Objective:To observe the curative effect of potassium magnesium aspartate in the auxiliary treatment of ventricular pre -mature beat.Methods:Totally 70 patients with ventricular premature beat were randomly divided into the observation group (36 ca-ses) and the control group (34 cases).The patients were treated with metoprolol , and the patients in the observation group was treated with potassium magnesium aspartate as the auxiliary therapy , and the patients in the control group were treated with potassium chloride sustained release tablets as the adjuvant treatment .After 3-week continuous treatment , the changes of serum potassium , serum creatine kinase, creatine kinase, lactate dehydrogenase and ECG were observed in the two groups .The therapeutic effects and adverse drug re-actions were compared between the two groups .Results: After the treatment , the levels of serum potassium , serum creatine kinase isoenzyme, creatine kinase and lactate dehydrogenase were significantly improved when compared with those before the treatment (P<0.05), and the improvement of the observation group were significantly better than that of the control group (P<0.05).After the treatment, the heart rate and PR interval in the two groups were significantly improved (P<0.05), and there was no significant differ-ences between the two groups (P>0.05).The total effective rate of the observation group was 91.67%, which was higher than that of the control group (82.35%, P<0.05).The incidence of adverse drug reactions in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:Potassium magnesium aspartate in the adjuvant treatment of ventricular premature beat can significantly improve the levels of serum potassium and serum myocardial enzyme and heart rate and ECG of the patients , and the efficacy and the incidence of adverse drug reactions are better than those of potassium chloride sustained -release tablets in the adju-vant treatment .

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

Objective To explore the correlation of metabolic disorder of newly diagnosed type 2 metabolism(T2DM) and nonalcoholic fatty liver disease (NAFLD).Methods A total of 117 patients with newly diagnosed T2DM in Beijing Ditan Hospital Affiliated to Capital Medical University from June 2014 to June 2015 were enrolled.Patients were divided into two groups:T2DM with NAFLD of 57 cases and T2DM without NAFLD of 60 cases.Body mass index (BMI),waist circumference (WC),liver and kidney function,serum lipid,glycosylated hemoglobin A1c (HbA1c),fasting glucose,fasting insulin and C-peptide (FCP) were detected.The insulin resistance and β-cell function were assessed by homeostasis model assessment insulin resistance (HOMA-IR) and HOMA-β.Results The incidence of NAFLD in T2DM patients was 51％ (that was,60 cases of T2DM patients with NAFLD),compared with 2TDM group,the metabolic index of T2DM without NAFLD was significantly increased (blood triglyceride (TG):(2.58 + 1.8) mmol/1 vs.(1.22 + 0.4) mmol/l,fasting blood glucose:(11.5+6.1) mmol/l vs.(9.2+4.3) mmol/l,serum uric acid:(465.3+65) umol/l vs.(325.3+72) umoL/l;P =0.03,0.03,0.02);HOMA-IR was more serious ((4.9 ± 2.8) vs.(3.8 ± 2.7);P =0.03);insulin β-cell function was compensatory more obvious ((49.2 ± 27) vs.(29.5 ± 18);P =0.02);prevalence rate of obesity,hypertension and diabetic ketoacidosis (DKD),diabetic retinopathy (DR),diabetic peripheral neuropathy(DPN) were significantly increased(P＜0.05).Logistic regression analysis showed that,smoking(OR=1.405,95％CI:1.262-1.567),male(OR=1.037,95％CI:1.015-1.063),BMI(OR=1.113,95％CI:1.278-2.531),WC (OR =1.624,95％ CI:1.162-1.761) and TG (OR =1.823,95％ CI:1.2822.563) were risk factors of NAFLD (P ＜ 0.05).Conclusion T2DM patients with NAFLD have severer insulin resistance than those without NAFLD.The β-cell function of those patients is compensatory increased.NAFLD prevalence rate significantly increase in patients with obesity,especially in male diabetic patients who smoking.

