Objective To explore the risk factors for in stent stenosis (ISR) in coronary artery disease in elderly patients undergoing postoperative percutaneous coronary intervention (PCI).Methods We chose 418 cases undergoing PCI in our hospital.There were 263 males and 156 females,aged from 60 to 79 years,average (71.3--8.9)years in this study.Under the same conditions of treatment strategies,we collected all possible risk factors for ISR in patients undergoing postoperative PCI,and statistics were analyzed.Results All patients were rechecked at 1 year after PCI.104 cases (24.9％) occurred ISR,and 314 cases (75.1％) were diagnosed without ISR.Multiple logistic analysis showed that,and sex had little effect on ISR incidence (P＞0.05).Body mass index(OR=9.54,95％CI:6.542～32.154,P=0.002),smoking history(OR=26.01,95％CI:5.532～122.238,P=0.000),hypertension(OR=15.72,95％CI:3.240～76.026,P=0.001),diabetes mellitus(OR=11.98,95％CI2.667～53.835,P=0.001),history of high cholesterol(OR=8.98,8,95％CI2.164～37.283,P=0.003),exercise time (OR 5.63,8,95 ％ CI2.004 ～ 25.385,P=0.013)had positive correlations with ISR incidence.Conclusions Effective control of risk factors including smoking,hypertension,diabetes,high cholesterol,proper exercise,and weight control can help prevent the development of ISR in elderly patients with postoperative PCI.

Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.

Objective To evaluate the efficacy of retroperitoneoscopic adrenalectomy for pheochromocytoma.Methods From January 2000 to October 2006,a total of 16 patients(aged from 32 to 65 with a mean of 42 years) with pheochromocytoma received retroperitoneoscopic adrenalectomy in our hospital.Among the cases,6 had the tumor on the right side,and 10 on the left.The size of the tumors ranged from 2.5 to 4.6 cm in diameter(mean,3.1 cm).Results The mean preoperative preparation time in this series was 11 days(range,6 to 28).The retroperitoneoscopic adrenalectomy was completed in all but one of the patients,who were converted to open surgery because of extensive adhesion of the tumor to surrounding tissues and massive bleeding.The mean operation time was 110 minutes(90 to 170),and the mean blood loss was 135 ml(80 to 650).Three cases,who had normal blood pressure and thus received no noradrenalin immediately after the surgery,was given noradrenalin emergently 4,6,or 56 hours later owing to a sudden drop of systolic pressure(from 135 mm Hg to 80 mm Hg in 2,and from 140 mm Hg to 85 mm Hg in 1).Postoperative examination showed benign pheochromocytoma in 15 of the cases,and low-grade malignant pheochromocytoma with local invasion of the capsule in the patient who was converted to open surgery.The mean postoperative hospital stay was 12 days(9 to 20).The patients were followed up for 3 to 24 months(mean,13),during which only one received antihypertensive drugs;the others restored normal blood pressure spontaneously.No patient had abnormal levels of 24-hour urine noradrenalin,adrenalin,and catecholamine.Conclusions Retroperitoneoscopic surgery is an effective and minimally invasive treatment for patients with adrenal pheochromocytoma.The patients have a few complications and recover quickly after the operation.Preoperative preparation and postoperative treatment are important for the outcomes of the disease.

The subject nature of nursing science was defined as that of humanity and social science.Qualitative and quantitative methods should be combined in studies of nursing science .Only the research methods of nursing science are used , can the nursing science turn out an independent subject .

Objective To explore the effects of intensive health education on psychological stress of outpatients with chronic HBV infection. Methods A convenient sample of 80 patients was selected as the subjects of the study. They were randomly allocated to the control and the intervention group with 40 patients in each group. The intervention group received intensive heath education, which was designed spe-cially by researcher, while the control group just received the routine clinic health education. Demographic Data Recording Form (DDRF) and the Perceived Stress Scale specific to Hepatitis B Patients (PSSH) were used to assess the intervention effect pre-treatment and 3 months after intervention. Results The scores of PSSH were high in two groups before intervention. Compared with the control group, the intensive health education decreased the score of PSSH more significantly in the intervention group. Conclusions The intensive heath education can reduce the psychological stress of the outpatients with chronic HBV infection.

