Objective To observe the efficacy of multifactor intensive nursing intervention on chronic heart failure patients with outside hospital treatment,including self-management ability and related clinical indicators.Methods By application of prospective study,a total of 215 patients with chronic heart failure discharged from hospital were randomized into the usual care group (105 cases) and the intensive nursing intervention group (1 10 cases).Patients were followed up for 12 months,and 205 patients completed the follow-up.The usual care group only received conventional outpatient follow-up,the intensive intervention group patients received telephone counseling,more detailed clinical follow-up and regular health education.The intervention effect was compared between two groups.Results Compared with the usual care group,the passing rate of sodium/water limit and daily monitoring of weight was higher in the intensive intervention group.Left ventricular ejection fraction and six-minute walking test were better in the intensive intervention group,while the level of NT-pro-BNP was lower in the intensive intervention group.Compared with the usual care group,re-hospitalization rate and incidence of cardiovascular events were lower in the intensive intervention group.Conclusions Multifactor intensive nursing intervention is helpful on improving self-management ability,alleviate cardiac function,reduce re-hospitalization rate and incidence of cardiovascular events for chronic heart failure patients.

Fourty wistar rats were used for experimental study of myocardial infarction (MI )induced by ligation of the left coronary artery. The results showed that the AF and HBFP stalng as well as Ao fluorescence were sensitive in demonstrating the early MI changes occuced 1 ~ 2 hour after coronary arteryligation. The TTC stamg method was reliable for demonstrating the MI margin. Both HBFP and AOfluorescence were under no influeence of the post-mortem autolysis, but the AF reaction were undeithe influence of the early post-mortem autolysis. Four hours were required for complete developemenof MI. The early stage of MI demonstrated by SEM was conslstant with that bv TEM. Both resuhwere influenced by the post-mortem autolysis.

Objective To investigate the clinical spectrum of respiratory viruses in infants and young children with acute lower respiratory infection(ALRI) in Chongqing area from 2003-2007.And to assess the clinical diagnostic value of virus detection in nasopharyngeal secretions(NPS) and serum viral antibody detection for ALRI.Methods Cases of 2 529 specimens of NPS in hospitalized children with ALRI from Apr.2003 to Oct.2007 were taken for detecting 7 common respiratory virus antigens by immunofluorescence assay including respiratory syncytial virus (RSV),adenovirus(ADV),influenza A(IA),influenza B (IB),parainfluenza virus1-3 (PIV1,PIV2,PIV3).Fifty-five thousand eight hundred and eighty-seven samples were tested for ADV-IgM by ELISA.Among those,45 159 cases were further tested for RSV-IgM by ELISA.Results Respiratory virus pathogens were detected in 778 samples out of 2 529(30.76%) including RSV positive in 668 samples (85.86%),PIV3 positive in 75 samples (9.64%),IA positive in 22 samples (2.57%),ADV positive in 15 samples ( 1.93%),only 1 sample ( 0.13%) positive for both PIV1 and RSV. And the positive rate of RSV-IgM was 0.9%-15.2%,and the positive rate for ADV-IgM was about 0.6%-10.6%.RSV infection occured mainly in winter and spring.Conclusions Respiratory virus is the most common pathogen in children with ALRI during the survey period in Chongqing area,especially for RSV infection.The pattern of RSV circulation varied every year with seasonality.It is suggest that this year is peak one for RSV infection from the monthly positive results,especially in Feburary(50%) in 2007.But the infection rate of PIV3,IA,ADV and PIV1 are lower,particularly IB and PIV2 infection have not been seen for the last 5 years.It is fast and accurate to detect RSV antigen and suit to clinical diagnosis by using immunofluorescence assay than other antibody detection.

OBJECTIVEDiscusses the distributive characters of the Creatine Kinase MM (CKMM) gene A/G Polymorphism in XinjiangUyghur, One hundred and fourtheen athletes and 441 general population of Uyghur were involved in the study.

METHODSPolymerase chain reaction-restriction fragment length polymorphism was used.

