Objective:To investigate the correlation between heart rate recovery at 1 min after exercise (HRR 1) and long-term prognosis in patients with acute myocardial infarction treated by percutaneous coronary intervention (PCI). Methods:The clinical data of 117 acute myocardial infarction patients who successfully underwent PCI in Qingdao Starr Heart Hospital from May 2014 to May 2017 were retrospectively analyzed. The patients were performed cardiopulmonary exercising test within 30 d after PCI, the peak heart rate (HR peak), resting heart rate, peak oxygen uptake (VO 2peak) were detected, and the HRR 1, heart rate reserve and oxygen pulse were calculated. The correlation between HRR 1 and cardiopulmonary exercise related indexes was analyzed. The incidence of major adverse cardiovascular events (MACE) was recorded 3 years after PCI. The risk factors affecting the prognosis in patients with acute myocardial infarction were analyzed by Cox regression. Results:Among 117 patients, HRR 1 didn′t decrease in 74 cases (non-reduced group), and HRR 1 decreased in 43 cases (reduced group). The proportion of Killip heart function grade Ⅱ to Ⅲ, proportion of triple coronary artery lesions, Gensini score, resting heart rate and oxygen pulse in reduced group were significantly higher than those in non-reduced group: 90.7% (39/43) vs. 70.3% (52/74), 53.5% (23/43) vs. 17.6% (13/74), (81.46 ± 21.55) scores vs. (58.06 ± 17.52) scores, (81.48 ± 11.17) times/min vs. (69.06 ± 10.10) times/min and (13.13 ± 2.93) times/min vs. (9.19 ± 3.06) times/min, the VO 2peak, HR peak, HRR 1 and heart rate reserve were significantly lower than those in non-reduced group: (20.19 ± 9.39) ml/(kg·min) vs. (26.38 ± 9.40) ml/(kg·min), (124.98 ± 22.79) times/min vs. (149.47 ± 22.88) times/min, (16.63 ± 5.92) times/min vs. (27.24 ± 10.21) times/min and (55.51 ± 10.29) times/min vs. (69.07 ± 12.27) times/min, and there were statistical differences ( P<0.01). Correlation analysis results showed that HRR 1 was positively correlated with heart rate reserve, HR peak, VO 2peak ( r = 0.793, 0.835 and 0.800; P<0.01), and negatively correlated with resting heart rate ( r = -0.748, P<0.01); but there was no correlation between HRR 1 and oxygen pulse ( P>0.05). Twenty-one patients did not complete 3 years′ follow-up, with 8 cases in reduced group and 13 cases in non-reduced group. The incidence of MACE in reduced group was significantly higher than that in non-reduced group: 62.9% (22/35) vs. 13.1% (8/61), and there was statistical difference ( χ2 = 12.546, P<0.01). Multivariate Cox regression analysis result showed that the number of coronary artery lesions and HRR 1 were independent risk factors affecting the prognosis in patients with acute myocardial infarction ( HR = 3.124 and 0.248, 95% CI 1.044 to 9.342 and 0.080 to 0.771, P<0.05). Conclusions:The reduction of HRR 1 is related to the exercise cardiopulmonary index in patients with acute myocardial infarction, which can be used as one of the important predictors of long-term prognosis of patients.

