ObjectiveTo evaluate left ventricle partial and global diastolic function in patients with silentmyocardial ischemia (SMI) by Doppler tissue imaging (DTI) combined with dobutamine stress echocardiography(DSE).Methods30 cases of silent myocardial ischemia(SMI) and 30 cases of normal control underwent dobu-tamine stressechocardiography(DSE). DTI was acquired at baseline and stress, and waveforms in mitral valve clos- ing, and the base and mid segments of left ventricle were used to measure diastolic early velocity(Ve), diastolic latelyvelocity(Va) ,and E deceleration time(Te). ResultsⅤ in control group increased accompanied with the increasingdose of dobutamine, Ve/Va decreased a little but not significantly. Ⅴ in the group with silent myocardial ischemia(SMI) increased at 10μg·kg-1·min-1 ,but decreased at 40μg·kg-1·min-1 compared with 10μg·kg-1·min-1 ,T inboth control and DSE group decreased at 40μg/kg accompanied with 10μg·kg-1·min-1, T in both control and DSEgroup decreased accompanied with the increasing dose of dobutamine, and there were significant differences betweenthe groups(P < 0.05). ConclusionDTI-DSE could quantificadvely detect the partial and global diastolic function ofleft ventricle.

Objective To evaluate the clinical significance of peripheral atheral atherosclerosis after treatment by folicacid in combination with mecobalarain in uremia patient using vascular ultrasound.Methods 99 cases of uremia patients with carotid atherosclerosis were treated with folie acid tablets and mecobalamin tablets for six months.The carotid intimia-media thiclmess(IMT),total plaque area,numbers and ultrasound types of carotid atherosclerotic before and after treatment were observed.Results After six months,carotid IMT became tinner significantly,and the totsl plaque area decreased(P＜0.05).The ultrasound types of carotid atherosclerotic plagues have changed after six montha.and the plaque numbers decreased significantly(P＜0.05).Conclusion Threatment by folie acid combination with mecobalamin in uremia patients maybe helpful to the progression of carotid athereaclerotie disease.

Objective To explore and set up the nurse post ability of the leveling exam plan in a third-grade class-A hospital.Methods The entry of more than one year of nurses will participate in the examination of N1-N4 is divided into four levels.According to different levels to set up the post ability of the leveling exam plan,through the review and interview,evaluate its effects and satisfaction in a third-grade class-A hospital.Results After the post ability of the leveling exam plan,nurses of different levels get more satisfied with the score on the assessment form,specialized knowledge,the core system,emergency plan,communication skills,ability of operation and emergency disposal,which significantly higher than the traditional methods,there were statistical differences between two groups.(t value was as follows:1.46,2.13,1.98,2.57,2.69,1.87,P ＜ 0.05),but the difference of foundation knowledge was not obvious (P ＞ 0.05).The new program get higher scores of nurses in critical thinking,clinical care,ethical,legal practice and professional ability,results were significant differences (t value was as follows:2.18,2.01,1.46,2.78,P＜ 0.05),but the scores in scientific research ability,leadership,interpersonal relationship,education and consulting capacity was not significantly different (P ＞ 0.05).Conclusion It is concluded that nurses of different levels on the leveling exam plan get a higher satisfaction.Through the new program,to assess the level of nurses,effectively improve the capacity on critical thinking,clinical nursing,ethical standards,law practice and professional development.

OBJECTIVE To understand the bacterial spectrum distribution of sputum among the lung infection patients in our hospital and their resistance mechanisms for the reasonable clinical application of antibiotics to effectively prevent the occurrence of nosocomial infections. METHODS The pathogens isolated from the sputum of patients were identified with pathogen micro-biochemical identification code and the commonly used antibiotics were detected by drug sensitivity tests. RESULTS From 415 samples of the sputum,537 strains were detected out,from them Gram-positive cocci accounted for 70.8%,Gram-negative bacteria accounted for 28.1%,and Candida albicans accounted for 1.1%;MRSA was in 18 strains and ESBLs 6 strains. CONCLUSIONS It is important to sputum culturing for lung infection patients and determining the pathogen species and in their drug susceptibility results,the in order to rationally use the antibiotics and enhance the effectiveness of treatment.

