Objective To summarize the nursing experience for three cases of above 1-month-oldinfants with total transposition of the great artery after Switch operation.Methods The vital signs of the infants were monitored,including the respiratory system,circulation system,temperature,urine quantity,feeding and delayed sternal closure.Appropriate measures were adopted to cope with changes in the above mentioned aspects.Results All the 3 infants were cured with good nursing effect.Conclusion Switch operation was a complicated operation.The 3 infants missed the-optimum operation time and left great difficulty for nursing.Close monitoring and delicate nursing proved to be the pivotal process to ensure the successful curement.

Objective To explore the mediator effect of coping styles in relationship between hope level and subjective well-being of empty-nesters in urban community.Methods 208 empty-nesters were tested with Herth Hope Scale,Coping Style Questionnaire and Subjective Well-Being to investigate the influence and the pathways of hope and coping styles on subjective well-being with structural equation modeling.Results Influence of hope level on subjective well-being of empty-nesters in urban community accorded with completely-mediated model (x2/df =1.971,GFI =0.955,AGFI =0.911,RMSEA =0.068),and influence of hope level mediated by positive coping styles accounted for 41.76％(Z=3.692,P＜0.01).Conclusion The influence of hope level on subjective well-being is mediated mainly by positive coping styles for empty-nesters in urban community.

Objective To investigate the clinical significance of ultrasonography in the diagnosis of simple polyhydramnios . Methods 186 singleton pregnancies cases of inpatient and outpatient diagnosed with simple polyhydramnios were divided into three groups with a two-dimensional semi-quantitative method ,separate amniotic fluid index (AFI)> 20cm (A group) ,separate maxi-mum amnionic fluid volume(AFV)>8 cm(B group) ,AFI≥20 cm and AFV≥8 cm(C group) ,and the changes were dynamically monitored .Results Occurrence rates of persistent polyhydramnios and fetal malformations in C group was higher than in the other two groups ,and the difference showed no statistical significance(P<0 .05);No correlation was found between recurrent polyhydr-amnios and fetal malformation among these three groups(P>0 .05);Among the 84 .4% of simple polyhydramnios ,no fetal malfor-mation was found .Conclusion Ultrasound diagnosis of simple polyhydramnios shows clinical value in assessment of fetal malfor-mation ,fetal outcome ,perinatal morbidity and prognosis ,and is good for prenatal counseling and treatment .

Objective The objective of this study was to compare the differences between Volumetric Modulated Arc Radiotherapy(VMAT)and Fixed Field dynamic Intensity Modulated Radiotherapy(dIMRT)in dose distribution of target and organ at risk and treatment time,and to provide basis for clinical treatment.Methods Ten patients with postoperative of cervical carcinoma were selected,VMAT and seven fields dIMRT plans were designed for each patient in Monaco 5.11 planning system.We compared the differences of dose distribution of target and organ at risk,monitor units and treatment time between VMAT and 7dIMRT.Results The average dose of target for VMAT plan(46.86 Gy)was higher than that of 7dIMRT plan(46.68 Gy)(P<0.05).The percentage of the V10 and V20 of rectum and the V30 of small intestine in VMAT plan was 0.63%,3.34% and 4.14% higher than that in 7dIMRT plan,respectively(P<0.05).The conformal index(CI),homogeneity index(HI)of PTV and the other exposure dose of organ at risk for both plans were no significant differences.The average monitor units and treatment time of VMAT plan were 13.4% and 50.6% than that of 7dIMRT plan,respectively(P<0.05).Conclusion The dose distribution of VMAT plan is better or equal to that of 7dIMRT plan,but the monitor units and treatment time of VMAT plan is decreased significantly,we suggest that VMAT plan should be used for postoperative of cervical carcinoma in clinical.

