Objective To summarize the nursing experience in prehospital first-aid of patients with cardiac traumas in order to improve the cooperation capability of prehospital first-aid. Methods The nursing cooperation of prehospital first-aid of 33 patients with cardiac trauma was analyzed retrospec-tively. Results 24 cases of them were rescued successfully, and were completely recovered without se-quelas. 4 cases complicated with severe multiple trauma, died after arriving at hospital, and 3 cases com-plicated with multiple trauma died of complications, while 2 cases with injury of thoracic aorta died during the surgery. Conclusions Early emergency treatment and judgment of traumatic condition could pro-vide valuable chance for inhospital first-aid.

ObjectiveTo study the mastery, acquiring ways and need of studying the knowl-edge and skill of emergency treatment in non- medical junior college and technical secondary school students. MethodsThe survey was carried out in 600 non-medical junior college and technical sec-ondary school students to investigate their mastery and need of emergency knowledge, the results underwent analysis. ResultsThe mastery of the emergency knowledge was uneven in non- medical junior college and technical secondary school students. 100.0% of them can call 120 correcdy, 58.5% of them mastered the e-mergency treatment of carbon monoxide poisoning, and 25.0% mastered cardiac pulmonary resuscitation. All the students desired to hold the knowledge and skill of emergency treatment. Television, broadcast and internet were the main ways for them to master emergency knowledge. ConclusionsThe mastery of the knowledge and skill of emergency treatment is not good. It is urgent to educate and train them with the knowledge and skill of emergency treatment, and to improve knowledge and skill of emergency treatment.

Background Choroidal neovascularization (CNV) is a major cause of visual loss in many fundus diseases.Fundus angiography (FA) is essential for the diagnosis,location and treatment of CNV.However, FA is an invasive examination method.Split spectrum amplitude decorrelation angiography (SSADA) OCT can quickly and clearly provide vascular signals.However, whether SSADA-OCT is feasible in the evaluation of CNV remains unclear.Objective This study was to detect and quantify CNV using OCT angiography.Methods Thirteen patients with unilateral CNV were included in Beijing Tongren Eye Center from June 2014 to August 2014.All affected eyes of the subjects were scanned with a high-speed frequency domain OCT.The SSADA-OCT images were obtained by scanning of macula covered 6 mm×6 mm area.The CNV area and grey scale were computed from the en face OCT images of retinal layer and choroidal layer.This study followed the Helsinki Declaration and was approved by the Ethics Committee of Beijing Tongren Hospital,and written informed consent was obtain from each patient prior to any medical examination.Results SSADA-OCT angiogram revealed CNV area and location confirmed by fluorescein angiography,and the CNV blood flow information of internal limiting membrane,inner plexiform layer,retinal pigment epithelium,and choroid was exhibited by OCT angiography.All CNVs with different causes showed the well defined and hyperreflected signal in macular region.The average CNV area was (0.15 ±0.09)mm2 , and the average grey scale of CNV was 75.40±32.35 in the affected eyes,and that in the contralateral eyes was 26.99±22.87 in the 300 μm area,showing significant elevation in gray scale in the affected eyes compared with the contralateral eyes (t =6.946, P＜0.001).Conclusions OCT angiography is a noninvasive observation technique of retinal and choroidal blood flow.It can provide quantitative information and detailed images of CNV.

