[Prevention of falls of hospitalized elderly patients using clinical pathway].

OBJECTIVE: To explore effective strategies for preventing falls of hospitalized elderly patients using clinical pathway. METHODS: A total of 2442 patients aged > or = 70 years who were hospitalized during December 2009 and December 2010 were recruited for the study. The patients were assessed with "Falls Risk Assessment and Nursing Care Inventory" and 1796 were identified as with high risk of falls. The clinical pathway for preventing falls was applied to those patients with high risk of falls. The interventions included timely assessments, safe environment and facilities, targeted health education, extended nursing care on patients with high risk, improved hand-off, rational use of medicine, and so on. RESULTS: Only 4 patients fell, with an incidence of 0.22%. Sex, age, disease, psychological factors, clothing, hospital environment, drug effects, and history of falls were associated with the occurrence of falls. CONCLUSION: Risk assessment and targeted intervention through clinical pathway are effective strategies for preventing falls of hospitalized elderly patients.

[Effects of PI3K signaling pathway on pathogenesis of ulcerative colitis].

OBJECTIVE: To elucidate the role of PI3K/Akt in the pathogenesis of UC patients and DSS-induced colitis model in mice. METHODS: (1) The mucosa biopsy specimens were collected from 40 patients with ulcerative colitis, and normal mucosa from 20 colon cancer cases served as control. Effects of wortmannin on expression of TNF-alpha in intestinal mucosal specimens from patients with ulcerative colitis were determined on the condition of tissue culture. (2) Thirty six Balb/c mice were divided randomly into four groups: normal control group, DSS-induced colitis group, DMSO control group and wortmannin treatment group. Colitis was induced by feeding 5% DSS in mice. Disease activity index (DAI) was evaluated and the level of TNF-alpha was measured by ELISA. RESULTS: (1) The TNF-alpha level of intestinal mucosa in wortmannin treatment group was significantly lower than that in UC group (P < 0.05). (2) The DAI scores and TNF-alpha levels were lower significantly in wortmannin treatment group compared with DSS group and DMSO group (P < 0.05), and were higher than those of normal control group (P < 0.05). There were no significance between DSS group and DMSO group (P > 0.05). CONCLUSIONS: PI3K/Akt signal transduction pathway participates in the expression regulation of pro-inflammatory cytokine TNF-alpha. Wortmannin can inhibit PI3K/Akt signal transduction pathway.