Objective To explore the relationship of preoperative hemoglobin concentration and use of hospital resources.Methods 108 patients receiving cardiac surgery in the central hospital of wuhan were included.The relationship of preoperative hemoglobin concentration was explored on blood transfusion rates,return to the operating room for bleeding and/or cardiac tamponade,postoperative intensive care unit(ICU)and in-hospital length of stay,and mortality.Results For every 10-unit increase in hemoglobin(g/L),blood transfusion requirements were reduced by 8.0%,6.0%,and 3.0% for red blood cell units,platelet pools,and fresh frozen plasma units,respectively.For each 10-unit decrease in hemoglobin(g/L),the probability(over time)of discharge from the ICU and hospital increased 7.0%,16.0% respectively.Conclusion A lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery.Therefore,the correction of decreasing preoperative hemoglobin concentration could improve the use of hospital resources after cardiac surgery.

Objective To evaluate the effect of breast-feeding on newborns' pain caused by heel prick. Methods A convenient sample of sixty newborns from a hospital in Beijing undergoing heel prick for the Newborn Screening Program Blood Test were enrolled. They were randomly divided into breast-feeding group and control group. The newborns in the breast-feeding group began to receive breast-feeding at two minutes before the heel prick until 8 minutes after the heel prick finished. The newborns' grimace,cry,heart rate (HR) and oxygen saturation (SaO_2) were recorded and compared between the two groups. Results There were significant differences on the starting time and lasting time of grimace and cry caused by pain,numbers of crying neonates,SaO_2 during and 1 to 4 minutes after heel stick,as well as the recovery time of SaO_2 after heel stick between the two groups (P＜0.05 or P<0.01). Conclusion Breast-feeding can relieve newborns' pain caused by heel prick.

Objective To analyze the incidence,risk factors,and impact of intraoperative conversion on the mortality in patients undergoing off-pump coronary artery bypass grafting.Methods This retrospective observational study included 207 patients undergoing off-pump coronary artery bypass grafting.According to whether intraoperative conversion,207 patients were randomly divided into intraoperative unchanged group(191 cases)and intraoperative changed group(16 cases).The incidence,patient characteristics,cause of intraoperative conversion,and its impact on outcome were studied.Results Intraoperative conversion increases odds for mortality to 25.0%,while the other group was 1.0%.The most common cause for intraoperative conversion was hemodynamic disturbances during grafting to the obtuse marginal artery.On multivariate logistic regression analysis,left main disease,mitral regurgitation and higher EuroSCORE II independently predicted intraoperative conversion.Conclusion Intraoperative conversion to on-pump coronary artery bypass grafting is independently associated with higher mortality in patients undergoing off-pump coronary artery bypass grafting.Identification of high risk group of intraoperative conversion may improve the outcome.

Objective To assess the characteristics of heart rate turbulencer (HRT) in elderly patients with decreased left ventricular diastolie function.Methods 40 patients were divided into two groups:20 patients with enlarged left atrium and 20 patients without enlarged left atrium.20 healthy people were selected as controls. Turbu1ence onset (TO) and turbulence slope (TS) were measured,and correlation was analyzed between TO,TS and the E/A,index of Macruz and heart rate variability (HRV).Results TO was higher (P<0.05) and TS was lower in patients (P<0.01),TO was higber in patients with enlarged left atrium than in with out enlarged lef atrium people (P<0.05) and TS was lower (P<0.01).TO was positively (P<0.01) and TS Was negatively (P<0.05),correlated with the index of Macruz.TO Was negatively (P<0.05) and TS was positively (P<0.05) related to SDNN and SDANN.Conclusion HRT can be used as a potential risk predictor in decreased left ventricular diastolic function patients.

Objective To understand the characteristic of value orientation during occupational choice and occupational development of nursing students with different background. Methods The study was non-experimental and descriptive with questionnaires. Results The correlation coefficients on 15 work value scales in different background students ranged from 0.561 to 0.940, P value ranged from 0.01 to 0.05. And the coefficients were significant. But there were significant differences on some scales in 15 work value of students who were different in grade, sex, family or areas and so on. Conclusions Nursing stu-dents with different background place emphasis on the same work value and ignore the same others because of the same social-cultural background. But there are some differences in recognition degree of some work val-ue in nursing students with different background.

