Objective:To study and analyze the application effect of intervention plan based on unplanned readmission risk model (LACE) in the rehabilitation of patients with acute myocardial infarction (AMI) complicated with cardiac shock (CS) after percutaneous coronary intervention (PCI).Methods:Ninety-three patients with AMI complicated with CS who received PCI in Tianjin Union Medical Center from January 2019 to December 2020 were enrolled. The patients were divided into LACE intervention group ( n = 46) and routine intervention group ( n = 47) according to the different nursing intervention methods. The patients in the routine intervention group received routine interventions, including drug care, diet care, psychological care, health education and telephone follow-up, while those in the LACE intervention group were assessed for the risk of LACE, and then intervention measures were formulated according to the score of LACE index, including strengthening risk awareness, life behavior, daily life ability, self-care ability, health recovery and health needs. The follow-up period in both groups was 3 months. The changes of cardiac function, incidence of adverse cardiac events, readmission rate, self-management ability after intervention and quality of life level before and after intervention were compared between the two groups. Results:There was no significant difference in cardiac function or quality of life before intervention between the two groups. After intervention for 3 months, the cardiac function and quality of life in the two groups were improved as compared with those before intervention. The left ventricular ejection fraction (LVEF) in the LACE intervention group was significantly higher than that in the routine intervention group (0.533±0.076 vs. 0.492±0.072, P < 0.05), the left ventricular end diastolic diameter (LVEDD) was significantly lower than that in the routine intervention group (mm: 47.09±7.01 vs. 53.23±7.15, P < 0.01), and the World Health Organization Quality of Life-brief (WHOQOL-BREF) score was also significantly higher than that in the routine intervention group (66.32±6.19 vs. 55.79±7.26, P < 0.01). The scores of self-management ability in the coronary heart disease self-management scale (CSMS) after intervention in the LACE intervention group were significantly higher than those in the routine intervention group (adverse hobbies score: 17.37±3.24 vs. 14.21±2.73, symptoms score: 14.82±3.11 vs. 10.56±2.65, emotional cognition score: 16.17±2.83 vs. 12.95±2.41, first aid score: 11.85±1.94 vs. 10.62±1.56, disease knowledge score: 15.58±2.73 vs. 12.68±2.61, daily life score: 17.80±2.61 vs. 14.33±2.36, treatment compliance score: 11.47±1.84 vs. 8.56±1.23, all P < 0.01). The incidence of adverse cardiac events and readmission rate in the LACE intervention group were significantly lower than those in the routine intervention group (10.87% vs. 29.79%, 4.35% vs. 17.02%, both P < 0.05). Conclusion:The intervention plan based on LACE risk model can effectively promote postoperative rehabilitation of patients with AMI complicated with CS after PCI, and also help to improve patients' self-management ability and quality of life, which is worthy of clinical promotion and application.

This study reported two women with extreme obesity who underwent metabolic surgery due to their mutations in leptin receptor (LEPR).Genomic DNA was extracted from the anticoagulant blood samples of the two patients and their parents.A panel of genes related to metabolic diseases or whole exon sequencing was screened and the results were confirmed by Sanger sequencing.This is the first time that these three mutations in LEPR were reported.Two patients complained insatiety and early-onset obesity since childhood at clinics.Patient 1 was a 39-year-old woman with height 150 cm,weight 130 kg,and BMI 57.8 kg/m2.Serum leptin level was 156.4 μg/L.A homozygous mutation of c.2317G＞T was found in exon 15 of LEPR gene in patient 1,which was descended from her father and mother respectively.Patient 2 was a 37-year-old woman with height 158 cm,weight 167 kg,and BMI 67 kg/m2.Serum leptin level was 193.4 μg/L.Genetic analysis showed compound heterozygous mutations of c.1482delT and c.1892C ＞ A.Her father showed heterozygous c.1482delT mutation,and her mother carried heterozygous c.1892C ＞ A mutation.Two patients all underwent metabolic surgery with body weight reduction of about 22 kg and 40 kg respectively after first six months.However,the follow-up studies showed that the body weight of patient 1 rebounded to pre-surgery level in two years and patient 2 did not further lose weight in the following six months.

