Objective To study and analyze the clinical observation and nursing measures of prednisone acetate combined leflunomide in the treatment of IgA nephropathy.Methods 100 patients with IgA nephropathy treated in our hospital from February 2015 to September 2016 were randomly divided into the control group and the experimental group,with 50 patients in each group.Patients in the control group were treated with prednisone and dropped to 0.5 mg/kg after 12 weeks.The patients in the experimental group were treated with leflunomide and dropped to 20 mg after 3 days.The patients in the experimental group and the control group were treated for 3 months.The two groups of patients were given reasonable nursing measures, and compared the treatment effect.Results The effective rate of treatment in the experimental group was 94.0％, significantly higher than that in the control group (64.0％),with statistical difference(P<0.05).After treatment,the level of 24 hours proteinuria in the experimental group was (0.541±0.322)g/L, significantly lower than that of the control group (1.516±0.568)g/L,with statistical difference (P<0.05) .The adverse reaction rate of the experimental group was 0％, and that of the control group was 8％,with statistical difference(P<0.05).Conclusion Prednisone acetate combined leflunomide was effective in the treatment of IgA nephropathy, and can significantly improve the efficiency of treatment, and has clinical significance.

BACKGROUND: Many factors can lead to a large area of skin defects, and tissue-engineered artificial skil transplantation composed by seeding cel s and scaffold materials can be used for skin defect repair. OBJECTIVE: To construct the skin implantation scaffold based on human epidermal stem cel s combined with acel ular dermal matrix in nude mice. METHODS: Human epidermal stem cel s from children’s foreskin were isolated and cultured, and the skin of nude mice was obtained to prepare acel ular dermal matrix scaffold. Then, the human epidermal stem cel s were cultured on the acel ular dermal matrix scaffold to construct artificial skin. Ten Sprague-Dawley rats were equivalently randomly divided into two groups: rats treated by human epidermal stem cel s combined with acel ular dermal matrix scaffold as combined group, and those treated by simple acel ular dermal scaffold as acel ular dermal scaffold group after skin defect models were prepared. RESULTS AND CONCLUSION: The artificial skin was milky white, soft and elastic, not easy to break, and has good flexibility, and good plasticity, and could be processed into different shapes. No obvious exudation appeared in the rat wound of two groups after repair. At 2 weeks after modeling, the transplanted skin showed good growth and skin wound healed gradual y in the combined group. In contrast, scar healing and two animals with transplant failure occurred in the acel ular dermal scaffold group. These results show that human epidermal stem cel s combined with acel ular dermal materials in nude mice can construct the tissue-engineered skin, which exerts good repair effects for skin defects in animals.

Objective To investigate the effect of atorvastatin on cytochrome c (CytC) expression and neuronal apoptosis after intracerebral hemorrhage in rots.Methods A total of 108 male Sprague-Dawley rats were randomly allocated into 3 groups:sham operation group,saline control group,and atorvastatin group (n =36 each group).All the groups were redivided into 6 h,12 h,day 1,3,5 and 7 time points (n =6 at each time point).An intracerebral hemorrhage model was induced by using a modified two-step injection method.After modeling,atorvastatin was used for gavages (20 rng/kg,once a day) in the atorvastatin group.The saline control group was given the same volume of saline.Behavior evaluation was used for neurological score.TUNEL staining was used to detect apoptosis in perihematoma tissue.Immunohistochemical method was used to detect the CytC expression in perihematoma tissue.Results Behavior evaluation showed that the neurological scores decreased gradually with the passage of time in the atorvastatin group and the saline control group.There were no significant differences at 6 h,12 h,day 1 and day 3,but the neurological scores in the atorvastatin group were significantly lower than those in thc saline control group at day 5 (0.50 ± 0.55 vs.1.50 ± 0.55; t =3.162,P =0.010) and day 7 (1.00 ±0.63; t =2.712,P =0.022).TUNEL staining showed that the numbers of apoptotic cells increased first and then decreased in the saline control group and the atorvastatin group.They reached the peak at 1 hour after modeling.There were significant differences in the number of apoptotic cells in each group in perihematoma tissue at the same time point (all P =0.000),and the significance in the saline control group was more than that in the sham operation group and the atorvastatin group (all P ＜0.05),but at day 7,there was no significant difference in the number of apoptotic cells between the atorvastatin group and the sham operation group (12.69 ± 3.35 vs.9.33 ± 2.07; P =0.148).Immunohistochemical method showed that the numbers of CytC positive cells increased first and then decreased in the saline control group and the atorvastatin group,reached the peak at 12 h after modeling in te saline control group (68.19 ± 11.93) and at 1 d in the atorvastatin group (35.64 ± 9.12).There were significant differences in the numbers of CytC positive cells in perihematoma tissue at the same time point in each group (P =0.000).The numbers of CytC positive cells in the saline control group was significantly more than that in the sham operation group and the atorvastatin group (all P ＜0.05),but there was no significant difference in the numbers of CytC positive cells between the atorvastatin statin group and the sham group at day 7 (16.08 ± 3.80 vs.13.67 ± 2.94; P =0.349).Conelusions Atorvastatin may inhibit the release of CytC of nerve cells in perihematoma tissue after intracerebral hemorrhage,and thus reduce CytC-mediated apoptosis and neurological deficit after intracerebral hemorrhage.

