75mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow up were assessed. Results PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83?0.12)cm 2 to (1.75?0.11)cm 2 ,pulmonary systolic pressure decreased from (85?7)mmHg to (61?13)mmHg (all P

Objective To explore the clinic value of sequential severity evaluation in emergency nursing for stroke patients. Methods 138 of stroke patients were enrolled in study group, which completed sequential severity evaluation in emergency medical and nursing provision drawn up according to the results. Another 207 of stroke patients were enrolled in control group, which emergency nursing provision drawn up according to general procedure. Length of time from emergency call to special therapeutic, mortality compared between the two groups respectively. Results In study group, length of time from emergency call to special therapeutic (48.9?34.1) min was significantly shorter than that of control group (73.1?46.7) min; mortality (11.1%) was significantly lower than that of control group (24.3%),cure rate (34.7%) was significantly higher than that of control group (26.9%). Conclusion Sequential severity evaluation in acute nursing may be a worthy procedure for proving reaction ability of nurse reaction ability in emergency medical and nursing, proving outcome for stroke patients and it should be commended.

Objective To investigate the delayed alteration of hippocampus proteome after an-esthesia with isoflurane in aduh and aged rats. Methods Ten 8-month-old SD rats were randomly divided into group Caduh and group Iadult (5 in each group) , and another ten 22-month-old SD rats were randomly divided into group Caged and group Iaged (5 in each group). The rats in group Iadult and group Iaged received 2 h anesthesia with 1.2 % isoflurane. The rats in group Cadult and group Caged inhaled 40% oxygen for contrast. The hippocampal proteome of each rat was measured by 2-dimensional gel electrophoresis and mass spectrometry. Results The vital signs of the rats in group Iadult and group Iaged were stable. There were 878±34 protein spots in group Cadult, 864±49 protein spots in group Iadult, 834±47 in group Caged, and 819±24 in group Iaged. There were 12 (4/8)different protein spots between group Iadult and group Cadult. There were 11 (3/8) different protein spots between group Iaged and group Caged. All of the protein spots were identified by MALDI-TOF-MS. Most of the different proteins were related to metabolism, anti-oxidation, and signal conditioning of synapse. Conclusion Isoflurane may cause the alteration of hippocampal pro-teome in rats, which is age-related.

Objective To investigate the effects of spontaneous agonal respiration on coronary perfusion pressure (CPP) during untreated cardiac arrest (ventricular fibrillation) in swine model.Methods Ten male healthy domestic swines (25.0 ± 1.5) kg were anaesthetised,intubated and mechanically ventilated.The catheterizations were separately inserted into the right atrium and thoracic aorta to monitor aortic pressure (AOP) and right atrial pressure (RAP).A pacing electrode was inserted into the right ventricle to induce ventricular fibrillation (VF).VF was induced by intra-ventricular stimulation withalternating electric current and untreated for 8 minutes.AOP and RAP were recorded until respiratory activity ceased.The CPP before and after agonal respiration was calculated and analyzed by paired-sample T test.Results All animals presented with agonal respiration from 1 to 6 minutes after VF during the first attempt.The CPP was (7.18 ±4.22) mmHg at 1 sec before agonal respiration,(11.78 ±5.16) mmHg at 0 sec after agonal respiration,(8.75 t:4.38) mmHg at 5 sec after agonal respiration and (8.23 ± 4.55)mmHg at 6 sec after agonal respiration.The CPP at 0 sec after agonal respiration was higher than that before agonal respiration (t =-3.140,P =0.012).The CPP at 5 sec after agonal respiration was higher than that at 1 sec before agonal respiration (t =-2.828,P =0.020).There was no difference in CPP between at 6 sec after agonal respiration and at 1 sec before agonal respiration (t =-1.778,P =0.109).Conclusions Agonal respiration accompanies ventricular fibrillation.After agonal respiration,the coronary perfusion pressure is increased for 5 seconds being in favor of cardiaopulmonary resuscitation.

