ObjectiveTo study the effects of perindopril on myocardial energy metabolism and ultrastructural changes in rats with chronic heart failure (CHF) induce by isoproterenol. MethodsTotally 55 male SD rats were randomly (random number) divided into two groups, namely control group (Group C) and CHF model group. The CHF rat models were made by subcutaneous injection of isopreteronol (ISO) in doses of 20 mg · kg-1 · d-1, 10mg · kg-1 · d-1 and 5 mg/kg/d for successive 3 days and then 3 mg· kg-1· d-1 for9 days. Four weeks later, the rats in CHF model group were randomly further divided into two subgroups, namely untreated subgroup (group M ) and perindopril treated subgroup (group P). After treatment for five weeks in average, echocardiography and myocardial pathology examination carried out to assess the cardiac function and structure changes of these rats. The levels of ATP, ADP, AMP, lactic acid (LA) and sarcoplasmic reticulum Ca2+ -ATPase (SERCA) activity in myocardium were determined by enzymatic reaction. ResultsCompared with rats in group M, the ejection fraction of left ventricle (EF) and fractional shortening of short axis of left ventricle (FS) of the rats in group P increased by 3.25％ and 7. 33％, respectively. Compared with rats in group C, the myocardial ATP, AMP, TAN (total adenosine) and LA significantly decreased in rats of group M. There were no significant differences in the levels of ADP, AMP, ATP/ADP and TAN between group C and group P (P ＞0. 05). Compared with rats in group M, the myocardial SERCA activity increased by 16. 41％ in rats of group P. The myocardial injury found under microscope and electronic microscope was ameliorated by treatment with peidolapril in rats of group P in comparison with rats of group M. ConclusionsPerindopril can improve myocardial energy metabolism,and lessen the pathological changes of ultrastructure, enhancing the cardiac function of rats with CHF induced by ISO.

BACKGROUND: Previous studies found that C57BL/6 mouse was susceptible to atherosclerosis, while BALB/c mouse was resistant to atherosclerosis. The stenosis of the culprit vessel and the severity of myocardial infarction were correlated to the levels of OX40L expression. Whether OX40L has differential expression between C57BL/6 and BALB/c mouse was not identified.OBJECTIVE: To observe the differential expression of OX40L mRNA and protein in C57BL/6 and BALB/c mouse.METHODS: Total RNA and protein were extracted by Trizol and RIPA Buffer from heart, brain, kidney, skeletal muscle and spleen tissues of C57BL/6 and BALB/c mice. RT-PCR and Western Blot were used to detect OX40L mRNA and protein expression in heart, brain, kidney, spleen and skeletal muscle of two kinds of mice. The differential expression of OX40L mRNA and protein between C57BL/6 and BALB/c mice was observed.RESULTS AND CONCLUSION: RT-PCR results showed that the mRNA expression level of OX40L in heart of C57BL/6 mice mouse was significantly higher than BALB/c mice (P ＜ 0.05); the mRNA expression level of OX40L in spleen of BALB/c mice was significantly higher than C57BL/6 mice (P ＜ 0.05). There were no significant differences in the brain, kidney and skeletal muscle between these two strains. The results of Western Blot showed that the protein expression level of OX40L in heart, brain and kidney of C57BL/6 mice were significantly higher than BALB/c mice (P ＜ 0.05). There were no significant differences in skeletal muscle and spleen between these two strains. The OX40L mRNA transcription level in heart was higher in C57BL/6 mouse than BALB/c mouse, while the expression in spleen was lower than the latter. The OX40L protein levels in C57BL/6 mouse heart, brainand kidney were higher than BALB/c mouse. The differences of OX40L expression between the two strains of mice indicated that OX40L may promote to C57BL/6 mouse susceptible to atherosclerosis.

