Objective To compare the clinical efficacy and safety of intravenous thrombolytic therapy with recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) and reteplase plasminogen activator (r-PA) in patients with acute ischemic stroke (AIS). Methods A total of 108 AIS patients admitted to the department of emergency of Pucheng County Hospital from January 2018 to December 2020 were selected as research objects. According to different intravenous thrombolytic drugs,the patients were divided into rhTNK-tPA group (60 cases) and r-PA group (48 cases). The rhTNK-tPA group was treated with 0.25 mg/kg rhTNK-tPA,which was dissolved in 3 mL sterile water for injection and rapidly injected intravenously within 5-10 s. In the r-PA group,18 mg r-PA was dissolved in 100 mL normal saline,10 mL was injected intravenously within 3 minutes,and the remaining 90 mL was infused intravenously within 1 hour. The National Institute of Health Stroke Scale (NIHSS) score was used to evaluate the changes in the degree of neurological deficit in the two groups before treatment and 24 hours,7 days and 14 days after treatment. Barthel index (BI) score was used to evaluate the changes in the activities of daily living (ADL) of the two groups. The coagulation function indicators,differences in clinical efficacy and the incidence of symptomatic intracranial hemorrhage (sICH) between the two groups were observed. Results Activated partial thromboplastin time (APTT) and prothrombin time (PT) after thrombolytic treatment in rhTNK-tPA group were significantly longer than those before treatment[APTT (s):34.20±7.62 vs. 29.73±5.76,PT (s):13.98±3.15 vs. 10.16±1.92,both P<0.05],the international normalized ratio (INR) was significantly higher than that before treatment (1.21±0.31 vs. 1.06±0.12,P<0.05),and the fibrinogen (Fib) was significantly lower than that before treatment (g/L:2.45±1.03 vs. 3.35±1.31,P<0.05). In the r-PA group,only Fib was significantly decreased after treatment (g/L:2.28±0.98 vs. 3.40±1.37,P<0.05). PT in rhTNK-tPA group was significantly higher than that in r-PA group (s:13.98±3.15 vs. 11.23±2.43,P<0.05). The NIHSS scores at each time point after thrombolysis were significantly lower than those before thrombolysis in both groups and the NIHSS scores at 24 hours and 7 days after thrombolysis in rhTNK-tPA group were significantly lower than those in r-PA group (24 hours after treatment:5.96±1.54 vs. 7.55±2.16,7 days after treatment:2.48±0.75 vs. 3.29±0.88,both P<0.05). BI scores at 24 hours,7 days and 14 days after thrombolytic therapy were significantly higher than those before thrombolytic therapy in both groups (rhTNK-tPA group:78.92±9.68、85.66±9.79、92.63±9.98 vs. 66.46±8.83,r-PA group:77.87±9.70、83.49±9.68、91.36±9.80 vs. 67.45±9.16,all P<0.05),but there was no significant difference in BI scores between the two groups at each time point. The total effective rate of thrombolysis in rhTNK-tPA group was significantly higher than that in r-PA group[93.3％ (57/60) vs. 85.4％ (41/48),P<0.05]. In terms of safety outcomes,the incidence of sICH within 36 hours after thrombolysis in rhTNK-tPA group was significantly lower than that in r-PA group[6.67％ (4/60) vs. 10.42％ (5/48),P<0.05]. Conclusions The use of rhTNK-tPA or r-PA intravenous thrombolytic drugs in the treatment of AIS is safe and effective. Compared with r-PA,rhTNK-tPA can improve the symptoms of neurological deficit faster,with higher safety and total effective rate.

