Objective To explore the effect of creatine phosphate combined with salvia miltiorrhiza polyphe-nols acid salt in treatment of coronary heart disease heart failure.Methods 114 cases of patients with coronary heart disease heart failure were selected as research objectives,who were treated in our hospital from August 2012 to August 2014.And they were randomly divided into control group(55 cases)and research group(59 cases)according to the number table method.Routine therapy of heart failure were given in both groups and the research group were added creatine phosphate combined with salvia miltiorrhiza polyphenols acid salt.The clinical efficacy of two groups of patients were observed and compared.Results The total effective rate in research group was 96.61%(57 /59), significantly higher than 85.45%(47 /55)in control group,the difference was statistically significant(χ2 =4.427, P =0.035).Before treatment,the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter(LVESD)and 6min walking distance between two groups had no sig-nificant difference(P >0.05).After treatment,the LVEDD and LVESD of research group were decreased and LVEF and 6 minutes walking distance of two groups were increased,the difference was statistically significant(P <0.05), the LVEDD and LVESD of research group were lower than that of the control group and LVEF and 6 minutes walking distance were higher than that of control group,the difference was statistically significant(P <0.05).No complications or side effects related to the treatment were found in both groups.Conclusion On the basis of routine therapy of heart failure,the effect of creatine phosphate sodium combined with salvia miltiorrhiza polyphenols acid salt in treat-ment of coronary heart disease heart failure can improve cardiac function of the patients with the indicators,and the clinical effect is obvious,and side effects is rarely observed.

Objective To investigate the role of problem-based learning (PBL) in the improve-ment of students' comprehensive ability in experimental classes of fundamental nursing. Methods A total of 172 nursing students were randomly divided into the experimental group (n=76) and the control group (n=96), they received PBL and traditional education, respectively.The teaching effect was compared using X2 tesL Results The experimental group was better than the control group in comprehensive a-bility such as communication skills, operant skills, coping skills, health education, appearance and at-titude. Conclusions PBL can promote the nursing students to understand the comprehensive information of special problems, and improve their skills of resolving practical problems and autonomic learning.

Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.

Objective To investigate the relationship of plasminogen activator inhibitor type 1(PAI-1) and ultrasensitive C-reative protein(hsCRP) in patient with metabolic syndrome and coronary heart disease.Methods Between June 2006 and December 2007,87 patients with metabolic syndrome were divded into two groups:simple MS group which consisted of 45 patients and MS with CHD group which consisted of 42 patients.30 health people at the same stage,whose age and sex were similar with those in MS group served as normal control group.The levels of body mass index(BMI),waist circumference(WC),systolic blood presser(SBP),diastolic blood presser(DBP),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),PAI-1 and hsCRP were measared.Results BMI,WC,FPG,SBP,DBP,TG,PAI-1 and hsCRP in both MS groups were higher than those in normal control group(P

Objective To investigate the association between postprandial triglyceride and the severity of coronary artery disease in patients with metabolic syndrome (MS). Methods AlI of 91 patients with MS were recruited for this study. Thirty-one patients with normal fasting and postprandial triglyceride was in MS1 group, 29 patients with normal fasting triglyceride and postprandial hypertrigtyceridemia was in MS2 group, and 31 patients with fasting hypertriglyeeridemia was in MS3 group. Blood triglyceride at the time of postprandial 4 hours was measured and the quantity of coronary artery branch disease was determined by coronary angiography. The relationship between them was analyzed. Result There was significant positive correlation between the quantity of coronary artery branch disease and the level of blood triglyceride at the time of postprandial 4 hours (r = 0.42, P < 0.01 ). Conclusions It is important to detect the level of blood triglyceride at the time of postprandial 4 hours. Prompt intervention maybe decrease the incidence and mortality rate of cardiovascular disease in patients with MS.

Purpose To evaluate the diagnostic value of two-dimensional multiple-echo recalled gradient echo (2D MERGE) with flexural position in the hirayama disease. Materials and Methods Conventional MRI and axial MERGE images (7 cases) were analyzed and the anteroposterior diameter was measured at C6 vertebral body, and the structure of spinal, extramedullary and subdural space and extradural space were compared. Results The anteroposterior diameter was (5.7±0.6) cm and (4.7±0.5) cm in the neutral position and flexural position (t=-2.95, P<0.05). The“butterfly”shape of spinal grey matter could not be detected in the 4 cases on MERGE with flexural position, which could not demonstrated on the conventional MR images. 2D MERGE was not sensitive for the CSF flow artefacts and the contrast between spinal and surrounding structures was improved. However, the vascular images could not displayed on 2D MERGE images. Conclusion 2D MERGE sequence is better than T1WI and T2WI on sagittal view and T2WI on axial view in the pathological changes of hirayama disease except flow-empty vein sign, thus it has an important role in diagnosing hirayama disease.

The nutritional survey was made in 184 anorexia children aged 3-7, 123 of them were treated with various measures for three months. The results indicated that the children with anorexia had low intake and deficiency in energy, protein, minerals and vitamins. Most of them had zinc deficiency, but they simultaneously had two to three nutrients deficiency.The zinc treatment could improve most patient's syndrome and nutritional status. The effect of zinc treatment with vitamines and iron preparations was better than zinc treatment only. The effect of treatment with Chinese medicine also was able to cure the children with anorexia to certain extent.

