Objective To explore the predictive value of plasma catestatin (CST ) and its influence factors for prognosis of patients with chronic systolic heart failure .Methods In a retrospective study ,the clinical data of 352 chronic systolic heart failure patients were collected from our hospital 2009 to 2013 .The patients were categorized into 4 groups (n= 88) according to CST (ng/L) quartile :≤ 60 .24 ,60 .25 - 76 .57 ,76 .58 - 86 .33 and ≥ 86 .34 ng/L .Blood pressure ,heart function ,blood biochemical index and renal function were compared among groups as well as the correlation with CST by Spearman correlation .According to the survival situation of follow‐up ,the patients were assigned into death and survival groups .The predictive value of CST for the prognosis of chronic systolic heart failure patients were analyzed by univariate and multivariate Cox survival analysis .Results Age ,sex ,body mass index ,red blood cell count ,red blood cell volume ,hemoglobin ,albumin ,total bilirubin ,serum creatinine ,blood urea nitrogen ,u‐ric acid and pathogeny among 4 groups had no statistical significance (P> 0 .05) .Patients with higher CST levels were more likely to had higher NYHA classification ,systolic pressure ,diastolic pressure ,high sensitivity C‐reactive protein (hs‐CRP) ,plasma N‐ter‐minal proBNP (NT‐proBNP ) ,left ventricular end‐diastolic diameter (LVEDD ) and right ventricular end‐diastolic diameter (RVEDD) ,and had a lower left ventricular ejection fraction (LVEF) (all P< 0 .05) .The CST was positively correlated with hs‐CRP ,NT‐proBNP ,LVEDD and RVEDD (r = 0 .452 ,0 .571 ,0 .536 ,0 .473) and negatively correlated with LVEF (r = - 0 .357) . Taken CST ≤ 60 .24 ng/L for reference ,the risks of death for groups of 60 .25 - 76 .57 ,76 .58 - 86 .33 and ≥ 86 .34 ng/L increased by 1 .471 ,1 .767 and 7 .822 ,respectively .The Cox survival analysis showed that NYHA classification ,LVEF ,cardiac arrhythmia , atrial enlargement ,heart failure history and CST were independent prognostic factors .Conclusion The mortality of patients with chronic systolic heart failure was associated with plasma CST .Elevated CST increased total mortality risk and were independent prognostic factors of these patients ,but the evaluation of the prognostic value of CST etiology factors should be considered .

Objective To explore and establish the possible method of low-intensity pulsed ultrasound(LIPUS) irradiation directly combined with SonoVue microbubbles could enhance 5-azacytine (Aza) induced cardiomyogenic differentiation of human bone marrow mesenchymal stem cellin(MSCs)vitro,initially explore the appropriate irradiation condition,and to provide experimental basic data for ultrasound-mediated microbubble destruction application in MSCs transplantation for acute myocardial infarction.Methods (1) In order to screen out the appropriate ultrasound irradiation intensity and time without conspicuous harm to MSCs,stem cells were exposed to different ultrasound intensity irradiation (0.11,0.33,0.55,0.77,0.99 W/cm2) and time (0,30,60,90 s) and then cell proliferation determined by methyl thiazolyl tetrazolium(MTT).In order to screen out the appropriate microbubble-to-cell ratio without conspicuous harm to MSCs,stem cells of different microbubble-to-cell ratios (0,10,50,100,150) were exposed above the screened ultrasound irradiation intensity and time and then cell proliferation determined by MTT.(2) MSCs were divided into four groups and induced cardiomyogenic differentiation by different inducing systems in vitro as follows:no-treatment group,5-Aza inducing group(10 μmol/L),microbubble and ultrasound group,5-Aza inducing (10 μmol/L) with microbubble and ultrasound group,followed by four weeks of further culture.The morphological changes were studied daily under phase-contrast microscope,then the expression of cardiac troponin-T (cTnT) was detected by immunocytochemistry method to analyze and compare differentiation rate of cardiomyocyte-like cells in each group.Results (1)The direct ultrasound irradiation condition of no conspicuous harm to MSCs,but with destruction was intensity of 0.55 W/cm2,exposure time of 30 s and microbubble-to-cell ratio of 50.(2) This study confirmed the feasibility of direct ultrasound exposure of LIPUS on MSCs in vitro.(3) At 28 days after induction,the stem cells of 5-Aza inducing group and 5-Aza inducing with microbubble and ultrasound group expressed cTnT and the positive rate of the latter was higher than the former by immunocytochemistry (13.69％ vs 34.13％,P ＜0.05).Conclusions The appropriate ultrasound direct irradiation condition was intensity of 0.55 W/cm2,exposure time of 30 s and microbubble-to-cell ratio of 50.Appropriate conditions of LIPUS could enhance 5-Aza induced cardiomyogenic differentiation of MSCs in vitro.

