Objective:To explore the teaching evaluation of online open course of hematology based on small private online course (SPOC) platform by means of quantitative method.Methods:The fourth-year undergraduates of clinical medicine major were selected to receive online course learning of hematology, including video viewing, rich text browsing, in-class quizzes, and seminars. The teaching contents covered the basis of hematological diseases, anemic diseases, hematological tumors, bleeding and coagulation disorders. Teaching evaluation was conducted through teaching behavior assessment, unit test, course examination and SPOC scoring. Linear regression analysis was used to analyze the correlation between the duration of the teaching video and student learning behavior. The correlation between video learning quantity and viewing time and course test scores and SPOC scores was analyzed. Kruskal-Wallis test was used to compare the differences in curriculum learning behavior (participation rate). T-test was used to compare the differences between the two results of two unit tests and to calculate the alternative-form reliability. Chi-square test was used to compare the differences in scores of different sub-specialty questions in hematology, and the differences of participation rate of different examination points of hematological tumors. Results:The teaching video viewing rate was significantly higher than the participation rate of rich text browsing and in-class quizzes ( P < 0.001; P < 0.001). There was no obvious correlation between video duration and video viewing, rich text browsing, in-class quizzes ( R = 0.168, F = 0.81, P = 0.376; R = 0.057, F = 0.07, P=0.802; R=0.124, F=0.37, P=0.546). There was a significant positive correlation between the participation rate of video viewing and rich text browsing and in-class quizzes ( R =0.890, F=76.41, P<0.001; R=0.934, F=163.67, P < 0.001). The participation rate of anemic disease unit test was significantly higher than that of hematological tumors ( χ2 = 49.08, P<0.001), bleeding and coagulation disorders ( χ2= 25.97, P< 0.001), and the second results were significantly improved ( t=-2.09, P=0.040), and the alternative-form reliability was 0.750. There was no significant difference in the participation rate of different sub-specialty courses ( χ2=5.20, P=0.074); the number of video watching was significantly positively correlated with SPOC scores ( R=0.523, F=196.22, P<0.001); the participation rate of molecular genetics and molecular biology tests of blood tumor was significantly lower than that of general clinical information questions ( P < 0.05). Conclusion:Teaching videos are the foundation of online courses. Increasing the number of video viewing and improving video viewing rate can effectively mobilize the enthusiasm of extensive learning, such as rich text browsing and in-class quizzes, and improve learning participation. It is conducive to the improvement of students' academic performance. Simple behavior factors such as video viewing time are not recommended as performance evaluation indicators. Unit test takes two times to get the highest score, which is conducive to improving professional learning level through learning behavior, without affecting the reliability of the performance evaluation. The online open course based on the SPOC platform is conducive to the balanced development of the course teaching of Hematology.

A 72-year-old female patient received intravenous injection of furosemide injection and oral metoprolol succinate sustained-release tablets, furosemide tablets, spironolactone tablets, digoxin tablets, and isosorbide mononitrate sustained release tablets for heart failure. Continuous intravenous pumping of levosimendan 12.5 mg dissolved in 0.9% sodium chloride 45 ml at a speed of 1.5 ml/h was additionally given because of her unimproved symptoms of heart failure. After 20 hours of intravenous pumping, the patient developed unconsciousness, no response to voice stimuli, and bilateral mydriasis suddenly. The electrocardiogram monitoring showed heart rate 200 beats per minute, prolonged QT interval, and QTc period 520 ms. The laboratory tests showed serum potassium 3.02 mmol/L. She was diagnosis as Torsades de Pointes and Aspen syndrome, which were considered to be related with levosimendan. Levosimendan was stopped immediately. The treatments such as closed-chest cardiac massage, electric defibrillation, and potassium supplementation were given. Four days later, the reexamining results showed her serum potassium 4.60 mmol/L, heart rate 80 beats per minute, and QTc period 450 ms.

A 72-year-old female patient received intravenous injection of furosemide injection and oral metoprolol succinate sustained-release tablets, furosemide tablets, spironolactone tablets, digoxin tablets, and isosorbide mononitrate sustained release tablets for heart failure. Continuous intravenous pumping of levosimendan 12.5 mg dissolved in 0.9% sodium chloride 45 ml at a speed of 1.5 ml/h was additionally given because of her unimproved symptoms of heart failure. After 20 hours of intravenous pumping, the patient developed unconsciousness, no response to voice stimuli, and bilateral mydriasis suddenly. The electrocardiogram monitoring showed heart rate 200 beats per minute, prolonged QT interval, and QTc period 520 ms. The laboratory tests showed serum potassium 3.02 mmol/L. She was diagnosis as Torsades de Pointes and Aspen syndrome, which were considered to be related with levosimendan. Levosimendan was stopped immediately. The treatments such as closed-chest cardiac massage, electric defibrillation, and potassium supplementation were given. Four days later, the reexamining results showed her serum potassium 4.60 mmol/L, heart rate 80 beats per minute, and QTc period 450 ms.

