Objective To compare the effects of target systolic blood pressure on cardiovascular events in patients with hypertension and type 2 diabetes after antihypertensive drugs. Methods This study was a retrospective cohort study. Randomly selected from March 2014 to March 2017, 1563 patients with hypertension and type 2 diabetes diagnosed in the Department of Cardiology of the Tiemei Group General Hospital. There was no cardiovascular complications at admission. After admission, the population variables of each patient were recorded. Each patient was adjusted for blood pressure and blood glucose according to the doctor's advice after admission. After the hospital was discharged, the patient was followed up for blood pressure every week. The follow-up was 3-4 months. The average systolic blood pressure of each patient was recorded as the target systolic pressure. The patients who were followed up were divided into three groups according to the target systolic pressure value, namely ≤120 mmHg(1 mmHg=0.133 kPa) group,>120-130 mmHg group,>130-140 mmHg group. After that, it was changed to a weekly telephone follow-up of the nurses for a total of 3 years. The cardiovascular disease (CVD) occurred in these patients within 3 years were recorded. The CVD was used as the dependent variable, and the systolic blood pressure of each group was used as the independent variable to do COX. Proportional risk regression analysis, the hazard ratio (HR) of each group of concurrent CVD. Taking CVD as the dependent variable, HR of CVD with >130-140 mmHg group was taken as the reference value, and all population variables were used as independent variables, respectively, ≤120 mmHg group,>120-130 mmHg group and>130-140 mmHg group combined with CVD risk ratio. Results During the 3-year follow-up period, 1401 patients with blood pressure met: 104 patients with systolic blood pressure ≤120 mmHg, 543 patients with >120-130 mmHg, and 754 patients with >130-140 mmHg. The incidence of CVD in the three groups was 14.4％(15/104), 8.8％(48/543), 7.0％(53/754). HR of CVD were 1.66, 0.96, 0.53 in≤120 mmHg group,>120- 130 mmHg group,>130-140 mmHg group .Compared with >130-140 mmHg group, the risk ratio of CVD in all subgroups of≤120 mmHg group was statistically increased (HR>1, P<0.05). Compared with >130-140 mmHg, >120-130 mmHg group with 65-79 years old, combined with more than 3 groups of antihypertensive drugs, patients with diuretics showed a statistically significant increase in the risk ratio of CVD (HR>1, P <0.05). Conclusions The target systolic blood pressure of patients with hypertension and type 2 diabetes should be >130-140 mmHg. For patients aged 65-79 years, more than 3 groups of antihypertensive drugs are used. Patients with diuretics should have a target systolic blood pressure of >130-140 mmHg.

Objective To explore the clinical value of 3D fast spin echo with an extended echo train acquistion (CUBE) T1WI enhancement sequence for purulent meningitis by comparing to contrast?enhanced T2WI?FLAIR sequence in the detection of lesions. Methods From August 2016 to July 2017, children with clinically suspected purulent meningitis underwent cranial magnetic resonance examination in our hospital. There were 35 children, 19 males and 16 females, aged 2 months to 3 years (median age 8 months) in total.A GE Discovery MR 750 3.0 T scanner was used to perform routine plain and enhanced scan in all children. After enhancement, the sequences of CUBE T1WI and FLAIR T2WI were applied randomly. Using the FLAIR T2WI enhancement sequence as the reference, we evaluated the detection rate of CUBE T1WI enhancement sequence for dura mater and leptomeningeal thickening. The number of enhanced lesions detected was tested by χ2 test. Results The enhanced FLAIR T2WI sequence showed 21 cases with dural enhancement, showing a rate of 60.0%. The enhanced CUBE T1WI sequence showed 31cases with dural enhancement, showing a rate of 88.6%. There were significant differences between the dural lesions detected(χ2＝6.058, P<0.01). The enhanced FLAIR T2WI sequence showed 16 cases of leptomeningeal enhancement,showing a rate of 45.7%. The enhanced CUBE T1WI sequence showed 19 cases of leptomeningeal enhancement,showing a rate of 54.3%.The enhanced CUBE T1WI sequence was not significantly higher than that of enhanced T2WI?FLAIR sequence in displaying leptomeningeal enhancement (χ2=0.229, P>0.05). Conclusion Enhancement of the CUBE T1WI sequence enables better visualization of meningeal thickening than FLAIR T2WI. It has great clinical value in the diagnosis of purulent meningitis in children.

