Objective To evaluate interventional therapy for acute massive and submassive pulmonary embolism.Methods From June 2011 to June 2014.53 patients were enrolled and divided into group massive pulmonary embolism (MPE,n =16) and group submassive pulmonary embolism (SPE,n =37),both receiving catheter thrombectomy + contact thrombolysis within 12 hours after diagnosis.Preand post-interventional measures were assessed,including mean pulmonary arterial pressure (MPAP),cardiac biomarkers,tricuspid regurgitation,right ventricular (RV) dilatation,and massive hemorrhage within 72 hours.Patients were followed up for 6 months for the occurrence of chronic thromboembolic pulmonary hypertension.Results In all 53 patients were successfully completed catheter thrombectomy +contact thrombolysis,the mean pulmonary artery pressure in group MPE decreased from (47 ± 6)mmHg to (34 ± 4) mmHg (P ＜ 0.05),and in group SPE decreased from (44.2 ± 1.5) mmHg to (31.4 ± 6.2) mmHg (P ＜ 0.05).The ventriculus dexter disfunction was alleviated in 78.4％ patient after therapy.Overall 1.9％ patients suffered from massive hemorrhage,(0) in group MPE,and (2.7％)in group SPE.The incidence of chronic thromboembolic pulmonary hypertension during 6 moths follow up was 0.Conclusion Early interventional therapy for massive and submassive pulmonary embolism decreased pulmonary artery pressure,relieved right ventricular dysfunction,reduced bleeding complications and the incidence of chronic thromboembolic pulmonary hypertension.

Objective: To investigate the correlation between serum inflammatory cytokines interleukin-6 (IL-6), IL-10, tumor necrosis factor alpha (TNF-alpha), C reactive protein (CRP) and prognosis in elderly patients with severe pneumonia. Methods: From May 2015 to September 2017, 82 cases with severe pneumonia in Shanxi Dayi Hospital were selected as severe pneumonia group, during the same period, 67 elderly patients with common pneumonia in Shanxi Dayi Hospital were selected as common pneumonia group.According to the outcome of severe pneumonia, the patients were divided into survival group and death group.The serum levels of IL-10, IL-6, TNF-alpha and CRP were detected.The correlation between the inflammatory factors and the prognosis of elderly patients with severe pneumonia was analyzed. Results: The serum levels of IL-6, IL-10, TNF-alpha, CRP in the severe pneumonia group were (88.34±11.62)pg/mL, (16.87±3.52)pg/mL, (69.35±10.26)ng/L, (27.81±5.54)mg/L, respectively, which in the common pneumonia group were (35.61±10.45)pg/mL, (8.12±1.37)pg/mL, (27.79±6.34)ng/L, (5.93±1.42)mg/L, respectively, the differences between the two groups were statistically significant (t=12.154, 8.637, 10.872, 6.993, all P<0.05). Of 82 elderly patients with severe pneumonia, 12 cases died, 70 cases survived, the serum levels of IL-6, IL-10, TNF-alpha, CRP in the survival group were (75.93±10.21)pg/mL, (12.93±2.31)pg/mL, (58.32±8.17)ng/L, (23.42±3.38)mg/L, respectively, which in the death group were (94.11±15.32)pg/mL, (19.12±3.78)pg/mL, (72.16±11.59)ng/L, (34.91±6.54)mg/L, respectively, the differences between the two groups were statistically significant (t=10.976, 5.618, 8.742, 9.013, all P<0.05). The correlation analysis showed that IL-6, IL-10, TNF-alpha, CRP were positively correlated with the prognosis of senile patients with severe pneumonia (r=0.793, 0.332, 0.528, 0.814, all P<0.05). Conclusion There is a significant correlation between IL-6, IL-10, TNF-alpha, CRP and prognosis of elderly patients with severe pneumonia, which is helpful for the prognosis evaluation of elderly patients with severe pneumonia.

Objective:To explore the effect of kangaroo care on the neurological behavior of neonatal intensive care unit (NICU) neonates with asphyxia.Methods:Totally 76 cases of neonatal asphyxia admitted to NICU from January 2018 to December 2018 were randomly divided into observation group (40 cases) and observation group (36 cases). The control group was given routine nursing care, while the observation group was given kangaroo nursing intervention on the basis of the control group. The neurobehavioral changes, the occurrence of nervous system damage and the physical development after 42 days of birth were compared between the two groups.Results:The scores of behavior ability (11.64 ± 0.26), original reflex (5.89 ± 0.32), passive muscle tension (7.64 ± 0.46), active muscle tension (7.83 ± 0.55), general reaction (6.17 ± 0.46) in the intervention observation group were significantly higher than those in the control group (11.02 ± 0.39), original reflex (5.53 ± 0.31), passive muscle tension (7.21 ± 0.47), active muscle tension (6.17 ± 0.46) Tension (7.41 ± 0.41), general reaction (5.88 ± 0.41) ( t values were 8.227, 4.970, 4.027, 3.740, 2.888, P<0.05). The incidence of neurological damage in the observation group was 2.50% (1/40) which was significantly lower than 16.67% (6/36) in the control group ( χ 2=4.117, P < 0.05). The growth of body weight (2.17 ± 0.42) kg, length (7.15 ± 1.74) cm and head circumference (4.38 ± 0.93) cm in the observation group were significantly higher than those in the control group (1.68 ± 0.39) kg, (5.89 ± 1.81) cm, (3.81 ± 0.79) cm ( t values were 5.252, 3.093, 2.863, P<0.05). Conclusion:Kangaroo nursing can effectively promote the neurological development and physical development of neonatal asphyxia, and reduce the nervous system damage of asphyxiated neonates, and the operation is simple and easy, which is worthy of clinical application.