Objective To study the effect of psychological nursing on heart rate variability (HRV)in patients with acute myocardium infarction. Methods 80 patients with AMI were randomly divided into group A(routine nursing group)and group B (psychological nursing group) with 40 patients in each group,HRV was evaluated in both groups.The time domain and frequency domain of HRV of 24 h sinus rhythm in two groups of patients were analyzed. Results In group B,24 h average standard deviation of RR interval (SDNN),5 min segments of continuous average standard deviation of RR intervals (SDANN),the difference between adjacent cardiac RR interval of the root mean square (rMSSD),the percentage of adjacent canrdiac RR interval greater than 50 ms (PNN50),low frequency (LF),high frequency (HF) and other HRV parameters were significantly higher than group A. Conclusions Psychological nursing can significantly increase HRV and improve the electric stability of the ischemic myocardium.Psychological nursing can stabilize emotion of patients,decrease sympathetic tone,and may have a role in the prevention of sudden death.

Objective To investigate the protective effect of sodium butyrate on brain injury induced by pneumolysin of infantile rats.Methods Ninety-six normal healthy 1-month-old Spragne-Dawley (SD) rats were randomly divided into three groups,including pneumolysin (PLY) group (n =32),in which rat was injected PLY via external carotid; Normal saline (NS) group (n =32),injected NS via external carotid; sodium butyrate (SB) group (n =32),after injecting PLY,immediately administrated SB via venous.In the injection the 24th h and 48th h,superior vena cava blood was taken,and the animals were sacrificed,and brain tissue samples were prepared.The brain water content (BWC) was recorded by measuring both wet and dry weight,the Evans blue (EB) level was measured by the formamide method.The serum levels of high mobility group protein B1 (HMGB1) and nuclear factor kappa B (NF-κB) were measured by enzyme-linked immunosorbent assay (ELISA).Results In PLY group,brain tissue BWC,EB level,and the blood level of HMGB1 and NF-κB were increased significantly compared with the NS group at each time point,the difference was statistically significant (P ＜ 0.05).These indices were lower in the SB group compared with PLY group,the difference was statistically significant (P ＜ 0.05).The positive correlation was gotten between HMGB1 and NF-κB,BWC,EB levels in the PLY group and SB group (r =0.817 ～0.917,P ＜ 0.05).Conclusions SB has neuroprotective effect in brain injury induced by PLY,which maybe relevant to inhibition of NF-κB activation and suppression of HMGB1 expression.

Objective To investigate the change of serum HMGB1 level and its clinical significance in children with sepsis.Methods Serum HMGB1 and procalcitonin (PCT) levels were determined in 30 healthy individuals and 46 children with sepsis,and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system was evaluated in children with sepsis.These indexes were also collected on the third and fifth days.The correlations between serum HMGB1 level and serum PCT level as well as APACHE Ⅱ score were analyzed.Results Serum HMGB1 levels in children with sepsis on the first day,the third day and the fifth day were significantly higher than those in control group,these differences were statistically significant [(26.28 ± 1.54) ng/ml,(20.32 ± 1.29) ng/ml,(12.84 ± 1.06) ng/ml vs (1.52 ± 0.29) ng/ml,P ＜0.05],HMGB1 levels among three time points were also significantly different(P ＜0.05).The serum HMGB 1 levels were positively correlated with the PCT levels (r =0.931,P ＜ 0.05) and APACHE Ⅱ score (r =0.915,P ＜ 0.05).Conclusion Serum HMGB1 level is obviously elevated in children with sepsis,and the level of HMGB1 can reflect the severity of sepsis.

