Acute myocardial infarction (AMI) is caused by acute occlusion of the coronary artery. The partial necrosis of the myocardium is caused by severe and prolonged ischemia,which is characterized by persistent and severe chest pain, the high mortality rate. Fast recovery can be achieved the coronary artery blood circulation by emergency percutaneous coronary intervention (PCI), can improve myocardial is-chemia, save moribund myocardium. The medical profession is generally believed that on the basis of en-suring the safety of patients with AMI, the normal rehabilitation should be carried out as soon as possible. In this article, the domestic in recent years, AMI emergency PCI in early postoperative rehabilitation treatment method, the intensity and evaluation index of three aspects were summarized. The starting time of the early rehabilitation of AMI patients in foreign countries is earlier than our country. As we all know that via radial artery PCI has the smaller puncture and more convenient hemostasis, so there is no doubt that it can pro-vide favorable conditions for recovery of patients. Therefore, it is necessary to expand the research field in order to determine the best rehabilitation opportunity and the most excellent rehabilitation program , so as so determine the best recovery time and the most excellent rehabilitation program in patients with AMI after PCI operation.

Objective To systematically evaluate risk factors for healthcare-associated infection(HAI)with multi-drug-resistant Acinetobacterbaumannii (MDRAB),so as to provide scientific basis for formulating MDRAB pre-vention and intervention strategies. Methods Literatures at home and abroad were searched,RevMan 5.3 statisti-cal software was used for meta analysis of the included literature data. Results A total of 21 papers were included, 8 in English and 13 in Chinese,35 risk factors were analyzed,20 of which were significantly different(all P<0.05),which included in 4 categories:① Related factors for antimicrobial use:use of antimicrobial agents prior to isolation of MDRAB(OR,12.87 [95% CI,5.14-32.21]),duration of antimicrobial use(MD,6.99 [95% CI, 2.21-11.78]),types of used antimicrobial agents (MD,1.07 [95% CI,0.60-1.54]),combined use of antimi-crobial agents(OR,4.16 [95% CI,2.63-6.57]),carbapenems use(OR,3.95 [95% CI,2.54-6.13]),use of third and above generation cephalosporins(OR,2.48 [95% CI,1.90-3.24]);② Related factors for invasive pro-cedures:mechanical ventilation(OR,4.30 [95% CI,3.03- 6.10]),endotracheal intubation/tracheotomy(OR, 4.17 [95% CI,2.41-7.22]),urinary catheterization(OR,2.35 [95% CI,1.42-3.88]),deep venous puncture (OR,2.18 [95% CI,1.14-4.16]),drainage catheterization(OR,2.06 [95% CI,1.19-3.58]);③Related fac-tors for intensive care unit (ICU):ICU admission(OR,5.60 [95% CI,2.73-11.48]),length of ICU stay(MD, 4.21 [95% CI,0.72-7.71]);④ Other factors:heart disease(OR,0.71 [95% CI,0.55-0.93]),tumor(OR, 0.67 [95% CI,0.48-0.95]),pancreatitis(OR,2.04 [95% CI,1.11-3.76]),mixed infection(OR,2.57 [95%CI,1.78-3.71]),length of hospital stay(MD,5.92 [95% CI,3.61-8.23]),APACHE II score(MD,4.56 [95% CI,1.94-7.18]),use of glucocorticoid(OR,2.18 [95% CI,1.21-3.90]). Conclusion Antimicrobial use,invasive operation,ICU-related factors are the main risk factors for MDRAB HAI,the relevant treatment and nursing intervention strategies should be formulated based on risk factors to prevent and reduce MDRAB infection.

OBJECTIVETo study the chemical components from dried roots of Zanthoxylum dimorphophyllum var. spinifoliun.

METHODThe chemical components were isolated by low pressure column chromatography and their structures were identified by spectroscopic methods.

RESULTFive compounds were isolated and identified as 6-(2', 3'-dihydroxy-3'-methyl-butyl)-7-hydroxy-5-methoxy-2H-1-benzopyran-2-one (I), 6-(2',3'-dihydroxy-3'-methyl-butyl)-7-methoxy-8-(3'-methyl-but-2'-enyl)-2H-1-benzopyran-2-one (II),6-(2',3'-dihydroxy-3'-methyl-butyl)-7-hydroxy-2H-1-benzopyran-2-one (III), 6-(2', 3'-oxiranyl-3'-methyl-butyl)-7-methoxy-8- (3-methyl-but-2-enyl)-2H-1-benzopyran-2-one (IV), 7-methoxy-8-(3'-methyl-but-2'-enyl)-2H-1-benzopyran-2-one (V).

