Objective To investigate the relationship between plasma level of platelet derived growth factor-BB (PDGF-BB), coronary heart disease (CHD) and the severity of coronary artery stenosis. Methods A total of 262 patients hospitalized in Department of Cardiology, Tianjin Chest Hospital were collected in this study. According to the medical history, symptoms, laboratory examination and the results of coronary angiography, patients were divided into stable angina pectoris (SAP) group (n=57), acute coronary syndrome (ACS) group (n=119) and normal control group (n=86). The ACS group was divided into three subgroups:single vessel group (n=38), double vessel group (n=35) and multiple vessel group (n=46). The general clinical data, biochemical parameters and plasma PDGF-BB levels were compared between SAP group, ACS group and control group. Spearman correlation analysis was used to analyze the relationship between PDGF-BB level, high-sensitivity C-reactive protein (hs-CRP) and Gensini scores. Logistic regression analysis was used to analyze the risk factors of coronary heart disease. Results (1) The plasma levels of hs-CRP and PDGF-BB were significantly higher in ACS group than those in control group and SAP group (P<0.05). (2) Spearman correlation analysis showed that there was no correlation between plasma levels of PDGF-BB and hs-CRP and Gensini score (P>0.05). (3) There was no significant difference in plasma level of PDGF-BB between single vessel group, double vessel group and multiple vessel group (P > 0.05). (4) Logistic regression analysis showed that high plasma level of PDGF-BB was the risk factor for coronary heart disease. Conclusion PDGF-BB plasma level is associated with the pathogenesis of coronary heart disease, which may reflect the instability of coronary atherosclerotic plaques, but it is not an index to evaluate the severity of coronary stenosis.

Objective To develop models of epileptic discharge by activating group Ⅰ metabotropic glutamate receptors (mGluR) or by blocking gamma-aminobutyric acid (GABA) receptors on rat hippocampal slices. Methods Rat hippocampal slices were exposed to mGluR group Ⅰ specific agonist dihydroxyphenylglycine (DHPG) or to GABAA receptor antagonists bicuculline methiodide(BMI), and single pyramidal cell in the CA3 region of the slice was recorded by whole cell patch clamp technique. Results Exposure to DHPG or BMI resulted in the induction of spontaneously occurring epileptic discharge in the CA3 region of rat hippocampal slice, and there was no significant difference in the frequency of discharge between them(P>0.05). Conclusion Epileptic discharge can be generated in vitro in response to a loss of balance between excitatory and inhibitory influences.

Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc?tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with pa?tients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur?vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P<0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms,P<0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(<0.35)[RR: 2.167(1.384-4.661), P=0.013]and DC (DC<4.5 ms)[RR: 3.706(2.709-5.374),P=0.020]were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1%and 76.4%respectively, and the specificity was 84.5%and 86.1%respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.

