Objective To analyze the management and outcomes of patients with ST-segment elevation myocardial infarction (STEMI) in Liaoning province.Methods The data were collected from a prospective and multicenter registry study including 8 tertiary hospitals and 12 secondary hospitals in Liaoning province.Total 1429 patients with acute STEMI admitted to hospitals from June 2009 to June 2010 were included in the study.A unified follow-up questionnaire was applied on patient discharged.Results The average age of patients was (63 ± 13)years.37.4％ of patients recognized the disease as heart disease and 39.7％ were transported by emergency ambulance with a median symptom-to-door time of 150 min.52.9％ patients underwent emergency reperfusion therapy,including fibrinolytic therapy (24.4％) and primary percutaneous coronary intervention (PCI,28.1％).The in-hospital treatment included aspirin (99.6％),clopidogrel (81.9％),statins (90.1％),low molecular weight heparin (89.5％),β-blocker (66.0％),angiotensin converting enzyme inhibitor (ACEI)/ angiotensin receptor blocker (ARB)(66.6％).The in-hospital mortality was 10.7％ ; the mortality in females was higher than that in males (18.3％ vs.7.9％,P ＜ 0.01) and the mortality in older patients (≥ 65 years) was higher than that in younger patients (＜65 years)(17.0％ vs.5.2％,P ＜0.01).The follow-up treatment included:aspirin (81.1％),clopidogrel (45.0％),statins (61.0％),β-blocker (48.3％),ACEI/ARB (42.4％).The follow-up mortality was 5.0％ after hospital discharge.Conclusions Longer pre-hospital delay is commonly seen in STEMI patients.There is still certain gap of emergency reperfusion therapy and the evidence-based medication with related clinical guidelines of STEMI management in Liaoning.

Objective To explore the application value of the situation-background-assessment-recommendation(SBAR) communication mode in the patients with acute myocardial infarction (AMI).Methods Ninety-four cases of AMI patients who were hospitalized in the department of cardiology in Wuxi No.2 People's Hospital of Nanjing Medical University were included and were randomly divided into the conventional group and the SBAR group. There were 47 cases in each group. The patients in the conventional group were given the routine care; the patient in the SBAR group was given the SBAR communication mode. The nursing satisfaction and the incidence of adverse events in the 2 groups were compared.Results The nursing satisfaction in the SBAR group was 95.74%, which was significantly higher compared to the conventional group (70.21%,P<0.05). The total incidence of adverse events in the SBAR group was 4.25%; in the conventional group the incidence was 25.53%. The difference between the 2 group was significant (χ2=6.42,P<0.05).Conclusions The SBAR communication model can effectively improve the quality of the nurses' disease observation and the nursing satisfaction and reduce the incidence of clinical adverse events, which was worth clinical promotion.

Objective To investigate the effect of periodontal mechanical treatment on serum interleukin-6 (IL-6) and carotid artery matrix metalloproteinase(MMP)-2 and MMP-9 expression in chronic periodontitis(CP) SD rats with atherosclerosis (As).Methods Forty-four six-week-old male SD rats were randomly divided into three groups:control group(group A),As group (group B),As + CP group (group C).According to different periodontal interventions,group C was randomly subdivided into four groups:natural process group (C 1),the periodontal mechanical treatment group (C2),the periodontal mechanical treatment + local drugs group(C3),and the periodontal mechanical treatment + local and system drugs group(C4).Each group received the appropriate treatment and periodontal interventions.Serum IL-6 levels were determined by enzyme linked immunosorrbent assay (ELISA).MMP-2 and MMP-9 levels in the proximal aorta were examined by immunohistochemistry.Results The gray value of MMP-2 and MMP-9 was basically the same in all groups.Compared with group A,the gray value of MMP-2 and MMP-9 of group B and C were decreased.C1 group showed the formation of atherosclerotic plaque and fibrous cap.Compared with group B (126.4 ± 2.0,124.8 ± 2.8),the gray value of group C1 (101.3 ± 2.4,101.2 ± 4.1) was significantly weaker(P ＜ 0.05).The staining depth of MMP-2 and MMP-9 of groups C1,C2,C3 and C4 were sequentially decreased,and the differences of gray value were statistically significant(P ＜ 0.05).The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that of group A(P ＜ 0.01).The levels of serum IL-6 in groups C2,C3,and C4 increased gradually and reached the peak 5 weeks after the establishment of model (P ＜ 0.001).After that,the levels of serum IL-6 decreased gradually and was lower than baseline.The levels of serum IL-6 in groups C3 and C4 were significantly lower than that in group C2 7 weeks after the establishment of model(P ＜ 0.01).Conclusions In rats with periodontitis and cardiovascular diseases,chronic periodontal inflammation may significantly increase the severity of As and promote the formation of atherosclerotic plaque.Mechanical periodontal therapy may cause short-term systemic inflammation and then reduce vascular inflammation in long term.With supplement use of local and systemic antibiotics,the mechanical periodontal therapy may get the vascular disease and systemic inflammation improved.

