 pg·ml-1) in the model group, IL-1βlevel in serum in the three QU groups was evidently reduced to 419. 26, 438. 72 and 492. 53 pg·ml-1 , re-spectively (P<0. 01). Conclusion:The effectiveness of QU pretreatment in MI/R injury appears to be associated with the inhibition of neutrophil infiltration and expression of inflammatory cytokines.

Objective To investigate the caregivers' difficulty in taking care of the elderly and the related factors. Method A self-designed questionnaire was used to investigate the difficulties in care giving among 1,517 caregivers. Results The total score on the difficulties was (16.16 ±5.79). The preventive factors were good care-related knowledge and family income and the risk factors were advanced age, poor health condition of the patients ( all P<0.01). Conclusions The difficulty in caring the elderly are varied. We should attach importance to those caregivers of advanced age, with lower income and lack of care-related knowledge. Meanwhile, we should provide consultation, education and training for caregivers according to their different situation, and carry out targeted and multi-level support services so as to solve their problems in care to the patients.

Objective To investigate the effect of pressure ulcers wound record form on the quality of nursing records in geriatric wards . Methods Twenty-eight patients with pressure ulcers hospitalized from January to June 2014 were assigned as control group , where the pressure ulcers assessment and nursing form was used for recording pressure ulcers . Another 30 patients during July to December 2014 were assigned as the trial group , where the pressure ulcers wound record form was used . The two groups were compared in terms of time for writing nursing records , satisfaction of nurses and problems in recording the pressure ulcers . Result Compared with the control group, the time for writing nursing records was much shorter, the satisfaction degree was significantly higher and the problems in recording wounds were significantly fewer as well. Conclusion The pressure ulcers wound record form can enhance the quality of pressure ulcers wound records, shorten the time for writing the records and increase the nurses′satisfaction.

Objective To investigate the effects of Chinese herbal medication combined with nutrition intervention on perioperative nutrition in patients with colon carcinoma.Methods Ninety-six patients with colon carcinoma were divided according to their odd or even number into the control group and the intervention group.The former were given routine nutrition and the latter Chinese herbal medication combined with nutrition intervention.Then the mini-nutritional assessment(MNA)was used to assess the changes before and after operation and the complications.Results The intervention group was significantly better than the control one in terms of all nutrition factors but hematoglobin(P<0.05).The incidences of complication and dystrophy in the intervention group were lower than in control group(P<0.05).Conclusion The application of Chinese herbal medication combined with nursing intervention is important for the improvement of their nutrition and the reduction of postoperative complications.

Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.

Objective To explore the application value of real-time shear wave elastography(SWE) in the liver injury caused by the blast injury.Methods The abdominal mild,moderate and severe blast injury animal models were built,liver and abdominal cavity conventional ultrasound scan and liver SWE measurement were processed before and immediately post-blast,and then the two groups' liver alanine aminotransferase (ALT) and the liver pathology results were compaired.Results The conventional ultrasound scan,immediately after the injury,had found no abnormities of the hepatic tissue in the mild blast injury group,while varying degrees of liver capsular rupture,part of the liver parenchyma regional uneven echo,subcapsular hematoma,obvious liver parenchyma interruption,effusion between the disruption of liver parenchyma and abdominal cavity effusion etc.a series of liver injury had been found in the moderate and severe groups,and the severe blast injury group was more obvious.Three groups' immediately liver elasticity and ALT of post-blast liver injury were increased compared with the pre-blast,the liver elasticity and ALT of each group pre-and post-blast comparing had statistically signifcant (P ＜0.05),and the three groups post-blast immediately liver elasticity and ALT and any two groups' comparing also had statistically significant (P ＜0.05).Conclusions After the blast injury,the changes of liver elasticity were associated with the liver injury degree,the higher elasticity values suggest the heavier damage.Based on conventional ultrasonography,SWE could provide a new evaluation method for the judgement of liver balst injury,especially in the diagnosis of mild liver blast injury.

The clinical data were collected from medical record of 749 patients admitted into Peking Union Medical College Hospital from January 2008 to March 2013.They were diagnosed with primary Sj(o)gren's syndrome (PSS) at discharge.Clinical manifestations,laboratory results and outcomes were compared between PSS patients with pulmonary hypertension (PSS-PH) and those without (PSS-non PH).PSS-PH group had higher proportions of Renault phenomenon (36.8％ vs.20.0％,P =0.05),pericardial effusion (55.3％ vs.0.0％,P＜0.01),leukocytopenia (42.1％ vs.30.0％,P =0.03),elevated IgG level [(28.8 ±11.2) vs.(21.5 ±10.0) g/L,P=0.01] and hypothyroidism(34.2％ vs.12.5％,P=0.05) with significant significance.The PSS patients had leukocytopenia low thyroid function,rising IgG and pericardial effusion with pulmonary hypertension.

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To investigate the application of peroneal artery chain perforator flap in repairing skin and soft tissue defects of ankle and lower leg and the corresponding clinical effect.Methods From 2005 to 2010,19 cases of skin and soft tissue'defects of the ankle and lower leg were treated by using peroneal artery chain perforator flaps.The sites of peroneal artery branches were detected by using Doppler flowmeter before operation.Supplied by the chain form of terminal branches of the peroneal artery,the cutaneous fulcrum straightly nearest to the wound was selected as the rotation point to design the flap,with area ranging from 25 cm × 8 cm to 16 cm × 6 cm.Results The follow-up for 1.5- 42 months revealed that all cases of flap survived with satisfactory shape,except for one case suffered from distal skin flap necrosis.Conclusions The peroneal artery chain perforator flap with unsteady peduncle has no restrictions of peduncle sites and can be cut flexibly.It is a perfect method in repair of soft tissue defect of ankle and lower leg.

Objective To construct recombinant Mycobacterium smegmatis vaccine expressing Cysticercus cellulosae cC1 anti-gen. Methods The recombinant pET28a-cC1 plasmid was extracted and double digested by Xho I and BamH I restriction en-zymes,and shuttle plasmid pMV261 was extracted and double digested by Hind III and BamH I restriction enzymes. Both frag-ments were modified by Klenow fragment to form blunt end,then the large fragments of cC1 and pMV261 plasmid were purified and ligated by T4 ligase enzyme. The recombinant pMV261-cC1 plasmid was constructed and sequenced. Then the pMV261-cC1 plasmid was transformed into Mycobacterium smegmatis by the electrotransformation method. The recombinant cC1-Mycobacterium smegmatis was induced by heat and identified by the Western blotting method with the sera of cysticercosis patients. In addition, the growth states of the Mycobacterium smegmatis and the recombinant cC1-Mycobacterium smegmatis were compared and the growth curves were drawn. Results The restriction enzyme and sequencing results showed that the recombinant pMV261-cC1 plasmid was successfully constructed. After heat induction,a 40 kD band was showed by PAGE analysis of cC1-Mycobacterium smegmatis. The Western blotting results showed that the sera of cysticercosis patients could recognize the 40 kDa band,which sug-gested that cC1 protein was expressed in Mycobacterium smegmatis. Compared with the Mycobacterium smegmatis,the recombi-nant cC1-Mycobacterium smegmatis showed no significant difference in proliferation characteristics. Conclusion The recombi-nant cC1-Mycobacterium smegmatis vaccine has been successfully constructed.