Objective To know the feasibiliy and the effects of shorten preoperative fasting time for patients with digital cerebral angiography. Methods Divided 110 patients with digital cerebral angiogra-phy into the observation group and the control group according to their sequence enter the hospital. Routine fasting method was used in the control group, shorten fasting time was used in the observation group, com-pared the incidence rate of fasting-related complications between the two groups. Results The incidence rote of belly discomfort, thirstily, strvation and hypoglyeemic during the digital cerebral angiogrsphy in the con-trol group was significant higher than those of in the observation group, while there were no significant difference about the incidence rate of postoperative complication between the two groups. Conclusions For patients with digital cerebral angiography can shorten the preoperative fasting time properly, which can avoid certain complieaitons.

Objective:To investigate the therapeutic effect of cardiac rehabilitation exercise on ventricular remodeling in patients with acute myocardial infarction undergoing percutaneous coronary intervention.Methods:A total of 100 patients with acute myocardial infarction undergoing percutaneous coronary intervention who received treatment in Wenzhou Central Hospital from June 2018 to June 2019 were included in this study. They were randomly divided into a rehabilitation group and a conventional treatment group ( n = 50/group). Patients in the conventional treatment group underwent conventional postoperative rehabilitation education while those in the rehabilitation group received targeted cardiac rehabilitation exercise. After surgery, all patients were followed up for 12 months. Real time three-dimensional echocardiography was used to evaluate ventricular remodeling (left ventricular ejection fraction, left ventricular end-diastolic volume , left ventricular end-systolic volume, left ventricular remodeling index) and ventricular synchrony (Tmsv-16dif, Tmsv-16sd, Tmsv16-dif%, Tmsv16-sd%) before and 3, 6 and 12 months after surgery. In addition, serum levels of ventricular remodeling indexes (fibroblast growth factor 23, PICP and PIIINP) were measured. The incidence of cardiovascular end-point events within 12 months was calculated. Results:At 3, 6 and 12 months after surgery, left ventricular ejection fraction was (51.81 ± 5.43)%, (55.88 ± 5.46)%, (55.63 ± 5.57)% in the rehabilitation group, which was significantly higher than (47.16 ± 5.38)%, (52.31 ± 5.44)%, (51.84 ± 5.59)% respectively in the conventional treatment group ( t = 4.302, 3.275, 3.396, all P < 0.05). At 3, 6 and 12 months after surgery, left ventricular end-diastolic volume was (124.65 ± 15.56) mL, (98.54 ± 14.54) mL, (99.82 ± 13.18) mL, respectively in the rehabilitation group, which was lower than (132.64 ± 16.58) mL, (112.55 ± 15.61) mL and (114.84 ± 17.35) mL, respectively in the conventional treatment group ( t = 2.485, 4.644, 4.874, all P < 0.05). At 6 and 12 months after surgery, left ventricular end-systolic volume was (52.26 ± 5.48) mL and (52.15 ± 5.32) mL respectively in the rehabilitation group, which was significantly lower than (57.92 ± 5.46) mL and (58.51 ± 5.72) mL in the conventional treatment group ( t = 5.174, 5.757, both P < 0.05). At 6 and 12 months after surgery, left ventricular remodeling index was (1.75 ± 0.42) g/mL and (1.74 ± 0.35) g/mL respectively in the rehabilitation group, which was significantly higher than (1.52 ± 0.37) g/mL and (1.50 ± 0.32) g/mL, respectively in the conventional treatment group ( t = 2.906, 3.579, both P < 0.05). At 3, 6 and 12 months after surgery, Tmsv-16dif ( t = 2.753, 4.283, 4.088, all P < 0.05), Tmsv-16sd ( t = 5.134, 4.326, 4.670, all P < 0.05), Tmsv-16dif% ( t = 7.714, 8.587, 7.800, all P < 0.05) and Tmsv16-sd% ( t = 9.004, 14.061, 10.305, all P < 0.05) respectively in the rehabilitation group, were significantly lower than those in the conventional treatment group. At 3, 6 and 12 months after surgery, fibroblast growth factor 23 ( t = 6.303, 5.053, 4.619, all P < 0.05). PICP ( t = 3.772, 2.798, 3.788, all P < 0.05) and PIIINP ( t = 3.110, 5.912, 4.294, all P < 0.05) in the rehabilitation group were significantly lower than those in the conventional treatment group. Within 12 months, the total incidence of cardiovascular end-point events in the rehabilitation group [12.00% (6/50)] was significantly lower than that in the conventional treatment [32.00% (16/50)] ( χ2 = 5.828, P < 0.05). Conclusion:Cardiac rehabilitation exercise can improve ventricular remodeling and synchrony in patients with acute myocardial infarction undergoing percutaneous coronary intervention and reduce the incidence of cardiovascular end-point events.

