OBJECTIVE To evaluate the ameliorative effect of Juanbi Tongluo Oral Liquid on sciatic neuronal apoptosis in Type 2 diabetic model mice.METHODS The Type 2 diabetes mouse model was established by feeding with high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin(STZ).The mice were treated with metformin(200 mg·kg-1·d-1),low dose(3.9 g·kg-1·d-1)and high dose(7.8 g·kg-1·d-1)Juanbi Tongluo Oral Liquid for 35 days.The latency of response to thermal stimu-lation was detected by hot plate,and the values of blood glucose insulin and glycosylated hemoglobin were determined.Biochemical kits were used to detect the expression of serum total cholesterol(T-CHO),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)and oxidation product malondialdehyde(MDA).The expression of tumor cytokine α(TNF-α),interleukin(IL)-1β,IL-6 and IL-10 in serum of mice were detected by ELISA method;the injury of sciatic nerve of model mice was detected by HE staining;the apoptosis of sciatic nerve was detected by TUNEL method;and the expression of neurofilament protein NF-L,apoptosis(cleaved Caspase-3,Caspase-3)and oxidative stress(Nrf2,HO-1)signal pathway proteins in sciatic nerve of model mice were detected by Western blot method.RESULTS High-dose Juanbi Tongluo Oral Liquid shortened the latent period of heat pain response in model mice(P<0.01);downregulated fasting blood glucose and glycated hemoglobin(P<0.01),and upregulated fasting plasma insulin in model mice(P<0.01);downregulated serum T-CHO,TG,and LDL-C levels(P<0.01),upregulated HDL-C levels(P<0.01);downregulated serum pro-inflammatory factors TNF-α,IL-1β and IL-6 levels(P<0.05),upregulated the anti-inflammatory cyto-kine IL-10 level(P<0.01);inhibited sciatic nerve structural damage and apoptosis(P<0.05);downregulated the ratio of cleaved Caspase-3 to Caspase-3 in the apoptosis pathway(P<0.01);upregulated the expression of neurofilament proteins NF-L and NF-H in sciatic nerve tissue(P<0.05,P<0.01);and upregulated the expression of antioxidant stress proteins Nrf2 and HO-1(P<0.01).CONCLUSION Juanbi Tongluo Oral Liquid can improve sciatic neuronal apoptosis of Type 2 diabetic mice,which may be related to its effect on improving oxidative stress and inflammatory stress.

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*

Objective:To investigate the value of 256-slice CT coronary angiography(CTA)in evaluating graft patency after coronary artery bypass grafting(CABG)in elderly patients.Methods:A total of 30 elderly patients under follow-up after CABG surgery in our hospital from May 2016 to May 2018 were randomly selected.During the same period, coronary angiography(CAG)and 256-slice CTA were performed to evaluate the patency of grafts.The diagnostic efficacy of CTA in evaluating the patency of bypass grafts was assessed by using CAG results as the gold standard.Results:In all, 82 grafts were observed on CAG, of which 31 were arterial grafts and 51 were saphenous vein grafts(SVG). Arterial grafts involved 27 original left internal mammary arteries(LIMA)→left anterior descending branch(LAD)grafts, 1 original right internal mammary artery(RIMA)→LAD graft, 1 aorta(AO)→LIMA→LAD graft, and 2 AO→radial arteries(RA)→right coronary artery(RCA)grafts.Venous grafts involved 9 AO→SVG→LAD grafts, 20 AO→SVG→left circumflex artery(LCX)grafts, and 22 AO→SVG→RCA grafts.CAG results showed that 28 arterial grafts were unobstructed with a patency rate of 90.3%, while 3 arterial grafts(9.7%)were occluded.Meanwhile, 34 venous grafts were unobstructed with a patency rate of 66.7%, 11 venous grafts(21.6%)had stenosis and 6 grafts(11.8%)were occluded.A total of 87 grafts were observed by using CTA.Based on the results from CAG, the overall sensitivity, specificity and Kappa value of CTA for the assessment of grafts were 95.1%, 97.6% and 0.93, respectively.The sensitivity, specificity and Kappa value of CTA were 96.8%, 95.0% and 0.90 for assessing unobstructed grafts, 81.8%, 97.2% and 0.79 for assessing stenosed grafts, and 100%, 98.6%, and 0.94 for assessing occluded grafts, respectively.Conclusions:256-slice CT coronary angiography can be used to accurately evaluate graft status and possesses advantages such as non-invasiveness, simplicity and low risk.Therefore, it should be recommended as the first choice in the evaluation of graft patency after CABG in elderly patients.