Objective To discuss the influence of personalized comprehensive nursing intervention on complications after coronary stent implantation in patients with acute cardiac infarction,and provide an effective and feasible method for prevention and reduction of these complications.Methods 118 patients with acute cardiac infarction after coronary stent implantation were divided into the intervention group (51 cases)and the control group (67 cases),the puncture site complications,CRP level were compared,and the mastering of health knowledge were compared between two groups through questionnaires and telephone return visit as well.Results The incidence rate of puncture site complications in the intervention group was lower than that of the control group.Significant differences were seen in reasonable diet,medicine knowledge,emotional adjustment and preventive measures between two groups.CRP levels were compared between two groups and the result showed no statistical difference.Conclusions Through strengthening the personalized comprehensive nursing intervention,nurses can significantly reduce the rate of complications after coronary stent implantation and facilitate the recovery of patients.

Objective To explore the impact of different doses of dexmedetomidine on the anesthetic sedative and analgesic effect of anesthesia agents in hysterectomy of patients with uterine fibroids under laparoscopy.Methods 90 patients with uterine fibroids with ASA class Ⅰ or Ⅱ who were going to undergoing general intravenous anesthesia laparoscopic hysterectomy were selected and they were divided into group A (dexmedetomidine 0.4μg·kg-1·h-1,n=30) and group B (dexmedetomidine 0.2μg·kg-1·h-1,n=30) and group C (no dexmedetomidine,n=30) by digital random method.The analgesia effect (VAS score) of group A,group B and group C preoperation and postoperative 1h,12h and 24h,and the sedation (Ramsay sedation score) were compared.General information,postoperative blood pressure,heart rate,pulse oxygen saturation,postoperative patients'' satisfaction on analgesic effect and the sedation effect and adverse reactions of the three groups were also compared.Results Age,body mass index and other basic information of three groups had no statistically significant differences (all P＞0.05).The preoperative VAS score of the three groups also had no statistically significant difference (F=0.625,P＞0.05).Postoperative 12h,24h,the VAS scores of group A and group B were lower than those of C group,which of group A were lower than group B (F=11.250,P＜0.05,F=21.181,P＜0.05).The Ramsay sedation score was higher than that of C group[(3.67±0.18) vs.(2.13±0.11)].The satisfaction of group A was significantly higher than group B and group C (96.67％ vs.73.33％,46.67％,χ2=25.953).The Ramsay sedation score and satisfaction were higher than those of group B (all P＜0.05).There were no significant differences in blood pressure (F=0.362,P＞0.05),pulse oxygen saturation (F=0.978,P＞0.05) and heart rate among the three groups before and after operation (F=1.268,P＞0.05).There was no obvious adverse reaction in the three groups.Conclusion Dexmedetomidine can promote anesthetic sedative and analgesic effect of anesthesia agents in hysterectomy of patients with uterine fibroids under laparoscopy,and the dose 0.4μg·kg-1·h-1 of dexmedetomidine has better effect,feasibility and safety,it is worthy of clinical promotion.

The paper probed into the building and application of the evaluation system for the target responsibility system centering on nursing units, in line with recent development hospital practices. It discussed the design of the target-based quantitative assessment standards for nursing units, and the methods of target-based evaluation for nursing units, which are used in the target responsibility evaluation of 21 nursing units of the hospital. Results of the practice prove that such responsibility system raises the nursing quality and efficiency, improves nurses' incentives and cooperativeness, as well as elevates the safety and creativity of nursing and its management efficiency.

BACKGROUND:Peripheral facial nerve injury first involves the retrograde reactions of central nervous system axons, and nerve regeneration wil depend on the survival and functional status of neuronal cel bodies. OBJECTIVE:To explore the expression of neuronal cadherin and placental cadherin in facial nuclei after facial nerve injury. METHODS:New Zealand white rabbits were randomly divided into model group (n=48) and control group (n=8). In the model group, every eight rabbits were used to carry out the test respectively at 1, 4, 7, 14, 21 days after the model of facial nerve injury (right side) was established. SP and real-time quantitative PCR methods were taken to test the expression of neuronal cadherin and placental cadherin in the facial nerve nucleus at mRNA and RESULTS AND CONCLUSION:The control group had neuronal cadherin-and placental cadherin-positive neurons. In the model group, neuronal cadherin and placental cadherin positively expressed in the facial motorneurons (right side), and their expressions were peaked at 14 days. Compared with the control group, the mRNA expression of neuronal cadherin in the facial motorneurons was increased significantly at 4-28 days after injury;the mRNA expression of placental cadherin in the facial motorneurons was decreased significantly at 1 day after injury, and then increased significantly at 7-28 days. It is suggested that the expression of neuronal cadherin and placental cadherin is positive in the early stage of facial nerve injury, and the expression of placental cadherin is always present, while the expression of neuronal cadherin relatively lasts for a short time. After facial nerve injury, the expression of neuronal cadherin and placental cadherin in the facial nerve nucleus is both increased, which indicates that the facial nerve regeneration may be related to the high expression of adhesion molecules.

