Systemic sclerosis（SSc）is a chronic autoimmune disease，and cardiac related complication is one of the leading causes of death of systemic sclerosis patients. Nevertheless，by the time cardiac complications become clinically evident，irreversible myocardial damage has usually already occurred. As a novel echocardiographic technique for assessing myocardial function，speckle-tracking technology can be used for the early identification of subclinical cardiac dysfuction in patients with systemic sclerosis，playing a vital role in the early clinical treatment intervention and prognostic evaluation. This article reviewed the current research status and the latest progress of speckle-tracking technology in cardiac damage in patients with systemic sclerosis.

Specialist nurses assume an important role in clinical practice, teaching and research, and even in the development of the nursing discipline. Their professionalism is critical to improving the quality of nursing, enhancing the practice experience, and promoting organizational progress. This article reviews the current status, influencing factors, and measurement tools of professionalism among specialist nurses, with the aim of informing subsequent studies and intervention programs by nursing administrators.

Specialist nurses assume an important role in clinical practice, teaching and research, and even in the development of the nursing discipline. Their professionalism is critical to improving the quality of nursing, enhancing the practice experience, and promoting organizational progress. This article reviews the current status, influencing factors, and measurement tools of professionalism among specialist nurses, with the aim of informing subsequent studies and intervention programs by nursing administrators.

Systemic sclerosis（SSc）is a chronic autoimmune disease，and cardiac related complication is one of the leading causes of death of systemic sclerosis patients. Nevertheless，by the time cardiac complications become clinically evident，irreversible myocardial damage has usually already occurred. As a novel echocardiographic technique for assessing myocardial function，speckle-tracking technology can be used for the early identification of subclinical cardiac dysfuction in patients with systemic sclerosis，playing a vital role in the early clinical treatment intervention and prognostic evaluation. This article reviewed the current research status and the latest progress of speckle-tracking technology in cardiac damage in patients with systemic sclerosis.

Objective To investigate the application of low-dose computed tomography virtual colonoscopy(LDCTVC)in colorec-tal tumor.Methods Forty-seven colorectal tumor were given low-dose CT abdominal scan(low-dose group),15 patients with normal body mass index(BMI)who received routine-dose CT abdominal scan at the same period(routine-dose group).Volume CT dose index(CTDIvol),dose length product(DLP),virtual colonoscopy and optical colonoscopy results were recorded.Results The effective dose with normal BMI was(2.86±0.47)mSv and(4.87±1.15)mSv in the low-dose and routine-dose groups,respectively.The CTDIvol and DLP between the two groups were statistically significant(P＜0.05).There were 14 cases of true positive,4 cases of false positive,5 cases of false negative and 24 cases of true negative in the low-dose group.The sensitivity,specificity and Kappa value of LDCTVC in the diagnosis of colorectal mucosal lesions were 73.7％,85.7％,and 0.6.Conclusion LDCTVC can reduce the effective dose by 50％and has a good diagnostic value for colorectal mucosal lesions,which can make up for the deficiency of colonoscopy and make accurate judgment of extra-mucosal lesions of the bowel wall.

