Objective Analysis of nitroglycerin combined with predictive nursing in the clinical application of coronary heart disease patients. Methods From January 2015 to December 2016, 200 patients with coronary heart disease were treated with angina pectoris. The patients were randomly divided into observation group and control group (100 cases). The control group was treated with routine nursing mode, and the patients in the observation group were treated with predictive nursing mode. The differences of hospitalization time and quality of life scores between the two groups were observed. The anxiety and depression of the two groups were observed before and after treatment, and the satisfaction of the two groups was observed. Results The scores of hospitalization and quality of life in observation group were better than those in control group (P<0.05). There was no statistically significant difference between SAS score and SDS score before treatment, but SAS score and SDS score of observation group were significantly lower than those of control group (P<0.05). The satisfaction degree of the patients in the observation group was better than that in the control group (P<0.05). Conclusion Predictive nursing has a good effect in the clinical nursing of patients with coronary heart disease and angina pectoris. It can effectively improve the patients' anxiety and depression, shorten the hospital stay and improve the quality of life. It is worth to be used in clinical practice.

Objective To investigate influence of ginsenoside Rb1 on the proliferation and bioactivity of olfactory ensheathing cells (OECs).Methods OECs were primary cultured and purified from olfactory bulb of the adult SD rats.MTT assay was used to detect proliferation of OECs treated with ginsenoside Rb1 (intervention concentrations of 0,10,20,40,and 80 μg/ml and intervention time of 12,24,36,48,and 60 hours).Optimal concentration and intervention time of ginsenoside Rb1 was determined and performed in the succedent experiments.Purified cells were divided into blank control group and ginsenoside Rb1 group.RT-PCR was utilized to determine mRNA expressions of nerve growth factor (NGF),brain-derived neurotrophic factor (BDNF),glial derived neurotrophic factor(GDNF) and neural cell adhesion molecule (N-CAM) in the two groups.ELISA analysis was performed to measure secretion levels of NGF,BDNF and GDNF in the cultural supernatant.Results MTF analysis suggested ginsenoside Rb1 promoted proliferation of OECs with optimal effect at 20 μg/ml concentration for 48 hours (0.648±0.019,P ＜ 0.05).RT-PCR analysis demonstrated that mRNA expressions of NGF,BDNF,GDNF and N-CAM were significantly up-regulated in ginsenoside Rb1 group compared to those in blank control group (0.620 ± 0.011 vs 0.180 ± 0.011,0.511 ± 0.090 vs 0.293 ± 0.051,0.343 ± 0.042 vs 0.064 ± 0.005,0.839 ± 0.017 vs 0.717 ± 0.044) (P ＜ 0.05).ELISA analysis confirmed that secretions of NGF,BDNF and GDNF was increased in Rb1 group compared to those in blank control group (200.167 ± 8.361 vs 51.467 ± 3.815,156.700 ± 4.190 vs 96.500 ± 2.707,26.264 ± 5.864 vs 4.917 ± 10.894,P ＜ 0.05).Conclusion Ginsenoside Rb1 significantly promotes proliferation and bioactivity of OECs and hence benefits to spinal cord injury repair.

OBJECTIVE:To investigate clinical efficacy and safety of Kang'ai injection adjuvant chemotherapy for advanced lung cancer. METHODS:A total of 146 patients with advanced lung cancer during May 2013-Apr. 2014 were divided into observa-tion group and control group according to odd-even admission number,with 73 cases in each group. Control group was given GP (gemcitabine+cisplatin)chemotherapy. Observation group was additionally given Kang'ai injection 60 mL added into normal saline 250 mL,qd,ivgtt,for consecutive 14 d each chemotherapy cycle,on the basis of control group. Both groups were given tropise-tron 5 mg for preventing gastrointestinal reaction during chemotherapy. A treatment course lasted for 3 weeks,and both groups were treated for 3 courses. Clinical efficacies of 2 groups were compared;the levels of serum inflammatory factors (hs-CRP, TNF-α,IFN-γ,IL-10),immune function indexes(CD3+,CD4+,CD8+,CD4+/CD8+)and tumor markers(SCC-Ag,CEA,CA50, CA72-4) were compared before and after treatment. The occurrence of ADR were recorded in 2 groups. RESULTS:The response rate and disease control rate of observation group were 39.73％ and 84.93％,which were significantly higher than 23.29％ and 71.23％ of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the lev-els of serum inflammatory factors,immune function indexes or tumor markers between 2 groups (P>0.05). After treatment,the levels of hs-CRP,TNF-αand IFN-γin 2 groups were significantly lower than before treatment,while the level of IL-10 was signifi-cantly higher than before treatment;above indexes of observation group were significantly better than control group,with statistical significance(P<0.05). The levels of CD4+ and CD4+/CD8+ in control group were decreased significantly and lower than observa-tion group,with statistical significance(P<0.05). Serum levels of SCC-Ag,CEA,CA50 and CA72-4 in 2 groups were decreased significantly,and observation group was significantly lower than control group,with statistical significance(P<0.05). The inci-dence of thrombocytopenia,neutropenia,abnormal liver function,nausea and vomiting,anemia in observation group were signifi-cantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Kang'ai injection adjuvant chemothera-py can effectively relieve inflammation symptoms of patients with advanced lung cancer,reduce toxic reactions,enhance immune function, and improve short-term therapeutic efficacy with good safety.

