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 analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.

Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8％ (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4％ (31/46).July to October was its peak time for attacking,taking up to 58.7％ (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1％ (35/46),84.8％ (39/46) and 91.3％ (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3％ (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.

OBJECTIVE To observe the effect of flushing dental handpieces to prevent suction-induced contamination and to lower the bacterial level in dental unit waterlines,and then to analyze the time-effect relationship of flushing.METHODS Twelve BienAir handpieces(group A) and 12 W&H TA-96 handpieces(group B) were employed in this study.The water samples from each handpiece′s outlet were immediately taken once when operations of de-caries,cavity-preparing and dental-drilling had been completed,and then taken once per 0.5 min while the handpieces were being flushed by running without work for 4 min.The bacterial colony formation of these water samples was counted on R2A agar plates.Colony forming units vs flushing time were then compared.RESULTS Alike in groups A and B,water bacterial levels were lowered the most significantly while flushing the handpieces for 0.5 min.BienAir or W&H TA-96 handpieces still showed decreased levels of water bacteria when being flushed for 3 or 2.5 min respectively.Afterwards,the flushing effect reached to a platform,that was,more flushing time didn′t bring the bacterial level down further.CONCLUSIONS Flushing handpieces by running without work can significantly reduce the level of bacterial contamination in the waterlines.Different types of handpieces may have different flushing time at which the most effect is reached.

Objective To understand the influencing factors of professional adaptability for college nursing students and the mechanism. Methods A group of 1 105 college students from grades 2010 and 2011 were surveyed with questionnaire for professional adaptability. The data were analyzed with SPSS 16.0. Measurement data were expressed as x±s while enumeration data were expressed as percentage. t test and variance analysis were used to compare the differces among groups of different grades and genders. Results The professional adaptability mean score of college nursing students was (102.66 ± 14.93) and significant differences in professional adaptability were observed between different grades and genders (P=0.004 3, P=0.001 5). The possible influencing factors professional adaptability were different sources of students, family location, family income, etc. There were statis-tic differences in professional promise between arts and science students and between rural an urban students (P=0.029 8, P=0.007 0). Conclusion Grade and genders are the main influencing factors for professional adaptability of college nursing students while other factors exert little effect on it.

Objective To evaluate the graduation clinical skill examination based on objective structured clinical examination(OSCE) for college nursing undergraduates.Methods Classic OSCE was simplified and taken as references for nursing undergraduate graduation clinical skill examination including nursing evaluation,nursing dignosis,nursing intervention and health education for stations.Self-made questionnaire was conducted among students.Examination scores and the questionnaire results were statistically analyzed by SPSS 16.0 software.Measurement data and categorical data were shown as ((x)±s) and ％ respectively.T test was used in comparison between the groups according to the inspection level of α =0.05,P ＜ 0.05 means significant difference.Results Simplified OSCE was composed of 4 stations and the mean score was (80.38 ± 4.22) with mean scoring rate of the 4 stations varied from 72.2％ to 88.0％.More than 93％ students thought that OSCE score can or basically can evaluate comprehensive clinical nursing competence,clinical thinking,communicating and adaptability.Conclusions Simplified OSCE is designed properly for the objective evaluation of nursing students' clinical competence and students are mostly satisfied with its design and organization,quality and efficiency.