Objective To study the effect of using Dexamethasone in different time for treatment and prevention of bronchopulmonary dysplasia (BPD), in order to provide the clinical reference as to whether dexamethasone can be used to prevent and treat BPD.Methods A total of 135 very low birth weight infants hospitalized for 1 week who still survived on mechanical ventilation were studied.The total cases were divided into early Dexamethasone group and none Dexamethasone group.Whether early using dexamethasone could prevent BPD or not were observed.The BPD infants were divided into 3 groups, early Dexamethasone group, later Dexamethasone group and none Dexamethasone group.The effect of using Dexamethasone on BPD in different time were observed.Results (1) Among these 135 infants,there were 65 infants developing BPD.The incidence of BPD was 48.15％.There were no significant differences in the prevalence of BPD, the death rate and the disease index of BPD between the early Dexamethasone group and the none Dexamethasone group (all P ＞ 0.05).(2) There were no significant differences in mechanical ventilation time among the 3 BPD groups [(19.81 ± 5.67) d vs (22.32 ± 6.20) d, (21.46 ± 7.02) d, P =0.405].But the average time of inhaling oxygen and hospital stays of later Dexamethasone BPD group were shorter than early Dexamethasone BPD group and none Dexamethasone BPD group.The differences were significant [(37.27 ± 10.14) d vs (45.96 ± 9.91) d,(43.42 ±8.73) d,P=0.012;(64.11 ±8.14) d vs (76.13 ±7.57) d,(68.59 ±8.53) d,P =0.000].(3) The incidence of infection (90.90％, 100.00％ vs 81.90％), hyperglycemia (27.27 ％, 30.43 ％ vs 10.00 ％), hypertension(9.09％ ,13.04％ vs 0) and neonatal necrotizing enterocolitis(22.73％ ,34.78％ vs 15.00％) of all the infants who received Dexamethasone were higher than the infants who did not receive Dexamethasone.But the differences showed no significance(all P ＞ 0.05).(4) There were no significant differences among the 3 BPD groups in growth [weight : (9.16 ± 1.53) kg vs (8.92 ± 1.13) kg, (9.07 ± 1.46) kg;height: (71.26 ± 8.59) cm vs (69.54 ± 9.32) cm, (70.32 ± 9.07) cm] or been in hospital again because of pulmonary infection during one year(75.00％ vs 65.00％ ,72.22％) (all P ＞ 0.05).The differences of abnormal Chinese children development scale scores among the BPD groups (mental development index ＜ 80:20.00％ vs 15.00％, 16.67 ％;physical development index ＜ 80:25.00％ vs 20.00％, 16.67％) showed no significance(all P ＞ 0.05).Conclusions Early use of Dexamethasone has no effect to prevent BPD.Dexamethasone therapy on BPD should be used in the later stages ,and small doses and short protocol are preferred.

With the increasing trade of traditional Chinese medicine(TCM),the issue of excessive levels of toxic heavy metals metals in TCM has raised worldwide concerns. Some countries and re?gions have set strict limits on the heavy in TCM. There are currently no uniform limits on heavy metals, partly for lack of a good understanding of heavy metals in TCM. The toxicity of heavy metals varies with their chemical forms so that it is not rational to evaluate safety in terms of total contents. Cinnabar and realgar are widely used TCM containing heavy metals in clinical practice. Because of the potential toxicity of heavy metals such as mercury or arsenic,and the related adverse reactions reported occa?sionally,the safety of cinnabar,realgar and their preparations has also attracted public attention. In the present paper,the progress in toxicological studies on cinnabar,realgar as well as commonly used preparations was reviewed while priorities of future research were proposed.

Objective To explore the clinical efficacy of Toutongning capsule combined with nimodipine in the treatment of 76 patients with primary vascular headache.Methods 76 patients with primary vascular headache were selected as the research subjects.According to the different surgery,the patients were randomly divided into control group (n =38) and observation group (n =38).The control group was given compound Danshen injection,while the observation group was given Toutongning capsule combined with nimodipine.The efficacy,the peak systolic velocity(Vs) and pulsatility index(PI) of each vessel,the time of stopping pain,recurrence rate and adverse reaction were compared between the two groups.Results The total effective rate of the observation group was 94.74％,which was higher than 84.21％ of the control group,the difference was statistically significant (x2 =4.785,P ＜ 0.05).The MCA,ACA,BA,VA value of Vs and PI,the time of stopping pain and recurrence rate in the observation group were better than those in the control group (t =5.385,6.834,7.407,6.651,4.032,5.716,6.203,5.016,4.785,x2 =5.473,all P ＜ 0.05).There were no significant differences between the two groups in PCA value of Vs and PI and adverse reaction(t =0.283,0.037,x2 =0.314,all P ＜ 0.05).Conclusion Toutongning capsule combined with nimodipine in the treatment of primary vascular headache has high application value and significant effect,and it can promote cerebral circulation,blood flow,time of stopping pain and recurrence rate,so it is worthy of clinical popularization and application.