Objective To elucidate the features of the expression of P53,proliferation and apoptosis in gestational trophoblastic tumor(GTT).Methods Ten cases of normal placenta,10 cases of complete hydatidiform mole(CM),20 cases of invasive hydatidiform mole(IM)and 19 cases of choriocarcinoma(CCA)paraffin-embedded tissues were studied.P53 and PCNA were detected with immunohistochemistry,apoptosis was detected with terminal deoxy-nucleotidyl transferase-mediated dUTP-biotin nick end labeling(TUNEL).Results In NP,CM,IM and CCA,the P53 indexes(P53-Ⅰ)were 4.12%,21.68%,39.61% and 27.39% respectively with significant differences among them(P

Objective To compare the values of peripheral blood and tumor tissue Annexin A3 protein expressions for predictinge platinum resistance in ovarian epithelial cancer. Methods A total of 72 cases of newly treated ovarian epithelial cancer and undergoing platinum based chemotherapy after surgery,and completely followed up in this hospital from February 2010 to February 2012 were selected and divided into the platinum-sensitive group(54 cases) and platinum-resistant group(18 cases) according to the platinum resistance evaluation criteria. Peripheral blood Annexin A3 level was detected by chemiluminescence immunoassay. Tumor tissue Annexin A3 level was detected by adopting the immunohistochemical staining. The predictive value of peripheral blood and tumor tissue Annexin A3 for predicting platinum resistance was analyzed by drawing the ROC curve. Results The peripheral blood Annexin A3 level in the platinum-sensitive group was significantly lower than that in the platinum-resistant group,the difference was statistically significant(P<0.05), the positive rate of tumor tissue Annexin A3 expression in the platinum sensitivity group was significantly lower than that of platinum-resistant group(P<0.05). The median survival time in peripheral blood Annexin A3 low concentration group was significantly higher than that of high concentration group(31.2 months vs. 20.4 months, P<0.05). The median survival time in tissue Annexin A3 low expression group was significantly higher than that in the high expression group (35.2 months vs. 23.1 months P<0.05). The multivariate analysis showed that the level of Annexin A3 expression in serum and tumor tissue were the independent risk factor for affecting platinum resistance (all P<0.05). The area of curve (AUC) of peripheral blood Annexin A3 in predicting platinum resistance was 0. 821, which of tissue Annexin A3 in predicting platinum was 0. 763, peripheral blood Annexin A3 for predicting platinum resistance was significantly higher than tissue Annexin A3 (P< 0.05). Conclusion The expression levels of Annexin A3 protein in peripheral blood and tumor tissue are significantly increased in the patients with platinum resistant ovarian cancer,the predictive value of Annexin A3 protein in peripheral blood for platinum resistance is better than that of tissue Annexin A3 protein.

Objective To evaluate the value of ultrasound biomicroscopy (UBM) in assessment of atherosclerosis in apolipoprotein E (ApoE) knockout mice feeding with western diet.Methods Sixteen ApoE knockout mice in 8 weeks age were selected,then divided into two groups.One group was fed with west diet as high-fat group,and another group was fed with normal diet as control group.Intima-media thickness (IMT) and plaque area in the aortic root were assessed by UBM in two groups after 8 weeks and 16 weeks.And the measurements of UBM were compared with results of histopathology and blood-fat.ResultsThicken wall and plaque could be find in aortic root in control group and high-fat diet group byUBM.IMT and plaque area in high-fat diet group was significantly higher than those of control group ( P ＜ 0.05).The IMT and plaque area in UBM were good correlation with histopathology ( rwas 0.81 and 0.70 respectively).The triglyceride(TC) and total cholesterol in high-fat diet group was significantly higher than those of control group ( P ＜0.05),and IMT in UBM were increased with the elevated level of TC,there was a positive correlation between IMT and TC( r =0.528).ConclusionsWestern diet can accelerate the process in formation of atherosclerotic plaque in ApoE knockout mice.UBM can be used to observe this prograss noninvasively in vivo mice.

This study aimed to investigate the protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice. After intratracheally giving bleomycin(3. 5 mg/kg), mice were orally administered Baibu Tang once a day for 14 consecutive days, takingnintedanib as a positive control. The anti-fibrotic effects were assessed by the hydroxyproline level and the histopathological changes in H&E or Masson stained lung tissues. The results revealed that the lung coefficient, hydroxyproline content, inflammation and collagen deposition were increased significantly in the lung tissue of the model mice. Both ethanol and water extracts of Baibu Tang significantly improved all the pathological indexes in mice, but the effect of the ethanol extract was better than that of the water extract. Baibu Tang with Baibu(root of Stemona tuberosa)containing different components(neotuberostemonine, tuberostemonine and stemoninine, respectively)could significantly reduce hydroxyproline level and collagen deposition in the lung tissue of bleomycin-induced mice, and there was no significant difference in their activity. This result showed that the changes in the chemical composition of Stemona tuberosa(Baibu, monarch drug for Baibu Tang)have little effect on the anti-fibrosis activity of Baibu Tang, and its mechanism and material basis need further investigation.

