Objective To discuss the influence of the management of family-doctor responsibility system on drug utilization and compliance of hypertensive patients.Methods 1039 primary hypertension patients in Zhenhai Lianhua Community who were under the management of the residents electronic health files in June 2012,were implemented with the latest family-doctor responsibility system for eight months.The on-site questionnaire survey and electronic health management platform were carried out to analyze the drug utilization and treatment compliance of hypertensive patients.Results The proportion of taking medicine treatment among 1039 patients with essential hypertension reached 85.2％,including 56.3％ patients who took one kind of drug,35.4％ patients who took two kinds of drugs and 8.3％ patients who took at least three kinds of drugs.The most commonly used drugs were Amlodipine Besylate,Felodipine,Irbesartan and Hydrochlorothiazide tablets,Irbesartan,Levamlodipine Besylate tablets,Metoprolol Tartrate tablets and etc.The rate of patient compliance was 65.5％.After comparing the compliance of any two among three kinds of drug groups,the comparison of compliance between patients who took one kind,two or three kinds of drugs showed statistical significance.The comparison of drug types and compliance showed that compliance with compound preparation was statistically different from compliance with ARB,calcium antagonists,sympatholytic agent,diuretics.The educational level was also related to the compliance.Conclusions After the implementation of the family-doctor responsible management,the treatment rate and compliance rate are high,and the patients with hypertension in community still give priority to long-acting drugs.

The pharmacokinetics of Luteolin ( Lut ) solution in rabbits and rats was investigated. Lut in plasma, bile and urine as well as protocatechuic acid (which is a product of Lut) in plasma and urine were determined by fluorescence spectrophotometry. A curve with multiple peaks was fitted to the data of plasma concentration versus time, employing a nonlinear program developed with an IBM-PC computer. The results indicated that the data set obtained with 30 mg /kg doses by iv fitted well to a peculiar open 3 compartment model involved in the enterohepatic recirculation of the drug and the undulations of the drug concentration.The essential pharmacokinetics parameters (mean?SD) were as follows; The t1/2 values for the ?-phase and ?-phase were about 0.18?0.01 h and 1.66?0.24 h respectively. The apparent volume of distribution ( Vd) was about 1.43? 0.45 L?kg-1. The reabsorption rate constant ( Ka ) was 0.465? 0.08 h-1 The reabsorption percent ( F' ) was about 6.9? 2.1% . The elimination rate constant was 1.124?0.35 h-1. The clearance was 588?113 ?g?h-1?kg-1. This study indicated that Lut was rapidly removed from the blood by both kidney and liver where Lut was excreted by way of the bile into intestine from which it Was reabsorbed. The 12 h urine excretion of Lut in rabbits was in the order of 37.7% of total iv dose. In rats, the 6 h bile excretion of Lut was about 11.2% of that total iv dose. A comparison of the C-T curve of PCA with of Lut suggested that PCA was the one of the products of Lut.In rats, the 3H-Lut orally administered was widely distributed in the tissues, the concentrations being higher in liver and kidney.

Objective To investigate the clinical value of combined tests,including A-fetus protein(AFP)、cancer embryo agent(CEA),carbonhydrate agent 19-9(CA19-9)for the diagnosis of malignant tumors in digestive system.Methods Chemicalill-umination tests were used to detect serum levels of AFP,CEA and CA 19-9 in 821 patients with diseases of digestive system.Results The levels of AFP,CEA,CA19-9 in malignant group and the benign group were significantly higher than the control group(t=2.345,2.224,all P＜0.05;t=2.785,2.749,2.897,2.865,all P＜0.01＝;The levels of AFP、CEA、CA19-9 in malignant group were significantly higher than benign group (t=2.445,P＜0.05;t=2.745,2.819,all P＜0.01);The level of AFP in liver cancer group was significantly hisher than other groups(t=2.715,2.812,2.877,2.845,2.799,all P＜0.01);The level of CEA in hver cancer group was significantly lower in patients with liver colorectal cancer and pancreatic cancer(t=2.775,2.801,all P＜0.01);The level of CA19-9 in bile duct cancer group was significantly hisher than that of other cancers (t=2.733,2.851,2.788,all P＜0.01);The positive rates of liver、stomach、colorectal cancer、pancreatic cancer、bile duct cancer combined detection in three item were 91.0%,90.0,88.0%,90.0%,70.2%which were higher than the single check-positive rate of 85.0%,72.0%,67.5%,79.4%、55.3%(χ2=3.781,3.841,3.798,3.814,3.994,all P＞0.05).Conclusion The three tumor markers could be used as auxiliary diagnostic and ioint detection which could improve the detection rate in patients with malignant tumors of digestive system.

