Objective To explore the short-term prognosis of tirofiban hydrochloride on the patients with acute ST-segment elevation myocardial infarction and the influence of tirofiban hydrochloride on myocardial biomarkers. Methods 334 patients with acute ST-segment elevation myocardial infarction were choosen. They were divided into two groups, 167 cases in each group. Tirofiban hydrochloride was used in the experimental group, and conventional therapy was carried out for control group. Compared the biochemical indexes, myocardial biomarkers and cardiac function of the two groups. Results The effective rate of experimental group was 165 cases (98.80%), which was higher than 150 cases (89.82%) in the control group (χ2=12.556,P<0.05). After treatment, the cardiac troponin I (cTnI) in experimental group was lower than control group (P<0.05). The levels of left ventricular end diastolic volume (LVEDV) and left ventricular endsystolic volume (LVESV) significantly decreased and the level of left ventricular ejection fraction (LVEF) increased in experimental group compared with those in control group(P<0.05).The global registry of acute coronary events (GRACE) after treatment in experimental group was lower than that in control group (P<0.05). The hyporrhea of thrombolysis in myocardial infarction (TIMI) in experimental group were 5 cases (2.99%), which was lower than 19 cases (11.38%) in control group (χ2=8.799,P<0.05). After 12 months, the attack frequency of angina in experimental group was (1.78±0.78)times, which was lower than (2.56±1.04) times in control group (P<0.05). Conclusion Patients with acute ST-segment elevation myocardial infarction should be diagnosed as soon as possible and take treatment strategies according to individual situation to chose suitable dosage of tirofiban hydrochloride for good therapeutic effect.

Objective To evaluate the impact of play therapy to the pain and the compliance of hospitalized children during tht course of lumbar puncture operation.Methods Divided 60 children with lumbar puncture operation into the intervention group (30 cases) and the control group(30cases)randomly.Routine cares were used in the control group,while the play therapy was used in the intervention group in addition during the course of lumbar puncture operation.Results There were statistical significance in the comparisons of the changes of respiratory rate and pulse rate during the preoperative and intraoperative of lumbar puncture between the two groups,P＜0.01.There were also significant differences in the comparisons of subjective and objective pain score as well as the puncture compliance in the lumbar puncture operation.The score of FLAFF scale and the Wong-Baker scale in the intervention group was (2.52 ± 1.37) and (3.59 ± 1.15) respectively,which was significant lower than that of in the control group,(4.22 ± 1.97) and (4.93 ± 1.71),the difference was significant,P＜0.01.Conclusion Play therapy can relieve the pain of children with lumbar puncture operation,reduce the changes of the vital signs,promote the puncture compliance and shorten the time of the whole operation completeness.

AIM: To study the changes of neurokinin A (NKA) and NKA mRNA in lung tissues of asthmatic guinea pigs exposed to chronic cigarette smoke and investigate the mechanism. METHODS: The model of asthma in guinea pigs was made by exposure to aerosolized ovalbumin and animals were randomly assigned into: ① inhale cigarette smoke (ICS) 2 weeks before provoked; ② ICS 2 weeks after provoked; ③ 2 weeks after provoked (no-ICS); ④ asthma (no-ICS before provoked); ⑤ normal control. The contents of NKA in lung tissues were detected by ELISA and NKA mRNA expression was detected by reverse transcription-polymerase chain reaction. RESULTS: ① The levels of NKA and NKA mRNA expression in lung tissues of asthma group were significantly higher than those in normal control group (P

Silk fibroin (SF) and hydroxyapatite (HA) composite powders were synthesized from CaO, H3PO4 and SF solution on the principle of neutralization. SF/HA porous materials were prepared through adding silk short fibers and NaCI particles as reinforcing material and pore-forming agent respectively by isostatic compaction. The structure and mechanical properties of the SF/HA porous materials were investigated. Results indicated that short silk fibers in it could markedly enhance flexural strength and flexural breaking energy. The average pore diameter and porosity could be regulated from 64 μm to183 pm and from 55% to 75% respectively by adding pore-forming agent.

