Objective:To explore changes of electrocardiogram (ECG)and cardiac markers,and its relationship with prognosis in aged patients with acute cerebral infarction.Methods:The data of 356 aged patients with acute cerebral infarction (acute cerebral infarction group),who hospitalized in our hospital from May 2007 to May 2012,and 258 non-cerebral infarction patients (normal control group)were retrospectively analyzed.Changes of ECG and cardiac markers were compared between two groups,and patients with cerebral infarction received a six-month follow-up. Results:Compared with normal control group,there were significant rise in percentage of abnormal ECG (22.9%vs.73.3%,χ2=150.53,P=0.00),levels of cardiac troponin I [cTnI,(0.02±0.003)μg/L vs.(0.07±0.002)μg/L],creatinine kinase isoenzyme [(9.1±5.6)U/L vs.(24.2±4.1)U/L]and creatinine kinase [(98±9.8)U/L vs.(202.7±10.2)U/L]in acute cerebral infarction group,P<0.05 all;the older these patients were,the high-er abnormal ECG rate was (60~75 years vs.>75 years:37.0% vs.83.8%,χ2=80.54,P=0.00);After six-month follow up,compared with normal group,there was significant increase in mortality rate (19.5% vs.86.8%,χ2=95.09,P=0.00)in acute cerebral infarction group.Conclusion:Incidence rate of abnormal ECG and cardiac marker level are higher in aged patients with acute cerebral infarction.It possesses important significance for judging patient′s condition,guiding treatment and evaluating prognosis.

Objective To investigate the effect of progesterone combined with psychological intervention on threatened abortion. Methods According to the different treatment and nursing intervention mode selected from be January 2015 to January 2017 in our hospital 60 cases of patients with threatened abortion group: the control group used dydrogesterone + routine nursing intervention, the observation group with psychological nursing mode + progesterone intervention; the two groups of patients with clinical symptoms, the incidence of adverse reactions and nursing satisfaction were recorded in detail, and the relevant data for comparative analysis. Results The psychological nursing mode of progesterone +(observation group) intervention is better than the clinical effect of patients with threatened abortion and dydrogestrone + routine nursing (control group) the clinical intervention effect, clinical symptoms improved better than the control group, the incidence rate of adverse reaction was lower than the control group, nursing satisfaction was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Threatened abortion patients choose progesterone + psychological intervention effect significantly, can effectively improve the clinical symptoms and adverse reactions and nursing satisfaction, is widely used in clinical intervention of threatened abortion patients.

Objective To investigate the effects of labetalol, Magnesium Sulfate, psychological intervention combined with the clinical effect of treatment of gestational hypertension. Methods According to the different treatment and nursing intervention mode of 120 cases of hypertension patients in January 2015 to 2017 year in January in our hospital for diagnosis and treatment of pregnancy groups: control group with routine nursing intervention in the observation group, Magnesium Sulfate +, Magnesium Sulfate + + mode labetalol psychological nursing intervention; the detailed records of the two groups of patients with clinical curative effect, complications, etc. the situation, and the related data for comparative analysis of labetalol, Magnesium Sulfate, psychological intervention combined with the clinical effect of treatment of gestational hypertension. Results The psychological nursing mode of labetalol + Magnesium Sulfate (observation group) intervention effect in patients with hypertension during pregnancy is better than the Magnesium Sulfate + routine nursing (control group) the clinical intervention effect, clinical symptoms improved better than the control group, the complication rate was lower than the control group, nursing satisfaction was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Patients with gestational hypertension selection effect of labetalol + Magnesium Sulfate +psychological nursing intervention significantly, can effectively improve the clinical symptoms and reduce the incidence of complications.

ObjectiveTo explore the effects and the side effects of different pattems of postoperative analgesia. MethodsThe data of postoperative analgesia in 725 patients underwent obstetrics and gynecology operation was analysed retrospectively, patient-controlled intravenous analgesia(PCIA) with 352 cases (PCIA group) or patient-controlled epidural analgesia(PCEA ) with 373 cases(PCEA group ). The analgesic effect, sedation scale and side effects were compared. ResultsThe analgesic effect and sedation scale at 12,24 h after operation in PCEA group was lower than that in PCIA group(P ＜0.05). The incidence of vomiting in PCEA group was lower than that in PCIA group [6.4％(24/373) vs. 9.9％(35/352)], the incidence of itchy skin and infection in PCEA group were higher than those in PCIA group [4.8％(18/373)vs. 2.6％ (9/352), 3.2％( 12/373 ) vs. 0], there was significant difference between two groups (P ＜ 0.05 ). Old people fell less pain than wrinkly and young people (P＜0.05). ConclusionsThe effect of PCEA is better than PCIA. Paresthesia is main in PCEA. Vomiting is more in PCIA. Old people feel less pain than wrinkly and young people. So postoperative analgesia is selected by concrete conditions.

