Objective To investigate the ability of myocardial fractional flow resever (FFRmyo) in predicting the incidence of major cardiac events (death, myocardial infarction, revascularization and recurrance of angina) 3 months after stent inplantation and also try to find out the cutoff point. Methods Coronary pressure was measured in 79 patients with stable angina immediately after stent implantation. The values of poststenting FFRmyo was calculated and found to be related to the presence of major adverse cardiac events during first 3 months. Results In 14 patients (18.4%), at least one adverse event occurred. Two out of 12 patients experienced recurrance of angina and underwent revascularization. By Logistic Regress analysis, FFRmyo immediately after stenting was the most significant independent variable for predicting major cardiac events. By receiver-operating characteristic (ROC) analysis, the cutoff point of FFRmyo was 0.92. Conclusion FFRmyo immediately after stenting is an independent predictor of clinical events at first 3 months.

To investigate the semi-quantitative method for evaluating lipid accumulation in livers, male C57BL/6J mice (CON), HFD mice characterized with the mild fatty liver induced by high-fat diet, and KKAy mice charactered with the moderately severe fatty liver induced by high-caloric diet were used. The lipid accumulation was estimated by the histological examination (HE staining) and the content of hepatic triglyceride, separately. Echo-intensity of two selected regions along the ultrasound transmission direction was recorded using a small animal ultrasonographic system, and the echo-intensity attenuation coefficient was calculated. Correlation between the echo-intensity attenuation coefficient and the content of hepatic triglyceride was analyzed by the Spearman's rank correlation analysis. The results showed that the lipid accumulation in livers increased significantly in both HFD and KKAy mice compared with CON mice and it was more serious in KKAy mice than that in HFD mice. The values of echo-intensity attenuation coefficient were also increased in sequence according to group. These values were positively associated with the content of hepatic triglyceride (r = 0.744, P < 0.01). In conclusion, the echo-intensity attenuation coefficient is a simple, impersonal, and non-invasive method for evaluating the hepatic lipid accumulation. It can be used to research the process and the treatment of fatty liver diseases in mice.

Potency is one of the most important indexes of inactivated vaccines.A number of methods have been established to assay the potency,of which the NIH test and single-dose mouse protection test are the prescribed methods.Here,we report a method to semi-quantitatively assay the potency of an inactivated rabies vaccine,which uses fewer animals and takes less time to complete.Depending on the quality requirements of a vaccine(e.g.minimum potency),a rabies reference vaccine is,for example,diluted to the minimum potency,and 50 μL of the dilution is taken to inoculate 10 mice.The same amount of the test rabies vaccine is inoculated into another 10 mice.After two weeks,all mice are bled and serum samples are assayed for viral neutralizing antibody by the fluorescent antibody virus neutralization(FAVN) test.By comparing the median and interquartile range of antibody titers of the reference vaccine with those of the test vaccine,the test vaccine potency can be semi-quantitatively judged as to whether it is in accord with the required quality.The reliability of this method was also confirmed in dogs.The procedure can be recommended for batch potency testing during inactivated rabies vaccine production.

Objective To evaluate the efficacy and safety of long pulsed Nd:YAG laser in the treatment of onychomycosis.Methods Thirty-five patients with onychomycosis were treated by long pulsed Nd:YAG laser with a wavelength of 1064 nm,power of 30-40 J/cm2,pulse width of 35 milliseconds,diameter of light spot of 4 mm.One treatment session included 4 times of irradiation at an interval of 2 minutes.Patients were treated once a week for 4 weeks followed by once a month for 6 months.Clinical and mycological efficacy was evaluated 9 months after the beginning of treatment.Side effects were recorded and analyzed.Nails were divided into various groups according to causative fungal species,clinical phenotypes,and distribution of affected nails.Data were processed by using SPSS 17.0 software.Chi-square test was performed to compare the response and recurrence rate between these groups.Results A total of 79 nails were treated by long pulsed Nd:YAG laser in this study.At 9 months after the first treatment,clinical response was observed in 67.1％ of these nails,mycological response in 73.4％,and recurrence in 19.0％.The Trichophyton rubrum group showed a better clinical (x2 =10.913,P ＜ 0.05) and mycological response (x2=13.532,P ＜ 0.05),but a lower recurrence/reinfection rate (x2 =10.980,P ＜ 0.05) compared with the other-species group.No significant difference was observed between the Trichophyton rubrum group and Candida albicans group in the clinical and mycological response rate or recurrence/reinfection rate.The clinical response in the distal lateral subungual onychomycosis (DLSO) group was significantly poorer than that in the white superficial onychomycosis (WSO) group (x2 =11.935,P ＜ 0.05),but better than that in the proximal subungual onychomycosis (PSO)/total dystrophic onychomycosis (TDO) group (x2 =17.515,P ＜ 0.05).Increased clinical response rate was observed in the second-fifth finger nail group compared with the thumb nail/second-fifth toe nail group (x2 =13.437,P ＜ 0.05)and hallux nail group (x2 =10.595,P＜ 0.05),while no statistical difference was observed in clinical response rate between the hallux nail group and thumb nail/second-fifth toe nail group (x2 =3.030,P＞ 0.05),or in mycological response rate or recurrence/reinfection rate among the second-fifth finger nail group,thumb nail/second-fifth toe nail group and hallux nail group.There was no obvious adverse reaction but pain during the treatment.Conclusions Long pulsed Nd:YAG laser appears to be an effective and safe approach to the treatment of onychomycosis,and the treatment outcome is affected by clinical types,location,and causative fungal species of onychomycosis.