Objective To observe the effect of panax notoginseng saponins on pulmonary artery pathology in chronic hypoxic pulmonary hypertensionp (HPH) rats models, discuss the role and possible mechanisms of panax notoginseng saponins in prevention of chronic hypoxic pulmonary hypertension.Methods Forty male Sprague-Dawley (SD) rats were randomly divided into four groups (n =10).Group C: control group;Group H: rats were treated with hypoxia only;Group HC: rats were treated with hypoxia and captopril;and Group HP: rats were treated with hypoxia and panax notoginseng saponins.To observe the effect of panax notoginseng saponins prophylactic treatment in chronic hypoxic pulmonary hypertension rats,after the establishment of the model of hypoxic rat animal pulmonary hypertension models, transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure, at the end of separation and cut for pulmonary artery to observe the pathological changes of pulmonary artery, results were recorded and statistically analyzed.Results (1)Transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure: pulmonary artery systolic pressure (PASP) and mean pulmonary arterial pressure (MPAP) were significantly higher in Group H than in Group C (P ＜ 0.05), Group HP was no significant difference relative to Group C.(2)Pathological section shew that the primary pathological change of group H is vascular intimal hyperplasia and the proliferation of smooth muscle cells, medial hypertrophy, extracellular matrix increased, thickening of the vessel wall and the vascular stenos.Conclusions Panax notoginseng saponins inhibit the formation of chronic hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats,and have the effect of prevention and treatment of pulmonary hypertension.

Objective To evaluate Effects of general anesthesia combined with thoracic paraver-tebral block(TPVB)on postoperative recovery after thoracoscopic pulmonary lobectomy. Methods Eighty patients were randomized into the general anesthesia group( G group)and general anesthesia combined TPVB group(GT group). Under the guidance of ultrasound,patients in the GT group received 20ml of 0. 5% ropivacaine for TPVB,and sevoflurane and propofol for combined anesthesia. Patients in the G group received sevoflurane,propofol and remifentanil for combined anesthesia. Extubation time,postoperative vis-ual analogue scale(VAS),quality of recovery(QoR)score,and adverse reaction were all recorded. Results Patients in the GT group had less extubation time and earlier ambulation time compared to the G group. Postoperatively,at the 1st,24th and 48th hour,patients in the G group had significantly higher VAS values both at rest and on movement than GT group(P < 0. 05). The opioid consumptions in GT group were lower than the G group(P < 0. 05). The QoR values of GT group at 24th and 48th hour[(152 ± 21)min and (175 ± 17)min]were significantly higher than the G group[(134 ± 25)min and(162 ± 20)min]respec-tively. There were significant differences in hospitalization expenses,the hospitalization stay and the inci-dence of complications between the two groups. Conclusion The ultrasound-guided paravertebral block can improve the quality of recovery in patients undergoing thoracoscopic pulmonary lobectomy.

Objective To evaluate the use of endoscopy in assessment of invasion depth of colorectal flat lesions and in choice of treatment strategy. Methods The invasion depth of 222 colorectal flat lesions from 188 patients was endoscopically estimated by pit patterns, air-induced deformation testing and/or lifting sign. The lesion was endoscopically rosected if both tests were positive, otherwise, surgery was applied. The pathological evaluation of resected lesion was made according to WHO criteria and was used as a reference of tumor invasion depth. The sensitivity, specificity, positive and negative predictive value of airinduced deformation testing and lifting sign in prediction of invasion depth of tumors were calculated. Results The air-induced deformation testing and lifting sign were both positive in 212 cases, in which 192 were treated with endoscopic mucosal resection (EMR), 15 with endoscopic piecemeal mucosal resection (EPMR), 2 with additional surgery after EPMR and 3 with surgery only. Either air-induced deformation tesring or lifting sign was negative in 10, in which 4 cases underwent surgical resection. The sensitivity, specificity, positive and negative predictive value of air-induced deformation testing and lifting sign in prediction of invasion depth of tumors were 97.2%, 44. 4%, 97.6% and 40. 0%, respectively. Conclusion Endoscopic air-induced deformation testing and lifting sign can be used to predict invasion depth of colorectal flat tumors, which can guide instant therapeutic strategies and avoid excessive or insufficient treatments.

