Objective:To explore the therapeutic effect of early rehabilitation nursing in patients with early acute myocardial infarction (AMI).Methods:A total of 78 AMI patients hospitalized in our department were enrolled and randomly divided into rehabilitation nursing group (n=39)and routine treatment group (n=39).Both groups received the same medication and routine nursing of internal medicine;rehabilitation nursing group also received rehabilitation nursing in addition.Short and long term therapeutic effects were compared and analyzed between two groups.Results:After two weeks,heart func-tion improvement of rehabilitation nursing group was significantly better than that of routine treatment group [NYHA car-diac function class I:(64.1% vs.41.0%),P<0.05];compared with routine treatment group after one-year follow-up, there were significant reduction in incidence rates of angina pectoris (30.8% vs.7.7%),arrhythmia (25.6% vs.7.7%) and heart failure (17.9% vs.2.6%),P<0.05 or<0.01,Compared with routine treatment group,recurrent rate of AMI of rehabilitation nursing group decreased,but no significant difference between two groups (P>0.05).Conclusion:Early rehabilitation nursing can significantly improve short and long term therapeutic effect in patients with myocardial infarc-tion,so it possesses extended value.

OBJECTIVE: To establish a HPLC method for the determination of content of entecavir and its related substances. METHODS: The HPLC condition was consisted of a Luna C18 column with a column temperature at 25 ℃, using gradient eluate method, the mobile phase was acetonitrile,with a flow rate of 1.0 mL?min-1 and detection at 254 nm. RESULTS: The calibrated linear curve of entecavir was within 0.033 45～0.167 2 mg?mL-1(r=0.999 98). The average recovery was 100.09%,RSD=0.20%, The content of related substance was 0.54%～1.48%. CONCLUSION: This accurate and reliable HPLC method is applicable for the quality control of entecavir and its related substances.

Objective To analyze the prevention and nursing measures of adverse drug reaction in patients with rheumatoid arthritis treated with Tolicizumab.Method The clinical data and nursing measures in 30 patients with rheumatoid arthritis treated with Tolicizumab were reviewed and analyzed.Result All the patients completed the treatment and no infusion reaction was observed in the first 24 hours.Conclusions Comprehensive and intensive assessment is necessary before application of Tocilizumab. Executing standard drug dispensing and injection process,mastering the infusion reaction emergency processing measures and establishing injection related systems are of great significance to observe and treat various adverse reactions in time,ensuring drug effects and safety of the patients.

Objective To observe the effect of neuromuscular facilitation technique and swallowing training combined with real-time electrical stimulation on dysphagia after stroke. Methods 50 patients with dysphagia were divided into treatment group (n=25) and control group (n=25).The treatment group accepted neuromuscular facilitation technique and VOCASTIM.The control group accepted routine vocal training and low frequency pulse electrical stimulation. They were assessed with the deglutition function classficaition and water drinking test. Results There was significant improvement in the both groups 2 weeks and 4 weeks after treatment (P<0.05), and it improved more in the treatment group than in the control group (P<0.05). Conclusion Neuromuscular facilitation technique and swallowing training combined with real-time electrical stimulation can promote the recovery of function of patients with dysphagia after stroke.

Objective To investigate the relationship between chronic atrophic antral gastritis and the decrease of somatostatin levels in blood and pyloric glands and adaptable protection ability of gastric mucosa.Methods Gastric mucosa biopsy specimen and blood samples were collected to determine the levels of somatostatin(SST)using radioimmunoassay.Histological changes between pre-and post-treatment were observed under light microscope as well as the changes of uhramicrostrucuture under transmission electron microscope.Distribution of SST in gastric mucosa was studied by immunohistochemical staining and then quantified.Results The quantities of gastric antral D cells of chronic atrophic antral gastritis decrease obviously.SST was mainly distributed in D cells of mucosa pyloric gland crypt.The nucleus of mucus epithelial cells in atrophic gastric antral crypt had SST negative staining.Mitochodria swellen,crista broken,rough endoplasmic reticulum distension,mucus secretory granules decreasing,the nuclear membranes disappearing as well as ehromatin integrating could have been seen in the intracytoplasm of mucus epitheliun cells of chronic atrophic gastric antral gastritis.The average level of SST in blood,epithelium and crypt were obviously reduced comparing to that of in the control group.By immunochemistry staining,the SST level in crypt of atrophic gastric antral gastritis Was significantly reduced comparing to that of in control group.With the level of SST in blood＜10 pg/100μl,the probability ratio of emerging atrophy Was 67.7%.Conclusions In case of no systemic inflammatory reaction state,the decreased ability of human pyloric gland D cell in producing SST not only rehtes obviously with human chronic atrophic antral gastritis but also with the weakened adaptable protection ability of gastric mucosa.

Objective To evaluate the effects of clinical nursing path on respiratory function exercise of patients with esophageal carcinoma.Methods A total of 60 postoperative patients with esophageal cancer were divided into the observation group and the control group according to the time period with 30 cases in each group.The observation group was given the clinical nursing pathway care in their respiratory exercise,and the control group routine nursing before and after the operation. The two groups were compared in terms of blood gas analysis implement on 5th day,pulmonary function on 10 th day and pulmonary complications after operation.Results PaO2,VC,MVV,FEV1 and FEV1/FVC in the observation group were much better than those of the control group.The incidence of complications was obviously lower than that of the control group(P<0.05). Conclusion Clinical nursing path used in respiratory function training of perioperative patients is effective for the improvement of pulmonary function and reduction of postoperative complications.

