Objective To investigate the influence of elastic band resistance training on cardiac function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods 64 hospitalized patients with acute myocardial infarction after PCI from January 2016 to June 2016,were randomly divided into two groups:rehabilitation group (n=30) and control group (n =34).The control group received a routine treatment and guidance,rehabilitation group received elastic band training as add-on therapy to above routine treatment and guidance.After 6 months of therapy,cardiac function,the number of daily chest discomfort and its duration were compared between two groups.Results After six months of therapy,6MWT [(530.9 ± 39.9) m versus (328.3±26.8)m,(t=24.104,P＜0.01)]and LVEF ≥50％ [n(％)] (83.3％ versus 50％)(x2 =7.850,P＜ 0.01)were significantly higher in the rehabilitation group than in control group,with statistically significant difference (t =24.104,x2 =7.850,all P ＜ 0.01).In addition,an average number of daily chest discomfort (x2=11.563,P＜ 0.01) and its duration (x2=9.067,P＜ 0.05) were obviously improved in rehabilitation group than in control group,with statistically significant difference.Conclusions Anti-resistance training can significantly improve the cardiac function of patients with acute myocardial infarction after PCI and can be applied in clinical practice.

Objective To investigate the effects of antioxidant SS-31 on sepsis-induced acute lung injury (ALI)in a mouse model of sepsis.Methods Sepsis was induced in male mice by cecal liga-tion and puncture (CLP).Forty-eight adult male mice (C57BL/6,weight 25-32 g)were equally as-signed to the sham+vehicle group (group A),sham+SS-31 group (group B),CLP+vehicle group (group C),or the CLP+SS-31 group (group D).At 0 or 5 h after CLP or sham operation,mice re-ceived an intraperitoneal injection of SS-31 (5 mg/kg of body weight)or the same volume of normal saline.Pulmonary tumor necrosis factor alpha (TNF-α),interleukin (IL)-6,IL-10,malondialdehyde (MDA),superoxide dismutase activities (SOD),myeloperoxidase activities (MPO ),wet-to-dry weight ratio (W/D),reactive oxygen species (ROS),ATP,NF-κB p65,inducible nitric oxide syn-thase (iNOS),and histological scores were assessed 24 h after operation.Results Pneumonia,edema were significantly heavier in group C than in group A (P <0.05).Lung congestion,inflammatory cell infiltration,alveolar wall edema was significantly less in group D than in group C (P <0.05).Pulmo-nary histological scores,IL-6,MDA,MPO,W/D,ROS,NF-κB p65 and iNOS significantly in-creased,while ATP levels decreased in group C when compared with group A (P <0.05).However, SS-31 treatment significantly reversed these parameters when compared with the group C (P <0.05). No difference was observed between the group A and group B.There was no difference of TNF-α,IL-10,and SOD among the four groups.Conclusion SS-31 improves sepsis-induced ALI in a mouse model probably by down-regulating the oxidative stress and inflammation in of sepsis-induced ALI.

Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.

Objective To study the difference of attentional bias towards general negative words between non-mediated obsessive-compulsive disorder (OCD) patients and healthy controls.Methods Event-related potentials (ERPs) were collected from 26 non-mediated OCD patients and 24 normal controls while they performed an emotional Stroop task.Results Compared to healthy controls,OCD patients showed significantly longer reaction time (OCD:(467 ± 14.88) ms,Controls:(409.65 ± 15.49) ms,P＜ 0.01),and had significantly larger P2 and P3 amplitude to all three types of words (P2 amplitude:OCD:(10.41±0.49) μV,Controls:(8.89±0.48) μV,P＜0.05;P3 amplitude:(10.04±0.68) μV,Controls:(7.68±0.67) μV,P＜0.05).In addition,the P2 peak latency of the frontal area in OCD patients was significantly longer than that in healthy controls(OCD:(190.09±4.71) ms,Controls:(179.60±4.72) ms,P＜0.05).Conclusion Current findings suggest that OCD patients are characterized by a general attentional inhibition deficit but not an attentional bias to the negative words.

