Objective To investigate the relationship between infarct location and prognosis after emergency percutaneous coronary intervention (PCI) treatment in patients with acute myocardial infarction.Methods Consecutive 121 patients with ST elevation myocardial infarction (STEMI) who underwent primary PCI were divided into 3 groups according to the infarct location.Their clinical,ECG,echocardiography and coronary angiography features were analyzed,and the follow-up was made. Results Compared with inferior wall infarction group and inferior wall infarction combined with right ventricular infarction group,anterior wall myocardial infarction group had higher CPK-MB and cTnT,less frequent collateral,reduced ST-segment resolution,higher mortality rates in hospitalization and one year after discharge.On the other hand,inferior infarction combined with right ventricular infarction group had more occurrences of shock and atrial vetricular block or ventricular arrhythmia,more incidence of multivessel disease and thrombus,and higher readmission rate.Conclusion Patients with anterior wall myocardial infarction and inferior wall in

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.

Objective:To study the effect of interference TIPE3 on the colon cancer cell growth by transfecting SW480 colon cancer cells with the TIPE3 interference plasmid were detected.Methods:Transfecting the constructed TIPE3-shRNA-pSIREN-RetroQ plasmid to SW480 cells.To determine the highest interference efficiency plasmid ,the mRNA and protein levels of recombined plasmid were detected by RT-PCR and Western blot separately and tested the cell proliferation with CCK 8.Meanwhile,apoptosis rate of SW480 cells was determined by flow cytometry assay with AnnexinV-FITC/PI.To further determined the effects of recombined plasmid on cell development ,the level of protein involved in proliferation and apoptosis were detected by Western blot .Results:The most effecient in-terference plasmids were successfully constructed.We found that the cell survival rate decreased when interference TIPE 3 gene express-ing in colorectal cancer cells .Flow cytometry indicated that interefering the expression of TIPE 3 would increase the sensitivity of SW 480 cell to apoptosis induced by aDR5ScFv.The results of Western blot showed that low expression of TIPE 3 would activate caspase3 and downregulate the expression of p-AKT,p-PDK1 and PCNA.Conclusion:Interference TIPE3 could promote apoptosis and inhibit prolif-eration in SW480 colon cancer cells .

Objective To explore the observation and nursing on complications of artificial vessel arteriovenous fistula in hemodialysis patients. Methods The targeted treatment and nursing care were implemented according to different complications in 40 hemodialysis patients with artificial vessel arteriovenous fistula. Results A total of 25 complications happened in 13 patients. All the patients were cured without dysfunctions after targeted treatment and nursing care. Conclusion Detecting and dealing with the symptoms of complications of artificial vessel arteriovenous fistula in time is important to prolong the using time of artificial vessel arteriovenous fistula.

Objective To evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in treatment of patients with liver cancer.Methods Totally 20 patients with liver cancer undergoing DEB-TACE treatment were enrolled.Clinical efficacy included complete response (CR),partial response (PR),stable disease (SD) and progressive disease (PD).The overall response rate (ORR) was defined as proportion of patients achieved CR and PR.Results After treatment of DEB-TACE,the ORR,CR,PR,SD,and PD of patients were 80.00％ (16/20),40.00％ (8/20),40.00％ (8/20),15.00％ (3/20),and 5.00％ (1/20),respectively;while for single tumor nodule,the ORR,CR,PR,SD,and PD were 81.58％ (31/32),50.00 (19/38)％,31.58％ (12/38),15.79％ (6/38),and 2.63％ (1/38),respectively.After the treatment of DEB-TACE,the relapse free survival rate in half year was 85.00％,and the overall survival rate was 95.00％.The adverse events of patients were mild pain,fever,nausea and vomiting.Conclusion CalliSpheres(R) DEB-TACE is an effective and well tolerated treatment in liver cancer patients.

Objective To explore the application of entire information management system in nursing of patients with high-risk pressure ulcers and to evaluate its influence on the high risk of pressure ulcers prevention management.Methods Established core group of pressure ulcers management to provide professional guidance to high-risk pressure ulcers patients nursing in whole hospital, structured information management module, improved high-risk pressure ulcers report, added statistical form for it, implemented intelligent record as well as automatic statistics, improved and implemented nursing management work flow for high risk pressure ulcers patients, strengthen supervise to the practical to pressure ulcers prevention, and dynamically managed the whole process from reporting to lapsing of high risk patients by information system.Results After the implementation of entire information management system, pressure ulcers incidence of high risk patients in hospital was significantly decreased compared with that of before(18.98%vs 32.64%;χ2 =10.032,P<0.01).The report accuracy of pressure ulcers was improved than that before (98.15% vs 91.71%;χ2 =9.084,P<0.01).The time for nursing administration department making statistics for pressure ulcers case quarterly was decreased from 6 hours to 20 minutes.Conclusions Adopting the entire information management system of pressure ulcers can decrease the pressure ulcers morbidity of high risk patients, increase the accuracy of report for high-risk pressure ulcer, improve work efficiency of statistical analysis to high-risk pressure ulcers, and improve the work for prevention and control of pressure ulcers.

