Objective To evaluate the aortomitral angle(AMA)changes in primary hypertension patients with left ventricular normal configuration (LVN) by echocardiography,and explore the correlation with left ventricular systolic function.Methods LVN group included 54 patients,control group included 79 healthy subjects.All subjects were examined by conventional echocardiography,the 2-dimensional gray-scale dynamic images of 5 consecutive cardiac cycles were collected by routine echocardiography;from parasternal left ventricular long axis,the related AMA at the starting isovolumic contraction time (S-IVCT),S-wave peak(SP),starting isovolumic relaxation time(S-IVRT),and starting-end diastole(SD) were measured respectively based on the tissue Doppler imaging,calculating the angle difference(⊿θ) as well as the rate of the angle change.The global systolic longitudinal strain(GLS) and circumferential strain (GCS) of left ventricle were measured by 2-dimensional speckle tracking and quantitative analysis software.Left ventricular ejection fraction (LVEF) was measured by Simpson′s biplane method.Results Compared with control group,the ⊿θ and AMA of each phases in cardiac cycles of LVN group were increased (P<0.05);Compared with control group,the GCS of the left ventricular was increased in LVN group (P<0.05).There was a correlation between AMA of the S-IVCT and that of GLS or GCS,and the LVEF of the left ventricular in the control group (r=-0.18,P=0.04;r=-0.17,P=0.04;r=-0.19,P=0.03).Conclusions AMA angle in patients with LVN is significantly greater than the normal population value,which may be to maintain effective left ventricular systolic function and could be used as an quantitative indicator to assess the left ventricular remodeling in patients with LVN.

Objective To evaluate the relationship between the change of the aortomitral angle (AMA) with left ventricular systolic function in patients with ischemic cardiomyopathy (ICM) by echocardiography.Methods Thirty-one patients were enrolled in the ICM group,and 59 healthy subjects were selected as the control group.On the parasternal left ventricular long axis plane,AMA were measured at the R wave apex (R-AMA),J-point(J-AMA),ST-segment midpoint(ST-AMA),T-final wave (T-AMA)and P-final wave (P-AMA).The angle difference(⊿ θ) =AMAmax-AMAmin,the angle changing rate =⊿ θ/AMAmax.The global left ventricular longitudinal strain (GLS) and global circumferential strain (GCS) were obtained by 2D-speckle tracking echocardiography.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV) and left ventricular end-systolic volume(LVESV) were measured using Simpson biplane method.Results The J-AMA was the largest in the control group,while the ST-AMA was the largest in the ICM group.The levels of LVEDV,LVESV and AMA in ICM group were significantly higher than those in control group,while LVEF,GLS,GCS,⊿ θ/AMAmax and ⊿ θ were decreased (P ＜0.05).In the control group,there was a correlation between T-AMA and LVEF (r =-0.349,P =0.007),and ⊿ θ was negatively correlated with GLS (r =-0.372,P =0.004).In the ICM group,⊿1 θ/AMAmax and ⊿ θ were correlated with LVEF (r =0.424,P =0.018;r =0.490,P =0.005).Conclusions AMA in ICM patients is significantly increased.The angle difference and the rate of its change are closely related to the LVEF,which is a manifestation of three-dimensional structure change of the myocardial.

Objective: To investigate the effect of preoperative play intervention during anesthesia induction in children. Methods: Totally 120 children who met the inclusion criteria undergoing elective surgery divided into control group (n=60) and study group (n=60) by random number table. The study group admitted to the anesthesia induction room, and performed therapeutic play nursing intervention on the children for 60 minutes before the operation. The children in the control group were admitted to the general preoperative waiting room for 60 minutes before the operation, and they were subjected to routine nursing intervention. The children′s anxiety was assessed using modified Yale Perioperative Anxiety Scale (mYPAS) when the children entered the operating room before the intervention and during anesthesia induction; the children′s compliance with anesthesia induction was assessed using the Induction Compliance Checklist (ICC) . Pediatric Anesthesia Emergence Delirium Scale (PAED) score was used to observe emergence agitation. The vital signs of the two groups were observed before and after intervention. Results: There was no significant difference in the mYPAS score between the study group (32.23±4.71) points and the control group (31.58±3.72) points (P>0.05). The mYPAS score (31.92±4.03) points was lower in the study group than in the control group (59.76±5.14) points (t=-33.016, P<0.01). The ICC score of the study group (1.55±0.76) points was lower than the control group (3.04±0.62) points. The PAED score of the study group (4.76±0.92) points was lower than the control group (7.52±1.36) points (t=11.767, -13.020, P<0.05). The systolic blood pressure (96.25±3.06) mmHg (1 mmHg=0.133 kPa), diastolic blood pressure (59.39±2.77) mmHg, heart rate (118.37±15.26) times/min, and respiratory (29.75±3.17) times/min in the study group were lower than the control group (103.46±3.21) mmHg, (62.72±2.94) mmHg, (124.58±16.41) times/min, (34.81±2.96) times/min (t=12.593, 6.385, 2.146, 9.037, P<0.05) . Conclusion Preoperative play intervention for children before anesthesia induction can reduce the anxiety and fear level of children, and the children′s compliance of anesthesia is improved, and reduce the incidence of agitation during recovery.

