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 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 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 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 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 health-related quality of life(HRQOL)of the recovered patients with depression and its influential factors.Methods From March 2008 to April 2009,150 depressive patients andergoing the following up treatment were recruited,and finally 124 patients rocovered,and quality of life for patients recovered were compared to published norms for the general Chinese people.The general demography material seale.Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),personality traits(Eysenck personality Inventory-EQP)the short form 36 item(SF-36)questionnaire and social support scale(SSS)were applied to an subjects.The SPSS 13.0 software for data processing,the group t test and the multiple linear regression analysis was adopted.Results ①The average score of seven domains of quality of life(RP,BP,GH,VT,SF,RE,MH )for the recovered patients were better than that of the pre-treatment patients(P<0.01),except the PF(89.23±14.09,87.23±16.81,t=1.044,P>0.05).But the average score of seven domains of quality of life for the re-covered patients were worse than that of the healthy people(P<0.01),except the PF(89.23±14.09,89.01±15.73,t=1.266,P>0.05).②The quality of life 0f the recovered patients remarkably related with the anxiety level, neuroticism, extraversion, recurrent depression,economic condition and social support(P<0. 01) . Conclusion The recovered depressive patient s health-related quality of life were improved significantly afer treatment, what were influenced by neuroticism,extraversion,anxiety as a trait,recurrent depression,economic condition and social support.Above mentioned factors should be taken into account when rehabilitation.

Objective To evaluate the clinical and endocrine effectiveness of different laser doses for ultrasound-guided transvaginal ovarian interstitial laser treatment in patients with polyeystic ovary syndrome (PCOS). Methods Between January 2005 and July 2007, 56 women with clomifene citrate-resistant PCOS selected from the patients who were referred to Shenzhen Maternity and Child Healthcare Hospital with a request for fertility underwent ultrasound-guided transvaginal ovarian interstitial laser treatment. All subjects were randomly divided into four groups of A, B, C and D. In group A, one coagulation point per ovary was done and group B, two points; group C, three points; group D, four to five points. The size of each point was about 10 mm in diameter (the electrical laser was projected persistently for 1-3 min with a power of 3-5 W) . The serum sexual hormone level, ovulation rate and pregnancy rate within six postoperative months were compared among the four groups. Results (1) The spontaneous ovulation rates of groups A (0) and B (21%) within six postoperative months were significantly lower than groups C (71%, P <0.05) and D (79%, P<0.01). The accumulative pregnancy rates of group C (43%) and D(36%) for six postoperative months were significantly higher than group A(0; P <0.01 ,P <0.05). Although they were also higher than that of group B, no statistical significance was found (P>0.05). (2) No statistically significant differences were found among four groups when various preoperative hormone values were compared (P>0.05). The mean serum luteinizing hormone (LH), testosterone level and LH/ follicle stimulating hormone (FSH) ratio was significantly lower postoperatively in groups C [(6.3±2. 6) U/L, (2.2±0.7) nmol/L, 1.1±0.3] and D [(5.8±2.5) U/L, (2.1±0.4) nmol/L, 1.0±0.4] than in groups A [(11.9±3.1)U/L,(3.9±1.6)nmol/L,2.1±0.5] and B [(10.4±3.9)U/L,(3.3±1.1) nmol/L, 2. 0±0.6],respectively(P<0.05). The mean LH, testosterone level and LH/FSH ratio reduced more obviously in groups C (42%,39% and 42% ) and D(53% , 40% and 58% ) than in groups A (4%, 9% and 16%)and B(11%, 6% and 5%;P<0. 05). All above-mentioned parameters between groups C and D had no statistical significant difference (P>0.05). Conclusions One and two intracvarian laser coagulation points per ovary are associated with poor results. Three points per ovary seem to represent the plateau of effective dose for the ovarian interstitial laser treatment. Increasing the dose above it does not improve the outcome.

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.