Objective To explore the clinical effect of two different connecting tubes in hemodialysis combined with hemoperfusion. Methods A total of 25 patients were selected and divided into observation group and control group by self- control method. In the observation group, the hemodialysis combined with hemoperfusion was used 8 times, and the control group was treated with hemodialysis combined with hemoperfusion 8 times using conventional connecting tube. The time of the unloading of the perfusate and the amount of physiological saline required were compared between the two groups. There was no blood spillover during the unloading of the perfusate, the number of cases of allergic reaction during the treatment, and the coagulation of the dialyzer and the pipeline after the treatment. Results There was no allergic reaction in both groups. There was no significant difference between the two groups in the amount of saline needed to return blood (t=46.412, P=0.307). In the control group, there was 15 cases of blood spillover, while the observation group did not show blood spillover. There was significant difference between the two groups in unloading perfusion time(4.43±0.14)min vs. (3.02±0.11) min (t=10.784, P=0.003). The level Ⅰ and Ⅱ blood coagulation of dialyzer and pipeline was 12, 2 cases in the control group after the treatment and 5, 0 case in the observation group, no level Ⅲ blood coagulation cases, and there was a significant difference between the two groups (χ2=10.667, P<0.01). Conclusion In the hemodialysis combined with hemoperfusion therapy, multi-function group of the application effect is superior to conventional piping, is worthy of clinical application.

Objective To evaluate the effects of the short-term intervention lifestyle intervention on metabolic measurements of community patients with impaired glucose regulation (IGR). Methods A total of 90 IGR participants were randomly assigned to the control group (n=45) or the intervention group (n= 45). The subjects in the control group received routine diet and physical exercise advice once a month. The subjects in the intervention group received additional individualized diet counseling and circuit-type resistance training. Metabolic parameters were compared before or after the intervention between the two groups. Results In oral glucose tolerance test (OGTT),2-h plasma glucose (PG) and homeostasis model of insulin resistance index (HOMA-IR) were significantly decreased in the intervention group at 3 months(F= 13.47 or 82.25 ,both P < 0.05). Body mass index (t=-2.44, P<0.05), systolic blood pressure (t= -3.39, P<0.05), diastolic blood pressure (t=-3.97, P<0.05), fasting plasma glucose (t=-3.89, P<0.05),2-h PG (t=-7.22,P <0.05) ,total cholesterol (t=-2.72,P<0.05),low-density lipoprotein cholesterol (t=-2.74, P<0.05), and glycosylated hemoglobin A1 C (t=-3.73, P<0.05) were significantly declined in the intervention group compared to the control group (all P<0.05). Conclusions Intensive lifestyle intervention can significantly improve the metabolic markers of IGR subjects and should be used to prevent type 2 diabetes.