Objective To explore the influence of antidepression therapy on symptom score and quality of life in elderly benign prostatic hyperplasia with depression.Methods A total of 94 elderly patients with benign prostatic hyperplasia and depression were randomly divided into two groups:control group (regular drugs) and therapy group adding citalopram 20 mg,once daily for 3 months.The changes of internatio nal prostate sympeom score (IPSS) symptom score,hamilton depression (HAMD) and scores of short form (36) health survey before and after treatment were compared between the two group.Results After treatment,IPSS symptom score [(10.74 ± 4.72) vs.(16.42±8.09)] was much lower in therapy group than in control group (t=4.16,P＜0.05).Each dimension of quality of life was increased after antidepression treatment [physical function (67.75 ± 9.99) vs.(63.09±7.90),SF-36 role physical (70.90±10.85) vs.(62.81±9.16),bodily pain indices (72.75± 10.59) vs.(63.13 ± 9.47),general health (62.59 ± 9.38) vs.(53.67 ± 7.52),vitality (64.09±8.96) vs.(58.11 ± 7.87),social functioning (71.84 ± 6.87) vs.(64.99 ± 7.21),roleemotional (70.15±9.93) vs.(65.01±9.18),mental health (68.74±8.23) vs.(61.77±7.83),all P＜0.05].Conclusions More attention should be paid to antidepression therapy in the elderly with benign prostatic hyperplasia and depression.

This study was aimed to observe changes of key molecular in insulin signaling pathway in the hypothala-mus of rats to explore the mechanism of spleen yin deficiency diabetes-associated cognitive decline (DACD) and Zibu Piyin Recipe (ZBPYR) in order to provide new ideas and new clues for treatment of DACD. Rats were randomly divided into five groups, which were the control (Cont) group, diabetes (DM) group, spleen yin deficiency (pi) group, spleen yin deficiency diabetes (piDM) group and the ZBPYR group. Insulin receptor substrate 1 (IRS-1) serine phos-phorylation levels and protein kinase B (PKB/Akt) serine phosphorylation levels which were involved in the insulin signaling were observed by western blotting in the hypothalamus to determine whether there were insulin signaling obstacles in the hypothalamus of rats. The results showed that the expression of p-IRS-1ser in the DM group, pi group and piDM group was increased compared with the Cont group (P< 0.05); while the p-Akt expression of the DM group and piDM group was decreased (P< 0.05). The expression of p-IRS-1ser in the ZBPYR group decreased compared with the DM group and piDM group (P< 0.05); while the level of p-Akt increased compared with the DM group and piDM group (P < 0.05). It was concluded that insulin signaling was not transduced normally in the hy-pothalamus of the DM group, pi group and piDM group. Insulin resistance may occur in the hypothalamus. And ZBPYR can correct insulin signaling transduction disorder.

Objective:To explore the relationship between atrial fibrillation stroke risk score (CHA2DS2-VASc score) and short-term prognosis of aged patients with nonvalvular atrial fibrillation (NVAF)complicated ischemic cerebral stroke (ICS).Methods:A total of 206 aged NVAF+ ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were di- vided into low risk group (n=24,0 score),medium risk group (n=78,1 score)and high risk group (n=104,2~9 scores).Modified Rankin scale (mRS)was used to assess patients'prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group (n=89,0~2 scores)and poor prognosis group (n=117,3~6 scores).Independent predictors for poor prognosis in three months were analyzed.Results:Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus (DM),heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score (NIHSS) in medium and high risk groups (P<0.05 or <0.01).Compared with good prognosis group,there were significant rise in age [(72.81±7.68)years vs.(81.56±8.03)years],percentages of hypertension (58.4% vs.71.8%)and stroke history (9.0% vs.29.9%),scores of NIHSS [(2.97±1.42)scores vs.(7.67±3.92)scores]and CHA2DS2- VASc [(1.70±1.63)scores vs.(4.03±2.53)scores]in poor prognosis group,P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated NIHSS score (high risk:OR=1.78,95%CI:1.27~2.56,P=0.001 ), CHA2DS2-VASc scores (high risk:OR=3.24,95%CI:1.32~6.98,P=0.001)and age (high risk:OR=1.23, 95%CI:1.07~1.54,P=0.01)were independent predictors for poor prognosis on three months in aged NVAF +ICS patients.Conclusion:CHA2DS2-VASc score is related to early improvement of patients with NVAF + ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.

