OBJECTIVE: Newer medicine therapies have been proved efficacy in patients with intermittent claudication. With rapid advances of intervention devices and techniques for peripheral vessels in recent years, which has improved the therapy of peripheral artery disease (PAD). To review the clinical developments in treatment of PAD so as to provide references for optimal integrated therapy of medicine with proper interventional treatment, which enable PAD patients to achieve the greatest long-term prognosis. DATA SOURCES: A computer-based search for literatures related to PAD from 1991 to April 2006 was conducted in Medline databasewith the of "peripheral arterial disease, catheterization, peripheral, genetics", and the language was limited to English. Meanwhile, Chinese relevant literatures between 1994 and April 2006 were searched in Journal Full-text Database and Wanfang Database by computer with the keywords of "peripheral arterial disease, intermittent claudication, management". STUDY SELECTION: Primary selection was performed by following inclusive criteria: PDA and drug treatment, stent, angioplasty, genetic therapy, surgery, and articles related to PDA were selected. Scientific criteria of treatment for PDA were looked for in basic researches, clinical studies and those published in formal organizations. Exclusive criteria: Repetitive studies, reviews and Meta analytical literatures were excluded. DATA EXTRACTION: A total of 60 literatures about the treatment for PDA were collected, 30 enrolled articles in which were reviewed. Thirty repetitive studies, reviews and Meta analytical literatures were excluded. DATA SYNTHESIS: ①The prevalence of PAD depends on the diagnosis. Given the inaccuracy of physical examination, use of pulse examination as the sole criterion would grossly overestimate the prevalence. In contrast, a historical query for intermittent claudication would underestimate the prevalence of PAD. The ankle-brachial index (ABI) has been validated by angiography with the sensitivity of 95% and the specificity of 100%.②The risk factors of PAD were similar to those in patients with cardiovascular disease and cerebrovascular disease. The goals of therapy for patients with PAD are to prevent systemic atherosclerotic disease progression and clinical cardiovascular events as well as prevent limb loss and improve the functional status of patients with intermittent caludication.③Medical therapy of PAD should include manipulations of risk factors for atherosclerotic heart disease, including smoke-stopping, body mass reducing, blood glucose controlling, blood pressure controlling and hypercholestermia reducing etc. Instructive exercise therapy is the most effective way in non-interventional therapy, while medicine therapy mainly included antiplatelet therapy, angiotenic therapy and anticoagulation therapy. If the patients has obvious clinical ischemia symptoms and cannot be relieved by medical treatment, then interventional therapy or surgery is necessary. CONCLUSION: Patients with PAD can achieve the best long-term prognosis by an instructive exercise treatment integrated with optimal medicine therapy and proper interventional therapy.

Objective To investigate the status and influencing factors of nurses' cognition to premature parents' health education demands,so as to provide reference for nursing leaders to take intervention.Methods 59 NICU nurses from two hospitals in Guangzhou and Shenzhen were chosen by convenience sampling.A self-designed questionnaire was used to investigate.Results A total of 56 questionnaires was recovered,with a rate of 94.92％.NICU nurses perceived the degree of parents total education demands was (3.20±0.48) points.The demands of knowledge about diseases progress and related diagnosis and nursing were high,reaching (3.33±0.47) points.Breast feeding got the highest score,(3.53±0.69)points.Ed-ucation,professional ranks,post of nurses had no correlation with total score,but ages and length of service were negatively correlated with general demand,mental nursing and social support.Conclusions NICU nurses value premature parents' health education,and nursing leaders should take interventions to prevent occurrence of job burnout.

Objective To analyze and deploy in the hospital network security for guarantee hospital network and information of safety, and ensure stability operation in the hospital management information system. Methods The network environment was based on the original hospital, which was added to measures about the isolation for network security, the prevention of computer viruses and firewall, data backup and recovery, physical safety management and so on. Results After the comparatively perfect measure of network security was deployed, the security of hospital information and data was effectively protected, and the security threat was solved from the inner and outer network. Conclusion The deployment of network security prevention system can better give fully play to important function on which management information system can efficiently operate in whole hospital.

Objective To evaluate the effects of two different chronic glaucoma models on intraocular pressure elevation and retinal structure changes in rat.Methods Two different chronic ocular hypertension (COH) models were made by three episcleral vein cauterization or latex microspheres injection into anterior chamber,6 cases of each model.IOP measurements of right eyes (COH eye) and left eye (control eye) were taken weekly by TonoPen (an applanation tonometer).Retinal ganglion cells (RGCs) were retrogradely labeled with 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI) seven weeks later.Retina structure was observed by immunofluorescence.Results IOP was elevated at postoperative 1-8 weeks,and the mean IOP in the episcleral vein cauterization group was (27.20 ± 1.83) mmHg (1 kPa =7.5 mmHg),whereas the control group was (19.80 ± 1.35) mmHg (P =0.001,n =6).The mean IOP in the latex microspheres injection group was (27.40 ± 1.88) mmHg,whereas the control group was (19.40 ± 1.00) mmHg (P =0.000,n =6).Compared with control rat at postoperative 8 weeks,RGCs loss in episcleral vein cauterization group were 37.9％,39.6 and 33.5％ (all P =0.000,n =6),latex microspheres injection group were 37.3％,39.4％ and 33.5％ (all P =0.000,n =6).There was no statistical difference between episcleral vein cauterization group and latex microspheres injection group (P =0.855,0.949,0.634,n =6).Compared with control rat at postoperative 8 weeks,GCL thickness in both COH models were also significant reduced,but there was no statistical difference in GCL thickness among control group (7.32 ± 0.39) μm,episcleral vein cauterization group (4.97 ±0.33) μm,latex microspheres injection group (5.00 ±0.31) μm.Misoperation or careless operation may lead to microspheres particle residual on flat-mounted rat retina.Conclusion The episcleral vein cauterization or latex microspheres injection into anterior chamber can all increase the IOP.However,there are some advantages in episcleral vein cauterization such as few costs than latex microspheres injection and no microsphere contamination.