Objective:To assess the age-related differences in the management strategies and outcomes of patients with acute coronary syndrome (ACS) under the chest pain center model.Methods:Clinical data of 2 833 patients with ACS were enrolled in the retrospective observational registry between January 2017 and June 2019 at 11 hospitals with chest pain centers in Chengdu. The patients were divided into four groups according to their ages: < 55 years old group ( n = 569), 55-64 years old group ( n = 556), 65-74 years old group ( n = 804), ≥ 75 years old group ( n = 904). The collected data included the patients' demographic characteristics, cardiovascular risk factors, medical history, symptoms and signs of onset, experimental examination, types of ACS and the time from the symptom to the hospital (S-to-D), etc., and the clinical characteristics, management strategies, all-cause mortality in the hospital, and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 1 year after discharge were compared. The primary end point was the clinical outcome of ACS patients in different age groups, including all-cause deaths in the hospital and the incidence of MACCE within 1 year after discharge. The secondary end point was the proportion of ACS patients underwent percutaneous coronary intervention (PCI) in different age groups. Multivariate Logistic regression was used to analyze the risk factors of all-cause deaths in ACS patients. Kaplan-Meier curve was used to express the incidence of MACCE within 1 year after discharge in different age groups. Multivariate Cox regression was used to analyze the factors affecting the incidence of MACCE within 1 year after discharge of ACS patients. Results:As age increased, the proportion of male patients gradually decreased, and the percentages of male patients aged < 55 years old, 55-64 years old, 65-74 years old, and ≥ 75 years old were 87.2% (496/569), 77.0% (428/556), 66.4% (534/804), and 60.1% (543/904), respectively; and ACS patients combined with hypertension, diabetes, coronary heart disease, and stroke history were more common [the percentages of patients with hypertension aged < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old were 41.3% (235/569), 52.2% (290/556), 59.7% (480/804), and 66.9% (605/904); the percentages of diabetes were 18.6% (106/569), 25.5% (142/556), 27.0% (217/804), and 28.2% (255/904); the percentages of coronary heart disease were 10.1% (57/564), 13.9% (77/555), 17.6% (141/803), and 23.7% (213/899); the percentages of stroke were 0.7% (4/564), 4.0% (22/552), 4.5% (36/801), and 8.6% (77/894)]. But the percentages of patients with a history of active smoking, typical chest pain/chest tightness and dyslipidemia were significantly reduced [the percentages of smoking history were 60.2% (340/565), 48.0% (266/554), 33.7% (270/801), and 21.7% (195/899), typical chest pain/chest tightness were 96.9% (536/553), 96.4% (516/535), 91.8% (716/780), 90.2% (776/860); the percentages of dyslipidemia were 11.2% (63/565), 9.2% (51/553), 5.7% (46/802), and 4.9% (44/896)], the time of S-to-D was significantly prolonged [minutes: 176.0 (73.5, 557.0), 194.5 (89.3, 682.3), 221.0 (98.8, 940.5), and 270.0 (115.0, 867.0)], hemoglobin (Hb) level was significantly reduced(g/L: 145.44±17.43, 135.95±19.25, 129.75±19.03, 122.19±20.55), and the incidence of non-ST-segment elevation myocardial infarction (NSTEMI) increased significantly [18.6% (106/569), 20.5% (114/556), 26.6% (214/804), 26.5% (240/904)], and the differences were statistically significant (all P < 0.05). The proportion of Killip grade Ⅲ -Ⅳ were the highest in patients aged ≥ 75 years old, 9.0% and 12.6%, respectively. Compared with the groups aged < 55 years old, 55-64 years old, and 65-74 years old, the proportion of patients aged ≥ 75 years old who underwent PCI was the lowest, and the all-cause mortality in the hospital and the incidence of 1-year MACCE of patients underwent PCI were significantly lower than those of patients underwent conservative treatment [6.0% (28/463) vs. 10.4% (45/434), 14.6% (43/294) vs. 24.3 % (55/226), both P < 0.05]. As age increased, the hospital all-cause mortality and the 1-year MACCE incidence increased (all-cause mortality rates in < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old groups were 0.9%, 2.2%, 5.5%, 8.3%, and the 1-year MACCE incidences were 5.0%, 6.7%, 13.9%, 18.7%, both P < 0.01). The multivariate Logistic regression analysis showed that age, cardiogenic shock, ST-segment elevation myocardial infarction (STEMI), the number of vascular disease and underwent PCI were the independent risk factors of all-cause mortality [the odds ratio ( OR) and 95% confidence interval (95% CI) were 1.644 (1.356-1.993), 11.794 (7.469-18.621), 2.449 (1.419-4.227), 1.334 (1.096-1.624), 0.391 (0.247-0.619), all P < 0.001]. Cox regression analysis showed that age, STEMI, the number of vascular disease and underwent PCI were independent risk factors of the occurrence of MACCE within 1 year after discharge [hazard ratio ( HR) and 95% CI were 1.354 (1.205-1.521), 1.387 (1.003-1.916), 1.314 (1.155-1.495), 0.547 (0.402-0.745), all P < 0.05]. Conclusions:In the chest pain center model, compared with other age of ACS patients, the proportion of NSTEMI in elderly patients group aged ≥ 75 years old was higher, the proportion of PCI was lower, and the clinical outcome was worse. However, the prognosis of elderly patients receiving PCI treatment was better than the patients receiving conservative treatment.

