Objective To evaluate the implementation effect of continuous nursing care in patients after percutaneous coronary intervention. Methods Totally 200 patients underwent coronary intervention were equally divided into the control group and the experimental group. Randomization was done by sealed envelopes. Routine nursing was applied inthe control group while the patients inthe experimental group werenursed continuously. Compliance of taking medication, the incidence of major adverse cardiac events (MACE events), satisfactory rate of the patients and the occurrence of stent restenosis were compared between the two groups. Results There was a significant difference between the experimental group and the control group in compliance of taking medication from the 6th month. According to the Morisky measurement, the score of the 6th month in the experimental group was 8.00 ± 0.00, while the control group was 7.66 ± 0.82. There was a statistical significance between the two groups (t=-4.086, P<0.01); the score of the 12th month in the experimental group was 7.94 ± 0.48, and for the control group, the score was 7.28 ± 1.58, the difference was statistically significant (t=-3.899, P<0.01). The major adverse cardiac events (MACE events) were 1% (1/100) and 4%(4/100) for the experimental and control group respectively. The satisfactory rate of the patients in the experimental group and the control group were 98%(98/100) and 81%(81/100) separately. The difference between the two groups was of statistical significance (χ2=36.39, P<0.01). The restenosis rate of the two groups was 1.2% (1/82) and 2.5% (2/79) separately, which was of no significance (χ2=0.392, P=0.613). Conclusions Continuous nursing can significantly improve the patients′ medication compliance, reduce the occurrence of MACE events, and improve the satisfaction of nursing care.

Objective To analyze diagnostic experience of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and assess its surgical results.Methods Six children with ALCAPA had been diagnosed in our hospital from Mar. 2006 to Oct.2007 aged from 6 months to 10 years old(median 43.5 months).The medical data included common clinical presentations,the findings of electrocardiogram(ECG),the echocardiogram,ECG-gated 64-slice computed tomography,the digital subtraction angiogram (DSA),surgical records and the outcome.Results Diaphoresis,fantod,breathlessness and difficult feeding were commonly presented in 5 cases ALCAPA and the 5 children presented with left ventricular failure in infancy.The predominant ECG findings were Q waves and ST segment changes in the anterolateral chest leads in 4 cases,ST changes in 1 case,and normal ECG in 1 case.Cross-sectional echocardiography showed dilated left ventricles with poor contractility in 4 cases,medium mitral regurgitation in 2 cases and severe mitral regurgitation in 2 cases,aneurysmal dilatation of the right coronary artery(RCA) in 2 cases.CT and DSA examinations showed characteristic changes in these children.The surgical reestablishment of a two-coronary system was performed in 5 cases,direct reimplantation in 2 cases and creation of an autologous extrapulmonary tunnel in 3 cases.Simultaneous mitral annuloplasty was performed in 2 cases.After operation,the symptoms of 5 cases were all improved and none died.Conclusions Understanding the clinical manifestations and lab findings of ALCAPA is helpful to making an early diagnosis of ALCAPA.Early surgical treatment can improve the patients′ outcome.

Objective To observe the effect of acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation on patients with deglutition disorder of early stroke.Methods 80 patients with deglutition disorder of early stroke were randomly divided into treatment group and control group,40 cases in each group.The treatment group was treated with acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation,while the control group was only treated with deglutition training.The therapeutic effects of all patients were assessed by using drinking experiment before therapy and twenty times after therapy. Results The total effective rate of the treatment group was 97.5%,which was significantly higher than 82.5% of the control group,the difference was statistically significant(χ2 =12.50,P <0.05).Watian integration of the two groups were decreased after treatment,the difference was significant(t =5.606,9.056,all P <0.05),which of the treatment group was significantly lower than the control group,the difference was statistically significant(t =3.044,P <0.05). The lung infection rate and malnutrition rates in the control group were 10.0% and 20.0%,which were significantly higher than those in the treatment group(2.5% and 5.0%),the differences were statistically significance(χ2 =4.80, 10.29,all P <0.05).Conclusion Acupuncture plus thunder fire moxibustion plus deglutition training plus VitalS-tim electrical stimulation are beneficial to the recovery of swallowing functions to early swallowing disorder in patients and could avoid the incidence of aspiration pneumonia and malnutrition.

To improve the class effectiveness,different teaching methods were chosen based on the characteristics of pharmacy students,such as to stimulate the students’ interest,raise the independently ability,design the appropriate multimedia content and practice.

Adolescent ; Biopsy ; Cough ; etiology ; Diagnosis, Differential ; Female ; Fever ; etiology ; Humans ; Lung ; diagnostic imaging ; pathology ; Sarcoidosis, Pulmonary ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To investigate outcomes of different operations in treatment of cervical spinal fracture in patients with ankylosing spondylitis and summarize experiences and bases in selection of operation.Methods A retrospective study was done on 19 patients with cervical spinal fracture following ankylosing spondylitis treated between 2005 and 2011 and received complete follow-up.Among them,nine patients were treated with combined anterior and posterior surgical approach (combined treatment group),seven with single posterior surgical approach (posterior approach group) and three with single anterior surgical approach (anterior approach group).Clinical data,follow-up data and image outcome of the patients were collected and compared.Results All patients received average 14 months of follow-up (range,12-20 months).In combined treatment group,the fracture was healed at postoperative 4-6 months.One patient had palsy of recurrent laryngal nerve but was recovered at postoperative three months.Seven patients with incomplete spinal cord injury had at least one level improvement in neurological function according to American Spinal Injury Association (ASIA) classification.No implant loosening or shifting were found in internal fixation.In posterior approach group,fracture was healed at postoperative 4-6 months,with no surgical complications,loosening or shifting of implants.Five patients with incomplete spinal cord injury had at least one level improvement in neurological function according to ASIA classification.In anterior approach group,an additional operation for implant loosening was performed in one patient at postoperative four weeks.The other two patients obtained fracture healing at postoperative four and five months respectively,without implant loosening.Condusions Combined anterior and posterior approaches can not only be the first choice for treatment of cervical spinal fracture following ankylosing spondylitis,but also be used for patients with bone defect at fracture site or separation at fracture end,with no necessity of postoperative external fixation.Single posterior reduction and fixation can be considered in patients with transvertebral fracture in the absence of bone defect,separation at fracture end,displacement or slight displacement,with necessary postoperative external fixation.However,single anterior fixation takes risk of implant failure and needs postoperative external fixation.

