Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

Objective To understand the implementation of the nursing group standards for oxygen inhalation therapy in clinical practice,and to provide a reference for improving the nursing practice of oxygen therapy.Methods A convenience sampling method was used to investigate nurses from 902 hospitals in 24 provinces and municipalities directly under the central government using a self-designed questionnaire from December 15th,2022,to January 14th,2023.The content of questionnaire included whether they had implemented the recommendations of the oxygen therapy standards,the knowledge of safety related to oxygen therapy,and the components of oxygen therapy prescriptions,the indications used for patients receiving oxygen therapy and practice status of oxygen therapy.Results A total of 10481 questionnaires were returned,of which 10447 were valid,with a valid questionnaire recovery rate of 99.68%.63.14%of the nurses indicated that the hospital had organized training on oxygen therapy standards.Only 47.82%of nurses know the correct use of the Venturi mask.41.90%of nurses could indicate the correct indicator of flow adjustment.31.88%of the nurses stated that they will adjust the oxygen flow rate based on the oxygenation status of carbon dioxide storage patients.Only 19.56%of nurses indicated that humidification is applied in oxygen therapy based on the oxygen flow and duration.Conclusion Even though nurses had received training related to oxygen therapy standards,the level of knowledge of oxygen therapy standards was still low;therefore continuous systematic training was needed,and the implementation of the content of oxygen therapy standards needed to be further standardized.Healthcare institutions would focus on organizing systematic training and maintaining the training effect,enhancing infrastructure and providing support for implementation.Recommendation to the nursing administration is to explore how to comprehensively and continuously implementing the oxygen therapy nursing standards with the ultimate goal of providing patients safer and more accurate oxygen therapy.

Cardiac rehabilitation is an important preventive and treatment method for patients with cardiovascular diseases. The application of artificial intelligence in home cardiac rehabilitation provides great potential for the development of cardiac rehabilitation services. This article reviewed the common forms, application effects, existing problems and development trends of artificial intelligence in home cardiac rehabilitation in order to provide a reference for the effective application of artificial intelligence technology in home cardiac rehabilitation in my country.

Objective:To explore the current status and influencing factors of psychological resilience of patients with acute aortic dissection, and analyze the correlation between psychological resilience and social support of patients.Methods:From August 2018 to December 2019, convenience sampling method was used to select 130 patients with acute aortic dissection hospitalized in Nanjing Drum Tower Hospital as the research object. The Basic Information Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC) and the Social Support Rating Scale (SSRS) were used to investigate the psychological resilience and social support of patients. SPSS 19.0 was used for statistical analysis of the data.Results:Among those acute aortic dissection patients, the scores of psychological resilience and social support were (67.44±15.56) and (42.07±7.22) respectively. Univariate analysis showed that patients with different family relationships and family income per capita had statistically significant differences in their psychological resilience scores ( t=13.264, 4.440; P<0.01) . Correlation analysis showed that the psychological resilience of patients with acute aortic dissection was positively correlated with the level of social support ( r=0.211, P<0.05) . Multiple linear regression indicated that family relationships and family income per capita were the influencing factors of patients' psychological resilience (adjust R2=0.129, P<0.05) . Conclusions:The psychological resilience of patients with acute aortic dissection is at a moderate level, and they have certain psychological recovery capabilities. Nursing staff should help patients make full use of their mental recovery capabilities, and provide necessary social support, so as to improve their psychological resilience and promote mental health.

Objective: To observe the relationship between hyperthyroidism and vascular endothelial injury. Methods: From 2016 to 2017, data of 60 patients with simple hyperthyroidism, autoimmune thyroid disease, cardiovascular and cerebrovascular diseases were collected from the Second Affiliated Hospital of Harbin Medical University. And 60 healthy subjects were enrolled in the same period as a healthycontrol group. The enzyme-linked immunosorbent assay (ELISA) was used to detect the content of vascular endothelial injury markers (vWF), thrombomodulin (TM), endothelin-1 (ET-1), P-selectin in serum of all subjects, as well as the serum thyroid stimulating hormone (TSH), free triiodothyronine (FT₃), free thyroxine (FT₄), anti-thyroglobulin antibody (TgAb), and anti-thyroid peroxidase antibody (TPOAb) in patients with cardiovascular and cerebrovascular diseases levels. The correlation analysis of vascular endothelial injury in the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group and healthy control group was conducted. Results: There were statistically significant differences between the healthy control group, the simple hyperthyroidism group, the autoimmune thyroid disease group and the cardiovascular and cerebrovascular diseases group in the serum levels of vWF, TM, ET-1 and P-selectin, respectively(F = 6.56, 9.19, 7.88, 12.45, P < 0.05), and the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group were significantly higher than the healthy control group (P < 0.05). Correlation analysis showed that the vascular endothelial injury in the patients with simple hyperthyroidism, autoimmune thyroid disease, and cardiovascular and cerebrovascular diseases groups was statistically significantly different compared with the healthy control group, respectively(χ² = 5.08, 5.08, 8.16, P < 0.05); the risk of vascular endothelial injury in each diseased group was 2.37, 2.37, and 3.07 times higher than that of the healthy control group, respectively. The abnormal rates of TSH, FT₃, FT₄, TgAb and TPOAb in patients with cardiovascular and cerebrovascular diseases were 18.33% (11/60), 15.00% (9/60), 15.00% (9/60), 10.00% (6/60) and 11.7% (7/60), respectively. Conclusion Simple hyperthyroidism and autoimmune thyroid disease are risk factors of vascular endothelial injury.

