Objective:To explore the difference of the vessel and plaque characteristics, myocardial perfusion and cardiac function between patients with ischemia with non-obstructive coronary artery disease (INOCA) and obstructive coronary artery disease (CAD).Methods:From July 2021 to June 2022, 101 patients with angina were referred to dynamic computed tomography myocardial perfusion (CTP) and coronary computed tomography angiography (CCTA) and retrospectively included in our hospital. Based on the results of CTP and CCTA, patients were divided into INOCA (27 cases), moderate obstructive CAD (26 cases) and severe obstructive CAD (48 cases). The anatomical coronary artery stenosis, plaque characteristics and myocardial perfusion features of all patients were analyzed. Furthermore, left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained on full-phase reconstruction CCTA image by using Medis Suite 3.2 postprocessing software. Multigroup analysis used one way ANOVA or Kruskal Wallis H test. Results:Patients with INOCA were younger than patients with moderate and severe obstructive CAD ( P<0.001). INOCA patients (7.4%, 2/27) had lower rate of positive remodeling than both moderate (57.7%, 15/26, P<0.001) and severe obstructive CAD patients (33.3%, 16/48, P=0.017). The percentage of ischemic myocardium volume in patients with INOCA were similar with those in patients with severe CAD (all P>0.05), but significantly higher than those in patients with moderate CAD (all P<0.05). No significant difference in terms of GLS was detected between patients with INOCA [-17.4% (-21.6%, -11.6%)] and severe CAD [-17.6% (-21.9%, -14.8%), P=0.536], however, patients both with INOCA and severe CAD also had higher GLS than patients with moderate obstructive CAD [-22.3% (-29.8%, -19.0%), all P<0.05]. Conclusions:Based on"one-stop-shop"CTP combined with CCTA imaging, early cardiac functional changes including abnormal myocardial perfusion and myocardial strain in INOCA patients were similar to those in patients with severe obstructive CAD and more severe than those in patients with moderate obstructive CAD.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective:To initially investigate whether simultaneous radiochemotherapy with hyperthermia can prolong the survival of glioblastoma (GBM) patients.Methods:Clinical data of 61 GBM patients undergoing surgery in our hospital from September 2016 to June 2019 were retrospectively analyzed. According to different treatment methods, all patients were divided into the control group ( n=34) and observation group ( n=27). In the control group, three-dimensional radiotherapy with a dose of 60 Gy combined with temoazolamine chemotherapy was delivered. In the observation group, simultaneous radiochemotherapy with 15-20 cycles of hyperthermia at 40-41℃ was supplemented. The survival time was calculated by Kaplan-Meier method, and the survival time was compared with log-rank test between two groups. Results:The median progression-free survival in the observation group was significantly longer than that in the control group (14.33 months vs.9.94 months, P<0.05). The median overall survival in the observation group was also remarkably higher than that in the control group (18 months vs. 14 months, P<0.05). Conclusions:Simultaneous radiochemotherapy with hyperthermia is innovatively applied to treat GBM after surgical resection. Preliminary findings demonstrate that compared with chemoradiotherapy, simultaneous radiochemotherapy with hyperthermia can prolong the survival time of GBM patients.

Objective:To explore the effect of auricular point pressing pill combined with rhubarb acupoint application on intestinal preparation and prevention of adverse events in colonoscopy.Methods:A total of 220 patients who met the inclusion criteria from May 2019 to February 2020 were randomly divided into 4 groups, 55 in each group. The control group was only given compound polyethylene glycol electrolyte powder. The auricular plaster group was combined with auricular point pressing pill on the basis of the control group. The acupoint sticking group was combined with rhubarb acupoint application on the basis of the control group. The combination group was combined with auricular point pressing pill and rhubarb acupoint application on the basis of the control group. The quality of bowel preparation was evaluated by Boston Bowel Preparation Scale(BBPS), and the adverse events such as perianal discomfort, defecation discomfort, abdominal pain and abdominal distension were observed.Results:After treatment, there was significant difference in BBPS score among the four groups ( F=3.038, P=0.030). The BBPS score in the acupoint sticking group (7.45 ± 1.20 vs. 6.78 ± 1.32) and combination group (7.26 ± 1.11 vs. 6.78 ± 1.32) were significantly higher than those in the control group( P<0.05). After treatment, there were significant differences in abdominal pain and abdominal distension scores among the four groups ( F=2.947, 5.879, P=0.034, 0.001). The scores of perianal discomfort (0.07 ± 0.38 vs. 0.44 ± 1.07), defecation discomfort (0.40 ± 0.81 vs. 0.87 ± 1.32) and abdominal pain (0.93 ± 1.32 vs. 1.69 ± 1.61) in the combination group were significantly lower than those in the control group ( P<0.05), and the abdominal distension score (1.05 ± 1.00 vs. 1.64 ± 0.95) in the acupoint sticking was significantly lower than that of the control group ( P<0.05). Conclusion:Auricular combined with rhubarb powder acupoint application can improve the quality of bowel preparation and reduce intestinal adverse reactions. It can be used with polyethylene glycol electrolyte powder for the intestinal preparation process.

