Objective To evaluate the efficacy and side-effects of 595 nm pulsed dye laser (PDL) in the treatment of cutaneous vascular diseases.Methods We analyzed 572 cases of cutaneous vascular diseases treated with 595 nm PDL retrospectively and compared the efficiency among different type of diseases.Results There were totally 243 cases of infantile hemangioma,186 cases of port wine stain,69 cases of telangiectasis,42 cases of spider angioma and 32 cases of rhinophyma.The efficiency was 93.8％,54.3％,95.7％,100％ and 56.3％,respectively,with 2.27％ of side-effect rate.The efficacy was correlated to age,type and location of the diseases.Conclusions 595 nm PDL is a safe option for cutaneous vascular diseases with high efficacy and low side-effect rate.

Objective To study the effect of paeonol (PAE) and panax notoginseny saponins (PNS) on the expressions of collagenⅠandⅢprotein and mRNA in rats with acute myocardial infarction (AMI), and to explore the molecular mecha?nism of improving myocardial fibrosis. Methods The rat model of AMI was made using the left anterior descending coro?nary branch ligation.According to the intervention rats were divided into model group, PAE (8 mg/kg) group, PNS (40 mg/kg) group, PAE (4 mg/kg)+PNS (20 mg/kg) group, PAE (8 mg/kg)+PNS (40 mg/kg) group and captopril positive control group (10 mg/kg). Sham operation group, only wear line without ligation. The left ventricular mass index (LVMI) was detected after treatment for 28 d. Masson staining was used to observe changes of myocardial fibrosis. Western blot assay and RT-PCR technique were used to detect protein and mRNA expression levels of collagenⅠandⅢ. Results The values of LVMI were increased in model group compared with those of sham operation group and treatment groups. Compared with PAE group and PNS group, values of LVMI were significantly decreased in PAE (4 mg/kg)+PNS (20 mg/kg) group and PAE (8 mg/kg)+PNS (40 mg/kg) group. There was a more significant decrease in formula high dose group (P < 0.01). The model group showed pathological change. There were different degrees of improvement in pathological structure in all treatment groups, more sig?nificant improvement was found in formula low dose group, formula high dose group and captopril positive control group. There were different degrees of increase in expressions of collagenⅠandⅢprotein and mRNA in model group compared with those of sham operation group and treatment groups. Compared with PAE group and PNS group, the protein and mRNA expression levels of collagenⅠandⅢwere significantly decreased in formula low dose group and formula high dose group,more significant decreased was found in formula high dose group (P<0.05). Conclusion Compound of paeonol and PNS can improve myocardial fibrosis in myocardial infarction rats, which may be related with reduced expressions of collagenⅠandⅢprotein and mRNA.

Objective:To study the scavenging activity of macroporous resin isolate of gynostemma pentaphyllum on free radical DPPH. Methods:The extract of gynostemma pentaphyllum via water boiling and precipitation with ethanol was separated by macro-porous resin respectively eluted by water, 40% ethanol and 80% ethanol to obtain the corresponding isolates. The antioxidant activity of the three isolates was determined by free radical DPPH systematic method, and the results were compared with that of gallic acid and ascorbic acid. Results: The 50% inhibitory concentration on free radical DPPH of the three isolates was 0. 081 2, 0. 028 7 and 0. 541 0 g·L-1 ,respectively. The 40% ethanol isolate had the highest saponins concentration. Conclusion:The macroporous resin i-solate with different solvent all shows antioxidant activity and the 40% ethanol isolate has the strongest effect, suggesting saponins may be the active substances for the lipid-lowering, hypoglycemic and free radical scavenging activities.

Objective To design a portable respirator that can facilitate both cardiopulmonary resuscitation and auxiliary oxygen inhalation.Methods Positive pressure design as well as pneumatically powered and controlled design were adopted for this respirator.Theoretical calculation of key components was carried out.The virtual prototype was established and the structure checked using the three dimensional design software Solidedge.Finally,the prototype was processed,assembled and tested.Results Experimental tests proved that the designed respirator was capable of cardiopulmonary resuscitation and auxiliary oxygen inhalation when oxygen supply pressure reached 3 -5.5 bar.It could achieve the expected technical indicators,such as the oxygen flow rate that was between 10 and 12 L/min.Conclusion The portable oxygen supply respirator has the advantages of a small size,light weight,simple operation,and automatic power supply.It has broad prospects of application.