RESULTS(1) The CKMM gene A/G frequency in Uyghur general population was(AA, AG and GG) 0.497, 0.392 and 0.111, the result test by Hardy-Weinberg (H-W) equilibrium and x² = 2.72, P = 0.1, df = 2, indicated that the control group had representative. (2) AA, AG and GG genotype frequency of power-oriented athlete respectively was 0.442,0.302 and 0.256, frequency of GG genotype and G allele was higher than the control group, there were significant differences compared to thecontrol( P < 0.05, df = 2); (3) A/G genotype frequency of Endurance-oriented athletere spectively was 0.571, 0.400 and 0.029, there were nosignificant differences compared to the controls ( P > 0. 05, df = 2). (4) A/G genotype frequency of Uyghur soccer athletes respectively was0.472, 0.361 and 0.167, G allele was higher than the Endurance-oriented athlete and lower than the power-oriented athletes. and no significant differences compared to the controls( P > 0.05, df = 2).

CONCLUSIONThe results indicate that the CKMM gene GG genotype and G alleleare represented in power-oriented athletes, but don't find A/G polymorphism correlation with endurance and the football sport performance.

Alleles ; Asian Continental Ancestry Group ; genetics ; Athletes ; Athletic Performance ; China ; Creatine Kinase, MM Form ; genetics ; Gene Frequency ; Genotype ; Humans ; Physical Endurance ; genetics ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Objective:To analyze the result of smooth pursuit test(SPT) in unilateral vestibular peripheral vertigo and investigate its influencing factors.Method:Smooth pursuit test (SPT) and spontaneous nystagmus (SN)were examined in one hundred and eighty-five patients with unilateral peripheral vertigo(case group) and 51 normal persons(control group) by Video-Nystagmography (Synapsys, France), and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Result:Of the 185 patients, 105(56.8%),72(38.9%) and 8(4.3%) cases producedⅠ,Ⅱ and Ⅲ waveforms respectively. Of these patients, 58(31.4%) demonstrated SN and none had Ⅳ waveform. While of 51 normal persons, 38(74.5%), 13(25.5%) persons producedⅠand Ⅱwaveforms repectively and there were no Ⅲ, Ⅳ waveforms or SN. There was statistical significance between the stong and weak gain of SPT in these two groups. Weak gain was significantly different between two groups. The stong and weak gain of SPT in case group were 0.86±0.06,0.80±0.06; 0.78±0.09, 0.65±0.1; 0.68±0.13, 0.45±0.12. The relativity between SN and the gain of SPT was positive when they had same direction(r_s=-0.63,P＜0.05)and negative when opposite (r_s=0.34,P＜0.05).Conclusion:Ⅰ,Ⅱ,Ⅲ three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing.SN is the influencing factor of SPT.

Objective To investigate the involvement of posterior auricular muscle (PAM) and the effect of botulinum toxin type A (BTX-A) injection into PAM in patients with hemifacial spasm (HFS)complicated by auricular symptoms.Methods Sixty-three consecutive HFS patients with auricular symptoms such as tinnitus or murmur,"ticking" or a "clicking" sound and discomfort on the same side,referred to our department between July,2009 and January,2010,were enrolled,and the diagnosis of idiopathic HFS was clinically made.The patients were largely randomized into two groups according to the order of referral.One was regular group including 33 cases whose injection sites were routinely at the frontal,orbicularis oculi,zygomaticus and buccinator muscles while another was PAM group including 30 cases,in which 4 units of BTX-A was additionally injected to the PAM.Before and after injection,the test of blink reflex was performed and lateral spread of blink reflex to orbicularis oris(OO)and PAM,I.e.Abnormal muscle response(AMR),were recorded,and the peak-peak amplitude of AMR was measured.The patients were followed up clinically and electrophysiologically at least 4 weeks((29.5±2.5)days) later.Results(1)The patients reported that their auricular symptoms subsided after injection in both groups.The remission rate was 45.5%(15/33)in the regular group and 76.7%(23/30)in the PAM group,respectively,with a higher rate in the PAM group(x2=6.40,P=0.011).(2)In both groups the AMR amplitude decreased significantly after injection.In the regular group,the OO amplitudes (μV) before and after injection were 304.0±30.3 and 129.3±9.6(t =5.820,P =0.000),and PAM amplitudes,298.0±33.3 and 184.7±20.2(t=2.818,P=0.014),respectively.In the PAM group,OO amplitudes were 405.3±66.7 and 116.0±10.0(t=4.214,P=0.001),PAM amplitudes,390.0±53.6 and 72.0±9.7(t=6.011,P=0.000),respectively.(3)The decrease of PAM amplitudes in the PAM group was more significant compared with those in the regular group (t=4.237,P=0.001).Conclusions In HFS patients with auricular symptoms,the electrophysiological studies are helpful for the guidance of treatment;and the auricular symptoms could be better improved after BTX-A injection into PAM in addition to those regular injection sites.