Objective To evaluate the clinical effect of hybrid operation in treating Stanford type B aortic dissection. Methods During the period from January 2011 to December 2013, hybrid operation was performed in 33 patients with complex Stanford type B aortic arch dissection. The patients included 28 males and 5 females with a average age of (50±12) years. The clinical effect and the complications, occurring in perioperative period and in 24-month follow-up period, were analyzed. Results The operation was successfully accomplished in all 33 patients, with a technical success rate of 100%. The average hospitali-zation time was 20 days. After the operation, 29 cases were followed up for 3-34 months and 4 cases were lost to follow up, the following-up rate was 87.9%. In 21 cases, the following-up time was over 12 months. Postoperative angiography showed that there was no typeⅠendoleak; complications included pulmonary infection (n=1), strokes (n=1), reversible abnormal renal function (n=6) and retrograde aortic arch dissection (n=1). No paraplegia occurred. During hospitalization time, two cases died, the mortality was 6.06%. During the following-up time, graft infection occurred in one case and continued presence of retrograde aortic arch dissection was observed in one case. Conclusion The complication occurrence after hybrid operation for Stanford type B aortic dissections is low. The hybrid technique is very safe and feasible, but several serious postoperative complications should not be ignored. The long-term effectiveness needs to be further clarified by systemic and large sample studies.

Objective:To investigate the prenatal diagnosis and prognostic factors of fetal sacrococcygeal teratoma (SCT).Methods:A retrospective analysis was performed on 41 pregnant women who were diagnosed with fetal SCT by prenatal ultrasound at the Women′s Hospital, Zhejiang University School of Medicine from January 2014 to September 2021. The prenatal imaging features and pregnancy outcomes, including tumor volume to fetal weight ratio (TFR), proportion of solid tumor, tumor growth rate (TGR), fetal hydrops, placentomegaly and polyhydramnios were analyzed. Receiver operating characteristic (ROC) curve was used to determine the critical values of TFR and TGR for predicting adverse fetal outcomes.Results:(1) Among the 41 pregnant women with fetal SCT, the diagnostic gestational week of ultrasound was (24.2±2.9) weeks (range: 18-28 weeks). Among them, 1 case progressed to fetal hydrops and induced labor at 22 weeks of gestation, 1 case developed intrauterine death and induced labor at 29 weeks of gestation, and 39 pregnancies continued until delivery. Among the 39 cases of continued pregnancy, 1 case underwent cesarean section at 31 weeks of gestation due to malignant polyhydramnios and increased fetal cardiothoracic ratio in the third trimester, 1 case underwent cesarean section at 32 weeks of gestation due to fetal heart failure, and 1 case underwent cesarean section at 32 weeks of gestation due to fetal heart failure and hydrops. The other 36 cases underwent surgical resection of tumor within 3 weeks after birth with good prognosis. (2) TFR>0.12 before 28 weeks of gestation could predict poor fetal prognosis, with a sensitivity of 100.0%, a specificity of 86.1% and an area under curve (AUC) of 0.922 ( P<0.01). Among the fetuses with TFR>0.12, 5/10 had poor prognosis, while the fetuses with TFR≤0.12 all had good prognosis (100%,31/31), and the difference between the two groups was statistically significant ( P<0.001). (3) TGR>48 cm 3/week could predict poor fetal prognosis with a sensitivity of 100.0%, a specificity of 78.3% and an AUC of 0.880 ( P<0.05). (4) Among the 28 SCT fetuses delivered in our hospital, the incidence rate of poor fetal prognosis was 0 (0/20) in those with solid tumor component<50%, and 5/8 in those with solid tumor component ≥50%, and the difference between the two groups was statistically significant ( P<0.01). The incidence rate of poor fetal prognosis was 2/2 in those with placentomegaly (all with fetal hydrops), and 12% (3/26) in those without placentomegaly. The risk of poor fetal prognosis was 8.67 times higher in those with placentomegaly than those without placentomegaly, and the difference between the two groups was statistically significant ( P<0.05). The incidence rate of poor fetal prognosis in those with polyhydramnios was 3/7, and 10% (2/21) in those without polyhydramnios, but there was no statistically significant difference between the two groups ( P>0.05). Conclusion:TFR combined with solid tumor morphology, TGR, and presence of placentomegaly could predict the adverse pregnancy outcomes of fetal SCT.

