Objective To investigate the clinical significance of the changes of electrocardiogram (ECG) and cardiac markers for myocardial damage after on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCABG). Method Monitoring 25 patients of OPCABG (OPCABG group) and 25 patients of CABG (CABG group) R wave amplitude of V4 and V5 on antorior electrocardiographic lead and simultaneously determining cardiac markers for myocardial damage creatine phosphokinase isoenzyme MB (CPK-MB), tropenin I (cTnI) and heat-shock protein 70 (HSPT0) on different lime. Results R wave amplitude of V4 and V5 on anterior electrocardiographic lead had no significant changes on 0, 6, 18 and 24 hours after OPCABG. On the contrary, R wave amplitude of V4 and V5 on anterior electrocardiographic lead decreased significantly on 0, 6 and 18 hours after CABG (P<0.01), and came back to preoperative values 24 hours after operation. The levels of CPK-MB and cTnI reached its peak and higher significantly for CABG than those for OPCABG on 24 hours after operation, 29.29 μg/L vs 5.98 μg/L and 6.74 μg/L vs 1.91 μg/L respectively. HSP70 increased significantly on 6 hours after operation in two groups, but median of HSP70 was higher significantly in CABG group (11044.5 pmol/L vs1702.0 pmol/L). In the first day after operation the HSP70 peak was correlated significantly with the level of CPK-MB(r=0.370, P<0.01) and cTnI (r=0.458,P<0.01). Conclusions Myocardial damage is significantly alleviated for patients of OPCABG comparing with those of CABG. The HSF70 in circulation may indicate the degree of myocardial damage.

Objective To investigate the diagnostic threshold value and the influencing factors of high‐sensitivity troponin I measurement in the diagnosis of patients with acute myocardial infarction .Methods Collecting 9 236 patients who are the first time hs‐cTnI testing in the internal emergency department of our hospital(including 9 099 patients with non‐AMI and 137 patients with AMI) as participants ,then dividing non‐AMI patients into elder group(>60 years old) and younger group(≤60 years old) ,hs‐cTnI concentrations were compared between the elder and the younger group with different gender .The optimal threshold value of hs‐cT‐nI for acute myocardial infarction was determined by receiver operating characteristic(ROC) curve of AMI patients with different age and gender .Results The hs‐cTnI concentrations of non‐AMI patients in the elder male group were 39 .21 ng/L [(37 .48-40 .93)ng/L] ,which was higher than those of non‐AMI patients in the younger male group 22 .38 ng/L[(21 .16-23 .6)ng/L] and the difference was statistically significant(P<0 .05) ,the same result was seen in the elder female group and the younger female group .The total male group was 31 .26 ng/L [(30 .17 -32 .34)ng/L] ,it was higher than the total female group 26 .8 ng/L [(25 .73-27 .86)ng/L] .According to the ROC curve ,the optimal threshold value for AMI diagnosis was 45 ng/L in total AMI group and 135 ng/L in the elder male group and 45 ng/L in the elder female group ,which was different with the cut off value(120 ng/L) .Conclusion the hs‐cTnI levels were related with age and gender ,it is very important for us to consider these factors when we make the optimal threshold value with our own data .

Objective To investigate the therapeutical effect and mechanism of tiotropium bromide in patients with stable phase midrange and severe chronic obstructive pulmonary disease (COPD). Methods Seventy-eight patients with stable phase midrange and severe COPD were selected, and they were divided into observation group (40 cases) and control group (38 cases) according to treatment method. All patients were given conventional treatment. The patients in observation group were given tiotropium bromide, and the patients in control group were given terbutaline according to the needs for 12 weeks. The changes of dyspnea, 6 min walking distance, pulmonary function, leukotrienes C4 (LTC4), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-ɑ) before and after treatment, and drug adverse reaction were observed. Results The dyspnea score after treatment in observation group was significantly lower than that in control group:(2.9±0.5) scores vs. (3.5±0.7) scores, 6 min walking distance in observation group was significantly longer than that in control group: (427.67±70.36) m vs. (365.41±61.42) m, forced expired volume in 1 second (FEV1) and FEV1/forced vital capacity in observation group were significantly higher than those in control group:(1.76±0.89) L vs. (1.29±0.53) L and (67.43±9.52)%vs. (56.32±8.51)%, LTC4, IL-8 and TNF-αlevels in observation group were significantly lower than those in control group: (397.41± 198.57)μg/L vs. (1 181.95±207.54)μg/L, (434.81±176.05) ng/L vs. (823.37±165.43) ng/L and (0.15±0.02) ng/L vs. (0.25 ±0.02) ng/L, there were significant differences ( P<0.01). Pearson correlation analysis result showed that serum LTC4 level was negatively related to FEV 1 (r=-0.578, P=0.024);and the serum IL-8 level was negatively related to FEV1 (r=-0.542, P=0.019). There was no obvious drug adverse reaction in the two groups. Conclusions Tiotropium bromide can significantly improve the clinical manifestations in patients with COPD. Tiotropium bromide may take effects by blocking various inflammatory factors release in the stable phase of COPD.