Objective:To conduct a scoping review on the literature related to the core competencies of clinical nursing specialists and clarify the contents and applicable scenarios of the core competency elements of clinical nursing specialists.Methods:Guided by the methodological framework of PRISMA-ScR, this study focused on the capabilities, competencies, roles, and responsibilities of clinical nursing specialists in the context of medical institutions. A systematic search was conducted in 6 English databases (Web of Science, PubMed, Embase, CINAHL, ProQuest, Cochrane Library) and 4 Chinese databases (Chinese National Knowledge Infrastructure, Wanfang, VIP, SinoMed) to extract relevant studies on categories of clinical nursing specialist positions, research types, authors, countries, publication years, core competency elements. The search time range was from January 1, 2013, to June 1, 2023.Results:A total of 1 406 relevant articles were retrieved, with 15 articles finally included. Six primary indicators (clinical nursing practice capability, public health management ability, nursing management ability, nursing research ability, nursing education ability, ethics/morality/law), 16 secondary indicators, and 57 tertiary indicators were summarized.Conclusions:China can reference the establishment of core competency elements for clinical nursing specialists from other countries, integrate them with Chinese clinical practice to improve the competency requirements for clinical nursing specialists, and further refine the nursing management system for various positions.

Objective To study radiographic classification of tarsometatarsal joint dislocation and postoperative imaging evaluation.Methods 74 patients with tarsometatarsal joint dislocation were included in this study.Tarsometatarsal joint dislocations were classified by the Myerson fracture displacements classification.All patients were evaluated according to the American Orthopedics Foot & Ankle Society (AOFAS)clinical rating systems.Results There were 19 patients with Myerson A,46 patients with Myerson B and 9 patients with Myerson C tarsometatarsal joint dislocation.39 distal tarsal bone fractures and 156 metatarsal fractures,with simultaneous scaphoid fractures in 10 patients were showed.All patients who were followed up and no infection.The AOFAS scale was categorized as excellent,good,fair or poor,and 22 patients were considered as excellent,29 patients as good,17 patients as fair and 6 patients as poor.Postoperative imaging evaluation required anatomical reduction of tarsometatarsal joint.On the anteroanterior radiogragh,the base medial edge of the second metatarsal bone and the medial edge of intermediate cuneiform were combined to form a straight line.The shortest distance between the base of the first metatarsal bone and the second metatarsal bone should be less than 2 mm.On the medial oblique radiogragh,a smooth line connecting the medial edge of the fourth metatarsal bone with the medial edge of cuboid bone always appeared.On the lateral radiogragh,the dorsal edge of the second metatarsal bone and intermediate cuneiform formed a smooth line.The height of metatarsus should not exceed the dorsal edge of corresponding cuneiform.The longitudinal arch angle was restored within normal limits.Conclusion The type-B tarsometatarsal joint dislocation is the most common type and frequently accompanies by multiple fractures.Intraoperative and postoperative multidirectional observation of anatomical reduction of tarsometatarsal joint dislocation can reduce incidence of posttraumatic arthritis.

Objective To evaluate the diagnostic value of ultrasound image features combined with cesarean section scores for placenta accreta . Methods A total of 151 pregnant women in the later trimester of pregnancy underwent two-dimensional and color Doppler ultrasonography . According to the results of the operation ,they were divided into the accreta group and the non-accreta group . The number of cesarean section and placental thickness in the two groups were recorded . The ultrasound image characteristics of the placenta previa ,the placenta posterior gap disappeared ,the placental lacuna in the placenta ,the muscle layer becoming thin or disappeared after the placenta ,the anatomical region of the uterus-bladder junction line and the abundant blood flow signal behind the placenta were compared between the two groups . Logistic regression analysis was performed according to the results of single factor analysis . After assigning the characteristics of the regression model ,the ROC curve was drawn to determine the best diagnostic intercept point . Results The presence of placenta previa ,placental lacuna and placental enriched blood flow signals combined with cesarean section scores were used to diagnose placenta accreta ,the area under the ROC curve was 0 .991 ,based the best cut-off point with 4 .5 ,the corresponding diagnostic sensitivity and specificity were 91 .1% and 100% ,respectively . Conclusions Ultrasound image features combined with cesarean section history scores have a high practical value in the diagnosis of placental accreta .

