Objective To observe the effects of intervention with Simvastatin and Aspirin on carotid artery atherosclerosis(CAA).Methods 120 patients with ischemic cerebrovascular disease and complicated CAA and blood-lipid abnormality were randomly divided into the Simvastatin group,Aspirin group,Simvastatin+ Aspirin group.Each group received corresponding therapy for 6 months.The changes of serum C-reactive protein(CRP) level,blood-lipid level,the carotid artery intimal and media thickness(IMT),the plaque areas before and after treatment and the recurrence rate of cerebrovascular event among the 3 groups were compared.Results Compared with before treatment,the levels of serum CRP were significantly decreased in the 3 groups after treatment(all P

Objective To study the mechanics situation of proximal femoral locking plate internal fixation after dynamic hip fixation in-tertrochanteric fracture. Methods Totally 10 couple of elderly proximal femur specimens were collected and intertrochanteric fracture model were prepared. Fixation material was removed after dynamic hip screw fixation. The left sides were collected as control group and given anti-rotation intramedullary nail internal fixation, while the right side were collected as observation group and given proximal femoral locking plate internal fixation. Then vertical displacement, axial stiffness and rotational stiffness under different loads were compared. Results Under dif-ferent loads, femoral bone vertical displacement and femur tuberosity vertical displacement in the observation group were both significantly shorter than those in the control group (P<0. 05), and femoral bone and femur tuberosity axial stiffness and rotational stiffness in the observation group were significantly higher than those of the control group (P<0. 05). Conclusion Proximal femoral locking plate internal fixation can improve stress load and enhance axial stiffness and rotational stiffness, and it's an ideal material for refracture fixation model after dynamic hip fixation intertrochanteric fracture.

Objective In this study ,we investigated the apoptosis of hair cell in the cochlea of age -related hearing loss(AHL) generated by ENU mutagenesis ,and to study a pan caspase inhibitor (z-VAD -FMK) which is to protect the cochlea hair cells from hearing loss induced by age-related hearing loss(AHL) .Methods Through z-VAD-FMK intraperitoneal injection and round window membrane (RWM) drug were delivered into the Cdh23 nmf308 nmf/nmf mice 5(postnatal days 2 -32) inner ear .ResuIts The results showed that the nmf308 mice with progressive hair cell loss along a base to apex gradient with age-related hearing loss .The cochlear OHCs reduced from 5% ~10% at 1 month to 100% at 3 month in the basal region .Substantial amounts of TUNEL -positive OHCs nuclei appeared at 1 month age ,and activated caspase-3 labeling demonstrated that most OHCs appeared at 2 months age .These suggested that DNA single strand break was attributed primarily to apoptosis of cochlear le_sions ,whereas in the later stage of lesion ,the expansion led to activation of caspase-3 activity reduced with further progression of nuclear condensation in age-related hearing loss .ConcIusion The addition of a pan caspase inhibitor (z -VAD -FMK ) significantly protected the cochlea against the hair cell loss induced by apoptosis .Our study showed that aspase inhibitor ,Z-VAD-FMK appeared to play a prominent role in age-related hearing loss media_ted hair cell death loss induced by apoptosis .Our study showed that aspase inhibitor ,Z-VAD -FMK appeared to play a prominent role in age-related hearing loss mediated hair cell death .

