Objective To explore the relevance between resting heart rate (RHR) and metabolic syndrome in young and middle-aged patients with essential hypertension.Methods Three hundred and forty patients with essential hypertension were enrolled in this study.According to the RHR,the hypertension patients were categorized into 3 groups:group RHR 1 (RHR ＜ 70 bpm,52 cases),group RHR 2(RHR 70-85 bpm,168 cases) and group RHR 3 (RHR ＞ 85 bpm,120 cases).The RHR,blood pressure,fasting blood glucose,triglyceride,high density lipoprotein cholesterol,2 h postprandial blood glucose and waistline were determined and compared.Results The level of fasting blood glucose,2 h postprandial blood glucose,triglyceride,waistline,systolic pressure,diastolic pressure,and high density lipoprotein cholesterol in group RHR 1 were (4.96 ± 0.65) mmol/L,(6.85 ± 0.51) mmol/L,(1.69 ± 0.43) mmol/L,(78.3 ± 6.5) cm,(143.2 ± 5.6) mmHg (1 mmHg=0.133 kPa),(85.4 ±5.2) mmHg and (1.08 ±0.64) mmol/L.In group RHR 2 they were (5.66 ± 0.77) mmol/L,(7.94 ± 0.66) mmol/L,(2.58 ± 0.75) mmol/L,(88.6 ± 7.3) cm,(156.7 ± 6.1) mmHg,(93.6 ± 4.7) mmHg,and (0.95 ± 0.59) mmol/L.In group RHR 3 they were (6.85 ± 0.73) mmol/L,(8.97 ± 0.59) mmo]/L,(3.52 ± 0.90) mmol/L,(95.8 ± 9.2) cm,(164.3 ± 7.4) mmHg,(101.2 ± 3.5) mmHg and (0.78 ± 0.33) mmol/L.With the increase of RHR,the level of fasting blood glucose,2 h postprandial blood glucose,triglyceride,waistline,systolic pressure and diastolic pressure increased step by step,high density lipoprotein cholesterol decreased step by step,and there were significant differences (P ＜ 0.05).Correlation analysis showed that RHR was positively correlated with fasting blood glucose,2 h postprandia blood glucose,triglyceride and waistline (r =0.52,0.45,0.50,0.36,P ＜ 0.05),and negatively correlated with high density lipoprotein cholesterol(r =-0.39,P ＜ 0.05).Conclusion RHR is closely related to the metabolic disorder in young and middle-aged patients with essential hypertension,and doctors should pay attention to the heart rate control while lowering blood pressure.

Pulmonary embolism(PE)is a relatively common cardiovascular emergency.Haemodynamic instability is the characteristics of massive pulmonary embolism,with a mortality as high as 20%.The goals of PE treatment are to remove the thromboembolic obstruction rapidly,exert beneficial effects on haemodynamic parameters and save the lives of patients.Haemodynamic and respiratory support is of vital importance in some critically ill patients with PE.The basic treatment is anticoagulation,the methods of which are different for PE during pregnancy,among cancer patients,with right heart thrombi and with heparin-induced thrombocytopenia.

Objective To optimize the medium for rhizomatous induction of Belamcanda chinensis in vitro. Methods By plant tissue culture technology, the effects of various carbon source, NAA, and active carbon at different concentration on the rhizomatous formation of B. chinensis in vitro were studied. Results MS+6-BA 2.0 mg/L+NAA 0.5 mg/L+6% white sugar was the optimal medium for the rhiz-omatous formation of B. chinensis in vitro. Active carbon should not be added to the medium. The germination rate of rhizomatous in vitro was 61.03% on the MS + BA 2.0 mg/L+3% white sugar. Conclusion Sugar concentration is the main factor of the influence on the rhizomatous formation of B. chinensis in vitro.

ObjectiveTo investigate and analyze the influence of modified admission education on im-provement of satisfaction degree of patients with coronary heart disease. Methods300 patients with coronary heart disease were randomly divided into the observation group and the control group with 150 cases in each group after admission. The observation group adopted diversified admission education, while the control group received simple education style, the satisfaction degree of both groups was compared. ResultsThe satisfac-tion degree of the observation group was higher than that of the control group. ConclusionsAdoption of di-versified admission education is beneficial to improve the satisfaction degree of patients, increase their cognition degree, thus make patients cooperate with treatment and nursing better and facilitate their rehabilitation.