Objective To investigate the characteristics of bone mineral density (BMD) in the patients with maintenance hemodi‐alysis(M HD) and relevant influencing factors to achieve the purpose of early diagnosis of osteoporosis .Methods Seventy‐two pa‐tients undergoing MHD and 76 healthy individuals(control group) were selected .The BMD values of lumbar spine and hip were measured in all subjects by using the dual energy X‐ray absorptiometry(DEXA) .The abnormal situation of BMD and the change of serum bone metabolism indicators in the patients with M HD were analyzed .Then the related factors affecting BMD were further ex‐plored .Results Compared with healthy controls ,the average BMD of lumbar and hip joints in M HD patients was significantly de‐creased ,which in elderly women was most remarkable ,and the incidence of osteoporosis was also significantly increased (P<0 .05) . Meanwhile ,the serum detection results showed that the levels of AKP ,iPTH ,P ,osteocalcin(OC) ,procollagen 1 N‐terminal peptide (P1NP) and β‐crosslaps (β‐CTX) in the NHD patients were significantly increased ;however the levels of Vit D and Ca were markedly decreased .The correlation analysis results showed that BMD was positively correlated with BMI and blood Ca ,while neg‐atively correlated with age ,dialysis age ,serum AKP and OC levels .Conclusion M HD patients are easily to appear the osteoporosis phenomenon ,in which the gender ,age ,dialysis age ,BMI ,serum AKP ,Ca and OC are the factors affecting BMD .

Objective:This study aimed to observe the curative effect and adverse reaction of docetaxel combined with intraperitoneal cisplatin chemotherapy and hyperthermia treatment of advanced ovarian cancer. Methods:A total of 83 patients with inoperable and recurrent advanced ovarian cancer were randomly divided into two groups:hyperthermia group and control group. The hyperthermia group consisted of 42 cases of docetaxel chemotherapy immediately treated with intraperitoneal cisplatin chemotherapy combined with abdominal local hyperthermia. The control group included 41 cases of docetaxel chemotherapy and intraperitoneal cisplatin chemotherapy treatment only. Results:The total efficiencies of the hyperthermia treatment group and the control group were 81%and 58.1%, respectively, which showed that the total efficiency significantly improved (P<0.05). The ascite control rates were 78.3%and 66.7%and CA125 decreased by 84.2%and 61.5%for the hyperthermia and control groups, respectively. The main adverse reactions were gastrointestinal reaction and bone marrow suppression. However, differences were not statistically significant. Conclusion:Docetaxel combined with cisplatin intraperitoneal perfusion hyperthermia significantly improved the curative effect on advanced ovarian cancer without increasing toxicity, which indicates that it is a treatment worth popularizing.

Objective This study aimed to construct an index system for nurse performance appraisal based on the quantity,quality,efficiency and technology in holistic nursing mode.Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system,and SPSS17.0 was used to do data statistics and reliability analysis.Results The nurse performance appraisal index system was constructed which contained 4 level-Ⅰ indicators such as level coefficient,nursing workload scores,nursing quality scoring rate and reward amount and 12 level-Ⅱ indicators.The calculation method of each part was also established.The expert positive coefficients were 94.3％ and 100.0％ respectively,the authority coefficients were 0.83 and 0.84,the importance and feasibility mean scores of every index were 4.27-5.00 and 4.26-4.94,and coefficients of variation were 0.00-0.26 and 0.05-0.26 in 2 rounds of enquiry.The importance of level-Ⅰ or level-Ⅱ indicators and operability coordination coefficients were 0.13-0.43,the significance test showed P ＜ 0.05.Conclusions The design of each dimension of the index system gives full consideration to nurse post management,hierarchical using,the nurse in charge of the patient,grading nursing care and many other factors.Representative of key indicators is strong,and it can reflect the distribution concept that more payment for more contributions,best's best reward and rewarding the good and punishing the bad.

