Honokiol is the predominant active ingredient in the commonly used traditional Chinese medicine, Magnolia, which has been confirmed in previous studies to exhibit anti-oxidation, antimicrobial, antitumor and other pharmacological effects. However, its effects on renal ischemia/reperfusion injury (IRI) remain to be elucidated. The present study aimed to examine the effects of honokiol on renal IRI, and to investigate its potential protective mechanisms in the heart. Male adult Wistar albino rats were induced into a renal IRI model. Subsequently, the levels of serum creatinine, blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), and the levels of serum nitrite and the kidney nitrite were examined in the IRI group. The levels of oxidative stress, inducible nitric oxide synthase (iNOS), inflammatory factors and caspase-3 were evaluated using a series of commercially available kits. The levels of phosphorylated signal transducer and activator of transcription 3 (p-STAT3) and the protein expression levels of STAT3 were determined using western blotting. Pretreatment with honokiol significantly reduced the levels of serum creatinine, BUN, ALT, AST and ALP, and the level of nitrite in the kidney of the IRI group, compared with the control group. The levels of malondialdehyde, the activity of myeloperoxidase, and the gene expression and activity of iNOS were reduced in the IRI rats, compared with the sham-operated rats, whereas the levels of superoxide dismutase and catalase were increased following treatment with honokiol in the IRI rats. In addition, the expression levels of tumor necrosis factor-α and interleukin-6 in the IRI rats were increased by honokiol. Treatment with honokiol suppressed the protein expression levels of p-STAT3 and caspase-3 in the IRI rats. These findings indicated that honokiol protects against renal IRI via the suppression of oxidative stress, iNOS, inflammation and STAT3 in the rat.

目的 探讨血清同型半胱氨酸(Hcy)的水平与血管性帕金森综合征(VP)的相关性.方法 检测我院门诊就诊及住院的42例血管性帕金森综合征患者和50例陈旧性脑梗死患者的血清同型半胱氨酸、维生素B12及叶酸水平.结果 血管性帕金森综合征组的Hcy浓度明显高于陈旧性脑梗死组,差异有统计学意义(P＜0.01),叶酸及维生素B12水平低于陈旧性脑梗死组,但差异无统计学意义(P＞0.05).结论 血清同型半胱氨酸水平与血管性帕金森综合征关系密切,高同型半胱氨酸(Hhcy)血症可能是血管性帕金森综合征发病的危险因素.

Objective To compare the serum homocysteine(Hcy) levels between patients with Parkinson's disease(PD) and Vascular Parkinsonism(VP).Methods 50 healthy controls,38 PD patients and 42 VP patients,who were accepted in our hospital,were enrolled to test serum Hcy levels.Results The serum Hcy levels in PD groups was higher than that of VP groups,but the difference had no significine(P > 0.05).The serum Hcy levels in PD groups and VP grous were significantly higher than that of healthy controls(P < 0.01).Conclusion Hyperhomocysteine exist in PD and VP patients.It suggested that Hyperhomocysteine may be a risk factor for Parkinson's disease and Vascular Parkinsonism.

1例78岁老年男性帕金森病患者为控制运动症状,在多巴丝肼基础上加用吡贝地尔缓释片口服,剂量加至每日100 mg,之后出现血压偏低至100/60 mmHg,心电图提示频发室性早搏二联律,停用吡贝地尔缓释片并加用β受体阻滞剂后好转.因患者帕金森病运动症状加重,再次服用吡贝地尔缓释片每日100 mg,患者低血压、频发室性早搏二联律复现,停用后上述现象好转.1例80岁老年男性帕金森病患者吡贝地尔缓释片单药治疗运动症状,剂量加至每日100 mg后,患者出现心悸,心电图提示频发室性早搏二联律,停用吡贝地尔缓释片加用稳心颗粒后逐渐好转.两例患者均是服用吡贝地尔缓释片后出现类似心电图变化,有时间相关性,又有可重复性,考虑为该药引起的不良反应.

睡眠障碍是老年住院患者的重要临床症状之一,可加重和诱发躯体疾病,严重影响治疗效果,是危害老年人健康的重要因素.主要表现为入睡困难、早醒、多梦、身体不适等.引起睡眠障碍的原因很多,但最常见的是合并焦虑、抑郁状况及睡眠卫生不良.

