50%) and the normal response group(NRP).Ischemic events including episodes of chest pain,ischemic manifestation or ECG and cardiac injury marker concentrations were analysed during in-hospital stay and clinical follow up of 6 months.Results Compared with the NPR group,patients in the HPR group were more likely to be women(55.2% vs.24.7%,P

Objective To investigate the clinical value and effect of peripherally inserted central eatheter(PICC) in patients with tuberculous meningitis. Methods 56 patients with tuberculous meningi-tis were randomly divided into the treatment group and the control group with 28 cases in each group. The treatment group was medicated by PICC, while the patients of the control group were medicated through pe-ripheral superficial vein. The curing rate, degree of anxiety, infusion response, satisfaction with nursing and related expense were recorded. Results The curing rate and satisfaction with nursing of the treatment group were higher than those of the control group. The anxiety degree, infusion response and related ex-pense of the treatment group were lower than those of the control group.Their difference had statistical sig-nificance. Conclusions PICC has clinical value in patients with tuberculous meningitis,which is worth promoting.

Objective To investigate the emotional memory characteristic in patients with leuloaraiosis(LA) and explore the neurobiological mechanisms through observing the changes of emotional memory.Methods Different valence images (including positive,neutral and negative pictures) were used to test twenty-four patients with Leuloaraiosis(LA group)and twenty-four healthy colltrols(HC group) at the same time.The emotional memory was evaluated by the recognition of emotional pictures.Results In appraisal of the emotional pictures,there was no significant difference between patients with LA (positive (10.42±2.30) and neulral (12.87±2.29),respectively) and healthy controls (positive (11.38 ± 3.25) and neutral (12.75 ± 2.86),respectively) in positive and negative appraisal (all P＞0.05).But the negative appraisal decreased between LA group (11.63 ± 1.81) and HC group (12.75 ± 2.02) (P＞ 0.05).Compared with healthy controls (38.08+±5.45),patients with LA(33.67±7.10) showed sharply decline in the emotional images memorizing task(P＜0.05).And the accuracy in recognizing positive and netural valence pictures in patients with LA ((Positive(11.04±2.40) and neulral (10.42±2.93)) was significantly lower than that in healthy controls ((positive(12.79±2.17) and neutral(12.08±2.59))(P＜0.05).But in negative stimulus,there was no significant difference between LA group(13.20± 1.86)and HC group(12.20±2.65) (P＞0.05).In addition the total correct recognition,positive and neutral valence in pictures recognition were negativly correlated with the se verity of white matter lesions in the LA patients group(r=-0.308,P=0.033;r=-0.462,P=0.003;r=-0.352,P=0.014).Conclusion The emotional memory is impaired in patients with LA,and the degree of damage is accompornied with the severity degree of LA.The emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for neutral is relatively reserved in patients with LA in pictures recognition phase.It suggests that impaired emotional memory with different valences may be related to different neuromechanisms.

Objective To compare the efficacy and predictability of sphere-cylinder-combined LASIK and two-zone cross-cylinder LASIK for the correction of moderate and high astigmatism.Design Prospective,comparative case series.Participants 40 eyes of 35 patients with mixed astigmatism undergoing LASIK.Methods All patients were treated with Visx Star IV LASIK system.20 eyes of 19 cases were used for sphere-cylinder combined LASIK mode and 20 eyes of 16 cases for two-zone-cross-cylinder LASIK mode.All sub- jects were followed more than 6 months.Main Outcome Measures Uncorrected visual acuity (UCVA),best spectacle-corrected visual acuity (BSCVA),spherical diopter,residual astigmatism and corneal thickness.Results For the patients who received two-zone-cross-cylinder LASIK mode,the UCVA at 6 months after surgery was 0.5 or above,and 13 eyes (65.0%) were 1.0 or above. For the patients who received sphere-cylinder-combined LASIK mode,the UCVA at 6 months after surgery was 0.5 or above,and 11 eyes (55.0%) was 1.0 or above (P=0.683).The residual astigmatism for the patients received sphere-cylinder-combined LASIK mode was (1.15?1.00)D,while for the patients received cross-cylinder LASIK mode was (1.13?0.62)D(P=0.045).The remotion depth of cornea for sphere-cylinder-combined LASIK mode and cross-cylinder LASIK mode was (36.73?13.12)?m and (15.60?6.85)?m,respectively (P= 0.031).Condusion The UCVA,residual astigmatism and corneal thickness after surgery in two-zone-cross-cylinder LASIK mode were better than that in sphere-cylinder-combined LASIK mode for the correction of moderate and high astigmatism.

One hundred patients were diagnosed with coronary heart disease through dual-source CT coronary angiography (DSCTA) in our hospital,including 53 cases aged ≥60 y (elderly group) and 47 cases ＜60 y (middle-aged group).The curved-planar reconstruction (CPR),maximal intensity projection (MIP) and other post-processing reconstruction techniques were used to evaluate the indicators and differences of coronary stenosis ≥ 50％ ; the X-ray coronary angiography (CAG) findings were regarded as the gold standard.The evaluable rates of coronary arteries through DSCTA were 97.0％ and 98.6％ for two groups (P ＞0.05).The positive rate of coronary artery stenosis ≥ 50％ in elderly group was higher than that of middle-age group ( 12.6％ vs 9.0％ P ＜0.05 ).The rates of multi-vessel disease in elderly group (28.3％ ) was also significantly higher than that of middle-age group (6.4％,P ＜0.05 ).The sensitivity,specificity,positive predictive value and negative predictive value in evaluation of coronary artery stenosis ≥ 50％ for elderly patients were 92.3％,98.0％,88.0％ and 98.9％ respectively; those for middle-aged patients were 96.0％,99.0％,90.6％ and 99.6％ respectively ( P ＞0.05 ).DSCTA imaging provides an effective screening and evaluation method for coronary heart disease in elderly and middle-aged patients.

Objective The use of in vivo cryotechnique (IVCT) in combination with electrocardiograph (ECG) to study cardiac microcirculation under different hemodynamic conditions in living mouse.Methods Living mouse heart monitored by electrocardiograph was suffered from IVCT and freezing substitution under normal blood flow,myocardial ischemia or cardiac arrest conditions.Hematoxylin eosin (HE)staining,Schiff's staining and immunofluorescence staining for serum albumin,immunoglobulin were utilized on continuous paraffin sections,respectively.Confocal microscopy and statistical analyses were used.Results Comparing with normal hemodynamics,microvascular red cell volume reduction,morphology changed,myocardial cell glycogen loss,serum albumin ectopic distribution to myocardial cytoplasm,T tubular network failure and spacing width were happened in myocardial iscbemia condition; different shapes of red blood cells,myocardial cells glycogen deficiency,T tubular network failure and interval narrowing were found under cardiac arrest conditions.Conclusions Cardiac microcirculation,pathological changes of myocyte and its surrounding microenviroument in living mouse heart can be immediately captured in situ by the application of IVCT and ECG.

Objective To evaluate the anesthetic efficacy of propofol used to supplement spinal anesthesia for sedation in the pediatric patients undergoing lower abdominal or lower extremity operations.Methods One hundred twenty pediatric patients of both sexes, aged 2-5 yr, weighing 11-21 kg, of ASA physical status Ⅰ or Ⅱ , scheduled for elective lower abdominal or lower extremity operations were randomly divided into 3 groups (n =40 each) using a random number table: general anesthesia group (group G), propofol used to supplement caudal block for sedation group (group PS+CB) , and propofol used to supplement spinal anesthesia for sedation group (group PS+SA).In group G, after induction of anesthesia, laryngeal mask airway was inserted, the patients were then mechanically ventilated, and anesthesia was maintained with iv infusion of propofol (5-7 mg· kg-1 · h-1), remifentanil (20-25 μg· kg-1 · h 1) and cisatracurium besylate (0.1 mg· kg-1 · h 1).In group PS+CB, caudal block was performed with the mixture 0.8 ml/kg of 1％ lidocaine and 0.25％ bupivacaine.In group PS+SA, spinal anesthesia was performed with isobaric bupivacaine 1.0 mg/age.Propofol was then infused at 3-5 mg · kg-1 · h-1 for sedation in PS+CB and PS+SA groups.Before anesthesia (baseline, T0) and at 1, 5 and 10 min after emergence from anesthesia (T1-3) , heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) were recorded.The emergence time, time for recovery of orientation, and duration of stay in postanesthesia care unit were recorded.Pain was assessed and scored, and agitation was graded at 5 min after emergence from anesthesia, and the occurrence of intraoperative traction reaction, body movement and nausea and vomiting within 24 h after operation was recorded.Results No intraoperative traction reaction and body movement was found in group PS+SA, and no patients stayed in postanesthesia care unit in PS+CB and PS+SA groups.HR and MAP were significantly higher at T1-3 than at T0 in group G (P＜0.05).Compare with group G, the HR, MAP at T1-3, pain scores, agitation scores, incidence of nausea and vomiting were significantly decreased, and the emergence time and time for recovery of orientation were shortened in groups PS+CB and PS+SA (P＜0.05).Conclusion Propofol used to supplement spinal anesthesia for sedation is effective and provides faster recovery from anesthesia with fewer complications in the pediatric patients undergoing lower abdominal or lower extremity operations.

Objective:To promote the rational drug use in the patients treated with ambulatory chemotherapy. Methods:A model of integrated pharmaceutical care was established using such service as the real-time prescription examination, configuration standardi-zation, active care and prescription review. Results:The integrated pharmaceutical care could effectively reduce the unreasonable drug use, optimize drug use structure, lower the medical expenses and provide supporting data for clinical decision-making. Conclusion:The development of integrated pharmaceutical care in the patients treated with ambulatory chemotherapy is an important field for phar-macists displaying professional skills, which can promote the rational drug use. The treatment efficacy and life quality of cancer patients can be improved with the cooperation of doctors, nurses and pharmacists.

Objective To evaluate the influence of age factors on etomidate sedative potency.Methods One hundred and fifty (ASA physical status Ⅰ or Ⅱ) patients of both sexes,scheduled for elective operation under general anesthesia,were divided into 3 groups according to age (n =50 each):group Y 18-44 yr,group M 40-64 yr and group O 65-75 yr.Each group was randomly divided into 5 subgroups receiving in'venous etomidate 0.07,0.09,0.11,0.13 and 0.17 mg/kg,respectively.Loss of consciousness was evaluated depending on loss of eyelash reflex within 5 min after intravenous administration.Results ED50 of etomidate inducing loss of consciousness was 0.13,0.11 and 0.09 mg/kg in group Y,M and O,respectively.Compared with that in group Y,ED50 was significantly decreased in group O,however,and showed no significant change in group M.Conclusion Age factors can affect sedative potency of etomidate,which appears greater in the elderly patients.

Objective To investigate and analyze the influencing factors of community nursing cognition and employment intention of higher vocational nursing students,and provide reference for higher vocational colleges to carry out community nursing education and employment guidance.Methods Using the stratified cluster sampling method,nursing students from different grades and different education levels were selected as the object of study and participate in the questionnaire survey.Results The nursing students from different grades,education levels and areas showed significant difference in community nursing and employment intention.Conclusions Higher vocational nursing colleges should strengthen the community nursing practice education and community employment guidance; improve the community nursing cognition and community employment intention of nursing students.