Objective:To explore the effect of grasping force circle training based on knowledge, attitude and practice theory in lung cancer patients with peripherally inserted central catheter.Methods:From March 2020 to December 2021, a total of 90 lung cancer patients with peripherally inserted central catheter in the Second People's Hospital of Datong were selected as the research objects using the convenient sampling method, and were divided into the control group and the observation group by the random number table method, with 45 cases each. The control group adopted routine grasping force circle training, and the observation group conducted grasping force circle training based on knowledge, attitude and practice theory. The scores of knowledge, attitude and practice, self-management ability and the incidence of complications were compared between the two groups.Results:After intervention, the scores of knowledge, attitude and behavior of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of compliance of catheter maintenance, abnormal handling, confidence of catheter management, exercise of catheter, daily observation of catheter, information acquisition and daily life of catheter of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the incidence of complications of the observation group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Grasping force circle training based on knowledge, attitude and practice theory can improve the knowledge, attitude and practice level of lung cancer patients with peripherally inserted central catheter, improve their self-management ability, and reduce the incidence of complications.

Objective:To evaluate the left ventricular myocardial strain in patients with light chain cardiac amyloidosis (AL-CA) with normal left ventricular ejection fraction (LVEF) by three-dimensional speckle tracking imaging(3D-STI), and to explore the clinical value of 3D-STI in predicting the prognosis of AL-CA patients with normal LVEF.Methods:A total of 80 patients with AL-CA and LVEF≥50% were retrospectively analyzed in the Xijing Hospital of Air Force Military Medical University from October 2014 to May 2020.According to whether the patients had endpoint events, they were divided into endpoint event group and non-endpoint event group. The clinical data, conventional echocardiographic parameters, 3D-STI related parameters and follow-up results were collected. Cox regression proportional hazards model was used to analyze the survival status of AL-CA patients with univariate and multivariate regression analyses, in order to find the relevant indicators of conventional echocardiography and 3D-STI to predict adverse events.Results:All patients were followed up for 20(7.3, 40.8) months. At the end of follow-up, 25 patients had all-cause deaths. Compared with the non-endpoint group, the endpoint event group had significantly increased left ventricular end diastolic maximum wall thickness (MLVWT), peak early diastolic flow velocity/peak early diastolic velocity at mitral annulus(E/e′) (all P<0.05), and decreased LVEF, left ventricular global longitudinal strain (GLS) and basal segment longitudinal strain (LS) (all P<0.05). Multivariate cox regression analysis after adjusting for age and gender showed that basal segment LS ( HR=0.812, 95% CI=0.675-0.976, P=0.026) was an independent predictor of end-point events in patients with AL-CA. Kaplan-Meier survival curve showed that AL-CA patients with basal segment LS≤13.07% were more likely to have endpoint events. Conclusions:Basal segment LS can be used as a predictor of endpoint events in patients with AL-CA.

Objective To reconstruct sparse views CT image based on defective projection data.Methods The position of bad bins in detector determined whether the linear interpolation was applied to the defective projection data.Moreover,reconstruction of air pixels in CT image was achieved rapidly and accurately.Results he experimental results showed that the proposed method could solve the problem from classical ART-TV method that the robustness was unstable due to the different positions of bad bin in CT detector.Conclusion Compared to analytical reconstruction methods,iterative methods can solve the reconstruction problems in this modality so that the radiologist is facilitated to perform image processing and quantitative analysis.

Objective To analyze the reasons and treatment methods of high transprothetic pressure gradient after aortic valve replacement. Methods The clinical data of 45 patients with high transprothetic pressure gradient after aortic valve replacement were retrospectively analyzed. The patients were followed up for average 24.6 (12 - 40) months. The postoperative effective orifice area (EOA) of artificial valve was measured by transthoracic color Doppler ultrasound. Compared with published referred EOA of different artificial valve, there were 2 kinds results:measured EOA=referred EOA and measured EOA0.85 cm2/m2 and EOAI<0.85 cm2/m2. The reasons of high transprothetic pressure gradient were analyzed according to the above different standard. Results In the 45 patients with high transprothetic pressure gradient after aortic valve replacement, prosthesis-patient mismatch (PPM) was in 33 cases, and prosthetic dysfunction was in 10 cases, among whom 5 cases were because of thrombus (3 cases improved after increasing the dosage of warfarin, 2 cases underwent re-aortic valve replacement), 3 cases were because of severe bioprosthetic calcification (underwent re-aortic valve replacement), and 2 cases were because of prosthetic ring pannus and influenced movement of the leaflets (underwent re-aortic valve replacement). High flow in the left ventricular outflow tract occurred in 2 cases. The patients had no obvious discomfort, and did not receive special treatment. Four cases died, among whom 2 cases were because of severe PPM, and the other 2 cases were because of noncardiac. Conclusions Many reasons can result to the high transprothetic pressure gradient, and the PMM is the most common reason. Choosing the right treatment plan can improve the survival rate of patients.