Objective To study the main influence factors of nosocomial infection(NI) and establish a model to predict and forecast the risk of NI on patients in hospitals. Methods Clinical data of 27352 inpatients extracted from hospital information system were sorted out and coded, and a logistic regression model about the probability of NI was established. The risk of NI was divided into four scales. Results With multiple factor analysis,16 risk factors of NI were identified, which were age, high body temperature, numbers of diagnosis, days of staying in hospital and seriousness, numbers of routine test for urine, times of blood transfusion, use or without use of antibiotic and radiotherapy, turning over the bodies or not, relationships between infection and interventional operations, with or without diabetes, categories of diseases based on ICD-9, numbers of interventional operations, type of anesthesia and department of admission. If NI was judged when predicted probability(Pr)of logistic regression model exceeded 0 35, the specificity and false diagnostic rate of diagnostic test were 0 995 and 0 005 respectively, and the area under ROC curve was 0 986. According to decision tree method, the risk of NI was classified into four degrees: low (Pr

Objective To discuss the application effects of trinitarian visualization teaching model in endoscopy reprocessing teaching practice. Methods Subjects in the study were divided into the trinitarian visualization teaching group (n=40) and the traditional teaching group (n=43) by random number table method; Compliance and credibility rating of endoscope reprocessing procedures were compared between 2 groups. 2 weeks after training, objectives were examined and assessed by questionnaires separately. Results Compliance of the trinitarian visualization teaching group was higher than the traditional teaching group (χ2=10.501, P=0.033). The trinitarian visualization teaching group had a higher rating in compliance, with 47.47 credibility points, theory test (93.79 ± 3.81) points and 93.02%(40/43) of operation pass. The traditional teaching group had a credibility point of 43.68 credibility points, with theory test (85.25±3.14) points and 77.50%(31/40) of operation pass. Significant difference between the two groups were statistical significant (t=4.84 and 11.097, χ2=4.038,P<0.01 or 0.05). Conclusions The trinitarian visualization teaching model can be used to improve the reprocessing training quality, to save time and human resource and to reach the training demand.

Targeted cancer therapy is one of the modalities to increase efficiency and decrease adverse effects of chemotherapy,and the selection of drug vector system is of importance for targeted therapy.An ideal adriamycin targeted vector system should have maximal efficacy and minimal adverse effects in inhibiting cancer cells through different mechanisms.This article reviews the recent progress in adriamycin targeted therapy,including the modes of adriamycin administration,the selection of drug vectors,as well as other chemotherapeutic drugs in targeted therapy of liver carcinoma.

Objective:To analyze the diagnosis and treatment of 1 case of primary bone marrow diffuse large B cell lymphoma (DLBCL),and to provide the reference for its dignosis and treatment. Methods:Combined the medical history and other auxiliary examination results, the possibility of diagnosis of primary bone marrow lymphoma (PBML)was suspected. Bone marrow biopsy and immunohistochemistry were carried out for diagnosis, and R-CHOP (rituximab, cyclophosphamide,doxorubicin,vincristine,and prednisolone) was selected as the chemotherapy scheme. Results:The diagnostic basis of the case was in accordance with the diagnostic standard of PBML.According to the results of immunohistochemical staining,it was classified as the DLBCL subtype. Then the patient received 6 cycles of R-CHOP immune chemotherapy. Complete remission of bone marrow cell morphology was gained after the first cycle of R-CHOP treatment,and the patient was treated for another five cycles and the complete remission was retained in 3 months of follow up after drug withdrawal. Conclusion:Bone marrow biospy and immunohistochemistry have the unique diagnostic values for primary bone marrow DLBCL,and the regimens containing rituximab may provide a ideal efficacy during short term observation.

OBJECTIVE:To discuss drug quality management practice in medical institutions.METHODS:The status quo of pharmaceutical administration and its trend of development were analyzed based on national laws and regulations for the drug control,the contents on drug quality management practice in medical institutions were presented.RESULTS:The management system,operation criteria,record system should be formulated respectively in drug quality management of medical institutions aimed directly at drug supply and drug use.CONSLUSION:The formulation of drug quality management practice in medical institutions is essential in the efforts to ensure safety,effectiveness and economy of drug use.

ObjectiveTo investigate the diagnosis and operative procedure for spontaneous perforation of congenital choledochal cyst in children. MethodsThe clinical data of 16 cases with spontaneous perforation of congenital choledochal cyst were analysed retrospectively.ResultsAll cases were under 4 years old with a mean age of 23 months. Abdominal distension, pain, vomiting, fever and diffuse tenderness were present in all patients. The preoperative diagnosis was established by paracentesis in ten patients. Abdominal sonography and CT found a cyst in 5 of the 10 cases reviewed. In 11 cases (68.7%), the site of perforation was found on the confluence of common bile duct and gallbladder cystic duct. T-tube drainage was used as a transition measure. All patients recovered uneventfully. Radical resection was performed in about three months after the initial operation. ConclusionsThe obstruction of the bile duct and poor blood supply to the choledochal cyst are major causes leading to perforation. Routine abdominal paracentesis should be carried out for a small child with peritonitis and general abdominal tenderness, especially on the right upper quadrant.T-tube drainage should be adopted as an emergent procedure to tide the patient over the crisis followed by elective choledochal cyst resection and bile duct reconstruction.