ObjectiveTo investigate the safety and clinical value of treadmill exercise testing for the patients with acute myocardial infarction in the early recovery. Methods36 patients with acute myocardial infarction performed treadmill exercise testing with Bruce protocol 15～57 d after infarction. ResultsThe outcome of 19 cases was positive, and the outcome of other 16 cases was negative. 1 case couldn't finish the testing, whose outcome could not be analyzed because his exercise time was too short. The average cardic fuction was (5.42±3.12) METs. ConclusionIt is safe that the patients with acute myocardial infarction performed treadmill exercise testing early.

Objective:To observe the changes of serum progastrin-releasing peptide (Pro-GRP) and neuron specific enolase (NSE) levels in patients with small cell lung cancer (SCLC) in the concurrent chemoradiotherapy and their significances.Methods:The data of 80 patients with SCLC who were admitted to Shanxi Provincial Cancer Hospital from June 2018 to December 2019 were retrospectively analyzed, and the patients were divided into the concurrent chemoradiotherapy group (26 cases) and chemotherapy alone group (54 cases). Enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence method were used to detect serum Pro-GRP and NSE levels before and after treatment; and the association of Pro-GRP and NSE levels with patients' condition, treatment method, treatment stage and treatment efficacy was analyzed.Results:Among 80 patients with SCLC, Pro-GRP level of patients with limited-stage [127.43 pg/ml (17.61- 1 547.30 pg/ml)] was lower than that of patients with extensive-stage [547.87 pg/ml (20.20-2 111.00 pg/ml)], and the difference was statistically significant ( U = 312.65, P < 0.01). NSE level of patients with limited-stage [25.02 μg/L (4.72-64.64 μg/L)] was also lower than that of patients with extensive-stage [88.08 μg/L (5.52-104.64 μg/L)], and the difference was statistically significant ( U = 203.14, P < 0.01). The levels of Pro-GRP and NSE in the concurrent chemoradiotherapy group and the chemotherapy alone group were decreased after 2 and 4 cycles of chemotherapy compared with those before treatment, and the differences were statistically significant (all P < 0.01); the decrease range in the concurrent chemoradiotherapy group was more than that in the chemotherapy alone group, but the differences between the two groups were not statistically significant (all P > 0.05). The objective response rate in the concurrent chemoradiotherapy group was 96.15% (25/26), which was higher than that in the chemotherapy alone group [70.37% (38/54)], and the difference was statistically significant ( χ2 = 6.972, P = 0.008). Conclusions:The serum levels of Pro-GRP and NSE for patients with SCLC in the concurrent chemoradiotherapy can reflect the changes of the condition of SCLC patients. Concurrent chemoradiotherapy is more effective compared with the chemotherapy alone in the treatment of SCLC.

The following report is on the early rehabilitation treatment of 35 cases with acute myocardial infarction,31 males and 4 females.The average age is 56.71±9.8 years.Among the 35 cases 15 are without complication of myocardial infarction and 20 are opposite.Besides the regular myocardial infarction treatment,the rehabilitation treatment is added after the initial period and before the patients leave the hospital, echocardiography, Holter monitor ECG and treadmill test are adopted to evaluate heart function.All the cases are without heart event during the early active treadmill test and rehabilitation treatment, so we conclude that it is safe and proper to early start treatment to acute myocardial infarction.The report will also discuss about the choice of the cases,the notes during the process and the evaluation of the cases after the treament and before leaving the hospital.

Objective To evaluate the effect of ecoimmunonutrition on systemic inflammatory response in swine with acute necrotizing pancreatitis (ANP). Methods Swine model of ANP was induced by retrograde injection of 5% sodium taurocholate and trypsin into the pancreatic duct. 24h after the ANP models were established, eighteen swine were randomly divided into total parenteral nutrition (PN) group (n = 6), enteral nutrition (EN) group (n = 6), and ecoimmunonutrition (E1N) group (n = 6). Each of the three nutrition formulas was given to each group respectively for eight days. The level of plasma endotoxin and serum concentrations of TNF-α, IL-1β, IL-6 and IL-10 were measured before, 24 h after the induction of ANP and 1,2, 4, 8 d after nutrition support. Results 24 hours after the ANP models were established, the serum level of plasma endotoxin, TNF-α, IL-1β, IL-6 and IL-10, NF-κB activities in EIN group were ( 1.85 ± 0.18) EU/L,(461.59 ± 128.25 ) pg/ml, ( 185.49 ± 58.81 ) pg/ml, ( 354.26 ± 34.63 ) pg/ml, ( 110.32 s 25. 18 ) pg/ml,(51.06 ± 2.27 )%, respectively, which all were significantly higher than those before the ANP models were established, but there were no difference among three groups. Eight days after nutrition support, those levels in EIN group were (1.48 ±0.16 )EU/L, (30.11 ±9.12)pg/ml, (20.17 ±7.04)pg/ml, (36.42 ±7.24) pg/ml and ( 89.46 ± 13.54 ) pg/ml, (9.06 ± 0. 17 ) %, respectively, which all were significantly lower than those of TPN and EEN group ( P ＜ 0. 05 ). The ration of IL-10/IL-6 was 2.51 ± 0.42 in EIN group, and 2.28 ± 0. 19 before the ANP models were established. Conclusions EIN could attenuate endotoxemia, decrease NF-κB activities and serum concentrations of cytokines and maintained the balance of pro- and anti-inflammation.