Objective To evaluate the attitudes of clinical nurses toward caring for the dying patients, and possible influencing factors concerning the attitudes were investigated, so as to provide a scientific basis for further intervention, thus improving the positive attitudes toward care of the dying patients in the future research. Methods A convenience sampling method was used to recruit 770 nurses from 15 hospitals located in 5 provinces in China. A demographic survey, Chinese version of Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C) and Chinese version Death Attitude Profile-Revised were employed in the survey. Results FATCOD-B-C scale was used to evaluate the attitudes of nurses toward caring for dying patients, with the mean score of all FATCOD-B-C item being 95.62 ± 7.45. To analyze relationship among demographic variables and the total score of FATCOD-B-C. Univariate analysis revealed that age group (F=2.285), years employed as a nurse (F=3.353), educational background (F=5.581), technical title (F=5.692), level of hospital (t=2.058), religious beliefs (t=-2.788), previous education on death and dying(F=9.743), previous experience in dealing with terminally ill persons (t=2.761) had significant influence on the nurses' attitudes toward caring for dying patients and families(P<0.05). Multiple linear regression analysis indicated that nurses' attitudes toward caring for dying patients had been affected by those factors, among which the most influential factor was educational background. Conclusions It shows that nurses'FATCOD-B-C scores are at a low level. It is suggested to improve nurses' positive attitudes of caring for dying patients and their families by making the specific methods based on the influencing factors, thus improving the development of palliative care.

OBJECTIVE Toinvestigatetheantidepressantandantianxietyeffectofproanthocyani-dins(OPC)inchronicallystressedratsanditsunderlyingmechanism.METHODS Onemethodwas selected from 8 different stress methods each day,and the rats were treated with OPC (25,50 and 1 00 mg·kg -1 )1 h before the stress method.The chronically stressed model was established.After 21 d stress experi ment,the i mmobility ti me in force swi mming test,sucrose consu mption and the nu mber of marbles buried in the marble burying test were observed respectively each day.OPC (25,50 and 1 00 mg·kg -1 )was given 1 h before each test.In addition,Western blotting was used to analyze the expression of brain derived neurotrophic factor (BDNF) and phosphorylated cyclic AMP response element-bindingprotein(p-CREB)inthehippocampusandfrontalcortex.RESULTS Comparedwith the control group,the chronically stressed group showed obvious depressive-like and anxiety-like behav-ior,while the immobility time decreased from (90.57 ±4.27)s in chronically stressed group to (78.25 ± 2.53)s (P<0.05),(72.12 ±3.21 )s(P<0.05)and (60.77 ±3.41 )s (P<0.05)when ig given OPC 25,50 and 100 mg·kg -1 respectively,the ratio of sucrose preference increased from (42.80 ±4.92)%to (67.54 ±4.32)%(P<0.05)and (72.21 ±7.99)%(P<0.05)when ig given OPC 50 and 1 00 mg· kg -1 respectively,the number of buried marbles decreased from 1 .57 ±0.21 in chronically stressed group to 0.63 ±0.26 (P<0.05)and 0.44 ±0.1 8 (P<0.05)when ig given OPC 50 and 1 00 mg·kg -1 respectively.The expression of p-CREB in the hippocampus and frontal cortex distinctively increased in OPC group (25,50 and 100 mg·kg -1 )(P<0.05),so did the expression of BDNF in the hippocampus andfrontalcortexinOPCgroup(50and100mg·kg-1)(P<0.05).CONCLUSION OPCcanreverse the depressive-like and anxiety-like behavior in chronically stressed rats,which may be related to the cAMP-CREB-BDNF signal transduction cascades.

Objective To investigate the time course of cerebral infarction with diffusion kurtosis imaging-related parameters.Methods According to the time interval from symptom onset to MRI examination, 114 cases of cerebral infarction were divided into five groups:8 cases of hyperacute phase(less than 6 hours), 14 cases of acute(>6-24 h), 60 cases of early subacute(>24 h-7 d), 20 cases of late subacute(>7-14 d), and 12 cases of chronic phase ( >14 d-2 months).They underwent routine diffusion weighted imaging (DWI) and diffusion kurtosis imaging (DKI) scanning, and apparent diffusion coefficient ( ADC) and DKI-derived parameters were obtained from them.The derived diffusion parameters were compared among different phases in the patients , and the percent of changes in the infarcted regions were calculated.Paired t-test was used to compare the difference of each parameter between the infarcted region and contralateral normal region , and their correlation with time interval was tested using Pearson correlation analysis.Results Except for chronic phase , mean kurtosis ( MK) , axial kurtosis ( K∥) , radial kurtosis (K⊥)map showed uneven high signal in the infarcted regions , while mean diffusion(MD), axial diffusion(D∥), radial diffusion(D⊥) showed uniform low signal.MK values in the infarcted regions of hyperacute, acute, early subacute and late subacute phase (1.331 ±0.357,1.578 ±0.453,1.519 ±0.455, 1.403 ±0.275 ) increased significantly , compared with the contralateral normal mirror regions ( 0.850 ± 0.236,0.827 ±0.194,0.865 ±0.144,0.939 ±0.212) (t values were 5.242,6.907,12.416,5.629, respectively.P values were all less than 0.01 ).MK, K∥, K⊥ achieved a peak in the acute and early subacute phase , and showed more amplitude than the decrease of MD , D∥, D⊥.Then they gradually reduced, and tended to normalize.MK, MD, ADC had a significant correlation with the time onset of cerebral infarction ( r was 0.354, 0.747, 0.723, respectively, P values were all less than 0.05 ).Conclusion Diffusion kurtosis imaging can provide more diffusion information than conventional DWI , which can better reflect the microstructure changes in tissue.