Objective To use clustering analysis to help physicians detect abnormal parameters in radiotherapy treatment plans and improve the efficiency of plan verification. Methods From 2010 to 2015, 835 breast cancer treatment plans for using 4?field hybrid intensity?modulated radiotherapy from MOSAIQ were collectted. Fractional dose, beam angle, and monitor unit were used as featured parameters of a treatment plan to generate a dataset. The K?means clustering algorithm based on principal component analysis was used to perform a clustering analysis of the dataset and divide the dataset into different clusters. The outliers of clusters were automatically detected based on the distance threshold. The outlier?contained treatment plans were manually verified by physicians to determine the accuracy of clustering analysis in detection of abnormal plans. Results In the clustering analysis, the sample space composed by parameters of treatment plans for breast cancer was divided into 4 clusters, 3 of which had outliers detected. In the targeted treatment plans, 3 plans became outliers because of special target volume and the other 4 plans needed improvement. Conclusions Clustering analysis is effective to help physicians to independently verify treatment plans.

Objective:To discuss the autoimmune response on the mechanism and clinical significance of nerve root injury induced by the non-compressive nucleus pulposus protrusion.Methods:Forty-eight female SD rats were randomly divided.Twenty-four female SD rats were recruited as model group,and the others as control.After ten days,twenty days and forty days,the pain threshold of left hind leg and the levels of TNF-α, CD4+, CD8+T cells were measured, the nerve root changes in morphology were observed by HE.Results:Compared with the control group,model group in ten days,twenty days,which left hind leg pain threshold,the proportion of CD4,CD8+T cell and the expression of TNF-αare significantly different.After forty days,these two groups have no statistical differ-ence.After ten days,lumbar nerve root cross-sectional myelin of model group was partial disintegrated.The worst damage happened in twenty days,and almost recovered to normal in forty days.Conclusion:T cell-mediated autoimmunity and TNF-αplay an important role to the nerve root injury in the early time of the non-compressive nucleus pulposus protrusion.

AIM: To explore whether strontium ranelate ( Sr ) promotes osteogenic differentiation of rat bone mesenchymal stem cells (BMSCs) through the Hedgehog/Gli1 signaling pathway.METHODS:BMSCs were isolated from 4-week-old rats by adherent culture and induced to differentiate into osteoblasts .According to the experimental purposes , the cells were exposed to different concentrations of Sr , cyclopamine ( Cy, an inhibitor of Hedgehog receptor ) or Gli1-siR-NA.The expression of Gli1 and Runx2 in the cells was detected by Western blotting .The activity of alkaline phosphatase ( ALP) was measured by the method of colorimetry , and the mineralized nodules were observed under microscope with aliz-arin red staining .RESULTS:Exposure to Sr at concentrations of 0.1 to 5 mmol/L for 7 d markedly increased the expres-sion of Gli1 in the BMSCs , and the increase in Gli1 expression was the most obvious following Sr exposure at concentration of 3 mmol/L.Cy at concentration of 10 μmol/L inhibited Sr-induced up-regulation of Gli1 expression.Transfection of the BMSCs with Gli1-siRNA not only obviously inhibited Sr-induced up-regulation of Gli1 and Runx2 ( a downstream protein of Gli1) expression, but also antagonized Sr-induced enhancement of ALP activity and the formation of mineralized nodules . CONCLUSION:The Hedgehog/Gli1 pathway is involved in Sr-induced osteogenic differentiation of rat BMSCs .

Objective To evaluate the efficiency and safety of exercise interventions on cancer related fatigue. Methods Cochrane Library, JBI Database of Systematic Reviews, MEDLINE, EMbase, CINAHL, Chinese Journal Full- text Database, Chinese Biomedical Literature Database, and Wanfang Databse were searched from the inception to November 2014 to screen the systematic review and Meta-analysis conforming to the inclusion criteria. Two authors independently appraised their methodological qualities with Overview Quality Assessment Questionnaire (OQAQ), and analyzed the data using descriptive analysis. The primary outcome included the scaling of cancer related fatigue, the secondary outcome included adherence to exercise intervention and the incidence of adverse events. Results Fourteen systematic review/Meta-analysis were identified, twelve of them had a high methodological quality (Scoring 5-7). Six systematic review/Meta-analysis found that aerobic exercise could effectively alleviate cancer related fatigue, especially for breast cancer patients;seven articles showed that exercise could modulate cancer related fatigue of patients under active treatments;seven articles reported the compliance to the exercise intervention, four articles reported adverse events occurring during the intervention, very few of them resulted directly from the exercise intervention. Conclusions Exercise intervention can modulate cancer related fatigue with good safety.

