Objective To explore the status quo of knowledge,belief,and practice of anticoagulationrelated self-management in rehabilitation period for patients with haeat valves replacement.Methods Van Manen's hermeneutic phenomenology was used as qualitative research method.Twenty patients who had undergone heart valves replacement operation were selected and interviewed.The results of interview were analyzed with category analysis.Results After repeated self-examination,comparison,and summery,four themes were refined,including patients lack anticoagulation-related knowledge and skills in rehabilitation period,the levels of patients' attitudes and beliefs varied greatly,patients' compliance of self-management behavior and taking medicine was low,there were limited channels to get anticoagulation-related information in rehabilitation period.Conclusions More attention should be paid to patients for anticoagulation management after valve replacement operation,especially to those of low literacy,older age,and rural area.Nurses should implement the specific health education about anticoagulation management to patients during discharge guide and following-up period to minimize complications,promote the survival rate,and improve their quality of life.

Objective To investigate the therapeutic effect and safety of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome. Methods A prospective randomized controlled trial was carried out.Seventy-two cases of primary nephrotic syndrome were equally divided into treatment group and control group. Two groups of patients were both treated with glucocorticoids , and combined with compoundα-keto acid tablets in the treatment group. The level of BUN ,Scr,CRP,IL-6,PA、Alb,TG,TC,Ca in blood and eGFR、MTP were detected before treatment and the 2nd,4th,6th,8th month after treatment to evaluate the efficacy and safety respectively. Results After 8 months of treatment, the total effective rate in treatment group was significantly higher than that in the control group (P < 0.05); Compared with before treatment, the Alb level was significantly increased in both groups, the level of MTP,TC,TG,PA,CRP,IL-6 were significantly declined in both groups (P < 0.05),while no significant difference was found in the level of BUN,Scr,eGFR,serum calcium in both groups(P > 0.05); the level of MTP,TC,TG,CRP、IL-6 in the treatment group were significantly lower and the Alb level in the treatment group was significantly higher (P < 0.05)compared with the control group, while no significant difference was found in the level of PA、BUN、Scr、eGFR、serum calcium (P > 0.05) between two groups;All of patients with no serious adverse reactions occurred during the investigation. Conclusion The curative effect of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome is sure and without significant sideeffect.

OBJECTIVE:To explore the material features and biocompatibility of coronary artery stent and related complications following implantation.METHODS:The databases of CNKI and Medline were searched by the first author using key words of "coronary artery stent,material,biocompatibility and complications" both in English and Chinese.Meta analysis or repetitive studies were excluded,and 16 papers were included in this analysis.RESULTS:Stent materials play an important role in reducing inflammatory reaction and restenosis following stent implantation.As a medical material for humans,the features of stent should be meet the requirements of reliable distensibility,mechanical persistence,good flexibilit and geometrical stability,possible small diameter,excellent blood compatibility,as well as good corrosion resistance.All of these depended on the mechanical and physical features of materials.CONCLUSION:The study of drug-coating stent and drug-eluting stent reduced the restenosis rates following implantation,and the biodegradable stent also attracted more attention.When treating coronary heart disease with cardiovascular stent,the complications should be avoided except consideration of the successful rate of reperfusion.

Objective:To explore influence of critical care unit (CCU)clinical nursing pathway (CCU-CNP)in de-partment of cardiology on quality of life in patients undergoing coronary artery bypass grafting (CABG).Methods:A total of 128 patients undergoing CABG,who hospitalized in our CCU from Jun 2012 to Jun 2014,were selected. According to random number table,patients were equally divided into CCU-CNP group and routine nursing group. Changes of quality of life and disease knowledge level were compared and analyzed between two groups before and after intervention.Results:Compared with routine nursing group,after intervention,there were significant rise in scores of anginal stability [(60.12±4.36)scores vs.(77.36±5.46)scores],physical limitation [(68.02±3.98) scores vs.(86.98±4.58)scores],anginal frequency [(60.28±5.12)scores vs.(78.47±3.45)scores],disease per-ception [(61.89±4.36)scores vs.(82.58±5.89)scores]and treatment satisfaction [(63.38±5.23)scores vs. (83.92±6.21)scores],P <0.05 or <0.01;and significant reductions in CCU time [(6.98±1.32)d vs.(3.32± 1.22)d],mean hospitalization time [(12.87±2.66)d vs.(6.36±2.45)d]and incidence rate of adverse cardiac events (14.06% vs.3.13%)in CCU-CNP group,P <0.05 or <0.01. Conclusion:CCU clinical nursing pathway can effectively raise disease knowledge and quality of life,reduce the incidence of adverse cardiac events,shorten CCU time and improve patient′s prognosis in CABG patients.

