Objective To explore the clinical efficacy and safety of nicorandil in the treatment of chronic ischemic cardiomyopathy patients with heart failure. Methods The chronic ischemic cardiomyopathy patients with heart failure in our hospital were divided into two groups according to the random number table method. Control group underwent conventional anti heart failure treatment and symptomatic supportive treatment , and treatment group was treated by the nicorandil in addition to above treatments. After treatment for 6 months , comparisons of clinical efficacy and safety between two groups were conducted. Results The improvement of heart function in observation group was better than that in control group (Z = -2.302, P = 0.021). After treatment, the LVEF, 6 min walking distance were greater than those before treatment, and the LVESD, LVEDD were less than those before treatment (P < 0.05). The LVEF, 6 min walking distance in observation group after treatment were greater than those in control group and the LVESD , LVEDD were less than those in control group (P < 0.05). The incidence rate of adverse reaction in observation group was 9.59%, and 6.94% in control group, without statistical difference between two groups (χ2 = 0.334,P = 0.563). Conclusion In addition to conventional anti heart failure treatment , nicorandil can significantly improve the curative effect and the heart function in the treatment of chronic ischemic cardiomyopathy patients with heart failure and there are no significant adverse reactions. In addition , patients are tolerant.

Objective To explore the effect of labels management on high-risk drugs. Methods Labels management group was established, to be responsible for use and storage of high-risk drugs. The management methods included taking analysis on adverse nursing events, designing and making labels in drug storage and use, and making a field survey on adverse nursing events before and after the management. Result After manipulation of the labels management, the number of adverse nursing events of drug use fell from 35 to 0. Conclusion Drug storage and use with special, standard labels is effective in preventing nursing adverse events in high risk drugs.

Objective To investigate the diagnostic value of transgastric peritoneal endoscopy in diagnosis of ascites with unknown origin.Methods Endoscopy was introduced into peritoneal cavity through gastric wall in 23 patients with exudative ascites which was able to be diagnosed by routine methods and biopsy was made through endoscopy to get pathological diagnosis.Results Definite diagnosis was made in 22 patient (95.7%),of which 12 (54.6%) were malignant tumors,8 (36.4%) were tuberculosis peritonitis,1 (4.5%) was spontaneous peritonitis associated with liver cirrhosis and 1 (4.5%) was eosinophilic enteritis.Conclusion Natural orifice transluminal endoscopy combined with biopsy is an effective and accurate procedure for diagnosis of ascites of unknown canses.

Objective To investigate the diagnostic value of trans-gastric peritoneoscopy with technique of natural orifice transluminal endoscopic surgery(NOTES)for tuberculosis peritonitis.Methods Clinical data of 20 patients with tuberculosis peritonitis diagnosed by trans-gastric peritoneoscopy via NOTES were retrospectively analyzed.Results All diagnoses were confirmed by biopsy.The findings of peritoneoscopy were defined as miliary type with miliary nodes scattered in ascites and on peritoneum,adhesive type with thickening of peritoneum and adhesion between peritoneum and intestines,cheese-like type with parietal peritoneal ulcer and cheese-like substances,and mixed type with 2 or 3 of above mentioned types.Positive findings in other laboratory examinations were hemoglobin decrease in 10(50％)patients,blood sedimentation rate increase in 16(80％),C reactive protein increase in 13(65％),CA125 increase in 18(90％),and positive tuberculin test in 9(45％).Abnormal findings were detected by chest X-ray in 8(40％)patients,by abdominal ultrasonography examination in 2(10％),by abdominal CT in 7(35％),and by colonoscopy in 1(5％).No abnormal results were found in all patients in anti-tuberculosis antibody test,ascites bacteria culture and gastroscopy.Conclusion Trans-gastric peritoneoscopy via NOTES with biopsy is effective for diagnosis of tuberculosis peritonitis.

