Objective To study pre-thrombosis state in patients with cor pulmonale and analyze the value of treatment with low molecular heparin (LMH). Method 46 patients with cor pulmonale were divided into LMH group and routine one. Von Willebrand factor (vWF), prethrombin F 1+2 fragment (F 1+2 ), Fibrinogen (Fg), granule membrane protein (GMP-140) and D-dimer fragment (DD) were detected separately.Result The concentrations of WF,F 1+2 ,Fg,GMP-140 and DD in the patients with cor pulmonale were significantly higher than control. In LMH group, these variables and PaCO 2 decreased and PaO 2 increased markedly after treatment. In routine group, these blood-gas index slightly improved, but no decrease were observed in coagulation variables. Conclusion Early detection and diagnosis of pre-thrombosis state in patients with cor polmanate and timely treatment with LMH can be beneficial to these patients during acute state.

Objective To probe the periodontal ligament regeneration following the implantation of bone marrow mesenchymal cells ( BMSCs ) sheet-collagen membrane-BMSCs sheet sandwich complex.Methods BMSCs cell sheet-collagen membrane-BMSCs sheet complexes were compounded on the root surface of teeth of Beagle dogs.All the dogs were killed on 4 and 12 weeks after implantation.Periodontal ligament regeneration was observed by radiological means, HE staining and Sirus-red staining.Results Compared with collagen membrane group and blank control group, there was a clearly periodontal ligament like tissue and Sharpey′s like fibres formation in test group only.Conclustion Cell sheet-collagen membrane-cell sheet sandwich complex can effectively improve the periodontal ligament regeneration.

Objective To construct a recombinant lentivirus containing human beta defensins -3 ( hBD3 ) , connective tissue growth factor gene (CTGF) and enhanced green fluorescent protein (EGFP), and to detect its translation in rabbit bone marrow mesenchymal stem cells (BMSC).Methods The lentivirus containing hBD3, CTGF and EGFP genes was constructed in vitro.The titer of lentivirus was tested with end-paint dilution assay .Rabbit BMSCs were transfected with recombinant virus.The best value of multiplicity of infection (MOI) was tested.The expression condition, transfection efficacy and genetic stability of the target genes were evaluated by using fluorescence microscopy and flow cytometry . Western blotting was used to detect the expression of the target protein .Results Recombinant lentivirus vectors: Lenti-CTGF-hBD3-EGFP, Lenti-hBD3-EGFP, and Lenti-EGFP, were successfully obtained . The titer of the recombinant lentiviruses was 3.21 ×108, 5.80 ×108, and 1.16 ×109, respectively.The best MOI value to transfect BMSCs was 150. The transfection efficacy of these lentivirus vectors was high , reaching 79.72%as assessed by flow cytometry , and it could be stably inherited .Western blotting displayed that target protein expression was successful .Conclusion The construction of recombinant lentiviruses carrying hBD3 and CTGF genes is successful and can be effectively transfected into BMSCs .

Objective To explore the relationship of depth of trophoblastic invasion with trophoblast cell activity and serum β-hCG according to the expression of proliferation antigen Ki-67 which viewed as an indicator of cell proliferation activity.Methods Fallopian tube specimens collected from 108 patients who underwent operation treatment for fallopian tubal pregnancy in our hospital were investigated by light microscopic examination.They were divided into three groups according to the depth of trophoblastic infiltration: Ⅰ group (stage): trophoblastic invasion of tubal mucosa,Ⅱ group(stage): trophoblastic invasion of the muscularis,Ⅲ group(stage): trophoblast invasion of serosa layer(muscularis penetration).The expression of Ki-67 was detected by SP method and blood β-hCG was detected within 2 hours of preoperative.The level of β-hCG,the expression of Ki-67 and the depth of trophoblast invasion were analyzed.Results Mean level of serumβ-hCG in Group Ⅰ,Ⅱ and Ⅲ were(1416.64 ± 859.94)U/L,(3380.33 ± 2392.36)U/L and(6999.33 ± 4949.90)U/L respectively.Positive expression rate of cell proliferation antigen Ki-67 in Group Ⅰ,Ⅱ and Ⅲ were 21.95％,53.66％ and 6.40％ respectively.There were significant difference on the expression of Ki-67 between group Ⅰ and group Ⅱ,group Ⅱ and Ⅲ group,group Ⅰ and group Ⅲ(x2 =3.94,4.07,4.35,respectively,P ＜ 0.05).The serumβ-hCG level also displayed statistics difference in the three groups(F =9.914,P ＜ 0.01).The positive expression of Ki-67 and serum β-hCG level were positively correlated with each other(r =0.678,P ＜ 0.05)Conclusion The high level of the serum β-hCG indicates high expression of Ki-67 and deeper trophoblast invasion of tubal wall.