OBJECTIVE: To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap. METHOD: The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap. RESULT: The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery. CONCLUSION The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Dermatologic Surgical Procedures ; Face ; surgery ; Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Wound Healing

Objective To observe the effects of Chinese medicinal herbs with the efficacy of invigorating spleen, upbearing the clear, and tonifying spleen on the obesity degree, fat hormones, and insulin resistance in diet-induced obesity (DIO) rats;To choose better anti-obesity herbs from different Chinese medicinal herbs that can tonify spleen. Methods Among the 130 Wistar rats, 10 were chosen as the blank control group (fed with basal forage), and the remaining 120 were administered with high-fat high-nutrition forage for 13 weeks. According to weight, 50 DIO rats and 10 diet-induced obesity resistance (DIO-R) rats were obtained. DIO rats were divided into model group (normal saline), sibutramine group, invigorating spleen group (Atractylodix Rhizome and Magnoliae Officinalis Cortex), upbearing the clear group (Bupleuri Radix and Aurantii Fructus Immaturus) and medicine for tonifying qi and spleen group (Astragali Radix). All groups received gavage with corresponding drugs. Rats in the blank control group and the DIO-R group received gavage with normal saline. The basal forage was administered to rats in the blank control group, while high-fat forage was continually given to rats in the other six groups. Insulin resistance index (IRI), blood glucose, triglycerides, cholesterol, tumor necrosis factor α (TNF-α) and adiponectin were detected after blood withdrawing. TNF-α and adiponectin in the fat homogenate were examined. Results Compared with the blank control group, body weight, IRI, and cholesterol of rats in the model group significantly increased (P<0.01);adiponectin in homogenate reduced (P<0.01);serum and adipose homogenate TNF-α increased (P<0.01). Compared with model group, body weight, IRI, cholesterol of rats in DIO-R group significantly decreased (P<0.01);adiponectin in fat homogenate increased (P<0.01). Body weight and cholesterol of rats in the sibutramine group significantly decreased (P<0.01), while serum and adipose homogenates TNF-αdecreased (P<0.05, P<0.01). Body weight, IRI and cholesterol of rats in upbearing the clear group decreased (P<0.05, P<0.01);serum and adipose homogenate TNF-α decreased (P<0.05, P<0.01);adiponectin increased in fat homogenate (P<0.05). IRI, cholesterol and serum TNF-αof rats in the invigorating spleen group decreased (P<0.05, P<0.01);adiponectin in serum and adipose homogenate increased (P<0.05). BMI, blood glucose, IRI and cholesterol of rats in Astragali Radix group decreased (P<0.05, P<0.01);TNF-α decreased and adiponectin increased in serum and adipose homogenate (P<0.05, P<0.01). Conclusion Astragali Radix could reduce obesity induced by high-fat forage, and its effects on improving glucose and lipid metabolism disorder and IR are better than the other TCM groups. Its mechanism is related to decreasing TNF-α and increasing adiponectin level.

[ ABSTRACT] AIM:To investigate the preventive effect of Guizhi decoction on myocardial injury after chemical sympathectomy induced by 6-hydroxydopamine (6-OHDA).METHODS:Wistar rats (n=54) were randomly divided in-to 6 groups.Methycobal and Guizhi decoction ( with different proportions between Ramulus Cinnamomi and Radix paeoniae Alba at 2∶1, 1∶2 or 1∶1) were pre-administered to the rats.Immunohistochemical method was used to observe the cardiac sympathetic nerve distribution.The contents of tyrosine hydroxylase (TH), choline acetylaminotransferase (ChAT) and growth-associated protein 43 (GAP-43) in the left ventricle were measured by ELISA.The serum levels of myocardial en-zymes and morphology of myocardial tissues were also observed.RESULTS:6-OHDA successfully induced cardiac sympa-thetic denervation as the contents of TH and GAP-43 in the left ventricle declined significantly.Compared with model group, the content of TH was elevated in both methycobal group and Guizhi decoction groups, while the content of GAP-43 was elevated only in Guizhi decoction groups.The serum levels of myocardial enzymes and the histopathological changes of the cardiac tissues were deteriorated after injection of 6-OHDA, indicating that the myocardial injury was established. Methycobal and Guizhi decoction normalized the abnormal change.Guizhi decoctions at 2∶1 and 1∶1 showed the best effi-cacy.CONCLUSION:6-OHDA-induced sympathetic denervation causes myocardial injury.Guizhi decoction with the proportions between Ranulus Cinnamomi and Radix paeoniae Alba at 2∶1 and 1∶1 effectively alleviate the myocardial injury after cardiac sympathetic denervation induced by 6-OHDA.