Objective:To investigate the clinical characteristics and perinatal outcomes of pregnancy with placental cystic lesions.Methods:A retrospective study was carried out on 48 pregnant women diagnosed as pregnancy complicated with placental cystic lesions from January 2000 to January 2020 at the Women′s Hospital, Zhejiang University School of Medicine. The clinical features, pathological diagnosis and perinatal outcome were analyzed.Results:The age of 48 cases was (30±5) years, and the diagnostic gestational week of ultrasound was (24±8) weeks. Twenty-five cases in which showed a cystic mass at the fetal surface were diagnosed as placental cyst. The live birth rate was 100% (25/25) and the premature birth rate was 20% (5/25). Twenty-three cases showed “honeycomb like” cystic echo. Cystic lesions of 10 cases were located in the uterine cavity connected with the margin of the normal placenta, and finally diagnosed as hydatidiform mole and coexisting fetus (HMCF). Six cases of HMCF terminated pregnancy, and the live birth rate was 4/10, the premature delivery rate was 2/4. Cystic lesions of 13 cases were located in the placenta substance, and finally diagnosed as 4 cases of placental mesenchymal dysplasia (PMD) and 9 cases of focal chorionic edema; the live birth rate was 6/13 and the premature delivery rate was 4/6. The median hCG was lower in focal chorionic edema group [80 kU/L (60-110 kU/L)] than in the groups of HMCF [240 kU/L (180-430 kU/L)] and PMD [360 kU/L (210-700 kU/L)], and the differences were statistically significant (all P<0.01). Conclusions:For pregnancy complicated with placental cystic lesions, prenatal ultrasound should be performed to evaluate the shape, location and blood flow of the lesions. Maternal serological examination and invasive prenatal diagnosis are helpful for prenatal diagnosis and treatment. Due to the difference of perinatal outcomes, maternal and fetal complications, individualized pregnancy management should be carried out.

Objective:To explore the feasibility, safety and effectivity of applying transmesenteric vein extrahepatic portosystemic shunt (TEPS) to treat extrahepatic portal vein obstructive disease (EHPVOD).Methods:From December 2020 to April 2021, 12 patients with EHPVOD in the Vascular Surgery Department of Zhengzhou University People′s Hospital were prospectively enrolled in the study. The infra-umbilical median longitudinal minilaparotomy was performed to expose the branch of superior mesenteric vein (SMV). RUPS-100 was introduced into the trunk of SMV. A balloon with a diameter of 20 mm was introduced through right internal jugular vein (RIJV) into inferior vena cava (IVC). Under fluoroscopy, RUPS-100 was used to puncture the balloon in IVC. A stiff guide wire was used to establish the pathway between RIJV and SMV. Finally the portosystemic shunt between IVC and SMV was established with a covered stent-graft. The total operative time, the time of establishing portosystemic shunt alone, the dosage of contrast agent, the preoperative and postoperative pressure of SMV were recorded. Paired t test was used to compare the preoperative and postoperative pressure of SMV. Results:All 12 patients were successfully performed TEPS. The total operative time was (113±32) min, the time of establishing portosystemic shunt alone was (31±5) min, the dosage of contrast agent was (129±48) ml. The postoperative pressure of SMV [(14.3±2.1) mmHg] decreased significantly ( t=20.125, P<0.01) compared to baseline [(27.8±2.7) mmHg]. All portal hypertension symptoms released after the operations.There was 1 case of delayed incision healing, 1 case of bacteremia and 1 case of slight hepatic encephalopathy, but all of them were cured. There was no death case. Postoperative CT showed all portosystemic shunts were patent. Conclusion:TEPS is a new, safe, effective and feasible treatment method for patients of acute and chronic EHPVOD.

This article reported the management and outcome of a pregnant woman diagnosed with massive subchorionic thrombohematoma at the umbilical cord insertion. The patient was found to have a large placental hematoma below the insertion site of the umbilical cord at 28 weeks of gestation by ultrasound and MRI. Fetal growth and the condition of the placenta were closely monitored thereafter. The patient was delivered with good maternal and infant outcomes through emergency cesarean section at 33 +5 weeks of gestation due to a significantly enlarged hematoma with abnormal umbilical blood flow.