Objective To investigate the expressions of ezrin,E-cadherin,paxillin and integrin β1 in skin squamous cell carcinoma (SCC) and their significance.Methods The expressions of ezrin,E-cadherin,paxillin and.integrin β1 were immunohistochemically detected in tissue specimens from 30 patients with SCC and 10 normal human controls.Results The expression rates of ezrin and E-cadherin in normal human keratinocytes were significantly higher than those in SCC cells [ 100.00％ (10/10)vs.56.67％(17/30),x2 =6.42,P ＜ 0.05; 100.00％ (10/10) vs 13.33％ (4/30),x2=24.76,P ＜ 0.05],while the expression rates of paxillin and integrin β1 in normal human keratinocytes were significantly lower than those in SCC cells [0.00vs.70.00％ (21/30),x2 =14.74,P ＜ 0.01; 10.00％ (1/10) vs.66.67％ (20/30),x2 =9.66,P ＜ 0.05].In SCC cells,there was a significant positive correlation between the expression of ezrin and E-cadherin (r =0.52,P ＜0.01 ),but a negative correlation between the expression of paxillin and E-cadherin and between that of integrin β1 and E-cadherin (r =- 0.56,- 0.52 respectively,both P ＜ 0.01); no significant correlation was observed between the expression of ezrin and paxillin or integrin β1,or between the that of paxillin and integrin β1 (r =0.5,0.24 and 0 respectively,all P ＞ 0.05).Conclusions The low expression of E-cadherin and high expression of paxillin and integrin β1 may synergistically promote the invasion and metastasis of tumor cells,while integrin β1 and E-cadherin may play an antagonistic role in the metastasis of SCC.

Objective To report a case of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) combined with idiopathic intracranial hypertension (IIH) and review the relationship between the IIH and OSA. Methods A case of increased intracranial pressure in a middle-aged male patient who was diagnosed as IIH after the MRI and angiography ruled out intracranial lesions was reported. This patient presented with drowsiness, obesity and other symptoms. An overnight polysomnography (PSG) confirmed severe OSA. The simple use of intracranial pressure lowering therapy could not achieve sustained effective control of symptoms of high intracranial pressure. The clinical effects of comprehensive treatment for the OSA including CPAP and weight loss were observed. Results After 3 months treatment, the body mass index of this patient dropped from 35.7 to 31.4, apnea hypopnea index dropped from 72.6 to 10. 1, and the minimum SaO2 increased from 67% to 82%. And the symptoms of high intracranial pressure including headache and papillaedema were continuously improved. Conclusion Sleep apnea is a risk factor for IIH, especially for obese male patients. PSG monitoring could help us to find the important but easily overlooked factor of OSA. Taking active measures to treat OSA can effectively relieve the high intracranial pressure symptoms in patients with IIH.

Objective To assess the feasibility of low-dose MDCT pulmonary angiography (MDCTPA) by using low kVp combined with individual-adapted low tube current protocol and noise reduction filter algorithms.Methods Fifty-six consecutively patients with MDCTPA were enrolled in the study.The patients were randomly divided into group A (120 kVp,100 mAs) and group B (100 kVp,individual-adapted tube current about 1.0 mAs/kg).Two series of images were reconstructed in group B:B1 with standard filter algorithms (FC13,B1) and B2 with noise reduction filter algorithms (FC11,B2).The image noise,quality and radiation dose in two groups were compared.Results The CTDIvol,DLP and E of group B were 5.1 mGy,83.3 mGy· cm and 1.4 mSv respectively,which were reduced by 64.3％,66.4％ and 66.7％,respectively (F =32.57,12.32,11.98,P ＜ 0.05) when compared with those in group A.Compared with group A,the image noise in B1 was increased by 118.2％ (t =10.05 P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 51.5％,46.6％,50.8％,45.3％and 20.4％,respectively(t =7.20,6.30,6.58,5.54,8.35,P ＜ 0.05).Compared with B1,the image noise in B2 was reduced by 32.5％ (t =6.12,P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 46.2％,46.2％,45.9％,46.9％ and 18.4％ (t =3.19,3.55,2.95,3.37,5.42,P ＜0.05).Compared with group A,the image noise in B2 group was increased by 47.3％ (t =4.03,P ＜0.05),the central and peripheral SNR and CNR and scores were reduced by 29.1％,21.8％,28.2％,19.6％ and 8.2％(t =4.06,2.82,3.68,2.22,3.02,P＜0.05).Conclusions Keeping effective diagnostic image quality,the protocol with low kVp and individual-adapted low tube current for low-dose MDCT pulmonary angiography would be effective and feasible,and the radiation dose would be significantly reduced.