CONCLUSIONThese compounds were isolated from the plant for the first time.

Coumarins ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Zanthoxylum ; chemistry

OBJECTIVETo determine whether long-term treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate influences the growth in height and weight of children.

METHODSAnalyses were performed on 146 school age children (126 boys) diagnosed as ADHD and treated with methylphenidate [0.27-0.64 mg/(kg.day)] for methylphenidate group and 29 children with ADHD who did not receive any medication for ADHD (controls). These children were followed-up for 2-4 years. Changes in height and weight after long-term treatment with methylphenidate were recorded and the factors affecting growth of height, weight, and height velocity were analyzed.

RESULTSThe change of difference between patients' height and mean height in methylphenidate group and controls was (-1.86 +/- 0.82) cm (paired t test, t = 27.335, P < 0.001) and (-0.26 +/- 0.51) cm (P < 0.05), respectively; the change of height standard deviation score (SDS) in methylphenidate group and controls was -0.14 +/- 0.23 SD (paired t test, t = 7.326, P < 0.001) and +0.05 +/- 0.10 SD (P < 0.05), respectively. When the height change and height SDS change in methylphenidate group and controls were compared by using independent-samples T-test, the t value was -10.078 and -4.262 respectively, P for both was < 0.001. Both of bivariate correlation analysis and stepwise multiple-regression analysis indicated that the duration of treatment contributed significantly to the variance in change of height (P < 0.001); but age, sex, DSM-IV type, NJ22 degree and dose of methylphenidate did not contribute significantly to the variance of height. The mean height velocity from 1st to 4th year was 4.28 cm/year, 4.90 cm/year, 4.98 cm/year and 4.95 cm/year, respectively. With Friedman test, Chi-square = 253.673, P < 0.001. The change of difference of patients' weight to weight for height after methylphenidate was (-0.14 +/- 1.25) kg (paired t test, t = 1.326, P > 0.05).

CONCLUSIONSmall but significant deceleration of height velocity is the identified long-term side effect of methylphenidate, the magnitude of height deficit is related to duration of treatment. The height velocity was significantly attenuated in the first year. Methylphenidate had no significant influence on weight.

Attention Deficit Disorder with Hyperactivity ; drug therapy ; Body Height ; drug effects ; Body Weight ; drug effects ; Case-Control Studies ; Central Nervous System Stimulants ; adverse effects ; therapeutic use ; Child ; Child Development ; Female ; Humans ; Male ; Methylphenidate ; adverse effects ; therapeutic use ; Regression Analysis

OBJECTIVETo study the chemical constituents of the dried roots of Zanthoxylum dimorphophyllumr. spinifolium and to find out the active constituents of the plant.

METHODModern chromatography was used to purify chemical constituents, and their structures were identified by various spectral methods.

RESULTFour compounds were isolated and identified as isopimpinellin (I), xanthoxyletin (II), 6-(2', 3'-dihydroxy-3'-methyl-butyl)-7-hydroxy-2H-1-benzopyran-2-one (III), 6-(2'-O-beta-D-glucopyranosyloxy, 3'-dihydroxy-3'-methybutyl)-7-hydroxy-2H-1-benzopyran-2-one (IV).

CONCLUSIONAll of the above compounds were isolated from the above mentioned plant for the first time.

Coumarins ; chemistry ; isolation & purification ; Furocoumarins ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Zanthoxylum ; chemistry

AIM To study the chemical constituents from Illicium brevistylum A.C.Smith and to evaluate their anti-inflammatory activities.METHODS The n-BuOH fraction of 80％ ethanol extract from I.brevistylum was isolated and purified by silica,ODS and Sephadex LH-20,the structures of obtained compounds were identified by spectral data.Then their anti-inflammatory activities were screened.RESULTS Nine compounds were isolated and identified as (7S,8R)-3,3',5-trimethoxy-4',7-epoxy-8,5'-neolignan-4,9,9'-triol (1),methylabieta-8,11,13,15-tetraen-18-oate (2),majusanin A (3),pubeside C (4),(+)-lyoniresinol-3a-O-α-L-rhamnopyranoside (5),junipercomnoside D (6),lyoniside (7),nudiposide (8),rhyncoside A (9).The inhibition rates of compounds 2,6,9 on NF-κB were 47.81％,37.33％,33.37％,respectively.CONCLUSION Compounds 1,5,7-9 are isolated from genus Illicium for the first time,and compounds 2,6,9 exhibit good anti-inflammatory activities.