Objective To investigate the association among cerebral lesions, mild cognitive impairment and artery stenosis.Methods In 685 cases which seek medical care in our hospital in recent years, we studied the cortical infarction lesions in this study, analysis of subcortical infarction in patients with cognitive impairment as well as the composition of the artery stenosis conditions were conducted .Results in this study, subcortical infarct patients with mild disturbance of consciousness accounted for 9.20%, while blood supply stenosis cases accounted for 49.34%.Elder than 70 years, long course of subcortical infarction, family history of alcohol consumption and dementia were associated with cortical (P <0.05), the incidence of subcortical infarct and mild cognitive disturbance were 2.138 times for infarct and mild disturbance of consciousness patients.Multivariate regression analysis showed that family history of hypertension and cerebrovascular disease were also risk factors.In addition, mild cognitive impairment can increase the risk of subcortical infarct and the incidence of vascular stenosis, OR was 2.077;elder than 70 years of age, subcortical infarct length, hypertension and family history of cerebrovascular disease were risk factors for subcortical infarction and stenosis of blood supply.In multivariate regression analysis, mild cognitive impairment, long duration of subcortical infarct, overweight and obesity, and hypertension showed to be risk factors of subcortical infarct and blood supply stenosis.Conclusion The artery stenosis and subcortical infarction with mild cognitive impairment show a positive correlation, while the presence of mild cognitive impairment and subcortical infarction and artery stenosis and an increased risk of an association, are related to each while age, duration and associated subcortical infarcts family history and other factors also affect the potential relationship between them .

OBJECTIVE To analyze distribution of the pathogens of catheter-related bloodstream infection ( CRBSI ), and provide doctors with the laboratory evidence of CRBSI diagnosis. METHODS A retrospective analysis of CRBSI pathogens′ distributions from 261 inpatients whose catheter culturing was positive in General Hospital of PLA from Jan 1, 2002 to Aug 31, 2004 was done, and from which true cases of CRBSI were judged and true pathogens or contaminants were identified and counted. RESULTS There were 88 (33.72%) patients diagnosed as CRBSI among 261 cases. They were from intensive care unit (41), surgical department (22), medicine (12), the old patients ward (10), and pediatric ward (3). The first four by rank order of the CRBSI pathogens were Acinetobacter baumannii (15.9%), coagulase-negative staphylococci (14.8%), Pseudomonas aeruginosa ( 11.4% ), and Candida albicans (9.1%). The prominent contaminants were as follows: coagulase-negative staphylococci , Streptococcus pyogenes, Micrococcus and Gram-positive rods. CONCLUSIONS To get a better understanding about distribution of CRBSI pathogens will help its diagnosing as early as possible.

0.05).CONCLUSIONS The rising rates of the drug-resistant Uu strains may be resulted of no-standard treatments.The treatment time will be shortened and the curative effects will be better if the treatments are based on the results of the susceptibility test.

AIM: To explore the inhibitory effect of honokiol on retinal NV. METHODS: Hyperoxia was induced in NV model in 60 mice.Twenty mice received an intraperitoneal injections of 100 mg/kg honokoil twice daily for 5 days as large-dosage group and 20 mice received 50 mg/kg as small one while 20 mice received BSS as control.The collagen IV immunohistochemical staining was used to observe retinal vessels.The effect was evaluated by counting the nuclei extending from retina to vitreous and expressions of VEGF and MMP-2. RESULTS: The reduced density of vessels in the treatment group were found in retinal.The number of nuclei was less in the treated groups,which in the lagre-dosage group was significantly less.The expressions to VEGF and MMP-2 were less in the treatment than in the control respectively.That in the large-dosage group was significantly less. CONCLUSION: Intraperitoneal injections of honokoil can effectively inhibit retinal NV,depending on dosage.