Objective To explore the value of color Doppler ultrasonography in diagnosis of transplant renal artery stenosis( TRAS) of children . Methods The results of ultrasound examination and clinical data of 82 kidney transplant children with suspected TRAS were retrospectively analyzed . According to the results of the CTA ,the enrolled children were divided into a stenosis group with 21 cases and a non-stenosis group with 61 cases . The differences of ultrasound hemodynamic parameters between the two groups were compared . The hemodynamic parameters and cutoff values of prediction of TRAS were determined according to the ROC curve ,and the corresponding sensitivity and specificity were calculated . Logistic regression was used to screen TRAS independent predictors . Results Compared with the non-stenosis group ,the peak systolic velocity ( PSV ) of the renal aorta ,the renal aorta PSV/interlobular artery PSV ( post PSV ratio ) and acceleration time ( AT ) of interlobular artery in the stenosis group were significantly higher ,but the PSV of the interlobular artery was lower ( all P ＜ 0 .05 ) . Differences of indicators between the two groups can be used to predict TRAS . Through the ROC curve the peak systolic velocity of the renal aorta and the interlobular artery were 218 .5 cm/s and 25 .5 cm/s ,respectively ,the post PSV ratio was 7 .2 ,and the AT of intervein arterial was 67 .5 ms ,the sensitivity and specificity were the highest ,which could be used as the ultrasound screening threshold . The PSV of the interlobular artery can be used as an independent predictor of TRAS . Conclusions Analysis of hemodyamic parameters of transplanted kidney arteries by Doppler ultrasonography might be useful in predicting TRAS in children .

Objective:To investigate the distribution characteristics of virulence-related phenotypes/genotype, capsular serotype, drug resistance phenotypes, and sequence typing (ST) of Klebsiella pneumoniae in patients living in Zhongjiang county, improve clinical understanding, and provide evidence for the prevention and control of bacterial drug resistance and clinical rational drug use. Methods:The data of 135 strains of Klebsiella pneumoniae isolated from patients who received treatment in Zhongjiang County People's Hospital from July to December 2019 were retrospectively analyzed. Bacterial identification and drug sensitivity testing were performed using the WalkAway-40Plus automated microbiology system. Strains with a high viscosity phenotype were identified using wire drawing experiments. Hypervirulence-associated capsular serotype and virulence genes were verified by polymerase chain reaction. ST of Klebsiella pneumoniae strain was identified using multilocus sequence typing. Results:Strains with a high viscosity phenotype were identified in 50.4% of the 135 strains. 54.1%, 54.8%, and 54.1% of the strains were positive for virulence genes iucA, iroN, rmpA. The proportion of strains with capsular Serotype K1 or K2 was 11.9% and 15.6%, respectively. A total of 65 kinds of ST were identified, with ST23 and ST37 being the most common, accounting for 11.1% and 6.7%, respectively. The resistance rate of the strains to 16 kinds of antibiotics was 0.0%-25.2%, and the resistance rate to Carbapenem antibiotics, Amikacin, and Tigecycline was less than 1%. The positive rate of virulence gene of strains with a high viscosity phenotype was significantly higher than that of strains without a high viscosity phenotype ( P < 0.001), and its resistance rate to Cephalosporin was significantly lower in strains with a high viscosity phenotype than that in strains without a high viscosity phenotype ( P < 0.001). Conclusion:Klebsiella pneumoniae in Zhongjiang County is characterized by "high virulence and low drug resistance". It is necessary to continuously monitor the changes in the virulence and drug resistance of Klebsiella pneumoniae in Zhongjiang County, Sichuan Province, and be alert to the rapid dissemination of highly virulent strains.

Sepsis and septic shock are important clinical problems in critically ill patients, accounting for the first cause of death in intensive care unit (ICU). Therefore, early diagnosis and treatment are particularly important. Recently, genome-wide expression analysis of non-coding RNA in septic patients showed that more than 80% were differentially expressed compared with healthy individuals. These molecules play important roles in biological processes, including innate immunity, mitochondrial function and apoptosis. Therefore, a class of non-coding RNAs such as microRNA (miRNA), long-chain non-coding RNA (lncRNA) and circular non-coding RNA (circRNA) are increasingly recognized as a regulator of various signaling pathways. The potential of regulatory non-coding RNA target to treat sepsis was discussed by studying non-coding RNAs that might serve as molecular markers of sepsis, and its clinical value was evaluated.