Objective To establish chronic periodontitis model in SD rats,and to investigate the effect of oral intervention on atherosclerosis.Methods Fifty male SD rats were randomly divided into three groups,group A(normal control),group B(atherosclerosis,As) and group C(chronic periodontitis,CP).Group C was further divided into group C1(natural process),group C2(simple mechanical treatment),group C3 (systemic antibiotics),group C4-1(teeth extraction) and group C4-2(teeth extraction+systemic antibiotics),each group consisted of 7 rats.Every group received oral intervention.Serum interleukin(IL)-6 levels were detected in five different time points(1,3,5,7,9 weeks after a successful modeling) by enzyme linked immunosorbent assay.All animals were killed after 24 weeks.Matrix metalloproteinase(MMP)-2,9 in the proximal aorta was detected by immuno histochemistry.Results The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that in group A(P＜0.01).Levels of serum IL-6 were increased gradually in each intervention group(C2,C3,C4-1,C4-2) and reached its peak at 5 weeks after modeling[C2:(62.3 ± 14.3) ng/L,C3:(58.2±8.7) ng/L,C4-1:(127.0±29.9) ng/L,C4-2:(120.6± 23.1) ng/L].Compared with group B,group C4-1 and C4-2 increased most significantly(P＜0.01).Levels of serum IL-6 decreased gradually.Eventually,group C2[(28.6± 8.1) ng/L],C3[(40.8 ± 15.1) ng/L] and C4-2 [(32.7± 11.1) ng/L] were significantly lower than group B(P＜0.05),and in group C2 IL-6 was the lowest.Although levels of serum of IL-6 significantly decreased in group C4-1[(72.8± 16.4) ng/L],but remained the highest.Immunohistochemistry showed that MMP-2,9 were expressed in group B,C 1 and C4-1,and significantly higher than in group A(183.0±2.0,181.3 ± 2.0),the gray value differences were statistically significant(P＜0.01).Group C4-1 (123.1 ±2.9,121.0± 3.2) was the strongest,group B (126.4±2.0,124.8 ±2.8)and C1 (140.0±2.2,139.7±3.2) were decreased (P＜0.01).While group C2(169.3±3.4,169.7±2.3),C3 (149.0±1.7,145.1±2.5) and C4-2(157.7± 1.2,155.8±2.7) were significantly lower than group C1(P＜0.01),and group C2 was close to normal.Conclusions Periodontitis could increase the risk of atherosclerosis in rats with chronic periodontitis.Periodontal mechanical treatment and teeth extraction may increase the risk of As in the short time.However,the risk would gradually reduce in a long time.

