Objective To observe the effect of conventional therapy plus trimetazidine on alcoholic cardiomyopathy (ACM) and plasma brain natriuretic peptide (BNP).Methods Eighty-six cases of ACM patients were divided into control group and observation group by random digits table method with 43 cases each.Control group was treated with conventional therapy,while observation group was added trimetazidine.Course of treatment was 3 months.The left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),6 min walk distance,plasma BNP before and after treatment and the efficiency in two groups was observed and compared.Results LVEF,LVEDD,6 min walk distance,BNP before treatment in control group were respectively (37.2 ±7.4)％,(57.6 ±7.4) mm,(312.8 ±21.6) m,(846.2 ±63.7)μg/L,and the indicators in observation group were respectively (38.5 ±8.1)％,(57.1 ±6.8) mm,(316.5 ± 23.9) m,(857.6 ± 61.4) μ g/L.All indicators between two groups was no statistically different (P＞0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in control group were respectively (43.5 ±8.6)％,(54.3 ± 6.4) mm,(511.6 ± 26.7) m,(679.4 ± 51.3) μg/L,and there were significant difference compared with those before treatment (P ＜ 0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in observation group were respectively (51.6 ± 9.2)％,(51.2 ± 6.3) mm,(579.3 ± 25.1) m,(536.5 ± 50.6)μ g/L,and there were significant difference compared with those before treatment (P ＜ 0.05).There were significant difference in LVEF,LVEDD,6 min walk distance and BNP after treatment between two groups (P ＜ 0.05).The total effective rate in observation group was 90.7％ (39/43),which was significantly higher than that in control group [72.1％ (31/43)] (x2 =4.914,P ＜ 0.05).Conclusion Adding trimetazidine on the basis of conventional therapy can improve the cardiac function and myocardial remodeling of ACM patients and improve clinical efficacy.

To investigate the effect of the basic knowledge of chemistry teaching for preparatory international students,bilingual teaching based on Chinese-English languages and multimedia teaching,such flexible applications are carried out,which increases the students' listening,speaking,reading and writing skills in Chinese and helps them to adapt to the academic environment in China,and to master basic chemistry knowledge efficiently so that students can lay a good foundation for undergraduate program.

Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.

This paper summarizes the application status of the Roy adaptation model in the process of nursing patients with cancer, during the perioperative phase, radiotherapy or chemotherapy period and the care phase of extending from hospital to the community. Through the analysis of existing problems, put forward corresponding countermeasures to provide reference for the application and improvement of this model.

Objective To explore a new method of parapancreatic abscess treatment and establish an idea of minimally invasive technologies for parapancreatic abscess to improve the recovery rate of acute pancreatitis. Methods The patients had experienced percutaneous puncture and placed drainage tube under the ultrasound guidance first, then the sinus tract was expanded gradually to 24F perimeter by Cook's fascia expender. Finally, the necrotic tissue and pyogenic membrane was removed and repeatedly washed under guidance of choledochoscopy. Results The recovery rate was 91.1 %(33/36). The complication incidence was 10.7% (hemorrage:2 cases, external intestinal fistula:3 cases, and fatal MOF: 1 case). Conclusions The viewpoint which parapancreatic abscess only can be cured by drainage operation can be changed by associating debridement by choledochoscope with percutaneous puncture drainage under the ultrasound guidance. It is a simple, safe and effective method. It can be used to reduce the patients' damage, complication and mortality and accomplish the idea of damage control by minimally invasive technologies.

Objective To compare nursing students' adaptation in clinical practice who are under two different curriculum systems in order to guide our college's curriculum reform. Methods ROY adaptation model was used as the theoretical basis to design the questionnaire. 48 students in the reform class and 80 students in the parallel class were surveyed by questionnaire. Results The reform class and the parallel class of students were both unadaptable in clinical practice, but the reform class's adaptation was better than the parallel class. Conclusions Curriculum reform has some positive effect in clinical practice, nursing educators should take appropriate approaches to promote students to adapt the clinical practice.