OBJECTIVE:To establish the method for the content determination of rapamycin (RAPA) in human monocyte THP-1 derived foam cells,and to study the effects of RAPA targeting preparation(RAPA-NP-Apt)targeting at foam cells. METH-ODS:Foam cells model were established through THP-1 cells were induced by oxidized low density lipoprotein. Foam cells were incubated with 200 ng/mL RAPA or 200,400,800 ng/mL RAPA-NP-Apt for 60 min. The content of RAPA was determined by HPLC. The determination was performed on Diamonsil C18 column with mobile phase consisted of acetonitrile-water(90:10,V/V) at flow rate of 1.0 mL/min. The column temperature was set at 40 ℃,and the detection wavelength was 278 nm. The sample size was 20 μL. RESULTS:The concentration of RAPA ranged 50-6400 ng/mL (r=0.99996) with average recovery of 98.72%(RSD=0.62%,n=3). RSDs of inter-day and intra-day were not more than 6.15%(n=6),RSD of stability was lower than 2%(n=6),and RSD of repeatability was 1.64%(n=6). After foam cells were incubated with RAPA or low-concentration,medi-um-concentration and high-concentration of RAPA-NP-Apt,the contents of RAPA were 12,43,98,140 ng/106 cells. CONCLU-SIONS:The method is simple,stable and reproducible. It can be used for content determination of RAPA in foam cells. RA-PA-NP-Apt can improve the effects of RAPA targeting at foam cells.

Objective: To explore the impact of nuclear factor-kappa B (NF-κB) in patients with left-to-right shunt congenital heart disease (CHD) combining pulmonary arterial hypertension (PAH) and its clinical signiifcance. Methods: A total of 78 relevant patients were enrolled in this study. According to mean pulmonary artery pressure (mPAP) measured during operation, the patients were divided into 4 groups: Non-PAH group, the patients with mPAP≤25 mmHg,n=20, Mild PAH group, 25 mmHg mPAP≤35 mmHg,n=21, Moderate PAH group, 35 mmHg45 mmHg,n=23. 2 mL pulmonary artery blood was taken from each patient and plasma level of NF-κB was measured by ELISA to study the relationship between NF-κB and mPAP. Results: Pulmonary arterial plasma levels of NF-κB were increased accordingly as in Non-PAH group was (180.59 ± 10.16) ng/L, in Mild PAH group was (572.83 ± 34.80) ng/L, in Moderate PAH group was (980.85 ± 24.95) ng/L and in Severe PAH group was (1 253.4 ±130.8) ng/L, allP<0.01; NF-κB level was positively related to mPAP (r=0.856,P<0.01). Conclusion: Plasma level of NF-κB was involved in the pathological physiology process of left-to-right shunt CHD combining PAH, it couldbe used as one of the references for distinguishing the severity of PAH and for monitoring the dynamic changes of PAH in relevant patients.

Objective To describe the clinical, neuroimaging and genetic profiles of amyotrophic lateral sclerosis with frontotemporal lobe degeneration ( ALS-FTLD).Methods From August 2011 to May 2015, patients with FTLD or other types of neurodegenerative dementia were physically examined in detail and electromyography was performed to those with suspected dysarthria, limb atrophy or weakness.Cognitive and behavioral screenings were performed to all ALS patients.Patients with ALS-FTLD entered further analysis of neuroimaging and genetics.Results Among the 8 patients diagnosed as ALS-FTLD, 4 patients began with personality change or amnesia, while diseases in the remaining 4 cases began with limb weakness or dysarthria.Dementia type of 7 cases was behavioral variant FTLD ( bvFTD) and 1 case was diagnosed as semantic dementia.Electromyography of all the 8 patients showed diffuse neurogenic changes.Constructional neuroimaging of 6 patients showed cerebral atrophy predominantly in frontal and temporal lobes.Fluorodeoxyglucose-positron emission tomography was conducted in 5 patients, indicating hypometabolism mainly in frontal and ( or) temporal lobes.NeuroQ analysis revealed that bilateral frontal lobes were the most hypometabolic areas for ALS-FTLD.Among 4 patients who underwent genetic screening, 1 patient was C9ORF72 mutation carrier.Conclusions bvFTD is the major type of dementia in the context of ALS.Metabolic neuroimaging could assist accurate diagnosis, and it reveals that bilateral frontal lobes are the most hypometabolic areas for ALS-FTLD.C9ORF72 gene mutation is an important pathogenic mutation for ALS-FTLD, although it is rare in Chinese population.