Objective To evaluate the clinical efficacy of direct percutaneous coronary intervention (PCI) in ST segment elevation acute myocardial infarction (AMI) Methods From April 2000 to April 2004, 458 patients with ST segment elevation AMI were randomized to receive invasive therapy ( n =205) or non invasive therapy ( n =253) Comparison was made in the 30 day mortality rate, major cardiac events rate, reinfarction rate during hospitalization, left ventricular ejection fraction (LVEF) and end diastolic diameter (EDD) of echocardiograph in 2 weeks after AMI between the 2 groups The PCI group was divided into 3 sub groups according to number of stenosis artries found during angiography We try to find not the relation between left ventricular function and the number of coronary artery with stenosis Results The result of selective coronary artery angiography in 205 PCI patients was: 66 patients with single branch lesion (32 2%), 68 patients with double branches lesion (33 2%) and 71 patients with triple branches lesion (34 6%) 203 patients were operated successfully (99%), 228 stents were placed on lesions, 194 patients (94 6%) obtained TIMI grade Ⅲ perfusion of the IRA Compared the invasive with the non invasive group, the in hospital 30 day mortality rate was 2 9% vs 9 1% ( P

Impaired glucose regulation includes three types, isolated-impaired fasting glucose, isolated-impaired glucose tolerance and combined glucose intolerance.The epidemiologic studies and pathogenetic studies indicate that each type has different characteristics of insulin secretion and insulin sensitivity.The distinct metabolic features conduce to different early interventions in order to prevent or delay their progress to type 2 diabetes.

Objective To observe the effect of Xingnao Kaiqiao Acupuncture on cognitive impairment post stroke. Methods Fifty-four patients from July, 2013 to December, 2015 with cognitive impairment post stroke were randomly divided into experimental group (accepted Xingnao Kaiqiao Acupuncture and repetitive transcranial magnetic stimulation) and control group (repetitive transcranial magnetic stimula-tion only). They were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and 4 weeks after treatment. Results The scores of MMSE and MoCA improved after treatment in both groups (t>3.52, P<0.01), and improved more in the experimental group than in the control group (t>2.29, P<0.05). Conclusion Xingnao Kaiqiao Acupuncture may further im-proved the recovery of cognitive impairment post stroke based on repetitive transcranial magnetic stimulation.

Objective To investigate the effect of health education and behavioral intervention on the self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.Methods From March 2012 to April 2013,70 patients with gastrointestinal malignant tumor whose lifetime was estimated to be within 6 months were extracted from five general hospitals in Tangshan.70 patients were randomly divided into the intervention group and the control group with 35 cases in each group.The two groups samely received routine nursing care,while the intervention group was given health education and behavioral intervention.Both groups were evaluated by SPBS-CP before and after intervention.Results The scores of the intervention group after intervention were lower than before intervention and the control group,which were reflected in 3 dimensions such as care burden,psychological and emotional burden and treatment burden.Conclusions Health education and behavioral intervention can effectively relieve self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.

The aim of this study was to evaluate the diagnostic value of MRCP and ERCP in patients with chronic pancreatitis. A total of 262 patients were diagnosed as charonic pancreatitis by clinical feature, screenage and pathology from January 1993 to December 2001 in Changhai Hospital. Among them 120 patients who had been subjected to MRCP and ERCP were analyzed retrospectively. There were 106 patients discovered constriction, dilatation and calculuses of pancreatic, bile ducts, and diagnosed chronic pancreatitis by MRCP, the sensitivity was 88 3%. Also there were 108 patients discovered cholangiopancreatic disorder and diagnosed chronic pancreatitis by ERCP, the sensitivity was 90%. No statistical difference was found between interpretations based upon MRCP and ERCP( P =0 678). Results from both MRCP and ERCP discovered 96 patients with chronic pancreatitis; the agreement rate in diagnosis was 81 4%. Furthermore, 118 patients were diagnosed chronic pancreaitis by MRCP or ERCP, and the sensitivity was up to 98 3%. In addition, all examined patients were succeeded and no severe complications were found in regard to examination itself. So MRCP is as sensitive as ERCP when detecting chronic pancreatitis. Furthermore, it is feasible to presume that all chronic pancreatitis cases could be diagnosed by MRCP combined with ERCP.

To evaluate the possible method for the diagnosis and treatment of chronic pancreatitis (CP), two hundred and sixty two cases of CP from January 1993 to May 2001 were involved and analyzed retrospectively. Etiologic factors in this group included 68 3% of biliary disorders, 21 4% of alcoholic intake, 29 8% of acute pancreatitis (AP) episode history, and 13% of pancreatic divisum (PD). The major symptom of CP was discomfort or pain over the upper abdominal. Ultrasonography, CT, MRCP, ERCP, and EUS were useful for the diagnosis of CP. One hundred and thirty two patients were treated conservatively, and 78 patients were treated with endoscopy, while only 52 patients were treated with operation. The short term remission rates of symptoms were satisfactory in all cases, and long term ones in 238 patients. Biliary disorders were the most common etiology for CP in this group.The results suggest that the clinical symptoms of CP are not specific and choices of image tools for diagnosis of CP are important. Medication can be used in mild CP patients, but in patients ac companied with sever complications and stubborn abdominal pain surgical operation should be carried out. Furthermore, endoscopy is a useful tool not only for the diagnosis of CP but also for its treatment.