Objective To investigate the relation between leukoaraiosis(LA) and homocysteine(Hcy) levels in elderly inpatients,and identify the risk factors associated with leukoaraiosis.Methods A total of 182 elderly inpatients were divided into the group of LA(n=95) and the group of non-LA(n=87) according to CT/MRI findings with or without leukoaraiosis.The Hcy levels were analyzed in all patients.Results The Hcy levels in LA groups(21.13±4.62) μmol/L was higher than that of non-LA groups(15.36±4.58)μmol/L,the difference between two groups had statistical significance(P<0.01).Conclusion Homocysteine were close related to leukoaraiosis.It suggested that hyperhomocysteinemia(Hhcy) may be independent risk factor of leukoaraiosis.

Objective To investigate the correlation between sleep disturbance and anxiety,depression in elderly inpatients. Methods A total of 200 elderly inpatients were selected from Navy General Hospital from October 2005 to October 2009. Pittsburgh sleep quality index(PSQI)was used to assess the sleep quality,and those with Pittsburgh sleep quality index more than 8 were considered having sleep disturbance. The 200 patients were divided into the group of PSQI more than 8(n=147)and the group of PSQI less than 8(n=53). The total was assessed using the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)and compared with national norm. Results Incidence of depression and anxiety(44.21%,54.42%)in the group of PSQI more than 8 were higher than those in the group of PSQI less than 8(11.32%,18.86%),the differences were significant(P<0.05). The anxious and depressive symptoms in the two groups of patients were both higher than those in the national norm,the differences were statistically significant(P<0.01). Conclusions The elder inpatients without sleep disturbance had higher incidence of anxious and the depressive symptoms. The poorer the sleep quality in elder inpatients had the higher rate of anxiety and depression.

本文对情感激励在护理实习生带教中的应用探讨如下. 1 鼓励机制在护理管理中的运用 护理管理者要尽可能为护理实习人员实现高层次的需要创造条件,要经常关心实习的护士人员,充分发挥其特长,实现自我实现需要的最高层次.在现实社会里,由于长期存在重医轻护的错误观点,逐渐形成了以医疗为主,护理为辅的工作关系,护理工作得不到社会的重视.

提示:(1)临床遇到不明原因的肠梗阻,应考虑IPO的可能,注意IPO与肿瘤性肠梗阻相鉴别;(2)IPO的原因很多,原发性IPO是由肠平滑肌异常(肌病型)或肠神经系统异常(神经元病型)造成;继发性IPO病因主要有结缔组织病(如系统性红斑狼疮、硬皮病)、内分泌紊乱(如甲状腺功能减退、糖尿病、甲状旁腺功能减退)以及帕金森病、副癌综合征、巨细胞病毒或EB病毒感染等;(3)在呕吐的诊断和鉴别诊断中,排除常见的病因后应考虑其他疾病的存在,要用局部和整体的辩证思维诊断和分析病情,不能单从症状上拘泥于消化系统疾病;(4)临床医生应注意肠道症状与雷诺现象并存的疾病;(5)在临床诊疗过程中应全面收集病史,仔细体格检查,正确有效地运用辅助检查,综合分析病情,当有多系统损害时,尽量用"一元化"解释所有的症状和体征.

Objective To observe the therapeutic effect of donepzil on elderly cognitive impairment due to ischemic stroke.Methods Sixty-two elderly patients of ischemic stroke combined with cognitive dysfunction were randomly divided into trial group and control group(n=31/group).The trial group was given 5 mg of donepezil tablets once every night,and the control group was given 30 mg of nimodipine tablets thrice per day.All the patients were treated for 12 weeks.Before and after treatment,Mini-Mental State Examination(MMSE) and Activities of Daily Living(ADL) scale were used to assess the efficacy.Results After 8 weeks'treatment,there was a significant difference in MMSE scoring between the trial group and the control group(P<0.05).After 12 weeks' treatment,ADL score was significantly higher in the trial group than in the control group(P<0.05).Conclusion Donepezil treatment,which is more effective than Nimodipine treatment,can significantly increase MMSE and ADL scoring in the patients of ischemic stroke combined with cognitive dysfunction,and therefore improve their cognitive function and life skills.

[目的]探讨糖尿病病人并发低血糖的原因。[方法]以36例糖尿病并发低血糖病人为研究对象,对其发生原因进行分析讨论。[结果]降糖药物应用、不合理饮食、运动不当、合并基础疾病或与其他药物合用等因素影响糖尿病并发低血糖的发生。[结论]加强对糖尿病病人并发低血糖的原因控制,可以减少低血糖的发生,提高护理质量。

Along with the improvement of people's civilization of material and immaterial life,patients have more requirements towards health care services.To some extent,the nursing conflicts have gotten more concerns.Therefore,nurses should strictly abide by the regulations and enhance more understanding of the relating laws and health care services.Improving quality of care as well as dealing with the conflicts at the early stage both have contribution to decreasing nursing conflicts.