Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

Objective To understand the current situation of multidrug-resistant organism (MDRO)infection in hospitalized patients in a tertiary first-class hospital,as well as efficacy of bundle intervention measures on preven-tion and control of infection. Methods Hospitalized patients who were infected with MDROs in this hospital during 2012-2014 were monitored and conducted bundle intervention. Results In 2012-2014,a total of 1909 MDRO strains were isolated. The isolation rates of MDROs in 2012-2014 were 30.69% ,31 .04% ,and 29.40% respec-tively,bedside intervention rates were 81 .02% ,92.05% ,and 94.23% respectively,implementation rates of clinical isolation were 69.97% ,82.98% ,and 93.04% respectively;MDRO isolation rates during 2012-2014 were not sig-nificantly different(P>0.05);bedside intervention rates and implementation rates of clinical isolation were both sig-nificantly different(both P<0.05). The top 3 isolated MDROs in 2012-2014 were extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli,multidrug-resistant Acinetobacter baumannii,and ESBLs-producing Klebsiel-lapneumoniae. Conclusion Bundle intervention measures,such as multi-department collaboration and strengthened on-site supervision,can promote more standardized management of healthcare-associated infection,enhance the im-plementation rate of clinical isolation,and effectively prevent and control the spread of MDRO in hospital.

As an important part of medical supplies, the logistics management of high-value medical consumables becomes a key link in modern hospital administration. Compare between the management of high-value medical consumables and modern supply chain management. Based on 4R theory, discusses and analyses the management of high-value medical consumables in Fuwai hospital. By means of 4R theory, modern supply chain management has been optimized for the actual consumable management. And found out a effective method to resolve bullwhip effect caused by the limitations of high-value medical consumables. This research demonstrate modern hospital want to win the competitive initiative only by the improvement of material flow management level.

Objective:To explore the influence of psychological and to identify determinants for patients using position immobility by thermoplastic sheet in the course of radiotherapy. Methods:55 patients who received radiotherapy using position immobility by thermoplastic sheet were investigated with questionnaires. Results:There are 34.5%(19/55) patients admit under psychological stress during the treatment, which were affected by the tension from doctors’ consultation and the chemotherapy experience. Conclusion:Some patients were under psychological stress caused by the position immobility with thermoplastic sheet. Nursing intervention is necessary to improve, especially to the patients who show stress when consultation with doctors and who had chemotherapy experience.

Objective To evaluate the effect and safety of ultrasound-guided pereutaneous thrombin injection for the treatment of iatrogenic femoral arterial pseudoaneurysm.Methods Thirty patients [6 male,24 female,age range 45-82 years,mean (63 ± 10) years] were found to have pseudoaneurysms confirmed by ultrasound between 1 and 7 days following femoral arterial puncture from July 2011 through July 2014.Results All patient had pseudoaneurysm thrombosis after the first procedure.Thrombin 200-1000 U (50 U/mL)was injected into the pseudoaneurysm under ultrasound-guidance,performed.One patient showed acute allergy 5 min after thrombin injection,which was relieved by anti-allergic therapy.No thromboembolic complications or infections occurred.Conclusions Ultrasound-guided pereutaneous thrombin injection is a safe and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.

Objective To explore the effect of aerobic exercise and progressive relaxation training on cancer-related fatigue in lung cancer patients during chemotherapy. Methods Sixty lung cancer patients undergoing chemotherapy were randomly assigned to an experiment group (n=30) and control group (n=30). The patients in the study group received regular nursing plus 6 weeks aerobic exercise intervention and progressive relaxation training, while the patients in the control group only received regular nursing care. The effect of intervention was evaluated by the Piper fatigue scale (PFS). Results Before the intervention, three were no difference in the PFS scores and all dimentions scores between the two group. After the intervention, the total score of the cancer-related fatigue and the score on every dimension of PFS were significantly lower than those of the control group (P<0.01). For the control group, the total score and the score on the dimension had insignificant difference between pre-and post-intervention (P<0.01), except the dimensions of emotion and feeling which showed significant differences between pre- and post-intervention (P < 0.05). Conclusion Aerobic exercise and progressive relaxation training can decrease the cancer-related fatigue and improve the quality of life.

Objective To evaluate the curative effect ofXuebijing injection combined with routine western medicine therapy in the treatment of hypertensive renal damage.Methods A total of 114 patients with hypertension were randomly divided into 2 groups according to the random number table method, 57 patients in each group. The control group was given conventional treatment (maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium), and the treatment group were givenXuebijing injection based on the conventional treatment. The two groups were treated for 6 months. The changes of blood pressure, renal function and serum inflammatory cytokine levels were evaluated.Results After treatment, the mean value of 24 h systolic blood pressure, mean value of 24 h diastolic blood pressure, systolic blood pressure variability and diastolic blood pressure variability in the treatment group were significantly lower than those in the control group (2 months after treatment:t values were 5.256, 5.595, 5.265, 2.564,P<0.05; 6 months after treatment:t values were 6.251, 5.267, 4.466, 5.264,P<0.05); the urinary mAlb, beta 2-MG, and urine albumin to creatinine ratio in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 5.566, 5.282, 2.862,P<0.05; 6 months after treatment:t value were 5.263, 6.565, 3.642,P<0.05);two plasma D-dimer, IL-6, TNF-α and fibrinogen levels in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 3.565, 5.652, 3.985, 5.251,P<0.05; 6 months after treatment:t value were 5.268, 4.836, 3.622, 4.265,P<0.05).ConclusionsXuebijing injection combined with routine western medicine therapy on hypertensive renal damage may have protective effect, and its curative effect was superior to simple maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium therapy.

Objective To explore the clinical significance of monitoring the femoral artery hemodynamics of acute cerebral hemorrhage patients under general anesthesia by color doppler ultrasound .Methods Totally 30 patients who received emergency craniotomy for intracra-nial hematoma were performed the induction of general anesthesia and endotracheal intubation .The changes of femoral artery peak systolic ve-locity (Vs),early diastolic reverse peak velocity (Vd),systolic diameter (Ds),diastolic diameter (Dd),systolic blood pressure(SBP),dias-tolic blood pressure ( DBP) ,mean arterial pressure ( MAP) and heart rate ( HR) at each time point of before and after anesthesia induction , intubation,cutting the endocranium ,suturing the flaps were observed and recorded .Results Compared with those before anesthesia induc-tion,the MAP,VD and Vs were decreased (P<0.05),DS and DD increased (P<0.05) at each time point.Compared with those after anes-thesia induction,MAP and VD increased,VS reduced(P<0.05) at the intubation moment,the changes of DS and DD was not statistically significant,which compared with those after cutting the endocranium ,MAP,VS and VD decreased,but DS and DD increased (P<0.05).The changes of HR at each time point was not statistically significant (P>0.05).Conclusion Color doppler ultrasound could reflect the femoral artery hemodynamics of patients who subjected to craniotomy for intracranial hematoma under general anesthesia ,which provides some guid-ance for the general anesthesia strategies .