Objective To compare the therapeutic effect of endoscopic variceal ligation (EVL) and β-blockers plus isosorbide mononitrate (ISMN) in prevention of esophageal varieeal re-bleeding. Methods The randomized clinical trials (RCTs) on EVL and β-blockers plus ISMN for the prevention of esophageal varieeal re-bleeding were searched, and only the results from those with Jadad score higher than 3 were eval-uated with RevMan 4. 2 software for odds ratio (OR) with 95% confidence intervals (95%C1). Analysis of sensitivity was performed on the quality of the data and publication bias was investigated with funnel plots. Results Four trials matched the criteria were recruited including 504 cases with a follow-up from 8 to 25 months. There was no significant difference in rates of re-bleeding (OR =0. 93, 95% CI =0. 41 ～ 2. 11 ; P = 0. 87), re-bleeding due to esophageal varices (OR = 0. 68, 95% CI = 0. 19 ～ 2. 37 ; P = 0. 54), therapy-re-lated adverse effects (OR = 1.12, 95% CI =0. 75 ～ 1.67, P = 0. 57), severe adverse events (OR = 0. 89, 95% CI =0. 47 ～ 1.67, P = 0. 71), bleeding-related mortality (OR = 2. 11, 95% CI = 0. 88 ～ 5.08, P = 0. 10), or overall mortality (OR = 1.46, 95% CI = 0. 95 ～ 2. 24, P = 0. 09) between EVL and β-blockers plus ISMN groups. However, a trend towards lower bleeding-related mortality and overall mortality favored drug therapy. There was no heterogeneity found in the outcomes apart from re-bleeding (P = 0. 003) or re-bleeding from esophageal varices (P <0. 0001). The result of sensitivity analysis remained statistically sta-ble. Symmetric funnel plots showed there was no evidence of publication bias. Conclusion EVL and β-blockers plus ISMN show an equivalent efficacy and safety for the prevention of esophageal variceal re-bleed-ing. There is a trend towards lower bleeding-related mortality and overall mortality in drug therapy. But EVL is free from drug-related side effects, and its adverse events are similar to those of drug therapy. Thus, either of the two approaches can be used as the first choice for prophylaxis of re-bleeding of esophageal varices.

Objective To discuss the anesthesia experience for the elderly patients undergoing total. Methods All 50 cases received the epidural anesthesia, during the operation, MAP,HR and SPO2 were monitored. The blood glucose was monitored for each 45 minutes for the diabetes patients. Results All patients satisfied with the effect of epidural anesthesia, blood pressure dropped to varying degrees, the appropriate colloidal solution was used to expand capacity, prepared baek-ephedrine and alropine. These measures help maintain a stable blood pressure, iinprove the blood indexes, save blood transfllsion, reduce the ineidenee of lung infection, also provide a good postoperative epidnral analgesia. reduce Ihe occurrence of postoperative complications. Conclusion Continuous epidural anesthesia in ehterly patients with total hip replacement might help reduce postoperative complications and improve the quality of rehabililtation.

Objective To evaluate the quality of life and correlated factors in patients with condyloma acuminatum (CA). Methods 101 patients with CA and 50 healthy people as control were assessed by using the questionnaire of QOL-35. Results Compared with control group, the total score and general, physical, inde-pendence, psychological, social, environment domains scores of QOL were lower significantly in the CA group ( P <0.05). The QOL score has negative correlation with course of disease( r= -0.233, P<0.05), recurrence times(r= -0.556, P<0.05). Nevertheless, it has no noticeable correlation with gender, age, marital status, education, career (P0.05). Conclusion Quality of life was lower in patients with CA, and it was closely related with the course of disease and recurrence times.

Objective To investigate the effect of health education on the family care for elderly patients.Methods Health education were done during family care for 65 elderly patients.A comparison was done between pre-intervention and post-intervention effect in terms of mastery of disease knowledge,health behavior,curative compliance and emotion management.Result The effect after intervention was significantly better than that before intervention (χ2=28.770,P<0.01).Conclusion During family care for elderly patients,health education is effective for the improvements of mastery of disease knowledge,health behavior,curative compliance,emotion management and ultimately the quality of life.

