Heart failure is the end stage of multiple cardiovascular diseases, which can easily form venous thromboembolism (VTE) due to the combination of vascular wall injury, hypercoagulable state and decreased blood flow velocity. VTE is an important cause of death in patients with heart failure. By adopting active VTE prevention strategies, the rehospitalization rate and incidence of VTE in patients can be reduced, and the health outcomes of patients can be improved. This article summarizes the incidence, mechanism, risk factors, preventive measures, evaluation tools, and nursing measures of heart failure combined with VTE, in order to provide reference for preventing VTE in heart failure patients.

Objective To summarize the preliminary application results of ultrasound-guided biliary drainage tube replacement, present the corresponding technical points, and discuss the operation strategy and clinical application value. Methods The clinical data of 60 patients who underwent ultrasound-guided biliary drainage tube replacement in Qilu Hospital of Shandong University between August 2014 and August 2020 were retrospectively analyzed. The operation procedure, clinical applications, and postoperative complications were summarized and analyzed. Results Fifty-eight of the 60 patients (96.67%) were successfully replaced with drainage tubes along the original sinus. Among them, dilated sinus tracts of 47 patients were placed with coarse-grade drainage tubes, and dilated sinus tracts of the remaining 11 patients were placed with the original type of drainage tubes, with the mean operation time of 15.8(12.0-19.0) min under local anesthesia. In total, bile was drained from 28 patients receiving PTCD drainage, 23 patients receiving gallbladder drainage, and 9 patients receiving T-tube drainage. The post-operation evaluation revealed that the drainage situation has improved, with a 100% effective rate. No obvious abnormality was found in the postoperative follow-up visit. Conclusion The replacement of drainage tube under ultrasound guidance is simple, safe and feasible, and it provides further promotion in clinical practice with sufficient data support.

Objective:To investigate the clinical characteristics of adult undifferentiated embryonal sarcoma of the liver (UESL).Methods:A retrospective analysis was performed on the clinical data of 5 patients with UESL who underwent surgical resection and were pathologically confirmed from January 2005 to December 2020 at the First and the Second Affiliated Hospital of Anhui Medical University. All the patients were female aged from 49 to 77 years old. Preoperative CT showed a solid cystic mass with low density and a slight density of cord like septum. Imaging findings were misdiagnosed as hepatocellular carcinoma or cystadenocarcinoma. CA125 was higher in 3 patients,and AFP in all patients was normal.Results:All patients were treated by surgery. The mean diameter of tumor was 20.2 cm (range:15.0 to 30.0 cm). All five patients had vimentin expression in immunohistochemistry. Three cases underwent complete resection of the tumor and achieved R0 resection,2 of them had tumor free survival until the end of the follow-up (89 and 55 months),the other 1 case died from renal cell carcinoma 158 months later. The remaining 2 cases were radically resected,but the tumors were ruptured during operation,and relapsed after 2 months and 19 months respectively. The overall survival was 3 and 26 months respectively.Conclusions:Radical hepatectomy is the first choice for treatment of UESL. Intraoperative tumor rupture should be avoided and implant metastasis is a major factor affecting the prognosis of UESL.

Objective:To investigate the effect of hourly ambient temperature exposure on emergency calls in Xuchang city and Zhengzhou city.Methods:The hourly meteorological data, air pollution data and emergency calls of Xuchang city and Zhengzhou city were collected from January 1, 2017 to October 31, 2019. A distributed lag non-linear model was used to calculate the excess relative risk ( ERR). The lag effect and cumulative effect of extreme temperature exposure on emergency calls were evaluated. Results:The relationship between hourly temperature exposure and emergency calls was a U-shaped curve. In Xuchang city and Zhengzhou city, both low and high temperatures would increase the number of hourly emergency calls. The earliest effect of low temperature occurred at a lag of 22 h and 52 h, with ERR values (95% CI) about 0.20% (0.00%, 0.39%) and 0.11% (0.00%, 0.22%), respectively. The earliest effect of high temperature occurred at a lag of 0 h with ERR values about 1.59% (1.09%, 2.09%) and 1.45% (1.22%, 1.69%), respectively. High temperature had the greatest impact on the number of emergency calls of cardiovascular disease at a lag of 4-8 h. The cumulative ERR values (95% CI) of the two cities were 8.70% (4.98%, 12.75%) and 3.89% (2.61%, 5.22%), respectively. Conclusion:High temperature exposure could increase the number of emergency calls within a few hours, while the effect of low temperature would not occur until 22 hours later.

