Objective To learn surgical nurses about their critical thinking ability and learning ability in order for nursing administrators to provide theoretical basis for improvement of critical thinking and self-learning ability of surgical nurses. Methods We investigated 200 nurses of three hospitals in surgery by California Critical Thinking Disposition Inventory(CCTDI) and Scale of Self-directed Learning Competence. Results Surgical nurse' critical thinking score was (282.41±19.87), and has a positive critical thinking; self-learning ability score was (131.65±10.29), the overall scores was at higher levels. Conclusions Care managers should pay attention to the surgical nurse' critical thinking skills and independent learning abilities and improve their quality of nursing staff.

Objective To investigate the effect of intrathecal injection of ropivacaine in the treatment of carpal tunnel syndrome with nervi medianus entrapment syndrome. Methods 164 patients with carpal tunnel syndrome were selected and divided into two groups, 82 cases in the control group were given intrathecal injection of lidocaine + methylprednisolone + vitamin B1, 82 cases in the experimental group received injection of ropivacaine + methylprednisolone + vitamin B1, the symptom score, nerve electrophysiological examination index, high frequency ultrasound quantitative parameters, the clinical effect and total recurrence rate were compared after treatment. Results The effective rate in the control group(74.39%)was lower than the experimental group(87.81%)(P<0.05); compared with the control group, the visual analogue scale (VAS), global symptom score (GSS), fatigue severity scale (FSS) and Levine carpal tunnel syndrome questionnaire score were lower in the experimental group after treatment, the nervi medianus distal motor latency (DML) level was lower, sensory nerve action potential (SNAP) and sensory conduction velocity (SCV) levels were higher after treatment, the diameter of the nervi medianus, the transverse diameter (a), anteroposterior diameter (b) of nervi medianus and cross sectional area (CSA) were lower after treatment, with significant difference (P<0.05); the total recurrence rate in the control group(53.66%)was higher than the experimental group(37.80%), with significant difference (P<0.05). Conclusion The clinical effect of intrathecal injection of ropivacaine in the treatment of carpal tunnel syndrome with nervi medianus entrapment syndrome was obvious, can effectively alleviate pain, improve the symptoms of nervi medianus entrapment, restore the nervi medianus conduction velocity and function, and reduce the recurrence rate.

Objective To better understand the age related changes of cardiac structure and function and their relationship with gender, body weight and blood pressure. Methods M mode, 2 dimensional, and Doppler echocardiographic studies were performed on 306 healthy intellectuals, including 165 males and 141 females, ranging in age from 30 to 85 years. Results Parameters in both male and female including the ratio of peak E wave to peak A wave velocity(E/A), the ratio of the right ventricular peak E wave to peak A wave velocity(E/Ar), the amplitude of aortic wall (Aao) and the angle between septum and the root of aorta (?) were all decreased with the aging significantly( P

BACKGROUND: Blood pressure of children increases with ages, and is related to anthropometric parameters, diet, sports, and other factors. To analyze relative factor of a little high blood pressure of children provides a scientific evidence for prevention and cure of primary hypertension. OBJECTIVE: To investigate correlation between blood pressure and anthropometric parameters among children. DESIGN: Cross-sectional study. SETTING: Department of Hygiene of Weifang Medical College. PARTICIPANTS: According to cluster sampling, 1 546 pupils in grade three or four were selected from a primary school for physical examination and questionnaires. Totally 1 508 pupils with complete data were regarded as the subjects.METHODS: Partial correlation analysis was used to analyze correlation between blood pressure and anthropometric parameters among children.MAIN OUTCOME MEASURES: Correlation among anthropometric parameters, systolic pressure and diastolic pressure.RESULTS: ① Correlation coefficients of systolic pressure with sex, age, height, body mass, chest circumference of Peason were 0.078, 0.166, 0.337, 0.313 and 0.304 (P ＜ 0.01). ② Correlation coefficients of diastolic pressure with sex, age, height, body mass, chest circumference of Peason were 0.047, 0.120, 0.268, 0.271 and 0.251 (P ＜ 0.01). ③ After controlling two effect of anthropometric parameters on each other, systolic pressure and diastolic pressure were only correlated with height and chest circumference (P ＜ 0.01), but was not correlated with age, sex and body mass (P ＞ 0.05). CONCLUSION: After controlling the effect of anthropometric parameters on each other, systolic pressure and diastolic pressure of children were positively correlated with height and chest circumference.

