ObjectiveTo investigate the effect of early intervention on shoulder pain in patients with hemiplegia after stroke. MethodsStroke patients were treated with bedside physical therapy on the shoulder 7 d after onset. They were assessed with short-form McGill pain questionnaire and Fugl-Meyer assessment of upper extremity before and 40 d after treatment. ResultsThe score of MPQ in the treatment group was significantly lower than that in the control group, while the score of FMA was significantly higher(P<0.01). ConclusionEarly intervention can reduce the pain and improve the function of the shoulder in patients with shoulder pain after stroke.

Objective To explore the advantage of mild hypothermia and beating heart bypass in patch therapy for atrial septal defect. Methods 92 patients with atrial septal defect were carried out surgical repairing by mild hypothermia and beating heart bypass. Results There was no death. There was 1 case complicated by cerebral air embolism;The consciousness recovered after 3 days of operation. There were 2 cases of pneumonia. Conclusion The patch therapy of mild hypothermia and beating heart bypass for atrial septal defect had small influence on internal environmental,fewer complications,and could be easy to carry out,and could be the first choice.

Fluorescence enhancement reaction of flavoxate hydrochloride (FX) in strong alkali solution was studied, the mechanism of the reaction was investigated, and a novel fluorimetric method for analysis of FX in drug sample was established. FX has no intrinsic fluorescence, but it can slowly produce fluorescence in strong alkali solution. Heating can promote the fluorescence enhancement reaction. In 3D fluorescence spectra of the decomposition product of FX, two fluorescence peaks, located respectively at excitation wavelengths λex/ emission wavelength λem =223/410 nm, and 302/410 nm, were observed. Using quinine sulfate as a reference, fluorescence quantum yield of the decomposition product was measured to be 0.50. The structural characteriza- tion and spectral analysis of the decomposition product reveal that ester bond hydrolysis reaction of FX is firstly occurred during heating process, forming 3-methylflavone-8-carboxylic acid (MFA), then a cleavage reaction of the γ-pyrone ring of MFA occurred, producing α, β-unsaturated ketone. This product includes adjacent hydroxyl benzoic acid group in its molecule, which can form intramolecular hydrogen bond under alkaline condition, so that increase the conjugate degree and enhance the rigidity of the molecule, and thereby cause fluorescence enhancement. Based on this fluorescence enhancement reaction, a fluorimetric method was proposed for the determination of FX. A linear calibration curve covered the concentration range 0.020 3-0.487 µg · mL. The regression equation was I(F) = 23.9 + 5357.3 c, with correlation coefficient r = 0.999 7 (n = 8), detection limit D = 1.1 ng · mL(-1). The method was applied to the analysis of FX tablets, with a spiked recovery rate of 100.2%. The reliability of the method was verified by a UV-spectrophotometric method.

Objective To investigate the incidence and risk factors of cerebral microbleeds(CMB) in ischemic stroke patients.Methods Patients with cerebral infarction for 1～6 months were recruited.Clinical data were recorded.MRI was reviewed blindly to determine the number of CMB and lacunar infarcts and the white matter lesions(WML).The independent risk factors of CMB were analyzed with the Logistic multivariable regression.Results 636 subjects were included.CMB were found in 250 cases(39.3%).The incidence of CMB in patients of ≤50,50～65 and >65 years old were 27.2%,38.1% and 47.6% respectively(P<0.05).CMB was more frequent in patients with more lacunar infarcts(P<0.05).The incidence of CMB in patients with negative,mild,moderate and severe WML were 21.9%,33.8%,46.9%and 63.1% respectively(P<0.05).Logistic regression analysis showed that history of hypertension(OR=1.523,95% CI 1.019～2.276),severity of WML(OR=1.535,95% CI 1.258～1.874) and lacunar infarcts(OR=1.517,95% CI 1.087～2.118) were the independent risk factors for presence of CMB.Conclusion CMB was frequent in ischemic stroke.The frequency of CMB increased with aging,grade of lacunar infarcts and WML.History of hypertension,severity of WML and lacunar infarcts were the independent risk factors for CMB presence.

