Objective To explore the correlation between anxiety and the severity of myocardial brigde of left anterior descending. Methods 118 patients with isolated myocardial bridge of left anterior descending underwent coronary angiography were evaluated with Self-rating Anxiety Scale (SAS). They were divided into anxiety group and non-anxiety group. Results There were 48 cases in the non-anxiety group, and 70 cases in the anxiety group. The stricture of myocardial bridge was more serious in the anxiety group than in the non-anxiety group (P<0.01), and positively correlated with the SAS score (r=0.765, P<0.01). Conclusion The anxiety is frequent in patients with isolated myocardial bridge of left anterior descending, and correlated with the severity of myocardial bridge.

Objective To summarize the experience of diagnosis and management of regional portal hypertension. Methods The clinical manifestations, diagnostic methods and therapeutic modalities of 16 cases of regional portal hypertension were analyzed retrospectively. Results Among 16 patients with ~regional portal hypertension, 12 cases resulted from pancreatic diseases, and 4 cases were complicated with non-pancreatic diseases. The main clinical findings were splenomegaly in 16(100%), abdominal pain ~in 10(63%) , gastrointestinal bleeding in 7(44%) and abdominal masses in 3(19%). All had normal liver function test. The main diagnostic methods were ultrasonography(US), computerized tomography (CT) and endoscopy. Splenic vein thrombosis could be detected by color Doppler ultrasonography (7/7). ~Enhanced CT could demonstrate enlarged and tortuous short gastric veins, gastroepiploic veins, and ~coll- ~ateral vessels around splenic hilum(16/16). Isolated gastric varices (4/5) were revealed mainly by ~gastro- ~scopy . Splenectomy was effective for controlling gastrointestinal bleeding, and its complication of portal vein thrombosis occurred in 1 case. Conclusions It is not difficult to diagnose regional portal ~hyper- ~tension based on findings of US and CT, together with special clinical characteristics. Therapeutic options should be ~individualized according to underlying diseases, however, splenectomy should be performed in the ~patients with gastrointestinal bleeding.

Objective To investigate the quality of life of nurses group in Shenzhen city and explore its influencing factors, so as to provide evidence for health policy making health promotion and science research. Methods Self-designed questionnaires were used in social demography survey and SF-36 was adopted to survey 495 in-service nurses on front line from four hospitals in Shenzhen. Paired samples t Test and multivariable stepwise regression were carried out to analyze the quality of life among nurses in Shenzhen city and general population in China. Results The data showed the scores of the physiological domain, psychological domain and quality of life nurses in Shenzhen city and Chinese general population was (68.60±17.61), (69.91±17.91), (67.29±20.29)and (78.18± 15.88), (79.36±17.00), (77.00± 17.42), respectively. The difference had statistical significance. Multivariable stepwise regression showed that quality of life was positively correlated with APN scheduling, education, department, monthly income, working range, age and the hospital level in descending sort Conclusions Health authorities, hospital leaders and nurses-selves should pay more attention to the quality of life for nurses group and take positive mea-sures to improve quality of life of nurses group.

Objective To evaluate the theoretical knowledge level of Chinese nursing students based on the problem-based learning(PBL)versus traditional teaching methods. Methods Databases including CNKI (1979-2013.03),VIP (1989-2013.03)and Wanfang (1982-2013.03)were searched (up to March,2013)for controlled studies comparing PBL and traditional teaching methods. The quality of included studies was critically evaluated and the data were analyzed by Stata 10.0 software. Results A total of 659 articles were retrieved but only 22 were included. Meta-analyses showed that there were significant differences between PBL and traditional teaching methods in improving theoreti-cal knowledge of nursing students(SMD merge=0.79,95%CI(0.55,1.03),P=0.000). Conclusions PBL can improve the theoretical scores of Chinese nursing students. However,the above conclusion needs to be confirmed by more large-scale randomized controlled trials of higher quality due to the limitation of studies include in this paper.

Objective To investigate the effects of exogenous biliverdin on lung injury induced by brain death (BD) in rats. Methods Twenty-three adult male Wistar rats in which Fogarty balloon catheter was successfully inserted into cranial cavity were randomly divided into 3 groups: group Ⅰ sham operation (group S,n = 7); group Ⅱ brain death (group BD, n = 8) and group Ⅲ biliverdin + BD (group B, n = 8). The animals were anesthetized, intubated and mechanically ventilated. Femoral artery and vein were cannulated for MAP monitoring and drug and fluid administration. Brain death was induced by injecting slowly normal saline into the balloon in group Ⅱ and Ⅲ. BD was confirmed by dilated and fixed pupils, apnea, transient hypertension and EEG changes. In group Ⅲ biliverdin 35 mg/kg was injected intraperitoneally as soon as BD was confirmed. The animals were mechanically ventilated for another 1.5 h during which MAP was maintained at 80-120 mm Hg by iv norepinephrine infusion. Arterial blood samples were obtained before anesthesia, immediately before and at 5, 30,60, 90 min after intraperitoneal biliverdin for blood gas analysis and determination of plasma bilirubin concentration. PaO2/FiO2 was calculated. The animals were sacrificed at 1.5 h after biliverdin administration. The left lung was removed for detection of MDA content, SOD activity, total antioxidant capacity, cell apoptosis and biliverdin reductase expression in lung tissue. Results Brain death significantly decreased PaO2/FiO2, lung SOD activity and total antioxidant capacity and increased lung MDA content and apoptosis as compared with sham operation group. IP biliverdin significantly attenuated BD-induced lung injury in group B as compared with group BD. The plasma bilirubin concentration and biliverdin reductase expression were significantly higher in group B than group BD. Conclusion Exogenous biliverdin can attenuate BD-induced lung injury by inhibiting pulmonary oxidative stress response and apoptosis.

Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.

Objective To observe the effect of acupuncture and massage on tiptoe in children with spastic cerebral palsy. Methods 49 children with spastic cerebral palsy were divided into treatment group (n=24) and control group (n=25) in accordance with the order of visiting. The control group accepted routine rehabilitation, and the treatment group accepted acupuncture and massage in addition. They were assessed with Composite Spasticity Scale (CSS), the angle of ankle passive dorsiflexion before and after treatment. Results The scores of CSS and the angle of ankle passive dorsiflexion improved in both groups after treatment (P<0.001), and improved more in the treatment group than in the control group (P<0.001). The rate of improvement was 95.6% in the treatment group, and 78.26% in the control group (P<0.05). Conclusion Acupuncture and massage may further improve the correcting of the tiptoe in children with spastic cerebral palsy.

Objective To evaluate the relationship between the concentration of pentane in the exhaled air and degree of the lung injury in non-heart-beating (NHB) rabbits.Methods Twenty-four healthy male Japanese white rabbits weighing 2.4-3.0 kg were randomly divided into 4 groups ( n =6 each):A,B,C and D groups.The NHB model was established by exsanguination through the femoral artery.The exhaled gases were collected and lung tissues were removed at 0,30,60 and 120 min after cardiac arrest in A,B,C and D groups respectively.The concentration of pentane in the exhaled gases was detected immediately using the gas chromatography-mass spectrography.The wet to dry (W/D) lung weight ratio and content of malondialdehyde (MDA) in lung tissues were measured.The lung injury score (LIS) was recorded.The maximal volume ( Vmax ) of the lung was recorded when the airway pressure reached 30 cm H2O.Results Compared with groups A and B,the exhaled pentane concentration was significantly increased in group C,and the W/D ratio,content of MDA and LIS were significantly increased,while Vmax was significantly decreased in group D ( P ＜ 0.05).Compared with group C,W/D ratio and LIS were significantly increased in group D ( P ＜ 0.05 ).Conclusion The concentration of exhaled pentane can not reflect the degree of the lung injury in NHB rabbits.

Objective To investigate the value of two-dimensional and three-dimensional transesophageal echocardiography (3DTEE) in transcatheter aortic valve implantation (TAVI). Methods Eleven patients with severe aortic stenosis and one patient with moderate to severe prosthetic valve regurgitation underwent TAVI in Zhongshan Hospital of Fudan University from May 2010 to December 2015. All patients received two-dimensional and three-dimensional transthoracic and transesophageal echocardiographic examination before surgery, during and after surgery.Results Procedural success was achieved in eleven patients, but one patient died in pericardial tamponade and aortic dissection three days after TAVI. The maximum and minimum diameter of aortic annule, the area of aortic annule and aortic valve were measured by multidetector computed tomography (MDCT) and 3DTEE before surgery. All parameters had strong correlations between MDCT and 3DTEE (r=0.98,P<0.01 for maximum diameter;r=0.97,P<0.01 for minimum diameter;r=0.97,P<0.01 for the area of aortic annule;r=0.99, P<0.01 for the area of aortic valve). There were good correlations for the area of aortic valve among MDCT, 3DTEE and equation of continuity (allr=0.99,P<0.01).ConclusionTwo-dimensional and three dimensional transesophageal echocardiography can quantify the size of aortic annular and comprehensively evaluate the anatomical structure of aorta rapidly and accurately, which can be used in guiding TAVI and monitoring its complications in real time.

Objective To investigate the effects of inhalation of different concentrations of carbon monoxide (CO) on brain death (BD)-induced lung injury in rats. Methods Thirty-two pathogen free adult male Wistar rats weighing 250-300 g were randomly divided into 4 groups ( n= 8 each): group Ⅰ sham operation (group S);group Ⅱ brain death (group BD) and group Ⅲ and Ⅳ BD + CO 0.025% and 0.050% (group C1, C2 ). The animals were anesthetized and tracheally intubated. Fogarty catheter was inserted into the skull. BD was induced by inflating the balloon slowly at 20 μl/min until apnea developed. The animals were then mechanically ventilated (VT 10 ml/kg, RR 50 bpm, PEEP 2 cm H2O) with 40% O2 in N2 . In group Ⅲ and Ⅳ CO 0.025% and 0.050%were added to the air mixture respectively. In group S the balloon was not inflated. BD was confirmed by apnea,dilated pupils and flat EEG. In group BD,C1 and C2, MAP was maintained at 80-120 mm Hg by norepinephrine infusion. The arterial blood gas analysis was performed before (baseline) and immediately after BD was confirmed (T1) and at 30, 60, 90 and 120 min (T2-5) of CO inhalation. The animals were then sacrificed. The plasma concentrations of IL-6 and TNF-α and the activity of myeloperoxidase (MPO) in the lungs were measured. The W/D lung weight ratio and lung injury score (LIS) were recorded. Results BD significantly decreased PaO2/FiO2, BE and pH while increased plasma IL-6 and TNF-α concentrations, MPO activity in the lungs, the W/D ratio and lung injury score as compared with group S. CO inhalation ameliorated the deleterious effects induced by BD. The antiinfiammatory effect of 0.050% CO was better than that of 0.025 % CO. Conclusion Inhalation of 0.025 % or 0.050% CO can ameliorate BD-induced lung injury in rats, but there is no significant difference in the efficacy.