BACKGROUND: Previous studies suggest that vascular endothelial growth factor 121 may be an optimal target gene for thetreatment of acute myocardial infarction.OBJECTIVE: To investigate effect of direct myocardial injection of adenovirus recombinant human vascular endothelial growthfactor 121 gene (Ad-hVEGF121) on myocardial infracted rat heart structure, function and angiogenesis.METHODS: Totally 78 male SD rats were randomly divided into the sham-surgery (n=18), acute myocardial infarction (n=24),Ad-VEGF121 (n=19) and normal saline (n=17) groups. Among them, left anterior descending coronary arteries of the latter threegroups were ligated to prepare acute myocardial infarction models and rats were randomly selected to receive Ad-hVEGF12 ornormal saline via three points in the cardiac muscle at the 10-15 minutes after ligation. The chest was exposed without ligation inthe sham-surgery group.RESULTS AND CONCLUSION: At 2 weeks after injection, cardiac ultrasound showed that, compared with the sham-surgerygroup, the number of new capillaries, body weight and left ventricular mass / body weight of the acute myocardial infarction,Ad-hVEGF121 and normal saline groups were obviously increased (P < 0.05 or P < 0.01), especially those received transfectedrAd-hVEGF12, had higher density of blood capillaries than those of the normal saline and acute myocardial infarction groups.However, there were no obviously differences between each group in infarct size, cardiac structure or functions. The directmyocardial injection of Ad-VEGF121 can significantly promote the formation of new blood vessels within the myocardium.

Objective To determine the cardiac structure and function by transthoracic highfrequency ultrasonography in Wistar rats, and to explore the patterns of age-related changes.Methods Male Wistar rats aged 1, 2, 5, 12, and 20 months (n= 12 each group) underwent transthoracic echocardiographic analysis to examine the parameters of cardiac structure and function.Finally, the rats were sacrificed and the left ventricles were weighed. Results The left atrial dimension (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septum thickness at diastole (IVSD), left ventricular posterior wall thickness (LVPWd) and left ventricular mass (LVM) increased with age (all P ＜ 0.05 ) . There was a positive relationship between echocardiographic value and the autopsy weight LVM (r=0. 78, P＜0.01). There were no statistical significances in ejection fraction and fractional shortening among groups (all P＞0.05). Isovolumic relaxation time (IVRT) prolonged with age (P＜0. 01). After 2 month-old, tissue Doppler imaging Ea gradually decreased with age, Aa tended to increase with age. Ea/Aa ratio was more than 1 value in 1-, 2- and 5-months-old group, and it was less than 1 value in 12-, and 20-month-old group.Multivariate analysis showed that age was the influence factor of LAD, LVEDd and Ea. Conclusions Transthoracic high-frequency ultrasonography can be used to evaluate cardiac structure and function in rats; In aged rats, the wall-thickness, LAD and LVEDd are significantly increased. There is no significant change in systolic function, but diastolic function is decreased.

Objective:To investigate the effect of chronic alcohol consumption on both left ventricular myocardial collagen and diastolic function in rats,and their relationship thereof.Methods:Twenty-four male Wistar rats were randomly divided into 2 groups:control group(n=12)and ethanol group(n=12).The changes in cardiac diastolic function were evaluated by echocardiography and tissue Doppler imaging(TDI).The value of myocardial hydroxyproline content was determined by hydroxyproline reagent kit.The expressions of collagen Ⅰ and collagen Ⅲ mRNA were detected by RT-PCR analysis.Results:It was found that mitral E and mitral annulus Ea were decreased,mitral annulus Aa was increased,and isovolumic relaxation time(IVRT)was prolonged in the ethanol group compared with those in control group(P＜0.05).The value of Ea/Aa ratio was greater than 1 in control group and less than 1 in ethanol group(P＜0.01).It was found that myocardial hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression and their ratio significantly increased in ethanol group compared with those in the control group(P＜0.01).There was positive correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with IVRT(P＜0.05),and negative correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with the Ea/Aa ratio(P＜0.01).Conclusion:Chronic ethanol consumption can induce increase in left ventricular myocardial collagen synthesis and impairment in diastolic function in rats.Left ventricular diastolic dysfunction correlates with increase in myocardial collagen synthesis positively.