Objective To compare the efficacy of and adverse reactions to a fractional micro-plasma radio-frequency technology versus fractional ultrapulsed CO2 laser in the treatment of atrophic acne scars.Methods Twenty-one patients with atrophic acne scars were enrolled in this study.Half of each subject's face was treated with micro-plasma,and the other half with fractional ultrapulsed CO2 laser,for one session.Treatments were randomly administered in a split-face manner.The efficacy and adverse effects were evaluated 6 months after the treatment by using the following outcome parameters:ECCA grading scale (échelle d' évaluation clinique des cicatrices d'acné),degrees of post-treatment pain and edema,time taken for crusting and durations of inflammatory erythema,patients' subjective rating of improvement in scar by using a quartile grading scale.A non-parametric rank test was conducted to compare the efficacy and adverse effects between the two treatments.A scar model was established on both ears of a New Zealand big ear rabbit,and treated with the CO2 laser and micro-plasma respectively,immediately followed by the resection of scar tissue for the observation of histological changes.Results A decrease of ECCAscore was observed in 90.5％ (19/21) of the patients after micro-plasma treatment,and in 86.7％ (18/21) after CO2 laser treatment; no significant difference was observed in the response rate (P ＞ 0.05).In detail,ECCA score decreased by 31.5％ (from 50.71 to 34.76 ) after micro-plasma treatment,compared to 29.9％ (from 53.57 to 38.10) after CO2 laser treatmet.Mild edema was observed after micro-plasma treatment,with the duration of erythema and crusting being 13.95 days and 6.95 days,respectively,compared to 45.81 days and 10.10 days respectively,after CO2 laser treatment.Pigmentation occurred in none of the patients after micro-plasma treatment,but in 19％ after CO2 laser treatment.Animal experiment showed that microscopic ablation zones were broad and shallow after micro-plasma treatment,but narrow and deep after CO2 laser treatment.Conclusions Fractional micro-plasma and CO2 laser are both effective for the treatment of atrophic acne scars,but the former seems to have less side effects with a lower incidence of pigmentation.

Objective To learn the status quo of core competency of registered nurses in tertiary level first-class hospitals in Liaoning Province and compare the level and characteristics of core competency of registered nurses in different working years in order to supply evidence to establish contrapuntal training protocol.Methods "The Competency Inventory for Registered Nurse scale"(CIRN,by LIU Ming)was distributed to investigate the core competency of registered nurses,the data underwent analysis.Results The overall score of core competency level was (174.11±31.89),the score of the nurses with 16～20 years of working experience was the highest,while the score of nurses working for 1～5 years was the lowest.The core competency varied with working years,evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for registered nurses from five tertiary level first-class hospitals in Liaoning Province.They are competent enough to provide health care.With the increasing length of working time,nurses' core competency level will strengthen gradually.

Objective To study the clinical diagnosis and therapy of scar pregnancy after uterine cesarean section.Methods Clinical data of 21 patients with uterine cesarean section in our hospital from June 2006 to December 2008 were retrospectively analyzed.Results The success rate of 16 cases by drug therapy (including three cases of surgical treatment) was 81.3%;3 cases of auto-discharge transferred to other hospitals to do intervention,1 case used expectant treatment,1 case used complete curettage of uterine cavity under B-Ultrasound.Conclusion Drug treatment can terminated scar pregnancy after uterine cesarean section effectively,but there is a potential risk of massive hemorrhage or uterine rupture;color doppler ultrasound,especially Transvaginal color doppler ultrasound was the primary means of cesarean section,and benefit to judge prognostic factors and observed treatment.