Objective To investigate the relationship between gene polymorphisms of homocysteine (Hcy), metabolic enzymes methylenetetrahydrofolate reductase MTHFR C677T and chronic pulmonary heart disease (CPHD). Methods The gene polymorphisms of MTHFR C677T were determined by the polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)in CPHD patients (n=120) and healthy control (HC, n=120), and genotyping was carried on. The automatic biochemistry analyzer was used to detect the level of Hcy and other related biochemical indicators. Results There was significant difference in Hcy level between the CPHD group and HC group (P<0.05). The mutation frequencies of CC, CT and TT were 24.17%, 43.33%and 32.50%, 35.00%, 47.50%and 17.50%in the CPHD group and HC group. The mutation frequencies of allele C/T were 45.83%and 54.17%in HC group, and 58.75%and 41.25%in control group. There was significant difference in the overall frequency distribution between the three genotypes (χ2 =8.010, P<0.05). The frequency of T allele was significantly higher in CPHD group than that in control group (χ2=8.025,P<0.05). Conclusion The increased Hcy and its metabolic enzyme MTHFR C677T may be involved in the occurrence and development of CPHD.

Objective To investigate the significance of treadmill exercise test in male patients with coronary heart disease.Methods Two hundred and twenty-four male patients who diagnosed as coronary heart disease by coronary angiography were enrolled in this study,and treadmill exercise test were performed before and 1 month after coronary angiography.The coronary artery stenosis degree and scope were compared between two methods.Results In coronary angiography of 224 patients,the positive was 171 patients and negative was 53 patients.The single stenosis,double stenosis and triple stenosis was 87,55,29 patients.In treadmill exercise test of 224 patients,the positive was 143 patients and negative was 81 patients.The sensibility of treadmill exercise test compared the standard of coronary angiography was 81.3％,positive predictive value was 97.2％.Meanwhile in patients combined with hypertension or diabetic,treadmill exercise test found that the ST segment depression appeared earlier,persistence time longer.The persistence time and the number of down lead in double stenosis and triple stenosis was higher than that in single stenosis.Conclusion Treadmill exercise test is an important method in the diagnosis of coronary artery disease,and can preliminarily estimate the extent of coronary artery stenosis.

This study was aimed to observe different forms of β-amyloid peptide (Aβ) and insulin degrading enzyme (IDE) in the hippocampus and cortex in order to further explore the role of Aβ and IDE on spleen yin deficiency di-abetes-associated cognitive decline (DACD), and the effect of Zi-Bu Pi-Y in method. The rats were randomly divided into five groups, which were the blank control (Cont) group, diabetes (DM) group, spleen yin deficiency (pi) group, spleen yin deficiency diabetes (piDM) group and Zi-Bu Pi-Y in recipe (ZBPYR) group. Soluble and insoluble Aβ in the hippocampus and cortex of rats were extracted by gradient centrifugation, and then measured by ELISA. The ex-pression of IDE was observed by western blot. The results showed that the content of soluble and insoluble Aβ1-42 in the hippocampus and cortex of the DM group and piDM group were higher than the Cont group. The soluble and in-soluble Aβ1-42 content in the hippocampus and cortex of the ZBPYR group were reduced compared with the DM group and the piDM group. The soluble Aβ1-40 in the cortex of the DM group, pi group and piDM group were in-creased compared with the Cont group (P < 0.05). The soluble Aβ1-40 content of the ZBPYR group was decreased compared with the DM group and the piDM group (P < 0.05). The expression of IDE protein was decreased in the hippocampus of the DM group and the piDM group compared with the Cont group (P< 0.05), and the IDE protein level in the hippocampus of the ZBPYR group was increased compared with the DM group and the piDM group (P<0.05). The expression of IDE protein in the cortex of the DM group, pi group and piDM group was lower than the Cont group (P< 0.05). The IDE protein level in the cortex of the ZBPYR group was reduced compared to the DM group (P< 0.05). It was concluded that the increased Aβ1-42 in brain may be a major pathological change of DACD and spleen yin deficiency DACD. The decreased IDE expression may be one of the reasons to induce increasing of Aβ1-42 level. The Zi-Bu Pi-Y in method may decrease the Aβ1-42 content by upregulating IDE protein expression.