Objective:To investigate the clinical characteristics of adult undifferentiated embryonal sarcoma of the liver (UESL).Methods:A retrospective analysis was performed on the clinical data of 5 patients with UESL who underwent surgical resection and were pathologically confirmed from January 2005 to December 2020 at the First and the Second Affiliated Hospital of Anhui Medical University. All the patients were female aged from 49 to 77 years old. Preoperative CT showed a solid cystic mass with low density and a slight density of cord like septum. Imaging findings were misdiagnosed as hepatocellular carcinoma or cystadenocarcinoma. CA125 was higher in 3 patients,and AFP in all patients was normal.Results:All patients were treated by surgery. The mean diameter of tumor was 20.2 cm (range:15.0 to 30.0 cm). All five patients had vimentin expression in immunohistochemistry. Three cases underwent complete resection of the tumor and achieved R0 resection,2 of them had tumor free survival until the end of the follow-up (89 and 55 months),the other 1 case died from renal cell carcinoma 158 months later. The remaining 2 cases were radically resected,but the tumors were ruptured during operation,and relapsed after 2 months and 19 months respectively. The overall survival was 3 and 26 months respectively.Conclusions:Radical hepatectomy is the first choice for treatment of UESL. Intraoperative tumor rupture should be avoided and implant metastasis is a major factor affecting the prognosis of UESL.

Objective:To investigate the effect of hourly ambient temperature exposure on emergency calls in Xuchang city and Zhengzhou city.Methods:The hourly meteorological data, air pollution data and emergency calls of Xuchang city and Zhengzhou city were collected from January 1, 2017 to October 31, 2019. A distributed lag non-linear model was used to calculate the excess relative risk ( ERR). The lag effect and cumulative effect of extreme temperature exposure on emergency calls were evaluated. Results:The relationship between hourly temperature exposure and emergency calls was a U-shaped curve. In Xuchang city and Zhengzhou city, both low and high temperatures would increase the number of hourly emergency calls. The earliest effect of low temperature occurred at a lag of 22 h and 52 h, with ERR values (95% CI) about 0.20% (0.00%, 0.39%) and 0.11% (0.00%, 0.22%), respectively. The earliest effect of high temperature occurred at a lag of 0 h with ERR values about 1.59% (1.09%, 2.09%) and 1.45% (1.22%, 1.69%), respectively. High temperature had the greatest impact on the number of emergency calls of cardiovascular disease at a lag of 4-8 h. The cumulative ERR values (95% CI) of the two cities were 8.70% (4.98%, 12.75%) and 3.89% (2.61%, 5.22%), respectively. Conclusion:High temperature exposure could increase the number of emergency calls within a few hours, while the effect of low temperature would not occur until 22 hours later.