Objective To compare the clinical efficacy and safety of intravenous thrombolytic therapy with recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) and reteplase plasminogen activator (r-PA) in patients with acute ischemic stroke (AIS). Methods A total of 108 AIS patients admitted to the department of emergency of Pucheng County Hospital from January 2018 to December 2020 were selected as research objects. According to different intravenous thrombolytic drugs,the patients were divided into rhTNK-tPA group (60 cases) and r-PA group (48 cases). The rhTNK-tPA group was treated with 0.25 mg/kg rhTNK-tPA,which was dissolved in 3 mL sterile water for injection and rapidly injected intravenously within 5-10 s. In the r-PA group,18 mg r-PA was dissolved in 100 mL normal saline,10 mL was injected intravenously within 3 minutes,and the remaining 90 mL was infused intravenously within 1 hour. The National Institute of Health Stroke Scale (NIHSS) score was used to evaluate the changes in the degree of neurological deficit in the two groups before treatment and 24 hours,7 days and 14 days after treatment. Barthel index (BI) score was used to evaluate the changes in the activities of daily living (ADL) of the two groups. The coagulation function indicators,differences in clinical efficacy and the incidence of symptomatic intracranial hemorrhage (sICH) between the two groups were observed. Results Activated partial thromboplastin time (APTT) and prothrombin time (PT) after thrombolytic treatment in rhTNK-tPA group were significantly longer than those before treatment[APTT (s):34.20±7.62 vs. 29.73±5.76,PT (s):13.98±3.15 vs. 10.16±1.92,both P<0.05],the international normalized ratio (INR) was significantly higher than that before treatment (1.21±0.31 vs. 1.06±0.12,P<0.05),and the fibrinogen (Fib) was significantly lower than that before treatment (g/L:2.45±1.03 vs. 3.35±1.31,P<0.05). In the r-PA group,only Fib was significantly decreased after treatment (g/L:2.28±0.98 vs. 3.40±1.37,P<0.05). PT in rhTNK-tPA group was significantly higher than that in r-PA group (s:13.98±3.15 vs. 11.23±2.43,P<0.05). The NIHSS scores at each time point after thrombolysis were significantly lower than those before thrombolysis in both groups and the NIHSS scores at 24 hours and 7 days after thrombolysis in rhTNK-tPA group were significantly lower than those in r-PA group (24 hours after treatment:5.96±1.54 vs. 7.55±2.16,7 days after treatment:2.48±0.75 vs. 3.29±0.88,both P<0.05). BI scores at 24 hours,7 days and 14 days after thrombolytic therapy were significantly higher than those before thrombolytic therapy in both groups (rhTNK-tPA group:78.92±9.68、85.66±9.79、92.63±9.98 vs. 66.46±8.83,r-PA group:77.87±9.70、83.49±9.68、91.36±9.80 vs. 67.45±9.16,all P<0.05),but there was no significant difference in BI scores between the two groups at each time point. The total effective rate of thrombolysis in rhTNK-tPA group was significantly higher than that in r-PA group[93.3％ (57/60) vs. 85.4％ (41/48),P<0.05]. In terms of safety outcomes,the incidence of sICH within 36 hours after thrombolysis in rhTNK-tPA group was significantly lower than that in r-PA group[6.67％ (4/60) vs. 10.42％ (5/48),P<0.05]. Conclusions The use of rhTNK-tPA or r-PA intravenous thrombolytic drugs in the treatment of AIS is safe and effective. Compared with r-PA,rhTNK-tPA can improve the symptoms of neurological deficit faster,with higher safety and total effective rate.

Objective To explore the willingness ofhemodialysis nurses and current application of indwelling needles for dialysis. Methods Based on the method of random survey and SPSS 22.0 statistical software, 295 hemodialysis nurses from 34 hospitals in Shenzhen were investigated by aself-designed questionnaire in a way to explore and application of indwelling needles for dialysis and the nurses' willingness of using them. Results Among 248 collected valid questionnaires, there were 200 (80.6%) hemodialysis nurses who are willing to use dialysis indwells. Univariate analysis showed the results are influenced by the class of hospitals and the safety of indwelling needles in their mind (P＜ 0.05). Multivariate analysis showed that whether nurses know dialysis indwelling needle and the safety of the dialysis indwelling needles in their mind are the influencing factors of their willingness to use the indwelling needle for dialysis. There were 167 (67.34%) nurses who had never used the dialysis indwelling needle. The first two influence factor of promotion of dialysis indwelling needle were the entrenched operating habits (31.05%) and their department had not applied the usage of them (27.82%).The biggest concern of hemodialysis nurses was the fixation of the indwelling needle (16.13%), followed by the punch/seal problem (8.87%). Conclusions The vast majority of hemodialysis nurses were willing to use dialysis indwelling needle in nursing work, but its promotion and application was not optimistic. Therefore, intervention measures should be carried out at individual, department and hospitallevel, intensifying the training and conceptual changes of department regulators and nurses.

Objective To explore the influence of different testing methods on detecting value of to-tal cell volume. Methods 60 reusable dialyzers(low-flux dialyzer and high-flux dialyzer were 30 respec-tively) were enrolled. They were divided into the traditional testing group, the modified testing group and the automatic dialyzer reuse group with 20 dialyzers in each group according to different detecting methods, the results underwent analysis. Results The basic total cell volume of the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (100.10±0.25) ml, (100.13±0.50) ml and (102.00±1.41) ml in 6LR dialyzer, while in 17R dialyzer, they were (113.67±1.30) ml, (118.67±1.30) ml and (119.93±1.77)ml respectively. The total cell volume of the dialyzer reuse in the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (95.20±7.76) ml, (96.20± 7.22) ml and (102.80±4.26) ml in 6LR dialyzer, while in 17R dialyzer, they were (100.00±11.48) ml, (114.35±3.31 ) ml and (117.07±2.96) ml respectively. There was significant difference between the tradi-tional and the modified testing groups in high-flux dialyzers reuse. Conclusions The modified testing method can improve the accuracy of the testing of total cell volume in high-flux dialyzer reuse.