Objective To prepare arginine-glycine-aspartic acid (RGD)-and ribonuclease A (RNase A)-conjugated CdTe quantum dot (QD) nanoprobes,and to observe their capability to target human A375 malignant melanoma cells.Methods RNase A-modified CdTe quantum dots (CdTe RQDs) were obtained by using a microwave-based heating method,and then chemically conjugated to the RGD peptide to prepare RGD-CdTe RQD nanoprobes,which were then physically and chemically characterized by transmission electron microscopy,powder crystal diffraction,fluorescence spectrophotometry,and ultraviolet absorption spectrophotometry.A375 cells were cultured in vitro and incubated with various concentrations (20,40,80 nmol/L) of RGD-CdTe RQD nanoprobes for different durations (12,24,36,72 hours).Then,methyl thiazolyl tetrazolium (MTT) assay was conducted to estimate the proliferative activity of A375 cells.To observe the targeting capability of RGD-CdTe RQD nanoprobes,A375 cells were treated with RGD-CdTe RQD nanoprobes at the concentration determined by MTT assay for one hour followed by laser confocal microscopy.Results CdTe RQDs with good dispersion and biocompatibility were obtained by using a microwave-based heating method,and then successfully conjugated to the RGD peptide to form RGD-CdTe RQD nanoprobes.The treatment with RGD-CdTe RQDs of 20 nmol/L for 12 hours exhibited the weakest effect on the proliferative activity of A375 cells,and hence,20 nmol/L was selected for the fluorescence imaging assay.Laser confocal microscopy revealed that RGD-CdTe RQD nanoprobes were able to actively target A375 cells.Conclusion RGD-CdTe RQD nanoprobes with a favorable capability to actively target A375 cells are successfully prepared in this study.

Objective To investigate the effects of preemptive analgesia with parecoxib sodium on postoperative analgesia and delirium after nerve injury-free surgery for fracture of thoracic and lumbar vertebrae and to promote the postoperative rehabilitation of the patients. Method 80 patients meeting the criteria were selected. and randomly divided into observation group and control group.40 patients each group. The observation group used parecoxib sodium for preemptive analgesia. while the control group used sufentanil. and the analgesia effects and the incidences of delirium were observed. Results The differences in operative time and intra-operative blood loss between the patients of the two groups were statistically insignificant. In 2 h. 6 h. 12 h.24 h and 48 h after the surgery.the VAS score and the accumulative time of intravenous self-controlled analgesia pump being pressed of the observation group were significantly lower than those of the control group. and the differences were statistically significant (P<0.05). The first time for the patients of the observation group to press the intravenous self-controlled analgesia pump is (3.84±0.62) h after the surgery, is significantly later than that of the control group (1.05±0.47)h.and the difference is statistically significant (P<0.05). The incidence of delirium in 7 days after the surgery in the patients of the observation group was 10.00%. and is significantly lower than that of the control group (25.00%) (P<0.05). Conclusion Using parecoxib sodium for preemptive analgesia before nerve injury-free surgery for fracture of thoracic and lumbar vertebrae can elevate the postoperative analgesia effects of the patients.decrease the incidence of postoperative delirium, and is highly safe and consequently worthy of clinical application.

Objective To compare the clinical diagnostic value of 320 row four-dimensional CT angiography (4D-CTA)and digital subtraction angiography (DSA)in untreated arteriovenous malformation (AVM)patients.Methods Thirty-six patients with AVM diagnosed by DSA were included in this study.Two independent readers blind to the results of all examinations evaluated the find-ings of DSA and 4D-CTA of each patient.All results were then documented using a standardized scoring sheet.Results The diagno-sis results of 4D-CTA for AVM lesions in all 36 patients were accurately consistent with those of DSA,including the position,size and vascular structure.There were 14 cases with the largest diameter <3 cm,20 cases 3-6 cm,2 cases >6 cm.Lesions involved only the anterior circulation in 13 cases,only the posterior circulation in 13 cases,and both the anterior and posterior circulation in 10 cases.Conclusion 4D CTA has excellent diagnostic accuracy in the detection of AVM lesions,including size,location,feeding ar-teries and draining veins,with similar value as DSA in the clinical diagnose and evaluation of AVM.