Objective To develop training program of evidence implementation(EI) based on PARIHS model and to evaluate the effectiveness on clinical nurses for evidence-based nursing knowledge,attitudes and ability,and to understand the evaluation of participants about the methodological training.Methods A quasi-experiment design was conducted.A 6-month comprehensive evidence implementation training program was developed including methodological lecture,group discussion,EI case analysis,EI project development and implementation,and was carried out among 44 clinical nurses from 11 tertiary hospitals in Shanghai.The participants' EBN knowledge,attitudes and ability were measured by EBN knowledge,attitudes and ability questionnaire at 3 months and 6 months after training.Results Participants' EBN knowledge and ability were significantly improved at 3 months and 6 months after training(P＜0.05),and participants' EBN attitude had no significant difference before and after training (P＞0.05).The level of training satisfaction among participants was higher than 80.0％,and participants had finished 22 evidence implementation programs.Conclusion Evidence implementation training based on PARIHS can enhance clinical nurses' EBN knowledge and ability.Participants' EBN attitude hasn't been significantly improved.Participants have high satisfaction towards methodological training.

Objective To explore the structure of violent attitude and the predictive character of the passionate criminal and recidivist. Methods This study used FMMU-Abnormal Personality Risk Factors Inventory (FMMU-APRI) for measuring explicit violent attitude of the passionate criminal and recidivist in prison; while used the picture Attitude Activation paradigm (AAP) for assessing implicit violent attitude. Results The AAP results showed that parts of passionate criminal and recidivist had reversed priming effect, according to whether reversed, there were divided into four types: no-reversal passionate criminals, reversal passionate criminals, no-reversal recidivists and reversal recidivists, VIO scores of no-reversal passionate criminals and recidivists recidivist were significantly higher than the norm, as reversal passionate criminals and recidivists had no significance; in noreversal passionate criminals, compatible response rate was 1.104, incompatible response rate was 1.053; in reversal passionate criminals, compatible response rate was 1.042, incompatible response rate was 0.997; in no-reversal recidivists, compatible response rate was 1.059, incompatible response rate was 1.097; in reversal recidivists , compatible response rate was 1.039, incompatible response rate was 0.998, as each group had strong priming effect, and each group had a dissociation of implicit and explicit violent attitude. Conclusion The results suggest that offenders who have committed a crime in the same category also had a different violent attitude; and integrating indirect methods with direct methods would predict a crime more accurately.

Objective To investigate the feasibility and safety of surgical device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary.Methods A total of 45 patients diagnosed as doubly committed sub-arterial ventricular septal defect (dcVSD) with transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) were enrolled from June 2014 to August 2016 in Henan Children Heart Center,Henan Provincial People's Hospital.There were 39 males and 6 females,with the mean age of (2.2 ±2.1) years old(0.5-8.0 years),the body weight (13.8 ± 7.1) kg(7.0-34.1 kg),the defect size (4.5 ± 1.0) mm (3.0-8.0 mm).After general anesthesia,the patients were in supine and evaluated by TEE which indicated whether they were fit to closure.Then,they were turned to the right lateral position while this technique was determined.A vertical incision of 2-3 cm was made between the third and the fifth intercostal space and invasion in thoracic space via fourth intercostal space.Puncture was done at the anterior surface of right ventricular outlet tract to build a delivery tract.The occluder was released and the VSD was occluded under transesophageal echocardiography guidance.Results Forty-one patients had a successful surgical dcVSD closure with asymmetric occluders sized (6.0 ± 1.5) mm(4-10 mm).Among 4 failure cases,2 cases (4.4％) were switched to open-heart surgical repair,1 case (2.2％) due to device related aortic regurgitation,the rest 1 case (2.2％) experienced a dislocation of occluder into pulmonary artery and was converted to surgical repair after retrieve of occluder.Trivial residual shunt was detected in 2 cases (4.4％) postoperatively,a spontaneous closure was observed by 1 month follow-up and 3 months follow-ups,respectively.All the patients were discharged 5 to 8 days after the operation.With a follow-up of (10.4 ±5.0) months [3-24 months],there were no complications such as pericardial effusion,displacement of device,atrioventricular block or new valvular dysfunction.Conclusions Minimally invasive device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary is a feasible and safe treatment for closure of dcVSD.This technique has advantages of minor wound,less exudation,covert incision,however,long term follow-up is necessary.