Objective To investigate the apoptosis of articular chondrocyte and the expression of Bcl-2, Bax, Fas and iNos in articular cartilage with Kashin-Beck disease(KBD) in order to understand the pathogenesis of chondronecrosis in KBD. Methods The collected samples of human articular cartilage were divided into two groups: control group (15 samples from 15 cases), KBD group (15 samples from 15 cases). KBD patients were diagnosed by "Pathological Criteria to Diagnose KBD in China". Chondrocyte apoptosis was detected by TUNEL staining, and the Bcl-2, Bax, Fas and iNos positive articular chondrocytes were stained by the B-SA of immunohistochemistry. Articular cartilage was classified three zones and the positive rate were counted by light microscope for cytoplasimic staining by polyclonal antibodies of Bcl-2, Bax, Fas and iNos and apoptotic chondrocytes by TUNEL. Results ① The percentage of positive apoptotic chondrocytes stained by TUNEL in the middle zone of articular cartilage from the KBD-children group(33.60±2.71%) was higher than that of the control (1.33±0.41% t=11.59, g=28, P<0.01). ②The percentage of chondrocytes staining for Bcl-2, Bax, Fas and iNos among the upper and the middle zone in KBD group were significantly higher than that of the control (t=11.75-18.65, g=14, P<0.01); the remarkable difference in the expression of Bcl-2, Bax, Fas and iNos among the upper, the middle and the deep zones was also seen in KBD articular cartilage (F=73.49-114.42, g=42, P<0.01), and staining for Bcl-2, Bax, Fas and iNos in KBD children was prominent in the upper zone(41.93±12.26%, 45.60±15.78%, 53.60±16.49%, 45.47±14.02%) and the middle zone(14.93±3.50%, 13.87±4.32%, 23.27±4.83%, 21.67±6.82%)of articular cartilage, respectively. Conclusion The chondrocyte apoptosis and the present of Bcl-2, Bax, Fas and iNos positive chondrocytes in articular cartilage of children with KBD were significantly higher than that of the control.

Objective To study the indications for extubation of percutaneous transhepatic gallbladder drainage(PTGD).Methods Between January 2009 and December 2013,PTGD were performed on 104 patients with acute cholecystitis.The clinical data were analyzed retrospectively.Results PTGD were performed on all 104 patients successfully.In all the patients,after drainage the abdominal pain was relieved within 0.5 to 8 hours and mean time was(2.3 ± 1.9) h.The temperature decreased to normal in 1 days after drainage.The time of drainage was from 7 to 49 days,(22.4 ± 10.3) days on average.Thirteen patients'tubes were accidentally off during 3 to 12 days,5 patients were performed PTGD again,and 8 patients were given anti-infection,fluid infusion and other symptomatic treatments and all these patients were back to normal in time.Re-intubation rate was 4.8％.In 78 patients laparoscopic cholecystectomy (LC) were performed 1 to 2 months after PTGD.Operation time was between 35 to 95 min and mean time was(52.7 ± 15.0) min.There were 6 patients done open operation and the conservation rate was 7.7％.A mount of blood during LC was 30 to 150 mL,(61.7 ± 31.0) mL on average.No operative deaths occurred during therapeutic session.Conclusions Patients who formed PTGD obey the indications can extubate in time and reduce retrograde infection and skin irritation,also shorten the time during hospital's,which will have a positive impact about LC.

To predict the occurrence ofposttraumatic stress disorder (PTSD),using a Support Vector Machine (SVM) on adults in flood district.Diagnostic and Statistical Manuals on Mental Disorders (IV Edition) were used to examine and diagnose the victims in flood districts.Based on the forecasting model of SVM with PTSD as dependent variables and 23 influence factors of PTSD as independent variables,prediction of PTSD was conducted among the victims.After considering 23 influence factors into the prediction model,the agreement rate of prediction of the model was 88.05 percent,with sensitivity as 75.0 percent,and specificity as 89.4percent.Conclusion: The prediction model based on SVM with 23 influence factors had good effect on predicting the occurrence of PTSD.