Objective Experimental Study of balloon catheter injury technique in establishment of atherosclerosis.Methods The healthy New Zealand rabbits were randomly divided into two groups.(ns=20,weight2.5～3kg,4month old) The two groups were fed a cholesterol-supplemented diet and one group were subject to balloon catheter injury of the abdominalaorta by femoral artery.And three New Zealand rabbits were fed ordinary diet.The abdominal aorta were observed by pathology in both groups in order to determined whether there was atherosclerosis of the rabbit model.The thickness was measured and the quality of plaque was identified.Results Comparing with cholesterol-supplemented diet group,balloon catheter injury group,the typical carotid atherosclerosis was observed.The neoiniimal thickening and plaque were signficant in two groups and the P/IM ratio reached 0.56?9.4 and 0.99?26.9.Conclusion The typical carotid atherosclerosis lesion can induced by cholesterol-diet plus balloon catheter injury of the abdominalaorta in rabbit.

Objective To assess the effects of Danhong injection on the perfusion function of the pancreas in patients with acute pancreatitis (AP). Methods A total of 102 patients with AP were collected, and there were 25 patients with severe acute pancreatitis ( SAP) and 77 patients with mild acute pancreatitis (MAP). They were randomly divided into routine treatment group ( RTG,n =54) and Danhong treatment group (DTG,n =48) , respectively. Another 33 normal individuals were used as controls. Patients in RTG received gastric decompression, acid inhibition, anti-infection and nutritional support. Patients in DTG received Danhong injection 30 ml i. v. b. i. d besides routine treatment. The hemodynamic parameters ( BF, BV, MTT, and PS) of perfusion of the pancreas were measured by 16-slice spiral CT scanner. Results The values of BF of control, MAP, SAP group were time was ( 12.6 ± 2.7) d in DTG, which were significantly shorter than those in routine treatment group [(14.5 ±3.2)d, (18.5 ±5.5)d, P <0.05]. Conclusions The parameters of CT perfusion imaging of the pancreas can be a quantitative criterion to assess the severity of microcirculation dysfunction in patients with AP, and Danhong injection is effective to improve the blood perfusion of the pancreas during the treatment of AP.

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).

Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.

Objective To evaluate the surgical treatment of splitting right hepatic duct with hepatolithiasis and stenosis. Methods The clinical data of 38 patients with splitting right hepatic duct and hepatolithiasis treated by operation were analyzed retrospectively. Results All the patients underwent operation. operative procedures were as follows: (1) in situ cholangioplasty of splitting right hepatic duct in 7 cases;(2) fenestration of splitting right hepatic with adjacent hepatic duct in 9 cases; (3) bilioplasty of splitting right hepatic duct with adjacent bile duct in 8 cases; (4) hepatic lobectomy or segmentectomy of splitting right hepatic duct in 14 cases. Postoperative complications developed in 6 cases, which were cured conservatively. There was no perioperative mortality. All patients were followed up for 5～16 years(averaged 9.2 years). Excellent rate was 78.9%,and residual stones were found in 26.3% of the patients . Conclusions Accurate localization and appropriate operation may get satisfactory result in treating patients with splitting right hepatic duct with hepatolithiasis and stenosis.

Objective To investigate the diagnosis and treatment of refluxing cholangitis.Methods Clinical data of 60 patients with refluxing cholangitis treated by surgery in recent 7 years in our hospital were reviewed retrospectively.Of the 60 patients,spontaneous refluxing cholangitis and iaotrogenic refluxing cholangitis ocurred in 42 and 18 patients respectively.Results Postoperactive complications occurred in 13 cases,including biliary fistula in 6 cases,incision infection in 2,intestinal obstruction in 2,subphrenic abscess in 2, all the complications were cured by various treatment.There was no perioperative mortality in this series.Fifty-five patients were followed-up for 2-11 years,42 were excellent,9 good and 2 poor;2 patients died of cerebral haemorrhage and myocardial infarction respectively during the follow-up period.Conclusions An appropriate operation should be chosen for patients with refluxing cholangitis according to the basic disorder and the extent of biliary duct wall deficit.