Objective:To explore whether metoprolol administration before emergency percutaneous coronary inter‐vention (PCI) can reduce incidence rate of reperfusion arrhythmia (RA) or not .Methods :According to random number table ,a total of 80 patients with acute anterior wall myocardial infarction (age< 75 years ,baseline heart rate >70 beats/min ,no PR interval prolongation ) were randomly and equally divided into routine treatment group (didn't receive metoprolol tartrate tablet before emergency PCI ) and metoprolol group (received metoprolol tartrate tablet 25 mg before emergency PCI ) .Incidence rate of RA after PCI was compared between two groups .Results:In metoprolol group ,a total of 32 cases received PCI and eight cases received percutaneous transluminal coronary angioplasty (PTCA);in routine treatment group ,a total of 35 case received PCI and five cases received PTCA ,suc‐cess rates of both groups were 100% .In metoprolol group , RA occurred in 4 cases ,including one case with ventric‐ular fibrillation (VF);in routine treatment group , RA occurred in 15 cases ,including four cases with VF .Inci‐dence rate of RA after emergency PCI in metoprolol group was significantly lower than that of routine treatment group (10.0% vs .37.5% ,P=0.032) .Conclusion:Metoprolol administration before emergency PCI can reduce in‐cidence rate of reperfusion arrhythmia in patients with acute myocardial infarction .

Objective:Comparative analysis of imaging features of abdominal CT, B ultrasound and magnetic resonance cholangiopancreatography in three different methods for detection of extrahepatic bile duct stones. Methods: A random sample of extrahepatic bile duct stones were a sample of 150 cases as the object of study, patients in the endoscopic retrograde cholangiopancreatography after diagnosis, followed by B ultrasound examination, the implementation of CT scanning and MRI imaging in 142 cases, including 78 cases of B ultrasound detection, CT detection, 118 cases underwent MRI examination. Results: The detection results were recorded and compared the 3 imaging methods. Results: The positive rate of B ultrasound 39.4%, the positive rate of CT was 53.8%, MRI positive rate was 86.4%, the positive rate of MRI was significantly higher than that of B ultrasound and CT (x2=59.725, x2=25.595; P<0.01), the detection rate of CT was significantly higher than that of B ultrasound(x2=4.231, P<0.05). Diameter less than 8 mm of extrahepatic bile duct stones with B ultrasound and positive rate of 25%, the positive rate of CT was 33.3%, MRI positive rate was 60%, the positive rate of MRI was significantly higher than that of B ultrasound and CT(x2=7.789, x2=7.789;P<0.01), the detection rate of CT with no significant differences between the B ultrasound. Conclusion:MRI of extrahepatic bile duct stones with B ultrasound and the positive rate of CT is higher, but the clinical needs according to the comprehensive evaluation of individual patients, economic status, symptoms, diagnosis method for selecting suitable.

Objective Health education provided by medical staffs can promote the patients 'abilities of self management . This article explored the teaching mode of health education course for nursing students of college to undergraduate level . Methods Reform took place in the course of health education for nursing students of Grade 2009 to 2012 who studied in the medical school of col-lege to undergraduate in Nanjing Genernal Hospital .The unidirectional teaching method was replaced by trinity teaching method which included cases , situational analogue training and clinical situation experience .In their clinical internship , the same questionnaire was used by designated personnel to survey the satisfaction degree of the patients , the clinical teachers and the nurses themselves .Analysis and comparison were conducted on the materials of satisfaction degree from 2009 to 2011 . Results Significant difference was found in the satisfaction degree of the patients , the clinical teachers and the nurses before and after the application of trinity teaching model (93.4%vs 56.9%, 91.6%vs 59.7%, 99.3% vs 78.1%). Conclusion The trinity teaching model is of high practical value , which is worth popularizing .

Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Encephalopathy of prematurity is still an important reason which affects the survival and quality of life of preterm infants. During hospitalized in neonatal intensive care unit(NICU),a variety of environmental factors such as noise,light,too much tactile stimuli,pain,and maternal - infant separation all will affect the development of preterm infants' brain,leading to encephalopathy of prematurity. Therefore,need to attach importance to the effects of NICU environment on the growth and development and the neurological function of preterm infants,try to optimize the environment of NICU,to reduce the incidence of brain injury of prematurity,improve the long - term prognosis of pre-term infants.

Objective To investigate good nutritional measurements of CKD patients.In order to diagnose malnutrition early in CKD patients.Methods Clinical data of 125 CKD patients have been collected.The glomerular filtration rate(GFR)was estimated from the modification of diet in renal disease(MDRD).According to the results of GFR,all CKD patients were divided into five groups.The levels of biochemical markers were assayed.At the same time,bioelectrical impedance analysis(BIA)were measured.We analyzed the relationship between nutritional parameters and GFR.Results According to SGA,malnutrition rate in fifth CKD stage is 29%.Impedance of leg is significantly correlated to GFR in 1kHz,50kHz and 500kHz,impedance of truck is also significantly correlated to GFR in 50kHz and 500kHz.The values of impedance reduced with the decreasing of GFR.Conclusion SGA and BIA all can be used to evaluate nutritional status of CKD patients.BIA is a more sensitive method to detect early malnutrition and may be useful in monitoring nutrition changes in CKD patients.

Bronchopulmonary dysplasia(BPD)is the main cause of chronic respiratory diseases in preterm infants.The research on the prophylaxis and treatment of BPD has been a concern of neonatologists because of its high incidence and poor prognosis in preterm infants.Glucocorticoid is a major therapy in the treatment of BPD because the pathological changes of BPD are characterized by persistent lung inflammation.Until now, a large number of clinical studies including different types and administration methods of glucocorticoids have been conducted.Compared with other types of glucocorticoids, low-dose and short-course dexamethasone has its unique advantages in the treatment of BPD.This article reviews the role of inflammation in the pathogenesis of BPD and the research progress of glucocorticoids in the prophylaxis and treatment of BPD.

Basal Ganglia ; Brain Neoplasms ; diagnosis ; therapy ; Germinoma ; diagnosis ; therapy ; Humans ; Thalamus

Acute Disease ; Adolescent ; Adult ; Aluminum Compounds ; poisoning ; Child ; Female ; Humans ; Male ; Middle Aged ; Pesticides ; poisoning ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.