Objective Analysis of nitroglycerin combined with predictive nursing in the clinical application of coronary heart disease patients. Methods From January 2015 to December 2016, 200 patients with coronary heart disease were treated with angina pectoris. The patients were randomly divided into observation group and control group (100 cases). The control group was treated with routine nursing mode, and the patients in the observation group were treated with predictive nursing mode. The differences of hospitalization time and quality of life scores between the two groups were observed. The anxiety and depression of the two groups were observed before and after treatment, and the satisfaction of the two groups was observed. Results The scores of hospitalization and quality of life in observation group were better than those in control group (P<0.05). There was no statistically significant difference between SAS score and SDS score before treatment, but SAS score and SDS score of observation group were significantly lower than those of control group (P<0.05). The satisfaction degree of the patients in the observation group was better than that in the control group (P<0.05). Conclusion Predictive nursing has a good effect in the clinical nursing of patients with coronary heart disease and angina pectoris. It can effectively improve the patients' anxiety and depression, shorten the hospital stay and improve the quality of life. It is worth to be used in clinical practice.

The chiral separation of three triazole pesticides, i.e. diniconazole, triadimefon and triadimenol was studied on a Chiralcel OJ-H and a Chiralcel OD-H HPLC chiral columns. The optical rotation quality of diniconazole and triadimefon enantiomers was measured and the absolute configurations of individual enan-)tiomers) were further concluded. On this basis, the absolute configurations of the four triadimenol stereoisomers were deduced via the reductive experiment of triadimefon to triadimenol. Furthermore, the chiral stability of the three triazole pesticides in organic solvents and buffer solutions was investigated. The results showed the obvious enantiomerization was observed as for triadimefon in methanol, ethanol and water, whereas dinicona-)zole) and triadimefon were chiral stable in organic solvents and water. The enantiomerization of triadimefon would be accelerated at higher temperature and in alkaline media.

Objective To optimize the process of extracting total saponins from Platycodon grandiflorum by orthogonal experimental design and central composite design-response surface method. Methods Independent variables were concentration of ethanol, reflux extraction time, reflux time and solvent fold. Dependent variables were extraction rate of total saponins in Platycodon grandiflorum and the yield of dry extract.Linear or nonlinear mathematic models were used to estimate the relationship between independent and dependent variables. Results The result of the orthogonal experimental design was 70%ethanol, 180 min for reflux, 6 fold of solvent and 2 times for extraction. The result of central composite design-response surface method was 70% ethanol, 140 min for reflux, 10 fold of solvent and 2 times for extraction. Conclusion The central composite design-response surface method is better than orthogonal experimental design in studying extraction process of Platycodon grandiflorum, which provides basis for feasibility of application of central composite design-response surface method in optimization of extraction process of Chinese traditional medicine.

Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9％(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2％(1 375/1 415) and 53.1％(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4％ (940/1 415) and 46.9％ (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1％ (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P ＜ 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.

Objective:To investigate the application of in vitro fenestration endovascular aortic repair(fEVAR) in the juxtarenal abdominal aortic pseudoaneurysm and its up to mid-term results.Methods:The clinical data of 5 cases of juxtarenal abdominal aortic pseudoaneurysm from Oct 2016 to Jul 2019 at the Department of Vascular Surgery, Henan Provincial People′s Hospital was retrospectively analyzed, including therapy options, accesses, techniques of fenestration, bundle of the stent-graft, near to medium-term effects.Results:All patients were treated with fEVAR, the technical success rate was 100%. Stent modify time ranged from 50 to120 minutes, fEVAR time ranged from 75 to 210 minutes. The follow-up period was 15~42 months. All of the stents are in good position, there is no stent-related complications, and no deaths. Primary diseases are well controlled.Conclusion:The treatment for juxtarenal abdominal aortic pseudoaneurysms with fEVAR , as a full-intraluminal method, is of minimal invasion, few perioperative complications, low mortality. Result of up to mid-term follow up is satisfactory.

Objective To evaluate the value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the diagnosis of recurrence and postoperative residual of glioma. Methods Of 30 cases of glioma, 21 cases were residual or recurrent of glioma, while 9 cases were not, confirmed by pathology or follow-up. 99mTc-MIBI SPECT positive tumor imaging and MRI were performed on all patients. Results The sensitivity of 99mTc-MIBI SPECT positive tumor imaging (80.1%)was lower than that of MRI (90.5%) (χ2 = 0.006 4,P = 0.035), while the specificity of 99mTc-MIBI SPECT(88.9%) was much higher than that MRI(77.8%)(χ2= 3.827,P = 0.006). The accuracy in diagnosing residual or recurrent glioma between the two imaging has no significant difference. The sensitivity, specificity and accuracy were 95.2%, 100% and 93.3% when the two imaging methods were combined. Conclusions 99mTc-MIBI SPECT positive tumor imaging has higher specificity in the diagnosis of recurrence and postoperative residual of glioma. The combination of 99mTc-MIBI SPECT positive tumor imaging and MRI has great clinical significance.

Objective To explore the diagnostic value of 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage. Methods 32 patients with diabetes and 26 healthy volunteers received 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging for assessing myocardial ischemia, viability status, and cardiac function. Results Myocardial perfusion abnormalitieswere observed in 47 regions on myocardial perfusion imagingin 21 of 32 (65.6%)patients with diabetes, showing perfusion/metabolism mismatched and suggesting viable myocardium. All the volunteers were normal on DISA. As compared with the normal control group, the positive rate of DISA in diabetic patients was significantly higher (P < 0.01). Left ventricular ejection fraction (LVEF) was (54.3 ± 7.2%) and (67.3±4.9%) respectively, the difference was statistically significant (P < 0.05). Conclusions 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging can assess myocardial ischemia ,viability and cardiac function in diabetic patients, and it is helpful for the early diagnosis of cardiac damage in patients with diabetes mellitus.

