Objective:To explore and observe therapeutic effect of nursing exercise rehabilitation on home patients with chronic heart disease (CHF) .Methods :A total of 122 CHF patients ,who performed home‐rehabilitation in community from Jan 2012 to Feb 2015 ,were selected .According to sealed envelope extraction method ,patients were randomly and equally divided into routine nursing group (received routine nursing intervention ) and exercise intervention group (received early exercise intervention based on routine nursing group ) ,the intervention period was eight weeks for both groups .The 6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) ,scores of Minnesota living with heart failure questionnaire (MLHFQ) and self‐behavior management scale were measured and compared between two groups before and after nursing .Results:Compared with before nursing ,after nursing , there were significant rise in 6MWD ,LVEF and score of self‐behavior management in both groups , P<0.01 all . Compared with routine nursing group after nursing ,there were significant rise in 6MWD [ (482.44 ± 65.29) m vs . (546.24 ± 76.13) m] ,LVEF [ (35.69 ± 7.22)% vs .(38.83 ± 6.92)% ] and score of self‐behavior management [(89.19 ± 25.14) scores vs .(103.49 ± 22.44) scores] ,significant reductions in physical [(62.12 ± 17.97) scores vs . (42.32 ± 17.67) scores] ,emotional [ (67.76 ± 17.17) scores vs .(51.32 ± 16.41) scores] and social dimension score [ (72.43 ± 10.31) scores vs .(62.44 ± 10.45) scores] of MLHFQ in exercise intervention group ,P<0.01 all .Con‐clusion:Nursing exercise can significantly enhance heart function and athletic ability ,improve self‐care capacity , help to improve quality of life in home patients with chronic heart failure .

Objective To observe the effect of blue light on apoptosis of cultured human retinal pigment epithelial (RPE) cells in vitro. Methods Human RPE cells were exposed to blue light, and the cells were divided into 3 groups: group A, with various intensity of illumination; group B: with same intensity but different time of illumination; group C: with same intensity and time of illumination but different finish time of the culture. The apoptosis of RPE cells was observed by TdT-dUTP terminal nick-end labeling (TUNEL) and annexin V-fluoresein isothiocyanate (FITC)/propidium iodide (PI) flow cytometry, and transmission electron microscopy. Results The positive cells stained by TUNEL shrinked and turned round, whose nuclei concentrated and congregated like the crescent or hat. Cracked nuclei and membrane bleb were found. Swollen mitochondrial, disappeared inner limiting membrane of mitochondria, and dilation of the rough endoplasmic reticulum with metabolite were observed by transmission electronmicroscopy. In group A, mild damage of RPE cells was found when the threshold value of the intensity of illumination was less than (500?100)lx, and the apoptosis and necrosis of RPE cells aggravated as the intensity of illumination increased; in group B, as the time of illumination extended, the number of apoptotic RPE cells didn′t increase while the necrosis increased; in group C, 6 and 12 hours after illumination, apoptosis of cells was the main injury, while apoptosis with necrosis was found and necrotic cells increased as the time of illumination was prolonged. Conclusions Illumination with blue light may cause damages of human RPE cells in vitro, with the modalities of apoptosis, apoptotic necrosis and necrosis. The extent of injury is dependent on intensity and duration of the illumination.

Objective To study the expression of cyclooxygenase-2 (COX-2) in the gastric epithelial carcinogensis and its relation with cell apoptosis and proliferation. Methods 15 cases of normal gastric mucosa (NGM), 30 cases of intestinal metaplasia (IM), 30 cases of dysplasia (Dys) and 40 cases of gastric cancer (GC) were used in this study. The expressions of COX-2 and proliferating cell nuclear antigen (PCNA) were detected by immunohistochemical SABC method, and cell apoptosis was measured by TUNEL. Results The expression level of COX-2 gradually increased from NGM, IM, Dys to GC. The positive rate of COX-2 in GC was 67.5%, 13.3% in NGM, and 33.3% in IM. There was a significant difference in COX-2 expression between GC and IM, GC and NGM(P0.05). The expression of COX-2 in poorly differentiated cancer was markedly higher than that in well differentiated cancer (P

Objective To analyze and compare the dosage,blood concentration and metabolic characteristics of Tacrolimus (Tac) for pediatric patients who underwent living related liver transplantation (LRLT) or donation after cardiac death liver transplantation (DDLT).Methods The clinical data of 75 liver transplantation pediatric patients from October 2012 to August 2015 were retrospectively analyzed.According to the different source of donors,the recipients were divided into two groups:LRLT group (40 cases) and DDLT group (35 cases).Results (1) Under the condition of same initial Tac dosage,the Tac dosage in LRLT group was less than in DDLT group during the first 28 days post-transplantation (P＞ 0.05).However,the Tac dosage in DDLT group was significantly higher than in LRLT group on the second and third months after sugery (P =0.000).(2) Correlation analysis revealed that graft-recipient body weight ratio (GRWR) was correlated with Tac dosage (mg·kg-1 ·d-1) on the 14th day postoperative (LRLT group:r=0.579,P＜0.05;DDLT group:r =0.583,P＜0.05) and Tac concentration/dosage ratio (LRLT group:r =-0.607,P＜0.05;DDLT group:r=-0.680,P＜0.05).Conclusion Tac has a satisfactory anti-rejection effect on liver transplantation pediatric patients while the metabolism varied with each individual.There is a positive correlation between the early Tac dosage and the GRWR in both groups.It is necessary to set individualized Tac administration regimen according to the metabolic characteristics and GRWR.