Objective To evaluate the effect of sexual health education for female nursing students. Methods Totals of 112 female nursing students were randomly selected from grade 2012.Their sexual knowledge was evaluated, and then were divided into three groups-high, medium and low, according to their sexual knowledge.The score of sexual health education was compared among groups.Results After the health education, the total score of sexual knowledge was (75.01 ±6.84), and the score of self-care, sexual transmitted disease, gynecological disease were (26.20 ±3.57), (18.15 ±3.45) and (30.66 ±4.50), which were significantly higher than (62.73 ±8.20), (20.25 ±3.75), (16.13 ±6.27) and (26.19 ±4.97) before the education, and the differences were significant (t=12.48, 12.09, 3.15, 7.80, respectively;P<0.05). The improvement of low score group was more significant compared with the medium and high score group, and the improvement of high score group was lower than medium and low score group, and there was a significant difference (F=38.38,P<0.05).There was no significant difference among different sexual education methods (F=0.35,P >0.05).Conclusions Sexual health education is an important way to enhance the sexual knowledge of female nursing students and it is necessary to develop various sexual health education methods in colleges and universities.

Objective To explore the effect of interesting teaching combined with PBL teaching method on strengthening comprehensive electrocardiogram ( ECG) application capability of nursing interns in CCU. Methods A total of nursing interns in CCU were randomly divided into experimental group (interesting ECG combined with PBL teaching method) and control group (traditional teaching method) on average. The effect of two teaching methods were compared. Results The satisfaction degree of ECG teaching method was 85. 0%among nursing interns of experimental group, which was higher than that of the control group (50. 0% ) (χ2 =4. 103,P < 0. 05). Application ability of ECG in the experimental group was higher than that of control group (P < 0. 05). Teaching by human was (12. 5 ± 2. 3)h in the experimental group comparing with (20. 8 ± 3. 1)h in the control group, while the length of learning materials collection was (4. 5 ± 1. 2) h in the experimental group higher than (2. 8 ± 0. 5)h in the control group (t = 2. 02, 1. 92;P < 0. 01). Conclusions Interesting teaching method combined with PBL is eased and funny, and can effectively enhance comprehensive ability of ECG application and satisfaction of teaching method among 90′s nursing interns.

Objective To explore the three-dimensional interesting electrocardiogram (3D-IECG) teaching to strengthen ECG comprehensive application ability for young nurses in CCU. Methods A total of 40 young nurses, who took part in rotary internship in 2013, had been chosen and randomly divided into experimental group and control group on average. The nurses of control group received traditional method of ECG training while the nurses of the experimental group underwent 3D-IECG teaching, and the satisfaction of teaching methods and ECG comprehensive ability were compared. Results The examination of comprehensive ability in the experimental group acquired basic ECG theory (83. 02 ± 10. 01) score, operation (92. 38 ± 4. 23) score, ECG documentation ability (89. 18 ± 9. 32) score, current ECG analysis (90. 01 ± 7. 03), nursing plan making (93. 23 ± 5. 61), personnel nursing round of arhythmia (91. 29 ± 8. 78) score higher those of control group (t=2. 13, 2. 41, 2. 03, 1. 95, 2. 32, 1. 83;P<0. 05). The satisfaction of ECG teaching method in young nurses were 85. 0% of experimental group and 50. 0% of control group with statistical significance between two groups (χ2 =4. 103,P<0. 05). Conclusions The application of 3D-IECG teaching can effectively improve young nurses ECG comprehensive application ability and satisfaction of teaching method, and is worthy of clinical application.

Objective To investigate implementing approach and clinical effect of 4-dimensional innovative model basing on JCI standards on health education to elderly patients with CHD.Methods Following JCI standards, a 4-dimensional model was innovated, regarding 4 aspects of health education for elderly patients with CHD:concept, platform, transmission system and technological application. Totals of 120 elderly patients with CHD were divided randomly into observation group and control group. For the patients in the observation group, health education was conducted according to the 4-dimentional innovative model, while in the control group, routine health education approach for CHD was used, which was to hand out health pamphlets explaining knowledge concerning diet, drug, exercise, follow-up visit, etc. After 5 days of intervention, CHD organism functional status and quality of life of the CHD patients in the two groups were evaluated and compared. Indexes, such as self-management skills, were compared 6 months after discharge. Results In SAQ scoring, there were significant differences between observation group and control group regarding limitation degree of motion, attacking condition of angina or stable condition of angina, scores of satisfaction on treatment and awareness of the disease ( P<0. 05 ) . Conclusions Conducting health education to elderly patients with CHD with the 4-dimensional innovative model basing on JCI standards plays a significant role in promoting guarantee of medical safety, prevention of harmful cardiac incidents, and enhancement of treatment compliance, patients′ self-management abilities and patients′satisfaction.

