Objective To evaluate the effect of PRECEDE-PROCEED model in elder patents with diabetes.Methods 70 elder patients with diabetes were divided into the control group (34 cases)and the intervention group(36 cases) randomly.Routine nursing care was used in the control group,while the PRECEDE-PROCEED model was used in the intervention group in addition.Compared the level of FBG and the 2hPG betweenthe two groups.Results Before and after the intervention,the difference of FBG and 2hPG was not significant between the two groups,P＞ 0.05.Two weeks after the intervention,the incidence rate of hypoglycemia in the intervention group was 8.3％(3/36),which was significant lower than that of in the control group (29.4％,10/34),thex2=5.137,P＜0.05.Conclusion PRECEDE-PROCEED model can be well-applied to decrease hypoglycemia in elder patients with diabetes.

Objective To explore the value of real-time tissue elastography (RTE) with tissue dispersion quantitative analysis technique for assessment of liver fibrosis stage.Methods 51 rats were injected 6％ thioacetamide to induce liver fibrosis model,and 9 rats were injected saline as control group.In modeling 4 weeks,8 weeks,12 weeks respectively,14 rats in group of liver fibrosis model and 3 rats in control group were randomly selected to RTE.All the rats underwent tissue dispersion quantitative analysis,to obtain 12 quantitative parameters of elasticity,which included average relative strain value (MEAN),standard deviation of relative strain value (SD),area ratio of low-strain region (％ AREA),complexity (COMP),kurtosis (KURT),skewness (SKEW),contrast (CONT),entropy (ENT),inverse difference moment (IDM),angular second moment (ASM),correlation (CORR) and liver elasticity index (LF index).Subsequently,rats were sacrificed and their livers were taken for pathology analysis.Liver fibrosis model group was divided into S0,S1,S2,S3,S4 group.The 12 quantitative parameters of elasticity were compared with each group.Results 49 rats were successfully modeled,and 42 rats were analyzed.Except COMP,KURT,CORR,the other quantitative parameters had statistically differences (P ＜ 0.05).The other 9 parameters were correlated with liver fibrosis stage.Among these parameters,MEAN,％ AREA and LF index had higher related coefficient(r =-0.831,0.882,0.866).The ROC curve was made by MEAN,LF index and ％AREA to estimate the fibrosis stage,when S≥S1,S≥S2,S≥S3,S =S4,the areas under the ROCcurve were 0.884,0.925,0.934,0.962 (MEAN);0.917,0.958,0.984,0.962 (％AREA);0.917,0.948,0.966,0.967 (LF index),respectively.Conclusions As a non-invasive examination,RTE dispersion quantitative analysis technology can be used to quantitatively assess liver fibrosis.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.

Objective To observe the effects of chemotherapy on nutritional status and quality of life in elderly patients aged 60 years and over with stage Ⅲ or Ⅳ non-small-cell lung cancer,who were unable to undergo molecular-targeted drug therapy according to genetic testing.Methods A total of 100 elderly patients with stage Ⅲ or Ⅳ non-small cell lung cancer were randomized into an observation group(n=50)and a control group(n=50).Patients in the observation group were treated with GP regimen(gemcitabine+ cisplatin),while patients in the control group were treated with TP regimen(paclitaxel+cisplatin).The scores of nutritionally relevant indicators and quality of life were compared between the two groups.Results After chemotherapy,the body weight,body mass index,plasma total protein,plasma albumin,and triglyceride concentrations were significantly lower in the GP regimen group than in the TP regimen group(P＜0.0001,P =0.0027,P =0.0305,P＜0.0001,P＜ 0.0001,respectively).The overall health status score,physical function,role function,and emotional function scores were higher in the GP group than in the TP group(P =0.0017,0.0044,0.0064,0.006,respectively) after chemotherapy.The scores of shortness of breath,insomnia,loss of appetite,constipation,and diarrhea were significantly lower in the GP group than in the TP group(P =0.0067,P ＜0.0001,P =0.0026,P =0.0066,P =0.0023).The clinical effective rate was significantly higher in GP regimen than in TP regimen(56.0％ vs 30.0％,x2 =6.90,P=0.009).The incidence of grade Ⅰ adverse reactions was higher in the observation group (54.0％,27/50 cases),and the incidences of grade Ⅱ,Ⅲ and Ⅳ adverse reactions were higher in the control group(36.0％,18/50 cases;24.0％,12/50 cases;and 24.0％,12/50 cases,respectively) (x2 =16.40,P =0.001).Conclusions The TP chemotherapy is more beneficial to patients' nutrition,while the GP chemotherapy can achieve both higher clinical efficacy and better quality of life.