Objective To investigate the effect of cardiopulmonary bypass (CPB)on platelet inhibition rate(INHAA) and Aspirin resistance (AR) after coronary artery bypass grafting (CABG)surgery.Methods A total of 114 patients undergoing CABG surgery were divided into two groups:on-pump group(n=54)and off-pump group(n=60).Aspirin treatment(100 mg/d)was paused 7 days before surgery and continued 6 hours after surgery.INHAA was detected and calculated by using thrombelastography(TEG)at 6 hours after taking the last dose of aspirin before surgery(T0),12 hours (T1),5 days(T2),10 days (T3) and 15 days (T4) after surgery respectively.The incidence of AR was calculated.Results There was no significant difference in the overall INHAA between the two groups of on vs.off-pump(F =0.336,P =0.563),while the differences of INHAA index at each time point was statistically significant between two groups of on vs.off-pump(F =95.519,P =0.000).There was an interaction effect of timing and grouping(F =15.500,P =0.000).In comparison of INHAA between the two groups of on vs.off-pump at each time point,INHAA was higher in on-pump group than in off-pump group at T1 (P＜0.05),while INHAAbecame lower in on-pump group than in off-pump group at T2 (P＜0.05),and there was no statistical difference in INHAAbetween the two groups at T3 and T4 (P ＞0.05).In the on-pump group,the total difference of INHAA at different time points was significant (P＜0.05),and the INHAA was lower at T2 than at T1,T3,T4 (P＜0.05).In the off-pump group,the total difference of INHAA between different time points was significant(P＜0.05),and the INHAA was lower at T1 than at T2,T3,T4 (P＜0.05).In comparison of AR incidence after CABG surgery between two groups of on vs.off-pump at each time point,the incidence of AR was lower in on-pump group than in off-pump group at T1 (P ＜ 0.05),while there were no statistical significance between two groups of on vs.off-pump at T2,T3 and T4 (P＞0.05).In comparison of AR incidence after CABG surgery between two groups of on vs.off-pump at each time point,the incidence of AR was lower in on-pump group than in off-pump group at T1 (P ＜0.05),while there were no statistical significance between two groups of on vs.off-pump at T2,T3 and T4 (P ＞ 0.05).Conclusions The increase of platelet inhibition rate and aspirin resistance occurs in early period after CABG surgery.The platelet inhibition rate is higher and aspirin resistance rate is lower in on-pump group than in off-pump group at 12 h after surgery,and the platelet inhibition rate is lower at 5 days after CABG surgery in on-pump group than in off-pump group.CPB has little effect on the platelet inhibition rate and on the incidence of AR after 5 days of CABG surgery.

Objective? To explore the status quo of creative self-efficacy and research performance in nursing undergraduates and to analyze the correlation between the two. Methods? Totally 190 senior nursing undergraduates who practiced in the Second Affiliated Hospital of Kunming Medical University were selected by convenient sampling and investigated with the Creative Self-Efficacy Scale and the Research Performance Self-Rating Scale for nursing staff. Results? The 190 nursing undergraduates' creative self-efficacy score totaled (65.31±9.51), and their total research performance score was (72.85±13.97). Univariate analysis revealed that there was statistically significant difference in creative self-efficacy scores between nursing undergraduates who were student leaders or not (P＜0.05); and there were statistically significant differences in research performance scores between nursing undergraduates with different English levels, computer skills and home address (P＜0.05). The scores of various dimensions creative self-efficacy were positively correlated with the scores of various dimensions of research performance (P＜ 0.01). Conclusions? Nursing undergraduates＇ creative self-efficacy and research performance need to be improved. Universities and colleges should actively launch activities which are beneficial to their research literacy and creative awareness and take scientific research activities as one of the most pathways to develop nursing students＇ research literacy and creativeness and entrepreneurship.

Objective To investigate curative efficacy of ginkgo biloba extract dripping pills in treatment of acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its effects on platelet aggregation rate(PAR), activated clotting time(ACT) and antithrombin(AT)Ⅲ. Methods 90 patients of ACS treated with PCI who received therapy from January 2014 to October 2016 in Zhejiang green town cardiovascular hospital were selected and randomly divided into the observation group and the control group , 45 cases in each group.The control group was treated with routine treatment after PCI, while the observation group was combined with ginkgo biloba extract dripping pills.After treatment of seven days, the changed of PAR, ACT, ATⅢ and adverse cardiovascular events were compared, after treatment three months, the seattle angina scale were compared. Results After treatment, the levels of PAR in the observation group were significantly lower than that of the control group, and the levels of ACT and ATⅢ were significantly higher than that of the control group, the difference was statistically significant (P<0.05), the total incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group , the difference was statistically significant ( P<0.05), in the seattle angina scale, the scores of stable state of angina pectoris, the attack of angina pectoris, physical activity limitation, treatment satisfaction in the observation group were significantly better than that of the control group, the difference was statistically significant (P<0.05). Conclusion Ginkgo biloba extract dripping pill is well for ACS after PCI, which can effectively relieve clinical symptoms, to improve the expression of PAR, ACT and ATⅢ, helps to reduce the incidence of adverse cardiovascular events.

