Objective To determine whether isometric handgrip exercise can increase collateral flow to the ischemic myocardium in acute coronary occlusion patients with coronary artery disease (CAD).Methods Sixty-five patients with one-vessel CAD were randomly assigned to either an isometric exercise (IME) group or no-exercise (NE) group.Patients in the IME group performed isometric handgrip exercises (50％ of the maximum voluntary contraction) during 1 min of coronary balloon occlusion.Patients in the NE group remained sedentary during the procedure.The collateral flow index (CFI),heart rare (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were determined prior to and at the end of 1 min of coronary occlusion.Results In the IME group the average CFI improved significantly more during the occlusion than in the NE group.The differences in HR,SBP and DBP were also significantly grcatcr in the CFI group than in the NE group controls.Conclusion Isometric exercise can induce significantly increased coronary collateral flow in CAD patients during acute vessel occlusion.

Objective To explore the effects of vascular endothelial growth factor (VEGF) and nitric oxide (NO) on coronary collateral blood flow (CCBF) in a rabbit model of physical ischemic training (PIT),and to provide a foundation for the study of the mechanism of collateral circulation formation in PIT.Methods Models of intermittent myocardial ischemia were established in 55 rabbits by installing a water balloon constrictor on the left ventricular coronary artery.The rabbits were then divided into a sham-operation group,a pure ischemia group,a PIT group,a PIT group with NO inhibition pretreatment,a PIT group with VEGF inhibition treatment,and a PIT group with both NO and VEGF inhibition pretreatment.Microspheres were injected at modeling and before sacrifice before and after ischemic stimulation.At the termination of the experiment the ischemic myocardial tissue of the left ventricular anterior wall was sampled,and then relative CCBF was measured using the microspheres.Results There was no significant difference among the 6 groups before training.After training prominent differences among the groups were observed,with the PIT group having the greatest increase in CCBF.CCBF in the pure ischemia group,the PIT group,and the PIT group with NO inhibition pretreatment were significantly higher than in the sham-operation group.Significant differences were also found between the PIT group and the three pretreatment groups.CCBF in the PIT group with NO pretreatment and VEGF inhibition was significantly different from that in the NO pretreatment group,while it was not found in the group with VEGF inhibition pretreatment.The CCBF in the group with VEGF inhibition pretreatment and the group with NO inhibition pretreatment was similar.Conclusions PIT can improve CCBF to the remote ischemic myocardium when combined with VEGF and NO pretreatment.Blocking VEGF or NO can reduce CCBF after training,and both VEGF and NO are involved in the formation of collateral circulation,with VEGF playing the major role.

Objective To investigate the effect of comprehensive training based on work process in the teaching of Pediatric Nursing.Methods A cluster sampling of Class 1,2 enrolled in 2008 were taken as the experimental group,and Class 3,4 enrolled in 2008 were taken as the control group.The comprehensive training method WaS used in the experimental group,and the conventional practice teaching method was used in the control group.The comprehensive skills and the comprehensive ability of clinical nursing were aSsessed after experiment,questionnaires were distributed to the two groups to investigate the stimuhted learning interest of students.Results The experimental group had higher scores in comprehensire skills and comprehensive ability of clinical nursing than the control group.The teaching method of the experimental group had better effect in stimulating students learning interest than that of the control group.Conclusions The comprehensive training method based on work process used in the teaching of and comprehensive quality.

Objective To investigate the effect of vascular tortuosity and bending radius on the new type knitting stents (LVIS stent ) releasing on the cavernous sinus segment of internal carotid artery. Methods From December 2015 to January 2016,31 consecutive patients with wide-neckedaneurysm treated with LVIS stents and the proximal end of the stent released in the cavernous segment at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled. According to whether the stents completely adhered to the walls or not after the first release,they were divided into two groups:a satisfactorily release group (n =23 )or an unsatisfactorily release group (n =8 ). The differences of vascular tortuosity and bending radius of the 2 groups were compared.Results Thevascular tortuosities of the satisfactorily release group and the unsatisfactorily release group were 118° ± 23° and 147° ± 19° respectively. There was significant difference (P=0. 028). The vascular bending radii were 3. 4 ± 0. 7 mm and 2. 8 ± 0. 7 mm respectively. There was significant difference (P=0. 042). The mean vascular tortuosity was larger and the mean vascular bending radius was smaller in the unsatisfactorily release group. Conclusions The greater the vascular tortuosity,the smaller the vascular bending radius may be connected with the unsatisfactorily release in the LVIS stent. The evaluation of vascular tortuosity is conductive to the guidance of the stent release technique before stent implantation.

Objective To investigate factors related to chronic pain in those injured with fractures 27 months after the Sichuan earthquake.The correlation between intensity of pain and quality of life was also analyzed.Methods A total of 705 victims were investigated on site.Their residual pain was categorized using a visual analogue scale (VAS) score as no pain,mild pain,moderate pain or severe pain.The pain-related biological,psychological and social factors were analyzed using the Barthel Index ( BI ),Life Satisfaction Questionaire-11 ( LiSat-11 )and the SF-36 health questionnaire. Rehabilitation and surgical interventions,employment,income and emotional status were also investigated. Results The incidence of chronic pain was 88.5％ in this population,of which mild pain and moderate pain were 35.7％ and 33.3％,respectively.The percentage of the victims who had received fracture surgery was 65.8％ ; the percentage of those who had recovered was 96.9％.BI scores for the victims without pain,with mild,moderate and severe pain were 92.7 + 10.2,92.8 + 8.4,91.2 ± 9.9 and 90.4 + 14.7,respectively ; the differences between these groups were all statistically insignificant.The influence of pain intensity on life satisfaction showed a significant linear trend.The percentages of the victims with restricted occupational ability in the four groups were 38.3％,61.5％,75.7％ and 62.8％ respectively.The median of personal annual income were ￥ 3550,￥ 2500,￥ 2000 and ￥ 2500.The VAS scores were significantly related to abnormal emotions,life satisfaction,employment and annual income.The subjects with different levels of residual pain also showed significant differences in the physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional and mental health sub-scales of the SF-36.The total SF-36 scores were highest among victims without pain (70.6 + 17.5) and declined significantly in those with mild (61.3 + 14.3 ),moderate (52.7 + 14.3 ) and severe pain (52.3 + 14.7 ).This negative correlation between pain intensity and SF-36 total score was statistically significant. Conclusions Chronic pain remains common among fracture victims 27 months after the earthquake.Its intensity is correlated with psychological and social factors as well as quality of life.