Cadmium targets on kidney and bone and results in many toxic effects. Disturbance of calcium metabolism is one of the important aspects of cadmium toxicity, which includes reduced intestinal calcium absorption, increased urinary calcium excretion, negative calcium balance, development of osteomalacia and osteoporosis. There exists two potential mechanism of influence of cadmium on calcium metabolism. One is the direct inhibition of cadmium on active transports of calcium. The other is the indirect influence on calcium metabolism due to reduced renal synthesis of 1,25-dihydroxycholesterol induced by cadmium. Further research should focus on revealing how cadmium directly inhibits calcium entering into cells and transporting by calcium binding protein, elucidating whether renal synthesis of 1,25-dihydroxycholesterol is reduced in low-level cadmium exposure population, and also on clarifying the molecular biological mechanism of effects of cadmium on calcium metabolism.

A mid-aged male patient manifested hyperglycemia, severe hypokalemia, weight loss, thin skin, round face and psychoneurotic symptoms without hypertension. CT showed a pancreatic tumor and a normal pituitary image. Preliminary assessment (blood and urinary cortisol, blood ACTH and dexamethasone suppression test) supported the diagnosis of ectopic ACTH syndrome. The differential diagnosis and treatment of this disease were discussed.

BACKGROUND:Currently, little is reported regarding the effectiveness of mineralized gelatin electrostatic spinning fibers on periodontal tissue osteogenic induction. OBJECTIVE: To investigate the effect of mineralized gelatin electrostatic spinning on the proliferation and osteogenic differentiation of periodontal ligament fibroblasts. METHODS: Human periodontal ligament fibroblasts were respectively compositely cultured with non-mineralized gelatin electrostatic spinning, gelatin electrostatic spinning after 1 day of nano-hydroxyapatite mineralization and gelatin electrostatic spinning after 5 days of nano-hydroxyapatite mineralization. Cel proliferation was determined at 1, 4, 7, 10 and 13 days of culture using MTT assay. Alkaline phosphatase activity of cels was determined at 1, 7, 14 days of culture using biochemical analyzer. RESULTS AND CONCLUSION:At the 10th day of culture, the periodontal ligament cels on the surface of membrane distributed uniformly, grew wel, spread out as sheets and secreted a large amount of extracelular matrix, linked closely with the materialsl; moreover, the effect was more obvious at 5 days of mineralization. Cel growth density and status were better than those in the non-mineralized gelatin electrostatic spinning membrane group. Cel proliferation and alkaline phosphatase activities at different time points: 5-day mineralized gelatin electrostatic spinning membrane group > 1-day mineralized gelatin electrostatic spinning membrane group > non-mineralized gelatin electrostatic spinning fibers group (alP < 0.05). These results demonstrate that the gelatin electrostatic spinning after nano-hydroxyapatite mineralization may promote the proliferation and osteogenic differentiation of periodontal ligament fibroblasts in a time-dependent manner.

Objective To discuss the efficacy and safety analysis of different doses of low molecular weight heparin combined with hormone in the treatment of refractory nephrotic syndrome.Methods 60 cases of patients with refractory nephrotic syndrome in our hospital from January 2014 to January 2016 were selected,According to the random number table,60 patients were divided into high,medium and low dose of low molecular weight heparin group and control group,control group were treated with hormonal therapy,the high,medium and low dose of low molecular weight heparin group were injected low-molecular-weight heparin calcium on the basis of the control group,twice daily,once daily and every other day,respectively.Results After treatment,the clinical total effective rate of the high,medium and low dose group and control group patients was 14(93.3%),12(80.0%),10(66.7%) and 9(60.0%)respectively,the total efficiency of the high dose group was significantly higher than that of the control group(P<0.05),while there was no significant difference among control,medium and low dose group.The 24 h urine protein quantitation,ALB and Cr in high dose group improved better than those in medium and low dose group(P<0.05).The TG,TC and LDL in high dose group improved better than those in control group(P<0.05). The prothrombin time(PT)and activated partial thromboplastin time(APTT)in high and medium dose group were longer than those in control group(P<0.05),while fibrinogen(FIB)was lower(P<0.05).The PT in low dose group was longer than control group(P<0.05),while there was no significant difference in other coagulation indicators compared with control group.The APTT in high dose group was longer than low dose group(P<0.05).There was no obvious adverse reactions among each dose group.Conclusion The clinical curative effect in different doses of low molecular weight heparin combined with hormone in the treatment of refractory nephrotic syndrome is better,which could be significantly improved in patients with hypercoagulable state,especially effect of high dose group is more obvious.

Objective To utilize the PBL method for the teaching reform of pedodontics lesson in Zhengzhou University. Methods Dental students of 2004 grade of Zhengzhou University were divided into 2 groups randomly,one group of which were taught with PBL method while the other group with traditional teaching method. The teaching effect was measured with questionnaire survey and examination. Result The PBL method was welcomed by undergraduate students and there was statistical significant difference between the examination scores of the two groups (P