In order to evaluate the effectiveness of everolimus vs. rapamycin in the treatment of diabetic nephropathy, 8-week old diabetic (db/db) mice received everolimus (2 mg/kg every day) or rapamycin (2 mg/kg every day) for 4 weeks or 12 weeks respectively. Blood and 24-h urine samples were collected for biochemical tests. One kidney from each mouse was homogenized for protein analysis and the other was removed for histological analysis. The expression levels of transforming growth factor-β1 (TGF-β1)and phospho-p70s6k were detected by using ELISA and Western blot, respectively in the renal tissue as well as in mesengial cell culture samples. Everolimus was significantly more effective than rapamycin in improving indexes of renal function and glomerular hypertrophy, and in decreasing accumulation and expansion of the extracellular matrix. However, everolimus inhibited TGF-β1 secretion and p70s6k phosphorylation induced by high glucose in vitro less efficiently than rapamycin at the same dose. Everolimus was more effective than rapamycin in preventing diabetic nephropathy in vivo, which may be contributed to the fact that everolimus has better bioavailability and a higher oral absorption rate.

Objective To investigate the clinical efficacy of recombinant human epidermal growth factor in the treatment of recurrent oral ulcers in elderly patients.Methods 82 cases of elderly patients in our hospital in the treatment of recurrent oral ulcer were selected,41 cases in the control group,the conventional western medicine treatment,41 cases of the study group,recombinant human epidermal growth factor in treatment before and after treatment,blood determination of immune status,clinical efficacy and adverse reactions of comparison were performed at one-year follow-up.Results the effective rate of treatment group is lower than 78.05％of the effective rate of treatment group 95.12％,study group 3,6 and 12 months recurrence rate(4.88％,7.32％,7.32％)than in the control group the recurrence rate(19.51％,24.39％,29.27％),the study group after the treatment of CD3+ and CD4+/CD8+ and NK were higher than the control group,the CD8+ level is lower than the control group(P<0.05),the two groups had no serious adverse reaction.Conclusion recombinant human epidermal growth factor is effective in the treatment of oral ulcer.

Objective Through developing the experimental animal model of ileal transposition (IT) with GK-rats,to explore the effects of ileal transposition on water and food intake,weight change and blood glucose.Methods Thirty male GK-rats were randomly assigned to three groups:IT(n =10),C (n =10) and B (n =10)group.Rats in IT group underwent ileal transposition,and others underwent sham operation.Every group was given sufficient clean water.Water and food intake,weight change blood glucose and oral glucose tolerance test(OGTT) were recorded preoperatively and postoperatively.Results The total deaths of the experiment was four and the general survival rate was 88.6％.After operation,water intake reduced visibly in all groups,IT group was kept low level for a long time but not in C and B group.The food intake of IT group was lower than the other two groups during a certain period,but that phenomenon didnt last long.The weight change showed similarly to the food intake.The fasting plasma glucose(FPG) and OGTT were ameliorated significantly in IT group but not in B and C group.Conclusions It is feasible to develop ileal transposition animal models with GK-rats.Moreover,the author found that the influence of IT on weight in GK rats was transient,but on water intake and blood glucose was lasting.

OBJECTIVE To explore risk factors of cervical lymph node metastasis in cN0 papillary thyroid carcinoma. METHODS The clinical data of 537 patients with cN0 papillary thyroid carcinoma were analyzed retrospectively in Beijing Tongren hospital from Jan 2009 to Dec 2015. Patients' gender, age, multifocal lesion, carcinoma complicated with Hashimoto's thyroiditis, capsule breakthrough and tumor size were counted. RESULTS The lymph node metastasis rate of 537 patients with cN0 papillary thyroid carcinoma was 30.9%(166/537). The incidences of lymph node involvement were 24.95%(166/537) at only level VI, 5.21%(28/537) at level VI plus lateral part of neck and 0.74%(4/537) at only skip metastasis, respectively. Chi square test and multivariate logistic regression analysis showed that cervical lymph node metastasis was statistically associated with male, age<45 years, capsule breakthrough and tumor diameter>1 cm (P<0.05). After the operation, there were 17 patients with temporary hoarseness, accompanied with 1 loss to follow-up and 1 failure to return to normal after 1.5 years. There were 61 patients with temporary hypocalcemia, 2 patients failed to follow-up and 2 patients with calcium supplements after respective 1.5 and 4 years. CONCLUSION To stratify the risk of patients with cN0 papillary thyroid carcinoma, male, age<45 years, capsule breakthrough and tumor diameter>1 cm are risk factors for cervical lymph node metastasis. And we suggest that prophylactic central lymph node dissection may be appropriate.

Objective To approach the expression and significance of CD30 in Hodgkin lymphoma cells which were transfected with mtr Ⅱ gene. Methods The CD30 expression of Hodgkin lymphoma cells in those transfected with mtr Ⅱ gene was analysed by immunohistochemical technique respectively. Results The CD30 expression rate of Hodgkin lymphoma cells which were transfected with mtr Ⅱ gene was higher than that of Hodgkin lymphoma cells which weren't transfected with mtrⅡ gene (P ＜0.01). Conclusion The mtr Ⅱ gene may be related to the malignant transformation of Hodgkin lymphoma.