Objective To investigate the features of white matter impairment and its relationship with cognition in patients with amnestic mild cognitive impairment (aMCI).Methods Eighty-three cases of aMCI and 85 normal aging volunteers were scanned with diffusion tensor imaging (DTI) using MR system.All subjects completed the neuropsychological battery.We analyzed the differences between two groups using tract-based spatial statistics and the association between regions in difference and cognition using correlation analysis.Results There were significant differences between aMCI and normal control in the neuropsychological battery including the Mini-Mental State Examination(26.2 ± 2.6 vs 28.3 ± 1.3,F =43.224,P =0.000),Mattis Dementia Rating Scale-2 (131.4 ± 6.9 vs 138.0 ± 3.5,F =62.308,P =0.000),Auditory Verbal Learning Test-delayed recall(2.4 ± 1.6 vs 7.5 ± 2.0,F =324.018,P =0.000),Boston Naming Test(8.7 ± 1.4 vs 9.2 ± 1.0,F =6.821,P =0.010),Rey-Osterrich Complex Figure Test (12.1 ± 7.3 vs 18.5 ± 6.1,F =40.674,P =0.000),Symbol Digit Modulation Test (30.0 ± 10.1 vs 38.6 ± 9.8,F =30.786,P =0.000),Trail-Making Test Part B ((256.8 ± 124.5) s vs (178.1 ± 59.0) s,F =27.601,P =0.000).Significantly higher diffusivity indexes and radial diffusivity were also found in aMCI subjects compared to healthy elders in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract,corpus callosum,cingulum,corona radiate.We also found that axial diffusivity was significantly increased in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract and corpus callosum,whereas fractional anisotropy changes were not observed in aMCI.Diffusivity indexes values in bilateral frontal lobe (left r =0.67 ; right r =0.70),left cingulum (r =0.63),parietal white matter (r =0.69) and radial diffusivity values in left parietal (r =0.68) were significantly related to Trail Making Test A among aMCI (all P ＜ 0.05).Conclusions In aMCI patients,there was a wide range of white matter damage,with no brain region-specific.Executive function deficit was related to the white matter impairment in bilateral frontal lobe,left cingulate and parietal lobe.The specificity and sensitivity of four DTI parameters fordetecting white matter lesions are variant.Trial registration Clinical Research Center of Jiangsu Province (BL2013025)

Objective To investigate the brain magnetic resonance imaging(MRI)findings in 33 patients with neuromyelitis optica(NMO).Methods Patients who fulfilled the latest diagnostic criteria of NMO and whose brain MRI did not satisfied with diagnostic criteria of multiple sclerosis(MS)were enrolled.All the patients underwent brain MRI and spinal cord scannings and subsequent images analysis.Results Thirty-three patients with NMO were included to study.Five out of 33(15.2%)patients did not have brain parenchymal abnormalities,28 out of 33 patients(84.8%)were detected to have brain abnormal findings.Brain parenchymal lesions were well-defined in 22 patients(66.7%),no non-specific or atypical brain parenchymal lesions were found in the supratentorium or infratentorium in the other 6 cases(18.2%).However,brain MRI disclosed macroscopic,symmetrical diffuse FLAIR and T2-visible hyperintensity in deep white matter.Fifteen cases had more than one lesion(≥2 lesions),and the other 7 cases had single lesion.Supratentorial lesions were mostly punctate or small dots in nonspecific hyperintensity in juxtacortical,subcortical and deep white matter regions,a few were atypical patches.In the infratentorium,brainstem was an easily involved region(14/33,42.4%),especially in medulla(7/33,21.2%).Conclusions Brain MRI abnormalities are common in Chinese NMO,and brain lesions do not exclude the diagnosis of NMO.The observations of brain lesions are helpful to improve and revise diagnostic criteria of NMO.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Objective To explore the values of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)measurements in various lesions of multiple sclerosis(MS).Methods Sixty patients with clinically diagnosed remitting-relapsing MS(RRMS)were included to undergo conventional brain MRI and DWI scans.the lesions were included when the diameter was more than 5 mm.mean ADC values were measured for various lesions of MS.The statistical analyses were performed to determine the differences of mean ADC values among various lesions of MS.and to compare the correlation between ADC values of lesions and Expanded Disability Status Scale(EDSS)scores.Results (1)The ADC value of hypointense lesions was significantly higher than that of isointense lesions(F=55.90,P<0.05),the ADC values were(127.5 ±9.3)×10-5mm2/s and(95.7 ±6.3)×10-5mm/s respectively.The nodular enhancing lesions had a significantly lower ADC value than the ring-enhancing lesions(F=64.18,P<0.01).the ADC values were(114.7 ±12.3)×10-5mm2/s and(140.7 ±11.0)×10-5mm2/s respectively.The ADC value of confluent lesions was substantially higher that of discrete lesions(t=9.04,P<0.01).the ADC values were(141.4±6.5)×10-5mm2/s and(105.4±13.9)×10-5mm2/s respectively.(2)No correlation between ADC of lesions and EDSS scores was found(r=0.35,P>0.05).Conclusion DWI and quantitative ADC are useful to explain the pathological changes in different lesions and to monitor the disease duration of MS.