Background Cystoid macular edema (CME) is caused by many fundus diseases.The noninvasive clinical diagnosis methods for CME are conventional color fundus photography up to now.However,these images can not display the CME range well.Confocal scanning laser ophthalmoscope (cSLO) based retinal imaging can provide clear picture with high contrast.However,whether cSLO imaging is feasible in the quantitative assessment of CME remains unclear.Objective This study was to image the boundary of CME and assess the quantification of CME image from cSLO imaging technology.Methods A series case-observational study was designed.This study protocal was approved by Ethic Committee of Beijing Tongren Hospital.cSLO based retinal imaging technology was carried out on consecutive 24 eyes of 24 patients with clinically diagnosed and OCT confirmed CME in Beijing Tongren Eye Center from August to December 2015 under the informed consent of each individual.The radial scan range was 45°× 45 ° and the line scan level was 49 at macula area.The pseudocolar image,green light reflective image (532 nm) and infrared reflective image (785 nm) were collected.The imaging was analyzed by EasyScan software (version 1.2.2).Fundus color photography and SD-OCT were carried out in each patient.The images were graded by specialists according to the SD-OCT cross sectional results.Results The primary causes of CME included epiretinal membrane (10 eyes),branch retinal vein occlusion (BRVO) (6 eyes),central retinal vein occlusion (CRVO) (4 eyes),diabetic retinopathy (DR) (3 eyes) and CRVO with BRVO (1 eye).A CME image was exhibited on the fundus color photogram with the obscure boundary;while the clear range of CME was displayed by the cSLO imaging.The mean score of CME from pseudocolar image,green light reflective image and infrared reflective image was 3.21±0.78,2.67±0.96 and 2.54±0.83,respectively,which was significantly higher than 1.33±0.82 from the fundus color photography (all at P＜0.01).Conclusions In CME patients,the imaging quality from cSLO-based retinal imaging technology is better than that from traditional fundus color photography.Combined with SD-OCT sectional scan analysis,cSLO-based retinal imaging technology may offer a method to observe and record more fundus details for CME diagnosis.

The accurate location of acupoints is the prerequisite for the efficacy of acupuncture-moxibustion. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are commonly used in clinic for acupoints location. Based on the systematic review of the ancient literatures, this article discussed the meaning, evolution and relations of bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement. It’s concluded that the bone-length measurement should be a benchmark in ancient anthropometry and an important basis for acupoints location. Bone proportional measurement, used in different genders, ages and body sizes, was based on the relatively stable proportional relations of various body parts, though some of the standards were adjusted in accordance with the correlation between meridians and acupoints. Location of points by proportional unit of the body simplified the application of bone-length measurement and bone proportional measurement, based on the ratio between short and long bones or the ratio of same body parts in anthropometry. However, proportional unit of the body measurement should be applied for the specific body parts. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are correspondingly the benchmark measurement, relative measurement, and simplified measurement.

Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera.Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study.There were 35 males (51 eyes) and 32 female (39 eyes),mean age was 51.32 years.All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera,positive numbers of every retinal pathological change were calculated and compared.Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes.Results The positive numbers of retinal microaneurysm (x2 =4.157,P＜ 0.05) and epiretinal membrane (x2 =5.428,P ＜ 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera,while the positive numbers of cotton wool spots (x2 =0.523),retinal hemorrhage (x2 =0.117),hard exudates (x2 =0.325) and macular hole (x2 =0.070)were no significant different (P＞ 0.05).The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (x2 =9.143,P=0.007).Conclusion In retinal and choroidal diseases,the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.

P2Y12 receptor antagonists and morphine are often recommended in patients with acute myocardial infarction.P2Y12 receptor antagonists can rapidly and potently reduce the platelet activity and prevent future thrombotic events.Meanwhile,combined morphine is used to relieve symptoms of angina.A number of studies have confirmed that morphine can decrease plasma concentrations of clopidogrel and impair its anti-platelet activity,which may lead to poor response in clopidogrel-treated patients with acute coronary syndrome.The randomized trials in healthy volunteers and patients with acute myocardial infarction also confirmed the similar drug-drug interaction between morphine and ticagrelor or prasugrel.Although the P2Y12 receptor antagonists combined with morphine are still used for myocardial infarction patients,there are few report on the objective evaluation of this drug interaction.This review,based on the findings of experimental as well as observational and randomized clinical studies,summarizes completely the drug interactions between oral P2Y12 receptor antagonists and morphine.