OBJECTIVE： To optimize the ultrasonic extraction technology for Jinjuan shengban capsules. METHODS： Using comprehensive score of indexes as transfer rate of gallic acid， chlorogenic acid， baicalin， aloe emodin and emodin methyl ether， with ethanol volume fraction， ultrasonic power， ultrasonic extraction time and liquid-material ratio as factors， the ultrasound extraction technology of Jinjuan shengban capsules was optimized by Box-Behnken response surface methodology based on single factor test. The validation test was conducted. RESULTS： The best extraction technology was 50-fold 70％ ethanol， extracting 40 min under 300 W. In validation test， average transfer rates of gallic acid， chlorogenic acid， baicalin， aloe emodin and emodin methyl ether were 85.92％， 86.37％， 92.76％， 90.84％ and 87.26％ （RSD＜3.57％，n＝3） in 3 batches of samples； comprehensive score was 88.95％， relative error of which to predicted value of 88.27％ was 1.10％. CONCLUSIONS： The response surface method combined with multi-index comprehensive scoring can be used to optimize the extraction technology of Jinjuan shengban capsules which is simple and stable.

Objective To summarize the experience of applying transradial sheathless technique in treat-ment of bifurcation coronary lesions. Methods The clinical data on 39 patients with bifurcation coronary lesions who received transradial PCI using sheathless guide catheter produced by ASAHI or self-made sheathless guide catheter were retrospectively analyzed. Passing ability of sheathless guide catheter, success rate and complications of PCI were observed.Results There were 10 patients with left main bifurcation lesions, 29 left anterior descend-ing branch and diagonal branch bifurcation lesions. 33 patients were treated using sheathless of 7.5 Fr and 6 were treated by self-made sheathless guide catheter.PCI achieved expected goal.No catheter placement related complica-tions, cardiovascular or cerebrovascular events were observed in 39 patients in their hospital stay. Conclusions Transradial sheathless technique can be applied in of coronary lesions. Sheathless of 7.5 Fr is easy to use and has perfect passing ability.Sheathless guide catheter is effective,safe and highly practicable.Both procedures are worth of clinical application.

Objective To discuss the clinical effects and the major adverse cardiac events of intracoronary prostaglandin E1 injection prior to percutaneous coronary intervention (PCI) in early(within 24h of symptom onset) interventional treatment for patients with acute non -ST segment elevation myocardial infarction ( NSTEMI ) . Methods 122 patients with NSTEMI who underwent early interventional treatment were divided into three groups according to the digital table:41 cases in prostaglandin E 1 group,41 cases in nitroglycerin group ,40 cases in control group.The TIMI blood flow was compared among the three groups after PCI .All patients were followed up during 6 months about major adverse cardiac events ( MACE) and the cardiac structure and function by echocardiography . Results After primary PCI,the corrected TIMI frame count(CTFC) was significantly better in the prostaglandin E 1 group[(20.22 ±6.82)] than in the nitroglycerin group[(26.35 ±8.71)] and the control group[(27.02 ±9.65), t=6.451,6.763,all P<0.05].The TIMI myocardial perfusion grade (TMP) was significantly better in the prosta-glandin E1 group(7.3％) than in the nitroglycerin group(26.8％) and the control group(30.0％)(P<0.05). There was no statistically significant difference between the nitroglycerin group and the control group (P>0.05).All patients were followed up for 6 months,the LVDd in the prostaglandin E1 group[(46.8 ±3.7)mm] was significantly lower than that in the nitroglycerin group[(49.5 ±5.8) mm] and the control group [(50.2 ±4.9) mm,t=6.312, 5.893,all P<0.05].The LVEF in the prostaglandin E1 group [(55.8 ±8.2)％] was significantly higher than that in the nitroglycerin group [(49.3 ±7.9)％] and the control group [(50.5 ±6.8)％,t=7.011,5.981,all P<0.05].The incidence rate of MACE in the prostaglandin E 1 group(4.9％) was significantly lower than that in the nitroglycerin group(12.2％) and control group(12.5％)(χ2 =5.834,5.719,all P<0.05).There was no statistically significant difference between the nitroglycerin group and the control group (P>0.05).Conclusion Intracoronary administration of prostaglandin E 1 injection prior to balloon dilation can significantly improve the myocardial microcir-culation perfusion,and can decrease MACE in patients with NSTEMI who underwent early interventional treatment .