ABSTRACT:Objective To investigate the roles of Ku70,epidermal growth factor receptor (EGFR),nuclear factor-kappa B (NF-κB)and Bcl-2 genes in the pathogenesis of Graves’disease.Methods Fine needle biopsies of 59 patients [M:F 1 6:43;mean age (44.66 ± 12.94)y)]diagnosed as having Graves’disease and 27 [M:F 6:21;mean age (44.64± 14.27)y]control normal tissues were collected.The mRNA expressions of EGFR,Ku70,NF-κB,and Bcl-2 were detected by Real-time polymerase chain reaction (RT-PCR).The Student’s t test was performed to analyze differences between patients with Graves’disease and control subjects.Pearson correlation analysis was applied to detect the relationship between gene mRNA expression and serological indexes.Results Compared with those of control subjects,the mRNA expression levels of EGFR (0.859 ±0.125 vs .1.752 ±0.660,P <0.05)and Ku70 (0.768±0.102 vs .3.304±0.402,P <0.001)were significantly higher in Graves’disease patients.However, the mRNA expressions of Bcl-2 (1.235±0.261 vs .0.834±0.086,P <0.05)and NF-κB (0.578±0.066 vs .0.884 ±0.085,P <0.05)were much lower in Graves’disease patients.Furthermore,the mRNA expression of Bcl-2 was positively correlated with that of NF-κB (r =0.399,P <0.05 ).The Pearson correlation analysis showed that the higher expression of Ku70 was positively associated with the serum TgAb level (r = 0.263,P < 0.05 ),but expressions of the other target genes were not significantly related to the serological indexes (all P > 0.05 ). Conclusion The signal transduction pathways mediated by Ku70,EGFR,NF-κB and Bcl-2 may participate in the occurrence and development of Graves’disease.

Objective To investigate influence of ginsenoside Rb1 on the proliferation and bioactivity of olfactory ensheathing cells (OECs).Methods OECs were primary cultured and purified from olfactory bulb of the adult SD rats.MTT assay was used to detect proliferation of OECs treated with ginsenoside Rb1 (intervention concentrations of 0,10,20,40,and 80 μg/ml and intervention time of 12,24,36,48,and 60 hours).Optimal concentration and intervention time of ginsenoside Rb1 was determined and performed in the succedent experiments.Purified cells were divided into blank control group and ginsenoside Rb1 group.RT-PCR was utilized to determine mRNA expressions of nerve growth factor (NGF),brain-derived neurotrophic factor (BDNF),glial derived neurotrophic factor(GDNF) and neural cell adhesion molecule (N-CAM) in the two groups.ELISA analysis was performed to measure secretion levels of NGF,BDNF and GDNF in the cultural supernatant.Results MTF analysis suggested ginsenoside Rb1 promoted proliferation of OECs with optimal effect at 20 μg/ml concentration for 48 hours (0.648±0.019,P ＜ 0.05).RT-PCR analysis demonstrated that mRNA expressions of NGF,BDNF,GDNF and N-CAM were significantly up-regulated in ginsenoside Rb1 group compared to those in blank control group (0.620 ± 0.011 vs 0.180 ± 0.011,0.511 ± 0.090 vs 0.293 ± 0.051,0.343 ± 0.042 vs 0.064 ± 0.005,0.839 ± 0.017 vs 0.717 ± 0.044) (P ＜ 0.05).ELISA analysis confirmed that secretions of NGF,BDNF and GDNF was increased in Rb1 group compared to those in blank control group (200.167 ± 8.361 vs 51.467 ± 3.815,156.700 ± 4.190 vs 96.500 ± 2.707,26.264 ± 5.864 vs 4.917 ± 10.894,P ＜ 0.05).Conclusion Ginsenoside Rb1 significantly promotes proliferation and bioactivity of OECs and hence benefits to spinal cord injury repair.

Objective To evaluate the clinical effect of hybrid operation in treating Stanford type B aortic dissection. Methods During the period from January 2011 to December 2013, hybrid operation was performed in 33 patients with complex Stanford type B aortic arch dissection. The patients included 28 males and 5 females with a average age of (50±12) years. The clinical effect and the complications, occurring in perioperative period and in 24-month follow-up period, were analyzed. Results The operation was successfully accomplished in all 33 patients, with a technical success rate of 100%. The average hospitali-zation time was 20 days. After the operation, 29 cases were followed up for 3-34 months and 4 cases were lost to follow up, the following-up rate was 87.9%. In 21 cases, the following-up time was over 12 months. Postoperative angiography showed that there was no typeⅠendoleak; complications included pulmonary infection (n=1), strokes (n=1), reversible abnormal renal function (n=6) and retrograde aortic arch dissection (n=1). No paraplegia occurred. During hospitalization time, two cases died, the mortality was 6.06%. During the following-up time, graft infection occurred in one case and continued presence of retrograde aortic arch dissection was observed in one case. Conclusion The complication occurrence after hybrid operation for Stanford type B aortic dissections is low. The hybrid technique is very safe and feasible, but several serious postoperative complications should not be ignored. The long-term effectiveness needs to be further clarified by systemic and large sample studies.