ObjectiveTo investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

Objective: To explore the status of care quality evaluation in the built-in type institution that integrating pension and health care service and analyze the focus on nursing service and management,it aims to provide theoretical basis for nurse managers to implement scientific nursing management. Methods: Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 8 nurse managers from 7 built-in type institutions that integrating pension and health care service.Data were analyzed based on Colaizzi′ s phenomenological research method. Results: Two themes were extracted, including the status of care quality evaluation in the built-in type institution that integrating pension and health care service; key indicators of nursing quality in the built-in type institution that integrating pension and health care service. Conclusions Through in-depth interviews with 8 nurse managers, we suggest that state should attach importance to the quality inspection of nursing care in the built-in type institution that integrating pension and health care service, and explore the evaluation criteria for nursing quality,in order to ensure the safety of elderly care, and it also can provide a basis for the comparison between inter-agency nursing quality and promote healthy competition among institutions.

Allergic bronchial pulmonary aspergillosis is a kind of lung disease that is a body of the parasitic in the bronchial aspergillus caused by allergic reactions.This disease usually occurs in patients with asthma and cystic fibrosis.Due to China's high incidence of asthma,to improve the awareness of asthma in patients with allergic bronchopulmonary aspergillosis and timely treatment are particularly important.Glucocorticoid inhibition of immune inflammatory response combined with antifungal agents to reduce fungal load is the main treatment.There are also anti-IgE treatment and other treatment.

Objective To explore the real user experiences of patients with PICC catheter for PICC maintenance network in Shandong province.Methods Descriptive phenomenological methodology was adopted in this study.A semi-structured interview was conducted with 18 patients of PICC-line maintained in different hospitals from PICC maintenance network in Shandong province.We analysed the data by Colaizzi's phenomenological research method.Results The experiences of patients with PICC catheter for PICC maintenance network in Shandong province contain positive and negative aspects.The positive aspects were convenient medical treatment,cooperation in various level hospitals,progress of basic hospitals,and enthusiastic services;the negative aspects were personnel shortage,different levels of nurses and imperfect supporting system.Conclusions Patients with PICC maintenance network possessed positive experience,but the accessibility of PICC maintenance network should be further enhanced,specialized development should be promoted.Meanwhile,for the questions proposed by patients,some measures should be taken to improve the overall PICC maintenance service from various level hospitals in Shandong province and make the experience of patients better.These measures include strengthening the standardized training and quality control of PICC,improving the supporting system,and promoting the implementation of continuous nursing mode in the primary hospitals.

Objective:To understand the current situation and demand of intracavity electrocardiographic positioning technique training for PICC specialist nurses in Shandong Province, and provide a reference for further improving and improving the training of PICC specialist nurses.Methods:From July 7-23, 2019, a total of 903 PICC specialist nurses in Shandong Province were selected by the convenience sampling method. The nurses were investigated by the self-made general information questionnaire of PICC specialist nurses in Shandong Province and the training demand questionnaire of intracavity electrocardiographic positioning technique.Results:40.75% (368/903) PICC specialist nurses had participated in intracavity electrocardiographic positioning technique training; 84.27% (761/903) PICC specialist nurses thought it necessary to conduct intracavity electrocardiographic positioning technique training. PICC specialist nurses had various training on intracavity electrocardiographic positioning technique, the average content requirements were all above 4.67 points. The highest score of theoretical training content was the judgment of the relationship between catheter tip position and electrocardiogram P wave (4.80 ± 0.47), and the highest score of operation training content was the intracavitary electrocardiography guided PICC catheterization (4.74 ± 0.55). 94.24%(851/903) PICC specialist nurses hoped to achieve the goal of improving clinical nursing practice ability through intracavity electrocardiographic positioning technique training. Intravenous therapy specialist academic conference was the main hoped training form(76.85%, 694/903). Multiple regression analysis showed that the number of years of catheterization, job position and understanding of the technology were the influencing factors of PICC specialist nurses′ training needs for intracavity electrocardiographic positioning technique ( t = -3.73,3.12, -3.63, all P<0.05). Conclusions:The training rate of intracavity electrocardiographic positioning technique was low, but PICC specialist nurses had higher training requirements for intracavity electrocardiographic positioning technique. Managers should pay attention to the training of intracavity electrocardiographic positioning technique, and develop targeted training programs to further improve the clinical practice capabilities of the PICC specialist nursing team.