Objective:To study the clinical characteristics and compliance of early-onset gout patients by case-control analysis.Methods:A total of 111 early-onset patients (onset age ≤35 years old) were included as Group A, and 111 non-early-onset patients (onset age >35 years old) with matched disease durationwere included as Group B. The differences ofclinical characteristics, causes of acute gout attack, dairy diet habits, compliance, and misunderstanding of the disease were compared.Results:Compared with the non-early-onsetgoutpatients, the early-onset patients had a higher proportion of obesity (63 cases vs 28 cases), family history (36 cases vs 20 cases) and tophus (39 cases vs 23 cases) and higher level of VAS scores (8.5±1.3 vs 7.6±1.7; χ2=22.988, P<0.01; χ2=5.749, P=0.016; χ2=5.729, P=0.017; t=4.639, P<0.01), lowerproportionof the first metatarsophalangeal joint involvement as the initial joint involvement (45.9%, 51 cases vs 59.4%, 66 cases; χ2=4.066, P=0.044), higher proportion of the ankle involvement as the initial joint involvement (34.2%, 38 cases vs 21.6%, 24 cases; χ2=4.386, P=0.036), higher proportion of alcohol drinkers and high fructose drinkers, which was more likely to relate to alcohol intake, strenuous exercise and high fructose intakeas trigger of the flare ( χ2=6.513, P=0.011; χ2=7.126, P=0.008; χ2=1.978, P=0.160), while the proportion of regular exercisers and on diet in the family was lower ( χ2=22.887, P<0.01; t=-4.917, P<0.01). The proportion of poor diet and medication compliance in Group A was higher than that in Group B(57.7%, 64 cases vs 38.7%, 43 cases; χ2=5.207, P=0.022; χ2=5.867, P=0.015). As for the reason for poor treatment compliance, early-onset gout patients were more worry about the side-effects of drugs than non-early onset patients ( χ2=4.190, P=0.041). There was no significant difference between the two groups in the main misunderstanding of gout. Conclusion:Although early onset gout patients are young, their condition is more serious, and compliance is poorer, this group of patients should be highly valued in clinical diagnosis and treatment.

Objective:To explore the standard intraoperative nursing procedure in MAKO robot-assisted unicompartmental knee arthroplasty.Methods:We retrospectively analyzed the Operating Room nursing procedure and related data among 34 patients (a total of 39 cases of unicompartmental knee arthroplasty were performed) with MAKO robot-assisted unicompartmental knee arthroplasty in Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital from September 2016 to December 2019. All patients were diagnosed with knee osteoarthritis before surgery, and all of them were operated with MAKO RIO robotic surgery system and RESTORIS MCK unicompartmental knee prosthesis. We summarized the main points of nursing management during unicompartmental knee arthroplasty assisted by MAKO robot.Results:We summarized the nursing procedures of 39 cases of MAKO robot-assisted unicompartmental knee replacement in our center, and formulated the standard nursing procedure in MAKO robot-assisted unicompartmental knee arthroplasty.Conclusions:This study has completed the formulation of details of standard procedures for nursing coordination during MAKO robot-assisted unicompartmental knee arthroplasty, which has a guiding significance for nursing management of MAKO robot-assisted unicompartmental knee arthroplasty in the future.

To observe the clinical efficacy of nicorandil for treating the patient with cardiac syndrome X (CSX) and its impact on vascular endothelial function. Methods: A total of 140 CSX patients were randomly divided into 2 groups: Control group, the patients received conventional anti-angina therapy and Nicorandil group, based on conventional anti-angina therapy, the patients received additional oral nicorandil treatment. n=70 in each group. All patients received resting emission computed tomography (ECT) and treadmill exercise ECG stress test (TET). Blood levels of endothelin (ET-1), high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) were examined before and 3 months after treatment. Results: Compared with pre-treatment condition, the attack frequency of angina pectoris and positive rate of ECT were decreased after treatment in both groups, P<0.05; in Nicorandil group, the suspicious positive rate and positive rate of TET were reduced after treatment, P<0.05. Compared with Control group, Nicorandil group had the much lower suspicious positive rate and positive rate of TET after treatment, P<0.05. Blood tests indicated that compared with pre-treatment condition, ET-1 and hs-CRP were decreased, NO was increased after treatment in both groups, all P<0.05; blood levels of ET-1, hs-CRP and NO were different between 2 groups after treatment, all P<0.05. Conclusion: Nicorandil could inhibit inflammatory factors, elevate endothelial function and therefore improve micro vascular angina symptoms, increase exercise tolerance obviously.

