Objective To investigate relationship among Brachial-ankle pulse Wave Velocity (baPWV),Homocysteine (Hcy),Serum Matrix Metallopro Teinases-9 (MMP-9) and coronary heart disease.Methods Sixty-six cases of patients diagnosed as coronary heart disease according to the coronary angiography showed any one of the main coronary arteries (left main,left anterior descending,left circumflex artery,right coronary artery) diameter stenosis≥ 50％ were selected into coronary heart disease from June 2009to March 2011 hospitalized in the Second Affiliated Hospital of Ningxia Medical Cardiology.And 40 cases of healthy people who had medical examination over the same period were selected into the normal control group.The 66 cases of patients were further divided into single-branch-affected group (n =18),two-branchaffected group(n =25) and multi-branch-affected group (n =23) according to the branches of coronary artery pathological changes shown in coronary angiography.Detected and compared baPWV,Hcy and MMP-9 among these groups.Results The baPWV,Hcy and MMP-9 in coronary heart disease group were significantly higher than those in the control group (baPWV:(2132 ±240) cm/s vs (1360 ±81) cm/s,t =23.97,P ＜0.01 ;Hcy:(14.32 ± 5.20) μmol/L vs (6.50 ± 1.40) μmol/L,t =11.54,P ＜ 0.01 ; MMP-9:(768.0 ± 95.3) μg/L vs (228.0 ±56.2) μg/L,t =36.69,P ＜0.01) ;The baPWV,Hcy and MMP-9 in multi-branch-affected group were significantly higher than those in single-branch-affected and two-branch-affected group; The baPWV,Hcy and MMP-9 in two-branch-affected group were higher than those in single-branch-affected group (baPWV (2041 ±168) cm/s vs (1873 ± 150) cm/s vs (1560 ± 172) cm/s,F =45.36,P ＜0.01 ;Hcy:(21.31 ±6.30) μmol/L vs (15.32 ± 5.80) μmol/L vs (10.50 ± 3.20) μmol/L,F =36.18,P ＜ 0.01 ;MMP-9:(1042.0 ± 180.2) μg/L vs (940.0 ± 175.8) μg/L vs (723.0 ± 102.2) μg/L,F =41.06,P ＜ 0.01).The serum MMP-9 was significantly positive correlated with baPWV and Hcy (r =0.630,P ＜0.01 ;r =0.351,P ＜0.05) ;The Hcy was significantly positive correlated with baPWV (r =0.475,P ＜ 0.05) in the coronary heart disease group.Conclusion The baPWV,Hey and MMP-9 were related with the degree of artery stenosis in coronary heart disease.Combined detection of these three markers can be used to assess the risk of coronary heart disease.

Objective To observe changes of CT quantitative indexes in patients with untreated chronic obstructive pulmonary disease(COPD)and relationships with pulmonary function indicators.Methods Totally 99 patients with untreated COPD were retrospectively enrolled.According to the degrees of airflow obstruction,the patients were divided into group A(GOLD grade 1 with mild obstruction,n=36),group B(GOLD 2 with moderate obstruction,n=37)and group C(GOLD 3 or 4 with obvious obstruction,n=26).The results of chest CT and pulmonary function tests conducted at the first diagnosis and the follow-up,as well as their correlations were analyzed.CT quantitative indicators included the whole lung volume,low-attenuation areas less than-950 percentage(LAA％),total number of vessels per 1 cm2 of lung surface area(Ntotal/LSA),total number of vessels with area less than 5 mm2 per 1 cm2 of lung surface area(N＜5mm2/LSA),the square root of the wall area of a hypothetical airway with a 10 mm internal perimeter(Pi10),the entire volume,wall thickness and wall area percentage(WA％)of airway wall,etc.,while results of pulmonary function tests included the forced expiratory volume in one second(FEV1)after administration of a bronchodilator,forced vital capacity(FVC),the ratio FEV1/FVC and FEV1 expressed as percent predicted(FEV1％).Results Compared with those at the first diagnosis,the follow-up results of FVC,FEV1,FEV1/FVC,Ntotal/LSA and N＜5mm2/LSA were lower,whereas LAA％,Pi10 and entire volume of airway were all higher in each group(all P＜0.05).Compared with those in group A,group B and C had decreased LAA％and increased Pi10,and the magnitude increased with the severity of airflow obstruction(all P＜0.05).LAA％,Pi1o and entire volume of airway wall were negatively correlated with pulmonary function indicators(all P＜0.05),while Ntotal/LSA and N＜5 mm2/LSA were positively correlated with pulmonary function indicators(all P＜0.05).Conclusion CT quantitative parameters,including LAA％,Ntotal/LSA,N＜5mm2/LSA,Pi10 and entire volume of airway wall were related to pulmonary function,which might reflect the longitudinal changes of airways and blood vessels in COPD patients.

Objective:To explore the application effect of multi-mode teaching guided by objective management in the standardized training of nursing students.Methods:A total of 39 standardized training nursing students from April 2019 to April 2020 in the department of oncology of a tertiary hospital were selected as the control group by cluster sampling method and they received traditional teaching; 40 standardized nursing students in the department of oncology from June 2020 to June 2021 were selected as the experimental group and the group adopted multi-mode teaching guided by objective management. The differences of theoretical and operational assessment scores, teaching satisfaction, critical thinking ability and nurse-patient communication ability between the two groups were studied. SPSS 20.0 was used for t-test and Chi-square test. Results:The scores of theoretical assessment [(86.17±3.74) vs. (83.92±4.93)] and operational assessment [(92.83±2.19) vs. (90.74±3.52)] in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The teaching satisfaction of the experimental group was higher than that of the control group [(46.10±2.96) vs. (42.67±2.45)], and the difference was statistically significant ( P<0.05). There were statistically significant differences in critical thinking, intellectual curiosity and analytical skills ( P<0.05). In terms of nurse-patient communication ability, except that there was no difference in collecting information, the rest were statistically significant( P<0.05). Conclusion:Multi-mode teaching guided by objective management can improve the theoretical and operational ability of nurses, nurse-patient communication ability, and teaching satisfaction.