Aim To study the change of blood pressure in 1079 workers for fifteen years and the effect of anti-hypertension drugs therapy. Methods We investigated the blood pressure of 1079 workers who were enrolled in six organizations in the year 1983 and 1998 respectively. Results During the 15 years: (1)Mean value of blood pressure: systolic blood pressure increased 22 mmHg in man and 16.9 mmHg in women; diastolic blood pressure increased 9 mmHg in man and 12.7 mmHg in women (P<0.05);(2)The incidence of hypertension increased by 25.03% in man and 28.28% in women;(3)The prevalence rate of hypertension is 27.9 percent in people with initially normal blood pressure (1.86%/y) and 72.6 percent in initially broder line hypertension (4.84%/y);(4)The control rate of hypertension is 2.9 percent;(5)The incidence of stroke is highly related to hypertension (P<0.001);(6)46.6 percent patients had a regular drug therapy, mainly reserpini complex(25.2%);(7)Drug therapy has no obviously effect of the control of hypertension and the incidence of stroke. Conclusion Both the mean value of BP and the incidence of hypertension were increased with age. The control rate of hypertension was low and the drug therapy shows little advantage. We should do mach more works to popularize the knowledge of the prevention of hypertension. Improve people's self-prevention. Regular cheek should be given to the hypertension patients.

Background and purpose:The incidence of liver cancer is high in China. Primary liver cancers usually occur in patients with liver cirrhosis, which is a challenge for the early diagnosis of liver cancer. Our purpose is to investigate the efifcacy of contrast-enhanced ultrasonography (CEUS) in the early identiifcation and diagnosis of small hepatocellular carcinoma (HCC) by regularly tracking and supervising the high risk population. Methods:A total of 320 high risk patients of HCC admitted in our hospital from February 2011 to November 2013 were enrolled in this prospective study. All patients underwent conventional ultrasound and hepatic CEUS. The differential diagnosis of malignant HCCs from benign ones was based on the enhancement patterns of hepatic lesions in different phases on CEUS. Results:Twenty patients were diagnosed as small HCC among 320 HCC high risk patients who were under regular surveillance using CEUS and all were pathologically conifrmed. Seven of the 20 HCC cases were smaller than 1.0 cm and 13 measured 1.1-2.0 cm. There were 6 (30.0%) HCCs presented as“early wash-in and slow wash-out”atypical pattern of HCC. The small size of the lesion and iso-echogenicity were the main factors of atypical pattern of HCC on CEUS.Conclusion:Ultrasonography and CEUS surveillance is a useful strategy for the early detection of small HCCs in high risk patients, which can help them to receive proper therapeutic management in time.

Objective To investigate the effect of atorvastatin on blood lipid and carotid atherosclerosis in patients with hyperlipidemia and cerebral infarction.Methods 98 patients with hyperlipidemia and cerebral in-farction in our hospital from September 2014 to February 2017 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The control group was treated with conventional treatment,the observation group was treated with atorvastatin on the ba-sis of the control group.The two groups were treated for 4 weeks.The ADL score,NIHSS score,blood lipid index,carotid IM T and carotid plaque area were compared between the two groups before and after treatment. Results ADL score of the patients in the observation group after treatment higher was than the control group (t=12.7783,P<0.05),NIHSS score was lower than the control group(t=10.941,P<0.05);LDL-C,TC and TG levels after treatment in the observation group were than in the control group(t= 17.239,9.216, 9.800,P<0.05),while the HDL-C level was higher than the control group(t=7.683.P<0.05);the patients in the observation group were treated by carotid artery IM T and carotid plaque area was higher than that of the control group(t=8.919,6.344,P<0.05).Conclusion Atorvastatin can improve hyperlipidemia in pa-tients with cerebral infarction and carotid atherosclerosis,dyslipidemia,has the important research signifi-cance.

Objective:To optimize the clinical nursing pathway, service program and evaluation parameters of percutaneous coronary intervention(PCI), for references for the cost accounting and compensation mechanism of nursing program in public hospitals.Methods:After literature analysis and group discussion, the initial templates were constructed for the PCI clinical nursing pathway, nursing service projects, and their evaluation parameters. 15 experts were consulted by two rounds of Delphi method to optimize PCI nursing path, nursing service items and their evaluation parameters (basic labor consumption, basic time consumption, technical difficulty and risk degree).Results:Two rounds of Delphi method finally determined the PCI clinical nursing path and 27 nursing service items, and adjusted the evaluation parameters of 10 nursing service items. The new projects for PCI clinical nursing services included adjustment and review of dual antiplatelet therapy plans, postoperative rehabilitation nursing, and key project verification. The three nursing service projects with the highest level of technical difficulty and risk were intravenous blood transfusion, gastric catheterization, and gastrointestinal decompression. The two items with the highest importance assigned were high pump assisted arterial/venous infusion (blood) and invasive continuous arterial blood pressure monitoring.Conclusions:The PCI clinical nursing pathway and nursing service project constructed in this study could closely integrate with clinical practice, highlight the integrated nursing service model, and reflect the labor value of nurses.