Objective To explore the relationship between platelet distribution width (PDW) and cardiac syndrome X.Methods Totally 58 patients with cardiac syndrome X and 70 normal controls were selected,and PDW level was detected in the blood samples of all the patients.Results The PDW level was (14.1± 2.9) in the cardiac syndrome X group,which was significantly higher than (12.6 ± 1.9) in the normal controls (P ＜ 0.01).The binary Logistic regression analysis showed that RDW could be used as an independent predictor for cardiac syndrome X.Conclusion High platelet distribution width is associated with attack of cardiac syndrome X.

Objective To explore the relationship between platelet distribution width (PDW) and cardiac syndrome X.Methods Totally 58 patients with cardiac syndrome X and 70 normal controls were selected,and PDW level was detected in the blood samples of all the patients.Results The PDW level was (14.1± 2.9) in the cardiac syndrome X group,which was significantly higher than (12.6 ± 1.9) in the normal controls (P ＜ 0.01).The binary Logistic regression analysis showed that RDW could be used as an independent predictor for cardiac syndrome X.Conclusion High platelet distribution width is associated with attack of cardiac syndrome X.

Objective To explore the clinical efficacy of prostaglandin E1 injected by coronary or peripheral venous in early stage (within 24 h of symptom onset) in treating patients with acute non-ST segment elevation myocardial infarction (NSTEMI) by percutaneous coronary intervention (PCI) and its influence on major adverse cardiac events (MACE).Methods A total of 136 patients with NSTEMI underwent PCI within 24 h were divided into intracoronary injection group,peripheral vein injection group and control group.All the patients were followed up for 9 months,no reflow or slow blood flow,the incidence of angina pectoris,heart failure,and target vessel revascularization,recurrent myocardial infarction and cardiac death and major cardiac adverse events during hospitalization were compared between three groups.The changes of left ventricular end diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and other indicators were compared.Results After PCI,the corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMP) were significantly better in intracoronary injection group than peripheral vein injection group and control group (P ＜ 0.05).All patients were followed up for 9 months,LVDd in intracoronary injection group was significantly lower than those in peripheral vein injection group and control group (P ＜ 0.05).LVEF in intracoronary injection group was significantly higher than that in peripheral vein injection group and control group (P ＜ 0.05).The incidence rate of MACE in intracoronary injection group was significantly less than that in peripheral vein injection group and control group (P ＜ 0.05).There was no significantly difference between the peripheral vein injection group and control group (P ＞ 0.05).Conclusion For NSTEMI patients with early PCI,intracoronary injection and peripheral intravenous injection of prostaglandin E1 can get a better myocardial microcirculation reperfusion during operation,and intracoronary injection can significantly reduce the incidence of adverse cardiac events.

Objective To explore the clinical efficacy of prostaglandin E1 injected by coronary or peripheral venous in early stage (within 24 h of symptom onset) in treating patients with acute non-ST segment elevation myocardial infarction (NSTEMI) by percutaneous coronary intervention (PCI) and its influence on major adverse cardiac events (MACE).Methods A total of 136 patients with NSTEMI underwent PCI within 24 h were divided into intracoronary injection group,peripheral vein injection group and control group.All the patients were followed up for 9 months,no reflow or slow blood flow,the incidence of angina pectoris,heart failure,and target vessel revascularization,recurrent myocardial infarction and cardiac death and major cardiac adverse events during hospitalization were compared between three groups.The changes of left ventricular end diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and other indicators were compared.Results After PCI,the corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMP) were significantly better in intracoronary injection group than peripheral vein injection group and control group (P ＜ 0.05).All patients were followed up for 9 months,LVDd in intracoronary injection group was significantly lower than those in peripheral vein injection group and control group (P ＜ 0.05).LVEF in intracoronary injection group was significantly higher than that in peripheral vein injection group and control group (P ＜ 0.05).The incidence rate of MACE in intracoronary injection group was significantly less than that in peripheral vein injection group and control group (P ＜ 0.05).There was no significantly difference between the peripheral vein injection group and control group (P ＞ 0.05).Conclusion For NSTEMI patients with early PCI,intracoronary injection and peripheral intravenous injection of prostaglandin E1 can get a better myocardial microcirculation reperfusion during operation,and intracoronary injection can significantly reduce the incidence of adverse cardiac events.