Objecitve To investigate the changes of chronotropic response before and after percutaneous coronary intervention ( PCI)in patients with coronary disease .Methods A total of 339 patients with coronary disease was included in this study .All sub-jects underwent treadmill exercise test and coronary angiogram , and some patients underwent PCI if necessary .The parameters of chro-notropic response were recorded and analyzed , including ratio of the highest to predicted heart rates ( rHR) ,chronotropic response in-dex ( CRI) , and heart rate reserve ( HRR) .After coronary angiogram , the score of gensin was recorded and analyzed .Results There was significant difference in the parameter of CRI between unstable angina pectoris and silent myocardial ischemia groups ( P <0.05 ) , CRI were 0.80 ±0.11 and 0.89 ±0.07 , respectively .After coronary angiogram and PCI , there were significant differences in the parameters of rHR, CRI, and HRR between pre-therapy and post-treatment ( t =2.440, 1.977, 2.529, all P <0.05).A nega-tive correlation was found between the parameters of rHR , CRI, and HRR and the score of Gensin ( r =-0.686 , -0.673 , and-0.672, all P <0.05).The significant difference in rHR, CRI, and HRR existed between the groups of <20 and >40 ( t =2.567, 2.223, 2.062, all P <0.05).Conclusions Parameters (rHR, CRI, and HRR) had important clinical values in evaluating the changes of chronotropic response before and after PCI in patients with coronary disease with a negative correlation with the score of Gensin.

Objective To investigate the genotype ,distribution and drug resistance of 24 multi-drug resistant Escherichia coli i-solates from the patients in the hospital 24 cases of multi-drug resistant genotyping and resistance ,the distribution of its depart-ments in the hospital ,to provide basis for rational use of antibiotics in clinical patients .Methods By MIC method to analyze antimi-crobial susceptibility of Escherichia coli ,Enterobacter Genetics adopt consistent between repetitive sequences (ERIC)-polymerase chain reaction (PCR) screening carried out the multi-drug resistant Escherichia coli genotyping .Results Statistics showed that the hospital were isolated 24 strains were divided into two types A and B2 type genotype .Distribution is 10 in respiratory ,6 in urology , 5 in ICU (B2 type 3) ,3 in hematology and oncology (B2 type 1) .Drug susceptibility results of 4 type B2 ,for cefoxitin ,ceftazidime , amikacin ,ticarcillin + clavulanic acid are all manifestations of resistance .24 strains of Escherichia coli ,amoxicillin ,cephalothin , gentamicin ,ticarcillin ,piperacillin resistance rate reached more than 70% .Conclusion B2-type strain showed multidrug resistance , pathogenicity strong ,and mainly in the ICU and hematology and oncology ,the use of antibiotics should be based on reasonable ad-justments in patients infected with different genotypes of Escherichia coli .

ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.

Objective To investigate nerve fibers distribution in endometrium of adenomyosis and their relationship with dysmenorrhea. Methods Endometrial tissue was sampled from 74 hysterectomy specimens including 32 cases with adenomyosis and 42 cases with uterine fibroids. Two-step Envision immunohistochemical staining was used to detect distribution of nerve fibers in endometrium. Highly specific polyclonal rabbit anti-protein gene product 9.5 (PGP9.5) and monoclonal mouse anti-neurofilament protein (NF) were used to demonstrate both myelinated and unmyelinated nerve fibers in endometrium in women with adenomyosis and uterine fibroids. Results The positive rate of PGP9.5 immunoreactive nerve fibers in the functional layer of endometrium of pain patients were with 64%(14/22) in adenomyosis and 67% (10/15) in uterine fibroids. And their density were 0.6(0-9.4)/mm2 and 0.6(0-6.0)/mm2 without reaching statistical difference (P> 0.05). No expression of NF could be detected in the functional layer of endometrium of adenomyosis and uterine fibroids. There were no PGP9.5 immunoreactive nerve fibers in the functional layer of endometrium in non-pain women with adenomyosis and uterine fibroids. Moreover, No NF immunoreactive nerve fibers in the functional layer of endometrium were shown in non-pain patients with adenomyosis and uterine fibroids. PGP9.5 immunoreactive nerve fibers and the nerve density in the basal layer of endometrium were 64%(14/22), 1.1(0-12.0)/mm2 in pain adenomyosis and 50%(5/10), 0.6(0-3.0)/mm2 in non-pain adenomyosis. NF immunoreactive nerve fibers and the density in the basal layer of endometrium were 23%(5/22),(0-0.6)/mm2 in pain adenomyosis and 20% (2/10),(0-1.0)/mm2 in non-pain adenomyosis. PGP9.5 immunoreactive nerve non-pain fibroids. NF immunoreactive nerve fibers and the nerve density in the basal layer of endometrium were 40%(6/15),0(0-0.4)/mm2 in pain fibroids and 15%(4/27),0(0-1.0)/mm2 in non-pain fibroids. There was no statistical different PGP9.5 and NF immunoreactive nerve fibers distribution in basal layer of endometrium between pain adenomyosis and pain fibroids or between non-pain adenomyosis and non-pain fibroids (all P>0.05). However, PGP9.5 immunoreactive nerve fibers density in basal layer of endometrium was higher in pain adenomyosis and fibroids when compared with non-pain adenomyosis and fibroids(P<0.05). Conclusions PGP9.5 immunoreactive nerve fibers might confer the occurrence of pelvic pain, however, NF immunoreactive nerve fibers may not involved in the pathogenesis of pain.