Objective To know about the influences of KTH integrated intervention on the blood pressure and quality of life of elderly patients with essential hypertension so as to explore the effective model of health education suitable for them. Methods 120 elderly hypertensive patients recruited from the community in Hengyang city were randomly divided into the experimental group and the control group, each group had 60 patients. The experimental group accepted KTH integrated intervention weekly, and control group was accepted routine hypertension education monthly. The blood pressure was taken before, during and after intervention. Meantime the quality of life was surveyed with WHOQOL- 100 questionnaires before and after the intervention. Results The systolic pressure and diastolic pressure in the experimental group were more lower than those before intervention and those of the control group after intervention. The hypertension of the experimental group was more stable as the time passed. There were distinguished differences between two groups in the quality of life, physical, psychological, social relationships, environmental and spirituality domain. However, there was no distinguished differences between two groups in the domain of independence. Conclusions KTH integrated intervention can make elderly hypertensive patients to keep blood pressure stable and improve their quality of life.

Objective To observe the clinical efficacy of vacuum sealing drainage(VSD) in the treatment of large-area wound infection of earthquake casualty after amputation.Methods Seven patients with large-area wound infection of earthquake casualty after amputation received sustained VSD.Results After VSD for 7~26 days,with an average of 13 days,the wound infection in the 7 patients was controlled.No systemic toxicity was found.The result of wound bacterial culture was negative.Of the 7 patients,4 received phase Ⅱ suture,3 received phase Ⅱ skin graft,and all of the grafted skin survived.Conclusion Vacuum sealing drainage exerts certain effect in the treatment of large-area wound infection of earthquake casualty after amputation.

AIM: The purpose of this study was to evaluate the mechanism of high altitude pulmonary edema (HAPE) and high altitude acute response (HAAR). METHODS: Pulmonary function and partial oxygen pressure were measured in 10 patients with HAAR and 6 patients with HAPE before and after bronchoalveolar lavage (BAL),10 high altitude healthy volunteers were served as control subjects. RESULTS: The partial oxygen pressure of HAAR and HAPE significantly decreased before BAL compared with control; DLCO%, DLCO/VA%, PaO_2 of HAPE increased significantly [from 76.01%?6.29%, 150.30%?15.20%, (31.73?3.01) mmHg before BAL to 103.31%?9.23%, 176.04%?16.10%, (45.31?3.56) mmHg after BAL]. The above parameters were also changed in HAAR and controls, but had no statistical significance. CONCLUSION: High concentration of proteins and cells in BAL fluid for HAPE, gas exchange impairment and PaO_2 increase after BAL suggest accumulation of protein-rich fluid and cells in the alveolar space plays a crucial role in the development of HAPE.

Objective To observe the protective effect of spironolactone on heart of hypertensive SD rats.Methods 30 male SD rats were randomly divided into the control group,hypertensive group(HS group),low spironolactone dose group(HSL group)and high spironolactone dose group(HSH group).The animals except the control group were treated with L-NAME 50 mg/kg/d.Then the animals of the HS group were fed with 1% sodium chloride water solution.Those of the HSL and HSH groups were treated same but the former added with spironolactone 20 mg/kg/d,the later added with spironolactone 100 mg/kg/d.8 weeks late,the animals were killed and hearts were taken out to observe following items:myocardial cross-sectional area,ratio of per-arteriolar fibrous area/arteriolar luminal area of arterioles,ratio of collagen area/total myocardial area,myocardial necrosis and inflammation.Results The myocardial cross-sectional areas in the HS group were significantly more than those in other 3 groups(P<0.01).Collagen ratios of the HS group were significantly higher than others(P<0.01).The ratios of arteriolar wall area versus luminal area in the HS group were significantly higher than those of control and HSH groups(P<0.01).Myocardial injuries in the HS group were more severe than those of other 3 groups.There were no differences between HSL and HSH groups.Conclusion Spironolactone has protective effect on heart of hypertensive SD rats.