Objective To screen and diagnose obstructive sleep apnea-hypopnea syndrome (OSAHS) in elderly males by obesity index using receiver operating characteristic(ROC) curves. Methods Data of 402 consecutive elderly male patients who underwent polysomnography from 2001 to 2008 were collected. The relationship between apnea hypopnea index(AHI) and obese indexes such as body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were analyzed by Pearson's correlation. ROC curves were used to determine the best cutoff values to screen and diagnose OSAHS, and their priority was compared by area under curve (AUC). A two-tailed P value less than 0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 13.0. Results (1) AHI was positively correlated with BMI (r=0.241,P<0.001), NC(r=0.201,P<0.001), WC(r=0.210,P<0.001) and WHR(r=0. 097,P>0.05)) in elderly male patients. The area under curve (AUC) of BMI, NC, WC and WHR was 0.61, 0.58, 0.51 and 0.45 respectively, and P value was 0.001,0.060,0.840 and 0. 250 respectively. Only BMI was competent in screening and diagnosing OSAHS in elderly male adults; (2) The optimal value of BMI was 22.0 kg/m~2 in screening OSAHS with specificity 90% and rate of missed diagnosis 10%; (3) The optimal value of BMI was 29.0 kg/m~2 in diagnosing OSAHS with specificity 90% and rate of missed diagnosis 10%. Conclusions BMI more than 22.0 kg/m~2 could be the reference standard to screen OSAHS and BMI more than 29.0 kg/m~2 to diagnose OSAHS in elderly men.

Objective To observe the clinical efficacy of ozone injection combined with extracorporeal shock wave in treatment of arthritis of perishoulderr.Methods 120 patients with arthritis of perishoulderr and treated were choiced,they were randomly divided into two groups.Patients in group C were performanced extracorporeal shock wave treatment.Patients in group H were performanced with ozone injection combined with extracorporeal shock wave.Visu-al analogue score(VAS)and rane of motion(ROM)were used to evaluate the therapeutic effect.Results There was no significant difference between the two groups preoperation.Then significant difference of VAS in the two groups for 1week,1 month,3 months and 6 months after treatment showed respectively as (4.56 ±0.27)points vs.(2.49 ± 0.25)points,t =43.57,(3.96 ±0.23)points vs.(1.86 ±0.29)points,t =43.95,(3.36 ±0.20)points vs.(1.79 ± 0.25)points,t =36.51,(3.98 ±0.23)points vs.(2.09 ±0.27)points,t =41.29,P <0.05;The ROM data were respectively(55 ±18)points vs.(67 ±16)points,t =3.86,(60 ±20)points vs.(72 ±18)points,t =3.45,(56 ±19) points vs.(78 ±15),t =7.04,(46 ±18)points vs.(77 ±14)points,t =10.53,P <0.05.Patients feeled pain eased significantly in group H was significantly higher than group C in 6 month postoperativeiy.(χ2 =38.90,P <0.01;χ2 =8.91,P <0.05).Conclusion There is significant effect in patients with arthritis of perishoulderr treated by com-bined ozone injection with extracorporeal shock wave.

ObjectiveTo investigate the risk factors for contrast-induced nephropathy (CIN) after endovascular therapy in patients with peripheral arterial diseases and to evaluate the conformance of serum cystatin C (Cys C) and serum creatinine in diagnosis of CIN. Methods In this prospective,single center study,in-hospital patients with peripheral arterial diseases undergoing non-emergency endovascular therapy from July 2010 to April 2011 in our hospital were enrolled.CIN was defined asScr increase ≥25％ after angiography.General clinical characteristics and blood biochemical parameters were compared between the non-CIN and CIN groups.Logistic regression analysis was performed to determine risk factors.Changes compared to baseline level in serum creatinine and Cys C at predefined time-points were evaluated.Results A total of 367 patients were enrolled in the study.The proportions of patients with diabetes mellims and treatment with diuretics before angiography,contrast-media dosage were significantly higher in the CIN group than those in non-CIN group (P＜0.05,＜0.01,＜0.01).Logistic regression analysis indicated that diabetes mellitus,contrast-media dosage were risk factors for CIN.Several serum Cys C increase criteria at 24 hours after contrast media exposure all had low sensitivity for predicting a Scr increase ≥25％.Only small overlapped regions were found in Venn diagram between several increasing criteria according to serum Cys C and serum creatinine criterion. Conclusions Diabetes mellitus,contrast-media dosage are independent risk factors for CIN.The results of several increasing criteria according to serum Cys C in evaluating contrast-induced AKI are not coincident well with that of serum creatinine criterion.