OBJECTIVE:To explore the effect of olmesartan on NT-proBNP and high-sensitive C- reactive protein(hs-CRP) and left atrial diameter (LAD) in elderly hypertensive patients with paroxysmal atrial fibrillation (PAF). METHODS:188 cases of elderly hypertensive patients with PAF from May 2011 to May 2013 were divided into control group(n=94)and observation group (n=94),both groups received the treatment of amiodarone,observation group were additionally given olmesartan on the basis of conventional treatment,the treatment cycle was 12 months in two groups. NT-proBNP,hs-CRP,LAD changes and atri-al fibrillation(AF)recurrence were compared between 2 groups before(T0)and after 1 month(T1),3 months(T2),6 months (T3)and 12 months(T4)treatment;related factors for recurrence of atrial fibrillation were analyzed. RESULTS:NT-proBNP and hs-CRP in observation group were lower than control group at T3-T4,with significant difference(P<0.05);LAD improvement in observation group was better than control group,with significant difference (P<0.05). After treatment,the decent range of NT-proBNP and hs-CRP in observation group were higher than that control group,with significant difference(P<0.05);AF re-currence in observation group were lower than control group at T3-T4,with significant difference(P<0.05);Multiple stepwise re-gression analysis showed that NT-proBNP and hs-CRP were positively related with LAD,with significant difference (P<0.05);multi-factor logistic regression analysis showed that the NT-proBNP level,hs-CRP,LAD were positively correlated with AF re-currence,NT-proBNP drop and hs-CRP drop were negatively correlated with AF recurrence. CONCLUSIONS:Serum NT-proB-NP and hs-CRP levels are closely related to LAD and AF recurrence in elderly hypertensive patients with PAF,and olmesartan can decrease the plasma NT- proBNP CRP levels,reduce inflammation response and improve left atrial remodeling so as to re-duce the AF recurrence.

Objective To investigate the imaging features in neonates with hypoglycemic brain injury by early and serial MRI.Methods Neonates who were admitted to neonatal department from May 2005 to Jul 2013 received MRI and diffusion-weighted imaging(DWI) scan within 7 days after hypoglycemia.Fortynine neonates were diagnosed with hypoglycemic brain injury.Thirty-four neonates received second MRI scan between 2 ～3 weeks after hypoglycemia.Seven neonates received third MRI scan.Results All the 49 neonates showed hyperintensity on DWI in the regions of occipital and parietal lobe for the first MRI scan(mainly involved 33 cases).Six cases combined frontal lobe and temporal lobe.Ten cases presented widespread cortex and white matter involvement.All the cases presented hypointensity on DWI for the affected area,T1 and T2 weighted image signal changes were not obvious.Some cases presented deep white matter and gray matter injury.Thirty-four cases received second MRI scan between 2 ～3 weeks after hypoglycemia,20 presented hypointensity on DWI,hypointensity on T1 weighted image and hyperintensity on T2 weighted image.Eleven cases with normal signals,and the other 3 were absorbing.Seven cases received third MRI scan,appeared encephalomalacia,myelin retardation,white matter volume decreased,hypoplasia of corpus callosum.The more severe the clinical symptoms was,the more severe the degree of brain injury showed.Conclusion Cerebral occipital and parietal regions are the most vulnerable in neonatal hypoglycemic brain injury.Early DWI for the imaging diagnosis of hypoglycemic brain injury should be taken within one week after hypoglycemia.Mild injury is recoverable,but severe would chang into necrosis and encephalomalacia.Some combined deep white and gray matter injury might related to hypoxia and ischemia.

Objective To investigate the influence of SDG on blood glucose and blood lipid concentrates of middle and old aged patients. Methods The impacts of SDG on blood glucose and blood lipid concentrates in body of patients with hyperglycemia were conducted through an 8-week random and double-blind experiments with controlled group only given placebo. The influence degree of SDG on blood glucose and blood lipid concentrates of the selected patients was analyzed. Results The results showed that serum glucose of the groups received 400mg/d of dietary SDG for 8 weeks or 600 mg/d for 4 weeks decreased significantly compared with the controlled group (P<0.05). Conclusion Giving either 400 mg/d of dietary SDG for 8 weeks or 600 mg/d for 4 weeks to patients could significantly decrease the serum glucose concentrates of them.

