Objective Anovel index based on frequency-domain analysis of heart rate variability (HRV) was tested on patients with reduced left ventricular systolic function.This index,namely VHFI,was defined as the very high frequency (VHF) component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component.Methods Patients (n=130) were divided into a study group,consisting 66 patients with decreased left ventricular systolic function,and a control group,consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis (＜50%).Results VHFI in the study group was significantly higher than that in the control group (19.17±13.35 vs 11.37±10.77,P＜0.001).Cardiac events occurred in 18 patients during follow-up (33.34±3.26 months).Defining the positive test as VHFI =15 and negative test as VHFI ＜15,achieved a sensitivity of 57.58% and a specificity of 78.13% for predicting decreased left ventricular systolic function,and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events.Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events.Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis.

Objective To investigate the effects of self-made Yishen Antai Decoction combined with progesterone in the treatment of recurrent spontaneous abortion (RSA) and the effect on pregnancy outcomes and blocking antibodies (BA). Methods 100 cases of patients with RSA were randomly divided into the observation group and the control group, 50 cases in each group. The control group was treated with progesterone and on the basis, the observation group was additionally treated with self-made Yishen Antai Decoction. Both groups were intervened till 12 weeks of gestation, and the clinical curative effect was evaluated. Results The total effective rate of treatment, the success rate of pregnancy and the positive rate of blocking antibody (BA) showed significant differences between the observation group and the control group (P< 0.05). After treatment, the total TCM symptom score and serum levels of interleukin-2 (IL-2) and interferon-γ (IFN-γ) were significantly lower while interleukin-10 (IL-10) level was significantly higher in the observation group than the control group (P< 0.05). There were no serious adverse reactions in the two groups. Conclusion Self-made Yishen Antai Decoction is effective and safe in the treatment of RSA. It can significantly improve the success rate of pregnancy and the positive rate of BA, which may be associated with the regulation of IL-2, IL-10 and IFN-γ levels.

Objective To make an evidence-based rehabilitation plan for a patient with osteogenesis imperfecta after external fixation. Methods Based on a comprehensive assessment for the patient's condition, the clinical problems were listed. Related articles were searched from National Guideline Clearinghouse (NGC), The Cochrane Library, PubMed, CBM, CNKI and Wanfang databases. And the reference list of each eligible article was also included. Finally the optimum rehabilitation program was designed with optimal clinical evidence, patient's conditions and relatives' willingness. Results 1 randomized controlled trial and 4 case reports were included. A progressive exercise program was developed and implemented. No new fractures occurred during the intervention. Muscle strength, gait, activities of daily living had been greatly improved. 20 weeks later, the Berg score was 43 and the Barthel index was 80. Conclusion The progressive rehabilitation exercise program developed from evidence-based practice is safe, effective and feasible.

Objective To study the cognition of scientific research integrity and know status of scientific research standard of nurses who had research experience so as to provide some evidence for nursing research integrity management.Methods A total of 296 nurses whose working years was more than 5years and who had delivered scientific research papers in 13 Grade A hospitals from 7 cities were investigated by self-designed questionnaires.Results More than 64.0％ nurses showed not appropriate or inappro-priate for those irresponsible research behavior.64.5％ nurses did not agree with the researchers to referring the research object situation for others,97.0％ nurses believed the research achievement should be objective.While nurses did not know the research standards well:only 56.1％ nurses knew the standard of submitting manuscript,and 20.6％ nurses knew research data collection,preservation and usage.Conclusions It is necessary to enhance the management of nursing research integrity through education and propaganda of the research standards,improving the scientific management system,increasing the research support for nurse scientific so as to promote the nursing research integrity.

Objective To explore the measurement of femoral neck shortening (FNS) after cannulated screwing for elderly femoral neck fractures and the effect of FNS on hip functional outcome.Methods Totally 214 elderly patients with femoral neck fracture were included in this study who had been treated by fixation with cannulated screws from June 2007 to October 2013.They were 71 males and 143 females,with an average age of 77.2 years.According to Garden classification system,65 cases were types Ⅰ and Ⅱ (undisplaced fractures),and 149 types Ⅲ and Ⅳ (displaced fractures).The postoperative X-ray and follow-up X-ray films were compared to observe whether the trailing end of screw shaft was exposed to the outer cortex of the proximal femur.We chose the screw which had the longest exposure of trailing end to measure the length of the exposed screw shaft as the length of FNS.FNS indexes were defined according to the ratio of the length of exposed screw shaft to the thickness of screw head.FNS degree 1:＜ 1 screw head; FNS degree 2:1 to 2 screw heads; FNS degree 3:＞ 2 screw heads.The relationships of the FNS length respectively with thefemur length decrease and Harris scores of hip functional outcome were analyzed statistically.Results FNS occurred in 78 cases,giving an incidence of FNS of 36.4％ (78/214).Of them,12 cases (15.4％)were defined as degree 1,24 cases (30.8％) as degree 2,and 42 cases (53.8％) as degree 3.There was a significant positive correlation between the FNS length and the femur length decrease(r =0.919,P =0.000).The average Harris score at 12 months postoperation for 180 cases was 77.3 points (ranging from 32 to 98 points).The average Harris score for those with FNS was significantly lower than that for those without FNS (t =9.904,P =0.000).There was a significant negative correlation between the FNS length and Harris scores (r =-0.707,P =0.000).Conclusions Our measurement of FNS and FNS indexes are easy to be used in clinic.Severe FNS can influence the function of hip joint.