Objective:To investigate the risk factors of initial non-invasive ventilation(NIV) failure and its association with adverse outcomes in very low birth weight infants (VLBWI).Methods:A retrospective cohort study was conducted, collecting clinical data of 2 102 VLBWI who received NIV within 30 minutes after birth, admitted to 18 NICU of Suxinyun Neonatal Perinatal Collaboration Network (SNPN) from January 1 st, 2019 to December 31 st, 2022. According to the outcome of NIV within the first 72 hours, the study cohort was divided into success group and failure group. Univariate analysis and multivariate Logistic regression analysis were performed to identify risk factors for NIV failure and its association with adverse outcome. Results:A total of 2 102 VLBWI were included, consisting of 1 078 males (51.3%). The gestational age was 29 (28, 31) weeks, and the birth weight was 1 250 (1 090, 1 380) g. The initial NIV failure rate was 15.3%(321/2 102). Multivariate Logistic regression analysis showed that smaller gestational age ( OR=0.67, 95% CI 0.61-0.74, P<0.001), maternal hypertensive disorders during pregnancy ( OR=10.31, 95% CI 7.48-14.21, P<0.001), Apgar score at the first minute ≤7 ( OR=1.40, 95% CI 1.01-1.93, P=0.042), grade 3-4 respiratory distress syndrome (RDS)( OR=2.85, 95% CI 1.69-4.81, P<0.001), ≥2 times pulmonary surfactant (PS) treatment ( OR=3.78, 95% CI 2.09-6.83, P<0.001), fraction of inspired oxygen (FiO 2)>0.30 ( OR=2.21, 95% CI 1.64-2.98, P<0.001) were all independent risk factors for initial NIV failure. The failure group had higher risks of mortality ( OR=10.19, 95% CI 6.50-15.97, P<0.001), pneumothorax ( OR=4.33, 95% CI 1.59-11.79, P=0.004), neonatal pulmonary hemorrhage ( OR=8.48, 95% CI 4.08-17.64, P<0.001), moderate to severe bronchopulmonary dysplasia (BPD)( OR=1.75, 95% CI 1.19-2.56, P=0.004), and intraventricular hemorrhage (IVH) ≥grade Ⅲ ( OR=2.18, 95% CI 1.27-3.73, P=0.004) compared to the success group. Conclusions:Small gestational age, maternal hyertensive disorders during pregnancy, Apgar score at the first minute ≤7, grade 3-4 RDS, PS treatment ≥2 times and FiO 2 >0.30 are risk factors for initial NIV failure in VLBWI. Initial NIV failure is associated with increased risk of mortality, pneumothorax, pulmonary hemorrhage, moderate to severe BPD, and IVH ≥grade Ⅲ.

Objective? To understand the work experience of PICC nurse specialists in using intracavitary electrocardiogram for PICC placement, so as to provide a reference for further promoting and standardizing of the intracavitary electrocardiogram method. Methods? From October 2018 to February 2019, the PICC nurse specialists from 5 Class Two and 16 Class Three hospitals which developed intracavitary electrocardiogram guided PICC in Shandong Province were selected by purposive sampling method as interveiwees. A qualitative phenomenological study was used to conduct semi-structured interviews with 21 PICC specialist nurses. Colaizzi's seven-step analysis method was used to analyze the data. Results? Three themes were identified:a method that "makes your mind at rest", difficulties met in work, growth and learn. The intracavitary electrocardiogram method effectively promoted PICC placement and released pressure of nurse specialists. Nurse practitioners will experience hardship at the beginning of using the intracavitary electrocardiogram method. As they gradually became skilled and came across difficulties, they would experience development personally and professionally. Conclusions? The intracavitary electrocardiogram method can benefit PICC nurse specialists both in their profession and career identity. However, the PICC nurse will face difficulties from different aspects while using this method. It is necessary to support better training courses and standardized management for the extension of intracavitary electrocardiogram method, promoting the promotion and application of new technologies.