Objective To explore the application of space sand as filling material in the prevention of pressure sore in the lateral position surgery in Neurosurgery Department.Methods A total of 130 cases of lateral decubitus position surgery in Second Hospital of Hebei Medical University from October 2016 to March 2017 were selected and randomly divided into control group (n=65) and observation group (n=65) by random number table method.The control group used traditional gel position pad for lateral decubitus position,while the observation group used self-made space sand position pad for lateral position.The incidence of pressure sores of patients with lateral decubitus surgery of two groups were compared.Results The incidence of pressure sores in the control group was 12.31％,while it was 3.07％ in the observation group.The difference was statistically significant (x2=3.900,P ＜ 0.05).Conclusions The use of space sand position pad can effectively prevent the occurrence of pressure sore in the lateral decubitus position in Neurosurgery Department.

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department,who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement (365.97±42.08) s and the incidence of pressure sore in the non-compression side upper limb (10.0%) were higher than those of the observation group[ (302.69± 38.25)s, 1.3%]. The differences were statistically significant (P＜0.05). The efficiency (100.0%) of the non-compression side upper limb restraint in the observation group was higher than that in the control group (91.3%). The difference was statistically significant (P＜0.05). Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.

ObjectiveTo discuss the potential relationship of plaque burden (PB) and coronary remodeling in acute coronary syndrome (ACS) patients.MethodsNinety-one patients with ACS in Qingdao Municipal Hospital during January 2011 to June 2014 underwent the conventional coronary angiography and intravascular ultrasonography (IVUS). The remodeling of 60 cases were positive (remodeling index [RI]>1) and those of 31 cases were negative (RI<1). All 91 patients were included in this study, including 9 cases (PB<60%), 19 cases (60%≤PB<70%), 48 cases (70%≤PB<80%) and 15 cases (PB>80%). The difference of plaque cross-sectional area (P-CSA), lumen cross-sectional area (L-CSA), external elastic membrane cross-sectional area (EEM-CSA), average EEM-CSA, PB between positive remodeling andnegative remodeling were compared by independent-samplest test. ANOVA was used to compare P-CSA, L-CSA, EEM-CSA and RI among patients with different PB. The relevance of PB, P-CSA, EEM-CSA, L-CSA and RI were analyzed by Pearson correlation analysis.ResultsThere were no signifi cant differences in P-CSA, L-CSA, EEM-CSA and PB between patients with positive remodeling and negative remodeling. Average EEM-CSA of patients with negative remodeling were signifi cantly greater than that of patients with positive remodeling ([13.24±1.98] mm2vs [17.30±3.16] mm2,t=2.46,P<0.05). P-CSA, EEM-CSA and L-CSA had signifi cant differences (F=24.56, 28.97 and 7.14,P<0.001) while RI had not statistical signifi cant difference among patients with different PB. With the increase of PB, P-CSA and EEM-CSA increased (P-CSA: [6.01±1.68], [9.12±2.00], [11.42±2.05] and [14.05±4.00] mm2, EEM-CSA: [11.43±1.90], [13.64±2.93], [15.14±2.64] and [16.64±4.08] mm2), L-CSA reduced ([5.44±0.89], [4.52±0.99], [3.72±0.74] and [2.60±0.63] mm2). PB was positively correlated with P-CSA and EEM CSA (r=0.76, 0.50,P<0.001), but was negatively correlated with L-CSA (r=-0.74, P<0.001). RI had no relationship with PB, P-CSA, L-CSA and EEM-CSA.ConclusionsCoronary artery remodeling is a very complicated dynamic process. Except the PB, other factors probably affect the direction of remodeling. RI is not suitable as the index for the assessment of vascular remodeling.

Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.

Objective To evaluate the role of three vessels and trachea view (3VT) in diagnosis of fetal heart disease and great artery abnormality.Methods 39 pregnant women undergoing fetal ultrasound scan and diagnosed with great artery abnormality were enrolled in this study.Then the image characteristics and significance of 3VT in these 39 cases were analyzed and evaluated.Results In these 39 cases proved by autopsy,persistent truncus arteriosus(7 cases),transposition of the great arteries(7 cases),coarctation of the aorta(5 cases),tetralogy of Fallot (4 cases),pulmonary stenosis (3 cases),hypoplastic left ventricle syndrome(2 cases),persistent left superior vena cava (2 cases),pulmonary valve stenosis with single ventricle(2 cases),Ebstein anomaly with pulmonary stenosis (1 case),interruption of the aortic arch( 1 case),hypoplastic right ventricle(1 case),dextroaortic arch (1 case),and ductus arteriosus stenosis( 1 case) were detected.All of them had anomalies performance on 3VT.While in the 2 cases of double outlet right ventricle,only one eoncurrenting with pulmonary artery stenosis showed reduced inner diameter of pulmonary artery on 3VT.According to the performance of 3VT in great artery abnormality,it could be divided into 4 categories:abnormal location,abnormal ratio,abnormal amount and abnormal blood direction of great artery.Conclusions 3VT is a useful supplement to the 4-chamber view,and has significant value in diagnosis of fetal heart and great arteries abnormities.

