Objective To research clinical significance of electrocardiogram(ECG) measuring in diagnosis of hyperkalemia. Methods ECG changes and serum potassium concentration from 72 cases have been analyzed and contrasted. Results Forty-one cases with hyperkalemia are detected by ECG changes. Coincidence rate is up to 56.9% with serum potassium test. When the serum potassium concentration exceeds 5.5mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 22.2%. The main features arc peaked T wave with tabernacle shape ;when the serum potassium concentration exceeds 6.7mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 74.3%. The main features are ST debased,P wave with low amplitude and time limit increased. Some patients appeared sinus node-ventride conduction. One or two appeared malignant ventricular arrbythmia; when the serum potassium concentration exceeds 10.0mmol/L,the accuracy of ECG was 100% ,most patients appeared malignant ventricular. Conclusion The electrocardiogram measurement has the better consistency with serum potassium test, and abnormal electrocardio-gram will be eccurred,when mixed other electrolyte unbalance. Pseudo-hyperkalemia can be distinguished accurately and conveniently by using this method.

Objective To investigate the curative effects of the modified coloclysis method on con-stipation in gerontal patients. Methods 80 cases of gerontal patients with constipation were divided into the observation group and the control group with 40 cases in each group.The observation group was treated with modified coloclysis method and traditional coloclysis method was used in the control group. The dura-tion of liquid retention time in enteric cavity, the times of defecation after coloclysis and relapse rate of constipation were recorded and compared. Results The retention time of liquid in enteric cavity was longer, the times of defecation after coleclysis was less and relapse rate of constipation was lower in the ob-servation group than those in the control group. Conclusions The modified coloclysis method to treat gerontal constipation is better than the traditional coleclysis method.

Objective To investigate ultrasound guidended nerve block of femoral nerve in emergency operation.Methods 40 patients who planned to accept surgery of feet,lower limb under knee.They were randomly devided into 2 groups:ultrasound guidended group and the control group.Femoral nerve and Sciatic nerve were blocked by ultrasound guidended technique or classic landmark technique.1.5% lidocaine was administered for nerve block.Sensory block was observed every 5 minutes in 30 minutes.Onset time,effect of anesthesia,algesia time and complications were recorded.T-test and varience difference were applied.Results The onset time of local anesthetics was faster in the ultrasound guided group than that of the control group.Effect of analgesia was better in in the ultrasound guided group than that of the control group. Conclusion Nerve block of femoral nerve and the sciatic nerve guided by ultrasound was better than the classic technique.

Objective To observe clinical efficacy of brinzolamide on mechanical contusion ocular trauma . Methods 50 patients(57 eyes) of mechanical contusion ocular trauma were selected and divided into observation group and control group randomly and evenly ( 29 eyes in the observe group ,28 eyes in the control group ) .On the basis of mechanical contusion ocular trauma basic treatment for all the patients , the observing group was added brinzolamide ophthalmic suspension .Their vision , intraocular pressure and ERG were observed .Results The vision of patients in the observing group was obviously better than that in the control group (χ2 =4.49,P<0.05).Intraocular pressure in the observing group (14.88 ±0.83)mmHg was obviously lower than that in the control group (19.64 ± 2.30)mmHg(P<0.05).Sum of a-wave amplitude and sum of b-wave amplitude after treatment were better than those before treatment ,and those in the observing group were higher than theose in the control group ( observation group:ta =0.44,tb =0.24;the control group:[ ta =1.03,tb =0.32;between two grous:ta =3.35,tb =2.37,P<0.05 ) ] .Conclusion Using Brinzolamide ophthalmic suspension to treat mechanical contusion ocular trauma preven -tively can obviously improve patients′vision, control their intraocular pressure and promote the recovery of retinal function.It has positive clinical effect .

Objective To investigate the effect of nursing clinical ladder program on the training of nurses in ICU.Methods Seventy seven nurses in ICU were trained with nursing clinical ladder program including defining the ladder system of nurse’s ability, regulating the standard of each level,conditions for promotion,range for practice,establishing courses.Regular assessment,classification and retraining were performed.Result After training,the qualification rate in special theory and skills was increased.The incidences of major complications were significantly lower than that before training(P<0.05).Conclusions Nursing clinical ladder program is good for the development of personal career and specialization.It may promote the improvement of positivity and the quality of nursing.