Objective To analyze the current situation of applying case-based learning (CBL) to the education of acupuncture-moxibustion by investigating the published literatures involving CBL in medical education.Method The literatures published between 2001 and 2015 were retrieved from VIP, CNKI, CBM, and WanFang databases, and the manuscripts about the application of CBL in the education of acupuncture-moxibustion were classified and analyzed.Result The related literatures involving the application of CBL in the education of acupuncture-moxibustion were rather limited, not enough for revealing the action and significance of CBL in the education of acupuncture-moxibustion.Conclusion CBL accords with the strong practicality of acupuncture-moxibustion, and is worth promotion; however, there are some shortcomings in the compiling of cases, students grouping, evaluation of study results, and the capability of teachers, which expect further standardization of teaching process and comprehensive use of advanced teaching methods, for cultivating elites in acupuncture-moxibustion.

Carcinoma, Hepatocellular ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Function Tests ; methods ; Liver Neoplasms ; physiopathology ; Preoperative Care

Adaptor Proteins, Signal Transducing ; Animals ; Carrier Proteins ; CpG Islands ; DNA Methylation ; Genes, Tumor Suppressor ; Genes, p16 ; Genes, p53 ; Humans ; MutL Protein Homolog 1 ; Mutation ; Neoplasm Proteins ; genetics ; Neoplasms ; genetics ; Nuclear Proteins

This paper summarizes the kinds of long term care facilities, service delivery organization, service model, service role and experience of long-term service system in the United States. It provides referral implications for China to explore and establish its own long-term care service system. . There is a variety of long-term care services such as short and long-term stay, adult day care, and home care services, with a gradual change from institutional services to home and community ones. Long-term care services are provided by paid both formal and mostly unpaid informal caregivers. Informal family caregivers are most frequently daughters (29. 3%), followed by spouses with (21. 2%). With the increased availability of the family and community-based services, the family caregivers are more likely to share long term care services with the paid formal ones. The United States has a well-structured long-term care service system whose access mechanism is rigorous and systematic, emphasizing the evaluation of service quality and effectiveness. Moreover, the U. S. long term care service system pays more attention on elders' wishes, respecting their preferences and rights of choice on the services. Based on the experience of the United States, China should primarily focuses on establishing a family and community-based long term care service system with a variety of service delivery facilities, give a full play to the community health facilities, social partners, and families. The Chi-nese government should not only give a focus to the service institutions and content diversification, but should as well establish a sound and detailed assessment and evaluation standard system to access the services and assure the effec-tiveness of service quality with a humanized concern.

OBJECTIVE To investigate the clinical distribution and drug resistance of the nonfermenters between 2000 and 2004 in our hospital. METHODS The bacteria were identified by ATB,drug resistance test was then performed by K-B method. RESULTS A total of 875 strains of nonfermentative Gram-negative bacteria were isolated from various clinical specimens during Jan 2000-Dec 2004.The dominant strains were Pseudomonas aeruginosa((313 strains)),Acinetobacter baumannii(287 strains) and Stenotrophomonas maltophilia(180 strains).They happened most commonly in the respiratory system.The positive rate from sputum and pharyngeal probe was 73.7% and 6.2%.The resistance rate of P.aeruginosa and A.baumannii to imipenem was the lowest,accounted for 17.6% and 7.7%.These nonfermenters were highly resistant to cefalotin,ceftriaxone and sulfamethoxazole/trimethoprim.The resistance rate of S.maltophilia to sulfamethoxazole/trimethoprim was lower than the others,the rate being 7.8%. CONCLUSIONS The drug resistance of nonfermenters to frequently-used antibacterials is higher.Due to the high resistant rates,the drugs should be chosen according to the result of the drug susceptibility test.

Objective: A capillary electrophoresis for the determination of berberine hydrochloride and palmatine hydrochloride in Ruyijinhuang Powder(Rhizoma Curcumae Longae, Radix et Rhizome Rhei, Cortex Phellodendri, Rhizoma Atractylodis, etc.) was established. Methods: The berberine hydrochloride and palmatine hydrochloride were determined using benzoic acid as an internal standard its detection wavelength was at 230nm. The optimized condition was achieved with a fused\|silica capillary 100?m?56.5cm, 10mmol?L -1 phosphate buffer(pH=4.80) containing 30% acetonitrile, a constant voltage of 20kv and temperature at 30℃. Results: Calibration curve was constructed in the range of 5?g?mL -1 ～100?g?mL -1 for berberine hydrochloride and palmatine hydrochloride, respectively. The regression equations were Y=0.02964X -0.00771 ( r =0.9998) and Y =0.01092 X -0.02939 ( r =0.9997) for berberine hydrochloride and palmatine hydrochloride, respectively. The average recovery was 98.7% and 102.1%( n =5), respectively. Conclusion: This method is sample, quick and sensitive.

Acetaminophen ; therapeutic use ; Child ; Fever ; drug therapy ; Humans ; Ibuprofen ; therapeutic use ; Neonatology