Objective To evaluate the effect of comprehensive experiments on multiple trauma emergency rescue in intensive training before nursing practice. Methods 772 students were divided into groups, 16 to 18 students in each group,each team distributed teaching notes, designed experiment scheme toget her, selected and played roles, undertook tasks, practiced independently before the class,then performed comprehensive training in class. Results 94.8% of the nursing students and 100.0% of the training teachers supported this method of comprehensive experiments in intensive training. Conclusions Nursing comprehensive experiments can shorten the gap between the clinical practice and class teaching, improve the students' professional ability and general quality. It is a popular education mode on intensive training before clinical practice.

Objectives To explore the change of interleukin-17 (IL-17) in Kawasaki disease (KD). Methods Fourty KD pediatric patients, among them 12 patients with echocardiographic abnormalities in acute phase, 25 age-matched non-KD patients were enrolled. The level of serum IL-17 was measured by enzyme linked immunosorbent assay in acute and convalescent phase of KD patients and non-KD patients. At the same time, C-reactive protein (CRP), globulin, albumin were detected. Results In acute phase of KD patients, the level of serum IL-17 were signiifcantly higher than that in convalescent phase of KD patients and non-KD patients (P<0.05). The level of serum IL-17 was no signiifcant differences in convalescent phase of KD patients and non-KD patients (P>0.05). In acute phase of KD patients with echocardiography abnormalities, the level of serum IL-17 was signiifcantly higher than that with non-echocardiography abnormalities (P<0.05). The level of serum IL-17 in acute phase of KD patients were positively correlated with CRP and globulin (r=0.750, 0.750, P<0.05), and negatively correlated with albumin (r=-0.779, P<0.05). Conclusions IL-17 may be involved in KD immune pathogenesis. Serum IL-17 is one of the activity index of KD, which associ-ated with cardiovascular damages.

Objective:To explore the hemodynamic changes in aged patients with essential hypertension (EH).
Methods: Our research included 2 groups, EH group, n=180 patients and Control group, n=100 subjects without cardiovascular diseases. The relevant indexes were recorded and compared by BioZ.com noninvasive hemodynamic monitor between 2 groups.
Results: With statistic processing, the cardiac output/index (CO/CI), cardiac index, thoracic lfuid content (TFC), systemic vascular resistance/index (SVR/SVRI) were signiifcantly different between EH group and Control group, all P<0.05.
Conclusion: The hemodynamic changes exist at certain degree indicating the potential injury of cardiac function in aged EH patients, such changes might be helpful for clinical diagnosis and treatment in EH patients.

Objective To explore the correlation between the distribution of uric acid (UA) level and the biochemical indicators which reflect the degree of organ lesions among hospitalized children.Methods Patients who were hospitalized to the Department of Pediatrics and received the blood UA test from June 2012 to October 2013 were included,23 217 cases in total.The biochemical analyzer-Japan's Olympus AU 2700 was used to detect blood biochemistry; and uricase-peroxidase coupling method was used to detect blood UA.Among these patients,2 099 cases whose UA level exceeded the normal level.Then the patients' gender,age,primary diagnosis and UA level were recorded; and the distribution of their UA level was described.The Chi-square or Fisher test was used to assess the incidence rate.At the same time,each blood biochemical indicators of the patients with high UA level were recorded ; and the relationships between the blood UA of the 1 650 patients with complete records and each blood biochemical indicator were analyzed with Pearson correlation analysis.Results The incidence rate of hyperuricemia among the hospitalized children was 9.04％(2 099/23 217).In particular,the incidence rate among boys and girls was 6.5t％(890/13 657) and 12.65％ (1 209/9 560) respectively (x2 =256.9,P＜0.05).The incidence rate of hyperuricemiin different diseases was as follows:in the critical illness 36.93％ (113/306),neonatal disease 20.34％ (922/4 533),urinary system diseases 12.08％ (47/389),circulatory system diseases 11.67％ (21/180),nervous system diseases 11.05％(112/1 014),digestive diseases 10.50％(190/1 810),infectious diseases 10.18％(120/1 179),blood diseases 7.58％ (55/726),endocrine system diseases 5.74％ (17/296),autoimmune diseases 4.24％ (48/1 131),respiratory diseases 3.90％ (454/11 653) respectively (x2=1423.0,P＜0.05).The incidence of hyperuricemia at younger than one month was 18.31％(929/5 075),younger than one year old was 4.22％ (359/8 501),younger than six years old was 10.68％(600/5 618),younger than 15 years old was 5.24％ (211/4 023) respectively (x2=858.5,P＜0.05).Blood UA was positively correlated to urea nitrogen,creatinine,lacticdehydrogenase,α-hydroxy-butyrate dehydrogenase,creatine kinase and creatine kinase-MB (r=0.426,0.44,0.324,0.367,0.413,0.431,P＜0.05).Blood UA was not correlated to fructosamine,blood glucose,triglycerides,total cholesterol,low-density lipoprotein and high density lipoprotein.Conclusion The incidence of hyper-uricemia among hospitalized children is high; and the incidence among children with severe diseases and newborn babies is high; followed by in children with urinary system and circulatory system diseases.The blood UA level is closely related to the blood biochemical indicators which reflect the lesions of heart and kidney.