AIM To study whether inhibition of semicarbazide (Sem)-sensitive amine oxidases (SSAO) attenuates myocardial ischemia-reperfusion (I-R) injury. METHODS Male Sprague-Dawley rats were randomly divided into 4 groups. Each group consisted of 10 rats. Sham group: the ligature was placed under the left coronary artery (LCA), but not ligated. Sham+Sem group: Sem (30 mg·kg-1, ip) was given 10 min prior to the experiment, the LCA ligature was not ligated. I-R group: the LCA was occluded for 30 min and reperfused for 180 min. I-R+Sem group: Sem (30 mg·kg-1, ip) was given 10 min prior to the experiment, and then 30 min ischemia followed by 180 min reperfusion. Myocardial infarct size was determined by using nitroblue tetrazolium staining. Plasma creatine kinase (CK) and myeloperoxidase (MPO) activities, and malondialdehyde (MDA) and hydroxyl radicals levels were determined by spectrophotometer. Plasma SSAO activity was determined by high performance liquid chromatography. HE staining was used for histopathological evaluation. RESULTS There were no significant differences on each index between sham and sham+Sem groups. Plasma MPO and SSAO activities, and MDA and hydroxyl radials levels significantly increased in I-R group, compared with sham group. Myocardial infarct size was remarkably smaller in I-R+Sem group (27.7±3.7)%, compared with I-R group (43.2±3.1)%. Plasma MDA level, MPO activity and hydroxyl radical level were lower in I-R+Sem group than those in I-R group, from (27.5±9.3) μmol·min-1·L-1,(2.6±0.4)mmol·L-1 and (628±50)mmol·min-1·L-1 down to (14.2±5.6)μmol·min-1·L-1,(1.7±0.5)mmol·L-1 and (503±88)mmol·min-1·L-1, respectively. Histological results showed that inhibition of SSAO activity significantly attenuated leukocyte infiltration. CONCLUSIONPlasma SSAO activity is increased in myocardial I-R injury and inhibition of SSAO can attenuate myocardial I-R injury.

Objective To investigate the association between the presence of cerebral microbleeds and chronic kidney disease in patients with ischemic stroke.Methods Patients with ischemic stroke within 1-6 months were consecutively recruited.Cranial MRI was taken within two weeks after recruitment.Cerebral microbleeds were assessed using Microbleed Anatomical Rating Scale on gradient echo MRI.Demographics including sex,age and risk factors were obtained.Chronic kidney disease was defined and classified according to National Kidney Fundation-Kidney Disease Outcome Quality Initiative Guideline.Glomerular filtration rate (GFR) was estimated by using the abbreviated Modification of Diet in Renal Disease equation.Results Of the 636 patients included,mean age was (59.8 ± 10.1) years,435 (68.4％) were male.Sixty-six had decreased estimated GFR (eGFR; ＜ 60 ml · min-1 · 1.73 m-2).Two hundred and one (31.6％) patients had cerebral microbleeds,which were most commonly located in deep or infratentorial location (133/201,66.2％).The presence of cerebral microbleeds was much higher in patients with decreased eGFR than the others (48.5％ (32/66) vs 29.6％ (169/570),x2 =9.709,P =0.002).Age,history of hypertension and decreased eGFR were associated with the presence of cerebral microbleeds in univariate analysis.In multivariate analysis,decreased eGFR was independently associated with the presence of cerebral microbleeds in deep or infratentorial location (OR =1.457,95％ CI 1.044-2.034,P =0.027),but not associated with the presence of cerebral microbleeds in pure lobe.Conclusion Impaired kidney function is associated with the presence of cerebral microbleeds in deep or infratentorial regions in patients with ischemic stroke.

Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before transcatheter closer (P < 0.05). Conclusion Single beat real-time 3-D echocardiography is a newly-developed technique. This technique can quickly and accurately assess the right ventricular volume and function. Right ventricular volume will decrease after ASD closer. In ASD patients without PH the right ventricular function will decrease after ASD closer, while in ASD patients with PH the right ventricular function shows no changes after ASD closer although their PAP will decrease.