Objective To study the protective role of continuous veno-venous hemofiltration (CVVH) in cardiac insufficiency refractory to diuretic therapy after acute myocardial infarction.Methods A total of 104 acute myocardial infarction patients admitted from march 2012 to march 2016 were recruited.According to their wishes,the patients were divided into two groups,continuous veno-venous hemofiltration combined with routine therapy as experimental group (n =52) and conventional treatment as control group (n =52).Mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,ventilator usage and urine output volume were documented.Then the difference in BW between pre-and post-treatment was determined for evaluation of fluid retention,and blood plasma C-reactive protein (ΔCRP),interleukin 6 (ΔIL-6),interleukin 8 (ΔIL-8),tumor necrosis factor-α (ΔTNF-α) and left ventricular ejection fraction (ΔLVEF) were measured and calculated.A multiple linear regression model to predict ΔLVEF was established.Data recorded at different intervals in the same group were analyzed by ANOVA.Data of the monitoring biomarkers,the mean length of ICU stay,the mean length of hospital stay of two groups were recorded at the same given intervals were analyzed by t test.Data of mortality rate within one month,drugs and ventilator usage in two groups were analyzed by x2 test.P value less than 0.05 was considered statistically significant.Results There were significant differences in mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,and the duration of ventilator usage between the two groups (P ＜ 0.05).Total volume of fluid output (urine and ultrafiltration volume) was higher in experiment group than that in control group in 48 hours after the treatment (P ＜ 0.01).The levels of CRP,IL-6,IL-8 and TNF-α decreased significantly (P ＜ 0.05) in experiment group after treatment but not in control group (P ＞ 0.05) as compared with those before the treatment.BW was decreased and LVEF was increased in both groups after treatment (P ＜ 0.05) compared with those before the treatment.Levels of CRP,IL-6,IL-8 and TNF-α were lower in experiment group than those in control group after treatment (P ＜ 0.05).BW was meagerly lower and LVEF was meagerly higher in experiment group than those in control group without statistical significance (P ＞ 0.05).However,the degrees of ΔLVEF andΔBW were greater in experiment group than those in control group (P ＜ 0.01).In experiment group,significantly positive correlations were found among ΔBW,ΔCRP,ΔIL-6,ΔIL-8,ΔTNF-α and ΔLVEF (P ＜0.05).Multiple linear regression analyses showed that ΔBW and ΔTNF-α were the independent factors forΔLVEF and ΔBW was the main independent factor for ΔLVEF in control group.ΔLVEF was positively correlated with ΔBW (P＜0.01) but had no correlation with ΔCRP,ΔIL-6,ΔIL-8 and ΔTNF-α (P ＞0.05).Multiple 1inear regression analyses showed that only ΔBW was the independent factor for ΔLVEF.Conclusion CVVH plays protective role in acute myocardial infarction patients with consequent cardiac insufficiency refractory to diuretic therapy by clearance of inflammatory cytokines and removal of retained fluid,and the removal of retained fluid is the most import mechanism to protect heart function.

The diagnosis related groups( DRGs) method is applied in hospital management at both hospital and clinical department level. This technology enabled us to evaluate hospital medical services in general, objectively evaluate discipline development, and formulate individualized discipline guidelines, supporting scientific distribution of hospital resources. At the department level, the technology supported clinical departments in their discipline construction and quality management. The application of DRGs can improve fine management of hospitals.

Objective To investigate the functional ankle instability in nurses,and provide references for increase preventive and protective awareness and establishment of preventive measures.Methods 100 nurses recruited from 10 wards of Provincial Hospital Affiliated to Shandong University were included into this study.Chinese version of the Cumberland Ankle Instability Tool (CAIT) was used to investigate the condition of functional ankle instability of these nurses.A self-designed questionnaire was used to investigate cognitive degree of ankle sprain prevention and treatment knowledge.Results Only 16％ of these nurses had no unstable problems in both of their two ankles.There were functional ankle instable problems in either single or both of the two ankles of the other 84％ nurses.And most of the nurses had little knowledge of how to prevent or treat ankle sprain properly.Conclusions There is a high rote of functional ankle instability in nurses.It is necessary to pay great attention to the prevention of ankle sprain and instability in nurses,which is of great importance to health and occupational safety assurance of nurses.

Objective To investigate brachial artery endothelial function and carotid intima-media thickness (IMT) in patients with H-type hypertension.Methods One hundred and twenty patients with newly-diagnosed mild to moderate hypertension were enrolled in the study,including 58 cases with normal homocysteine (HCY) level (＜ 10 μmnol/L,non H-type group) and 62 cases with high HCY (≥10 μ moL/L,H-type group).Systolic pressure,diastolic pressure,blood lipid (TC,TG,LDL-C,HDL-C),fasting plasma glucose and two hours postprandial plasma glucose were measured in all patients.Brachial artery endothelial function and carotid IMT were determined with ultrasonography and compare between two groups.The factors related to brachial artery endothelium-dependent dilation (EDD) and carotid IMT were analyzed with multiple linear stepwise regression.Results Compared with non H-type group,the brachial artery EDD was reduced [(6.85 ± 0.77) ％ vs.(5.98 ± 0.85) ％,t =2.552,P =0.041] and carotid IMT was increased [(0.90±0.13)mm vs.(1.01 ±0.17)mm,t =2.426,P=0.048] in H-type group.The multiple linear stepwise regression analysis showed that EDD was negatively correlated to systolic pressure,diastolic pressure,fasting plasma glucose,two hours postprandial plasma glucose and HCY (r =-0.685,-0.654,-0.571,-0.627,-0.529,respectively,all P ＜ 0.05).IMT was positively related to systolic pressure,diastolic pressure,TC,TG,LDL-C and HCY (r =0.596,0.584,0.652,0.665,0.673,0.541,respectively,all P ＜ 0.05).Conclusion Patients with H-type hypertension are at a higher risk to arteriosclerosis than those with non H-type hypertension,which may be related to high HCY levels.