Objective To assess left ventricular(LV) regional and global systolic function of patients with coronary artery disease using strain parameter of velocity vector imaging(VVI) technique in quiescent condition. Methods Thirty patients with coronary artery disease and 30 healthy volunteers were enrolled in this study. The two-dimensional gray scale images were obtained in apical 4-chamber view,apical 2-chamber view and long axis view of left ventricle, and three levels of the short axis views(mitral valve, papillary muscle and cardiac apex). The LV wall was divided according to 18 segment model and the longitudinal,radial and circumferential systolic strain (SL, SR, SC) of each segment were analyzed. The difference between the epicardial and endocardial strain measurement were defined as strain gradient and the average of each strain component as global systolic strain. The correlation between global systolic strain of each strain component and the LV ejection fraction(LVEF) were analysed. Results Group A (coronary stenostic degree≤70%) included 176 segments, compared with control group, LS and LS gradient (LSG) decreased significantly from control group( P ＜0.05), while there was no significant difference in CS, RS and CS gradient (CSG) ( P ＞ 0.05). Group B ( coronary stenostic degree＞ 70% ) included 132 segments, compared with control group, LS, CS and RS decreased significantly in group B ( P ＜ 0.05), while there was no significantly difference in LSG and CSG( P ＞0.05). There were also significant difference in LS, RS,CS and LSG between group A and B( P ＜0.05). Global systolic strain of each strain component shown significant correlation with LVEF (P ＜ 0.0001 ). And the global longitudinal systolic strain (GLS) correlated with LVEF most tightly. Conclusions Strain parameter of VVI technique could not only accurately analyze the LV systolic dysfunction but also reflect the stenostic degree of coronary artery. GLS could be a new index for LV systolic function assessment in patients with coronary artery disease.

Objective To estabolish a scientific, objective, comprehensive and quantitative combined with qualitative evaluation indicator system for research input-output effeciency, which is applied especially for grade 3 and firt-class hospital in Xinjiang Uygur aotunomous region.Methods We analyzed the research input-output effeciency of one hospital.We performed three time questionaires to 25 experts who come from different fields, by using Delphi method and analytic hierarchy process.Based on screening estimation of experts, we determined the indicators, the weight and the standards of each indicator, the logic consistency of the above were tested, and the model of input-output ratio was set up.Results The response rate of three-time quesitonaires was above 85％.Authority coefficient of estimation indicators from experts was above 0.7.The kandall coefficient of concordace was between 0.179 and 0.442, P＜0.01.We estabolished evaluation indicator system for research input-output effeciency composed of 5 grade Ⅰ indicators, 12 grade Ⅱ indicators and 28 grade Ⅲ indicators.Conclusions This study result is reliable, the index system conform to the industry standard and regional characteristics.In order to improve the hospital performance level, increaseing investment in scientific research should be needed.Combined with scientific research input-output, the management should take measures to optimize the allocation of resources, broaden the way of project application fighting for money, pay attention to personnel training amd form a scientific research team.

AIM: To investigate the changes of cardiac function, oxidative stress and apoptosis in myocardium of rat model of heart failure induced by adriamycin (ADR). METHODS: At the end of the study, we observed content of malondialdehyde (MDA), activity of superoxide dismutase (SOD) and apoptosis. Expression of P53 protein and p53 mRNA were measured with immunohistochemical method and RT-PCR, respectively. RESULTS: Our data showed that content of MDA increased, activity of SOD decreased and apoptosis in myocardium happened while cardiac function decreased after ADR treatment. p53 gene expression and P53 protein obviously increased in heart failure group. CONCLUSION: There were oxidative stress and apoptosis occurred significantly in a model of heart failure induced by ADR. p53 gene might play an important role in the apoptosis. Correlation analyses suggested that apoptosis in myocardium is related to oxidative stress in ADR-induced heart failure.

Objective To study the effect of total rhizoma panacis japonica saponins (tRPJS) on hemorheology in rats with occlusion of the middle cerebral artery. Methods Ischemia rat models were made by using the method of thread inserting right middle cerebral artery occlusion. The effects of tRPJS on whole blood viscidity, erythrocyte deformability and erythrocyte congregate in model rats were observed. Results tRPJS 200, 100, 50 mg/kg could significantly improve the erythrocyte deformability, reduce whole blood viscidity and erythrocyte congregate. Conclusion tRPJS can improve the hemorheology after cerebral ischemia. It may be one of the mechanisms for tRPJS in treating ischemic stroke.

Objective:To observe the effect of calcitonin gene-related peptide (CGRP) on the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in osteoblast cells through an in vitro breast cancer cell and osteoblast cell co-culture system. Methods:The metastatic breast cancer MDA-MB-231 or MDA-MB-435 cells were co-cultured with osteoblast MG63 cells to establish an in vitro microenvironment of bone metastasis of breast cancer. After treated with CGRP(1?108 mol/L),OPG and RANKL mRNA and protein expressions in osteoblast MG63 cells were examined by RT-PCR and Western blotting. Results:Expression of RANKL in osteoblast MG63 cells was up-regulated at both mRNA and protein levels when osteoblast MG63 cells were co-cultured with breast cancer MDA-MB-231 or MDA-MB-435 cells,while those of OPG in osteoblast MG63 cells were both down-regulated (P