Objective To investigate the nurse self-directed learning readiness in some 3A hospital in Shandong province and discuss the strategies how to improve it. Methods Self-designed questionnaire and The Nurses Self-Directed Learning Readiness Scale were used to investigate 210 nurses from 23 departments in Shandong provincial hospital. Results Before and after the implementation of the video training, a total of 230 and 210 self-directed learning readiness scales were distributed, 210 and 210 questionnaires were returned, the effective recovery rate was 91.30%and 100%respectively. The data of questionnaires were statistically analyzed by the method of paired t test. The results showed that after the implementation of the project, the total score of the after test (156.63±19.48) was higher than the before (137.91 ± 13.71). The difference was statistically significant (t=-9.54, P<0.05). The score in the three dimensions of self-management, self-control, and desire for study (48.03 ± 7.25), (48.71 ± 6.44), (59.89 ± 7.61) points, were higher than (40.11±5.48), (43.40±5.34), (54.40±6.26) pointsbefore implementation. The difference was statistically significant (t=-10.22,-7.67,-6.83,P<0.05). Conclusions The video training would provide the convenient and quick way and could inspire the nurses′ learning motivation even more which is of great significance to improve the nurses ability of autonomic learning.

Objective To construct and implement theSTARnurse training model, and discuss its application effect and the problems that should be paid attention to, and to provide operational cases and practical basis for nursing clinical education. Methods Through literature review and expert consultation, the framework and content of STAR nurse training model were set up and implemented. The questionnaire survey and semi structured in-depth interviews were conducted among the nurses in the hospital to evaluate the effect of improving the nurses′self-directed learning ability. Results After the implementation of the project, the scores of the three dimensions of self-management, desire for study and self-control were (3.67±0.57), (4.05±0.54), (3.99±0.50) points, which were higher than (3.55±0.49), (3.71± 0.52), (3.53±0.42) points before implementation. The difference was statistically significant (P<0.05 or 0.01). The semi structured in-depth interviews showed that all the nurses believed that STAR nurse training model could promote independent learning and stimulate interest in learning. 14 nurses thought it was beneficial for the nurses to find the problems. Conclusions STAR nurse training model can create a favorable learning environment for nurses, and stimulate the learning motivation. It plays a positive role in improving nurses′ability of self-directed learning.

Objective To survey prevalence of behavior problems in children of off-farm workers and effects of family factors on children' s behavior problems.Methods The study was done in the whole 7 schools for off-farm workers' children in Shanghai Baoshan district,including all 3 ～ 6 grades students of primary school and 1 ～3 grades students of junior high school.Totally 4350 students finished survey (95.4％).Achenbach' s child behavior checklist ( CBCL,parent' s version) and general family questionnaire were used.Results ( 1 ) Prevalence of behavior problems in children was 11.2％ ; 12.8％ 12 ～ 16 years children had behavior problems( 14.7％boys and 10.4％ girls) ; 11.4％ of one-child children had behavior problems compared with that of 11.2％ child with siblings children ( x2 =0.038,P ＞ 0.05 ).(2) Total score ( 20.64 ± 17.67 ) and factor scores of thought problems,depressed,hyperactivity,delinquent rule-breaking behavior were higher than those of Chinese norm (P ＜0.05 or P ＜ 0.01 ) among 6 ～ 11 years boy group.Total score ( 17.23 ± 14.73 ) and scores of thought problems,depressed,social problems,hyperactivity,delinquent rule-breaking behavior were higher than those of Chinese norm (P ＜ 0.01 ) among 6 ～ 11 years girl group.Among 12 ～ 16 years boy group,total score (20.44 ± 19.32) and all factor scores of CBCL were higher than those of Chinese norm(P＜0.01 ).Total score ( 17.02 ± 16.72) and scores of immature,delinquent rule-breaking behavior,brutality were higher than those of Chinese norm(P ＜ 0.05 or P ＜0.01 ) among 6 ～ 11 years girl group.(3)Multi-regression analysis showed that poor parent-child relationship was the most important predict factor for higher score of CBCL among all family risk factors (P ＜ 0.05 ).Conclusion Children of the off-farm workers and their families need special mental health care program.