A novel hydrophobic ferrocene polymer ( P-Fc) was synthesized successfully. Taken the advantage of 2-hydroxypropyl-β-cyclodextrin ( HP-β-CD ) with hydrophilic outside and hydrophobic inside, P-Fc was successfully enveloped in the cavity of HP-β-CD to form macromolecular vesicle by a self-assembly process. The structure and morphology of the macromolecular vesicle was characterized by FTIR, 1HNMR, SEM and CV. Rhodamine 6G (R6G) and doxorubicin hydrochloride (DOX) was used as target drugs and loaded in the vesicles successfully. After added the oxidant, ferrocene was oxidized to dicyclopentadienyl iron, which destroyed the vesicles successfully. The rapid directional release of the drugs was realized. The maximum loading values of R6G and DOX were 6. 89 and 39. 06 μg/mg, respectively. The release rates were 73. 7%and 88. 2%, respectively. It would increase the utilization level of the drugs and enhance their efficiency.

Objective:To investigate the effects of B ultrasound-guided lumbar plexus combined with sciatic nerve block on immune function, stress response, and postoperative analgesia in older adult patients undergoing hip surgery, providing theoretical evidence for clinical diagnosis and treatment.Methods:We included 300 older adult patients undergoing hip surgery who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2018 to August 2019 in this study. We randomly allocated them into the observation and control groups ( n = 150/group). The control group was subject to general anesthesia and the observation group was subject to B ultrasound-guided lumbar plexus combined with sciatic nerve block. Hemodynamic changes and plasma cortisol levels were recorded in each group immediately after endotracheal intubation (T1), at 2 hours of surgery (T2), at the end of surgery (T3), and 24 hours after surgery (T4). Each patient's immune function was assessed 3 months after surgery. The Visual Analog Scale score at each time point was compared between the two groups. Results:The systolic blood pressure, diastolic blood pressure, and heart rate in the observation group at T1-T4 were (122.14 ± 8.68) mmHg, (117.41 ± 8.72) mmHg, (109.62 ± 8.43) mmHg, (127.82 ± 7.83) mmHg, (83.47 ± 6.32) mmHg, (72.34 ± 7.02) mmHg, (67.13 ± 6.72) mmHg, (74.15 ± 7.12) mmHg, (71.94 ± 7.64) beats/minute, (71.84 ± 7.11) beats/minute, (63.52 ± 6.16) beats/minute, (73.43 ± 7.29) beats/minute , respectively, which were significantly lower than those in the control group [(131.22 ± 8.69) mmHg, (125.81 ± 8.76) mmHg, (115.11 ± 8.44) mmHg, (133.26 ± 7.85) mmHg, (89.28 ± 6.12) mmHg, (77.64 ± 7.13) mmHg, (75.51 ± 8.02) mmHg, (81.13 ± 7.14) mmHg, (79.24 ± 7.65) beats/minute, (75.27 ± 7.13) beats/minute, (70.54 ± 6.22) beats/minute, (80.11 ± 7.32) beats/minute, t = 9.05, 8.32, 5.63, 6.00, t = 8.08, 6.48, 9.80, 8.47, t = 8.26, 4.17, 9.82, 7.91, all P < 0.001]. Plasma cortisol levels in the observation group at T2-T4 were (332.28 ± 15.64) ng/L, (334.67 ± 15.77) ng/L, (331.40 ± 15.68) ng/L, respectively, which were significantly lower than those in the control group [(344.75 ± 15.63) ng/L, (346.02 ± 15.76) ng/L, (345.83 ± 15.66) ng/L, t = 6.90, 6.23, 7.97, all P < 0.001]. At 3 months after surgery, the proportion of CD 4+ helper T cells, the proportion of CD 8+ cytotoxic T cells, and the ratio of proportion of CD 4+ Helper T cells to the proportion of cytotoxic CD 8+ T cells in the observation group were (31.39 ± 6.72)%, (25.73 ± 6.24)%, 1.31 ± 0.38, respectively, which were significantly lower than those in the control group [(38.61 ± 6.73)%, (32.79 ± 6.25)%, 1.52 ± 0.39, t = 9.29, 9.79, 4.72, all P < 0.001]. At 12-48 hours after surgery, The Visual Analog Scale scores in the observation group were (1.59 ± 0.54) points, (1.47 ± 0.33) points, (1.55 ± 0.41) points, respectively, which were significantly lower than those in the control group [(2.72 ± 0.55) points, (2.29 ± 0.36) points, (2.39 ± 0.43) points, t = 17.95, 20.56, 17.31, all P < 0.001]. Conclusion:B ultrasound-guided lumbar plexus combined with sciatic nerve block can effectively stabilize the hemodynamics in older adult patients undergoing hip surgery, reduce the occurrence of the stress response, promote the recovery of immune function, and alleviate pain.

