Objective To study the biomechanical strength of calcium phoshphate cement (CPC) in fixating distal radial fractures. Methods A total of 18 human distal radius fracture models were made and randomly divided into three groups: fixed with Kirschner wire (Kirschner group), CPC (CPC group) or CPC combined with Kirschner wire (combination group). Compression test was performed to measure compression rigidity and rotational angle of distal fragment at 100 N and anticompression strength and maximum compression strength at 2 mm displacement. Results Compression rigidity, distal fragment rotation angle in coronal or sagittal plate had no significant statistical difference at 100 N of compression in three groups. Compression strength at 2 mm displacement in CPC group (average 375 N) and combination group (average 386 N) exceeded that in Kirschner group (average 116 N), with significantly statistical difference (P

Objective To explore the effects of losartan potassium and simvastatin combination therapy on oxidative stress indicators in diabetic patients on peritoneal dialysis through 12 weeks observation. Methods Diabetic patients with end-stage nephropathy (n=80) who were treated with continuous ambulatory peritoneal dialysis were randomly divided into two groups:control group who received routine treatment (n=40), treatment group who were given losartan potassium 50 mg, once per day and simvastatin 20 mg, once every night (n=40). HbA1C, Insulin dosage, Oxidative stress indicators(SOD, GSH-PX, MDA and Hcy)were compared between two groups before and after peritoneal dialysis. Results There was no significant difference of HbA1C between the 2 groups before and after treatment(P>0.05). The insulin doses increased be?fore dialysis in both groups after CAPD treatment. It is lower in the treatment group than that in the control group ( P<0.05). The expression levels of GSH-PX and SOD in treatment group were higher while the expressions of Hcy and MDA were lower after treatment. The expressions of GSH-PX and SOD were higher while the expressions of Hcy and MDA were lower in treat?ment group than those in control group when comparing the same time point(P<0.05). GSH-PX expression level was lower while the expressions of MDA and Hcy were higher after dialysis than those before dialysis in control group ( P<0.05). Con?clusion Losartan potassium combined with simvastatin treatment can improve curative effect and oxidative stress indicators in diabetic patients on peritoneal dialysis.

With standard of living gradually increasing, people expect higher and higher from nurses, which brings great challenge to nursing service. However, excellent nursing team is the basic guarantee of promoting the development of nursing career better. Hence, this paper reviewed the researches on theory, influence factors and methods of construction of Chinese clinical nursing team, then sum up its tendency of development, so as to provide reference for building and managing our nursing team better.

Objective To observe the expression of ChemR23 induced by Angiotensin Ⅱ (Ang Ⅱ) in podocyte and its role in renal injury.Methods Conditionally immortalized mice podocytes were cultured in vitro.Immunofluorescence was used to observe the sub-cellular location of ChemR23.The expressions of ChemR23,Nephrin and Podocin stimulated by different concentrations of Ang Ⅱ were detected by qRT-PCR and Western blotting.Lentivirus targeting ChemR23 was used.The expressions of Nephrin and Podocin and the phosphorylation state of NF-κB P65 were detected by Western Blot.The inhibitor of NF-κB P65 was added to the cultural medium for 2 h before Ang Ⅱ stimulation.The effect of NF-κB P65 inhibitor on Ang Ⅱ-induced expression of Nephrin and Podocin was detected by Western Blot.Results It is showed that ChemR23 was located in cytosol and membrane.Compared with the normal control,the expression of ChemR23 was significantly increased by Ang Ⅱ in mRNA and protein level,while the expressions of Nephrin and Podocin were decreased (P ＜ 0.05).When using Lentivirus vector to interfere the expression of ChemR23,Ang Ⅱ-repressed expressions of Nephrin and Podocin were restored (P ＜ 0.05).Western Blot showed the level of phosphorylated NF-κB P65 was significantly increased by Ang Ⅱ stimulation (P ＜ 0.05),which could be inhibited by interfering the expression of ChemR23.When adding the NF-κB P65 inhibitor,the low expression of Nephrin and Podocin induced by Ang Ⅱ stimulation was restored (P＜0.05).Conclusions Ang Ⅱ can induce ChemR23 expression,which activates NF-κB P65 signaling pathway,and then inhibits the expressions of Nephrin and Podocin.Targeting ChemR23 is a potential way to alleviate podocyte injury caused by Ang Ⅱ.

Objective To evaluate the efficacy and safety of holmium laser in situ fenestration for aortic arch diseases during thoracic endovascular repair.Methods The clinical data of 12 patients with aortic dissection or aortic pseudoaneurysm was analyzed from Nov 2016 to Feb 2017.After thoracic aorta stenting the left common carotid artery and left subclavian artery were reconstructed using holmium laser in situ fenestration.Results The success rate of operation was 100％,no type Ⅰ or type Ⅱ endoleak occurred,1 case complicated with left retinal artery occlusion.All patients were followed up for 6 to 9 months,the mean time was 7.3 months.The location of the stent graft was good.The left carotid artery and left subclavian artery kept patent.Conclusions The laser in situ fenestration technique can provide the opportunity of stenting for patients with aortic arch lesion near the branch.Short term follow-up results were satisfactory.