Objective To evaluate the protective effect of adiponectin in early atherosclerosis and the diagnostic value of adiponectin in metabolic syndrome in obese children. Methods Total 176 obese children and 88 normal weight children aged 9-12 years were included in the present study. All participants underwent hematologic and biochemical tests including serum adiponectin, high sensitivity C-reactive protein (hsCRP),fasting blood glucose, insulin, and plasma lipids. Homeostasis model assessment of insulin resistance (HOMA-IR)was calculated. Noninvasive ultrasound measurement including intima-media thickness of the common carotid artery(IMT), brachial flow-mediated dilatation (FMD), carotid artery compliance (CAC), and the maximum fatthickness ahead of peritoneum (Pmax) were obtained to investigate arterial mechanical properties and endothelial function. Results (1) The level of adiponectin was negatively correlated with obese index, blood pressure,fasting insulin, hsCRP, HOMA-IR, and IMT(P<0.05 or P<0. 01 ); but not with triglyceride, fasting blood glucose, CAC, high-density lipoprotein-cholesterol (HDL-C), and FMD. (2) The risk of metabolic syndrome increased 3.43 times in children with adiponectin level <7. 060 mg/L compared with ＞7. 060 mg/L. (3)Receiver operating characteristic( ROC ) curve was used to choose the optimal cutpoint of adiponectin to identify obese children with the metabolic syndrome. The area under the curve (AUC) for adiponectin to discriminate the sensitivity of metabolic syndrome was 0. 769 (95% CI0. 714-0.816, P< 0. 0 1 ). (4) The obese children were divided into three groups according to the cut-off value for adiponectin (high, middle, low groups). There were significant differences in the prevalences of severe obesity, visceral fat accumulation, hypertension, insulinemia,low HDL-C, metabolic syndrome among three groups (P<0.05). Conclusions High levels of serum adiponectin could prevent early stage of atherosclerosis. The lower the adiponectin level, the higher the incidence of metabolic syndrome.

Objective To evaluate the combination use of transcatheter arterial chemoembolization (TACE), portal vein embolization (PVE) and high intensity focused ultrasound (HIFU) in treating portal vein tumor thrombus(PVTT). Methods A total of 85 patients with primary hepatocellular carcinoma complicated by PVTT, who were encountered during the period from Jan. 2011 to Feb. 2012 at authors’ hospital, were enrolled in this study. The patients were divided into the study group (n=47) and the control group (n=38). TACE, PVE and HIFU were performed in the patients of the study group, while only TACE and PVE were carried out in the patients of the control group. The therapeutic process was as follows: PVE was carried out 2 weeks after TACE was performed, and for the patients of the study group additional HIFU was conducted about 10 days after PVE procedure. Results The short-term effective rate in the study group and the control group was 89.4% (42/47) and 39.5% (15/38) respectively, and the difference between the two groups was statistically significant (P< 0.05). The 6-month, one-year, and two-year survival rate in the study group were 87.2%(41/47), 66.0%(31/47) and 27.7%(13/47) respectively; the median survival time was 15.4 months. In the control group, the 6-month, one-year, and two-year survival rate were 55.3% (21/38), 39.5% (15/38) and 10.5%(4/38) respectively;the median survival time was 10.3 months. The differences between the two groups were statistically significant (P< 0.05). Conclusion For the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus, transcatheter arterial chemoembolization, portal vein embolization together with high intensity focused ultrasound is an safe and effective therapy as it can significantly improve the therapeutic effect and prolong the survival time.

