Objective Through application of clinical pathway in hospitalization patients undergoing uterectomy, we aimed to study the efficacy of clinical pathway in uterectomy patients. Methods 120 patients randomly sampled into the experimental group and the control group with 60 in each. The experimental group received diagnosis, treatment, nursing and rehabilitation according to the clinical pathway table, patients in the control group received routine nursing interventions. The average hospitalization days, medical costs, patient satisfaction degree, disease cognition, first exercise time after operation and medical disputes were compared between the two groups. Results The average hospitalization days and hospitalization costs of the experimental group were obviously lower than those in the control group, patients' satisfaction degree, knowledge of health and first functional exercise time in the experimental group were better than those of the control group, while the medical disputes in the experimental group were obviously de -creased in the experimental group. Conclusions Application of clinical pathway in nursing care for uterectomy patients can effectively decrease hospitalization days, medical costs and disputes. It is also helpful for patients to cooperate with doctors in diagnosis, treatment, nursing, thus increase the satisfaction degree of patients, ensure the reasonable use of medical resources and promote the sustainable improvement of nursing quality.

Objective To study the clinical features,pathological characteristics and prognosis of renal cell carcinoma(RCC)in young adults,and to improve the recognition of RCC in young population. Methods The data of 35 young patients with RCC under the age of 35 years from August 1983 to June 2005 were analyzed retrospectively.There were 22 males and 13 females with a mean age of 31 years(age range, 19-35 years).The clinical presentations were as follows:painless hematuria in 12 cases(34%),low back pain in 12(34%),abdominal mass in 2(6%),fever in 3 and Stauffer syndrome in 1.The tumor size was 1.2-13.8 cm in diameter(mean,6.0cm).AJCC staging showed stage I tumor in 8 cases,stageⅡin 4, stageⅢin 18 and stageⅣin 5.Of the 35 cases,28 underwent radical nephrectomy(including simultaneous extraction of the vena cava emboli in 3 cases and extraction with pulmonary lobectomy in 1);5 cases under- went partial nephrectomy;and 2 cases lost the chance of operation(1 of them had biopsy).Results The operations were successful.The postoperative pathologic diagnoses consisted of clear cell carcinoma in 23 ca- ses,mixed cell carcinoma in 5,papillary cell carcinoma in 2,and chromophobe cell carcinoma in 2,low-dif- ferentiated and undifferentiated cell carcinoma each in 1.Of them,26 cases were followed for 12-148 months(mean,56 months).Postoperative 3-and 5-year survival rates were 65% and 50%,respectively. Conclnsions In young population,RCC is difficult to diagnose because of occult symptoms at early stage and lack of tumor specificity,which leads to relatively late clinical staging at diagnosis.RCC is characterized by higher malignancy,easy invasion to surrounding tissues and metastasis,and thus poor prognosis.

Purpose　To investigate the diagnostic valuation of Gd-DTPA enhancement MRA in intracranial occuping and vescular diseases. Methods　Gd-DTPA MRA（63 cases）, MRA without Gd-DTPA（16 cases）as a control group was performed with Elscint Prestige 2.0T MR,MRA. 56 cases were proved by operation or pathology, 7 cases were proved by clinical observation. Results　The shape of aneurysms, the feeding arteries, the draining veins of AVM and diploe angioma, the feeding arteries of occuping were clearly showed by Gd-DTPA enhancement MRA and were not showed by MRA without Gd-DTPA.There wasn't much difference between cavernous angioma with Gd-DTPA enhancement MRA and MRA without Gd-DTPA in the shape and blood supply of cavernous angioma. Conclusion　Gd-DTPA enhancement MRA is useful and worthy for showing blood circulation of intracranial occuping and vascular diseases.

AIM: To select the macroresin used for purification of total saponins of Polygala Fallax Hemsl. METHODS: The adsorption and desorption capability of five different macroresins LSA-7,LSA-10,LSA-30,D-101A and HPD-100 in static state were studied by UV. RESULTS: nonpolar LSA-30 and HPD-100 macroporus resin had the optimum comprehensive properties of adsorption and desorption. CONCLUSION: The experimental results provide the basis for selection of macroporus resins used to purify total saponins of Polygala Fallax Hemsl.

Objective To explore the risk factors of newly emerging advanced schistosomiasis patients in endemic areas.Methods The study areas were selected in two counties of Dongting Lake regions and a 1 :2 match case-control study was designed.Sixty schistosomiasis patients,who newly evolved into advanced schistosomiasis from 2006 to 2007,were selected into the case group,and 120 cases with chronic schistosomiasis into the control group.Questionnaires including potential risk factors of advanced schistosomiasis were designed and the information was collected based on face to face interviews.SPSS 12.0 was used to analyze the simple factors and multi ones (logistic regression) attributable to the development of advanced schistosomiasis.Results The history of hepatitis B (OR = 10.729),models of water contact (OR = 3.919) ,yearly exposure days to the infested water (OR = 5.457) and times of chemotherapy in the nearly 10 years(OR = 1.578) were the risk factors of development of advanced schistosomiasis.The times of examinations with positive schistosome eggs were protective factors.No association was found between yearly income,education degree,times of checking for schistosomiasis,times of examination with sera positive results and the emergence of advanced schistosomiasis.Conclusion The high frequency of exposure to the infested water,repeated infections,incomplete diagnosis and treatment are the risk factors of advanced schistosomiasis.The concurrent infection with hepatitis B is associated with the acceleration of development of advanced schistosomiasis.