Objective To reveal the potential different longitudinal motion characteristics and differences of left and right muscular band (L-MB,R-MB)of interventricular septum (IVS) during systole and diastole in normal subjects.Methods Dual Doppler tissue imaging was applied for the longitudinal velocity curves of L-MB and R-MB of anterior and posterior interventricular septum(P-IVS,A-IVS) at basal,mid,and apical levels in eighty-two healthy subjects.Peak isovolumetric contraction (VIVC),systolic (Vs),early(Ve) and late (Va) diastolic velocities were measured,and myocardial velocity gradient(MVG)and Ve/Va ratio of each segment of L-MB and R-MB were calculated.Results ①Peak velocity of MB:the VrvC,Vs,Ve and Va of R-MB of both A-IVS and P-IVS were higher than those of L-MB; the VrvC,Vs,Ve and Va were gradually decreased from the base to apex of both A-IVS and P-IVS;the VIVC and Vs of A-IVS were higher than those of P-IVS; the Ve and Va of A-IVS were lower than those of P-IVS.②Correlation and MVG analyses of peak velocity of MB:the systolic and diastolic velocities between L-MB and R-MB of both A-IVS and P-IVS have shown a very strong positive correlation;the isovolumetric systolic MVG1 of L-MBof A-IVS,systolic MVG1 of R-MB of P-IVS and the diastolic MVG1 of both A-IVS and P-IVS were higher than those of MVG2.Conclusions The heterogeneity of longitudinal peak systolic and diastolic velocity and regional myocardial compliance,the consistency of moving direction and positive correlation of longitudinal peak systolic and diastolic velocity between L-MB and R-MB of both A-IVS and P-IVS have been demonstrated in normal subjects.

Objective To investigate the current status of nursing information services on the hospital web sites,and provide empirical reference for the development of nursing information services. Methods Seventy three level hospitals were recruited in the study. The famous search engines such as Baidu and Google were used to locate the target hospital web sites. The nursing-related information was recorded and classified. Results Nursing related information could be found on 41(58.6%)hos-pital web sites. The data was not updated timely,and the click frequency was low. The contents were far of abundant and the presentation rates were under 25.0% except the contents of introduction to nursing and nursing news. Conclusions The nurs-ing-related information on the hospital web-sites were insufficient. Nursing administrators should pay close attention to the defi-ciency of nursing information on hospital web-sites and take actions to promote the development of nursing information ser-vices.

Objective: To evaluate the effect of postoperative chemotherapy on bone density change in the patients with breast cancer and the therapeutic effect of 99 TC-MDP.Methods: Totally 58 breast cancer patients with postoperative chemotherapy were se-lected, and the changes of bone density , blood calcium element (BGP), alkaline phosphatase (ALP) and 24 h urinary calcium levels were observed .After the chemotherapy , the osteoporosis patients were divided into the control group and the observation group , and the control group was given calcium carbonate D 3, while the observation group was given calcium carbonate D 3 combined with 99 TC-MDP. The bone density , BGP, ALP and 24 h urinary calcium levels were compared between the two groups .Results:After the chemothera-py, the bone mineral density of lumbar vertebra and thighbone was decreased significantly , BGP, ALP and 24 h urine Ca were in-creased significantly, and compared with those before the treatment , the differences were statistically significant (P<0.05).After the 3-course postoperative chemotherapy , the incidence of osteoporosis was 22.4%(13/58), and after the six-course chemotherapy, the incidence of osteoporosis was 39.7%(23/58).The bone mineral density of lumbar vertebra and thighbone in the observation group was increased significantly , BGP, ALP and 24 h urine Ca were decreased significantly , and compared with those in the control group , the differences were statistically significant (P<0.05).Conclusion: Postoperative chemotherapy for breast cancer can lead to reduced bone density , and 99 TC-MDP in the treatment of osteoporosis induced by breast cancer postoperative chemotherapy is safe and effective .

