Objective To study the relationship between plasma level of tissue factor(TF)and severity of coronary heart disease(CHD).Methods Coronary angiography was performed in 237 patients with suspected CHD,with 149 diagnosed as CHD and 88 excluded.Seventy of stenosis of coronary arteries (CA)was evaluated by modified Gensini score on the basis of angiographic imaging.Blood glucose,serum levels of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],uric acid,high sensitivity C-reactive protein(Hs-CRP),fibrinogen(FIB)and plasma level of TF were determined for all the subjects.Relationship between plasma level of TF and severity of pathological changes in CA was evaluated by linear correlation and multiple regression analyses for controlling other relevant factors.Results Plasma level of TF in patients with CHD[(138±39)ng/L]was significantly higher than that in controls[(61±19)ng/L](P＜0.01).Plasma level of TF obviously correlated with severity of pathological changes in CA(r=0.710,P＜0.01).Partial correlation analysis showed a positive correlation between plasma TF and severity of pathological changes in CA,independent of other potential influential factors,with a partial coefficient of correlation of 0.509(P＜0.01).Multiple stepwise regression analysis indicated that plasma level of TF associated with severity of pathological changes in CA,as well as with diabetes,LDL-C,Lp(a),Hs-CRP and FIB,with coefficients of correlation of 0.172,0.180,0.147,0.308 and 0.175,respectively(P＜0.05).Conclusion Elevated plasma level of TF may be one of important risk factors for CHD,which reflects severity of pathological changes in CA.

Objective To explore the effects and safety of early urinary continence for elderly prostate cancer patients treated with laparoscopic radical prostatectomy with bladder neck preservation.Methods Retrospectively analyze the datas for 123 elderly prostate cancer patients treated with laparoscopic radical prostatectomy with bladder neck preservation,including operative time,blood lose,margin status and early continence status,etc from group A (56 cases) and group B(67 cases).Classify the urinary incontinence through Common Toxicity Criteria of National Cancer Institute while evaluate the postoperative urinary continence for patients by number of daily pads usage.Lastly, record the urinary continence at the very day, 7 days,1 and 3 months in detail.Results There were no significant differences in body mass index, prostate volume, preoperative serum PSA level and preoperative Gleason score between the two groups.2 cases of patients were postoperative 5 cases and 7 cases of surgical margin positive, and postoperative A, B two groups were 6 cases and 9 cases of leakage of urine.The number of urinary incontinence 0 and urinary incontinence were significantly different between the two groups (P<0.05).Conclusion Elderly prostate cancer patients treated with radical prostatectomy with bladder neck preservation,is useful for early urinary continence, which is available and safe to be generalized.

Objective To evaluate the efficacy of 3+x mode for the reduction of unplanned extubation in the patients with stomach cancer. Methods 107 patients with the indwelling gastric tube of gastric cancer perioperative from June 2014 to September 2014 were collected as the observation group, and 101 patients with the indwelling gastric tube of gastric cancer perioperative from June 2013 to September 2013 were collected as the control group. Once preoperative education on stomach tube was performed in the control group, and 3+x education mode was used in the observation group, so as to compare unplanned extubation rate of two groups. Results The tube unscheduled decannulation rate in postoperative patients with gastric cancer in the control group was significantly higher than that in the observation group [4.95 %(5/101) vs 0 (0/107)], and there was significant difference (χ2= 5.168, P= 0.029). Conclusion 3+x mode education can significantly reduce unplanned extubation rate in operation patients with gastric cancer.