Objective To systematically evaluate risk factors for healthcare-associated infection(HAI)with multi-drug-resistant Acinetobacterbaumannii (MDRAB),so as to provide scientific basis for formulating MDRAB pre-vention and intervention strategies. Methods Literatures at home and abroad were searched,RevMan 5.3 statisti-cal software was used for meta analysis of the included literature data. Results A total of 21 papers were included, 8 in English and 13 in Chinese,35 risk factors were analyzed,20 of which were significantly different(all P<0.05),which included in 4 categories:① Related factors for antimicrobial use:use of antimicrobial agents prior to isolation of MDRAB(OR,12.87 [95% CI,5.14-32.21]),duration of antimicrobial use(MD,6.99 [95% CI, 2.21-11.78]),types of used antimicrobial agents (MD,1.07 [95% CI,0.60-1.54]),combined use of antimi-crobial agents(OR,4.16 [95% CI,2.63-6.57]),carbapenems use(OR,3.95 [95% CI,2.54-6.13]),use of third and above generation cephalosporins(OR,2.48 [95% CI,1.90-3.24]);② Related factors for invasive pro-cedures:mechanical ventilation(OR,4.30 [95% CI,3.03- 6.10]),endotracheal intubation/tracheotomy(OR, 4.17 [95% CI,2.41-7.22]),urinary catheterization(OR,2.35 [95% CI,1.42-3.88]),deep venous puncture (OR,2.18 [95% CI,1.14-4.16]),drainage catheterization(OR,2.06 [95% CI,1.19-3.58]);③Related fac-tors for intensive care unit (ICU):ICU admission(OR,5.60 [95% CI,2.73-11.48]),length of ICU stay(MD, 4.21 [95% CI,0.72-7.71]);④ Other factors:heart disease(OR,0.71 [95% CI,0.55-0.93]),tumor(OR, 0.67 [95% CI,0.48-0.95]),pancreatitis(OR,2.04 [95% CI,1.11-3.76]),mixed infection(OR,2.57 [95%CI,1.78-3.71]),length of hospital stay(MD,5.92 [95% CI,3.61-8.23]),APACHE II score(MD,4.56 [95% CI,1.94-7.18]),use of glucocorticoid(OR,2.18 [95% CI,1.21-3.90]). Conclusion Antimicrobial use,invasive operation,ICU-related factors are the main risk factors for MDRAB HAI,the relevant treatment and nursing intervention strategies should be formulated based on risk factors to prevent and reduce MDRAB infection.

Objective: To explore the value of preventive nursing in the treatment of neonatal respiratory distress syndrome (NRDS) mechanical ventilation in premature infants. Methods: A total of 45 NRDS preterm infants who received treatment during the preventive care program from February 1, 2018 to November 1, 2018 were selected as group A, 45 cases of NRDS preterm infants who received treatment during the preventive care program from January 1, 2017 to January 10, 2018 were included in group B for retrospective study. Baseline data, mechanical ventilation index, complications, and family satisfaction of the children were observed. Results: The number of pulmonary surfactant applications, mechanical ventilation time, hospitalization time and hospitalization cost were (1.5±0.5) times, (92.5±13.8) h, (12.5±1.3) d, (26±4) thousand yuan in group A, and (2.6±0.4) times, (131.4±23.1) h, (16.0±2.8) d, (33±5) thousand yuan in group B, the highest oxygen saturation value was 468.9±42.1 in group A,401.2±22.3 in group B, there were significant difference between the two groups(t=7.334-11.524, P<0.05). The total incidence of complications during treatment was 15.6%(7/45) in group A and 48.9%(22/45), there was significant difference between the two groups (χ²=11.447, P<0.05). The total satisfaction rate of family members was 95.6%(43/45) in group A, which was significantly higher than that in group B (64.4%, 29/45). The difference was statistically significant (χ²=13.611, P<0.05). Conclusions Prophylactic care can be used in the mechanical ventilation of premature infants with NRDS, which can significantly reduce the incidence of complications, reduce the amount of pulmonary surfactant, shorten the mechanical ventilation time, and save the cost of treatment. It is worth promoting.