Objective To observe whether appropriate intermittent exercise at the ischemic threshold can safely promote collateral circulation in an ischemic area of the myocardium through the increased expression of vascular endothelial growth factor(VEGF)and its receptor fetal liver kinase-1(Fik-1). Methods A balloon constrictor was surgically implanted in the first obtuse marginal coronary artery(OM1)of miniature pigs.The subjects were divided into 3 groups:a sham-operation group,a pure ischemia group,and an exercise training group.Subjects in the exercise training group performed individualized treadmill programs 30 min daily,5 d per week,for 8 weeks,including 2 two-minute episodes of exercise-induced ischemia.Two pre-exercise episodes of pure ischemia induced by brief OM1 occlusion were also conducted.Only pure ischemia was induced in the pure ischemia group,and the sham-operation group remained sedentary for the experimental period.Relative myocardial blood flow(RMBF)was measured using microspheres.VEGF and Flk-1 expression levels were measured by Western blotting and real time RT-PCR analyses.Cardiac troponin I(ctnI)levels were determined using an enzyme-linked immunosorbent assay(ELISA). Light and electron microscopy were employed to examine myocardia damage in the ischemic area.Results RMBFs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups. RMBFs in the pure ischemia group were significantly higher than those in the sham-operation group.The expression of VEGF and Flk-1 proteins and mRNAs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups,and the levels in the pure ischemia group were also significantly higher than those in the sham-operation group.After training,no myocardial damage and no ctnI increase was observed in the pure ischemia group.Microscopy revealed no obvious structural changes. Conclusion Intermittent exercise at the isehemia threshold intension can safely promote coronary collateral formation through upregulation of VEGF and Flk-1 expression in the ischemic myocardial area of a porcine model.

Objective To investigate the expression of CYP2W1 in gastric cancer and its effect on proliferation and invasion.Methods CYP2W1 protein expression in 326 gastric cancertissues and in the corresponding normal gastric mucosa was measured by immunohistochemstry.The expression of CYP2W1 mRNA in 10 randomly chosen gastric cancer tissues and its corresponding normal gastric mucosa was tested by semi-quantitative RT-PCR.4 groups pairs of gastric cancer and normal gastric mucosa cell lines were constructed.CYP2W1 expression in each of the cell line was tested.The effect of CYP2W1 expression on the proliferation and invasion capacity of the gastric cancer cells was studied by MTT experiment and transwell cell experiment.Results Expression of CYP2W1 protein in the gastric cancer tissues is higher than that in normal gastric mucosa (26.7％ vs.0,x2 =100.396,P ＜ 0.05).CYP2W1 mRNA in the gastric cancer tissues is higher than that in normal gastric mucosa [(0.413 ± 0.026) vs.(0.074 ± 0.005),t =28.115,P ＜ 0.05].CYP2W1 protein expression in the gastric cancer cell lines is higher than that in normal gastric mucosa cell lines [(0.481 ± 0.024) vs.0,t =49.097,P ＜ 0.05].The growth capacity of CYP2W1 positive gastric cancer cell is stronger than that of CYP2W1 negative cells (P ＜ 0.05),and CYP2W1 positive gastric cancer cells are also more of invasiveness,[(63 ±8) vs.(18 ±3),t =24.134,P ＜0.05].Conclusions CYP2W1 is only expressed in the gastric cancer tissues,hence it is closely related to the growth multiplication,and invasiveness of gastric cancer cells.

Objective:To explore the current situation of demoralization syndrome among young and middle-aged female breast cancer patients with radiochemotherapy after radical resection and to analyze its influencing factors.Methods:From January 2019 to September 2019, this study selected 204 young and middle-aged female breast cancer patients of Breast Surgery at a ClassⅢ Grade A hospital in Jilin Province as subjects by convenience sampling. All patients were investigated with the General Information Scale, Demoralization Scale-Mandarin Version (DS-MV) , Medical Coping Modes Questionnaire (MCMQ) and the Social Support Rate Scale (SSRS) . A total of 204 questionnaires were sent out and 192 valid questionnaires were collected.Results:Among 192 young and middle-aged female breast cancer patients, the score of DS-MV was (33.72±14.23) ; the total score of MCMQ was (42.49±8.83) , scores of confronce, avoidance and resignation dimension were (19.12±4.10) , (14.28±3.26) and (9.39±3.48) respectively; the total score of SSRS was (35.39±6.23) . Multiple linear regression analysis showed that the influencing factors of demoralization of breast cancer patients included the age, education level, time after surgery, confronce coping, resignation coping and social support.Conclusions:Demoralization of young and middle-aged female breast cancer patients with radiochemotherapy after radical resection has a high level. Medical staff should provide targeted intervention for patients with young age, low level of education, short time after surgery, facing disease with the resignation coping style and low level of social support so as to improve their physical and mental health.

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .