Objective: To observe the relationship between plasma levels of NT-proBNP and pulmonary hypertension in patients with left heart failure (LHF).
Methods: A total of 391 LHF patients were enrolled in our study, according to pulmonary arterial pressure, the patients were divided into 3 groups: Control group, the patients without pulmonary hypertension,n=102, Mild pulmonary hypertension group,n=94 and Moderate to severe pulmonary hypertension group,n=195. Plasma levels of NT-proBNP, left ventricular diameter (LVD), right ventricular diameter (RVD) and left ventricular ejection fraction (LVEF) were examined and compared among 3 groups.
Results: Plasma levels of NT-proBNP and RVD in Mild pulmonary hypertension group and Moderate to severe pulmonary hypertension group were higher than Control group, those indexes in Moderate to severe pulmonary hypertension group were higher than Mild pulmonary hypertension group,P<0.05-0.001. While LVD and LVEF were similar among 3 groups, P>0.05.
Conclusion: Plasma levels of NT-proBNP were increased in LHF patients combining pulmonary hypertension, the changing trend elevated with the increased pulmonary hypertension accordingly.

OBJECTIVE: Exploring the clinical features of aviatic nasal diseases to provide references for medical evaluation, prevention and control measures in aircrew. METHOD: To analysis and summary 605 cases with 503 pilots of nasal diseases in aircrew during 1966 to 2013. RESULT: (1) There were 605 cases of aviatic nasal diseases, including 550 cases of general diseases and 55 cases of specific diseases. The general nasal diseases included 140 cases of anatomical abnormalities in nasal cavity type, 290 cases of inflammation in nasal cavity, 73 cases of allergy type, 47 cases of cyst and tumor type, and the specific nasal diseases were 55 cases of sinus barotrauma (SB). (2) The, constituent ratio of SB, which was happened in frontal sinus and /or maxillary sinus, was 95.55%. (3) The constituent ratio of cyst and tumor type in nasal cavity was easier causing to SB than anatomical abnormalities, inflammation, allergy disease in nasal cavity (P < 0.05). (4) The grounded constituent ratio of secondary SB was higher than anatomical abnormalities, inflammation, allergy, cyst and tumor disease in nasal cavity (P < 0.05). (5) The ways of hypobaric chamber tests were different for the kinds of aircrew. The qualified adjustment function of sinuses for barometric pressure was an essential condition for aircrew to continue flying. (6) The key point for the treatment of aviatic nasal diseases was to remove pathological change in nasal cavity and sinus and restore sinus ostium patency. The key point for the medical evaluation was to restore normal sinus pressure balance function. CONCLUSION The key point of medical evaluation about aviatic nasal diseases is to assess the sinus pressure balance function in hypobaric chamber tests. Normative treatment and medical evaluation can effectively avoid flight accidents and improve the attendance rate for aircrew.