Objective To verify and valuate the performance of small dense low-density lipoprotein cholesterol (sdLDL-C) detection by the direct clearance method and evaluate its preliminary clinical application in acute coronary syndrome (ACS).Methods Case control study:The performance (accuracy,precision,linearity) of sdLDL-C was assessed by direct clearance method.In 143 cases of ACS patients selected from Cardiology Department and Emergency Department of Shangdong Provincial Hospital from April to October in 2016,with 100 cases male,female 43 cases,including acute myocardial infarction (AMI)group of 59 cases,unstable angina pectoris (UAP) group of 84 cases;83 cases of healthy volunteers as a control group selected from health physical examination center of Shandong Provincial Hospital,with 59cases male,female 24 cases.Levels of sdLDL-C,total cholesterol (TCH),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A (ApoA I),apolipoprotein B (ApoB),lipoprotein (a) (Lpa) and high sensitive C-reactive protein (Hs-CRP) were detected separately by automatic biochemical analyzer.Non high density lipoprotein cholesterol (non-HDL-C) equals TCH minus HDL-C.x2 test,t test,one-way ANOVA,Pearson correlation and multiple linear regression analysis were used as statistical methods.Results The within-lot or between-lot variation was 2.85％ and 3.36％.Methodological comparison:regression equation Y =0.984X + 0.018,r2 =0.966,t =-0.191,P =0.850.There was a good linear correlation (Y =1.026X + 0.007,r2 =0.999) between theoretical values and actual detection results in range of 0.15-2.65 mmol/L.SdLDL-C concentrations were positive correlated with TCH,non-HDL,LDL-C,TG,ApoB (r =0.758,0.848,0.839,0.514,0.885,respectively,P ＜0.01),and negative correlated with HDL-C (r =-0.224,P =0.001),but no correlation with APOA I,Lpa and Hs-CRP(r =-0.021,0.050,0.003,respectively,P ＞ 0.05).Multiple linear regression analysis showed that the factors influencing sdLDL-C level were HDL-C,ApoB,LDL-C and TG.The levels of sdLDL-C,TG in the ACS group were significantly higher than those in the control group (t =3.415,4.660,respectively,P ＜ 0.01),but no difference between the two groups in the levels of TCH,non-HDL-C and LDL-C (t=-1.831,-0.452,-1.398,respectively,P ＞0.05).Comparing AMI group with control group,sdLDL-C,TG and Hs-CRP were significantly higher than the control group (P =0.000,0.000,0.000,respectively),but TCH,LDL-C and non-HDL were similar between the two groups (P =0.800,0.320,0.120,respectively);Comparing UAP group with control group,TG and Hs-CRP were higher than control group (P =0.001,0.047,respectively),TCH and LDL-C were significantly lower than the control group (P =0.003,0.008,respectively),but sdLDL-C had no difference (P =0.305);Comparing AMI group with UAP group,sdLDL-C,TCH,LDL-C and Hs-CRP were significantly higher than UAP group (P =0.000,0.003,0.001,0.000,respectively),and TG were no statistical significance (P =0.473).Conclusions Direct clearance method can meet the requirement of sdLDL-C detection.sdLDL-C level can assess the metabolism of blood lipids and be used as an independent risk factor and predictive index of ACS,superior to LDL-C.

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia (PCIA) in the patients undergoing transcatheter hepatic arterial chemoembolization (TACE).Methods One hundred and twenty patients of both sexes,aged 40-65 yr,weighing 45-80 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective TACE under monitored anesthesia care,were divided into 2 groups (n =60 each) using a random number table:sufentanil group (S group) and dexmedetomidine mixed with sufentanil group (DS group).At 15 min prior to surgery,0.1 μg/kg sufentanil and 5 mg tropisetron were intravenously injected in both groups.In addition,dexmedetomidine 0.6 μg/kg was intravenously infused for 15 min in DS group,while the equal volume of normal saline was given instead in S group.PCIA solution contained sufentanil 2 μg/kg and tropisetron 5 mg in 100 ml of normal saline in S group.PCIA solution contained sufentanil 2 μg/kg,dexmedetomidine 2.μg/kg and tropisetron 5 ng in 100 ml of normal saline in DS group.The PCIA pump was programmed to deliver a 0.5 ml bolus dose with a lockout interval of 15 min and background infusion of 2 ml/h.Observer's Assessment of Alertness/Sedation Scale scores and scores for patient's satisfaction with analgesia were recorded at 30 min and 2,6,12,24 and 48 h after surgery.The pressing times of PCIA,total consumption of sufentanil and requirenent for morphine as rescue analgesics were recorded.The development of requirement for antiemetics,nausea and vomiting,bradycardia,respiratory depression and agitation was also recorded during analgesia.Results Compared with S group,the pressing times of PCIA,total consumption of sufentanil and requirement for morphine were significantly reduced,scores for satisfaction with analgesia were increased,and Observer's Assessment of Alertness/Sedation Scale scores were decreased (P＜0.05),and no significant change was found in the incidence of nausea and vomiting,additional requirement for antiemetics,bradycardia,respiratory depression or agitation in DS group (P＞0.05).Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy than sufentanil alone when used for PCIA in the patients undergoing TACE.