Objective To determine whether specific angiotensin-conventing enzyme inhibitor with ramipril would affect ventricular arrhythmia generation in rabbits after myocardial infarction and discuss the mechanism of its antiarrhymic efficacy.MethodsTwenty-four New Zealand rabbits (Wuhan Laboratory Animal Research Center) were separated into 3 groups:sham-operated (SHAM) group (n =8 ),myocardial infraction (MI) group ( n =8) and myocardial infraction with ramipril (RAM) group ( n =8).SHAM group received a median sternotomy without left ventricular coronary artery ligation.MI and RAM groups' rabbits received a median sternotomy followed by left coronary artery ligation. The successful anterior MI was confirmed by elevation of the ST segment with more than 0.2 mV in lead Ⅱ and Ⅲ.After MI,RAM group rabbits were fed with ramipril [ 1mg/ ( kg · d) ]by intragastric administration for 12 weeks.Before and after MI 12 weeks in three groups.Ventricular tachycardia or fibrillation episodes and the monophasic actionpotential duration in epicardium,mid-myocardium and endocardium cadiocytes were recorded.The statistical technique was t-test and ANOVA.Results Ventricular tachycardia or fibrillation episodes were markedly decreased in RAM group than that in MI group after 12 weeks [ (2.6 ± 0.8) vs.(12.4 ± 2.9),P ＜0.05 ].After MI 12 weeks,the action potential duration of repolarization 90％ (APD90) of three-tier ventricular myocytes in MI group was prolonged than that before MI [ (258.2 ±21.1 ) vs.(230.1 ±23.2),( 278.0±23.8 ) vs.(245.8±25.4),(242.6±22.7) vs.(227.0±21.7),P＜0.05]; however,it was not significant difference between before and after MI 12w in RAM group (P ＞ 0.05 ).Moreover,the transmural dispersion of repolarization(TDR) was markedly increased after MI 12w in MI group than in SHAM and RAM group [ (36.2 ± 10.2 ) vs.( 18.7 ± 6.2 ),(24.9 ± 8.7 ),P ＜ 0.05 ]; but the TDR was not significant difference between RAM and SHAM group ( 18.7 ± 6.2 ) vs.( 24.9 ± 8.7 ),P ＞ 0.05].ConclusionsRamipril significantly reduced the malignant arrhythmia incidence in rabbits after MI.Mended the abnormal TDR was the mechanism for ramipril to therapy.

Objective:Effects of oxymatrine on the sodium current were studied .Methods:The whole cell voltage clamp technique was used in isolated ventricular cells of guinea-pig.Results:Oxymatrine (0.1,0.3 and 1 mmol/L) showed inhibition to the sodium current in dose-dependence.Conclusion:These results indicate that inhibition of oxymatrine to the sodium current may be one of mechanisms of its antiarrhythmic action.

Brain ; pathology ; Cerebral Hemorrhage ; pathology ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; pathology ; Magnetic Resonance Imaging ; methods ; Male

OBJECTIVE To investigate the effect of quercetin on primary cultured newborn rat cortex neuron cell which is estrogen depletion, and discuss the possible mechanism, to provide new ideas and strategies for developing a drug of neurodegenerative disease. METHODS Rat cortex neurons were isolated from one day old Sprague Dawley rats and treated with estrogen, quercetin and estrogen receptor antagonists (ICI182,780). Cell viability was determined by MTT assay, neurite outgrowth was measured by fluorescent microsope and estrogen receptors were determine by Western blot. RESULTS Quercetin functions like estrogen to increase cortex neuronal cell viability, the Que (50, 100 μmol·L-1) group compared with the control group could significantly improve the activity of the cortical neurons(P<0.05). It can also increase neurite out growth, the Que (50,100 μmol·L-1) group significantly promoted the formation of synapse, most of the neurons were full, and the synapses of neurons became thick, growth, and connect to a dense neural network. And in the Western blot experiments, Que (50, 100 μmol·L-1) group could obviously increase the expression of estrogen receptor alpha protein, in addition, the neural protective effect of quercetin can be inhibited by ICI182,780. CONCLUSION Quercetin like estrogen can protected cortex neuronal and the effect of quercetin on cortex neuronal cells was mediated by estrogen receptor alpha.

Objective:To assess the effect of rosiglitazone on inflammation in peritoneal dialysis patients. Methods:Fifty patients undergoing continuous ambulatory peritoneal dialysis were collected in our hospital. The treatment group was assigned to receive regular peritoneal dialysis and rosiglitazone 4mg once daily while the control group was received regular peritoneal dialysis for 12 weeks. Such serum examinations as fasting blood glucose (FBG), glycosylated hemoglobin A1c, haemoglobin, serum total cholesterol, high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol, triglycerides and high sensitivity C reactive protein (hs-CRP) were measured, tumor necrosis factorα(TNF-α) and interleukin-6 (IL-6) levels were measured by ELISA, and homeostasis model as-sessment of insulin resistance( HOMA-IR) was also evaluated before and after the treatment. Results:After the 12-week treatment by rosiglitazone, the levels of FPG, HOMA-IR, hs-CRP, TNF-αand IL-6 were declined significantly(P<0. 05), and the level of HDL-C was increased significantly(P<0. 05). Conclusion: Rosiglitazone shows significant anti-inflammatory, insulin resistance improve-ment and anti-lipidemic effects in peritoneal dialysis patients.