Objective:To discuss the essentials of anesthesia management and treatment strategies for emergency transcatheter aortic valve replacement (TAVR), and to provide standardized recommendations for the development of emergency TAVR technology in China.Methods:This study retrospectively analyzed the relevant data of patients undergoing emergency TAVR surgery in the Second Affiliated Hospital of Zhejiang University School of Medicine from March 2019 to February 2021, including baseline patient characteristics, perioperative echocardiography data, prognosis and 30-day follow-up. Post-operative data were compared with pre-operative data using paired-sample test.Results:Thirteen patients, aged (75.62±9.63) years, underwent emergency TAVR surgery, and 6 of them were male. Eleven patients were New York Heart Association class Ⅳ. The preoperative Society of Thoracic Surgeons score was (20.31±15.15)%. The trans-aortic valve differential pressure was significantly reduced after surgery [(68.92±30.66)mmHg vs. (2.70±2.36)mmHg, P<0.01]. Two patients died within 30 days after surgery, one patient developed a new third degree atrioventricular block, one patient had a stroke, and 4 patients developed pulmonary infection. Conclusions:Emergency TAVR surgery is a feasible and effective rescue strategy for patients with aortic stenosis in critical condition. The establishment of anesthesia standard operation procedure process for TAVR surgery helps ensure homogenized medical behavior and good teamwork.

Objective To explore the effect of uremic clearance granule combined with losartan potassium on the microinflammation status and peritoneal function in patients underwent peritoneal dialysis (PD).Methods A total of 60 patients with end-stage renal disease (ESRD) who were admitted in our hospital from August 2014 to February 2016 for continuous ambulatory PD (CAPD) were included in the study and randomized into observation group and control group.The patients in the two groups were performed with CAPD.The patients in the control group were orally administrated with losartan potassium tablets.On this basis,the patients in the observation group were given uremic clearance granules.After 1-year treatment,the efficacy was evaluated.PET was performed in the beginning and at the end and 24 h urine volume and 24 h ultrafiltration volume were recorded.Meanwhile,RRF was determined.Hs-CRP,IL-6,TNF-α,TGF-β1,VEGF,and FN were detected.Results RRF,24h urine volume and 24h ultrafiltration volume in 1 year after treatment in the two groups were significantly reduced compared with treatment before (P ＜ 0.05),while PET was significantly elevated (P ＜ 0.05).The reduced degree of RRF,24 h urine volume and 24 h ultrafiltration volume in 1 year after treatment in the observation group was significantly less than that in the control group (P ＜ 0.0 5),and the elevated degree of PET was significantly less than that in the control group (P ＜ 0.05).Hs-CRP,IL-6,and TNF-α in 1 year after treatment in the two groups was significantly reduced compared with treatment before (P ＜ 0.05).The reduced degree of hsCRP,IL-6,and TNF-α in 1 year after treatment in the observation group was significantly greater than that in the control group (P ＜0.05).TGF-β1,VEGF,and FN in 1 year after treatment in the two groups were significantly elevated compared with treatment before (P ＜ 0.05).The elevated degree of TGF-β1,VEGF,and FN in 1 year after treatment in the observation group was significantly less than that in the control group.Conclusion Uremic clearance granule in combined with losartan potassium can effectively improve the microinflammation status,inhibit PF,protect the peritoneal function,and delay the reduction of RRF.

Objective To explore the effect of uremic clearance granule combined with losartan potassium on the microinflammation status and peritoneal function in patients underwent peritoneal dialysis (PD).Methods A total of 60 patients with end-stage renal disease (ESRD) who were admitted in our hospital from August 2014 to February 2016 for continuous ambulatory PD (CAPD) were included in the study and randomized into observation group and control group.The patients in the two groups were performed with CAPD.The patients in the control group were orally administrated with losartan potassium tablets.On this basis,the patients in the observation group were given uremic clearance granules.After 1-year treatment,the efficacy was evaluated.PET was performed in the beginning and at the end and 24 h urine volume and 24 h ultrafiltration volume were recorded.Meanwhile,RRF was determined.Hs-CRP,IL-6,TNF-α,TGF-β1,VEGF,and FN were detected.Results RRF,24h urine volume and 24h ultrafiltration volume in 1 year after treatment in the two groups were significantly reduced compared with treatment before (P ＜ 0.05),while PET was significantly elevated (P ＜ 0.05).The reduced degree of RRF,24 h urine volume and 24 h ultrafiltration volume in 1 year after treatment in the observation group was significantly less than that in the control group (P ＜ 0.0 5),and the elevated degree of PET was significantly less than that in the control group (P ＜ 0.05).Hs-CRP,IL-6,and TNF-α in 1 year after treatment in the two groups was significantly reduced compared with treatment before (P ＜ 0.05).The reduced degree of hsCRP,IL-6,and TNF-α in 1 year after treatment in the observation group was significantly greater than that in the control group (P ＜0.05).TGF-β1,VEGF,and FN in 1 year after treatment in the two groups were significantly elevated compared with treatment before (P ＜ 0.05).The elevated degree of TGF-β1,VEGF,and FN in 1 year after treatment in the observation group was significantly less than that in the control group.Conclusion Uremic clearance granule in combined with losartan potassium can effectively improve the microinflammation status,inhibit PF,protect the peritoneal function,and delay the reduction of RRF.

As a secondary preventive measure for patients with coronary heart disease, cardiac rehabilitation can improve their quality of life and reduce mortality. One key aspect is to ensure that patients receive sufficient information. This article provides a review of the content, influencing factors, and support strategies for the cardiac rehabilitation information needs of patients with coronary heart disease, in order to provide reference for establishing a secondary prevention strategy for patients with coronary heart disease guided by information needs.

Objective: To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19. Methods: A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg^-1·d^-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results: The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P<0.05). The clinical conditions at hospital admission were different between the two groups (P<0.01). There were 52.0% critical ill patients in the glucocorticoid treatment group, compared to that of 71.4% normal patients in the control group. The median times from the onset tostable virologic conversion to negative in the two groups were 15 (IQR:13,20) days and 14 (IQR:12,20) days (P>0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group. Conclusions Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.