Objective To investigate the effects of Xueshuantong injection on levels of inflammatory factors and homocysteine (Hcy) in patients with acute cerebral infarction.Methods 128 patients of acute cerebral infarction who received therapy in the hospital from January 2014 to May 2015 were collected as research objects to retrospectively analyze their clinical materials.According to therapeutic schemes, those patients were divided into control group (n=62) and observation group (n=66).The control group were given conventional treatments, such as anti-platelet aggregation, lipid regulation, maintaining balance of water-electrolyte and acid-base, controlling blood glucose, controlling blood pressure and so on.Besides that, the observation group were given Xueshuantong injection.After two weeks treatment, the curative efficacy, levels of inflammatory factors as high-sensitivity C reactive protein (hs-CRP), tumor necrosis factor α(TNF-α), interleukin 8 (IL-8), Hcy and adverse reactions were compared.Results The total efficacy of observation group was 93.9%, which was statistically higher than that of 80.6%in control group (χ2 =5.166,P=0.023).After treatment, hs-CRP, TNF-α, IL-8 levels in observation group were significantly lower than those in control group (all P<0.05).After one and two weeks treatment, The Hcy level in observation group was statistically lower than that in control group ( all P<0.05 ).The adverse reactions in observation group was 8 cases ( 12.1%), 6 cases ( 9.7%) in control group, with no significant difference between two groups (χ2 =0.196, P =0.658 ). Conclusion Xueshuantong injection is effective in treatment of acute cerebral infarction, which could significantly increase curative efficacy, alleviate inflammatory reaction and reduce level of Hcy with less adverse reactions.

Objective To investigate characteristics of symptoms, tongue and pulse of high-risk group of stroke, and provide evidence of differential treatment for stroke prevention, diagnosis and treatment of stroke, thus laying a solid foundation on further study of differential treatment system of high-risk groups of stroke. Methods With prospective observational method, 2536 cases of stroke were selected by multi-center screening, and characteristics of TCM symptoms, tongue, pulse and syndrome distribution in different gender and age were observed. Results The top five symptoms were:blurred vision (1670 cases, 65.9%), irritability (1458 cases, 57.5%), limp or pain on waist and knees (1445 cases, 57.1%), dizziness (1286 cases, 50.7%) and dry eyes (1274 cases, 50.2%). The top five tongue and pulse were:white moss (1401 cases, 55.2%), thin moss (1260 cases, 49.7%), string pulse (1201 cases, 47.4%), dark tongue (1168 cases, 46.1%) and red tongue (1027 cases, 40.5%). The detection rate of dizziness, insomnia, white coating, thin coating, etc. were higer in women than that in man (P<0.01). The detection rate of teeth shaking, greasy fur, yellow fur, string pulse, etc. were higher in man than that in woman (P<0.01). The detection rate of teeth shaking, dry eyes, thirst, dark tongue, red tongue, string pulse, etc. in the elderly group were higher than the middle-aged one (P<0.01). The detection rate of irritability, numbness, shortness of breath, scalloped tongue, thin coating, deep pulse, etc. in the middle-aged group was higher than the aged one (P<0.01). Conclusion The clinical manifestations of high-risk group of stroke are complicated. There were root deficiency such as deficiency of spleen and kidney, and branch excess such as wind-fire and phlegm-stasis. Difference and regularity were showed in different gender and different age groups to some extent.

Objective To investigate the genotypes of host killing genes and their single nucleotide polymorphisms (SNPs). Methods Three hundred and twenty strains of Escherichia coli that collected from the First Affiliated Hospital of Wenzhou Medical College were analyzed. The first sample ( E1 ) contains 160 strains isolated during the years from 2002 to 2003. The second sample (E2) contains 160 strains covering the years from 2008 to 2009. The plasmids of Escherichia coli were extracted by alkaline lysis method. Solexa/Illumina sequencing technology was used to sequence plasmids metagenome. Solexa Genome Analysis System and Soap programs were used to analyze gene distribution, SNPs and lineage-specific mutations. Results 11 077 768 reads were generated and 0. 045% of them can map to the reference sequences from El sample. Whereas 9 377 792 reads were generated and 0. 053% of which mapped to the reference from E2 sample. There are nine host killing genes identified in the two samples, of which hok gene is the most prevalent. A total of 29 SNP sites dispersed in five genes of the two samples. Approximately 33% of them were non-synonymous mutations. One position of A and G is the most prevalent polymorphism. Conclusion The known nine genotypes of host killing genes were all identified in plasmids of Escherichia coli in Wenzhou. hok gene showed the highest frequency. There were SNPs in five genotypes.