Objective:To explore methods and effects of training and rotation of newly recruited nurses in ClassⅢ hospitals of traditional Chinese medicine (TCM) so as to provide references for improving the clinical nursing service ability of newly recruited nurses in hospitals of traditional Chinese medicine and providing practical TCM nursing talents for clinical practice.Methods:According to the requirements of the"Standardized Training Outline for Newly Recruited Nurses (Trial)""Systematic and Standardized Training Program for Newly Recruited Nurses in ClassⅢ Hospitals of Traditional Chinese Medicine"was formulated. Using the convenience sampling method, 95 nurses from the First Affiliated Hospital of Zhejiang University of Chinese Medicine were selected as the research objects. A total of 95 newly recruited undergraduate nurses who graduated in 2016 were given pre-job training for 3 weeks and specialist rotation training for 24 months. After 3 weeks of training, theoretical test and nursing skills assessment of traditional Chinese medicine and western medicine were conducted to evaluate the comprehensive ability of clinical practice after 1 year and 2 years of rotation.Results:After 3 weeks of training, the average scores of theoretical test, western medicine nursing operation and TCM nursing operation of 95 newly recruited nurses were respectively (88.63±4.74) , (95.57±0.75) and (93.18±1.63) . The score of comprehensive ability of clinical practice after 1 year of rotation was (84.05±4.96) , and that after 2 years of rotation was (90.62±2.38) . The differences in scores were statistically significant ( P<0.05) . During the rotation phase, none of 95 newly recruited nurses had patient complaints or serious errors. Conclusions:Through training and rotation, newly recruited nurses can quickly complete the role transformation of nurses, consolidate the basic theoretical knowledge and skills related to TCM nursing and improve the comprehensive ability of clinical nursing practice to ensure the quality of nursing.

Objective:To construct a Traditional Chinese Medicine (TCM) nursing training system for nurses with medium-grade professional title in TCM hospitals based on Kirkpatrick model, so as to provide a reference for the training of nurses with medium-grade professional title in TCM hospitals.Methods:Based on the Kirkpatrick model, combined with the results of literature review, questionnaire survey and semi-structured interviews, the first draft of the training system was formulated and the expert consultation questionnaire was prepared. A total of 21 experts from Zhejiang Province were selected for 2 rounds of expert correspondence.Results:The questionnaire recovery rate of the two rounds of expert correspondence was 100%. The expert authority coefficients were 0.89 and 0.91, and the Kendall's W were 0.239 and 0.176 ( P<0.001) . The final training system included 3 first-level indicators, 11 second-level indicators, 37 third-level indicators and 145 fourth-level indicators. Conclusions:The construction method of the TCM nursing training system for nurses with medium-grade professional title is scientific and the content is reasonable and comprehensive, which can provide a scientific reference for the training of nurses with medium-grade professional title in TCM hospitals.

OBJECTIVE To screen the quality biomarkers of Gnaphalium affine with anti-chronic obstructive pulmonary disease （COPD） effect and determine their contents. METHODS The effective components and targets of “G. affine” with anti- COPD effect were predicted by using network pharmacology as a search criterion. HPLC fingerprints for 10 batches of G. affine were established by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）； common peak identification and similarity evaluation were conducted； cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed to screen differential components as quality maker that affected the quality of G. affine using variable importance projection （VIP）＞1 as the standard. The same HPLC method was adopted to determine the contents of the differential components in 10 batches of samples. RESULTS A total of 10 flavonoids （such as quercetin， luteolin， and chlorogenic acid） and organic acid components， were identified through network pharmacology search， with 91 targets closely related to anti-COPD. A total of 9 common peaks were identified in 10 batches of samples， with similarity greater than 0.90. Among them， the differential components included chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid and apigenin 7-O-β-D-glucopyranoside； S3， S4， S6， S7 and S10 were clustered into one category， S2， S5， S8 and S9 clustered into one category， and S1 clustered into one category. The contents of chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid， and apigenin 7-O-β-D-glucopyranoside in 10 batches of G. affine ranged 0.070-7.653， 0.010-0.097， 0.001- 0.036， 0.508-6.627 mg/g， respectively. CONCLUSIONS Chlorogenic acid， caffeic acid， 1，3-O-dicaffeoylquinic acid， apigenin 7- O-β-D-glucopyranoside can serve as the potential quality marker for the anti-COPD effect of G. affine， with the highest content of chlorogenic acid in G. affine produced in Ji’an， Jiangxi province， and the highest content of caffeic acid in G. affine produced in Ji’an， Jiangxi province and Sanming， Fujian province. The contents of the last two components are highest in G. affine produced in Chaoshan， Guangdong province.