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 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 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 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 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 investigate the effect of clinical classification and operational methods of gallblad-der carcinoma on the prognosis.Methods Clinical data of 88 patients with gallbladder carcinoma treated surgically from January 1994 to December 2004 were retrospectively analyzed.Results 8 cases were in class Ⅰ and Ⅱ , 14 in class Ⅲ ,28 in class Ⅳ,38 in class Ⅴ.The mean survival of these 4 classifications was 36.5,9.3,4.6,3.9 months respectively.There was a remarkable difference(P <0.01,P<0.05) in survival among these 4 classifications ex-cept between class Ⅳ and class Ⅴ (P0.05).The mean survival of radical resection and palliative resection in class Ⅳ and Ⅴ was 4.2 and 3.8 months.There was no remarkable difference( P0.05 ) between them.Conclusion The key to increase the therapeutic effect gallbladder carcinoma is early diagnosis and radical resection.

Objective To analysis the clinical manifestations of a large Spinocerebellar Ataxia 3 pedigree to pro-vide the information for the early diagnosis of Ataxia 3. Methods SCA3/ATXN3 gene was determined by using Poly-merase Chain Reaction and fragment analysis in the large pedigree members and patients ’clinical data was collected. Five patients underwent MRI imaging and fundus examination. Results There were eighteen clinical patients and twelve ATXN3 carriers in this Pedigree . In addition to ataxia, three patients presented with intellectual disability, one with cer-vical spondylosis, one with dysmyotonia, one with disorder in visual system, and seven with abnormality in autonomic ner-vous system. The MRI revealed that pons and cerebellar atrophy in some patients inordinately. Undus examination did not reveal any obvious abnormality. Conclusions The symptoms of SCA3 are heterogeneous in the same pedigree. When patients present with symptoms of cerebellar system, visual system and autonomic nervous system, or cervical spondylosis and intellectual disability, SCA3 should be considered.

Objective To evaluate the impact of individualized occluder application on efficacy and complications of transcatheter closure treatment for multi-feneatrated atrial septal defects (mfASD).Methods Seventy six patients with mfASD who were hospitalized at Fudan University Zhongshan Hospital from July 2006 to July 2015 were retrospectively enrolled.Clinical and follow-up data were collected and analyzed.Results Among the 76 patients including 18 males and 58 females,transcatheter closure was successfully performed in 73 patients (96.1%).The morphological features of ASD included: 60 cases (78.9%) with two defects and 16 cases (21.1%) with cribriform defects, 3 cases (3.9%) combined with patent foramen ovale (PFO),13 cases (17.1%) with atrial septal aneurysm (ASA).Dual occluders were used for closure in 26 patients (35.6%),while single occluder was implanted in 47 patients (64.4%).In single-occluder group,measuring balloon was used to assist occlusion in 7 patients (14.9%).3 patients versus 11 patients required the small-waist-big-edge occluders in the dual-occluder group and the single-occluder group respectively (11.5% vs.23.4%, P=0.352).The complication rate in the dual-occluders group was higher than that in the single-occluder group (19.2% vs.4.3%, P=0.037),while the incidence of residual shunt showed no significant difference between these two groups (11.5% vs.10.6%, P=0.906).Conclusions The occluder for transcatheter closure of multiple atrial septal defects needs to be individually chosen according to the morphological characters.Transcatheter closure of mfASD using two devices is feasible,safe and effective for selected patients.