Objective To study the deficiency of serf-regulation in impulsivity children with attention deficit hyperactivity disorder(ADHD)based on both procedures of action and inhibitory control.The event related potentials(ERPs)component P3 in Go/NoGo tasks was analyzed.Methods There were 15 impulsive children with ADHD and15 normal children in control group.Their age was from seven years old to eleven years old.The Go/NoGo stimulate-response model was adopted in the ERPs test.The occurrence of Go and NoGo trials was equal probability(each of 50%).Results(1)The high impulsive children had slower Go-RTs(reaction times)in making correct response than normal children,tended to be faster of NoGo-RTs in making error response and had lower correct rate.(2)P3amplitudes in both control and ADHD children had the tendency of Go-P3 > NoGo-P3,especially significant at CPz and Pz in ADHD children,showed the trend of parietal central to parietal maximum and the frontal minimum,The NoGo-P3 amplitude of ADHD group was smaller especially significant at FCz and Cz,and tended to be smaller than control on left hemisphere.(3)NoGo-P3 is smaller in impulsive children with ADHD than normal children,most significant at FCz.(4)Brain maps showed that impulsive children with ADHD were lower activation significantly in the right frontal area.Conclusions The efficiency of ADHD in action is lower.The behavior regulation in impulsive children is limited.Go/NoGo-P3 reflects action processing and attention.The left parietal lobe to central area is engaged much more in action procedure and attention.This research shows the evidence of weakened parietal cortex and right frontal cortex in impulsive children with ADHD.

Objective: To study the effects of vitamin E and selenium on apoptosis and c-Myc expression in human leukemia cells. Methods: DNA gel electrophoresis and Northern blotting hybridization were used to detect the apoptosis and the expression of c-Myc gene, respectively. Human leukemia cell line HL-60 and K562 were cultured in vitro. Results: The apoptosis of HL-60 and K562 cells were induced after being exposed to vitamin E (100 ?mol/L) and selenium (8 ?mol/L) for 24 hours, respectively. In HL-60 cell line, c-Myc mRNA was down-regulated significantly by vitamin E(100 ?mol/L),but not selenium(8 ?mol/L).In contrast, the expression of c-Myc gene was repressed by selenium(8 ?mol/L) and not by vitamin E(100 ?mol/L) in K562 cell. Conclusion: Our observations suggest that c-Myc down-regulation and induction of apoptosis by selenium and vitamin E are important pathways in repressing leukemia cell proliferation.The results suggest there are different mechanisms of repressing leukemia cell proliferation for selenium and vitamin E.

ObjectiveTo investigate the effect of flurbiprofen axetil on lung ischemia-reperfusion(I/R) injury in rats.MethodsSixty healthy male SD rats weighing 250-300 g were randomly divided into 3 groups( n =20 each): group sham operation(group S) ;group I/R and group flurbiprofen axetil (group FA).The animals were anesthetized with intraperitoneal 2％ pentobarbital 50 mg/kg and tracheostomized and mechanically ventilated.Lung I/R was induced by 60 min occlusion of left hilus pulmonis followed by 120 min reperfusion.In FA group flurbiprofen axetil 10 mg/kg was injected iv at 15 min before occlusion of left hilus pulmonis.The rats were sacrificed at 120 min of reperfusion and then the lungs were removed for measurement of lung wet/dry weight ratio,apoptosis index,NF-κB activity,Bcl-2 and Bax protien expression,and microscopic examination.Bcl-2/Bax ratio was caculated.ResultsI/R significantly increased lung wet/dry weight ratio,apoptosis index,NF-κB activity,Bcl-2 and Bax protien expression,and decreased Bcl-2/Bax ratio.Flurbiprofen axetil preconditioning significantly attenuated the I/R-induced changes in lung wet/dry weight ratio,apoptosis index,NF-κB activity,Bcl-2 and Bax protien expression,and Bcl-2/Bax ratio in group FA as compared with group I/R.Flurbiprofen axetil preconditioning also ameliorated I/R-induced lung damage.ConclusionFlurbiprofen axetil can attenuate lung I/R injury in rats by inhibiting NF-κB activity,up-regulating Bcl-2 expression and down-regulating Bax expression and inhibiting apoptosis.