Objective To investigate the therapeutic effect of levosimendan on acute decompensated heart failure and its effect on SDNN and SDANN values.MethodsThe clinical data of patients with acute decompensated heart failure treated in Zhejiang Greentown Cardiovascular Hospital from January 2014 to August 2016 were retrospectively analyzed.According to their treatment methods, they were divided into control group and observation group.There were 49 cases in the control group and 71 cases in the observation group.The control group was given conventional drug treatment, the observation group was given levosimendan treatment on the basis of the control group.The therapeutic effects of the two groups were observed.The difference of cardiac function, SDNN, SDANN value and adverse reaction between the two groups were compared before and after treatment.ResultsAfter treatment, the observation group efficiency was 98.59%, significantly higher than the control group;the observation group LAD, RAD, LVESD, LVEDD and BNP lower than the control group, the level of LVEF was higher than the control group, the difference was statistically significant (P<0.05);the observation group SDNN, SDANN, RMSSD and PNN50 (%) was higher than that of the control group, the difference was statistically significant (P<0.05).ConclusionLevosimendan has good therapeutic effect on acute decompensated heart failure, can significantly improve the level of SDNN, SDANN, and the incidence of adverse reactions is low.

Objective To investigate the current situation and correlation of cognitive dysfunction, activities of daily living (ADL) and quality of life in patients with traumatic brain injury (TBI). Methods A total of 148 patients hospitalized in the Rehabilitation Department of the Second Affiliated Hospital of Kunming Medical University from January to December 2016 were included in this study. The Montreal cognitive assessment scale (MoCA),modified Barthel Index scale (MBI) and WHO quality of life scale (WHO-QOL) were used to investigate the status of patients with traumatic brain injury. Results There were 78 of 148 patients with cognitive dysfunction and the incidence rate was 52.98%. Cognitive dysfunction after TBI was significantly positively related to the ADL ability (r=0.968,P<0.01);the visual space and executive function,attention,abstraction,delayed recall and orientation had the prediction effect on the ADL ability. Cognitive dysfunction after TBI was significantly positively related to the quality of life (r=0.973,P<0.01);cognitive items except the name could predict the quality of life. Conclusions There is a high incidence of cognitive dysfunction in patients with traumatic brain injury,which can affect their ADL ability and quality of life. It is necessary to take effective measures to improve the rehabilitation training of the cognitive function in early stage.

OBJECTIVE:To investigate the effects of Wenxin granule on the related indexes of senile patients with primary hy-pertension and acute left cardiac failure. METHODS:160 senile patients with primary hypertension and acute left cardiac failure were randomly divided into control group(80 cases)and observation group(80 cases). Control group received 12.5 mg captopril, orally,twice to 3 times a day (if patients had taken plenty of diuretic drugs,in low sodium and/or low blood volume,patients with normal or low blood pressure,the initial dose was 6.25 mg,3 times a day). Observation group additionally given 9 g of Wenxin granule,3 times a day. The treatment course for both groups was 4 weeks. SBP,DBP,PP,SDANN,SDNN-Index,RMS-SD,PNN50,improvement of cardiac functions before and after treatment,and incidence of adverse reactions in 2 groups were ob-served. RESULTS:After treatment,the SBP,DBP and PP in 2 groups were significantly lower than before,and observation group was lower than control group,SDNN,SDANN,SDNN-Index、RMSSD and PNN 50 were significantly higher than before,and ob-servation group was higher than control group,the differences were statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on conventional treatment,wenxin granule can significantly reduce the bloop pressure of senile patients with primary hypertension and acute left cardiac failure,improve cardiac functions and inhibit autonomic disorders,with good safety.

Objective To research the clinical efficacy and nursing on treatment of idiopathic choroidal neovascularization by intravitreal injection of anti-VEGF drugs. Methods From January 2011 to May 2013, a total of 36 cases of idiopathic choroidal neovascularization were given intravitreal injection of anti-VEGF drugs. Psychological care was used to eliminate patients′tension and fear, and to establish the confidence of overcoming the disease. Preoperative and postoperative care and disease health guidance were given to patients. Results 36 patients had stable psychological state and could coordinate well with treatment and care. During the 8 to 96 weeks follow up, all patients′ vision had begun to improve after 1 week, and stabilized after 4 weeks. Conclusions Intravitreal injection of anti-VEGF treatment can subside choroidal neovascularization quickly, and improve vision rapidly, and significantly shorten the recovery course. Good psychological care of patients before surgery, enhancing patients′postoperative care and health guidance could shorten the course of disease, and improved the quality of nursing service.