Objective To explore the correlation between anxiety and the severity of myocardial brigde of left anterior descending. Methods 118 patients with isolated myocardial bridge of left anterior descending underwent coronary angiography were evaluated with Self-rating Anxiety Scale (SAS). They were divided into anxiety group and non-anxiety group. Results There were 48 cases in the non-anxiety group, and 70 cases in the anxiety group. The stricture of myocardial bridge was more serious in the anxiety group than in the non-anxiety group (P<0.01), and positively correlated with the SAS score (r=0.765, P<0.01). Conclusion The anxiety is frequent in patients with isolated myocardial bridge of left anterior descending, and correlated with the severity of myocardial bridge.

Objective To summarize the experience of diagnosis and management of regional portal hypertension. Methods The clinical manifestations, diagnostic methods and therapeutic modalities of 16 cases of regional portal hypertension were analyzed retrospectively. Results Among 16 patients with ~regional portal hypertension, 12 cases resulted from pancreatic diseases, and 4 cases were complicated with non-pancreatic diseases. The main clinical findings were splenomegaly in 16(100%), abdominal pain ~in 10(63%) , gastrointestinal bleeding in 7(44%) and abdominal masses in 3(19%). All had normal liver function test. The main diagnostic methods were ultrasonography(US), computerized tomography (CT) and endoscopy. Splenic vein thrombosis could be detected by color Doppler ultrasonography (7/7). ~Enhanced CT could demonstrate enlarged and tortuous short gastric veins, gastroepiploic veins, and ~coll- ~ateral vessels around splenic hilum(16/16). Isolated gastric varices (4/5) were revealed mainly by ~gastro- ~scopy . Splenectomy was effective for controlling gastrointestinal bleeding, and its complication of portal vein thrombosis occurred in 1 case. Conclusions It is not difficult to diagnose regional portal ~hyper- ~tension based on findings of US and CT, together with special clinical characteristics. Therapeutic options should be ~individualized according to underlying diseases, however, splenectomy should be performed in the ~patients with gastrointestinal bleeding.

Objective To investigate the quality of life of nurses group in Shenzhen city and explore its influencing factors, so as to provide evidence for health policy making health promotion and science research. Methods Self-designed questionnaires were used in social demography survey and SF-36 was adopted to survey 495 in-service nurses on front line from four hospitals in Shenzhen. Paired samples t Test and multivariable stepwise regression were carried out to analyze the quality of life among nurses in Shenzhen city and general population in China. Results The data showed the scores of the physiological domain, psychological domain and quality of life nurses in Shenzhen city and Chinese general population was (68.60±17.61), (69.91±17.91), (67.29±20.29)and (78.18± 15.88), (79.36±17.00), (77.00± 17.42), respectively. The difference had statistical significance. Multivariable stepwise regression showed that quality of life was positively correlated with APN scheduling, education, department, monthly income, working range, age and the hospital level in descending sort Conclusions Health authorities, hospital leaders and nurses-selves should pay more attention to the quality of life for nurses group and take positive mea-sures to improve quality of life of nurses group.

Objective To investigate the effects of exogenous biliverdin on lung injury induced by brain death (BD) in rats. Methods Twenty-three adult male Wistar rats in which Fogarty balloon catheter was successfully inserted into cranial cavity were randomly divided into 3 groups: group Ⅰ sham operation (group S,n = 7); group Ⅱ brain death (group BD, n = 8) and group Ⅲ biliverdin + BD (group B, n = 8). The animals were anesthetized, intubated and mechanically ventilated. Femoral artery and vein were cannulated for MAP monitoring and drug and fluid administration. Brain death was induced by injecting slowly normal saline into the balloon in group Ⅱ and Ⅲ. BD was confirmed by dilated and fixed pupils, apnea, transient hypertension and EEG changes. In group Ⅲ biliverdin 35 mg/kg was injected intraperitoneally as soon as BD was confirmed. The animals were mechanically ventilated for another 1.5 h during which MAP was maintained at 80-120 mm Hg by iv norepinephrine infusion. Arterial blood samples were obtained before anesthesia, immediately before and at 5, 30,60, 90 min after intraperitoneal biliverdin for blood gas analysis and determination of plasma bilirubin concentration. PaO2/FiO2 was calculated. The animals were sacrificed at 1.5 h after biliverdin administration. The left lung was removed for detection of MDA content, SOD activity, total antioxidant capacity, cell apoptosis and biliverdin reductase expression in lung tissue. Results Brain death significantly decreased PaO2/FiO2, lung SOD activity and total antioxidant capacity and increased lung MDA content and apoptosis as compared with sham operation group. IP biliverdin significantly attenuated BD-induced lung injury in group B as compared with group BD. The plasma bilirubin concentration and biliverdin reductase expression were significantly higher in group B than group BD. Conclusion Exogenous biliverdin can attenuate BD-induced lung injury by inhibiting pulmonary oxidative stress response and apoptosis.

Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.

Objective To observe the effect of acupuncture and massage on tiptoe in children with spastic cerebral palsy. Methods 49 children with spastic cerebral palsy were divided into treatment group (n=24) and control group (n=25) in accordance with the order of visiting. The control group accepted routine rehabilitation, and the treatment group accepted acupuncture and massage in addition. They were assessed with Composite Spasticity Scale (CSS), the angle of ankle passive dorsiflexion before and after treatment. Results The scores of CSS and the angle of ankle passive dorsiflexion improved in both groups after treatment (P<0.001), and improved more in the treatment group than in the control group (P<0.001). The rate of improvement was 95.6% in the treatment group, and 78.26% in the control group (P<0.05). Conclusion Acupuncture and massage may further improve the correcting of the tiptoe in children with spastic cerebral palsy.