Objective To observe the expression of Toll-like receptors (TLRs) 2,4 and 9 in lesions of lupus vulgaris and tuberculosis verrucosa cutis,and to evaluate the possible roles of these receptors in the pathogenesis of cutaneous tuberculosis.Methods Skin specimens were obtained from the lesions of 18 patients with clinically and pathologically diagnosed lupus vulgaris or tuberculosis verrucosa cutis,15 patients with plaque-type psoriasis (positive control),and from perilesional normal skin of 10 patients with pigmented nevi (negative control).Immunohistochemistry was used to detect the expression of TLRs 2,4 and 9 in these specimens,and the expression intensity was expressed as absorbence values.Data were analysed by using the SPSS 13.0 software,and t test was conducted to assess the differences between the three groups of specimens.Results TLR-2 was observed mainly in the middle and upper layer of epidermis in lesions of cutaneous tuberculosis and psoriasis,and in the whole epidermis except the basal layer in normal skin,with no significant difference in the expression intensity between the three groups of specimens (0.25 ± 0.04 vs.0.25 ± 0.05 vs.0.28 ± 0.03,P ＞ 0.05).TLR-4 was weakly expressed in cutaneous tuberculosis lesions,absent or slightly expressed in normal skin and psoriatic lesions,and the expression level of TLR-4 was significantly higher in cutaneous tuberculosis lesions than in normal skin and psoriatic lesions (0.16 ± 0.07 vs.0.07 ± 0.09 and 0.02± 0.05,t =2.58,6.24,P ＜ 0.01 and 0.05).TLR-9 was expressed in the whole epidermal layer,including appendages and vascular walls,of cutaneous tuberculosis and normal skin,with a significant increase in cutaneous tuberculosis than in the normal skin (0.25 ± 0.05 vs.0.19 ± 0.05,t =2.88,P＜ 0.05).Conclusions TLRs 2,4 and 9 are all expressed in cutaneous tuberculosis losious,and the expression intensity of TLR-4 and TLR-9 is higher in cutaneous tuberculosis lesions than in normal skin,hinting that TLR-4 and TLR-9 play a certain role in the immune response of cutaneous tuberculosis.

Objective To systematically compare propofol and isoflurane for myocardial protection in patients undergoing coronary artery bypass grafting (CABG).Methods Electronic databases were searched for randomized controlled clinical trials comparing propofol and isoflurane for myocardial protection in patients undergoing CABG.Data which were extracted independently by two reviewers included the general data of patients,premedication,induction of anesthesia and anesthetics applied during maintenance of anesthesia,level of cardiac troponin I (cTnI) before operation and at 6,12,24 and 48 h after operation,requirement for positive inotropic agents during operation,and development of myocardial infarction within 24 h after operation.Meta-analysis was conducted using Review Manager 5.0.2.Results Sixteen randomized controlled clinical trials involving 794 patients were included in this meta-analysis.The patients were divided into 2 groups:propofol group (n =405) and isoflurane group (n =389).There were no significant differences between the two groups in the plasma concentration of cTnI after operation,incidence of myocardial infarction within 24 h after operation,and requirement for positive inotropic agents during operation (P ＞ 0.05).Conclusion There is no significant difference between propofol and isoflurane for myocardial protection in the patients undergoing CABG.

Objective To estimate the application for the rapid identification of common clinical bacteria by MALDI-TOF MS. MethodsFour hundred and twenty-six bacteria, including Salmonella spp strains collected from Zhejiang center for disease control and prevention were collected from blood, sputum,secretion and urine in 2nd Affiliated Hospital of Zhejiang University during December 2008 to August 2009. The isolates included 76 gram positive coccus and 350 gram negative bacilli. Species identification was performed with the Vitek system, and serotypes of Salmonella and Shigella were determined by serum agglutination test. 16s rDNA gene of 91 bacteria were amplified by PCR. The RCP products were sequenced. Then the results were compared with the reported sequences from GenBank. All strains were identified by MALDI-TOF MS. Results of three identification methods were compared with each other. Results Among 426 tested isolates, identification results from Vitek system and MALDI-TOF MS for gram positive coccus and 323 out of 350 gram negative bacilli (exception for Salmonella and Shigella spp.),were identical. For 23 Salmonella and Shigella spp. , only 2 Salmonella enterica subsp, enterica serovar Typhimurium were identified the same results by the three methods. Besides, results from Vitek system and serum agglutination test for 1 Salmonella enterica subsp, enterica serovar Typhi, 3 Salmonella enterica subsp.enterica serovar Paratyphi A, 1 Salmonella enterica subsp, enterica serovar Paratyphi B, 1 Salmonella enterica subsp, enterica serovar Enteritidis, and 1 Salmonella enterica subsp, enterica serovar Bovis-morbificans were consistent with that from 16S rDNA gene sequence. Four isolates which were confirmed as S. flexneri by Vitek system and serum agglutination test were identified as Escherichia coli by both 16S rDNA gene sequence and MALDI-TOF MS. ConclusionMALDI-TOF MS could be used for rapid and accurate identification of common clinical bacteria with good repeatabihty, excepting for the Salmonella and Shigella spp.