Objective:To explore the mechanism of factors affecting the long-term care needs of disabled elderly in elderly care institutions, and provide basis for taking targeted nursing intervention.Methods:From July to November 2018, convenience sampling method was used to conduct cross-sectional survey of the current situation and influencing factors of long-term care needs of 508 disabled elderly people in 10 elderly care institutions in Baoding City by general information questionnaire, Barthel index, the Long-term Care Needs of the Disabled Elderly in elderly care institutions, the Questionnaire on the Factors Affecting the Long-term Care Needs of the Disabled Elderly in elderly care institutions. SPSS 21.0 was used for correlation analysis and multiple regression analysis, and AMOS 24.0 was used for model fitting, path and mediation effect analysis.Results:The score of long-term care needs of the disabled elderly in elderly care institution was (105.04 ± 21.68) points; the scores of intra-personal, interpersonal, and extra-personal factors were (16.93 ± 5.20) points, (10.51 ± 3.39) points, (19.80 ± 6.24) points, respectively. Intra-individual factors, interpersonal factors, extra-individual factors and care needs were all positively correlated ( r values were 0.222-0.645, P<0.05). Intra-individual, inter-personal and extra-individual factors could directly affect the long-term care needs of the disabled elderly ( β=0.455, 0.527, 0.403); intra-individual and inter-personal factors had independent mediating effects and chain mediating effects between extra-individual factors and the long-term care needs of the disabled elderly, and the effects were significant, with effect value of 0.078, 0.095 and 0.023, accounting for 15.15%, 18.45% and 4.47% of the total effect, respectively. Conclusions:Each influencing factor has a strong ability to predict and explain the long-term care needs of the disabled elderly, and nursing staff could meet the care needs of the disabled elderly according to different influencing factors.

Objective To analyze the association between β2-AK 27 locus genetic polymorphisms and asthma, and the protective effect in airway hyperreactivity. Methods The allel polymerase chain reaction were used to determine β2-AR 27 locus genetic polymorphisms in 149 patients with cough variant asthma who have the airway hyperreactivity. To observe these people for two years in order to know the proportion of changed to typical asthma. And compare with 90 people in healthy group. Results (1) The distribution frequency of β2-AR 27 locus genetic polymorphisms is major in heterozygote (57 % ) , and the Glu/Glu homozygote has the least ( 20% ) , (2) There was a significant decrease in the frequency of Glu/Glu genotype in asthmatics compared with healthy group(9% VS 20% ) ,OR = 0.4(P<0.05) ,95% CI (0.2 ～0. 9) ,but there was no significant difference in the allele frequency of asthmatics compared with healthy group,(3)The frequency of Glu/Glu genotype in severe asthma was lower than stable asthma group(P<0. 05). Conclusion These results suggesteded that β2-AR 27 locus genetic polymorphisms is correlated with asthma,and the Glu27 could have the protective effect to the airway.