This study was to investigate the effect and mechanism of saikosaponin D(SSD)combined with oxaliplatin on nude mice bearing human lung carcinoma A549 cells. The A549 cell-bearing nude mice model was established and then the optimal dosage of SSD for intragastric administration was valued by tumor inhibitory ratio in vivo. The effect of SSD combined with oxaliplatin on tumor growth in A549 cells-bearing nude mice was observed. The apoptosis was detected by TUNEL method, the concentration of prostaglandin E2(PGE2)in plasma was checked by ELISA method, and the expression of COX-2 in tumor was analyzed by Western blot. The result showed that SSD exerted best tumor inhibitory effect(40. 96%)at the dosage of 1. 0 mg/kg. SSD combined with oxaliplatin group induced better apoptosis effect in A549 cells-bearing nude mice than those of SSD group and oxaliplatin group, respectively. The concentration of PGE2 and the expression of COX-2 in model group were increased markedly, while decreased significantly in SSD, oxaliplatin or SSD combined with oxaliplatin treated groups(P< 0. 05), and the concentration of PGE2 and the expression of COX-2 in SSD combined with oxaliplatin group were significantly lower than those treated by SSD or oxaliplatin alone(P< 0. 01). In conclusion, SSD combined with oxaliplatin could exert synergistic effect to induce apoptosis of A549 cells in nude mice, which may achieved by down-regulation of the expression of COX-2.

Objective To investigate the value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules. Methods Eighty-six thyroid nodules in 62 patients with pathologic diagnosis were included in this study and were examined using Q-analysis real-time elasticity. The real-time elasticity features were observed and the quantitative index including the whole elasticity rate and the local elasticity rate were compared between benign and malignant nodules. Results There were 51 benign and 35 malignant nodules according to histopathological examination. The Q-analysis curve of real-time elasticity of benign nodules was smoother and with lower peak, compared with that of malignant nodules. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.59±0.84 vs 2.32±0.56, P=0.000). And the local elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.96±1.32 vs 2.39±0.58, P=0.000). The cutoff point of whole elasticity rate for the differential diagnosis was 3.25 with sensitivity, specificity and diagnostic accuracy as 71.4%, 96.1% and 86.0% respectively. The cutoff point of local elasticity rate for the differential diagnosis was 3.45 with sensitivity, specificity and diagnostic accuracy as 68.6%, 96.1% and 84.9% respectively. The diagnostic efficiency of whole elasticity rate and local elasticity rate had no significant difference (P=0.591).Conclusions Q-analysis real-time elasticity could provide the real-time elasticity features of thyroid nodules. The whole and local elasticity rate as the quantitative index contributed to the differential diagnosis of benign and malignant thyroid nodules.

Objective To evaluate the feasibility and efficacy of laparoscopic single-port transumbilical renal pedicle lymphatic disconnection (TRPLD) for treatment of chyluria. Methods Nine cases of chyluria underwent laparoscopic single-port TRPLD. In all cases a 2-3 cm single inverted Ushaped supraumbilical incision was made, two 5-mm and one 12-mm trocars were inserted, and a medical rubber glove was sutured surrounding the three trocars and incision was made for gas proofing.Conventional straight and flexible instruments were used for dissection. Results All laparoscopic operations were successfully completed without conversion to open surgery. The mean operative time was 135 (96-178) minutes, and the mean estimated blood loss was 126 (50-250) ml. Chyluria disappeared in all patients after operation and did not reoccur during the follow-up (1 - 6 months).Conclusions Laparoscopic single-port transumbilical TRPLD represents a feasible and novel mini-invasive option for patients with chyluria.

Objective To study the validity of RAND-UCLA (Rand Corporation and University of California at Los Angeles) consensus panel method in developing guidelines of referral indications for low back pain (LBP).Methods Evidence-based clinical guidelines for LBP management at community level and its referral guidelines published since 2001 and other tools were retrieved with varied tools.All clinical guidelines met inclusion criteria were evaluated with clinical studies and evaluation tools (AGREE).An pool of indication items was established based on evidence for developing referral indications for LBP, which were added by RAND-UCLA consensus panel method, and alternative referral indications were selected and clinical guidelines for LBP referral were established.Results A total of 15 copies of clinical guidelines from nine countries or regions were included in it after critical appraisal.Four copies of referral guidelines from two countries were included.Referral indications for LBP were derived directly from the RAND-UCLA consensus panel process, consisting of 44 referral indications for three groups (immediate, urgent and routine referral).Conclusions The RAND-UCLA consensus panel method is a more useful and practical tool in developing clinical guidelines, referral guidelines, which is worthwhile being recommended and spread.