Objective To evaluate the effect of ecoimmunonutrition on maintenance of the mucosal barrier function in pigs with severe acute pancreatitis(SAP).Methods Twenty pigs were injected with5% sodium taurocholate and trypsin into the pancreatic duct to establish SAP models.Twenty four hours later,18 suvival pigs were randomly given parenteral nutrition(PN group,n=6),elemental enteral nutrition(EEN group,n=6),or ecoimmunonutrition(EIN group,n=6)for 8 days.The serum amylase,endotoxin and intestinal permeability were determined on different times.All pigs were sacrificed 8days later,and their venous blood,mesenteric lymph nodes(MLN),liver,lung,spleen and pancreas specimens were cultured quantitatively and qualitatively with standard techniques.The morphology of small bowel was observed and pathological changes of the pancreas was analyzed.Results Serum amylase of all groups were obviously elevated,but there was no significant difference among them(P＞0.05).The plasma endotoxin and intestinal permeability were lower in EIN group[(1.50±0.18)EU/L and(42.8±20.0)×10-3 respeetively]compared to EEN group[(1.98 4±0.20)EU/L and(67.4±23.0)×10-3 respectively]and PN group[(3.96±0.40)EU/L and(197.2±47.4)×10-3.respectively](all P value＜0.05).The incidence and the magnitude of bacterial translocation in EIN group were lower than those in PN and EEN groups.However,the ileum mucosa thickness,villus height,crypt depth and the rate of the normal intestinal villi in EIN group were(398.27±52.93)μm,(269.72±41.66)μm,(681.98±58.33)μm and 79%,respectively,but in PN group were(218.32±35.81)μm,(145.76±23.34)μm,(376.20±48.23)μm and13%,respectively and in EEN group were(305.70±42.72)μm,(192.52±38.17)μm,(507.31±68.23)μm and 47%,respectively.Conclusions EIN can maintain the integrity of intestinal mucosal barrier and decreasing intestinal bacterial and endotoxin translocation in SAP pigs.

Objective To investigate the status quo and influencing factors of compassion fatigue among nurses in psychiatric hospitals. Methods The self-designed demographic questionnaire,compassion fatigue scale,occupation-al identity assessment scale and social support rating scale were employed to investigate 480 nurses in five psychi-atric hospitals from two provinces. Results The scores for each dimension in compassion fatigue scale were as fol-lows:compassion satisfaction(32.26±5.34),occupational burnout(27.67±4.34),and secondary traumatic stress(23.72± 4.41).Age,position,individual monthly income,health status,job satisfaction and occupational identity had significant influence on compassion satisfaction(F=19.351,P<0.001). Individual monthly income,health status,job satisfaction and occupational identity had significant influence on occupation burnout (F=35.705,P<0.001). Individual monthly income, personality and social support had significant influence on secondary traumatic stress(F=17.203,P<0.001). Conclusion Nurses in psychiatric hospitals had severe compassion fatigue and this status was influenced by multiple reasons. Nursing managers should pay great attention to nurses with low monthly income,poor health,low job satisfaction, weak social support and low occupational identity,and take effective measures to decrease compassion fatigue of nurses.