Objective To explore the nursing effect evaluation of vacuum sealing drainage based latissimus dorsi bridge free skin flap to repair refractory wound. Methods Thirty-seven cases of patients with intractable wounds were chosen as the observe group from January 2009 to January 2012, and 26 cases accepting the traditional way of wound care with intractable wounds were selected as control group from January 2006 to December 2008. Control group adopt conventional methods wound and the observation group accepted VSD accessories line wound negative pressure closed drainage before the wound phase 2 latissimus dorsi bridge free skin flap repairment. After treatment, the dressing time, interval and dressing change, the time of hospitalization were observed, and the nursing effect were compared after skin flap to repair for 8 days and 16 days between patients of two groups. Results The dressing time and hospitalization days in observation group after treatment were significantly less than that in control group ( <0.05), the number of dressing have significantly shortened compared with control group ( <0.01), and the dressing change interval in control group had significantly difference ( <0.01) . The effect of 2 patients in control group after skin flap to repair was poorer, but the observation group did not appear significant necrosis. Compared the good rate of two groups, the observation group patients was significantly higher than control group ( <0.01) . The therapy good rate of observation group was significantly better than that of control group (<0.01) . Conclusion The negative pressure closed drainage based ascending latissimus dorsi bridge free skin flap repairment has contributed to cure the refractory wound recovery significantly.

Objective To study the effect of rosuvastatin(RSVT) on the vascular endothelial function(VEF) ,inflammatory fac‐tors(IF) and prognosis in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention(PCI) .Methods Eighty cases of ACS patients with PCI in our hospital selected from July 2010 to July 2013 were randomly divided into observed group and control group ,40 cases in each group .The observation group were given interference treatment with RSVT while the control group received conventional treatment .The VEF ,IF and prognosis were compared between groups .Results The VWF at 4 weeks after PCI in observation group was lower than that in control group [(92 .6 ± 12 .3)% vs .(105 .4 ± 13 .6)% ,P<0 .05];The ET‐1 at 4 weeks after PCI in observation group was lower than that in control group[(55 .6 ± 5 .6)ng/L vs .(67 .8 ± 7 .4)ng/L ,P<0 .05] .The NO at 4 weeks after PCI in observation group was higher than that of control group[(78 .6 ± 9 .4)μmol/L vs .(63 .2 ± 9 .5)μmol/L ,P<0 .05] .The CRP at 4 weeks after PCI in observation group was lower than that in control group[(5 .4 ± 2 .2) mg/L vs .(10 .5 ± 4 .1)mg/L ,P<0 .05] .The incidence of CVE was 5 .00% (2/40) ,restenosis rate was 2 .50% (1/40) in observa‐tion group ,which was significantly lower than those of the control group [30 .00% (12/40) ,10 .00% (4/40)] ,the differences were statistically significant(P<0 .05) .Conclusion RSVT could effectively improve the VEF and reduce inflammation ,CVE and rest‐enosis rate in patients with ACS after PCI .

Objective To evaluate the effect of operation associated with uterine arerial chemotherapy and embolization preoperation.Methods 31 patients with pathologically confirmed cervical carcinoma were treated with interventional therapy,followed by uterectomyandpelvic lymphadenectomy.Results Curative effect was obvious.The lymph metastasis of Ⅱ and Ⅲ stage was 12% and 66.67%respectively.27 patients followedup for 3 years,23 were survived(85.19%).Conclusion For cervical carcinoma,before operation,the interventional therapy can reduce the size of tumor and the metastasis of lymph,improve the ectomy by operation and the survival rate.

OBJECTIVE:To introduce the operation instructions and routine maintenance method of horizontal laminar flow cabinet(HLFC) in PIVAS to provide reference for standardized operation of HLFC.METHODS:The standardized utilization and maintenance of HLFC in respects of compositions,operation principle,operation instructions,etc.RESULTS & CONCLUSIONS:The standardized operation and correct maintenance can ensure the dispensation quality of intravenous drugs and extend service life of HLFC.

Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.