Aerospace Medicine ; Barotrauma ; Cysts ; Frontal Sinus ; pathology ; Humans ; Hypersensitivity ; Maxillary Sinus ; pathology ; Nasal Cavity ; pathology ; Nose Diseases ; epidemiology ; prevention & control ; Paranasal Sinuses ; pathology

OBJECTIVE: To research the serum levels of BDNF, H2S and S-100β as metabolic product of hippocampus and cerebral cortex in moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients before and after surgery, and to analyze their correlations with cognitive impairment. METHOD: Forty-four randomly selected diagnosed OSAHS patients were divided into two groups according to Montreal Cognitive Assessment (MoCA), 19 cases in cognitively normal group and 25 cases in cognitive dysfunction group. Cases in cognitive dysfunction group underwent UPPP oriented surgery, and received 6 months follow-up, 21 cases were remained as treament group, 4 cases lost. 19 cases of healthy subjects were randomly selected as the normal control group. All groups were detected for the serum BDNF, H2S and S-100β levels to analyze the correlations between the biochemical indexes and sleep disorders indexes, hypoxia levels and cognitive function scores. RESULT: (1) In the comparison between the treatment group and the normal control group regarding PSG monitoring results, the AHI, I + II, LA/HT and SLT90% indexes of OSAHS patients increased, and the III + IV phase, REM phase, MSaO2 and LSaO2 decreased. In the comparison between the cognitive dysfunction group and the cognitively normal group, the III + IV, REM and LSaO2 indexes of the cognitive dysfunction group decreased. (2) In the comparison between cognitive dysfunction group and cognitively normal group, and between the treatment group and the normal control group, BDNF and H2S levels increased and S-100β levels decreased, and the MoCA total scores, attention, memory/delayed recall scores decreased. (3) The correlation between biochemical indexes with PSG indexes was as follows. The serum BNDF and H2S levels were negatively correlated with AHI index. The serum BNDF and H2S levels were positively correlated with III + IV stage, REM stage and MSaO2 indexes. The S-100β level was positively correlated with AHI index, and S-100β levels were negatively correlated with III + IV stage, REM stage, MSaO2 and LSaO2 indexes. (4) The correlation between biochemical indexes and MoCA scores was as follows. The serum BNDF and H2S levels were positively correlated with MoCA total scores, attention, and memory/delayed recall scores. The serum S-100β levels were negatively correlated with MoCA total scores, attention and memory/ delayed recall scores. (5) The linear regression equation between MoCA total scores in cognitive dysfunction group of OSAHS patients and the serum BNDF, H2S and S-100β levels was as follows: Y(MoCA) = 40.131 + 0.22 X(BDNF) + 0.012 X(H2S)-0.647X(S-100β) (R2 = 0.461). CONCLUSION OSAHS patients with sleep disorder and nocturnal hypoxemia might suffer from cognitive dysfunction in which attention and memory predominates. Serum BNDF, H2S and S-100β levels, which could indirectly reflect the metabolic abnormalities degree of hippocampus and cerebral cortex, are sensitive indicators of early cognitive dysfunction in OSAHS patients.
Brain-Derived Neurotrophic Factor ; metabolism ; Cerebral Cortex ; physiopathology ; Cognition Disorders ; complications ; Hippocampus ; physiopathology ; Humans ; Hypoxia ; Memory ; Metabolic Diseases ; physiopathology ; S100 Calcium Binding Protein beta Subunit ; metabolism ; Sleep Apnea, Obstructive ; complications

Objective To investigate the cerebral ischemia/reperfusion protection mechanism of viper venom nerve growth factor(vNGF) by the change of expression of growth associated protein-43 (GAP-43) and neurological function.Methods 45 adult male Wistar rats (weight 220～280 g) were divided randomly into 3 groups: sham group(S, n=9), balanced salt solution group (BSS, n=9) and venom nerve growth factor group (vNGF, n=27). Each group was observed for 7 days. vNGF group was divided into 25 U, 50 U and 100 U subgroups respectively. The following indexes in 3 groups were observed respectively: neurologic deficits and the expression of GAP-43 (immunohistochemistry method).Results Neurological function: The scores of neurological function was 0 in S group. The neurological deficits score was lower at the same time in vNGF group than that in BSS group (P<0.05). Immunohistochemistry: GAP-43 expressed in both BSS group and vNGF group. The expression of GAP-43 in vNGF group increased in 25 U, and to maximum in 100 U. The expression of GAP-43 in BSS group was significantly lower than in vNGF group (P<0.05). Conclusion vNGF can effectively enhance and prolong the expression of GAP-43, increase the survival rats of nerve cells, and has the protection effect on nerve cells after cerebral ischemia injured.