Objective:To explore the application effect of Roy adaptation model combined situational teaching method in pediatric nursing teaching.Methods:A total of 108 nursing students interned in our hospital in 2019 were selected and randomly divided into two groups, among which, 54 nurses who accepted the traditional teaching method were taken as the control group, and 54 ones who adopted Roy adaptation model combined situational teaching method were taken as the research group. The scores of theory and operation skills of the two groups were evaluated before and after teaching, at the same time, the comprehensive ability was assessed and the satisfaction survey was conducted among the students after the teaching. SPSS 20.0 was used for data processing, the scores of theory and operation skills comprehensive ability and nursing students' satisfaction with teaching were described with ( ± s) and t test was performed. Results:After the teaching, the theoretical knowledge and operational skills scores of the two groups were significantly improved than those before the teaching ( P<0.05), and those of all students in the research group were significantly higher than those in the control group ( P<0.05). The scores of ability to integrate theory with practice, self-learning ability, communication ability, teamwork ability, independent thinking and problem solving ability, clinical thinking ability in the research group were higher than those in the control group, with statistical differences ( P<0.05). And students in research group had significantly higher overall satisfaction scores on the teaching than those in control group had ( P<0.05). Conclusion:Application of Roy adaptation model combined situational teaching method in pediatric practice teaching can improve the theoretical knowledge and operational level of nursing students, enhance their communication ability and other abilities, and help to improve their satisfaction with teaching.

Objective To explore the role of homocysteine(Hcy)on angiogenesis at peri infarct region after focal cere-bral ischemia in rats, to elucidate inhibitory factors of angiogenesis, and to establish a clinic foundation for clinical brain functional recovery. Methods Spragur-Dawley (SD) male rats (n=36) were randomly divided into three groups with 12 rats in each group including Sham Operation (SO) group, Middle cerebral artery occlusion (MCAO) group and MCAO+Hcy group. The rats in Sham and MCAO groups were intra-peritoneally injected with 5 mL/(kg·d) saline and rats in MCAO+Hcy group were injected with 2%5 mL/(kg·d) Hey solution from the same route. MCAO was introduced by intraluminal filament meth-od after 7 d Hcy intervention. Rat brains were harvested on the 7th day after MCAO. BrdU(50 mg/kg, as a marker of cell pro-liferation)was intraperitoneally injected three days before the rats were killed. High performance liquid chromatography (HPLC)was used to measure serum Hcy concentration in rats. Brain infarction size was observed by TTC staining. Immuno-fluorescence staining was used to detect the number of BrdU+/laminin+cells at the thalamus of infarction side. Results Se-rum Hcy concentration significantly higher in MCAO+Hcy group than in SO and MCAO groups(P<0.05). Brain damage increased and the number of BrdU+/laminin+cells decreased in MCAO+Hcy group compared with those of MCAO group (P<0.05). Conclusion Increased Hcy concentration in rats lead to more severe damage of cerebral infarction as well as to inhibit the angiogenesis at surrounding ischemia area.

Objective To investigate the expressions of IgG,Gab2 and PTEN in human gliomas and analyze their relationship with patient prognosis. Methods Immunohistochemistry was performed to detect the expressions of IgG,Gab2 and PTEN in 55 cases of gliomas and 20 cases of normal brain tissues. The mRNA expression of IgG in glioma tissues was detected by in situ hybridization. Results IgG protein and IgG mRNA were expressed in glioma tissues. IgG,Gab2,PTEN expression rate in normal brain tissues was significantly different to that in glioma-tissues(5.0%vs. 69.0%,5.0%vs. 52.7%,and 85.0%vs. 25.5%,P<0.05). Expression of IgG was positively related with expression of Gab2 in glioma(r = 0.3124,P < 0.05),IgG and PTEN expression were negatively related with each other(r=-0.422,P<0.05). Conclusions IgG and Gab2 are highly expressed in glioma. The expression of PTEN was downregulated in glioma. IgG,Gab2 and PTEN might be involved in the development of glioma.