Objective To investigate the application and effect of pediatric nursing cooperated with obstetrical nursing on breast-feeding effect of ICU preterm children. Methods Totally 126 cases of premature children hospitalized in our hospital NICU form January 2015 to December 2015 as the research object. Cases from January to June were selected as the control group ( n=65) , cases from July to December were selected as the intervention group ( n=61) . In the control group, routine post-natal nursing was performed respectively in obstetric and pediatrics. In the intervention group, pediatric nursing cooperated with obstetrical nursing was performed.Results Exclusive breast-feeding rate of 1 week in the intervention group was higher than the control group;mixed feeding rate and artificial feeding rate were lower than the control group. Feeding mode in two groups was significantly different (χ2 =7. 025, P=0. 006 ); breast-feeding day for the first feeding in the intervention group was significantly earlier than the control group (χ2=2.365, P=0.020) . The degree of breast-feeding in 1 week was higher than the control group (χ2=5.628, P=0.021;t=5.158, P<0.001);the degree of breast-feeding in 2 weeks was higher than the control group (χ2=6.852, P=0.009;t=6.542, P<0.001); the exclusive breastfeeding rate during hospitalization was higher than the control group (χ2=7.852, P<0.001). The rate of weight gain in the intervention group was significantly higher than the control group (t=4.526, P=0.003) , hospital stay shortened compared with the control group ( t=3.524, P=0.009) , the incidence of sepsis was significantly lower than the control group (χ2 = 4. 159, P= 0. 042 ) . Conclusions Pediatric nursing cooperated with obstetrical nursing can effectively improve the breast-feeding level and exclusive breast-feeding rate of NICU preterm children, promote neonatal weight gain, shorten hospital stays and reduce the incidence of sepsis.

Objective To explore the negative psychological experience of nursing students during clinical practice in NICU .Methods The qualitative phenomenological research method was adopted in this study.Semi-structured in-depth interviews were conducted with twelve nursing students during practice in NICU.Data were analyzed by content analysis .Results Four themes were extracted , including high tension , exhaustion of body and mind , lack of confidence , and sense of worthlessness .Conclusions The head nurse and the clinical teachers should pay attention to the negative psychological experience of nursing students during clinical practice in NICU , make a scientific and reasonable practice teaching program , take effective measures , and help them to complete the task of practice better in NICU .

Objective To evaluate the clinical significance of antiplatelet antibody in patients with systemic lupus erythematosus complicated with thrombocytopenia.Methods Antiplatelet antibody (anti-GP Ⅱb/Ⅲa antibody, anti-GP Ⅰb/Ⅸ antibody, anti-GP Ⅰa/Ⅱ a antibody, anti-GP Ⅳ antibody) were detected by modified antigen capture ELISA. The positive rate of antiplatelet antibody between SLE complicated with thrombocytopenia group and without thrombocytopenia group before therapy were compared,and the positive rate of antiplatelet antibody before therapy and after therapy in SLE complicated with thrombocytopenia were compared,and the relevance between antiplatelet antibody and conditions in SLE complicated with thrombocytopenia were analyzed. Rank test and Chi square test were used for statistical analysis. Results The positive rate of anti-GP Ⅱb/Ⅲa antibody and anti-GP Ⅰb/Ⅸ antibody in SLE complicated with thrombocytopenia group before therapy was 50% and 67% respectively, however,the positive rate in SLE without thrombocytopenia group before therapy was 11% and 28% respectively,there was significant difference between the two groups (P＜0.05) and the positive rate of anti-GP Ⅱb/Ⅲa antibody and anti-GP Ⅰb/Ⅸ antibody in SLE complicated with thrombocytopenia group after therapy was 6% and 28% respectively, which was significantly lower than those before therapy (P＜0.05). In SLE complicated with thrombocytopenia group before therapy, there was significant relevance between anti-GP Ⅱb/Ⅲ a antibody and anti-GP[b/Ⅸ antibody, and there was significant relevance between these two antibodies and SLEDAI score,but no significant relevance between these two antibodies and ANA,dsDNA, ANCA. Neither anti-GPⅣ antibody nor anti-GP Ⅰ a/Ⅱ a antibody was detected in patients of this study. Conclusion The positive rate of antiplatelet antibody (anti-GP Ⅱb/Ⅲ a antibody, anti-GP Ⅰb/Ⅸ antibody) is significantly higher in patients with active systemic lupus erythematosus complicated with thrombocytopenia,and these two antibodies are significantly associated with clinical outcomes.