Implant restoration ; Provisional restoration ; Healing abutment ; Esthetic zone ; Esthetic outcomes: To compare the esthetic outcomes of peri-implant soft tissue conditioning with provisional restorations and healing abutments. Methods : A total of 48 patients missing a single tooth in the esthetic zone were chosen for the present study and divided into two groups. Twenty-six patients in Group A used provisional restorations to condition the peri-implant soft tissue before final restorations, while 22 patients in Group B used healing abutments to condition the soft tissue. All patients were evaluated by pink esthetic scores (PESs) at the time of the final restoration and at a 1-year follow-up. Results: A total of 26 implants in Group A and 22 implants in Group B showed good peri-implant soft tissue condition. PESs at the time of the final restoration and at the 1-year follow-up in Group A were 8.18 and 8.35, respectively, and 6.73 and 8.18 in Group B, respectively. PESs at the time of final restoration and at the 1-year follow-up were not significantly different in Group A but were significantly different in Group B. The PESs of the two groups were significantly different at the final restoration but were not significantly different at the 1-year follow-up. Conclusions Provisional restoration in the esthetic zone can improve the pink esthetic effect when permanent restoration.

Objective: To evaluate the clinical effect of two different resin cements on the glass fiber-reinforced posts. Methods : One hundred and thirty-six teeth were randomly divided into two groups, with sixty-eight in each. Group A used Multilink N self-etch system and group B used RelyX Unicem self-adhesive system to bond fiber posts. Follow-up examinations took place at 6, 12 and 24 months after the placement. Results : The success ratios of two groups were all 97% above and there was no significant difference between two groups (P > 0.05). Conclusion Multilink N self-etch system and RelyX Unicem self-adhesive system all have good effect on glass fiber-reinforced posts bonding.

Objective To compare proprotein convertase subtilisin/kexin type 9 (PCSK9) levels between premenopausal and postmenopausal women,and to investigate the relationship between serum PCSK9 and metabolic factors.Methods Totally 515 women were enrolled from the study on diabetes of prediction,prevention,and intervention in Nanjing in 2009.Survey,physical examinations,and determination of related metabolic indexes were performed.Serum PCSK9 level was measured by sandwich ELISA.Results Serum PCSK9 level was positively correlated with low density lipoprotein-cholesterol (LDL-C),total cholesterol (TC),triglyceride,fasting plasma glucose,body mass index,waist-hip ratio,and age in women (all P＜0.01).PCSK9 level was significantly lower in premenopausal women than that in postmenopausal women [(58.18 ± 25.44 vs 80.91 ± 33.74) ng/ml,P ＜0.01].Conclusion Higher level of PCSK9 exists in postmenopausal women compared with premenopausal women.The level of PCSK9 is closely correlated with age,TC,and LDL-C.

The effect of cholesterol ester transfer protein(CETP) on SR-B1 mRNA expression in mouse liver was investigated.The results demonstrated that CETP transgenic mice showed lower serum total cholesterol and high density lipoprotein-cholesterol levels but higher total cholesterol and cholesterol ester content in liver when compared with wild type mice(P＜0.05).The expression of SR-B1 mRNA in liver of CETP transgenic mice was significantly lower as compared with the control group(P＜0.05).

OBJECTIVE: To sum up the diagnosis and surgical treatment of oblique vaginal septum syndrome (OVSS). METHODS: The clinical data of OVSS patients from January 2005 to June 2010 were retrospectively analyzed. The patients were divided into 2 groups: a re-operation group (n=11)and a first-operation group (n=17).The general clinical data, surgery Methods and outcome between 2 groups were compared. RESULTS: The number of patients with pelvic mass on first attendance in the re-operation group was significantly more than those in the first-operation group(χ(2)=8.134,P=0.004). Only 1 patient was diagnosed during the first operation in the re-operation group. All the patients were diagnosed with OVSS in the first-operation group. Except for 1 case of hysterectomy in the post-cavity of the septum in each group, the basic operation was oblique vaginal septum resection. All the patients were followed up. Symptoms as the pelvic mass, irregular vaginal bleeding, and vaginal flow of purulence completely disappeared, and dysmenorrhea symptoms completely disappeared or apparently improved. CONCLUSION The diversity of clinical manifestations of OVSS increases the difficulty of diagnosis and treatment. In younger patients with pelvic mass,primary dysmenorrheal, and one side renal agenesis, OVSS should be highly suspected. The basic treatment for OVSS is septum resection and drainage, and the correct pre-operative diagnosis is critical. If necessary, combination of hysteroscopy with laparoscopy will be helpful.
Adolescent ; Adult ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Syndrome ; Urogenital Abnormalities ; diagnosis ; surgery ; Vagina ; abnormalities ; surgery ; Young Adult

