Thoracic vascular ultrasound was used to evaluate left internal mammary artery to left anterior descending artery (LAD) bypass (LIMA) blood flow pattern in CABG patients. A transthoracic vascular transducer (5～10 MHz) was placed in the second rib space left to the sternum. Doppler spectrum was obtained under 2 D color Doppler image guide. Systolic and diastolic flow was analysed as systolic peak velocity (SPV), systolic velocity time integrate (SVTI), diastolic peak velocity (DPV) and diastolic velocity time integrate (DVTI). Successful examination was done in 106 patients ( 106/110, 94% ) , In patients with patent LIMA, Doppler spectrum showed a notable diastolic flow spectrum. The results of this study suggested that trans thoracic echocardiographic examination could provide avaluable blood flow information. A notable diastolic flow spectrum can be taken as a sign of satisfactory LIMA coronary diastolic myocardium perfusion.

Objective To evaluate the nursing effect of wenjing moxibustion with ginger in zhuang medicine to knee osteoarthritis (KOA), which can provide an effective nursing intervention for KOA. Methods Totally 80 cases were divided into two groups by random number table. There were 40 cases in zhuang moxibution group and 40 in traditional moxibution group. These two groups were taken the same nursing intervention and exercise. However zhuang group were spend 20 minutes and covered by ginger mud on zhuang xiguan point, and fire moxa on the ginger mud. Xuehai, Liangqiu, Neixiyan, and Waixiyan were chosen and fired moxa cone with ginger in traditional group that spent 20 minutes. It was observed the knee pain and swelling before and after 1 week during the treatment. 2 groups were compared with the cost of treatment. Results There was no different in pain and swilling before treatment (P>0.05), but there was significantly difference after 1 week in two groups (t=14.72、12.90;7.04, 2.73, P﹤0.01). It was significantly different in two groups after 1 week treatment (t=-5.06,-3.64, P﹤0.01). There was no significantly difference in the cost of treatment (F=0.041 6, P>0.05). Conclusions these two nursing intervention can release pain and swelling. However it is effective and no different in the cost of treatment when using wenjing moxibustion with ginger in zhuang medicine.

Objective To investigate the effects and mechanisms of prostaglandin E2 receptor subtype 3 (EP3) on transforming growth factor β1 (TGF-β1)-induced mouse mesangial cells damage. Methods Primary mouse mesangial cells were separated and cultured. Three siRNAs were synthesized and transfected into mesangial cells for silencing EP3 by LipofectamineTM 2000 and the best one was chosen. MCs were grouped into: (1)control group; (2)TGF-β1 (10 μg/L) group; (3)NC-siRNA plus TGF-β1 (10 μg/L) group; (4) EP3-siRNA group; (5)EP3-siRNA plus TGF-β1 (10 μg/L). Then the proliferation of MCs was evaluated by CCK-8 assay. The expression of PGE2 and cAMP in cell supernatant were detected by ELISA. The mRNA and protein expression of fibronectin (FN), connective tissue growth factor (CTGF), cyclooxygenase-2 (COX2), membrane-bound prostaglandin E2 synthase 1 (mPGES1) were detected by real - time quantitative PCR and Western blotting. The phosphorylation of p38 MAPK and ERK1/2 was decected by Western blotting. Results Compared with control group, the cell proliferation induced by TGF-β1 was increased (P<0.05), the expression of PGE2 and cAMP were improved, mRNA and protein expression of FN, CTGF, COX2 and mPGES1 were up-regulated (all P<0.05). Compared with TGF-β1 group, the cell proliferation in EP3-siRNA plus TGF-β1 group was reduced, the expression of FN, CTGF, COX2 and mPGES1 mRNA and protein were downregulated (all P<0.05), the phosphorylation of ERK1/2, p38 MAPK were also declined (P<0.05). Conclusion EP3-siRNA may reduce TGF-β1-induced cell damage through upregulating the expression of cAMP, repressing the activity of ERK1/2 and p38 MAPK, inhibiting the expression of COX2 mPGES1 and PGE2 by feedback, then decreased the expression of FN and CTGF.

Objective To explore the effects and mechanisms of prostaglandin E2 (PGE2) receptor 1 antagonist (SC-19220) on proliferation,prostaglandin synthase and extracellular regulated protein kinases (ERK) signal pathway induced by transforming growth factor β1(TGF-β1) in glomerular mesangial cells.Methods Mouse glomerular mesangial cells (GMCs) were divided into 5 groups:control group,TGF-β1 (10 μg/L) group,TGF-β1 (10 μg/L) plus SC-19220 group (0.1,0.5,1.0 μmol/L).The proliferation of GMCs was measured by CCK-8.The PGE2 in supernatant was measured by ELISA.The expression of connective tissue growth factor (CTGF),laminin (LN),cyclooxygenase 2(COX2),membrane-bound prostaglandin E2 synthase 1 (mPGES1) protein and mRNA was examined by Westem blotting and real-time quantitative PCR,ERK1/2 or phospho-ERK1/2 was measured by Western blotting as well.Results TGF-β1 induced the proliferation of GMCs and increased the secretion of PGE2.Besides,TGF-β1 significantly up-regulated the expression of CTGF,LN,COX2 and mPGES1 mRNA and protein (P ＜ 0.05),and increased the expression of phospho-ERK1/2 protein (P ＜ 0.05).However,SC-19220 significantly attenuated the changes of above-mentioned parameters and their activities (P ＜ 0.05).All the effects of SC-19220 were in dose-dependent manner.Conclusions SC19220 may reduce TGF-β1-induced cell damage by suppressing the activity of ERK1/2,and feedback inhibition of COX2,mPGES1 and PGE2,thus decreases the expression of LN and CTGF.