Objective To determine the levels of serum visfatin and HbA1c in patients with coronary heart disease and ex-plore the correlation with the severity of coronary atherosclerosis .Methods Totally 264 patients were enrolled who performed cor-onary angiography totally ,visfatin and HbA1c levels were detected respectively of 33 cases of control group ,51 cases of atheroscle-rosis group ,75 cases of single-vessel disease group ,72 cases of double-vessel disease group ,33 cases of triple-vessel disease group . Gensini score was used for evaluation of coronary artery lesion ,and to establish a multiple linear regression analysis of the relation-ship between each risk factor for coronary heart disease .According to the degree of coronary artery stenosis ,the patients also could be divided into the control group(33 cases) ,the non severe stenosis group (174 cases) and the severe stenosis group (57 cases) ,the changes of visfatin and HbA1c levels were analyzed in the three groups .Results In the groups by the coronary lesion count ,HbA1c levels increased with the degree of coronary artery lesions in the control group [(4 .98 ± 0 .21)% ] ,the atherosclerosis group [(5 .58 ± 0 .36)% ] ,the single-vessel disease group[(6 .17 ± 0 .48)% ] ,the double-vessel disease group[(6 .63 ± 0 .80)% ] ,the tri-ple-vessel disease group[(7 .97 ± 1 .49)% ] ,and comparisons had significant difference between any two groups(P< 0 .05) ;Visfatin level in the control group ,the atherosclerosis group ,the single-vessel disease group ,the double-vessel disease group ,the triple-ves-sel disease group were(0 .73 ± 0 .42)μg/L ,(1 .50 ± 0 .87)μg/L ,(3 .45 ± 2 .50)μg/L ,(5 .45 ± 2 .96)μg/L ,(9 .21 ± 6 .35)μg/L ,a-mong them coronary heart disease group (the single-vessel disease group ,the double-vessel disease group ,the triple-vessel disease group) is higher than the atherosclerosis group and the control group(P< 0 .05) ;the atherosclerosis group is higher than the con-trol group ,but there was no statistically significant difference(P> 0 .05) ;In according to the degree of coronary artery diameter ste-nosis ,the levels of visfatin ,HbA1c in severe stenosis group [(8 .25 ± 4 .86)μg/L ,(7 .35 ± 1 .43)% ] is significantly higher than the non severe stenosis group [(3 .22 ± 2 .74)μg/L ,(6 .14 ± 0 .70)% ] and the control group [(0 .73 ± 0 .42)μg/L ,(4 .98 ± 0 .21)% ] , P< 0 .01 ;The non severe stenosis group is significantly higher than the control group (P< 0 .01) .The levels of visfatin ,HbA1c ,hs-CRP ,LDL and TC had positive correlation with Gensini score(P< 0 .01) .The level of HDL was negatively correlated with Gensini score(r= - 0 .535 ,P < 0 .01) .The levels of visfatin ,HbA1c ,hs-CRP ,LDL and TC had positive correlation with visfatin ( P <0 .01) ,and the level of HDL and TG were negatively correlated with visfatin(P< 0 .01) .In multiple linear regression analysis ,the factors which finally entered the regression equation were HbA1c ,LDL ,hs-CRP ,visfatin and HDL .Conclusion The levels of visfa-tin and HbA1c is closely related to the severity of coronary atherosclerosis .Combined detection of visfatin and HbA1c can be used as important indicators for evaluating the severity of coronary atherosclerosis .

Objective:To explore the effect of mobile health management model in patients with acute myocardial infarction after percutaneous coronary intervention (PCI) under the background of "Internet +".Methods:From July 2018 to March 2020, convenience sampling was used to select 124 patients with acute myocardial infarction who underwent PCI successfully in the First Affiliated Hospital of Zhengzhou University as the research object. According to the random number table method, the patients were divided into the observation group and the control group, 62 cases in each group. The control group received routine nursing after surgery, and the observation group was given the mobile health management model under the background of "Internet +" on the basis of the control group. Self-management Scale for Patients Undergone Coronary Artery Stent Implantation, Hamilton Depression Scale (HAMD) , Hamilton Anxiety Scale (HAMA) , and Nursing Satisfaction Questionnaire were used to evaluate the effect of the intervention.Results:After six months of intervention, the scores of each dimension of the Self-management Scale for Patients Undergone Coronary Artery Stent Implantation in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . After six months of intervention, the HAMD and HAMA scores of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After six months of intervention, the nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The mobile health management model under the background of "Internet +" is conducive to improving the self-management ability of patients with acute myocardial infarction after PCI, reducing patients' depression and anxiety, and increasing patients' satisfaction with nursing.

Objective:To explore the correlation between early exercise capacity, mental state and quality of life in patients with acute myocardial infarction after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 120 patients with acute myocardial infarction treated by PCI who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2021 as the research objects. Exercise cardiopulmonary test system, Positive and Negative Emotion scale and SF-36 were used to investigate.Results:In 120 patients with acute myocardial infarction, oxygen uptake at anaerobic threshold after PCI was (8.11±0.95) ml/ (kg·min) , peak metabolic capacity was (3.04±0.12) METs, peak oxygen uptake was (10.97±1.25) ml/ (kg·min) and the metabolic equivalent at the anaerobic threshold was (2.25±0.12) METs. The early exercise capacity of patients with acute myocardial infarction after PCI was positively correlated with positive emotions and quality of life ( P<0.01) , and negatively correlated with negative emotions ( P<0.01) . Conclusions:There is a positive correlation between early exercise ability and positive emotions and quality of life in patients with acute myocardial infarction after PCI.