Objective To investigate the role of protein O-linked mannose β1,2-N-acetylglucosaminyltransferase 1 (POMGnT1) in the pathogenic process of Alzheimer's disease (AD).Methods The expression of POMGnT1 gene was examined in AD model cells (N2a/amyloid-precursor protein (APP) 695swe,n=3) and N2a/wt cells (n=3) using real-time PCR and Western blotting.This expression was also examined in AD model mice (APP/PS1,n=3) and wild-type mice (n=3) using immunofluorescence staining.Amyloid β-protein (Aβ) were examined in POMGnT1-gene-knockout mice (n=3) and wild-type mice (n=3) using immunochemistRy.Results The expression of POMGnT1 gene decreased in mRNA and protein levels in N2a/APP695swe cells compared to N2a/wt cells (mRNA:0.80±0.02 vs 1.00,t=10.52,P＜0.01;protein:0.50±0.02 vs 1.31±0.04,t=18.64,P＜0.01).Immunofluorescence results showed the reduced expression of POMGnT1 protein in neurons of APP/PS1 mice.Immunochemistry results showed more Aβ deposits in POMGnT1-gene-knockout mice (2 months old:0.358±0.014 vs 0.048±0.001,t=22.58,P＜0.01;1 year old:0.266±0.004 vs 0.229±0.003,t=7.771,P=0.002).Conclusion These findings suggest POMGnT1 gene may play an important role in the pathogenic process of AD.

Wnt7a is a secreted glycoprotein in the Wnt signaling family. It is located on chromosome 3p25 and is easy dele-ted. It is mainly expressed in placenta,kidney,testis,uterus,fetal lung and brain,and participates in human embryonic development and cell differentiation. More and more studies have found that Wnt7a is also expressed and plays an important role in many tumor cells. As a new tumor target of therapy or an important factor in the tumor growth pathway,Wnt7a has begun to attract the attention of many scientists.

OBJECTIVETo understand the level of hemoglobin (Hb) and determine the risk factors of Hb concentration among the Tibetan pregnant women in rural Lhasa.

METHODSBetween August 2008 and May 2011, a hospital-based study was conducted among 1 530 Tibetan pregnant women after getting their informed consent in agricultural and pastoral areas in maternity clinic or hospital in city, county and township level of Lhasa. Their blood samples were tested and related socio-demographic information was collected. Blood was collected on tip of finger and the Hb concentration was measured using B-Hemoglobin photometer. American Centers for Disease Control and Prevention(CDC) method was used to adjust the Hb measurements based on altitude for estimating the prevalence of anemia. Anemia was assessed according to WHO criteria. A hemoglobin concentration of less than 110 g/L in a pregnant woman was considered an indication of anemia.

RESULTSFrom August 2008 to May 2011, 1 530 Tibetan pregnant women living at (3 716.4 ± 69.1) m above sea level in rural Lhasa were examined. The findings indicated that average Hb concentration was (122.0 ± 17.5) g/L; the Hb concentration of 1(st), 2(nd) and 3(rd) trimester were (125.5 ± 18.0), (122.5 ± 16.9) and (120.6 ± 17.4) g/L, respectively. The Hb concentration of pregnant women decreased with the increase of gestational age(P < 0.05). Based onCDC method and the adjusted Hb level, the prevalence of anemia in pregnant women were 85.6% (1 310/1 530), the prevalence of anemia of 1(st), 2(nd), and 3(rd)rd trimester were 79.5% (206/259) , 86.1% (395/459)and 87.3% (698/800), respectively (P < 0.05) . The rate of moderate and severe anemia were 46.7% (612/1 310) among pregnant women. Multiple linear regression analysis showed that high Hb level was associated significantly with low family income status (β = 2.74, 95%CI:1.73-3.74), no bad habits (drinking or smoking) (β = 7.34, 95%CI:4.87-9.81) and fewer times of pregnancies(β = -1.62, 95%CI:-2.93--0.31) after adjusting for potential confounding factors.

CONCLUSIONHb concentration level in pregnancy was rather low in rural Lhasa. The increase of family income, reduction the intervals of pregnancies and no bad habits might benefit for the improvement of Hb level of pregnant women in this region.