Objective:To explore the application effect of nursing intervention based on Neil Noddings' caring theory in school-age children with asthma.Methods:From August 2018 to August 2019, a total of 112 school-age children with bronchial asthma were admitted to the Second Department of Pediatric Internal Medicine of Tangshan Maternal and Child Health Hospital. According to the random number table method, they were randomly divided into the control group and the observation group, with 56 cases in each group. The control group adopted routine nursing intervention, while the observation group adopted nursing intervention based on Neil Noddings' caring theory on the basis of routine intervention. The scores of The Screen for Child Anxiety Related Emotional Disorders (SCARED) , Self-Rating Scale for Depressive Disorder in Childhood (DSRSC) and self-management behavior of patients were compared between the two groups before the intervention and 1 month after the intervention.Results:After the intervention, the total scores and the scores of all dimensions of self-management behavior scale for children with asthma in the two groups were higher than those before the intervention ( P<0.05) , and score of the observation group was higher than that of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, scores of SCARED and DSRSC of children in the two groups were lower than those before the intervention ( P<0.05) , and the score of the observation group was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing intervention based on Neil Noddings' caring theory can effectively reduce negative emotions of school-age children with asthma and improve their self-management behavior.

Objective:To explore the clinical value of adenosine stress myocardial contrast echocardiography in detecting myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus.Methods:Twenty-six patients with type 2 diabetes mellitus clinically diagnosed from May 2019 to January 2020 in the endocrinology department of Fuwai Central China Cardiovascular Hospital and 28 healthy examinees with gender and age matched during the same period were enrolled. Routine echocardiography, rest and adenosine stress myocardial contrast echocardiography were performed, the plateau signal intensity(A value), curve rising slope(K value) and A×K value of the myocardial perfusion time-intensity curve were obtained by offline analysis. And general data such as age, gender, disease course, body mass index and glycated hemoglobin were collected, and results of the two groups were compared statistically.Results:In the rest state, the A value of the myocardial perfusion parameter in the diabetic group was not significantly different from that of the control group, both in whole and in segments ( P>0.05), while the K value and A×K value of the myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group ( P<0.05). In the stress state, the A value, K value and A×K value of myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group, both in whole and in segments ( P<0.05). The detection rate of myocardial perfusion abnormality in the stress state was significantly higher than that in the rest state, and the difference was statistically significant ( P<0.05). The myocardial blood flow reserve in the diabetic group was negatively correlated with the course of disease and the level of glycated hemoglobin ( r=-0.580, P=0.020; r=-0.481, P=0.013). Conclusions:Adenosine stress myocardial contrast echocardiography can be used for detection of left ventricular myocardial perfusion abnormalities in patients with type 2 diabetes mellitus, which has great clinical application value.

Objective:To investigate the relationship of glycated hemoglobin(HbA1c)and brain natriuretic peptide(BNP)levels with clinical prognosis of acute myocardial infarction.Methods:A total of 108 patients with acute myocardial infarction combined with diabetes mellitus, who underwent percutaneous coronary intervention(PCI)from March 2016 to June 2017 in our hospital, were enrolled.According to the HbA1c level, patients were divided into three groups: Group A(HbA1c≤6.9%, n=36), Group B(7%≤HbA1c≤7.9%, n=31)and Group C(HbA1c≥8%, n=41). HbA1c and NT-proBNP levels, cardiac function classification at admission and discharge, the incidence of adverse cardiac events during hospitalization and left ventricular ejection fraction(LVEF)at admission, discharge and 3 months after discharge were analyzed.Results:Among the three groups, plasma NT-proBNP levels were higher in Group C than in Group B and Group A( P<0.05), and there was no significant difference between Group B and Group C( P<0.05). Furthermore, HbA1c levels were positively correlated with NT-proBNP levels in Group C( P<0.05). Cardiac function grading was better in Group A and Group B than in Group C at discharge.During hospitalization, the incidence of adverse cardiac events in Group C was 29.3%, which was higher than in Group A(8.3%)and Group B(9.7%)( P<0.05). LVEF levels were significantly improved in Group A and Group B at discharge and 3 months after discharge, compared with those at admission, while Group C had no significant improvement in LVEF levels and had lower LVEF than Group A and Group B( P<0.05). Conclusions:HbA1c and NT proBNP levels can be used as a joint monitoring indicator in patients with acute myocardial infarctions after PCI, to help prevent and reduce the incidence of complications and mortality in patients with acute myocardial infarction after PCI and improve clinical prognosis.