ObjectiveTo explore the feasibility and safety of preoperative cardiac rehabilitation (CR) nursing intervention in patients with severe valvular disease, and to evaluate the effect of preoperative exercise-mediated cardiac rehabilitation nursing on the clinical outcomes of patients after operation. MethodsFrom January to December of 2017, 108 patients with advanced valvular heart disease (AVHD) admitted in Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected based on the diagnostic standard for AVHD. The AVHD patients should not be younger than 18 years old, left ventricular ejection fraction(LVEF) less than 40%, and need repair of interventricular septal perforation, resection of ventricular aneurysm and radiofrequency ablation of surgical atrial fibrillation simultaneously. Random number method was used to divide the patients into control group and cardiac rehabilitation nursing intervention group (CR group). Mitral and aortic valve lesions were the main types of valvular lesions in the two groups, and the principles of preoperative treatment were the same. Patients in the control group received routine nursing after admission. The patients in the observation group were evaluated by 6 minute walking test (6MWT) after admission. According to the distance of 6MWT, MOTO Med nursing intervention was carried out in gradeⅠ andⅡ. Frequency was once a day, 30 minutes each time, the first movement resistance was 1 kg, and was adjusted appropriately according to the individual situation. Exercise training and aerobic training were carried out for gradeⅢ andⅣ, with emphasis on lower limb muscles, abdominal muscles and ectopectoralis once a day for 20 minutes each time. ResultsThere was no significant difference in hospital stay, ICU stay time and mechanical ventilation time between the two groups (P＞0.05). The LVEF value of CR group was significantly higher than that of control group at the early stage after operation [(42.5±6.2) vs .(31.0±4.5),P＜0.001)]. The 6 MWT (P=0.009) and self-management(Barthel) score (P=0.001) of CR group were better than those of control group. There was no significant difference in quality of life between the two groups 30 days after operation(P＞ 0.05). ConclusionsPreoperative cardiac rehabilitation nursing intervention can effectively improve the cardiac function of patients with severe valvular disease early after operation, increase the early exercise tolerance of patients after operation, improve the early self-care ability of patients after operation, and help patients recover better and faster.

Objective To explore the effect of hepatitis B virus (HBV) X protein (HBx) on autotaxin (ATX) expression and its significance. Methods The recombinant eukaryotic expression vector of HBx ,pcD-NA3.1(+)-HBx,and the recombinant luciferase reporter gene vector of ATX promoter,pGL3-ATX,were con-structed and used to co-transfect HepG2 cells to examine the effect of HBx on the activity of ATX promoter. The sta-ble cell expressing HBx,HepG2.HBx,was constructed,and Western blot(WB)was used to detect the effect of HBx on ATX expression. Results The luciferase activity of pcDNA3.1(+)-HBx and pGL3-ATX group was 1.47 times as that of the empty vector cDNA3.1(+)and pGL3-ATX group(P<0.000). WB detection showed that the expression of ATX protein was increased in HepG2.HBx cells,and 1.75 times as that of HepG2 cells(P<0.05). Conclusion HBx can activate ATX promoter and up-regulate ATX expression ,thus suggests that HBV infection might enhance ATX/LPA signaling.

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

Objective Oridonin is a poorly water soluble drug with low bioavailability.The study aimed to prepared improve the dissolution rate of oridonin by preparation of oridonin solid dispersion with poloxamer. Methods The oridonin solid dispersion was prepared by dissolvent method with poloxamer188 as the carrier and determined by DSC and powder X-ray diffraction.The dissolu-tion rates in different pH dissolution mediums of pure drug, physical mixture and solid dispersion were determined by HPLC method. Results Oridonin exists as an amorphous state in the solid dispersion.Compared with the pure drug and physical mixture, the orido-nin solid dispersion was improved greatly without the pH influence on the drug release.The dissolution rate of oridonin solid dispersion in water, pH 6.8 PBS and pH 1.2 HCl were (92.6 ±4.2)%, (93.1 ±3.5)%and (94.4 ±2.9)% respectively. Conclusion Taking inpoloxamer188 as the carrier, the oridonin solid dispersion has successfully developed its dissolution rate.

Objective To assess the myocardial function with early insulin treatment by velocity vector imaging (VVI) combined with dipyridamole stress in diabetic rats.Methods The 30 rats comprised 20 diabetic rats and 10 normal rats in the study.The 20 diabetic rats were divided into the diabetes mellitus(DM) group and the treatment group.Every rat in the treatment group was hypodermic injected with protamime biosynthetic human insulin after the diabetic model established.The control group was including 10 normal rats of the same age.After 8 weeks,each rat was performed with VVI at baseline and after dipyridamole stress.Results At baseline VVI,the parameters in the DM and the treatment groups were reduced compared with those in the control group.The systolic velocity,circumferential strain,systolic and diastolic circumferential strain rate in the treatment group were increased significantly compared with those in the DM group.After stress,the VVI reserve parameters in the treatment group were higher than those in the DM group.Conclusions The myocardial function are improved with early insulin treatment in the diabetic rats.