Objective To investigate the relationship among serum levels of suppressors of cytokine signaling-3(SOCS-3),insulin-like growth factor binding protein-1(IGFBP-1) and hyperglycemia in critically ill children. Methods The 64 critically ill children who suffered from sepsis,after surgical repair of congenital heart dis-ease by extracorporeal circulation, and after surgery of severe traumatic from January 2009 to January 2012 in Depart-ment of Pediatric Intensive Care Unit( PICU) of Guangzhou Women and Children′s Medical Center were selected as the research object. According to the blood glucose levels on admission, the 64 children were divided into the normal glu-cose group and the hyperglycemia group. The 15 cases of healthy children in the same period in Guangzhou Women and Children′s Medical Center were selected as the healthy control group. The levels of blood glucose,insulin,SOCS-3,IG-FBP-1 and insulin resistance index( HOMA-IR) were measured and compared among groups when they were on ad-mission. Results (1) The blood glucose of the hyperglycemia group was significantly higher than those in the normal glucose group and the healthy control group[(9. 83±2. 48) mmol/L vs (4. 82±0. 76) mmol/L,(4. 49±0. 81) mmol/L] (P<0. 05). (2) Both of the insulin and HOMA-IR in critically ill children with hyperglycemia were significantly higher than those in the other 2 groups[9. 68(5. 85,17. 35) mU/L vs 4. 08(2. 00,7. 41) mU/L,2. 83(2. 00,10. 10) mU/L;4. 30(2. 70,7. 66) vs 0. 87(0. 39,1. 94),0. 52(0. 38,2. 56)](P<0. 05). (3) The serum SOCS-3,IGFBP-1 levels among the hyperglycemia group,the normal glucose group and the healthy control group were not of significant difference (P>0. 05). (4) The blood glucose was positively correlated with the insulin and HOMA-IR(r=0. 455,0. 773,P<0. 05),but there was no significant correlation among the blood glucose,insulin,HOMA-IR,SOCS-3 and IGFBP-1(P>0. 05). Con-clusions In the critically ill children,hyperglycemia was related to the insulin resistance which can not be evaluated through changes in serum levels of SOCS-3 and IGFBP-1. In addition,it cannot be excluded that the critically ill chil-dren may have insulin resistance and pancreaticβ-cell dysfunction simultaneously.

Continuous blood purification is continuous, slow removal of water and solute molecules in the blood.So,it is a treatnent modality of organ supports.With the development of blood purification in children,application of continuous blood purification in children is beyond the field of renal replacement therapy.Treatment indications include systemic inflammatory response syndrome,sepsis,multiple organ dysfunction syndrome,acute respiratory distress syndrome,bums,etc.Continuous blood purification has become the most important treatment in pediatric intensive care unit.Because of the children's physiological features,blood purification equipment and the disease spectrum, continuous blood purification requires higher technology and presents more difficultits.

Objective To observe influence of basic osteoporosis intervention on the 25-hydroxy vitamin D[25(OH)D] levels,low limb muscle strength and its balance function among Chinese elderly people.Methods Cross sectional study and statistics analysis were performed among total 1026 elderly (≥65years) patients from 16 hospitals throughout China.Daily taking amount of dairy products,calcium,vitamin D supplement,sunlight and physical exercise were recorded.Serum 25 (OH) D level was measured.Limb muscle strength and balance tests were performed.Results Daily intake of dairy products was insufficient in more than 42.0％ (430 cases) participating patients.The average sunlight time of participating patients was (1.2 ± 0.8) h per day.The average physical exercise time was (1.2 ± 0.7) h per day.37.7 ％ (387 cases) participating patients took supplemental calcium and vitamin D.36.8％ (278 cases)participating patients took supplemental calcium.The 25 (OH) D level was less than 50 nmol/L in 77.2％ (792 cases) participating patients,while 50～75 nmol/Lin 16.7％(171 cases).48.7％ (474/973),64.6％(624/966)and 63.6％ (614/966) patients were in high fall risk according to the timed up and go test(TUG),chair rising test(CRT) and tandem gait test(TGT),which showed that the levels of 25 (OH) D deficiency were positively correlated with the elderly fall risk.Conclusions Daily intake of dairy products,sunlight,calcium and ordinary vitamin D supplement are insufficient among Chinese elderly people.Decreases of muscle strength and balance function among elderly people are related to 25 (OH) D levels.Exercise,not Vitamin D supplement,can reduce fall risk through improving muscle strength and balance function in elderly people.

The β-cyclodextrin cross-linked polymer(β-CDCP) was used as adsorbent to pre-concentrate/separate the trace p-nitrophenol and then the determination was carried by UV-Vis spectrophotometry. Under alkaline condition,the adsorption/elution behavior of p-nitrophenol was studied. In 0. 02 mol/L NaOH solution and at room temperature for 30 min,the resin could separate and pre-concentrate the p-nitrophenol effectively. Methanol solution(1:1,V/V) was used as eluent and the β-CDCP could be used repeatedly. The linear range and detection limit was 0.5 -90.0 mg/L and 3. 10 μg/L,respectively. The proposed method has been used to determine the p-nitrophenol in synthesized sample with satisfactory results.

AIM　To observe the protective effects of TGP on local cerebral ischemia. METHODS　The local cerebral ischemia in rat was made by middle cerebral artery occlusion(MCAO). The infraction weight was determined by NBT stain. SOD, MDA and apoptosis were determined with different method respectively. RESULTS　TGP 20 mg*kg-1 ip markedly improved the abnormal nervous symptoms, increased the SOD activity and reduced contentes of MDA in MCAO rat. TGP 20 mg*kg-1 ip significantly decreased the numbers of apoptotic cells in ischemic cortex. CONCLUSION　TGP has protective effects against cerebral infarction, and its mechanism may be related to anti-apoptosis and free radical.

The neonatal period is important for the dramatic increment as well as function improvement of islet β-cell.β-cell mass augmentation is primarily regulated by neogenesis,replication,and apoptosis.The mechanisms involve cell cycle related proteins and mitosis-promoting signaling pathways.This remodeling period has far-reaching effects on the body in adapting to the metabolic needs and regulating glucose homeostasis later in life.