Objective To describe the patients′satisfaction with multimodal analgesia management after total knee arthroplasty. Methods 110 patients with total knee arthroplasty selected from February 2013 to February 2014 were recruited to complete a questionnaire, which was composed of the Visual Analogue Scale (VAS) , the Houston Pain Outcome Instrument (HPOI), and the Scale of Perceptions of Patients′Pain. Results VAS scores at different times were ranged from (2.14±1.21) points to (1.19±0.62) points, mean rating for general satisfaction with pain management was 80.04% (136.06/170.00), satisfaction with education on pain control was only 63.20% (37.92/60.00). Patients with different age and educational level of satisfaction with pain control had significant differences (P<0.05). Patients who thought relieving pain was harmful was 56.4% (62/110), the patients who did not understand the impact of pain on the body was 62.7% (69/110), the patients who did not understand the common methods of analgesia was 59.1%(65/110), the patients who did not understand the adverse reactions of pain measures was 63.6% (70/110). Conclusions Patients′satisfaction with the analgesic effect of multimodal analgesia is higher after total knee arthroplasty, while satisfaction with education on pain control was lower. Nurses should strengthen health education to patients with total knee arthroplasty about knowledgement of multimodal analgesia.

Objective To investigate the value of screening bridge vessels before coronary artery bypass graft(CABG) by ultrasonic examination. Methods To analyze the ultrasonic result of internal mammary arteries,carotid arteries,and radial arteries before CABG. Results Among the 140 cases,11 internal mammary arteries were not qualified,14 of 74 radial arteries were not qualified. And the stenosis of carotid arteries were present in 28 cases. Conclusions It is valuable to examine the bridge vessels before CABG.

Objective To assess the reliability and validity of the effect evaluation index system for health education of coronary heart disease.Methods A total of 306 patients with coronary heart disease in four third-grade and A-level hospitals extacted by convenient sampling method were surveyed.Project analysis,exploratory factor analysis,correlation analysis and so on were applied to analyze and select items.Then the Cronbach's alpha coefficient,test-retest reliability,and content validity of the scale were tested.Then the original system was modified and the eventual system was formed.Results The scale was consisted of 8 first-dimensions and 35 indexes.The Cronbach's α of the total system was 0.832,and the α of subscales were from 0.629 to 0.882.The test-retest reliability of the total system was 0.966,and the testretest reliability of subscales were from 0.848 to 0.942.The S-CVI/Ave of system was 0.99,and the S-CVI/UA of indexes was 0.91.The Pearson correlation coefficient of the indexes with their dimensions were from 0.574 to 0.916,which were higher than the coefficient of the indexes with other dimensions.Factor analysis supported the eight-factor structure of the system,which could explain 65.61％ of the total variance and the factor loading of each index were from 0.430 to 0.938.Conclusions The system is reliable and valid,and can provide a unified reference standard for effect evaluation of health education of coronary heart disease.

Objective To establish a scientific,standard and comprehensive effect evaluation index system for health education of coronary heart disease.Methods Based on KABP (knowledge,attitude,belief,practice,KABP) model of health education,the effect evaluation index system for health education of coronary heart disease was formulated by documentary analysis,qualitative research,questionnaire survey,Delphi method,and analytic hierarchy process.Results The authoritative coefficient,determination coefficient and familiarity coefficient was 0.89,0.91,0.86,respectively.The coordination coefficients of the first-dimension and the second-dimension were 0.295 and 0.302,respectively.The index system consisted of 6 first-dimensions,45 second-dimensions.The weight coefficient of health knowledge,health belief,health behavior,physical signs,quality of life,and satisfaction degree of health education was 0.153 8,0.153 8,0.366 1,0.086 3,0.153 8,0.086 3,respectively.Conclusions The effect evaluation index system for health education of coronary heart disease is reliable and valid,which can provide a quantitative basis for effect evaluation of health education.