AIM: To explore the antitumor mechanisms of bifidobacteria adolescence in vivo. METHODS: The activity of NF-?B and its inhibiting protein I ?B? of large bowel carcinoma tissues was detected by using laser scanning confocal microscope and immunohistochemistry. RESULTS: The positive cell density of NF-?B of large bowel carcinoma transplantation tumors in bifidobacterium injection group was markedly lower than that in tumor control group( P

BACKGROUND:At present,the use of a locking bone plate combined with steel wire or steel cable for the treatment of periprosthetic femoral fracture often adopts monocortical fixation,which is not stable and the proximal end of the bone cannot be achieved anatomically fitted by plate.The customized anatomical plate system can effectively solve this problem. OBJECTIVE:To explore the biomechanical strength of a customized anatomical plate system in fixation of Vancouver BI periprosthetic femoral fracture. METHODS:CT thin layer scanning data of normal femurs of 1 006 cases were selected and input into the MIMICS 21.0 software to establish the three-dimensional reconstruction model of the femur,which was set as the three-dimensional reconstruction group.56 complete human femoral specimens were selected as the femoral specimen group.The measured results of the two groups for femoral anatomical appearance were compared.If there was no significant difference between the two groups,the approximate appearance of a customized anatomical plate system was designed based on the measurement results in MIMICS 21.0 software and NX11.0 software.The customized anatomical plate system was designed and prepared according to the above measurement results.Eight pairs of frozen human femurs were selected to make Vancouver BI periprosthetic femoral fracture,which of the left were thin layer scanned by dual-source CT to obtain data.The data were transferred to determine the customized anatomical plate system model by the above design software.Eight sets of customized anatomical plate systems were ultimately produced,relying on the instrument company.The eight pairs of models were numbered 1-8.The left side was fixed with the customized anatomical plate system(customized anatomical plate system group);the right side was fixed with a metal locking plate system-large locking plate(claw plate group).L1-L4 and R1-R4 were subjected to vertical short-cycle loading test and vertical loading test.L5-L8 and R5-R8 were subjected to horizontal short-cycle loading test and four-point bending test.The vertical loading test and four-point bending test were used to collect bending load,bending displacement,and bending strain.Two short cycle loading tests were used to collect strain displacement to compare the maximum load,maximum displacement,bending stiffness,and short-period displacement resistance of the two kinds of bone plates. RESULTS AND CONCLUSION:(1)There were no significant differences in all indexes between the three-dimensional reconstruction group and the femoral specimen group(P>0.05).Individual customized anatomical plate system was designed based on the measurement results combined with digital software.(2)In the vertical loading test,the maximum load was higher(P=0.015),the maximum bending displacement was smaller(P=0.014),and the bending stiffness was higher(P=0.005)in the customized anatomical plate system group compared with the claw plate group.(3)In the four-point bending test,the maximum load was higher(P=0.023),the bending stiffness was higher(P=0.005),and the maximum bending displacement was not significant(P=0.216>0.05)in the customized anatomical plate system group compared with the claw plate group.(4)In the vertical short-cycle loading test,the average level of bending displacement in the customized anatomical plate system group(0.23±0.10 mm)was significantly lower than that in the claw plate group(0.44±0.02 mm)(P<0.05).(5)There was no significant difference in the average level of bending displacement between the two groups in the horizontal short cycle loading test(P>0.05).(6)It is concluded that the customized anatomical plate system has personalized anatomical characteristics,and the fixation of Vancouver BI periprosthetic femoral fracture is more stable,which has certain significance for clinical treatment.

ObjectiveTo understand intensive care unit （ICU） doctors’ opinions and suggestions on implementing palliative care， and provides a reference basis for the implementation of palliative care in Chinese ICU. MethodsA purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors. Colaizzi’s phenomenological analysis method was utilized to code， classify， interpret， and comprehensively analyze the interview data. ResultsA total of 4 themes and 18 sub-themes was extracted， including cognitive biases toward palliative care， the belief that implementing palliative care in the ICU has significant humanistic implications （palliative care practice is the most perfect embodiment of medical humanities， palliative care in the ICU can alleviate patient pain and reduce invasive operations， palliative care can achieve comfortable care for ICU patients， palliative care focuses on maintaining the dignity of ICU patients， palliative care can pay attention to the inner voice of ICU patients， and implementing palliative care will help to more effectively allocate resources）， difficulties faced by ICU in carrying out palliative care （lack of clarity in relevant policies at the legal level， closed management environment in the ICU， insufficient manpower in the ICU and lack of palliative care professional team， inadequate understanding of ICU patients’ families， lack of death education， not included in medical insurance payments， and lack of communication skills of young doctors）， strategies to promote the development of palliative care in the ICU （ICU palliative care can be piloted first， the development of ICU palliative care screening tools will help with the development of palliative care， the palliative environment and the handling of death procedures can be further optimized， and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care）. ConclusionsThe integration of palliative care and ICU in China is still blank. The significance of implementing palliative care in ICU should be emphasized， ICU doctors’ knowledge and skills of palliative care should be improved from multiple perspectives， patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients’ families， and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.