Altitude ; Anemia ; Demography ; Female ; Hemoglobins ; Humans ; Income ; Pregnancy ; Pregnancy Complications, Hematologic ; epidemiology ; Pregnancy Trimesters ; Prevalence ; Risk Factors ; Rural Population ; Socioeconomic Factors ; Tibet

Objective: To study the relaxant effect and underlying mechanisms of evodiamine on isolated myometrium of rats. Methods:Prostaglandin F2α( PGF2α) was used to induce isolated myometrium contraction. The relaxant effect of evodiamine and the influence of capsazepine (an antagonist of transient receptor potential cation channel, subfamily V, member 1, TRPV1), U73122 (an antagonist of phospholipase Cβ,PLCβ) and W-7 ( an antagonist of camodulin, CaM) on the relaxant effect of evodiamine on myometri-um were observed respectively by biological function experiments. The median effective concentration ( EC50 ) was analyzed by non-line-ar various slope regressions using Prism-5. 01 software. Results:Evodiamine showed concentration-dependent relaxant effect on PGF2α-induced myometrium contraction with the EC50of 9.56 ×10 -9mol·L-1. Incubation with capsazepine (6.30 ×10 -11 mol·L-1), U73122 (2. 57 × 10 -11 mol·L-1 ) and W-7 (5. 65 × 10 -13 mol·L-1 ) markedly increased the relaxant effect of evodiamine, the EC50 of evodiamine decreased and dose-effect curves left shifted. The order of EC50 was as follows: W-7- evodiamine (8. 88 × 10 -15 mol· L-1) < capsazepine-evodiamine (7.35 ×10 -13 mol·L-1) < U73122-evodiamine (1.95 ×10 -12mol·L-1). Conclusion: Evodia-mine can inhibit myometrium contraction induced by PGF2αobviously, and the mechanisms are probably related to TRPV1, PLCβand CaM.

Objective: To study the relaxant effect and underlying mechanisms of evodiamine on isolated myometrium of rats. Methods:Prostaglandin F2α( PGF2α) was used to induce isolated myometrium contraction. The relaxant effect of evodiamine and the influence of capsazepine (an antagonist of transient receptor potential cation channel, subfamily V, member 1, TRPV1), U73122 (an antagonist of phospholipase Cβ,PLCβ) and W-7 ( an antagonist of camodulin, CaM) on the relaxant effect of evodiamine on myometri-um were observed respectively by biological function experiments. The median effective concentration ( EC50 ) was analyzed by non-line-ar various slope regressions using Prism-5. 01 software. Results:Evodiamine showed concentration-dependent relaxant effect on PGF2α-induced myometrium contraction with the EC50of 9.56 ×10 -9mol·L-1. Incubation with capsazepine (6.30 ×10 -11 mol·L-1), U73122 (2. 57 × 10 -11 mol·L-1 ) and W-7 (5. 65 × 10 -13 mol·L-1 ) markedly increased the relaxant effect of evodiamine, the EC50 of evodiamine decreased and dose-effect curves left shifted. The order of EC50 was as follows: W-7- evodiamine (8. 88 × 10 -15 mol· L-1) < capsazepine-evodiamine (7.35 ×10 -13 mol·L-1) < U73122-evodiamine (1.95 ×10 -12mol·L-1). Conclusion: Evodia-mine can inhibit myometrium contraction induced by PGF2αobviously, and the mechanisms are probably related to TRPV1, PLCβand CaM.

Objective To investigate the current status of job burnout among anesthetists in Ningxia and to analyze its related risk factors.Methods A total of 310 anesthetists from 30 public hospitals in Ningxia were conducted to collect data on the job burnout by Maslach Burnout InventoryHuman Services Survey (MBI-HSS).The factors associated with severe job burnout and its three domains (high emotional exhaustion,high depersonalization and low personal accomplishment) were included in the multinomial logistic regression analysis.Results The incidence of job burnout and its three domains (high emotional exhaustion,depersonalization and low personal accomplishment) were 18 (5.81％) cases,134 (43.22％) cases,35 (11.29％) cases and 128 (41.29％) cases,respectively.Multinomial logistic regression analysis results indicated that the risk degree associated with job burnout was master and higher degree (OR=4.695,95％CI 1.556-4.172).The risk facts associated with three components of job burnout were work time per week [40-60 h (OR=4.420,CI 2.504-7.802);≥60 h (OR =7.469,95％CI 1.758-31.733)] and tertiary hospital (OR =1.847,95％oCI 1.112-3.069);master and higher degree (OR=2.306,95％CI 1.032-5.155),working years [6-15 years (OR=0.358,95％CI 0.135-0.949)] and cases of anesthesia per year [≥390 cases (OR =3.352,95％CI 1.301-8.639)];secondary hospital (OR =1.717,95％CI 1.045-2.823).Conclusion This survey indicates that job burnout exists among anesthetists in Ningxia and is mainly displayed in emotional exhaustion and low personal accomplishment domains.Master and higher degree tend to occur serve job burnout.