Objective To study the feasibility of reducing radiation dose in aorto-iliac and lower extremity arteries CT angiography (CTA) with low tube voltage (100 kV) and automatic tube current modulation(ATCM).Methods Totally 61 patients requiting aorto-iliac and lower extremity arteries CTA for clinical reasons were prospectively enrolled in study.The patients were randomly assigned to 3 groups:Group A(120 kV),Group B (100 kV) and Group C (100 kV with automatic tube current modulation).Both quantitative and qualitative analysis were included in this research.Group C was divided into obese group(BMI≥ 24.9 kg/m2) and normal group(BMI ＜ 24.9 kg/m2).The radiation doses were analyzed respectively among two groups.Results The subjective evaluations of image quality for axial,MIP and VR were good.There were no significant differences among group A,B and C in SNR and CNR (P ＞0.05).The effective dose of group A,B and C was 8.20 mSv,5.36 mSv,and was 7.48 mSv,respectively Group B was 34.6％ less than group A.Group C was 39.5％ more than group B,and there was no significant differences between group A and C (P ＞ 0.05).The effective dose of group C1 was 7.11mSv,group C2 was 9.69 mSv,the E with group C1 were significantly less than group C2 (t =-3.163,P ＜0.05),the effective dose of group C1 was 13.3％ less than group A (Z =-2.822,P ＜ 0.05),but the group C2 was more than group A (P ＞ 0.05) and group B (Z =-3.426,P ＜ 0.05).Conclusions Lowkilovoltage (100 kV) CT scanning protocol is feasible in multi-detector CT angiography for aortoiliac and lower extremity arteries.Automatic low tube voltage (100 kV) with automatic tube current modulation (ATCM) scanning protocol can be used for someone with BMI less than 24.9 kg/m2.

Objective To understand the current situation of adversity quotient (AQ) of senior nursing students,then to provide reference for nursing educators to conduct AQ education and improve the comprehensive quality of nursing students.Methods 474 senior nursing students in Fuzhou were investigated with the Lusi Scale.Results AQ of senior nursing students was (67.84±5.62),the five dimensions were between 50 and 89.Gender,education qualifications,grades and academic performance had a significant impact on AQ of nursing students,among which gender and grade had certain prediction effect for nursing students' AQ.Conclusions AQ level needs of senior nursing students need to be further improved; Nursing educators should take targeted interventions and personalized measures to enhance the ability of anti-frustration,lay the foundation for better adaptation of clinical care.

Objective To analyze the relationship among the general self-efficacy,self-esteem and professional identification of nursing baccalaureate students and to provide some suggestions for educational practice. Methods A total of 403 nursing baccalaureate students in traditional Chinese medicine colleges were recruited. They were investigated with general self-efficacy scale (GSES), Rosenberg self-esteem scale(SES)and questionnaire for baccalaureate nursing students (QBNS). The relationship among general self-efficacy,self-esteem and professional identification was analyzed by multiple stepwise regression analysis. Results The mean score of general self-efficacy was 23.81± 5.27. There were significant differences in the score of general self-efficacy among different grades and enrollment methods (P<0.01). The nursing students,general self-efficacy was positively correlated with self-esteem,professional identification,professional emotion and professional skills(r=0.11-0.50, P<0.05). Conclusions Nursing educator should pay attention to the cultivation of self-esteem and professional identity in the training of nursing student in order to improve the self-efficacy of nursing students.