Objective To investigate the protective effect of nimodipine on neuron of the rats with focal cerebral ischemia-reperfusion injury and the expressions of Bax and Bcl-2,and to clarify their mechanisms.Methods The focal cerebral-ischemia reperfusion model was induced by the middle cerebral artery occlusion(MCAO)method. 30 male Wistar rats were randomly divided into sham operation,model,and nimodipine groups(n=10).The neurological deficit score was performed after 2 h ischemia following 2 h reperfusion.The infarction was observed by TUNEL staining and the expressions of Bax and Bcl-2 were detected by SP immunohistochemistry method. Results Compared with model group, the number of apoptotic cells of the rats in nimodipine group was significantly decreased(P<0.05),the expression of Bax was significantly decreased (P<0.05),and the Bcl-2 expression was increased significantly(P<0.05).The morphological examination showed that the neurons of the rats in model group had serious necrosis and edema while the number of dead cells in nimodipine treatment group was reduced and the edema was improved.Conclusion Nimodipine has a protective effect on brain tissue of the rats with focal cerebral ischemia-reperfusion inj ury, which is closely related to the down-regulation of Bax and up-regulation of Bcl-2 and inhibition of the apoptosis of neuron.

Objective Complex of oxymatrine(OMT)-carbenoxolone sodium(CS)was prepared,and the acute toxicity of the OMT-CS complex and their protective effects on injured liver induced by carbon tetrachloride(CCl_4)were also studied.Methods The OMT-CS complex was formed after preparing OMT and CS solutions individually then mixing them in ratio,the constant was detemined by UV-vis,the complex was characterized by powder X-ray diffraction,IR,and NMR.The sequence method was employed to test LD_50 of the complex by iv injection.The aspartate transaminase(AST)and alanine aminotransferase(ALT)in serum were measured in acute hepatic injuried models by CCl_4 proportionally im injected the complex in mice.Results The ratio of OMT and CS in the complex appeared to be 1∶1.The results of powder X-ray diffraction measurement indicated that a novel crystalline structure of complex was formed.The acute toxicities of LD_50 of the complexes in 1∶1,and 2∶1 were lower than that of both OMT and CS only.Compared with the model group by CCl_4,AST and ALT levels in serum were lower than that in the complex at 1∶1 and 2∶1 ratios.Conclusion The toxicity of the complex in different proportions on acute hepatic injuried mice by CCl_4 decreases obviously,compared with their precursor drugs.

0.05). At time points of end of cold preservation, 10, 30 and 60 min of reperfusion, the activity of p38MAPK in control group was significantly higher than that at the time points of before resection and 120 min of reperfusion (P0.05). The expressions of TNF-? mRNA and ICAM1 mRNA at the time points of before resection, end of cold preservation, and 10 and 30 min of reperfusion were significantly lower than those in 60 and 120 min of reperfusion in both two groups (P

Objective To expand the utilization of minimally invasive technologies for parapancreatic abscess,and summarize the application experience of choledochoscope for treatment of parapancreatic abscess.Methods The clinical data and treatment effectiveness of 36 patients with parapancreatic abscess from Dec.2000 to Dec.2008 were analyzed retrospectively.These patients had experienced percutaneous puncture and been placed drainage tube under the ultrasound guidance first,then expanded the sinus tract gradually,and performed debridement by choledochoscope.The flexibility of choledochoscope was used to remove the necrotic tissue and pyogenic membrane repeatedly by clamping,netting and vacuum aspiration in every domain.Results Thirty-six patients were performed percutaneous puncture and placed drainage tube,3 cases were given canalis singularis,7 cases were double tube,26 cases were over three tube.The debridement times were 3-14 by choledochoscope,average 5.6 times.There were 6 cases with improving systemic symptoms,blood routine and temperature recovering normal,and drink and food recovering,then discharged from hospital with tube after 1-2 times of debridement.Length of stay was 25-132 d,average 76 d.The curing rate was 91.7% (33/36).Two cases were turned into open surgery because of broad necrotic tissue range combined with many abdominal cavity abscess with good postoperative recovery and cured.One case was dead of severe multiple organ failure combination.There were 2 patients with hemorrhage,3 patients with external intestinal fistula.Conclusions The debridement of choledochoscope for parapancreatic abscess treatment is a simple,flexible and effective method.It changes the viewpoint that parapancreatic abscess can be cured only by operation drainage,decreases the patients’ trauma and accomplishes the idea of damage control by minimally invasive technologies.