Objective To compare the clinical outcomes between oblique and non-oblique fixation with cannulated screws for femoral neck fractures in the elderly patients.Methods Totally 189 patients of over 65 years old were treated for femoral neck fracture from June 2007 to October 2013 at our department.Oblique fixation with cannulated screws was used in 130 cases.They were 43 males aud 87 females with an average age of 77.8 ± 7.5 years.According to Garden classification,40 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 90 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them 26 were Pauwells type Ⅲ.Non-oblique fixation with cannulated screws was conducted in 59 cases.They were 24 males and 35 females with an average age of 75.5 ± 8.2 years.According to Garden classification,12 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 47 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them,15 were Pauwells type Ⅲ.The fracture union,postoperative complications,rate of reoperation and Harris scores at the last follow-up were compared between the 2 groups.Results All the 189 patients were followed up for 10 to 38 months (average,17.4 months).The oblique fixation led to a union rate of 99.2％ (129/130),a fixation failure rate of 3.1％ (4/130) and a femoral head necrosis rate of 2.3％ (3/130),which were not significantly different from those resulted from the non-oblique fixation [98.3％ (58/59),10.2％ (6/59) and 5.1％ (3/59) respectively] (P ＞ 0.05).However,the rate of femoral neck shortening [35.4％ (46/130)] and the reoperation rate [3.1％ (4/130)] in the oblique fixation group were significantly lower than those in the non-oblique fixation group [50.8％ (30/59) and 15.3％ (9/59) respectively] (P ＜ 0.05).The mean Harris hip score at the last follow-up for the oblique fixation(75.7 ± 14.3) was significantly higher than that for the non-oblique fixation (70.8 ± 16.7) (P ＜ 0.05).Conclusion As oblique cannulated screwing can reduce the rates of femoral neck shortening and reoperation to some extent,it may be a better fixation choice than the non-oblique cannulated screwing for femoral neck fracture in elderly patients.

There are an increasing number of survivors of successful treatment of lymphomas over the past 30 years. Although these survivors may be cured of their lymphoma, long-term morbidity and mortality are associated with late toxicities of the treatment. Identification of these late complications will lead to strategies to manage them when they occur and hopefully decrease the risk of their development. Secondary malignancies and treatment associated cardiovascular disease are the leading causes of late morbidity and mortality.Musculoskeletal difficulties, endocrine abnormalities, including sterility and thyroid disease, and heart and lung damage, have also been seen.The late complications of primary treatment of lymphoma and autologous stem cell transplantation usually for relapsed disease are the subjects of this paper.

Objective: To standardize the bill management, protect the economic order of public institutions. Methods: According to the current status of bill management in public health institutions, the corrective measurements comparing to national stipulation were proposed. Results: It is an important measure to manage the economic environment. Conclusion: It needs to follow the National Law of Negotiable Instrument, so as to ensure the right of party. Implement the law of bill to ensunre the right of party.

BACKGROUND:In vitro experiments have confirmed that human umbilical cord mesenchymal stem cells can be induced to differentiate into hepatocyte-like cells, thus which can be considered to function as liver repair.
OBJECTIVE:To observe the therapeutic effect of human umbilical cord mesenchymal stem celltransplantation on acute liver injuries in rats through in vivo animal experiments.
METHODS:Healthy Sprague-Dawley rats were randomly divided into three groups:normal control group without modeling, celltransplantation group, and PBS group. Rat models of acute liver injury were prepared by 10%CCl4-olive oil solution in the celltransplantation and PBS groups which were fol owed by intraperitoneal injection of 0.5 mL human umbilical cord mesenchymal stem cellsuspension and 0.5 mL PBS, respectively.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that pathological changes related to acute liver injury appeared at 24 hours after intraperitoneal injection of CCl 4 . Then, the liver structure recovered at 7 days after celltransplantation, but it did not recover til the 14th day after PBS injection. Compared with the normal control group, serum alanine aminotransferase and aspartate aminotransferase levels were significantly increased in the other two groups (P<0.05-0.01). In the celltransplantation group, the serum alanine aminotransferase and aspartate aminotransferase levels were significantly lower than those in the PBS group at 3 days after treatment (P<0.05-0.01), and recovered normal y after 7 days. cells positive for anti-human nucleoprotein antibody were found in the portal area of liver tissues in the celltransplantation group after 3 days of transplantation, and then cells positive for anti-human albumin antibody appeared after 7 days. These findings indicate that intraperitoneal transplantation of human umbilical cord mesenchymal stem cells can improve liver function and repair injured liver tissues after acute liver injury in rats to some extent.

Abdominal incisional hernia is a common complication of abdominal surgery,of which the two major direct causes are surgery wound healing and intra-abdominal pressure.Therefore,the factors causing poor wound healing and intra-abdominal pressure are incisional hernia incentives.Surgery is the only radical method to cure it,including open surgery and laparoscopic surgery.This review contains two contents,the summary of the current research and the prospects.