Objective An improved water-fat separation method based on region-growing was proposed for use in regions with low signal-noise ratio (SNR).Methods Region-growing method was applied to 4 sub-images acquired by a downsampling operation on the acquired phasor maps.The spatial smoothing constraint was exploited to calculate 4 error phasor maps to construct the final smooth error phasor map,which was used in two-point Dixon technique for water-fat separation.Results The simulation experiment showed that the proposed method produced smaller errors,and for dinical images of the knees,abdomen and lower limbs,the proposed method achieved accurate water-fat separations.Conclusion The proposed method is more robust and reliable than the original global region-growing algorithm,and serves as a promising water-fat separation method for clinical applications.

Objective An improved water-fat separation method based on region-growing was proposed for use in regions with low signal-noise ratio (SNR).Methods Region-growing method was applied to 4 sub-images acquired by a downsampling operation on the acquired phasor maps.The spatial smoothing constraint was exploited to calculate 4 error phasor maps to construct the final smooth error phasor map,which was used in two-point Dixon technique for water-fat separation.Results The simulation experiment showed that the proposed method produced smaller errors,and for dinical images of the knees,abdomen and lower limbs,the proposed method achieved accurate water-fat separations.Conclusion The proposed method is more robust and reliable than the original global region-growing algorithm,and serves as a promising water-fat separation method for clinical applications.

Objective To construct the new diet intervention scheme of dyslipidemia of university teachers, discuss the effect of this plan on eating behavior change. Methods Choose two groups of college teachers in Harbin, who were hyperlipemia and had physical examinations from June to September, 2014. 44 teachers from one college were conducted the new dietary intervention as experimental group, 37 teachers from another college were the control group, used the usual method. Compared two groups before and after the intervention of dietary behavior and blood lipid. Results The experimental group′s dietary behaviors changed strongly after implement the new dietary intervention, the scores of DTS before the experiment (58.82 ± 18.47) points,3 months after the experiment (48.36 ± 14.25) points and 6 months after the experiment (44.18±14.92) points were statistically significant (F=21.308, P < 0.01). There was no statistically significant difference in control group (F = 1.129, P > 0.05), respectively (60.51 ± 16.91) points, (57.19 ± 16.35) points, (56.92 ± 21.35) points. After 6 months, the experimental group′s subjects of TC was (4.28±3.73) mmol/L, the control group was (6.23±1.04) mmol/L, the difference was statistically significant (t = 3.082, P < 0.05), there were no significant differences in TG, LDL-C and HDL-C of the two groups (P>0.05). Conclusions The new dietary guidance plan can effectively improve and maintain the dietary behavior in hyperlipidemia college teachers, and decrease the blood lipid level.

Objective To explore the application effects of the innovative nursing practice in the patients with the uterine fibroid surgery based on the concept of homogeneous medical treatment was investigated in the study.Methods Two hundred and twenty patients with the uterine fibroid surgery in our hospital before (from October 201 4 to March 201 5 ) and after (from April 201 5 to September 201 5 ) the practice of homogeneous innovative nursing were included as the objects.The patients before the practice was included into control group (1 1 0 patients ) and the patients after the practice was included into experimental group (1 1 0 patients).The patients in the control group accepted the conventional nursing of the uterine fibroid surgery,while the patients in the experimental group accepted the innovative nursing based on the concept of homogenous medical treatment. The anxiety state, the mastery of health knowledge, the incidence of complications,the quality of life,the satisfaction rate of nursing of patients before and after the intervention were compared between two groups.Results The nursing effects (the anxiety state,the grasp of health knowledge, the incidence of complications)in the patients of the experimental group were significantly better than that in the control group (P <0.05).Three months after the intervention,the quality of life including social life,vigor, sleep,somatic movement,emotional response and pain in the experimental group was significantly better than that in the control group (P <0.05).Three months after the intervention,the satisfaction rate was 96.36% in the experimental group,which was significantly higher than that in the control group (86.36%)(P <0.05). Conclusions The nursing effects,the quality of life and the satisfaction rate are significantly improved when the innovative nursing model based on the concept of homogenous medical treatment is applied in the nursing practice of the patients with the uterine fibroid surgery.

Objective To establish a new method to analyze the position accuracy of multileaf collimator (MLC) in the dynamic mode.Methods The MLC test sequence was created in a field,where intentional leaf positional errors ranging from 0.1 to 1 mm per centimeter were introduced.In order to establish the relationship between the ion chamber readings and leaf position,whose slope indicated the leaf position error per centimeter,a two-dimensional ion chamber array was used to measure absorbed dose while leaves were moving at dose rates of 100,300 and 600 MU/min,respectively.For routine test,leaf position error was easily found via dose profile in y direction of the field created by dynamic leaves,where the position error could be quantitatively calculated as the slope of absorbed dose line of x direction of the same field.Results The error of 0.2 mm or more per centimeter was obviously shown through y dose profile.The calibration curve was linear at different dose rates.At 600 MU/min,a 0.1 mm leaf position error corresponded to a slope variation of 0.74％,and the differences between the tested errors and the introduced errors were within 0.1 mm.Conclusions The simple and reliable method is helpful to establish the intensity modulated radiation therapy (IMRT) quality control (QC) system.