Objective:To investigate clinical effects of anterolateral thigh flap with blood supply source of medial femoral perforator in repairing the wounds on extremities.Methods:A retrospective observational study was conducted. From October 2018 to June 2021, Suzhou Ruihua Orthopedic Hospital admitted 12 patients (11 males and 1 female, aged 24-64 years) who met the inclusion criteria, and did not have the lateral circumflex femoral artery during anterolateral thigh flap resection, or changed to medial femoral perforator as a source of blood supply due to small perforator to repair the wound with flap transplantation. The wounds were on the upper limbs in 7 cases and on the lower limbs in 5 cases. The wound area after debridement was 8.0 cm×5.0 cm-24.0 cm×6.5 cm, and the applied flap area was 9 cm×6 cm-25 cm×7 cm. During transplantation, the perforating branch or source artery of the flap was anastomosed end to end with the vascular pedicle of the recipient area. Subcutaneous beauty suture was performed on all the donor wounds. After operation, the survival of the flap and vascular crisis were observed; and the wound healing at the donor site was observed. During follow-up, the texture of the flap and complications at the donor site were observed. At the last follow-up, the effect of flap repair was evaluated by using the modified self-made comprehensive efficacy rating table.Results:After operation, all the flaps of patients survived without vascular crisis; the wounds in the donor site healed smoothly. During follow-up of 6 to 26 months, the flaps had good texture; only linear scars remained in the donor area without scar contracture, pain or other discomfort. At the last follow-up, the total score of flap repair effect of 12 patients was 75-95, with an average of 87, of which 5 cases were rated as excellent, 6 cases as good, and 1 case as fair, and the proportion of excellent and good patients was 11/12.Conclusions:The application of anterolateral thigh flap with blood supply from the medial femoral perforator to repair wounds on extremities is an alternative method for the vascular variations such as no descending branch, oblique branch, or small perforator of the lateral circumflex femoral artery during the resection of the anterolateral thigh flap. This operation has the advantages of simple operation, small trauma, and others, which effectively ensures the smooth operation.

ObjectiveTo evaluate the efficacy of Zishui Bugan decoction on perimenopausal insomnia of liver-kidney deficiency type and the safety. MethodA randomized， double-blind， placebo-controlled trial was designed. To be specific， 72 patients of perimenopausal insomnia with Liver-kidney deficiency were randomized into the treatment group and the control group at the ratio of 1∶1 and they were respectively treated with Zishui Bugan decoction and placebo for 3 weeks. The Pittsburgh sleep quality index （PSQI）， modified Kupperman index， traditional Chinese medicine （TCM） syndrome score， self-rating anxiety scale （SAS） score， and self-rating depression scale （SDS） score， were compared before and after treatment to determine the clinical efficacy， with adverse effects recorded. ResultThe total effective rate for insomnia was 85.3%（29/34） in treatment group and 17.6%（6/34） in control group（Z=-5.582，P<0.01）. After treatment， PSQI score， modified Kupperman index， TCM syndrome score， and SAS score were improved in both groups （P<0.05， P<0.01）， particularly the treatment group which showed significant difference from the control group （P<0.05，P<0.01）. The safety indicators were insignificantly different between two groups before and after treatment. No related adverse effects were reported in both groups during the treatment. ConclusionZishui Bugan decoction can improve the sleep quality and alleviate the menopausal symptoms， such as depression and anxiety， which shows ideal efficacy and safety for the perimenopausal insomnia with liver-kidney deficiency type.