ObjectiveTo study the diagnosis of thyroid cancer concurrent with multiple thyroid nodules.Methods The clinical data of 23 patients of multiple thyroid nodules with thyroid cancer undergoing exploration from May 1988 to December 2000 were analyzed retrospectively.ResultsThe diagnosis of concurrent carcinoma was made preoperatively in 6 cases. 13 out of the 23 patients underwent second operation for the postoperative pathology being malignant. Thyroid cancer was identified concurrent with benign nodules in 20 cases. Conclusion Thyroid cancer when found on the background of multiple thyroid nodules is often coexistant with benign thyroid disease, hence the diagnosis is difficult to make clinically. Second operation is sometimes inevitable when the pathology identified a cancer in preoperatively diagnosed benign nodules.

With the establishment and perfection of the system of the socialist market economy, ideological work in hospitals is confronted with quite a few new challenges: ①influence of the complicated circumstances both at home and abroad; ②discord between the managerial mechanisms of ideological and political work and the development of the system of the market economy; ③means and methods of ideological work lagging behind the times. Thus, the authors, in light of their own experience in this aspect, put forward the "three threes" mode, viz. three buildings, three close combinations and three innovations, referring respectively to buildings of ideology, organization and the style of work for the leading group, the contingent of party members and cadres, and the team of cadres engaged in political work; close combinations with the basic requirements of the developmental goals of hospital reform, the difficulties and problems confronted by cadres and the masses in their practical work, and dynamic ideological trends; and innovations in the mechanisms, contents and methods and means of ideological and political work. The authors also point out that attention ought to be paid to the demonstrative, concrete, mass, complicated and advanced nature of ideological work.

After the necessity of research on bio-entities was pointed out, the advances and status quo in research on the relation between bio-entities were analyzed with concrete ideas and project put forward for the research on bio-entities using scientometric methods according to thecitationrelation in bio-entities similar to that in litera-ture.This kind of research will promote and perfect the research on scientometric theory and practice, and open a new visual angle for the research on knowledge management .

Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

Objective:To observe the effect of nape acupuncture on vertebral-artery type cervical spondylosis.Methods:Eighty patients with vertebral-artery type cervical spondylosis were randomly divided into nape acupuncture group and Jiaji acupuncture group,with 40 cases in each group.The patients in the nape acupuncture group were treated with the nape acupuncture plus Jiaji acupuncture,while the patients in the Jiaji group were treated with Jiaji acupuncture only,to observe the functional scale before and after treatment.Results:The total effective rate in the nape acupuncture group was 95.0%,while the total effective rate in the Jiaji acupuncture group was 82.5%.By Ridit analysis,u=5.186,P＜0.01.It indicated that the therapeutic effect in the nape acupuncture group was better than that in the Jiaji acupuncture group.Compared with Jiaji acupuncture group,the difference value of pre- and post-treatment about functional scale of vertebral-artery type cervical spondylosis and the post-treatment score have statistic differences (P＜0.01).It indicated that the therapeutic effect of nape acupuncture group was more obvious in treating vertigo than that in the Jiaji acupuncture group.Conclusion:The treatment of vertebral-artery type cervical spondylosis by Jiaji acupuncture plus the nape acupuncture may enhance the therapeutic effect significantly.

Objective To investigate the role of induced sputum in monitoring airway inflammation of chronic obstructive pulmonary disease (COPD). Methods Induced sputum was taken from 26 patients with stable COPD. IL-8 level in the sputum was detected, and the lung function of the patients was determined. 15 healthy volunteers served as control group. Results The total cell count and the number of AM and PMN in sputum were significantly higher in the patients than those in the control group (P