Objective To compare the efficacy and safety between whole brain radiotherapy (WBRT) and WBRT combined with temozolomide (TMZ) in the treatment of non-small cell lung cancer with brain metastases.Methods According to the retrieval strategy,the Chinese and English literatures before February 2018 were retrieved from EMbase,Cochrane,PubMed,Wanfang database,Chongqing VIP and CNKI,The target literatures were selected according to the inclusion and exclusion criteria,The quality of the included studies and extracted data was independently assessed by 3 researchers,The RevMan 5,3 and STATA 12,0 software was used for statistical analysis,The objective remission rate (ORR),the total survival period (OS),the progression-free survival (PFS),and the side effects of chemotherapy were evaluated.Results In total,17 trials consisting of 1128 patients were included,The results of Meta-analysis demonstrated that compared with the WBRT group,the ORR was significantly higher (OR=2.54;95％CI:1.93-3.36;P＜0.001),the PFS was significantly longer (MS R=1.329;95％CI:1.143-1.545;P＜0,001),and the incidence of hematological toxicity (OR=3.44;95％CI:1.63-7.26;P＜ 0.05) and the gastric intestinal reaction (OR=1.69;95％CI:1.24-2.31;P＜0.05) was significantly higher in the WBRT+TMZ group,The heterogeneities were within the acceptable range with statistical significance,The results of OS were invalid due to relatively large heterogeneity,The incidence of headache did not significantly differ between two groups (OR=1.05;95％CI:0.72-1.55;P=0,79).Conclusions Compared with WBRT alone,WBRT combined with TMZ is beneficial to improve the short-term efficacy,whereas the incidence of hematological toxicity and gastrointestinal reaction is higher,The occurrence of headache does not significantly differ between two groups,The benefit of long-term survival remains uncertain.

OBJECTIVETo observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect (ASD) in dogs.

METHODSASD was established with the help of transthoracic echocardiography in 18 dogs. ASD size was (6.0 ± 0.2) mm. Dogs were randomly divided into normal size group (implanted with 8 mm occlude, n = 9) and oversized group (implanted with 12 mm occluder, n = 9). Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure. The endothelialization process on device surface was observed by scanning electron microscope.

RESULTSFour animals died around 1 month post procedure. Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation. While microscopic sections showed lack of endothelialization at 3 months post implantation, nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.

CONCLUSIONIncomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.

Objective To explore the main cause of displacement of peripherally inserted central catheters ( PICC) among pediatric patients with hematologic disease .Methods Eleven nurses and 10 children's parents received the questionnaire on the cause analysis of displacement of PICC among pediatric patients with hematological tumor which was made through the analytical hierarchy process theory , the literature review and interview.The weight of each indicator was calculated in the two groups , and the indicator was put in the right order according to their weights .Results The top 4 main causes agreed by nurses and parents in the displacement of PICC among pediatric patients with hematologic disease were respectively poor supervision C 6 , non-standard dressing methods C 1 , different adhesive forces of dressings C 15 , excessive activity of arm in where the PICC line was located C 9 , and the predominant reason was the poor supervision C 6 .Conclusions We should strengthen the training of nurses , and choose the appropriate dressings , and enhance the guard consciousness of the displacement of PICC in children's parents , and reinforce the supervision , and reduce the arm activity so as to decrease the displacement of PICC among pediatric patients with hematologic disease .

Objective To observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect ( ASD) in dogs.Methods ASD was established with the help of transthoracic echocardiography in 18 dogs.ASD size was ( 6.0 ±0.2 ) mm.Dogs were randomly divided into normal size group ( implanted with 8 mm occlude , n =9 ) and oversized group (implanted with 12 mm occluder, n =9).Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure.The endothelialization process on device surface was observed by scanning electron microscope.Results Four animals died around 1 month post procedure.Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation.While microscopic sections showed lack of endothelialization at 3 months post implantation , nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.Conclusion Incomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.

Objective:To retrieve, evaluate, and integrate the best evidence for the management of neurogenic bowel dysfunction (NBD) in spinal cord injury patients both domestically and internationally, providing a basis for relevant evidence-based practices.Methods:The guidelines, expert consensus, clinical decision-making, and systematic review of NBD management for spinal cord injury patients were electronically searched in various databases and professional association websites at home and abroad. The search period was from database establishment to March 31, 2023.Results:A total of 13 articles were included, including five guidelines, five evidence summaries, two expert consensus, and one clinical decision-making. A total of 33 recommendations for NBD management in spinal cord injury patients were summarized from five aspects of medical history assessment, medication management, physical therapy, diet and exercise, and health education.Conclusions:The best evidence for NBD management in spinal cord injury patients summarized is scientific and practical. Medical and nursing staff should selectively apply the best evidence based on clinical practice.