Objective:Scope review of exercise-related research in patients with inflammatory bowel disease (IBD), while pointing out the limitations of existing research, and providing references for future studies in this area.Methods:We searched PubMed, EMBASE, Web of science, Cochrane databases, China Biology Medicine, Chinese National Knowledge Infrastructure, Wan Fang Data, and Chinese Science Journal Database for studies related to exercise intervention in patients with IBD from January 1974 to July 2020. We extracted data from the included studies. Then we summarized and presented the results.Results:16 articles were finally included, of which 14 were randomized controlled trials and 2 were quasi-experimental studies. Results show that exercise methods can be divided into four categories: aerobic exercise, resistance exercise, flexibility exercise and mixed exercise. The intensity of exercise was mostly low to moderate. The frequency of exercise was mostly 3 times/week, lasting for 30-60 minutes per session. The results showed that exercise had positive effects on physical fitness, bone density, anxiety and depression, quality of life among patients with IBD. However, the effect of exercise on disease activity are diverse.Conclusion:exercise is beneficial to the mental and physical health among this group, but the existing studies have small sample sizes, short exercise intervention period, neglect of individualization in exercise prescription design, low exercise compliance, non-uniformity of exercise effect evaluation indicators.

Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.

Self-disclosure is a simple and effective intervention to improve the health outcomes of patients. Foreign scholars have paid attention to it and applied it in the self-management of patients with chronic diseases widely. However, there are few domestic related studies in China. This article reviewed the definition, significance, assessment tools, and summarized the influencing factors and intervention studies of self-disclosure in patients with chronic diseases. It would provide references for research of self-disclosure, further improving the self-management and mental health of patients with chronic diseases.

Objective:To observe the effect of self-designed Buqi Huoxue Decoction on the rehabilitation of patients with stroke sequelae and qi deficiency and blood stasis syndrome.Methods:A total of 116 patients with stroke sequelae treated from October 2019 to October 2020 were selected and divided into observation group and the control group by randomized digital tables, 58 patients in each group. The control group was given the conventional treatment, and the observation group combined self-designed Buqi Huoxue Decoction and conventional treatment. Both groups were treated for 3 months. The soluble vascular cell adhesion molecule-1 (sVCAM-1), nito-oxide (NO), endothelin (ET-1), endothelial-derived hyperpolarization factor (EDHF), insulin-like growth factor (IGF-II), interleukin-1β (IL-1β), interleukin-6 (IL-6) levels were detected by ELISA. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit, motor function was evaluated by the Fugl-Meyer motor function scale (FMA), patients' daily living ability was assessed by daily living ability assessment table (ADL), the QLQ-C30 was used to evaluate the QoL of patients. The TCM syndrome scores were evaluated. The clinical response was compared between the two groups.Results:The total response rate was 94.8%(55/58) in the observation group and 81.0%(47/58) in the control group. There was significant difference between the two groups ( χ2=3.98, P=0.046). After treatment, the scores of TCM syndrome and NIHSS of pruritus in the observation group were significantly lower than those in the control group ( t values were 5.61, 5.21, respectively, all Ps<0.01). After treatment, the scores of FMA, ADL QLQ-C30 of pruritus in the observation group were significantly higher than those in the control group ( t values were 3.61, 3.13, 9.38, respectively, all Ps<0.01). After treatment, the NO[(87.61±19.18) μmol/L vs. (77.93±17.26) μmol/L, t=2.81], EDHF [(21.14±6.14) μmol/L vs. (16.61±4.52) μmol/L, t=4.45] levels in the observation group were significantly higher than those in the control group ( P<0.01). After treatment, the sVCAM-1[(309.58±30.11) μg/L vs. (354.16±33.04) μg/L, t=7.46], ET-1 [(50.07±18.23)ng/L vs. (66.31±17.89)ng/L, t=4.76] levels in the observation group were significantly lower than those in the control group ( P<0.01). After treatment, IL-1β, IGF-Ⅱ, IL-6 levels in the observation group were significantly lower than those in the control group ( t values were 4.66, 8.14 7.43, respectively, all Ps<0.01). Conclusion:The treatment of self-designed Buqi Huoxue Decoction can improve the vascular endothelial function, inhibit the inflammation, reduce the nerve function damage, improve the limb movement function, daily life ability, quality of life and the clinical symptoms.

Objective:To deeply explore the supportive care needs of patients with inflammatory bowel disease, in order to provide reference for the development of supportive care strategies.Methods:A qualitative description was conducted based on the supportive care needs framework. Objective sampling method was used to select 17 patients with inflammatory bowel disease from the First Affiliated Hospital with Nanjing Medical University from August to November 2021 for semi-structured in-depth interview and directed content analysis was used to analyze the interview data.Results:The final analysis yielded a total of 5 categories. These were physiological need, information need, practical (daily life) need, emotional and social support need, psychological and spiritual needs. They were all within the framework of supporting care needs.Conclusions:In the future, targeted education and diversified social support should be implemented based on the needs of patients with inflammatory bowel disease and from the perspectives of hospital, family members and peers.