Objective To study risk factors of cardiovascular disease (CVD) and status of bone mineral density (BMD) in women with hypoestrogenism.Methods From Jul 2011 to April 2013,a total of 256 women with hypoestrogenism in the First Affiliated Hospital of Shanxi Medical University were enrolled in this retrospective study,which were divided into four groups:133 women in ppausal group,25 women in premature ovarian failure (POF) group,67 women in menopausal transition group and 31 women in premature ovarian failure transition group.General statue,CVD risk factors and BMD were compared among four groups.General statue include menopausal period,menopausal symptoms (Kupperman Index),CVD risk factors include body mass index,blood pressure,waist circumference,waist-hip ratio,blood lipids and glucose,BMD include left hip,lumbar spine bone mineral density and T or Z value.Results (1) The median menopausal period were 3.4 years in postmenopausal group and 3.6 years in premature ovarian failure group,which did not show no statistical difference (P ＞ 0.05).Kupperman Index in four groups were 12 in postmenopausal group,9 in POF group,9 in menopausal transition group and 8 in premature ovarian failure transition group,which reached statistical difference (P ＜ 0.05).(2) The difference of body mass index (BMI),waist circumference,waist-hip ratio,diastolic blood pressure were no statistically significant among four groups(P ＞ 0.05) ; the systolic blood pressure in four groups were 120,110,110,110 mm Hg (1 mm Hg =0.133 kPa),their differences were statistically significance (P ＜ 0.05); the high-density lipoprotein (HDL-C) was 1.6 mmol/L in postmenopausal group,and 1.3 mmol/L in premature ovarian failure transition group,their differences were all statistically significance (P ＜ 0.05) ; the difference of the fasting plasma glucose (FPG) was not statistically different in 4 groups (P ＞0.05).(3) The abnormal rate of lower bone mass in lumbar spine were 57％ (46/81) postmenopausal group,8/15 in POF group,32％ (9/28) in menopausal transition group,12/19 in premature ovarian failure transition group,and osteoporosis was 9％ (7/81),3/15,1％ (3/28)and 0 respectively,their differences were statistically different (P ＜ 0.05) ; the abnormal rate of BMD of left hip and lumbar spine of 11/15 and 12/16 in POF group was higher than 65％ (53/81) in postmenopausal group.In the mean time,the abnormal rate of BMD of left hip and lumbar spine were,12/19 and 10/20 in premature ovarian failure transition group,which were significantly higher than 43％ (12/28) and 39％ (12/31) in the menopausal transition group.Conclusions The menopausal symptoms resulting from hypoestrogenism in natural postmenopausal women are mostly remarkable.The decrease of BMD in lumbar spine is more significant than that of left hip among postmenopausal women.Women with earlier menopause was prone to cause the changes of blood fat and abnormal of BMD,especially HDL-C decreased significantly compared with those natural postmenopause,it is more likely to cause CVD and osteoporosis.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

The influence extent of students from teachers is related to the teaching effect , which means whether it can successfully promote the study of students and reach the expected teach-ing goal during the teaching process. To have a good teaching effect, guided by the micro-system en-gineering of teaching reform, we used SIMPP to analyze the related factors of the influence of students extent from teachers during the teaching process in TCM colleges and universities. The result shows that the influence extent from teachers is related to not only teachers themselves but students and their self-condition and family backgrounds as well. Going further in researching these factors and the related behavior patterns of influence extent of students from teachers is helpful to making the teach-ing more effective and more targeted.

Purpose To investigate the correlation between BRAF V600E mutation and clinicopathologic parameters in bilateral welldifferentiated thyroid carcinoma.Method Collected 80 patients with papillary thyoid carcinoma (PTC) (67 patients with classical type,8 patients with follicular variant,3 patients with oncocytic variant,2 patients with tall cell variant),5 patients with follicular carcinoma and 30 normal tissues near the tumor,BRAF V600E mutation was detected via polymerase chain reaction.Result The presence of BRAF V600E mutation was found in 52 patients with PTC (65.0％),the mutation was not in the 5 patients with ollicular carcinoma as well as in the 30 normal tissues near the tumor.The BRAF V600E mutation was positively correlated with age,capsule invasion,lymph node metastasis,tumor clinical stage.In the histological variant of PTC,the BRAF V600E mutation rate of classical type and tall cell variant is very high (70.1％,100.0％),but the BRAF V600E mutation rate of follicular variant is very low (33.3％).Conclusion The BRAF V600E mutation rates are different in different age groups.The BRAF V600E mutation was positively correlated with capsule invasion,lymph node metastasis,tumor clinical stage.The BRAF V600E mutation rate of classical type and tall cell variant is very higher than follicular variant.