Objective: To describe the differences of plasma folate concentration and prevalence of folate deficiency in genders and ages in Chinese adults aged 35 to 64 years. Methods: By cross-sectional analysis, plasma folate concentration was measured in 2 545 adults including men and women by microbiological assay. Results: (1) Men tended to have lower plasma folate concentration and higher prevalence of folate deficiency(9.70 nmol/L, 31.0%) than did women(14.2 nmol/L, 12.5%, P=0.001). (2) Men in South have significantly higher plasma folate concentration and lower prevalence of folate deficiency than in North. The difference of plasma folate concentration was not evident between urban and rural area, but evident in North between in winter and spring. There were no significant differences of prevalence of folate deficiency for men between urban and rural areas in both regions. For women, the differences of plasma folate concentration in areas were significant, which were higher in South and urban, and lower in North and rural areas. (3) Plasma folate concentration increased with age in Southern men. A similar trend for others was not significant. Conclusion: Men have lower plasma folate concentration and higher prevalence of plasma folate deficiency than do women. The distribution of plasma folate concentrations in urban and rural areas seems different between men and women.

Objective To access the left internal thoracic artery (LITA) graft late postoperative patency after coronary artery bypass grafting (CABG) by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging (CDCFI).In contrast with angiography,try to find available flow parameter to access graft patency.MethodsForty-six patients with CABG more than 1 year postoperatively followed-by angiography were detected by ultrasound.The LITA graft and left anterior descending artery were examined.Systolic and diastolic peak velocity(Smax,Dmax),velocity time integral(VTIs,VTId)of each segment were measured separately.The ratio of diastolic and systolic peak velocity (D/S),and diastolic velocity time integral fraction(DVTIF) were calculated.All patients were divided into groups according to angiography results.ResultsThirty -one LITA grafts were patent,11 were dysfunctional,4 were occlusive.According to the angiography results,the flow parameters of the proximal segment of LITA graft were significant.The D/S and DVTIF of patent group was higher than that of dysfunctional group.The diastolic peak velocity of distal segment of LAD of patent group was higher than that of dysfunctional group.ConclusionsPeripheral blood vessel ultrasound combined with CDCFI could provide the evidence to access the patency of the graft.It was an effective method for the clinical follow-up.

The relationship between the hepatic ischemia/reperfusion (I/R) injury and the balance of nitric oxide/endothelins (NO/ET) was studied. The changes of the ratio of NO/ET and the hepatic injury were observed in a rat hepatic I/R model pretreated with several tool drugs. In the acute phase of hepatic I/R injury, the ratio of plasma NO/ET was reduced from 1.58 +/- 0.20 to 0.29 +/- 0.05 (P < 0.01) and the hepatic damage deteriorated. NO donor L-Arg and ET receptor antagonist TAK-044 could alleviate the hepatic I/R injury to some degree, whereas NO synthase inhibitor L-NAME aggravated the damage. It was concluded that the hepatic I/R injury might be related with the disturbance of the NO/ET balance. Regulation of this balance might have an effect on the I/R injury.
Arginine ; Endothelins/*blood ; Liver/*blood supply ; NG-Nitroarginine Methyl Ester ; Nitric Oxide/*blood ; Receptors, Endothelin/antagonists & inhibitors ; Reperfusion Injury/*blood

Objective: To compare two methods (microbial assay and radioimmunoassay) for measuring plasma folate concentrations, and to examine the relationship between plasma folate levels, and alcohol consumption, tobacco use and body mass index, and the risk of hyperhomocysteinemia in China. Methods: We used a microtiter plate microbial assay and a radioimmunoassay to measure the folate concentration in 88 plasma samples. After comparing the results of these two methods and fitting a regression line, we examined the geographical, seasonal, and gender differences in folate concentration of plasma collected from 2 422 adults in south and north areas in China, and evaluated the association of plasma folate concentration, with alcohol consumption, cigarette smoking, and body mass index, and with the risk of hyperhomocysteinemia, using the data from the two assays. Results: The data from the two assays had a linear relationship ( r =0.879, P =0.000); the regression was Y =0.683 X +0.308 (where X and Y were nature logarithmic transformations of plasma folate by microbial assay and radioimmunoassay, respectively); however, the mean plasma folate levels by microbial assay were much higher than those obtained by radioimmunoassay. Both data sets showed similar plasma folate distributions among Chinese adults, associations with other risk factors, and the risk of hyperhomocysteinemia. We estimated that 19.9% of the Southerners and 67.1% of the Northerners had plasma folate concentrations by radioimmunoassay lower than the 6.8 nmol/L used to define plasma folate deficiency. Conclusion: There is a linear relationship between plasma folate levels determined by microbial assay and radioimmunoassay, but because of the different levels obtained in the two assays, it is difficult to use the microbial assay results to evaluate folate status at this time. The use of 10.5 nmol/L as a cut off for plasma folate deficiency by microbial assay needs further study.