Objective To investigate imaging and clinical findings of severe adenoviral pneumonia in children.Methods The imaging and clinical findings of severe adenoviral pneumonia in three children were retrospectively analyzed. All cases underwent radiography and CT examinations of chest. Results Two patiens showed fairly homogeneous opacity with air bronchograms in segmental or lobar distribution in left lung,in company with volume decreased in one case. There was interstitial change in 1 case,pleural effusion in one case and heart shadow enlarged in 3 cases. All of patients had cough and fever (range,38.4℃～40.3℃). Physical examinations showed decreased breathing sound and crackles in all cases. Laboratory findings included abnormally elevated aspartate aminotransferase,lactic dehydrogenase, hydroxybutyric dehydrogenase and creatine kinase and positive adenovirus examination in all cases. Conclusion Lobar pneumonia in company with liver and heart dysfunction should be suspected as the severe adenoviral pneumonia in children.

Objective To investigate the possible signaling mechanisms by which recombinant human platelet-derived growth factor (rhPDGF) accelerated healing of cutaneous wound in diabetic rats. Methods Four full-thickness skin wounds were incised in the back of 26 male Wistar diabetic rats. The wounded rats were divided into 3 groups (7 or 8 rats each group). One group without treatment was used as a control, and the other 2 groups were treated with rhPDGF at a dose of 7.0 μg/cm2 wound or vehicle ( DMSO/0.9%NaCl, vol/vol 1:1) from 1 to 14 days. The wound healing was evaluated by the measurements of the wound volume and area. Immunofluorescent and immunohistochemical staining were used to examine the phosphorylation of extracellular signal-regulated kinase 1/2(ERK1/2) and the expression of proliferative cell nuclear antigen (PCNA), respectively. Results Granulation tissue appeared in the bed of wound after injury. The number of blood capillary buds and fibroblasts was greater in the rhPDGF-treated group than that in the other 2 groups. A lot of inflammatory cells infiltration and collagen deposition were observed in the wound. The wound-volume in the rhPDGF-treated group was smaller than that in control group ( P ＜ 0.05). The reepithelialization rate in rhPDGF-treated group was higher than that in the other 2 groups at 7 days after injury ( P ＜ 0.05). The expression of PCNA in reparative cells was higher in rhPDGF-treated group than in control group or vehicle-treated group at 3,7 days after injury( P ＜ 0.05). The phosphorylation of ERK1/2 was stronger in rhPDGF-treated group than that in control group or vehicle group at 7 and 14 days after injury( P ＜ 0.05). Conclusion These results suggest that rhPDGF accelerates wound healing and improves healing quality by increasing the phosphorylation of ERK1/2.

Objective To study the imaging features of primary mediastinal cysts,and to improve the diagnostic ability of these diseases.Methods The imaging findings of primary mediastinal cysts proved by pathlolgy in 42 cases were retrospectively.All of cases underwent posteroanterior and lateral views of chest.The plain and contrast-enhanced CT scans were performed in 28 and 15 cases.MRI examination was done in 6 cases.The location,size,shape,density,edge,wall and adjacent structures of the primary mediastinal cysts were observed.According to imaging features all of cases was divided into typical group and atypical group.Results The mediastinal cysts were located in anterior mediastinum in 28 cases,in middle mediastinum in 7 cases,in posterior mediastinum in 7cases.Bronchogenic cyst was in 9 cases.Cystic lymphangioma was in 4 cases.Thymic cyst was in 11 cases.Pericardial cyst was in 5 cases.Mature cystic teratoma was in 13 cases.The typical group was in 38 cases.The atypical group was in 4 cases.Conclusion 90% of the typical primary mediastinal cysts can be diagnosed.The final diagnosis of the atypical group desponds on pathology.