Objective To investigate the change of serum von willebrand factor(vWF)level in the different stages of diabetic nephropathy and its significance. Methods 50 healthy subjects and 150 patients with type 2 diabetes mellitus were enrolled in this study. Diabetic patients were further divided into three subgroups according to their urinary albumin excretion rate(UAER): 56 patients with normal UAER,49 patients with microalbuminuria and 45 patients with clinical proteinuria. Serum vWF concentration was measured with emzyme linked immunosorbent assay (ELISA) method. Results vWF concentration was significantly higher in patients with type 2 diabetes mellitus than that in normal controls. Serum vWF concentration increased with the elevation of UAER. Serum vWF level was positively related with UAER, blood creatine and course of disease independently. Conclusion Serum vWF concentration increased in the patients with type 2 diabetes mellitus and the increased extent of vWF was consistent with the severe degree of diabetic nephropathy.

Objective To investigate changes in cardiac markers and its effect on instructing nursing of patients with acute coronary syndrome(ACS).Methods 100 ACS patients from cardiology department and CCU were randomly divided into the observation group and the control group. The control group was given routine care. the observation group was given intervention according to positive results of cardiac markers. Some indexes such as B-type natriuretic peptide, myoglobin, creatine kinase isoenzyme, cardiac troponin I, and EKG, congestive heart failure and cardiogenic shock as well as appraisal of patients and relatives to nurses were compared between the two groups. Results The observation group was better than the control group in subsequent indicators: B-type natriuretic peptide, myoglobin, creatine kinase isoenzyme, cardiac troponin I,EKG, congestive heart failure and cardiogenic shock, and appraisal of patients and relatives to nurses was also better than the control group. Conclusions Detection of cardiac markers not only has significance for diagnosis, risk stratification and prognosis of ACS, but also help to instruct nursing of ACS patients. It has an important role in raising the nurses ability to identify risk factors and take effective measures to reduce complications and mortality, improve satisfaction degree of patients and their family members.

Objective To study the possibility and effects of fixed TH glue embolization through gastroesophageal and percutanenous. Methods Forty-six patients of bleeding esophageal varices were divided randomly into two groups: in treatment group:twenty-five patients treated with TH glue (?-cyanoacrylate) embolization PTVE+PSE. Absolute alcohol-cilia steel ring-TH glue ,but in control group, 21 patients of esophageal varices by variceal ligation. Analysis the percentage of rebleeding, death rate and improvement rate of liver functions. Results In the treatment group,the rebleeding of gastroesophageal varices was 8.7%, the percentage of death was 4.3%, the function of liver improved by 87.0% . In the control group, the percentage of rebleeding was 28.6%, death rate was in 19.1% and liver function improved by 48.0%. Conclusion PTVE+PSE fixed TH glue embolization is safe, less destroyed. Compared with dense edoscopic ligation, DEVL, the advantage is lessre bleeding, less death rate and higher liver function improvement rate. It is an effective method for gastroesophageal varices.

Objective:To investigate predictive value of model based on pre-surgical 18F-FDG PET/CT metabolic parameters for mediastinal lymph node metastasis (LNM) in lung adenocarcinoma. Methods:A total of 288 patients with lung adenocarcinoma (135 males, 153 females, age (61.6±8.5) years) who diagnosed and treated in the Fourth Hospital of Hebei Medical University from January 2016 to February 2021 were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination within 1 month before operation, and underwent complete resection of primary lung tumor and standard lymph node dissection. PET/CT parameters were extracted (PET metabolic parameters: minimum SUV(SUV min), SUV max, SUV mean, SUV standard deviation (SUV std), metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT parameters: minimum CT value (HU min), maximum CT value (HU max), mean CT value (HU mean), CT value standard deviation (HU std)). Multivariate logistic regression analysis was used for screening parameters and establishing model to predict LNM. ROC curves analyses were used to evaluate the predictive performance of models. Results:Among 288 patients, 90 had LNM, and 361 metastatic lymph nodes (N1: 186, N2: 175) were reported by pathology. SUV min (odds ratio ( OR)=1.859, 95% CI: 1.074-3.220, P=0.027), SUV max ( OR=2.255, 95% CI: 1.306-3.893, P=0.004), SUV mean ( OR=0.277, 95% CI: 0.115-0.665, P=0.004) were predictors of LNM. The AUC of PET/CT model was 0.849 (95% CI: 0.804-0.893), and the sensitivity, specificity, accuracy, and positive and negative predictive values were 87.8%(79/90), 72.2%(143/198), 77.1%(222/288), 59.0%(79/134) and 92.9%(143/154), respectively. Conclusion:The model based on 18F-FDG PET/CT metabolic parameters can improve the accuracy of pre-surgical N-staging in patients with lung adenocarcinoma.