Objective To explore the diagnostic value of electrocardiogram parameters combined with serum microRNA(miR)-322 and miR-568 levels in patients with chronic heart failure(CHF)complicated with ventricular arrhythmias(VA).Methods A total of 230 CHF patients admitted to Zhangjiakou First Hospital from April 2020 to April 2023 were selected as the study objects,including 120 VA patients(VA group)and 110 non VA patients(non VA group),and 110 patients who underwent health examinations in Zhangjiakou First Hospital during the same period as the control group.Compared three sets of general information,electrocardiogram parameters,left ventricular ejection fraction(LVEF),cardiac function grade and serum miR-322 and miR-568 levels.Logistic regression analyzed the influencing factors of VA in CHF patients.Receiver operating characteristic curve(ROC)analyzed electrocardiogram parameters combined with serum miR-322 and miR-568 for the diagnostic value of VA in CHF patients.Results The three groups showed statistically obvious differences in classification of nyha heart function(NYHA)and left ventricular ejection fraction(LVEF)(F=6.033,691.853,all P<0.05).The electrocardiogram parameters of CHF patients,including QT interval dispersion(QTD),QRS wave duration and corrected QT systolic time(QTc)were obviously higher than those in the control group(t=16.539,17.709,14.414),and the VA group were obviously higher than the non VA group(q=10.984,7.794,10.174),and the differences were statistically significan(all P<0.05).The serum levels of miR-322 and miR-568 were obviously lower than those in the control group(t=23.719,17.359).and the VA group were obviously lower than the non VA group(q=10.345,9.941),the differences were statistically significant(all P<0.05).Logistic regression analysis showed that NYHA grading,LVEF,QTD,QRS,wave duration,QTc,serum miR-322 and miR-568 levels were all influencing factors in the complication of VA in patients with CHF(Wald χ2=4.267～9.839,all P<0.05).The combination of electrocardiogram parameters and serum miR-322,miR-568 was better diagnosing CHF patients with concurrent VA that QTD,QRS duration,QTc and serum miR-332,miR-568 were measured separately.Conclusion Serum levels of miR-322 and miR-568 are obviously reduced,and the combination of electrocardiogram parameters with serum miR-322 and miR-568 has high diagnostic value for CHF patients with VA.

Objective To explore the diagnostic value of electrocardiogram parameters combined with serum microRNA(miR)-322 and miR-568 levels in patients with chronic heart failure(CHF)complicated with ventricular arrhythmias(VA).Methods A total of 230 CHF patients admitted to Zhangjiakou First Hospital from April 2020 to April 2023 were selected as the study objects,including 120 VA patients(VA group)and 110 non VA patients(non VA group),and 110 patients who underwent health examinations in Zhangjiakou First Hospital during the same period as the control group.Compared three sets of general information,electrocardiogram parameters,left ventricular ejection fraction(LVEF),cardiac function grade and serum miR-322 and miR-568 levels.Logistic regression analyzed the influencing factors of VA in CHF patients.Receiver operating characteristic curve(ROC)analyzed electrocardiogram parameters combined with serum miR-322 and miR-568 for the diagnostic value of VA in CHF patients.Results The three groups showed statistically obvious differences in classification of nyha heart function(NYHA)and left ventricular ejection fraction(LVEF)(F=6.033,691.853,all P<0.05).The electrocardiogram parameters of CHF patients,including QT interval dispersion(QTD),QRS wave duration and corrected QT systolic time(QTc)were obviously higher than those in the control group(t=16.539,17.709,14.414),and the VA group were obviously higher than the non VA group(q=10.984,7.794,10.174),and the differences were statistically significan(all P<0.05).The serum levels of miR-322 and miR-568 were obviously lower than those in the control group(t=23.719,17.359).and the VA group were obviously lower than the non VA group(q=10.345,9.941),the differences were statistically significant(all P<0.05).Logistic regression analysis showed that NYHA grading,LVEF,QTD,QRS,wave duration,QTc,serum miR-322 and miR-568 levels were all influencing factors in the complication of VA in patients with CHF(Wald χ2=4.267～9.839,all P<0.05).The combination of electrocardiogram parameters and serum miR-322,miR-568 was better diagnosing CHF patients with concurrent VA that QTD,QRS duration,QTc and serum miR-332,miR-568 were measured separately.Conclusion Serum levels of miR-322 and miR-568 are obviously reduced,and the combination of electrocardiogram parameters with serum miR-322 and miR-568 has high diagnostic value for CHF patients with VA.

OBJECTIVE To establish an HPLC method for determination of the related substances in papaverine hydrochloride. METHODS NanoChrom ChromCore 120 C8 column was used; the mobile phase A consisted of 3.4 g·L−1 potassium dihydrogen phosphate aqueous solution, adjust pH to 3.5 with phosphoric acid-acetonitrile(90∶10), the mobile phase B was methanol, with gradient elution at the flow rate of 0.8 mL·min−1; the detection wavelength was 238 nm; the column temperature was 50 ℃. RESULTS The minimum separation between the main component and each impurity was >1.5; Papaverine and its thirteen impurities showed a good linear relationship in the self-concentration range(r>0.999); and the average recoveries were 93.1%−101.2% with RSDs of 2.3%−8.1%. CONCLUSION The method is accurate, sensitive and reliable, which is suitable for the determination of related substances in papaverine hydrochloride.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.