Objective To explore the regulatory effects of HTLV-1 ( human T-cell leukemia virus type 1 ) Tax protein on the expression of HMGB 1 ( high mobility group box 1 ) gene in T cells .Methods Total RNA and protein were extracted from Tax +-T cells ( TaxP ) , Tax--T cells ( TaxN ) and Jurkat cells which were stably transfected with pCMV-Tax and pCMV-Neo, respectively.Then, the expression levels of HMGB1 mRNA and protein in different CD 4+T cells were analyzed by real-time PCR and Western blot (WB).By using liposome-mediated method, pGL3-HMGB1-luc reporter genes and pGL3-neo-luc were tran-siently transfected into TaxP and TaxN cells and the basal transcriptional activity was observed in different T cells.Additionally, pCMV-Tax and pGL3-HMGB1-luc reporter genes were also co-transfected into Jurkat cells and the regulatory effects of Tax protein on HMGB 1 gene was detected .The chromatin immunoprecipi-tation (ChIP) assay was used to identify HMGB1 genomic sites directly targeted by Tax .Results The ex-pression levels of HMGB1 mRNA and protein in Tax+-T cells ( TaxP) were higher than those in Tax--T cells (TaxN).The transcription regulation trends for HMGB1 gene in TaxN and TaxP cells were similar but not identical in diverse T cells.pHLuc3 (containing -504-+83 HMGB1) showed the highest transcriptional ac-tivity of HMGB1 gene in both TaxP and TaxN cells , but HMGB1 transcriptional activity of pHLuc 6 in TaxP cells was significantly stronger than that in TaxN cells .Luciferase assays also showed that Tax protein promo-ted the transcription of HMGB1 gene in a dose-dependent manner .The ChIP assay further confirmed that Tax protein enriched at the HMGB1 region of -1163--1043.Conclusion The region of nt -504--383 is essen-tial for the basal promoter activity of -1163-+83 HMGB1 gene originated from pHLuc 6 reporter plasmid , and Tax protein enriched probably at the HMGB 1 site of -1163--1043 enhances HMGB1 transcription.

Objective: To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE). Methods: Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected. The consistency of two-dimensional ultrasound, RT-3DE and the detection of LVO on the maximum diameter, location, number and shape of ventricular septal rupture (VSR) with the surgical results were compared. Through LVO combined with RT-3DE, the changes of left ventricular function indexes before and after surgery were compared. According to the general data and clinical data of patients, independent risk factors affecting survival and prognosis were explored. Results: ①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P>0.05). The location, number and shape of VSR detected by LVO were consistent with the surgical results (all P<0.05). RT-3DE had good consistency in detecting VSR location, shape and surgical results (all P<0.05). Among them, of LVO′s detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively. LVO had a sensitivity of 0.923, specificity of 1.000, accuracy of 0.947, positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape. ②LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients. The parameters of left ventricular function improved significantly(all P<0.05). ③The independent risk factors affecting the 30 d survival rate included: gender, Killips pump function classification, and whether or not surgery was performed. Conclusions LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter, location, number and shape, which provides the basis for the selection of treatment strategy. LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery, which can provide reference for clinical evaluation of prognosis.