Objective:To explore the application effect of root cause analysis (RCA) in the safety management of electrosurgical instruments and equipment.Methods:The safety management of electrosurgical instruments in Sterilization Supply Center of the First Affiliated Hospital of Zhengzhou University from February 2018 to March 2020 was retrospectively analyzed. The research objects included 12 medical staff and 175 surgical patients. Using the before-and-after comparison method, the 89 surgical patients before the implementation of RCA from February 2018 to February 2019 were used as the before improvement, and the 86 surgical patients after the implementation of RCA from March 2019 to March 2020 were used as the after improvement. The RCA score, nursing staff's cognition of surgical equipment, the incidence of equipment-related adverse events and infection rates were compared before and after the implementation of RCA.Results:After the improvement, the RCA scores of 12 medical staff were lower than those before the improvement, and the differences were statistically significant ( P<0.01) . The cognitive scores of medical staff on surgical instrument were higher than before, and the differences were statistically significant ( P<0.01) . The incidence of device-related adverse events and infection rates in patients after improvement were lower than those before improvement, and the differences were statistically significant ( P<0.05) . Conclusions:The use of RCA in the safety management of electrosurgical instruments and equipment is conducive to improving nursing staff's cognition of surgical instruments and equipment and reducing the incidence of adverse events of surgical instruments.

Objective To investigate the incidence and influencing factors of geriatric syndrome (GS) in Beijing area, and to analyze the relationship between GS and Barthel Index (Barthel ADL) score and quality of life. Methods From June 2018 to December 2018, a community-based or door-to-door survey of elderly people >65 years old in some communities in Beijing was conducted. The incidence of GS and its gender distribution, age distribution, and type distribution were investigated. At the same time, GS patients were selected as the observation group, and among people without GS in physical examination, a random sampling method was used to select the control group. The general data, Barthel ADL score, and World Health Organization Quality of Life (WHOQOL-BREF) score were compared between the two groups. The relevant influencing factors of GS and its correlation with the Barthel ADL score and WHOQOL-BREF scores were analyzed. Results Among 500 elderly people in the community investigated in the present study, 97.00% of patients had ≥1 types of GS, 84.80% of patients had ≥2 types, and 70.20% of patients had ≥3 types of GS. High education level (OR=0.329, 95%CI: 0.259-0.418) and retirement pension (OR=0.727, 95%CI: 0.576-0.918) were the protective factors for the occurrence of GS. Hyperlipidemia (OR=3.176, 95%CI: 2.518-4.007), diabetes (OR=2.473, 95%CI: 1.718-3.559), coronary heart disease (OR=2.658, 95%CI:1.649-4.286), hypertension (OR=3.230, 95%CI:2.008-5.197), osteoarthropathy (OR=4.166, 95%CI: 3.008-5.769), cancer (OR=3.008, 95%CI: 1.894-4.778), acute cerebral infarction (OR=3.420, 95%CI: 2.335-5.009), and acute myocardial infarction (OR=2.112, 95%CI: 1.169-3.814) were the risk factors for GS (P<0.05). The Barthel ADL score and WHOQOL-BREF score of the observation group were lower than those of the control group (P<0.05). GS was negatively correlated with Barthel ADL and WHOQOL-BREF scores (P<0.05). Conclusion GS was common in the elderly in Beijing, and its occurrence was related to factors such as education level, retirement pension, hyperlipidemia, diabetes, coronary heart disease, hypertension, osteoarthropathy, cancer, acute cerebral infarction, and acute myocardial infarction. Strengthening the early assessment and management of GS will help improve the daily life and quality of life of the elderly.