Objective: To describe the distribution of plasma vitamin B12 concentration in Chinese adults aged 35 to 64 years.Methods:Cross-sectional analysis was empolyed.Plasma vitamin B12 concentration was measured in 2 459 adults sampled from the representative urban and rural areas in the South and North of China.Results:Adjusted plasma vitamin B12 concentration was significantly higher (260 pmol/L) in the Southerners than in the Northerners (189 pmol/L).There were different patterns of seasonal changes of plasma vitamin B12 concentration between South and North.Plasma vitamin B12 concenration was higher during the summer and autumn (269 pmol/L)than during the winter and spring (252 pmol/L) in the South.However,the concentration was lower during the summer and autumn (177 pmol/L) than during the winter and spring (200 pmol/L) in the North.Women tended to have higher plasma vitamin B12 concentration than men.There were 5.5 percent of the participants whose plasma vitamin B12 concentration was lower than 110 mol/L.Conclusion:Significant regional and gender differences in plasma vitamin B12 concentration were observed in Chinese adults.The seasonal changes between the South and North were different.

1.The external features and arterial supply of the papillary muscles of the leftventricle were studied in 54 human,52 dogs' and 110 rabbits' hearts.Radiopaquemedium or Chinese ink were injected into coronary arteries.After injection,arter-iography of some hearts were taken,and serial celloidin sections of the papillarymuscles of other hearts were made.The diameters of the papillary arteries and thedensity of the vessels were measured.2.The papillary muscles could be divided into three patterns,depending on theextent of their attachment to the ventricular wall and the relative length of theirfree part protruding into the ventricular cavity.The three patterns were as follows:(1)The attached type,the papillary muscle was largely adherent to the sucbjacentventricular myocardium,with only one third or less of its length protruding into theventricular cavity(34% in human hearts,100% in dogs' and 38% in rabbits').(2)The free type,the free end of the papillary muscle was one half of its length ormore(28% in human hearts,10% in rabbits').(3)The intermediate type,thelength of the free protruding part of the papillary muscle was intermediate between(1)and(2)(38% in human hearts,52% in rabbits').3.In the human and the dogs' hearts the anterolateral papillary muscle receivedbranches from the anterior descending artery and the diagonal left ventricularbranches or the left circumflex artery;while in the rabbits' it received branchesmainly from the anterior branches of the left ventricular artery.The posteromedialpapillary muscle received a variable supply from the left circumflex artery and orthe branches of the right coronary artery in the dogs' hearts and in the human hearts,while in the rabbits' hearts,it mainly received branches from the posteriorbranches of the left ventricular artery.4.The arrangement of the arterial vasculature of the papillary muscle seemedto be related to the different patterns of the papillary muscles.The free typereceived a large central artery which coursed through the entire papillary muscle toits apex(87.5%).The attached type had a segmental supply of 3～9 long penetrat-ing intramyocardial vessels(94.29%).The intermediate type had a combination ofboth types of vascular arrangement(98.5%).5.The average diameter of the central arteries was 617.50 ? in human hearts atits entry into the base of the papillary muscle,and 236.05 ? in rabbits.The dia-meters of the segmental arteries were 323.60 ? in human hearts,300.05 ? in dogs',121.78 ? in rabbits' respectively.The diameters of the capillary vessels were 5～8 ?in human hearts,3～6 ? in dogs',2.5～6 ? in rabbits' respectively.The numbersof capillaries that observed in a length of 200? were 15.45 in human hearts,16.2in dogs',19.3 in rabbits'.The specific values of the density of vessels per unitarea were 34.4% in human hearts,34.1% in dogs',56% in rabbits'.