Objective To investigate clinical nursing pathway management combined with nurse hierarchical system so as to promote the smooth implementation of clinical pathways.Methods The process of clinical nursing pathway was distributed into the work of nurses at different levels by using the present available resources; their process quality was quantitatively evaluated, which was closely related to their achievements, with the aim of making the nursing activity procedurized and standardized.Results Patients' satisfaction before and after implementing the clinical care pathway management combined with nurse hierarchical system was significantly different (P<0.01); the average hospital stay for a single disease was decreased after its implementation (P<0.05).Conclusions Implementing clinical nursing pathway management combined with nurse hierarchical system could effectively control the health care costs, improve quality of care and achieve the best possible care and management objectives.

Objective To investigate the methods for establishment of evaluation index system of clinical nursing pathway management.Methods Delphi method was used to screen evaluation indexes of clinical nursing pathway management and three rounds of expert consultation was carried out to establish the clinical nursing pathway management evaluation system. Analytic hierarchy process and comprehensive evaluation method was used to determine the levels of the index weight,and finally the establishment of weight factors at all levels.Results Aiming at the process of clinical nursing pathway management and following the principle of continuous improvement,an evaluation index system of clinical nursing pathway management was established.Conclusions The evaluation index system of clinical nursing pathway management provides a feasible and effective evaluation tool for the application and improvement of clinical nursing pathway and guides the promotion of application and development of clinical nursing pathway.

Objective To analyze the epidemiological characteristics of COVID-19 cases reported in Xianyang City from January to February 2020. Methods We retrospectively studied 17 COVID-19 patients diagnosed in Xianyang Central Hospital. The patients were characterized clinically and epidemiologically. Results The 17 patients included 10 male and 7 female, with an average age of(39.59±17.31)years. The median interval of time between onset and diagnosis was four days(1-10 days), whereas the median duration of COVID-19 was 16 days(3-23 days). Of the patients, six were mild, 10 were pneumonia, and one was severe. A total of 15 patients had fever as the onset, accompanied by fatigue, sore throat, sputum, vomit, muscle soreness; the other two patients were asymptomatic. There were no complications documented in all the patients. Patients had low levels of white blood cells and lymphocytes. Chest CT scan showed diverse diffuse ground-glass shadow. Eleven patients had travel history in Wuhan before the onset, four patients had contact with people who had travel history or residence history in Wuhan, and the other two patients did not report epidemiological exposure history. In addition, four of the 17 patients were clustered cases. Conclusion General population is susceptible to COVID-19. The majority of the confirmed cases have epidemiological exposure history. Routine examination, including white blood cell, lymphocyte count and CT scan may facilitate early diagnosis.

Objective To compare the efficacy of neuroendoscopic vs microscopic endonasal transsphenoidal pituitary adenoma resection and effects on hormone levels and clinical symptoms. Methods A retrospective analysis was conducted on 211 cases with pituitary tumor resection patients from January 2012 to June 2016, of which 112 cases with endoscopic endonasal transsphenoidal pituitary tumor resection (group A), 99 cases with microscopic transsphenoidal pituitary tumor resection (group B), and operation related indexes, hormone variations before discharge and symptoms remission 24 weeks after operation were extracted and compared. Results Two groups of patients with different tumor resection extent (Z = 2.14, P = 0.032), group A achieved total resection rate was significantly higher than the group B (79.5% vs 67.7%) (P = 0.037); the operation time of group A was significantly longer than group B [(93.6 ± 26.7) vs (79.8 ± 20.2) min, t = 4.26, P = 0.000], group A with the mean hospitalization stay was significantly less than group B [(7.9 ± 2.5) vs (10.2 ± 4.3) d, t = 4.67, P = 0.000], postoperative complications of group A were significantly lower than those of group B (5.4% vs 14.1%, χ2 = 4.73, P = 0.030). Two groups of postoperative hormone levels decreased in different degree (Z = 2.42, P = 0.016), group A with hormone recovery rate before discharge was significantly higher than group B (82.2% vs 66.7%, χ2 = 6.09, P = 0.014), and decline on prolactinomas, ACTH adenoma, ghrelin hormone were significantly higher than group B [(43.2 ± 10.5) vs (33.5 ± 9.1) ng/ml, (26.0 ± 8.8) vs (20.2 ± 7.0) pmol/L, (11.0 ± 3.9) vs (8.7 ± 3.2) μg/L, t = 3.60, t = 2.65, t = 2.12, all P < 0.05]. There was no significant differences between the two groups in remission of clinical symptoms 24 weeks after operation (P > 0.05). Conclusion Neuroendoscopic endonasal transsphenoidal pituitary adenoma resection is more efficient and less operative complications compared with microscopic surgery, which is more conducive to the recovery of postoperative hormone levels.