ObjectiveTo evaluate the effect of enteral ecoimmunonutrition (EIN) on hepatic injury in swine with acute necrotizing pancreatitis (ANP).MethodWith 20 pigs,swine model of ANP was induced by injecring 5％ sodium taurocholate into the pancreatic duct.24 hours after the ANP models were established,2 pig were dead,and the remaining 18 pigs were randomly divided into total parenteral nutrition (TPN) group ( n =6),elemental enteral nutrition (EEN) group ( n =6 ),and EIN group ( n =6 ),and received nutrition support for 8 days.The level of plasma endotoxin and serum concentrations of AST,ALT,TNF-α,and IL-6 were measured at different time points ( before model establishment,24 hours after model establishment,and the 1,2,4,8 days of nutrition support).All the pigs were sacrificed after the 8-day nutrition support,and ascites quantity,hepatic malondialdehyde (MDA),superoxide dismutase (SOD) were measured.The mRNA expression of TNF-α and IL-6 in hepatic tissue were detected by RT-PCR.Pathologic changes of the livers were analyzed.Results24 hours after the ANP models were established,the plasma endotoxin,AST,ALT,TNF-α,IL-6 in EIN group were significantly higher than the levels before model establishment ( all P ＜ 0.01 ),but not significantly different from the 9ther 2 groups.After 8 days of nutrition support,the above 5 indexes in EIN group were significantly lower than those in TPN group and EEN group ( all P ＜ 0.05 ).In addition,the ascites quantity,hepatic concentration of MDA,the expression of TNF-α and IL-6,and hepatic pathological score in EIN group were lower than those of TPN group and EEN group,while hepatic SOD activity was higher in EIN group than in the other 2 groups (all P ＜ 0.05 ).ConclusionEarly EIN could attenuate hepatic injury in ANP from various aspects.

OBJECTIVE To discuss the clinical traits,pathogenesis and traditional Chinese medicine(TCM) stepwise treatments of the patients who suffered from pulmonary infection after kidney transplantation.METHODS Because of patients after kidney transplantation easily suffered from pulmonary infection,which was characterized by non-typical symptoms,concealment and varity.In the aspects of the pathogenesis of this disease,the principal aspect of which was the weakened body resistance(kidney deficiency)and the secondary incidental was affected pathogenic factor(heat,toxin,stasis brewing in the lungs),viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should attach importance to regulate entire faculty condition.Considering the acute attack stage and restoration stage,we would differently inflict therapies of clearing heat,resolving toxin,quickening the blood,supplementing the kidney and nourishing yin,clearing heat and moistening the lung and so on,according to differentiation of symptoms and signs,in which way we could give attention to both the root and tip.RESULTS The TCM stepwise therapy of pulmonary infection after kidney transplantation had the characteristics of high efficacy,few side reactions and stable long-term curative effects.CONCLUSIONS The TCM therapy of pulmonary infection after kidney transplantation has more potentiality and predominance,which deserves further study.

OBJECTIVE To discuss the clinical traits and pathogenesis of uremic pneumonia for early diagnosis to avoid misdiagnosis and give effective treatment. METHODS The clinical manifestation,chest X-ray characteristics and treatment in 33 cases of uremic pneumonia patients were retrospectively analyzed. RESULTS In 33 cases of uremic pneumonia patients,27 cases had main respiratory symptoms such as cough,much phlegm and respiratory difficulties. The main signs of chest X-ray were pulmonary hemostasis,pulmonary interstitial edema,pulmonary alveolar edema and pleuritis. In 20 cases of receiving hemodialysis treatment,1 case was dead (5.00%). The symptoms of other patients were significantly improved. In 13 cases without hemodialysis treatment,6 cases were dead (46.15%),the difference was significant (P

Objective To study the molecular mechanisms of ampicillin- resistant haemophilius influenzae (Hi)in Nanjing. Methods One hundred and fifty- eight strains of Hi isolated from children were collected to detect bata-lactamase. TEM and ROB bata- lacta-mase genes were detected by polymerase chain reaction (PCR) ,and cloned into T vector for sequencing. Results The rate of ampicillin resistance was 41. 77% in Hi isolated from children in Nanjing,40.51 % was found to be bata-lactamase production. Eighty-nine strain were TEM positives, 1 strain was ROB positive,63 strains bata - lactamase positive ampicillin- resistant Hi were identified. The resistance mechanism of ampicillin resistant Hi was production of bata - lactamase , mainly TEM - type enzyme. Two bata - lactamase negative ampicillin - resistant Hi were identified , predicts the other mechanisms of ampicillin - resistant Hi was occuered yet . One strain of non -TEM - type,and non - ROB - type bata - lactamase - producing Hi was identified. Conclusions Ampicillin - resisitant in Hi isolated from children in this region is challenging. TEM bata - lactamase is the principal mechanism of ampicillin - resistant of Hi.