Objective To investigate the state of perceived discrimination,mental health knowledge and self-discrimination of the public,and analyze the relationship among these variables,and explore the mediating effect of mental health knowledge between the perceived discrimination and self-discrimination.Methods A total of 1 088 residents in Guangzhou City were assessed with the Perceived Devaluation-Discrimination Scale (PDDS),Attitudes about Mental Illness Associated Stigma Scale-Chinese Version (AMIASS-C) and Mental Heahh Knowledge Questionnaire (MHKQ).Results The average score of PDDS was 2.63±0.35.The rate of mental health knowledge was 72.4％(788/1 088) and the score of AMIASS-C was 2.58±0.45.The perceived discrimination,mental health knowledge and self-discrimination were significantly correlated with each other,r=0.320,-0.240,P＜0.01.The mental health knowledge played a negative mediating role between perceived discrimination and self-discrimination.Conclusions The mental health knowledge was a mediator between perceived discrimination and self-discrimination.

Objectives To explore the clinical features, diagnosis and treatment of Crohn’s disease complicated by erythromelalgia (EM) in a pediatric case. Methods The clinical manifestation, results of laboratory testing and endoscopy, mutational analysis of the SCN9A gene, and the follow-up record were collected and analyzed based on review of literature to a thirteen-year-old girl with Crohn’s disease complicated by erythromelalgia. Results The patient experienced symptoms of anorexia, fatigue, diarrhea, dark red and swelling skin, increased skin temperature and burning pain in her both lower extremities during the course of disease. The endoscopic ifndings included multiple ulcerations and polypoid protrusion lesion in colon, and the pathological examination showed the local abscess formation in colonic mucosa. The mutation in SCN9A gene of the child was excluded by gene analysis. The symptoms were gradually ameliorated after treatment using prednisone and mesalazine combined with dipyridamole and low-molecular-weight heparin calcium. Conclusions Crohn’s disease complicated by erythromelalgia is rare. The pathogenesis may relate to immune factors, thrombocytosis, and hyper-coagulable states, etc. The combination of glucocorticoids, 5-aminosalicylic acid and anticoagulants may lead to a better therapeutic effect.

Objective To explore the significance of interleukin (IL)-1β and IL-6 in serum of children with hyperuricemia (HUA). Methods 142 children including 71 children with HUA (HUA group) and 71 control children (control group), healthy and inguinal hernia children were selected as control group. 71 HUA children were subdivided into GA (gout attacks) group (n=28) and NGA (non-gout attacks) group (n=43) according to whether they had a history of acute gout attacks, including sudden monoarthritis of rapid onset with intense pain and swelling or without. Enzyme-linked immunosorbent assay was used to measure the level of IL-1β and IL-6 in serum. Results Serum IL-1β and IL-6 levels of HUA children were significantly higher than those of control group (all P<0.05). Serum IL-1β and IL-6 levels of HUA children in GA group were significantly higher than those of NGA group (P<0.05). Serum IL-1β and IL-6 levels of GA group in acute phase was significantly higher than those of HUA children in remission stage、NGA group and control group (P<0.05). Serum IL-1β and IL-6 levels of GA group in remission stage and NGA group was significantly higher than those of control group (P<0.05). There were no significant differences between HUA children in remission stage and NGA group (P>0.05). The serum IL-1β and IL-6 levels of HUA children were positively correlated with WBC, neutrophils, monocytes, uric acid, ESR, CRP, BUN and Cr (all P<0.05), while not correlated with triglyceride, total cholesterol, LDL-C and HDL-C(all P<0.05). Conclusion IL-1β and IL-6 play an important role in the pathogenesis of HUA in children.