Objective:To explore the effects of teamwork strategy in cardiac rehabilitation exercise therapy for elderly patients with myocardial infarction.Methods:From November 2017 to May 2019, we selected elderly patients with myocardial infarction at Shulan (Hangzhou) Hospital as the study objects by convenience sampling. All patients were divided into control group ( n=58) and observation group ( n=60) . Control group implemented the routine nursing. On the basis of routine nursing, observation group carried out the cardiac rehabilitation exercise therapy by applying the teamwork strategy. We compared the exercise compliance and activities of daily living (ADL) of patients between two groups. Results:The exercise compliance of patients in observation group was higher than that in control group with a statistical difference ( P<0.01) . At discharge, the score of Barthel index of patients in observation group was higher than that in control group also with a statistical difference ( P<0.01) . Conclusions:Teamwork strategy helps to improve the exercise compliance and ADL in elderly patients with myocardial infarction.

Objective To analyze the process of clinical nursing operation assessment in a third-grade class-A hospital in China, and design the scoring system of clinical nursing operation examination (SSCNOE), and discuss its clinical application effect. Methods Through operation process analysis chart to analyze the flow of current clinical nursing operation assessment of shanxi provincial people's hospital to look for improvement priorities that can be optimized, and based on Microsoft Visual Basic technology and 15 commonly used clinical nursing operation, we developed SSCNOE. A total of 102 nurses were selected as subjects and were randomly divided into the experimental and control groups using random numbers. The experimental group accepted SSCNOE examination, while the control group received the traditional paper test. The differences in the examination time and examination cost between the two groups were compared. Results SSCNOE simplified the examination process of clinical nursing operation and saved a lot of manpower, material and financial resources. The time required to use SSCNOE was (202.13±24.69)min, shorter than the traditional assessment (347.67±6.51)min (t=12.99, P<0.01), and the overall cost was (948.13± 72.47)yuan, lower than the traditional test (1689.12 ± 126.72)yuan (t=13.56, P<0.01). Conclusion The research and application of SSCNOE can improve the efficiency of the assessment of nursing operation, save the cost of examination and improve the level of hospital nursing information construction.

Objective To discuss the influence of hierarchical management mode on psychological empowerment and innovation behavior of nurses in intensive care unit (ICU). Methods From April 2016 to April 2017, hierarchical management mode was applied among 41 ICU nurses in Shanxi Provincial People's Hospital for 12 months. The levels of psychological empowerment and innovation behavior were compared before intervention, on the 6th and the 12th month after intervention. Results Before the intervention, the score of the psychological empowerment was (3.07±0.46), which was at a middle level. Meanwhile, the score of innovation behavior was (2.91±0.40), which was at a low level. With the implementation of hierarchical management mode, the differences in the scores of each dimension and the total score of psychological empowerment were statistically significant (F=11.463, 27.192, 13.700, 36.609, 45.733;P<0.001). The differences in the scores of each dimension and the total score of innovation behavior were statistically significant (F=43.149, 106.489, 21.836, 80.586;P< 0.001). Conclusions ICU nurses' psychological empowerment is at a moderate level, and individual innovative behavior is at a weak level. Hierarchical management mode helps to improve ICU nurses' psychological empowerment and personal innovative behavior level.

Objective:To evaluate the prophylactic application of antibiotics in oral and maxillofacial surgery and to provide a scientific basis for its reasonable use .Methods: The use of prophylactic antibiotics in the oral and maxillofacial surgery was conducted in our hospital from January 2011 to August 2013 based on a retrospective survey , and the conditions and affecting factors were analyzed .Results:The utilization rates of prophylactic antibiotics were respectively 98.9%, 61.8%, and 24.6%, showing a downward trend .But the infection rate of surgical site did not significantly increase , and by Fisher ’ s exact test, the difference was not significant (P>0.05).Surgical site infections (SSI) rates did not rise between using and not using prophylactic antibiotics ( P>0 .05 ) .Conclusion: The use of prophylactic antibiotics is greatly influenced by the policy , and along with the decline in antibiotic usage , SSI have not increased significantly .

Objective To understand the enterovirus infection in family close contacts of patients with hand,foot and mouth disease (HFMD) and the contamination of environment.Methods Forty-one HFMD cases confirmed by laboratory from web-based surveillance system during July to August 2010 in Guangdong Province were selected.All members of the cases′ family were investigated by collecting their information on demography,habit of domestic hygiene and hygiene status in household.The stool samples of all members and the smear samples from the surface of family belongings from 16 families were collected and the enterovirus was detected by real time quantitative polymerase chain reaction.The data were analyzed by chi square teat and t test.ResultsForty-one HFMD cases′ families and 135 close contacts were included in this survey.The infection rate of the enterovirus was 39.2％ (53/135) in all close contacts.Of all the investigated families,the infectionrate was 58.5％ (24/41) in family with one or more close contacts and 9.8％ (4/41) in family with all close contacts.The differences of infection rates of enterovirus among the members of parents (32.5％,25/77),grandparents/aunts/ uncles (43.3％,13/30) and cousins (53.6％,15/28) didn′t show statistical significance (χ2 =4.07,P=0.131).The infection rate of enterovirus in close contacts from family with more than 5 members was higher than that from family with 4 or less members (OR=1.4,95％CI 1.1-1.9).Among 135 close contacts,27.4％ (37/135) were infected with the same types of entervirus as that of HFMD case in the family and 11.9％ (16/135) were infected with the different virus types.In 33 family belongings samples from 16 families,the positive rate of enterovirus detection was 6.1％ (2/33).Between 17 families with enterovirus testing negative and 23 families with enterovirus testing positive in close contacts,there were no statistical differences of the family hygiene status,hand-washing of babysitter,disinfection of tableware and drinking,sharing towels,airing bedding articles and toy cleaning (P＞0.05).ConclusionsThe infection rate of enterovirus in close contacts of HFMD cases is high and the enterovirus contamination exists in case family environment.Management of close contacts of HFMD cases and disinfection of the family environment are important in HFMD controls.