Objective:Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis.Methods:A total of 91 cases of critically ill patients in general surgery department were selected who were admitted to the general surgery of General Hospital of Eastern Theater Command of the Chinese People′s Liberation Army in Nanjing from June 2021 to March 2022 by convenient sampling method, demographic and enteral nutrition interruption data were collected,and patients were divided into enteral nutrition interruption group and enteral nutrition uninterrupted group to investigate the analysis of the factors of affecting enteral nutrition interruption and its impact on prognosis by Logistic regression analysis.Results:There were 59 cases in the enteral nutrition interruption group and 32 cases in the enteral nutrition uninterrupted group. There were statistically significant differences in gender, analgesic and sedatives, Gastro-kinetic agent and feeding intolerance between both groups ( χ2 values were 4.51-9.97, all P<0.05). Logistic regression analysis results showed that gender ( OR=4.566, 95%CI 1.332-15.657, P<0.05), analgesic and sedatives ( OR=3.437, 95%CI 1.112-10.621, P<0.05), and feeding intolerance ( OR=4.116, 95%CI 1.257-13.479, P<0.05) were the factors of enteral nutrition interruption. There were statistically significant differences between the two groups in the number of days of enteral nutrition up to goal in 3 days, 3-7 days and 7 days, albumin,length of stay in intensive care unit, total length of stay and hospitalization expenses between both groups ( Z values were -2.80 - -0.73, all P<0.05). Conclusions:Female, analgesic and sedatives and feeding intolerance are the risk factors of enteral nutrition interruption in critically ill patients in general surgery department, and enteral nutrition interruption has an adverse impact on the prognosis.Medical staff should avoid excessive use of analgesic and sedatives, and do well in feeding tolerance management to reduce the occurrence of enteral nutrition interruption.

Objective:To investigate the clinical significance and correlation between blood glucose variability and cognitive impairment in elderly patients with metabolic syndrome.Methods:A total of 80 elderly metabolic syndrome patients and 50 healthy controls in Chinese People′s Armed Police Corps Hospital in Sichuan Province from December 2017 to March 2019 were selected as study group and control group respectively, and the difference of general data and biochemical indicators between two groups were compared. The cognitive function of the metabolic syndrome patients was measured by Montreal cognitive assessment scale (MoCA) at admission. The patients were divided into cognitive dysfunction group and normal cognition group according to MoCA score. The glycemic variability was detected by 72-h dynamic monitoring of blood glucose started within 24 h after admission, and the difference of average blood glucose (Glu Ave), standard deviation of glucose (Glu SD), mean amplitude of glycemic excursions in 24 h (MAGE), glycemic index (GLI), glucose variability (Glu CV) and other indicators between cognitive dysfunction group and normal cognition group were also compared. Results:The levels of body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterin (LDL-C), glycated hemoglobin (HbA 1c) were significantly increased in the study group [(25.48 ± 3.86) kg/m 2 vs. (22.83 ± 4.60) kg/m 2, (139.09 ± 10.17) mmHg (1 mmHg = 0.133 kPa) vs. (128.12 ± 7.8) mmHg, (73.00 ± 6.65) mmHg vs. (69.90 ± 5.99) mmHg, (9.12 ± 1.54) mmol/L vs. (4.92 ± 0.63) mmol/L, (2.17 ± 0.49) mmol/L vs. (1.70 ± 0.48) mmol/L, (5.32 ± 0.62) mmol/L vs. (4.61 ± 0.45) mmol/L, (3.05 ± 0.79) mmol/L vs. (2.31 ± 0.53) mmol/L, (7.89 ± 1.92)% vs. (5.30 ± 0.56)%], high density lipoprotein cholesterol (HDL-C) were significantly decreased in the study group [(0.98 ± 0.25) mmol/L vs. (1.19 ± 0.43) mmol/L] compared to the control group, and the differences were statistically significant ( P<0.05). The disease course, HbA 1c, Glu Ave, Glu SD, MAGE, GLI, Glu CV were markedly increased in the cognitive dysfunction group compared to those in the normal cognition group [(7.39 ± 1.87) years vs. (6.50 ± 1.52) years, (8.52 ± 2.21)% vs. (7.32 ± 1.21)%, (11.6 ± 3.35) mmol/L vs. (9.84 ± 2.19) mmol/L, (2.98 ± 0.54) mmol/L vs. (2.17 ± 0.47) mmol/L, (1.19 ± 0.46) mmol/L vs. (0.71 ± 0.28) mmol/L, 95.83 ± 19.77 vs. 86.94 ± 15.22, (27.96 ± 10.38)% vs. (23.02 ± 8.16)%]( P<0.05). Logistic regression model showed that disease course, HbA 1c, Glu Ave, Glu SD, MAGE, GLI, Glu CV were independent risk factors for the cognitive impairment in elderly patients with metabolic syndrome.In addition, there were positive correlation between MoCA score and disease course, HbA 1c, Glu Ave, Glu SD, MAGE, GLI, Glu CV ( P<0.05). Receiver operating characteristic curve demonstrated that GluSD>2.56 mmol/L [area under the curve (AUC)=0.897] or (and) MAGE>1.11 mmol/L (AUC = 0.821) may indicated the occurrence of cognitive impairment. Conclusions:Glu Ave, Glu SD, MAGE, GLI and Glu CV are all correlated with cognitive dysfunction in elderly patients with metabolic syndrome, and Glu SD and MAGE may be considered as a potential maker for prediction of cognitive dysfunction.