Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

AIM: To observe the clinical effect of Ex - press glaucoma filtration device implantation under scleral flap for traumatic glaucoma.
METHODS: Totally 19 eyes of 19 patients with traumatic glaucoma were implanted with Ex - press glaucoma filtration device under the scleral flap from December 2012 to May 2013. The postoperative visual acuity, anterior chamber depth and hyphema,intraocular pressure(IOP), filtering bleb and other complications were observed and summarized.
RESULTS: Ex - press glaucoma filtration device were implanted successfully in 19 patients. At 1d postoperatively shallow anterior chamber was occurred in 2 eyes and hyphema was occurred in 3 eyes. At 3mo postoperatively increased vision was occurred in 9 eyes (47%),functional filtering bleb was occurred in 18 eyes ( 95%), and IOP was 12. 1 ± 6. 1mmHg. At 6mo postoperatively increased vision was occurred in 11 eyes (58%),functional filtering bleb was occurred in 18 eyes (95%),and IOP was 13. 3±6. 9mmHg. Compared with the preoperative IOP ( 29. 8 ± 6. 7mmHg), the difference was significant(P<0. 05).
CONCLUSION: Ex - press glaucoma filtration device implantationfor traumatic glaucoma can improve the postoperative vision and control the postoperative IOP stably with fewer complications and high safety.

Continuing medical education is one of major parts in medical education system of minimal invasive surgeon. Based on the characteristics of net continuing medical education such as freedom of learning, no regional restriction and abundant resource, combined with visualized teaching of minimal invasive surgery education, the novel training model of e-learning based on internet was applied to establish minimal invasive surgery continuing education system.

To improve the management level of patients' information of schistosomiasis control stations in Nanchang City,the B/S three-layer architecture and ASP+SQL technology were applied to formulate the WEB-based management system of chronic schistosomiasis patients' information,so as to achieve the information sharing of chronic schistosomiasis among schistosomiasis control stations.

Heart Aneurysm ; mortality ; pathology ; surgery ; Humans ; Mitral Valve Insufficiency ; mortality ; physiopathology ; surgery ; Myocardial Infarction ; mortality ; physiopathology ; surgery ; Ventricular Dysfunction, Left ; pathology ; surgery

Objective To provide basis for the formulation of policies and measures that will reduce the work pressure on nurses and to provide them with a better working environment. Methods An investigation was made via questionnaires into 942 nurses working in designated SARS hospitals and a comprehensive analysis was conducted by means of multivariant stepwise regression. Results The major factors affecting the pressure on nurses include: lack of support from and communications with families, arduousness of tasks to an unbearable point, extreme strictness in management, and unsoundness of treatment and living conditions. Conclusion Good communications with families are of great significance to nurses working in isolated areas. It is imperative to rationally allocate the human resources of nurses, show more concern for them, encourage them to participate in management, and strengthen scientific prevention so as to create a better working environment.

Objective To evaluate the early outcome of off-pump total arterial revascularization using bilateral IMA with "Y" manner. Methods Between Oct.2002 to Aug.2004, 52 patients underwent off-pump coronary artery bypass grafting (OPCABG) using bi-IMA. The mean age was 56 (33-78) years. Triple vessel disease was in 42 (80%) patients. The free right IMA was anastomosed to the in-sitr left IMA, composed “Y” graft. LIMA anastomosed sequentially to the diagonal branch and LAD and RIMA were sequentially to the ramus, obtuse marginal and PDA. Results There was no 30-day death. 171 grafts were constructed and the mean number of grafts per patient was 3.3. Peri-operation MI occurred in 2 patients, temporary IABP in one. There were no sternal wound infection and strode. Conclusion Off-pump total arterial revascularization using bilateral IMA with "Y" manner is secure and feasible.

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

Based on high requirement on trainingtarget ofcultivating8-year medical students and combined with the characteristic of general surgical teaching,we applied logical thinking to strengthen students'clinical thoughts and self-analysis ability to make them become the advanced medical talents with good clinical thoughts.

Objective To compare the treatment effects and toxicity of convention fractionation ra- diotherapy(CFR),late course accelerated hyperfractionafion radiotherapy(LCAFR) and whole course accel- erated hyperfractionation radiotherapy(WCAFR) for patients with middle or low thoracic esophageal moder- ately differentiated squamous cell carcinoma.Methods Ninety patients with middle or low thoratic esoph- ageal carcinoma were divided into three groups:1.CFR group,patients were irradiated 2.0 Gy/f,5 times a week,to a total dose of 70 Gy;2.LCAFR group,patients were first irradiated with CFR to 40 Gy,then fol- lowed by 1.5 Gy/f bid,at more than 6 hoursinterval,5 times a week,to a total dose of 70 Gy;3.WCAFR group,patients were irradiated 1.5 Gy/f bid,at more than 6 hoursinterval,5 times a week,to a total dose of 72 Gy.Results The 1-,2-,3-year local control rate was 47%,17% and 0% in CFR group,60%,20% and 20% in LCAFR group,60%,40% and 33% in WCAFR group,respectively.The 1-,2-,3-year survival rate was 47%,20% and 10% in CFR group,63%,43% and 17% in LCAFR group,and 63% ,50% and 33% in WCAFR group,respectively.There were better results in the latter two groups(P＜0.01).The a- cute toxic effect was severer in the WCAHF and LCAF groups than in CF group.Highter grade 2-3 acute esophagitis rate was observed both in WCAHF and LCAF groups.There were no significant differences in late esophagitis rate between the three groups.The grade 1-2 acute radiation pneumonitis rates were higher in WCAHF group than in LCAF and CF groups.One patient died of radiation pneumonitis in WCAHF group. Conclusions Whole course accelerated hyperfractionation radiotherapy can significantly improve the local control rates and the 1-and 2-year survival rates of esophageal cancer,but can also increase the toxicity.