Objective:To explore the effect of continuous nursing model based on family unit in long-term warfarin anticoagulation in elderly patients with mechanical heart valve replacement (MHVR) .Methods:From July 2018 to March 2021, 87 elderly patients who underwent MHVR in Wuxi Second People's Hospital and received long-term warfarin anticoagulation after surgery were selected by convenience sampling as the research subject. The patients were divided into the observation group ( n=46) and the control group ( n=41) by random number table method. The control group adopted the routine nursing model, and the observation group adopted the family unit-based continuous nursing model on this basis. The two groups of patients were compared in terms of 3 indicators, namely treatment compliance, treatment effectiveness, and treatment safety. Results:In terms of treatment compliance, the compliance rates of smoking and drinking cessation, diet control, compliance with medicines and regular review of patients in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . In terms of treatment effectiveness, the international normalized ratio (INR) compliance rate and the quality of life score of the observation group were higher than that of the control group with statistical differences ( P<0.05) . In terms of treatment safety, there was no significant difference in the incidence of bleeding events and thrombosis events between the two groups ( P>0.05) . Conclusions:The continuous nursing model based on family unit is effective and safe, and can improve the compliance of elderly patients with MHVR taking warfarin after surgery, and improve the INR compliance rate and quality of life of elderly patients.

Objective To explore the clinical efficacy of Chaiqi Ningshen Anmian Decoction(CNAD)combined with wrist ankle acupuncture(WAA)in treating chronic insomnia(CI)patients with heart and spleen deficiency.Methods CI patients diagnosed and treated at the Beijing Huairou Hospital of Traditional Chinese Medicine from April 2022 to April 2023 were selected,and patients were randomly divided into the Eszolam(ET)group and the combination group(CNAD combined with WAA)according to the random number table method,with 50 cases in each group.The primary outcome was clinical efficacy[evaluated by the Traditional Chinese Medicine Syndrome Integral(TCMSI)].Secondary outcomes included changes in cognitive function[assessed by the Montreal Cognitive Assessment(MoCA)],anxiety level[assessed by the Hamilton Anxiety Scale(HAMA)],sleep quality[assessed by the Pittsburgh Sleep Quality Index(PSQI)],glycated serum albumin(GA),serotonin(5-HT),interleukin-1 β(IL-1β),and C-reactive protein(CRP)before and after treatment in both groups.Results Before treatment,there was no significant differences in total TCMSI between the two groups(P＞0.05).After treatment,the total TCMSI of the combination group was significantly lower than that of the ET group(P＜0.05),and the treatment effectiveness rate was significantly higher in the combination group(P＜0.05).Before treatment,there were no significant differences in MoCA score,HAMA score,PSQI score,serum GA level,serum 5-HT level,serum IL-1 level and serum CRP level between the groups(P＞0.05).After treatment,the MoCA score,serum GA level,and serum 5-HT level in the combination group were significantly higher than those in the ET group(P＜0.05),while the HAMA score,PSQI score,serum IL-1β level,and serum CRP level were significantly lower in the combination group(P＜0.05).Conclusion Compared with ET,CNAD combined with WAA significantly improves insomnia symptoms in CI patients with heart and spleen deficiency,enhances cognitive function and sleep quality,and reduces anxiety levels.This may be related to the upregulation of serum 5-HT,IL-1 β and the inhibition of the inflammatory response.