Objective:To evaluate the effect of anti-vascular endothelial growth factor (VEGF) in patients with wet age-related macular degeneration (wAMD) and investigate the recurrence factors.Methods:In this case-control study, 40 eyes of 38 patients with wAMD treated by anti-VEGF therapy in Xijing Hospital from October 2015 to April 2017 were included.Ranibizumab or conbercept was consecutively intravitreally injected monthly under 3+ pro re nata (PRN) regimen.All included patients were followed-up at least 12 months.The best corrected visual acuity (BCVA) was expressed in logarithm of the minimum angle of resolution (LogMAR) units.Optical coherence tomography (OCT) was used to observe the morphologic characteristics of macula and measure the central retina thickness (CRT). Patients were divided into recurrence and recurrence-free group based on whether recurrence occurred during follow-up.Potential associated factors with recurrence after treatment were analyzed by multivariate logistic regression analysis.Meanwhile, the morphological and functional response were identified at 1 month after loading phase as well as at last follow-up visit.This study protocol was approved by the Ethics Committee of Shanghai General Hospital (No.2016KY243) and written informed consent was obtained from each patient prior to receiving injection.Results:All the operative eyes showed retinal effusion absorption at least once, and 21 (52.5%) eyes had relapse during follow-up.The patients with lower BCVA (LogMAR) value at the first absorption time had higher risk of recurrence ( OR=16.7, 95% CI=1.22-100, P<0.05). The eyes in the recurrence group received more times of treatment than eyes in the recurrence-free group (5.8±2.3 vs 3.5±1.4, t=3.64, P<0.05). However, there was no significance between the two groups in BCVA change before and after treatment ( t=-1.52, P>0.05). In the recurrence group, the BCVA (LogMAR) and CRT at last visit were 0.73±0.34 and (187.2±81.7)μm respectively, while were significantly improved in comparison with 0.81±0.37 and (234.2±74.5)μm at the relapse time ( t=2.14, 2.62; both at P<0.05). There were 87.5% (35/40) eyes showed good morphological responses at 1 month after the loading phase while 12.5% (5/40) eyes presented poor morphological responses, the retinal effusion was absorbed after additional (3.2±2.2) times of injections.The BCVA of eyes with a good morphological response at 1 month following loading phase was better than that at the first retinal effusion absorption time ( t=-2.23, P<0.05). Average CRT at last visit was significantly decreased in comparison with the baseline CRT ( Z=-4.62, P<0.01). Conclusions:For wet AMD patients, the anti-VEGF treatment is safe and effective in the short term, while there is still a high rate of recurrence.More attention should be paid to eyes with better vision at the first time of retinal effusion absorption which may have more chance to experience recurrence.Patients need long-term follow-up after treatment to prevent recurrence.In addition, the complete loading treatment is needed for patients who have a good morphological response after the first retinal effusion absorbed.

Objective To explore the regularity of incidence of agonal respiration (AR) and agonal respiration frequency rate (ARFR) during untreated cardiac arrest (CA) after ventricular fibrillation (VF) in a swine model.Methods Ten healthy male domestic pigs weighing (25.0± 3.0) kg were employed in this experiment.VF was induced by intraventricular shock with alternating current without treatment for 8 minutes.The incidence of AR and ARFR per minute were recorded for 8 minutes.Statistical analysis was performed using SPSS 19.0 system software.Results AR occurred in all animals after VF induced CA within 8 minutes.There was 1 animal showed AR at the first minute with ARFR (0.2±0.1) times/min,4 animals showed AR at the second minute with ARFR (1.2 ± 1.0) times/min,7 animals showed AR at the third minute with ARFR (2.7 ± 1.4) times/min,all animals showed AR at the fourth to fifth minute with ARFR (3.7 ± 1.6) times/min and (3.2 ± 1.9) times/min,7 animals showed AR at the sixth minute with ARFR (1.3 ± 1.0) times/min,no animal showed AR at the seventh minute,and 1 animal showed AR at the eighth minute with ARFR (0.2±0.1) times/min.The first and the last AR were observed at (2.02±0.84) minutes and (5.21 ± 1.12) minutes respectively.Occurrence of AR reached its peak at the fourth to fifth minute,and it was absent at the seventh minute.ARFR after CA showed a crescendo-decrescendo pattern,which increased from (0.2±0.1) times/min to (3.7±1.6) times/min followed by a fall to (0.2±0.1) times/min.Conclusions AR is one of the symbolic signs after CA.AR occurred in all animals during untreated VF,and it reaches its peak at the fomrth to fifth minute,with a crescendo-decrescendo pattern of ARFR.Effective identification and treatment in victim with AR timely can help to improve the success rate of cardiopulmonary resuscitation and survival rate.