Objective:To improve the early graded rehabilitation nursing model suitable for postoperative children with congenital heart disease, providing reference for related research and clinical practice.Methods:Searched databases like JBI, PubMed, Medline, CINAHL, CNKI, Wanfang Data and related websites for information on postoperative rehabilitation of children with congenital heart disease. We improved the first draft model with qualitative interview results and used Delphi method to conduct two rounds of consultation for 16 experts from 6 provinces and cities to further test the scientific and feasibility of the model.Results:The early graded rehabilitation nursing model for postoperative children with congenital heart disease includes 4 first-level items, 15 second-level items and 48 third-level items. The 4 first-level items are the evaluation of the early graded rehabilitation nursing model, the grading standard of the early graded rehabilitation nursing model, the implementation of the early graded rehabilitation nursing model, the effect evaluation and health education. Experts′ response rates were 100% in the 2 rounds, experts′ authority coefficient were 0.82 and 0.84 respectively, and the Kendall′ s W rank-order correlation coefficients of all levels of indicators were 0.188-0.246, 0.223-0.287 (all P<0.01). Conclusions:The improved early graded rehabilitation nursing model for postoperative children with congenital heart disease is scientific, pertinence and safe, which can provide guidance for clinical rehabilitation nursing practice.

Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.

ObjectiveTo observe the clinical effect of Tianma Goutengyin combined with acupuncture on adult patients with tic disorder of ascendant liver-yang hyperactivity. MethodThe 64 adult patients with tic disorder of ascendant liver-yang hyperactivity who were treated in the outpatients and inpatients of the 989^th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2019 to December 2020 were selected and classified into the control group （32 cases） and the treatment group （32 cases） with the random number table method. The control group took oral western medicine Duloxetine Hydrochloride Enteric Capsules， and the treatment group was treated by Tianma Goutengyin and acupuncture. The treatment lasted 8 weeks for both groups and the efficacy was observed. ResultThe traditional Chinese medicine （TCM） syndrome score， Yale Global Tic Severity Scale （YGTSS） score， total bile acid （TBA）， triglyceride （TG）， and partial pressure of carbon dioxide （PaCO₂） were significantly lower， and the Na⁺ concentration and partial pressure of oxygen （PaO₂） were significantly higher than those before treatment in both groups （P<0.05）. After treatment， the TCM syndrome score， YGTSS score， and TBA were significantly lower， and and the Na⁺ concentration and PaO₂ were significantly higher than in the treatment group than in the control group （P<0.05）. The efficacy on TG and PaCO₂ was similar in the two groups. The total clinical effective rate of the treatment group was 90.6% （29/32）， as compared with the 64.5% （20/31） of the control group （χ²=6.210， P<0.05）. The incidence of clinical adverse reactions in the treatment group was 12.5% （4/32） in comparison with the 35.5% （11/31） in the control group （χ²=4.585， P<0.05）. The recurrence rate in the treatment group （9.4%， 3/32） was lower than that （32.3%， 10/31） in the control group （χ²=5.035， P<0.05）. ConclusionThe combination of Tianma Goutengyin and acupuncture can remarkably alleviate the clinical symptoms of adult tic disorder patients with ascendant hyperactivity of liver yang， reduce TBA， TG and PaCO₂， and increase the concentration of Na⁺ and PaO₂. Patients treated with the combination show small adverse reactions and low recurrence rate.