BACKGROUND:Vertebroplasty with bone cement injection in treatment of osteoporotic vertebral compression fractures has a positive clinical outcome, but there is a big controversy on the optimal timing of surgery. OBJECTIVE:To analyze the effect of fracture time on bone cement dispersion within pathologic vertebrae in vertebroplasty treatment. METHODS: Totaly 160 elderly patients with osteoporotic vertebral compression fracture were included, and al were treated with vertebroplasty with high viscosity bone cement injection. According to the duration from fracture to surgery, patients were divided into three groups: fresh fracture group (< 3 weeks), subacute group (3-6 weeks) and old group (> 6 weeks). The bone cement distribution features, diffusion and leakage within the pathologic vertebrae were analyzed by three-dimensional CT image and X-rays. RESULTS AND CONCLUSION:The bone cement dispersion volume was ranked as fresh group > subacute group > old group, and there was significant difference between groups (P < 0.05). Bone cement dispersion characteristics of each group were uniform distribution with cement-based lumpy shape. The vast majority of bone cement al can disperse to exceed vertebral midline, reaching the upper and lower lamina to a greater degree. Bone cement dispersion coefficient within the pathologic vertebrae of patients in each group was 

Objective To deeply study the soft skills that pediatric nurses should have. Methods 8 pediatric registered nurses were interviewed, the whole interviewing process was fully noted, then the data were analyzed acconting to Colaizzi methods. Results Soft skills that pediatric nurses should have included: affinity, empathy, caring about others, sympathy, communication skills, spirit of contribution, a bridge for com-munication between patients and doctors, resolving conflicts skills, cooperation, seE-regulation, stress manage-ment, emotion management and working achievements. Conclusions Soft skills are very important to pedi-atric nurses, so we need progress it gradually.

AIM To evaluate the prevention and treatment of N-(2-mercaptopropionyl)-glycine sodium (MPG-Na) and tiopronin (MPG) on acute liver injury. METHODS The experimental mouse model of hepatotoxicity induced by D-galactosamine (Gal) was applied to investigate preventive and remedial effects. In the preventive experiment, the mice were ip administered with MPG-Na or MPG 37.5，75 and 150 mg·kg~(-1), respectively, for 7 d. Gal 800 mg·kg~(-1) was ip given into the mice 30 min after the last administration. In the remedial experiment, the mice were ip given Gal 800 mg·kg~(-1) and 30 min later followed by MPG-Na or MPG 37.5, 75 and 150 mg·kg~(-1) , respectively, for 2 d. The mice were euthanized and serum was prepared 24 h (pre-treatment) or 48 h (post-treatment) after Gal injection. The activities of serum glutamyl pyruvic transaminase (GPT) and glutamyl oxaloacetic transaminase (GOT), the contents of total protein (TP) and albumin (Alb), and the Alb/globulin (A/G) ratio were determined. The liver tissues were collected for histopathological assessment (HE staining) under light microscope. RESULTS Compared with normal control group, the activities of serum GPT and GOT in model group were significantly increased. The injuries such as fatty degeneration and liver cell necrosis were observed. Compared with model group, the activities of GPT and GOT in pre-treatment groups were obviously decreased in MPG-Na 150 mg·kg~(-1) group. In post-treatment groups, the activity of GPT decreased in 3 MPG-Na groups. The contents of TP, Alb and A/G ratio had little change. In addition, MPG-Na alleviated the injuries such as fatty degeneration and liver cell necrosis obviously. Compared with MPG, MPG-Na showed similar effect. CONCLUSION MPG-Na has an obvious protective effect against Gal-induced acute liver injury in mice and the efficiency is equivalent as MPG.

Objective To investigate the effects of insulin on vascular diameter of the peri -infarct region and infarct volume after cerebral infarction in mice. Methods Forty male C57/BL6j mice w ere randomly divided into a control group ( n = 5), a cerebral infarction group ( n = 15), a cerebral insulin resistance group (n = 5), and a cerebral insulin resistance infarction group ( n = 15). A model of cerebral infarction w as induced by the photochemical method. A model of cerebral insulin resistance w as induced by intracerebroventricular injection of streptozocin. Tw o -photon confocal microscope w as used to in vivo evaluate the changes of vascular diameter in the peri-infarct region at 20 min after insulin injection into the cerebelomedulary cistern. After modeling of cerebral infarction, artificial cerebrospinal fluid or insulin (10 ng/ml) w as immediately injected into the cerebelomedulary cistern, and the effect of insulin on cerebral infarct volume w as evaluated at 24 h after infarction. Results Insulin did not have significant effect on various types of cerebral vascular diameters in the normal control group, but it significantly contracted cerebral arteries ( -23.16% ±6.86% and -23.32% ±6.40%, respectively; al P <0.001) and penetrating arteries ( -15.20% ±5.51% and -16.40% ±4.27%, respectively; al P < 0.001) in the cerebral insulin resistance group and the cerebral insulin resistance infarction group, but it did not have any effect on the diameters of the cerebral veins. There w ere no significant differences in the vasoactive effects of insulin betw een the cerebral infarction group and the normal control group, as w el as betw een the cerebral insulin resistance group and the cerebral insulin resistance infarction group. Insulin significantly reduced the volume of cerebral infarction in the cerebral infarction group (9.0 ±1.0 mm3 vs.6.0 ±1.2 mm3; t = 4.294,P =0.002), and it did not have significant effect on the volume of cerebral infarction in the cerebral insulin resistance infarction group ( 12.6 ±2.3 mm3 vs.11.6 ±1.7 mm3; t = 0.782, P = 0.456). Conclusions Insulin can reduce ischemic brain injury in normal mice and can not affect the cerebrovascular diameter of the peri-infarct region. The neuroprotective effect of insulin is not significant in cerebral insulin resistance in mice, and it may be associated w ith the vasoconstrictor effects of insulin in the peri -infarct region.