Objective To know the effect of using clustering intervention on insulin injection in the patients with type 2 diabetes.Methods 123 patients with type 2 diabetes were selected in the research.Clustering intervention was carried out in these patients with a series of effective measures to develop and integrate the application.Compared the controlling condition of blood sugar and the condition of insulin injection in patients by self control.Results The fasting blood glucose and the postprandial blood glucose after the intervention was (5.91±0.41) mmol/L and (8.27±0.53)mmol/L respectively,which was significant lower than that of before the intervention [(8.94±1.32) mmol/L and (11.15±1.34)mmol/L respectively,P＜0.01].Conclusion Clustering intervention can regulate insulin injections,improve patients' ability of self-management and the treatment compliance,effectively control blood sugar and delay or reduce complications after the implementation of cluster intervention.

Pulse-taking is the most specific diagnostic method of TCM.Its significance has been recognized by ancient and modern doctors.However,at present the application and spread of pulse-taking is limited.In this paper,the author made detailed explorations of literatures and studies the value of pulse condition in guiding syndrome differentiation of liver diseases.The study shows abnormal pulse in left guan and taut pulse in cunkou location both suggest the liver is disordered.We can judge the location of diseases through pulse condition.This exploration shows pulse-taking plays important role in syndrome differentiation.But there is one thing should be paid more attention,pulse condition should be integrated with other symptoms,that will be reliable in guiding diagnosis.

Objective To discuss the application of sperm mobility parameters in semen quality analysis. Methods The semen samples from 2343 outpatient males were examinated following theWorld Health Organization (WHO) guide, and sperm mobility parameters were also evaluated.Results There are significant difference of all sperm mobility parameters between normal and unnormal semen groups. As spermatozoa vialibity reduced, VCL、VSL、VAP、MAD、ALH、STR had decreased and BCF had increased significantly. Compared with the group which spermatozoa density and activity were both normal, LIN、STR had reduced and MAD、BCF had increased in the small quantity sperm group. All parameters were significant difference besides ALH in the lower sperm activity group. And for that in the group which spermatozoa density and activity were both unnormal, only MAD and ALH were no significant difference. Conlusion Sperm mobility parameters may serve as key parameters of semen quality analysis and play an important role in evaluating the ability of male fertility.

Objective To observe the location of the watershed zones of the choroidal blood supply relative to the optic disc in glaucoma by indocyanine green angiography, and to investigate the mechanisms in the development of glaucomatous neuropathy. Method Simultaneous ICGA and FFA were performed on 31 eyes of 31 patients with glaucoma (17 of POAG, 14 of NTG) and 37 eyes of 37 control subjects. The watershed zones were classified into three types according to their location relative to the optic disc: by type Ⅰ, no watershed zone around the optic disc; type Ⅱ, the optic disc surrounded partially by watershed zone; type Ⅲ, the optic disc surrounded completely by watershed zone. Each of the watershed zone types was scored (i.e., type Ⅰ=1, type Ⅱ=2, type Ⅲ=3). Results In 87.1% of the glaucomatous eyes, the watershed zones included or partially included the optic disc. However, the figure in the control group was 56.8%. The glaucoma group had a higher score of watershed zone type than the control group. Conclusions The mechanisms in the development of glaucomatous neuropathy are correlative to the choroidal blood supply around the optic disc.