BACKGROUND:Some control studies attempt to answer the advantages and disadvantages of high-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults, but have arrived at different conclusions. OBJECTIVE:To explore the therapeutic efficacy of high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults by Meta analysis. METHODS:PubMed, Embase, Cochranel Library, CBMdisc, VIP and WanFang Databases were searched by computer, and relevant Chinese and English orthopedic journals were retrieved by hand. Controled trials related to high-dose methylprednisolone sodium succinate therapy of acute spinal cord injury in adults were included. The methodology quality of included trials was criticaly assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION:Nine clinical controled trials were included. Meta-analysis results showed that compared with the conventional therapy, the neurological recovery rate after 24 hours of administration, pneumonia incidence and gastrointestinal reactions increased significantly after high-dose methylprednisolone sodium succinate therapy. However, there were no statistical differences in the rate of urinary tract infection, nonunion rate and stress ulcer incidence between these two therapies. These findings indicate that the high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults has better outcomes in neurological function recovery, but can lead to higher incidence of lung infection and gastrointestinal reactions. Therefore, lung infection and gastrointestinal reactions should be avoided as much as possible during the course of treatment.

To establish the identification method for Physalis angulatae fructus Seu calyx and Physalis calyx Seu fruc-tus. Methods:Four methods including macroscopy,microscopy,TLC and HPLC were used. Results: There were some differences in macroscopic and microscopic characteristics and physicochemical identification between Physalis angulatae Fructus Seu Calyx and Phys-alis Calyx Seu Fructus. Conclusion:The established method is simple and easy,which can objectively and accurately distinguish Phys-alis angulatae Fructus Seu Calyx from Physalis Calyx Seu Fructus.

Objective To explore the technological and therapeutic value of endoscope for removal of hepatobiliary necrosis after liver transplantation.Methods Data of 36 patients with suspected hepatobiliary diseases,who underwent choledochoscopy or duodenoscopy to remove necrosis after liver transplantation,were reviewed.Liver function before and after the treatment were compared.Results Hepatobiliary necrosis located in common bile duct (n =6),intrahepatic bile duct (hilar bile duct included) (n =24) and intraand extra-hepatic duct (n =6).The total success rate was 72.2％ (26/36).Full clearance of bile duct necrosis was accomplished in 16 patients,partial clearance in 15 patients and the necrosis could not be removed in 5 others.The serum bilirubin and transaminase decreased significantly,compared with those before endoscopic treatment (P ＜ 0.05).No serious complications or death related to endoscopy occurred during the treatment.After 6-84 month follow-up,in 17 survivals,3 patients underwent a second liver transplantation with good prognosis.All the survivals had a life of good quality with no placed drainage tube except for one with drainage tube for four years with unstable serum bilirubin.Nineteen patients died from biliary tract related complications or other diseases during the long-term follow-up,among which eleven patients survived beyond four years.Conclusion Endoscopy for hepatobiliary necrosis removal,a minimally invasive method,is effective and safe.

Objective To construct human canstatin gene eukaryotic expression vector and investigate the therapeutic effect of intramuscular canstatin gene delivered by electroporation on tumor growth.Methods Canstatin cDNA was amplified from total RNA extracted from fresh fetal liver by reversing transcription polymerase chain reaction (RT-PCR).The canstatin cDNA fragment was in serted into pEGFP-N1 eukaryotic expression vector.The recombination plasmid was delivered to the quadriceps of the mice with Lewis lung carcinomas by electroporation intramuscular.Fluorescence intension measured by fluorescence microscope,reverse-PCR assay,and immunohistochemistry assay were performed to detect the expression of canstatin gene in the muscle and in circulation.The tumor weight and volume were used to detect the biological effects of canstatin gene delivery.Results Recombinant eukaryotic expression vector of recombinant human canstatin was successfully constructed.The canstatin mRNA was significantly increased in the skeletal muscle and intramuscular delivery of canatatin gene by electroporation acquired the expression of enhanced green fluorescent protein (EGFP)/canstatin protein in the circulation and significantly inhibited tumor growth.The percent of the inhibition of tumor weight was 57.7 ％.Conclusions Electroporation mediated gene transfer efficiency in skeletal muscle was compared to simple plasmid injection and lasted for a long time.It was an efficient and safe,convenient and economic,gene transfer methods and might have certain clinical application value.Electroporation mediated canstatin gene transfer in skeletal muscle had obvious inhibitory effect on Lewis lung cancer in mice subcutaneous xenograft tumor growth.

ObjectiveTo approach the value of diagnosis with the 256-slice spiral CT in severe tetralogy of Fallot of infant.MethodsFrom January 2008 to December 2010,48 cases (severe tetralogy of Fallot of infant) were examined with 256-slice spiral CT preoperatively.All cases were then analyzed in workspace with maximum intensity projection(MIP),multiplanar reconstruction(MPR) and volume rendering (VR),while compared with transthoracic echocardiography (TTE) and surgical results.Results CT examination found that TTE misdiagnosis 4 cases of patent ductus arteriosus and 6 cases of aortic coarctation.Meanwhile,CT showed 6 aorta pulmonary collateral arteries in 5 cases.In 48 cases,surgical results confirmed 47 cases by 256-shce spiral CT,while 33 cases by TTE.The diagnosis accuracy rate of 256-slice spiral CT and TTE was 97.9％ (47/48) and 68.8％ (33/48) respectively.There was statistically significant difference of the two inspections in diagnostic accuracy (P ＜ 0.05).ConclusionThe inspection of 256-slice spiral CT can benefit the preoperative diagnosis and operation program in severe tetralogy of Fallot of infant.