Objective:To investigate the effect of ethyl pyruvate on proliferation activity of vascular endothelial cells after heat stress.Methods:Human umbilical vein endothelial cells (HUVECs) were placed in incubators with different temperatures (39 ℃, 41 ℃, 43 ℃) for heat shock for 4 h, or placed into the incubator with the same temperature at 43 ℃ and received heat shock for different times (2 h, 3 h, 4 h), and the control group were always placed in 37 ℃ incubator. Then the morphological changes of the cells were observed under an inverted microscope, and the cell proliferation activity was detected by the cell counting - 8 (CCK-8) kit. According to the above experimental results, the optimal intervention temperature (43 ℃) and time point (4 h) of heat stress were selected. After that, ethyl pyruvate (EP) with a concentration of 10 μmol/L was used for intervention (HS+EP group), and the cell proliferation activity was detected by CCK-8.Results:With the increasing of the heat stress temperature or the extension of exposure time, the cell morphology gradually changed under the inverted microscope, and the cells in 43 ℃ incubator for 4 h was the most obvious; and the cell proliferation activity of HUVECs decreased gradually, and the most significant decrease occurred in the group that exposure for 4 h in 43 ℃ ( F=25.79, P < 0.001 vs. control group). In addition, the cell proliferation activity of HUVECs in the HS+EP group was significantly higher than that in the HS group ( P < 0.001). Conclusions:EP can reduce significantly the effect of heat stress on the proliferation activity of HUVECs, and help to alleviate the changes of vascular endothelial cell activity caused by heat stress.

Objective To investigate the image quality and radiation dose of coronary computed tomography argiograply(CCTA) with wide-body detector CT in single cardiac cycle with different heart rate.Methods A total of 821 patients with clinically suspected coronary artery lesions were performed CCTA examination continuously.They were divided into six groups:group A (＜65 bpm) with 132 cases,group B (66-75 bpm) with 244 cases,group C (76-85 bpm) with 145 cases,group D (86-95 bpm) with 101 cases,group E (96-105 bpm) with 101 cases and group F (106-135 bpm) with 98 cases.The CT values of the aorta root and the middle segment of LAD and RCA,the signal to noise ratios (SNRs),the contrast noise ratios (CNRs),the effective doses (E),the diagnostic rates and scores were compared among six groups of CCTA images.Results There was no significant difference in objective quality between the six groups (P＞0.05).There was no significant difference in the diagnostic rates of LAD,LCX and RCA (all P＞0.05).However,there were significant differences in LAD,LCX and RCA with 4 points (excellent) among the six groups (x2 =27.614,58.475,39.571,P ＜ 0.05).There were significant differences in radiation dose among the 6 groups (F=37.32,P＜0.05).The radiation dose of group B was highest,and that of group D,group E and group F was the lowest.Conclusions The CCTA images with wide-body detector CT in single heart cycle with different heart rate can meet the clinical diagnostic requirements,but image quality declined with heart rate increasing.The higher heart rate groups (heart rate ＞ 85 beats/min) had lower radiation doses.

Objective To explore the value of IL-1 β and IL-18 in predicting the prognosis of patients with RA-IP.Methods One hundred and five patients diagnosed as RA-IP were involved and their baseline information were recorded.Then,all of the 105 patients were followed-up for 1 year and divided into two groups according to the outcomes of follow-up.The poor prognosis rate of patients was showed by survival curves.Single factor analysis and multiple factors Cox's model analysis were applied to evaluate the influencing degree of factors affecting the prognosis of RA-IP.Meanwhile,the difference of the selected factors of two groups was analyzed and the sensitivity and specificity of the factors in predicting prognosis of patients were calculated by ROC curves.Results The results of single factor analysis and multiple factors Cox's model analysis showed that RF-IgM IL-1 β and IL-18 had influence on the prognosis of patients with RA-IP and IL-1β was the most influential factor (RR =1.624).Compared with those in the favorable group,IL-1 β,IL-18,and the positive numbers of RF-IgM (x2 =4.152,P =0.042) in the unfavorable group were higher.The ROC analysis showed that the AUC of IL-1 β was the highest,and the sensitivity and specificity were 55.9％ and 86.2％,respectively.Conclusion IL-1 β may assess the prognosis of patients with RA-IP.

Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation (MV). Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit (ICU), which is simple, non-invasive, and easy to operate. It is also accurate in the assessment of diaphragmatic function and guidance on weaning, which is worthy of promotion and application.