Objective:To investigate the nursing effect of irritant dermatitis around drains after debridement of infected pancreatic necrotic tissue.Methods:A total of 108 patients with post-infectious pancreatic necrosis tissue debridement drains were divided into the experimental group and the control group with 54 patients in each group according to the time of hospital admission. The control group was given routine care and the experimental group was given stepped skin care, including education and training, assessment, skin preparation, and skin protectants and the use of disposable urinary ostomy bags, and the effect was evaluated.Results:The incidence of irritant dermatitis was 20.4% (22/54) in the test group and 40.7% (11/54) in the control group, with a statistically significant difference between the 2 groups ( χ2 value was 5.280, P < 0.05); 4 cases (36.36%) were cured in the experimental group, 5 cases (45.45%) in class I, 2 cases (18.18%) in class Ⅱ, 0 cases in class Ⅲ, and 0,13 cases (59.09%), 8 cases (36.36%), 1 case (4.54%) in the control group, respectively. The difference between the two groups was statistically significant ( χ2 value was 8.353, P < 0.05); In the experimental group, the duration of dermatitis incidence and total nursing time during hospitalization were (18.00 ± 2.25)d and (12.69±1.96)h, respectively, compared with (12.13±5.84)d and (15.79±2.09)h in the control group, which were statistically significant between the two groups ( t value was 29.167, -2.791, all P<0.05); the total cost of care in the experimental group was (570.38 ± 88.01)yuan and (448.79±59.44)yuan in the control group, the difference between the two groups was not statistically significant ( t value was -0.372, P>0.05). Conclusion:The stepped skin care protocol can reduce the incidence of infected pancreatic necrosis after tissue debridement and improve caregivers′ work efficiency.

Hemostatic materials are essential for the treatment of trauma patients with massive blood loss in battlefields and disaster environments. According to the site and severity of trauma, different types of hemostatic materials need to be used to stop bleeding urgently. At present, first-aid hemostatic materials for bleeding on body surface wounds, extremities and junctions have been well applied. However, in the case of deep bleeding wounds in the thoracic and abdominal cavity and internal organs and even non-compressible hemostasis, there are still no ideal hemostatic materials in early emergency treatment. In this review, the authors elaborate the classification and mechanism of hemostatic materials and their application in trauma first aid, so as to provide references for the use of hemostatic materials in first aid.

Objective To investigate the current status of acute stress disorder in ICU survivors after transferring and analyze the influencing factors. Methods A total of 73 ICU survivors who underwent ICU therapy for more than 48 hours and were transferred from ICU during hospitalization from May 2016 to August 2016 in the department of general surgery and the department of vascular surgery in our hospital were analyzed for ASD. And the influencing factors of ASD were analyzed. Results The positive rate of acute stress disorder (ASD)was 39. 7％ in surgical ICU patients within 1 week after transferred out of the ICU. Logistic regression revealed that the high age and low Barthel index were risk factors of ASD after surgical ICU patients were transferred from the ICU. Conclusion The incidence of ASD in surgical ICU survivors is as high as 39. 7％, which is related to the age and the level of daily living ability of the patients when transferred out of ICU.

Objective To compare the anesthetic effects,safety and side effects of the mixture with different ratios of etomidate to propofol in painless gastroscopy.Methods Two hundred patients scheduled for painless gastroscopy,95 males and 105 females,aged 18 to 65 years,BMI 18.5-27.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomized into two groups,group A (the ratio of eto-midate and propofol volume 1:1);group B (the ratio of etomidate and propofol volume 1:2).All of the patients were injected with sufentanil 0.1 μg/kg at first.All patients were given the first dose of 0.15-0.2 ml/kg intravenously slowly.Repeated doses of 1-2 ml etomidate-propofol were administered to maintain an adequate level of sedation.HR,SBP,DBP and SpO2were monitored.The dosages of etomidate and propofol were recorded.At the same time the induction time,the operation time,the recovery time and the leaving time were recorded.And low blood pressure,hypoxia saturation,re-spiratory obstruction,muscle fibrillation,nausea and vomiting and other adverse reactions were re-corded.Results There was no significant difference between group A and group B in the induction time,the operation time,the recovery time,the leaving time,perioperative hypotension,periopera-tive hypoxia and injection pain.The dosage of etomidate in the group A was significantly more than in the group B (P<0.01).The dosage of propofol in the group A was significantly less than in the group B(P<0.05).The incidence of myoclonus in group A was notably higher than that in the group B (P<0.01),The incidence of nausea and vomiting in group A was higher than that in the group B (P<0.05).Conclusion Etomidate plus propofol (1:2)had less incidence of myoclonus and nausea and vomiting,and it is more suitable for gastroscopy than 1:1 EP mixture.