OBJECTIVE To evaluate the effects of arsenic trioxide (As2O3) on the cell cycle and microfilament cytoskeleton in human nasopharyngeal carcinoma cell line(CNE1),as well as possible mechanisms. METHODS The variation of cell cycle and microfilament cytoskeleton in CNE1 were observed using the flow cytometry (FCM),the laser scanning confocal microscopy(LSCM)and technology of fluorescence.RESULTS FCM showed that the proportion of G1 phase cells significantly increased in cells exposed to 2 and 4?mol/L As2O3(P

Objective To investigate the causes, clinical features, classifications and liver function change of drug-induced liver damage (DILD) in the elderly. Methods One hundred and sixty seven inpatients with acute drug-induced liver injury in our hospital in the past ten years (January 2000 to December 2009) were retrospectively investigated,and the diagnosis and classification methods of acute DILD were based on international consensus meeting (international criteria). Results Among 167 DILI cases, there were 53 cases (31.7%) in the older group and 114 cases (68.3%) in middle-youth age group. Fatigue and jaundice were the more common symptoms, accounting for 50.3% and 46.7%, respectively. In 167 cases, no obvious symptoms and signs were shown in 25 cases. There were no significance differences in clinical manifestation between two groups. Many drugs could induce liver injury. The most common drugs inducing DILD were Chinese traditional and herbal drugs, accounting for 47.9%. Drugs used in heart diseases and inducing liver injury were more common in the older group. In this study, 40 (75.5%), 5 (9.4%) and 8 (15.1%) cases were designated as hepatocellular, cholestetic and mixed DILD in the older group, and 91 (78.9%), 8 (7.4%) and 15 (13.7%) in middle-youth age group, respectively. There were no significance differences between two groups in classifications. Conclusions Many drugs could cause liver injury. The symptoms of acute DILD are nonspecific. Drugs used in heart diseases and inducing liver injury are more common in older patients.

Objective:To investigate the ocular clinical manifestations in pediatric patients with incontinentia pigmenti (IP).Methods:A case series study was carried out and a retrospective analysis was performed.Clinical data of 13 pediatric patients with IP treated from January 2013 to December 2019 in Xijing Hospital were collected.All the patients underwent regular ophthalmologic examination.Three patients accepted fundus fluorescein angiography and six eyes of five patients were treated with retinal photocoagulation or anti-vascular endothelial growth factor (VEGF) intravitreal injection according to severity of the condition.The follow-up period ranged from 6 months to 6 years.The medical history, family history, systemic manifestations, ocular characteristics, diagnosis, treatment as well as ocular and systemic changes during follow-up were recorded and analyzed.This study followed the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Xijing Hospital, Fourth Military Medical University (No.KY20203287-1).Results:All the 13 patients were female aged from 5 days to 42 months at first visit, with the average age of 2.0 (1.0, 8.5) months.As for the main skin lesions at first visit, there were 4 cases in erythematous vesicle stage, 3 cases in verrucous exanthema stage, and 6 cases in hyperpigmented stage.There were 7 cases in shrinkage stage during follow-up.Among the 26 eyes of 13 patients, 18 eyes of 10 patients showed ocular anomalies, accounting for 76.9% of total patients (69.2% of total eyes). Among the 13 patients, 8 patients presented bilateral ocular involvement, 2 patients showed unilateral anomalies, and 3 patients had no ocular lesions.The retina was involved in all patients with ocular manifestations.The typical retinal lesions included avascular zone of peripheral retina in 13 eyes, tortuous and dilated retinal vessels in 10 eyes, increased vascular branch in 7 eyes, white linear retinal arteries and partial vascular occlusion in 4 eyes, retinal neovascularization in 3 eyes, total retinal detachment in 2 eyes, and retinal fold with macular lamellar hole in 1 eye.In addition, there was retinal hemorrhage in 11 eyes, retinal pigment changes in 4 eyes, grey ridge lesions in 3 eyes, macular dysplasia in 2 eyes, choroidal atrophy in 1 eye, optic gliosis in 1 eye and yellowish-white retinal exudate in 1 eye.There were also 4 patients with other ocular manifestations, such as strabismus and eyeball atrophy.Retinal photocoagulation was performed in 4 eyes of 3 patients and anti-VEGF intravitreal injection in 2 eyes of 2 patients.The retinal lesions regressed and the condition of patients kept stable during follow-up.Conclusions:The ocular clinical manifestations in patients with IP are usually typical and diverse, and the retinal vascular lesion is the main type.Early diagnosis and timely treatment are of great significance.

Objective An 80 years old man,suffered from cardiopulmonary arrest during swimming.After successfully cardiopulmonary resuscitation,he was sent to a hospital.After examination and inspection,he was diagnosed as cardiopulmonary arrest,aspiration pneumonia,hyperlipidemia,high level of creatine kinase.We prescribed a statin for the hyperlipidemia,but the level of creatine kinase was higher and higher.Finally he was diagnosed as hypothyroidism and lung cancer.We considered that severe weakness may be the reason of cardiopulmonary arrest in swimming pool.