Objective:To explore the application effect of the new cleaning and drying integrated device (referred to as the new device) of hard endoscope in disinfection and supply center in improving the working efficiency of nurses′ endoscopic instruments.Methods:From August 1 to 30, 2018, the first 24 sets (192 pieces) of surgical instruments for general external endoscopy recovered to the disinfection and supply center every day were used as the control group, and the hard endoscope special cleaning rack (referred to as special cleaning rack) was used for cleaning, and the pressure air gun was used for drying. From September 1 to 30, 2018, the same number, category and recovery time of devices were used as the experimental group, and new devices were used for cleaning and drying. Before using the special cleaning rack, the two groups were cleaned by hand and ultrasonic cleaning machine. The time efficiency and the qualified rate of cleaning and drying were compared between the two groups.Results:In the total time of daily cleaning, the efficiency of (408.10 ± 3.49) min in the experimental group was higher than that of (701.03 ± 2.62) min in the control group ( t value was 2.36, P < 0.01). In the control group, 95.56% of them were qualified for cleaning by Adenosine Triphosphate (ATP), 95.47% for crepe paper test, 93.89% for mirror test, 97.36% for ATP Test, 95.92% for crepe paper test and 94.61% for mirror test. There was no significant difference between the two groups ( P > 0.05). Conclusion:The new device not only ensures the cleaning and drying quality of the endoscopic instruments, but also improves the working efficiency and meets the supply demand of the instruments in the operating room.

The technical operation criteria and clinical application guidelines for pediatric nuclear medicine include information related to the preparations,precautions,responsibilities of nuclear personnel,dosage of radiopharmaceutical,history-taking,imaging protocol,as well as indication and safety,focusing primarily on the usual pediatric nuclear medicine examinations.The purpose of the criteria and guidelines is to offer nuclear medicine physicians a framework that could prove practical and helpful in daily clinical practice.

Objective:To explore the management effect of information nurses in the reception of new surgical instruments and to provide a reference for improving the quality of instrument management in central sterile supply department.Methods:This was a quasi-experimental study. A total of 45 packages of 227 pieces received from January to July 2021 in central sterile supply department of the First Affiliated Hospital of Zhengzhou University were selected as the control group by convenience sampling method, and the conventional mode was used to receive new surgical instruments. Another 51 packages of 259 pieces received from November 2021 to June 2022 were selected as the observation group, and the information nurse management system was set up to receive new surgical instruments. The observation and comparison of the time to complete the receipt of new surgical instruments in central sterile supply department, the incidence of adverse events in the operation process and the satisfaction of medical and nursing staff with the management of new surgical instruments were conducted.Results:The receiving time for newly added surgical instruments of the observation group was 6.00(5.00, 8.00) hours and that of the control group was 28.00(20.00, 42.50) hours, with a statistically significant difference between the two groups ( Z = - 8.26, P<0.01). The incidence of adverse events of new surgical instruments was 0.4%(1/259) in the observation group and 6.2%(14/227) in the control group, there was significant difference between the two groups ( χ2 = 13.52, P<0.01). The satisfaction degree of medical staff in the observation group was 100% (50/50), higher than 72% (36/50) in the control group, and the difference between the two groups was statistically significant ( χ2 = 16.28, P<0.01). Conclusions:The implementation of the post of information nurse in the special post responsibility system in the management of new surgical instruments can effectively manage the specifications of surgical instruments, reduce the receiving time and the occurrence of adverse events, improve the satisfaction of medical staff.

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.

[Abstract] Objective: To investigate the short-term clinical efficacy and safety of intraperitoneal perfusion of natural killer (NK) cells in the treatment of ovarian cancer with ascites. Methods: The clinical data of 15 ovarian cancer patients with ascites effusion, who received NK cell perfusion in the Qinhuai Medical District of the General Hospital of Eastern Theater Command from November 2016 to January 2019, were analyzed. The peripheral blood was collected to isolate the peripheral blood mononuclear cells, and to further obtain the NK cells after culture. NK cell suspension was intraperitoneally perfused into the abdominal cavity (no less than 2×109 cells/ time). The volume of peritoneal effusion, the level of serum tumor marker CA-125, the level of serum cytokines IL-2, INF-γ and TNF-α as well as the changes in peripheral blood lymphocyte subsets were detected before and after the treatment; Moreover, the clinical efficacy and adverse reactions were observed. Results: The effective rate of intraperitoneal perfusion of NK cells was 66.7%, and there were no obvious treatment-related adverse reactions. Compared with before treatment, the serum tumor marker CA-125 level significantly decreased after treatment (P<0.05), and the levels of IL-15, IFN-γ and TNF-α increased significantly (P<0.05 or P<0.01), while there was no significant changes in peripheral blood lymphocyte subsets (all P>0.05). Conclusion: Intraperitoneal infusion of NK cells in the treatment of ovarian cancer associated peritoneal effusion has a good short-term clinical efficacy with little adverse reactions, which is a promising method for the treatment of cancerous peritoneal effusion.