Objective To evaluate blood flow structure within left ventricle,quantify the variation of the flow at infarct segments,and assess the impact of myocardial infarction.Methods Twenty-eight patients with chronic myocardial infarction(CMI)and 30 healthy controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by vector flow mapping(VFM).Timeflow(T-F)curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile were analyzed by DSA-RSI program.Results Ventricular ejction peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower in CMI group at infarct segment than normal control group,the time duration from bottom to peak was relatively longer in CMI group.Normal velocity profile,parallel velocity profile,vector profile,flow profile at peak S and E were lower in CMI group than normal group.Conclusions The velocity of CMI group was lower and the time to peak was longer than that of control group.VFM is a new noninvasive and clinically useful parameter for the evaluation of regional left ventricular segment flow dynamics.

Type 2 diabetes is a metabolic disease with increasing prevalence,which causes great socioeconomic burden.Intestinal flora is the microbiota located in the human intestines,which are participating in human growth and development,physiological procedures,or even pathogenesis as a closely connected environmental factor.There have recently been rapid progresses in the research on the relationship between intestinal flora and type 2 diabetes in the field of endocrinology and metabolism.In this article,we reviewed the overall framework and research progress in the relationship between intestinal flora and type 2 diabetes,aiming to shed some light on the future research about this topic.

Objective To systematically analyze and assess the risk of venous thromboembolism in the patients with rheuma‐toid arthritis(RA) .Methods The related literatures on the venous thromboembolism occurrence in the patients with RA published at home and abroad were performed the electronic retrieval .The obtained data were analyzed by adopting the RevMan5 .1 software . The data unable to merge were analyzed by adopting the descriptive analysis method .Results A total of 10 related papers were in‐cluded .The 3 indicators of venous thromboembolism occurrence rate ,deep vein thrombosis occurrence rate and pulmonary thrombo‐embolism occurrence rate were performed the meta analysis .The RR and 95% CI of the occurrence rates of venous thromboembo‐lism ,deep vein thrombosis and pulmonary thromboembolism were 2 .00(1 .71 ,2 .33) ,2 .31(1 .84 ,2 .90) ,2 .25(2 .23 ,2 .28) respec‐tively .Conclusion The risk degree of venous thromboembolism occurrence in the RA patients is higher than that in the non‐RA pa‐tients .

Objective To establish a RP-HPLC fingerprinting analysis method for quality evaluation and control of the four variants of Chrysanthemi Morifoli Flos. Methods RP-HPLC was used to establish the fingerprinting method.Results Despite of the similarity in terms of holistic HPLC chromatograms, the four variants of Chrysanthemi Morifoli Flos exhibit characteristic fingerprints and can be readily recognized by similarity clusters. Conclusion A simple and reliable HPLC fingerprinting method has been developed and validated to authenticate the four variants of Chrysanthemi Morifoli Flos, providing a scientific basis for quality control of Chrysanthemi Morifoli Flos.

After more than3 years of pilot (since 2010), standardized training of resident physicians in Shanghai has made great progress, however, it still needs to be improved. Cerebral and spinal vascular diseases are main types of neurological diseases and they seriously influence people's life and health. Interventional neuroradiology plays an important role in the diagnosis and treatment of cerebral and spinal vascular diseases. However, in the current residency training system in Shanghai or other provinces of China, the training of interventional neuroradiology is not included. In this paper, the authors analyzed the important role of interventional neuroradiology in diagnosis and treatment of cerebral and spinal vascular disorders and discussed the feasibility, method, and time arrangement of including interventional neuroradiology curriculum into the schedule of neurology standardizedresidency training and hoped to provide reference for the relevant departments to formulate a future policy.

Objective To investigate the antimicrobial resistance and genotype distribution of staphylococcal cassette chromosome mec (SCCmec) of staphylococcus aureus (S.aureus) isolated from children hospitalized at Pediatric People's Hospital of Zhongjiang County.Methods Seventy-seven strains of S.aureus were collected by nasopharyngeal swabs at the Pediatric Department of People's Hospital of Zhongjiang County from January to December 2015.Methicillin-resistant staphylococcus aureus (MRSA) and methicillin-susceptible staphylococcus aureus (MSSA) were identified by cefoxitin disc diffusion and detection of mecA method.The minimum inhibitory concentrations (MIC) of antibiotics were determined by E-test method.SCCmec typing on MRSA strains was performed by using multiplex PCR.Results MRSA accounted for 54.5％ (42 strains) strains of 77 strains.All MRSA strains were resistant to Penicillin,and the rates of antibiotic resistance to Cefuroxime,Ceftriaxone,Erythromycin were 78.6％,95.2％ and 97.6％,respectively.The rates of antibiotic resistance of 35 MSSA to Penicillin and Erythromycin were 97.1％ and 62.9％,and they were also sensitive to other antibiotics.In 42 strains of MRSA,SCCmec type Ⅳa was the predominant type (27 strains,64.3 ％),which was followed by type Ⅳ g and Ⅴ (each 5 strains,11.9％),type Ⅳ c and Ⅳh (each 1strain,2.4％).Non-susceptibility rate of SCCmec Ⅳ to cefuroxime was significantly higher than that of other SCCmec types (P ＜ 0.05).Conclusions All strains from children hospitalized in People's Hospital of Zhongjiang County are often resistant to Penicillin and Erythromycin.The proportion of MRSA isolated from hospitalized children was high.SCCmec type Ⅳa is the main genotype of MRSA.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

Objective In view of the trend of networking development in modern high education and the characteristics of students' strong self-learning ability, Peking Union Medical College established a multimedia morphological teaching website from 2013 including human anatomy, neuroanatomy, histology and embryology.Methods According to the teaching demand, the use of the ASP script, combined with Mysql database completed the website development, from the interface design to the curriculum, the syllabus, presentations and laboratory videos uploading.Results Through the questionnaire survey, 45% of the students use website more than 3 times a week, and course content column has the highest use frequency (79%).An independent learning platform effect has been achieved.Conclusions After nearly 4 years exploration and practice, multimedia website has become an important part of morphological courses, as a kind of new teaching mode, not only popular for college teachers and students, but also widely used in clinical teaching.

Objective To investigatethe status of physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals in Suzhou, and to analyze the influence factors and to provide the basis for promoting cooperation consciousnes and quality of work. Methods One hundred and seventy-seven physicians and 506 nurses were investigated by the Nurse-Physician Collaboration Scale(NPCS) in 15 secondary hospitals and 15 tertiary hospitals in Suzhou. Results The cooperative status of physicians in tertiary hospitals was better than that of nurses (t=2.597, P=0.010). The cooperative status of nurses in tertiary hospitals was better than that in secondary hospitals (t=2.080, P=0.009). There was no significant difference in the cooperation between physicians and nurses in secondary hospitals (t=1.845, P=0.066). Multiple regression analysis showed that sex, profession, professional title, age, education degree and work seniority were the influence factors of physician-nurse collaboration intertiary hospitals (t=2.771, 2.597,F=3.745-12.513,P<0.01 or 0.05). Conclusions The physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals is in good shape.Administrators should pay attention to influence factors of physician-nurse collaboration, and take measures to promote quality of medical care and nursing care.