Objective:To explore the construction mode and innovative operation mode conducive to the sustainable development of nursing studio, and evaluate the practical effect of "named nursing studio".Methods:On the basis of carrying out outpatient specialized nursing service in Xuanwu Hospital of Capital Medical University, through further refining diagnosis and treatment service, optimizing treatment process, strengthening personnel training and promoting discipline development, a nursing studio named after nursing experts was formed, quality control standards and long-term follow-up were established, and a complete named nursing studio operation system was established. The number of nursing clinic patients before and after "named nursing studio" (January to December 2018 and January to December 2019) were counted. The data of patients before and after "named nursing studio", the patient′s satisfaction and other indicators after "named nursing studio" were compared.Results:The number of nursing clinic patients was 1 332 before "named nursing studio" and 1 346 after "named nursing studio". After "named nursing studio", re appointment increased from 63.59% (847/1 332) to 70.51% (949/1 346), and the proportion of patients referred by doctors increased from 10.66% (142/1 332) to 12.93% (174/1 346); the total satisfaction of patients reached 96.97% (993/1 024), forming a trinity of nursing, teaching and scientific research development model of nursing.Conclusions:The development of "named nursing studio" promotes the specialty nursing discipline characteristic and the specialty of nursing service brand construction. It is beneficial to solve the problem of difficulty of outpatient and inpatient care, meets the needs of nursing staff career development, reflectes the value of nurse staff, promotes the development of nursing science.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective:To construct a prediction model of pancreatic fistula after pancreaticoduodenectomy and explore its application value.Methods:The retrospective case-control study was conducted. The clinicopathological data of 285 patients with periampullary diseases who underwent pancreaticoduodenectomy in the the First Affiliated Hospital of Harbin Medical University from January 2015 to September 2018 were collected. There were 183 males and 102 females, aged (56±14)years, with a range from 12 to 84 years. According to the random numbers showed in the computer, patients were randomly divided into training dataset consisting of 214 patients and validation dataset consisting of 71 patients, with a ratio of 3∶1. The training dataset was used to construct prediction model, and the validation dataset was used to evaluate performance of prediction model. Observation indicators: (1) incidence of postoperative pancreatic fistula; (2) construction of prediction model of pancreatic fistula after pancreaticoduodenectomy; (3) validation of prediction model of pancreatic fistula after pancreaticoduodenectomy. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. The accuracy of prediction model was analyzed by drawing receiver operating characteristic curve and calculating area under curve (AUC). Results:(1) Incidence of postoperative pancreatic fistula: of 214 patients in the training dataset, 45 patients had postoperative pancreatic fistula, including 39 of grade B and 6 of grade C, respectively. (2) Construction of prediction model of pancreatic fistula after pancreaticoduodenectomy. Results of univariate analysis showed that body mass index(BMI), diameter of the main pancreatic duct on computed tomography (CT) scan, diameter of the main pancreatic duct by intraoperative exploration, pancreas texture, and level of amylase in ascites at the postoperative first day were related factors for pancreatic fistula after pancreaticoduodenectomy ( χ2=32.450, 15.789, 19.577, 4.559, Z=-7.962, P<0.05). Results of multivariate analysis showed that BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651U/L were independent risk factors for pancreatic fistula after pancreaticoduodenectomy ( odds ratio=0.148, 4.286, 0.086, 95% confidence interval: 0.058-0.376, 1.736-10.580, 0.032-0.231, P<0.05). Based on results of multivariate analysis, a prediction model of pancreatic fistula after pancreaticoduodenectomy was built: the predicted value of pancreatic fistula=Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]/1+ Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]. The model had the AUC of 0.888 (95% confidence interval : 0.832-0.943, P<0.05). (3) Validation of prediction model of pancreatic fistula after pancreaticoduodenectomy: in the validation dataset, the prediction model of pancreatic fistula after pancreaticoduodenectomy had the AUC of 0.868 (95% confidence interval: 0.780-0.957, P<0.05). There was no significant difference in the AUC between the training dataset and validation dataset ( Z=0.514, P>0.05). Conclusions:BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651 U/L are independent risk factors for pancreatic fistula after pancreaticoduodenectomy. Construction of a prediction model of pancreatic fistula after pancreaticoduo-denectomy can effectively predict the risks of postoperative pancreatic fistula.