Objective To investigate clinical therapeutic effect of valsartan/amlodipine compound preparation on patients with hypertension. Methods From Juue 2011 to June 2013, a total of 110 columns with hypertension as the research object, according to randomly divided into two groups.Valsartan/amlodipine compound preparation(group A) and amlodipine combined with metoprolol group(group B), continuous administration for 24 weeks, patients symptoms, former state, improve heart function and blood clots compared curative effect were monitored.Results After 24 weeks of treatment with valsartan/amlodipine compound preparation group, compared with group B, SBP and DBP were decreased significantly, the TC, TG and Glu content were also decreased significantly, clinical symptoms improved ratio was 90.91%(P<0.05).Cardiac function improvement recovery was 89.09%(P<0.05).D-Dimer level was decreased significantly(P<0.05), the former state blood clots were effectively prevented.Conclusion The high blood pressure in treatment with valsartan/amlodipine compound preparation has more therapy advantages in clinical treatment .

Objective To investigate whether HA affects the inflammatory cytokines and chemokines of synoviocytes. Methods FLS were derived from the SD mice with knee OA by papaya enzyme and stimulated by IL-1. Then, FLS were cultured with 600 ~ 800 kDa HA. Anti-CD44 blocking experiments were determined. The expressionsof TNF-γ, IL-1 , IL-6 , MMP-3 , MMP-9 , CX3CL1 , CCL11 , CCL2 , CXCL12 were detected by RT-PCR. In addition, the tunel test was used to detect the apoptosis rate. Results MMP-3, CX3CL1 and CCL2 gene expression were down regulated by HMW-HA in unstimulated FLS and TNF-α,MMP-3, CX3CL1 and CCL2 expression were decreased by HMW-HA in IL-1-stimulated FLS. CD44 blocking inhibited the down-regulatory effects of HMW-HA. Besides, HMW-HA promoted cell apoptosis under condition of inflammation. Conclusion HMW-HA has an anti-inflammatory effect by down-regulating of pro-inflammatory cytokines and chemokines and promoting apoptosis, possibly through the interaction of CD44 and HMW-HA.

Objective To evaluate the effect of evidence- based nursing for patients receiving percutaneous coronary intervention and stent implantation. Methods A total of 136 patients with coronary heart disease were randomly divided into the intervention group (n = 68) and the control group (n = 68). Traditional nursing measures were employed for the patients of the control group , while evidence-based nursing intervention was adopted for the patients of the intervention group. The patient’s comfortableness, satisfaction and the occurrence of complications were determined at 24, 48 and 72 hours after the operation, and the results were compared between the two groups. Results At 24, 48 and 72 h after percutaneous coronary intervention, the each dimension score of GCQ and the total score of the intervention group were significantly higher than those of the control group (P<0.05). The occurrence of back pain, urinary retention and hypotension in the intervention group was significantly lower than those of the control group (P < 0.05). Patient’s satisfaction extent of the intervention group was significantly better than that of the control group (P < 0.05). Conclusion Evidence-based nursing intervention can effectively enhance the nursing skill and orientation, and reduce the occurrence of back pain, urinary retention and hypotension, thus improve patient’s comfortableness and satisfaction. Therefore, evidence - based nursing intervention should be recommended in clinical practice.

Objective To evaluate the efficacy of healthcare failure mode and effect analysis in enhanced recovery after surgery(ERAS) in thoracic surgery. Methods Establish the healthcare failure mode and effect analysis group and evaluate the possible healthcare failure modes in implementation of ERAS.Calculate the odds ratio and make a decision tree in order to find out the failure modes and make safe schemes for bowel preparation, peri-operative pain monitoring and evaluation, vein thrombosis screening and management, early mobilization and food-taking after surgery and catheter removal for patients with benign prostate hyperplasia. Results Before and after the implementation of ERAS, 237 patients were selected.The risk priority number after the implementation of ERAS had been reduced,all less than 8 points. After the implementation of ERAS, the rate of initial pain score greater than 4 was 53.2%(126/237),the incidence of nausea and vomiting was 13.5%(32/237),and incidences of thrombosis and constipation were all 6.8%(16/237),the urinating patency rate after pulling-out the tube was 100.0%(237/237). Before the implementation of ERAS, the indicators was 96.6%(229/237), 43.0%(102/237), 30.0%(71/237), 36.7%(87/237),79.7%(189/237).There was significant difference before and after the implementation of ERAS (χ2=5.455-15.022, P<0.05). Conclusions The application of healthcare failure mode and effect analysis can reduce the incidence of adverse reaction and complications after thoracic surgery and ensure a secure and high-quality implementation of ERAS,which is worth using widely.

Objective:To evaluate the feasibility of high resolution MRI for the measurement of anterior cartilaginous acetabulum-head-index (A-CAHI) and the value of A-CAHI for predicting hip clinical function after treatment in developmental dysplasia of the hip (DDH).Methods:The imaging data of 92 hips from 61 children with treated DDH were retrospectively reviewed in Shandong Medical Imaging Research Institute from January 2019 to January 2020. All children underwent conservative treatments or surgical interventions 3 years ago. Hip function after treatment was evaluated clinically based on the modified MacKay criteria. The hips were divided into satisfactory clinical function group (McKay rating excellent or good, n=46) and unsatisfactory group (McKay rating fair or poor, n=46). All patients were imaged with conventional MRI, high resolution fat suppressed proton density weighted image (FS-PDWI) of the unilateral hip joint in oblique sagittal view, and anteroposterior hip radiographs. A-CAHI and lateral cartilaginous acetabulum-head-index (L-CAHI) were measured respectively on high-resolution oblique sagittal PDWI and conventional coronal T 1WI. Acetabulum head index (AHI) was also measured on anteroposterior hip radiograph. Mann-Whitney U test or independent-samples t test was used to compare the difference of A-CAHI, L-CAHI and AHI between satisfactory and unsatisfactory clinical function groups. The diagnostic value using A-CAHI, L-CAHI, AHI, or A-CAHI combined with L-CAHI for unsatisfactory clinical function were investigated by the ROC curve. The area under the curve (AUC) and the Z statistic were used to compare diagnostic performance. Results:The values of A-CAHI, L-CAHI and AHI were significantly higher in satisfactory clinical function group compared with the unsatisfactory group ( Z=-7.746, -7.735, t=-7.199, all P<0.001).A-CAHI combined with L-CAHI had the significant highest diagnostic accuracy compared with A-CAHI, L-CAHI and AHI (AUC were 0.994, 0.969, 0.968, 0.861, respectively), with significant differences ( Z=1.975, 2.006, 3.553, P=0.048, 0.051,<0.001). The sensitivity and specificity of A-CAHI combined with L-CAHI for the diagnosis of prognosis were 95.7% and 97.8%, respectively. Conclusions:A-CAHI measured by high resolution MRI was found to have the highest diagnostic accuracy for prediction of hip clinical function in the treated DDH, and combined with L-CAHI can improve the diagnostic accuracy significantly.