BACKGROUND: Abnormal lipid metabolism is one of the risk factors in patients with ischemic cerebral disorders, and is correlated with the changes of lecithin cholesterol acyltransferase activity.OBJECTIVE: To observe the relationship between the changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane.DESIGN: A case-control study(experimental group with control as standard level).SETTING: Department of clinical laboratory, emergency room and department of neurology of a hospital affiliated to a medical college of a university.PARTICIPANTS: Totally 105 inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Medical College of Qingdao University, from March 2002 to December 2003. They accorded with the Diagnostic Criteria set at the Second National Conference on Cerebrovascular Diseases. A total of 42 patients with cerebral arteriosclerosis and 63 patients with cerebral infarction were selected as patients group consisting of 67 males and 38 females. Another 65 healthy people receiving physical examination in the hospital, 36 males and 29 females, were selected as control group.METHODS: Venous blood of 8 mL was drawn from the participants on an empty stomach. We assayed the activity of lecithin cholesterol acyltransferase,high density lipoprotein cholesterol, low density lipoprotein cholesterol,apolipoprotein A1 and apolipoprotein B. Red blood cell membrane cholesterol was determined by phthalyl aldehyde-acetometry and red blood cell membrane phospholipid was determined by chemical quantitative analysis.MAIN OUTCOME MEASURES: Changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane in patients group and control group.RESULTS: According to intention analysis, all the 105 patients in patients group and 65 patients in control group entered the results analysis. Activity of lecithin cholesterol acyltransferase: Activity changes in cerebral arteriosclerosis group and cerebral infarction group were obvious lower than those in control group[(2.14±0.72) kat/L, (2.06±0.80) kat/L, and(2.61± 0. 74) kat/L, P ＜ 0.01 ] . Level of high density lipoprotein cholesterol and apolipoprotein A1: The level in cerebral arteriosclerosis group and cerebral infarction group was obvious lower than that in control group[ (1.32±0.33) mmol/L, (1.37±0.33) g/L, (1.28±0.33) mmol/L; (1.27±0.31) g/L, (1.60±0.43) mmol/L, (1.60±0.43) g/L, t=2.72 to 5.01, P ＜ 0.01 ]. Content of low density lipoprotein cholesterol and red blood cell membrane-cholesterol: The content in cerebral arteriosclerosis group and cerebral infarction group was obvious higher than that in control group [ (2.94 ± 0. 82) mmol/L, (0.63 ±0.05) mmol/g, (3.02 ±0.79) mmol/L;(0.60 ±0.07) mmol/g, (2.56 ±0. 58) mmol/L, (0.57 ±0.05) mmol/g, P ＜ 0. 01 ] . Moreover, the activity of lecithin cholesterol acyltransferase was positively correlated with high density lipoprotein cholesterol and apolipoprotein A1(r=0.247, P ＜0.05; r=0.303, P ＜0.01), but was negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol(r= -0.212, P ＜0.05;r= -0.346, P ＜0.01).CONCLUSION: In patients with ischemic cerebral disorders, the major change of plasma lipid is the decrease of lecithin cholesterol acyltransferase,but it is not secondary to cerebral infarction. The activity of lecithin cholesterol acyltransferase is positively correlated with high density lipoprotein cholesterol and apolipoprotein A1, but is negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol.

Objective To evaluate the incidence and epidemiologic characteristics of Kawasaki disease (KD)in Nanjing.Methods We reviewed the medical records and reports of all patients admitted to Nanjing Chil-dren′Hospital with KD diagnosed during 3 -year periods from 2012 to 2014.Results We studied 1 446 inpatients diagnosed with KD from 2012 to 2014.There were 1 135 cases(78.5%)with complete KD.The ratio of male to female was 1.7241.The disease occurred in all of the seasons,but the peak was from spring to summer.Age at onset ranged from 1 month to 14 years old,and the peak age group was 1 year old.Fever(99.45%)was the most common clinical symptom,followed by conjunctive congestion(93.15%),rash(73.32%),oral changes(51.76%), extremities desquamate(75.08%)and lymphadenopathy(45.89%).There were 131(9.05%)patients with coronary aneurysm,the ratio of male to female was 3.02  1.14 patients (0.97%)developed recurrent KD.Conclusion Patients with KD has become more and more in Nanjing,and clinical doctors should improve the understanding of KD. Early diagnosis and treatment is very important to reduce the sequelae and reduce the mortality of KD.