Objective To investigate the mechanism of the effects of heavy alcohol consumption in a short term and the protection of angiotensin Ⅱ receptor blocker (valsartan) on cardiac function in rats. Methods The 42 male Wistar rats aged 20 weeks were randomly divided into 4 groups:control group (group C, n= 10), alcohol group (group A, n=10), low-dose valsartan group (LD group, n= 11) and high-dose valsartan group (HD group, n= 11). They were supplied with same animal feeds, but all of them were administered different dose of alcohol and medicine via intragastric tube: group C was administered water, group A was administered alcohol (6. 4 g/kg), LD group was administered alcohol (6.4 g/kg) and valsartan (15 mg/kg), HD group was administered alcohol (6.4 g/kg) and valsartan (30 mg/kg). And 9 weeks later, the change of cardiac function was observed by echocardiography, the body and heart weight were measured, the hydroxyproline content of rat myocardium was determined by sample alkaline solution. Results After 9 weeks, there were no significant differences among four groups in left ventricular ejection fraction (LVEF), stroke volume (SV) and fraction shortening (FS). But the E peak, Ea/Aa, Ea peak and Aa peak were obviously lower in group A than in groups of C, LD and HD (all P＜0.05), and there were significant differences among C group, LD group and HD group in E peak, Ea/Aa (all P＜0. 05). The HW/BW and hydroxproline (Hyp) contents of myocardium were higher in group A than in groups of C, LD and HD (all P＜0. 01), but there were no statistical significances among group C, LD group and HD group (all P＞0. 05). Conclusions The short term heavy alcohol consumption results in impaired ultrastructure and diastolic function of myocardium in rats, the angiotensin Ⅱ receptor blocker (valsartan) may protect it.

Objective Explore the reversibility and potential molecular mechanisms of pulmonary hypertension in pa-tients with complete transposition of the great arteries (cTGA) combined with ventricular septal defect (VSD) in comparison with those with simple VSD. Methods Twenty-four patients with pulmonary hypertension (mean pulmonary arterial pressure was greater than 30 mmHg) were enrolled in our study, in which 10 patients suffered from cTGA with VSD, and the rest 14 pa-tients suffered from simple VSD. Lung specimens were taken from the right middle lobe of lung before cardiopulmonary bypass. The extent of pulmonary hypertension was then graded according to the Heath-Edwards classification. ELISA was used to exam-ine the expression of eNOS, iNOS, ET-1, ET-AR, ET-BR, MMP-2, MMP-9 and TIMP in all the specimens. Results No statistically significant differences in age, height, weight, the size of VSD, and the pulmonary artery pressure before operation were found between the groups. The level of hemoglobin, aortic and pulmonary arterial oxygen saturation, and the reduction value of pulmonary arterial pressure after surgery were significantly higher in the cTGA patients than that in the simple VSD pa-tients (P < 0.05). All patients had grade 0 - Ⅱ Heath-Edwards changes in their lung biopsy samples. The expression of eNOS and MMP-2 was significantly lower in the TGA group than that in the simple VSD group [eNOS: (280.13 ± 101.92) ng/mg vs. (488.41±249.6) ng/mg, P<0.05; MMP-2:(31.68±15.36)ng/mg vs. (69.28±49.12)ng/mg, P<0.05]. There were no statistically significant differences between the two groups regarding the expression of iNOS, ET-1, ET-AR, ET-BR,MMP-9 or TIMP. Conclusion The imbalance of the NOS/ET system and the MMP/TIMP system involves in the development of pulmonary hypertension in patients with TGA combined with VCD. In patients with cTGA, the high oxygenation state in pul-monary circulation may decrease the expression of MMP2 and eNOS, and may affect the progress of pulmonary hypertension to a certain extent.

Objective:To analyze the application value of the mechanical thrombectomy system in the treatment of acute limb ischemia.Methods:The clinical data of 50 patients with lower limb ischemia who were treated with the Rotarex mechanical thrombectomy system from Jun 2017 to Sep 2019 were retrospectively analyzed.Results:In 4 cases of popliteal artery rupture occurred during the operation. The success rate of the operation was 92%. Catheter-directed thrombolysis was used in 7 cases, percutaneous transluminal angioplasty was used in 4 cases and percutaneous transluminal angioplasty combined with stent implantation was used in 39 cases. The ankle-brachial index of these 50 patients before and after operation was 0.18±0.24 and 0.64±0.28 respectively ( t=12.87, P<0.001). Treatment was successful in 43 cases. Follow-up ranged from 1 to 24 months, 5 cases were amputated, 2 cases had no improvement of toe ulcer gangrene, 9 cases had thrombus recurrence, and no complications such as bleeding were observed. The primary patency rates at 3, 6 and 12 months were 92%, 84% and 74%, respectively. Conclusion:The mechanical thrombectomy system is safe and effective in the treatment of acute lower limb ischemia with ideal short-term patency.