Objective Analyzing the performance of microbial barrier of needleless positive pressure closed connectors. Methods Three kinds of brand needleless positive pressure closed connectors were chosen to do the access of microorganisms test. Results Positive results were detected in the three experimental groups. Conclusions So far, lots of the connectors are not qualified strictly on the market, some improvement is required in the structure design and process.

Objective The aim of this paper is to study the hemostasis and security of soluble hemostatic gauze in the rabbit liver hemorrhage model.Methods After making the rabbit liver hemorrhage model, the control group used sterile gauze to stop bleeding, the positive control group used TISTAT to stop bleeding, the test group used soluble hemostatic gauze to stop bleeding. Hemostasis, blood loss and animal clinical symptoms were measured. Liver and kidney parameters, along with histopathology were recorded and analyzed. Transmission electron microscopy examination was also done. Results The blood loss is cut back and hemostasis is shortened in the test group. Other tests have no difference with the control group.Conclusion No toxic effects on rabbit are found in the test group. The hemostatic effects have no difference with positive control group.

Objective:To explore the potential biomarkers and pathogenesis of diabetic kidney disease (DKD) using bioinformatics techniques.Methods:Three DKD glomerular tissue datasets, GSE30528, GSE96804, and GSE104948, were downloaded from the gene expression database. The bioinformatics techniques, combined with machine learning, were applied to screen DKD biomarkers and establish a DKD gene diagnostic model. The CIBERSORT algorithm was applied to analyze immune cell infiltration in DKD glomerular tissue. The correlation between biomarkers and immune cells, model risk scores, and the glomerular filtration rate (eGFR) of patients was investigated.Results:A three-gene model consisting of G6PC, CDH10 and TPPP3 was screened and established from 26 differentially expressed genes, which showed good diagnostic efficacy in both the training set (AUC=0.984) and validation set (AUC=0.992). Analysis of infiltrating immune cells in DKD glomerular tissue showed that γδ T cells, activated NK cells, M2 macrophages, resting dendritic cells, resting mast cells, activated mast cells, and neutrophils may be involved in the DKD process, and that G6PC, CDH10 and TPPP3 were associated with multiple immune cell infiltrations. Using the model to calculate the risk score of DKD patients, the higher the score, the lower the eGFR level, and the risk score was significantly negatively correlated with the eGFR level. Conclusions:G6PC, CDH10 and TPPP3 can be good diagnostic markers for DKD, correlate with DKD immune cell infiltration, and be used as targets for DKD diagnosis and treatment.

Objective To explore the risk factors of early venous thromboembolism (VTE) based on Caprini risk assessment model among patients with thoracoscopic lobectomy for lung. Methods From June 2015 to December 2017, retrospective analysis was used to collect the data of 28 patients with pulmonary embolism one week after thoracoscopic lobectomy for lung of Shanghai Chest Hospital, Shanghai Jiaotong University, in observation group. And we selected 84 patients with the same operation in the same term by convenience sampling in control group according to the ratio of 1:3. Patients of two groups were scored with the Caprini risk assessment model. Single factor analysis and Logistic regression analysis were used to the risk factors in Caprini risk assessment model and related factors of lung lobectomy. Results The Caprini score of patients group in observation group was higher than that in control group with a significant difference (P＜0.01). The proportion of moderate risk and high risk in patients with VTE was 78.6% in observation group and was 20.2% in control group with a statistical difference in the risk classification (P＜ 0.01). Logistic regression analysis took patients in case group as dependent variable and 16 risk factors in clinical baseline information as the independent variable showed the body mass index≥25 kg/m2, smoking history, preoperative plasma D-dimer higher than the critical value had positive correlations with the risk of VTE after surgery (OR=13.354, 5.639, 3.084;P＜0.05). Conclusions The Caprini risk assessment model can well determine the risk factors of VTE among patients with thoracoscopic lobectomy for lung. The high risk factors of VTE of these patients may include long-term and heavy smoking, overweight and preoperative plasma D-dimer higher than the critical value.

Objective To strengthen the management of the handover and transfer process of surgical patients in the department of thoracic surgery, improve surgery and transfer efficiency and ensure transfer safety. Methods In 2015, Shanghai Chest Hospital, Shanghai Jiaotong University reconstructed a nursing team by building the surgical handover and transfer process, analyzed the needs of transferees and transferees and the factors contributing to low efficiency and high safety risks in transfer, rebuilt, optimized and standardized the existing surgical handover and transfer process in the department of thoracic surgery, and enhanced relevant training after the process was rebuilt. Totally 1591 transferred patients who received thoracic surgery between January and March 2015 were selected as a control group, while 2126 patients who received thoracic surgery from January to March 2016 were selected as an observation group. The handover and transfer efficiency before and after the rebuilt process was then compared, including time of handover delay for the first surgery, time of delay for consecutive surgery, the number of patients detained in operation rooms postoperatively as well as doctors and nurses′ satisfaction to the rebuilt process.Results After the process was rebuilt, the delay rate for the first surgery was 1.7%; the delay rate for consecutive surgery was 2.7%; the retention rate in recovery rooms was 2.8%, lower than the figures before the process was rebuilt (χ2=24.059, 63.146, 53.675;P＜0.01). Doctors and nurses′ satisfaction to the rebuilt process was ＞90%.Conclusions Management optimization by process reengineering helps to improve surgical handover and transfer efficiency, safety as well as doctors and nurses′ satisfaction.

OBJECTIVEAnalyzing the performance of microbial barrier of needleless positive pressure closed connectors.

METHODSThree kinds of brand needleless positive pressure closed connectors were chosen to do the access of microorganisms test.

RESULTSPositive results were detected in the three experimental groups.

CONCLUSIONSSo far, lots of the connectors are not qualified strictly on the market, some improvement is required in the structure design and process.