Objective To evaluate the theoretical knowledge level of Chinese nursing students based on the problem-based learning(PBL)versus traditional teaching methods. Methods Databases including CNKI (1979-2013.03),VIP (1989-2013.03)and Wanfang (1982-2013.03)were searched (up to March,2013)for controlled studies comparing PBL and traditional teaching methods. The quality of included studies was critically evaluated and the data were analyzed by Stata 10.0 software. Results A total of 659 articles were retrieved but only 22 were included. Meta-analyses showed that there were significant differences between PBL and traditional teaching methods in improving theoreti-cal knowledge of nursing students(SMD merge=0.79,95%CI(0.55,1.03),P=0.000). Conclusions PBL can improve the theoretical scores of Chinese nursing students. However,the above conclusion needs to be confirmed by more large-scale randomized controlled trials of higher quality due to the limitation of studies include in this paper.

Objective To investigate the alternation of right ventricular volume and systolic function in patients with severe pulmonary regurgitation under percutaneous pulmonary valve implantation(PPVI) by real-time three-dimensional echocardiography(RT-3DE).Methods Ten patients with severe pulmonary regurgitation were enrolled.The 2D echocardiography images and real-time 3D full volume images on apical four-chamber view on a Philips IE33 system were acquired before PPVI and at 3 days,1 month,3months and 6 months after PPVI.Right ventricular end diastolic volume (EDV),end systolic volume(ESV),stroke volume (SV),ejection fraction(EF),fractional area change(FAC),tricuspid annular plane systolic excursion (TAPSE),right ventricular longitudinal strain-free wall(RVLSf) and right ventricular longitudinal strainseptum(RVLSs) were analysed using off-line TomTec software,the differences among the five groups were compared,and correlation analysis was made between the CMR and RT-3DE measurements.Results The level of pulmonary regurgitation had decreased or disappeared after PPVI.Compared with the preoperation,EDV,ESV at 3 days,1 month,3months and 6 months after operation had decreased significantly.EF,FAC,TAPSE,RVLS had increased significantly(all P ＜0.05).There were close correlation in EDV,ESV,EF between RT-3DE and CMR(pre-operation r =0.811,0.817,0.807,post-operation r =0.735,0.834,0.800,all P ＜0.055).Conclusions RV volume notably decreases while RV systolic function remarkably improves.The RT-3DE is a helpful technology in the evaluation of right ventricular volume and systolic function in patients after PPVI.

Objective To investigate the effect of hypercapnia on hypoxic-ischemic brain injury in rats.Methods Forty-eight adult male SD rats were randomly divided into three groups: sham group (group S), hypoxic ischemic group (group HI) and hypercapnia group (group HP), n=16 in each group.Levine`s model was used to cause hypoxic-ischemic brain injury.In group S, the left common carotid artery was separated without ligation for 1 h, then ventilation with air maintaining the normal levels of PaO2 and PaCO2 for 3 h.In group HI, the left common carotid artery was separated and ligated for 1 h, PaO2 was maintained at 30-49 mm Hg by ventilating with low concentration (11%-13%) O2 for 3 hours.Based on group HI, PaCO2 in group HP was maintain at 60-80 mm Hg by inhalation of mixture gas containing (11%-13%) O2-8%CO2-N2 for 3 hours.FITC-dextran was used to measure the permeability of blood-brain barrier, TUNEL staining were used to observe the changes in the structure of the cerebral cortex.The expressions of aquaporin AQP4 and RECA-1 in cerebral cortex were detected by immunofluorescence and western blot.Results The level of brain water content, permeability of blood brain barrier and AQP4 expression were significantly increased in group HP as compared with group S and group HI (P<0.05).The histopathologic damage,as well as neuronal apoptotic index were aggravated in group HP as compared with group HI (P<0.05).Conclusion Hypercapnia may aggravate the brain damage during severe hypoxic-ischemic brain injury.This may associate with the increased expression AQP4 and the damage of blood-brain barrier.

Objective To study the relationship between the inflammatory cytokine levels and the expression of hepatic alpha-7 nicotinic acetylcholine receptor (α7 nAChR) in hyperlipidemia rats and to investigate the intervention effect of Yirui Capsules ( mainly composed of Radix Salviae Miltiorrhizae, Fructus Crataegi, Rhizoma Alismatis, etc). Methods Fifty male SD rats were randomly divided into blank control group ( fed with conventional diet, N=10) and high-fat diet group (fed with high-fat diet, N=40). After feeding for 14 d, the forty rats in high-fat diet group were further randomly divided into model control group, and low-, middle-, and high-dose Yirui Capsules groups (140, 280, 560 mg/kg, respectively), 10 rats in each group and the treatment lasting 30 days. And then, the serum levels of lipids were detected, C-reactive protein (CRP) and tumor necrosis factor (TNF) -α in the serum were detected by enzyme-linked immunosorbent assay ( ELISA) , and the expression of hepatic α7 nAChR was analyzed by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) . Results Yirui Capsules in different dosages could improve serum lipid levels in hyperlipidemia rats to various degrees. The contents of serum inflammatory cytokines CRP and TNF-α and the mRNA expression of hepatic α7nAChR were increased in the model control group as compared with those in the blank control group ( P<0.01). The contents of inflammatory cytokines CRP, TNF-αand the mRNA expression of hepatic α7nAChR were decreased in the three Yirui Capsules groups as compared with those in the model control group ( P<0.01). The results of immunohistochemical staining for α7nAChR expression were consistent with RT-PCR results. Conclusion The expression of hepatic α7nAChR is increased in hyperlipidemia rats. Yirui capsules are effective on decreasing inflammatory cytokine levels, improving lipid metabolism, and down-regulating α7nAChR expression.