Objective To analyze the pregnancy outcomes of 204 cases of multiple pregnancies following early transvaginal fetal reduction and sum up the experiences of peri-operation nursing care. Methods A total number of 204 twin and triplet pregnancies under treatment in the reproductive medical center from Jan. 2009 to Dec. 2012 were involved in the study. All patients underwent transvaginal multifetal pregnancy reduction during pregnancy of 7 to 8 weeks . The pregnancy outcomes were analyzed , and the nursing measures including preoperative preparation , intraoperative cooperation and postoperative nursing were analyzed . Result The successful rate of multifetal reduction was 100%, and the rate for taking the infants home reached 77.0% ~ 92.3%. Conclusion The outcomes of multifetal reduction for the twin or triplet pregnancy are good . Such nursing measures as perioperative mental care , intraoperative cooperation and postoperative follow-up are key to the alleviation of mental pressure during operation , raise of the success rate of fetal reduction and prevention of postoperative complications.

Objective To explore a variety of sustainable development under the network environment of doctor-patient communication service platform in the role of reproductive medicine nursing,to improve the reproductive efficiency of medical care services in the new environment,build new doctor-patient communication platform.Methods In reproductive medicine nursing practice,based on the internet to build diversification of doctor-patient communication information service platform,such as reproductive center website,QQ group of doctor-patient communication,Wechat public service platform.Through the questionnaire survey form,understand reproductive center patients through various network platform in the query,the information,make an appointment for reproductive assisted reproduction related information and interact with staff and other aspects of the usage and satisfaction.Results Recycling effective questionnaire was 517 papers.A total of the use of network platform for the overall coverage was more than 80％ of patients,among them the most widely Wechat public platform,utilization rate was 78.1％ (400/512);60.8％ (312/513) patients think Wechat platform using the most convenient.The overall satisfaction rate for center web services platform was 89.5％ (460/514).Conclusions Online platforms provide better nursing efficiency and quality,as well as improving doctor-patient communication based on the internet environment.It provides a new way for sustainable development for nursing system in the field of reproductive medicine.

BACKGROUND:The position of median and radial nerves corresponding to elbow is usual y estimated by macroscopical measurements, but there are big data errors when the elbow is bent. OBJECTIVE:To measure and analyze the impacts of elbows in different positions on median and radial nerves under X-ray. METHODS:Ten fresh frozen upper limb specimens were selected. The distance of median and radial nerves to the osseous marks inside the elbow was measured when the elbow was in extension, extension-half pronation, bent at flexion 90 degrees and bent at 90 degrees with the injection of normal saline into the joint capsule, respectively. RESULTS AND CONCLUSION:The positions of median and radial nerves were not influenced when the elbow was in extension or in extension-half pronation (P>0.05). The distance of median and radial nerves to the osseous mark of the elbow was significantly lengthened when the elbow was moved from from extension to was bent at 90 degrees (P<0.05). The intra-articular injection of normal saline when the elbow flexion 90 degrees significantly elongated the distance of median and radial nerves to the osseous mark of elbow (P<0.05). These results suggest that the elbow in different positions can induce the displacement of median and radial nerves. In addition, the distance between median, radial nerves and the osseous marks of the elbow is obviously lengthened when the elbow is in flexion with intra-articular injection of normal saline.