Objective To investigate the influence of atherosclerotic reference segments on coronary remodeling by intravascular ultrasound(IVUS) in patients with acute coronary syndrome(ACS). Methods One hundred and three consecutively enrolled patients [male 68 cases,female 35 cases,average age (60 ±11) years] with ACS were undergone by coronary artery angiography and IVUS with time selecting operation. The remodeling index(RI) was defined as lesion external elastic membrane cross section aere (EEM CSA) divided by the mean reference EEM CSA at the culprit vessel. Positive remodeling was RI≥ (67 cases), negative remodeling was RI <1(36 cases). The parameters of plaque were analysed between two remodeling groups, as well as compared between distal and proximal references. Results Only one patients do not have plaque at reference sites. In the analysis of 103 lesions and 102 reference sites, there were not significant different in plaque burden,plaque CSA,lumen CSA and lesion EEM CSA between two groups. Distal plaque burden[(39. 76 ±12. 54)% vs (32.38 ± 13.97)%, P <0.001] and plaque CSA [(6.14 ± 3.20)mm2 vs (4. 75 ± 3. 07) mm2, P = 0. 001] were larger than those at proximal reference. EEM CSA at distal reference was smaller than proximal one[(14. 99 ± 4. 12)mm2 vs (28. 37 ± 4. 48)mm2 , P <0. 001]. Plaque burden, plaque CSA and lumen CSA persented positive corelation between distal and proximal reference sites. Conclusions The reference segments lay a severe diffuse atherosclerosis in the group of ACS, which may influence assessment of coronary remodeling. Coronary remodeling as a process, a accurate evaluation could be result from the combination of static and serial approach by IVUS.

Objective To investigate the relationship between β-fibrinogen (β-Fg) gene -455G/A,- 148C/T polymorphisms and atrial fibrillation (AF) with cerebral infarction.Methods Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of -455G/A and -148C/T in 97 patients with AF with cerebral infarction (AF with cerebral infarction group),80 patients with AF alone (AF group),and 98 health subjects (healthy control group).Results The A allele frequencies of -455G/A in the AF with cerebral infarction group and the AF group were 0.304 and 0.344 respectively.They were significantly higher than 0.179 in the healthy control group (all P＜0.05).The T allele frequencies of - 148C/T in the AF with cerebral infarction group and the AF group were 0.348and 0.369,respectively.They were significant higher than 0.240 in the healthy control group (all P＜0.05).Conclusions The A allele of -455G/A and the T allele of -148C/T were associated with AF with cerebral infarction and AF.

Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome(ACS). Methods lntravascular ultrasound(IVUS) was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors(sPE,t-PA, MCP-I, IL-8,IL-6,sVCAM-1, and sCD40L) was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction (AMI) and ustable angina (UA) patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-1sPE, sVCAM-1-sCD40L, sCD40L-sPE, IL-6-IL8,IL8-MCP4, and MCPI-sVCAM-1; CRP (18.868±4.907mg/L vs 5.806±3.553 mg/L)and IL-6 (19.5 pg/ml [9.2±44.6 pg/ml]vs 5.3 pg/ml [2.3～ 13.4 pg/ml])were elevated in the vulnerable plaque group(P <0.05). sCD40L(473.82±126.11 vs 237.94±34.78 pg/mi),sPE (107.214±39.90 vs 49.06±5.61 μg/L) and MCP-1(132.42±17.85 vs 127.174±13.27 pg/ml) were increased in the plaque rupture group(P < 0.05);There was correlation between tPA and plaque morphology(P < 0.05). Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.

Insufficient intracellular fat oxidation is an important contributor to aging-related insulin resistance, while the precise mechanism underlying is unclear. AMP-activated protein kinase (AMPK) is an important regulator of intracellular fat oxidation and was evidenced to play a key role in high-glucose and high-fat induced glucose intolerance. In the present study, we investigated whether altered AMPK expression or activity was also involved in aging-related insulin resistance. Insulin sensitivity of rats' skeletal muscles was evaluated using in-vitro glucose uptake assay. Activity of alpha subunit of AMPK (AMPKalpha) was evaluated by measuring the phosphorylation of both AMPKalpha (P-AMPKalpha) and acetyl-CoA carboxylase (P-ACC), while expression of AMPKalpha was assessed by determining the mRNA levels of AMPKalpha1 and AMPKalpha2, and protein contents of AMPKalpha. Compared with 4-month old rats, 24-month old rats exhibited obviously impaired insulin sensitivity. At the same time, AMPKalpha activity significantly decreased, while AMPKalpha expression did not alter during aging. Glucose transporter 4 expression also decreased in old rats. Compared with 24-month old rats, administration of the specific activator of AMPK, 5-aminoimidazole-4-carboxamide riboside (AICAR), significantly elevated AMPKalpha activity and GluT4 expression. Also, aging-related insulin resistance was significantly ameliorated by AICAR treatment. In conclusion, aging-related insulin resistance is associated with impaired AMPKalpha activity and could be ameliorated by AICAR, thus indicating a possible role of AMPK in aging-induced insulin resistance.
AMP-Activated Protein Kinases ; Acetyl-CoA Carboxylase/metabolism ; Aging/*physiology ; Aminoimidazole Carboxamide/analogs & derivatives/pharmacology ; Animals ; Glucose/*metabolism ; Glucose Transporter Type 4/metabolism ; Insulin/*blood ; *Insulin Resistance ; Male ; Multienzyme Complexes/*antagonists & inhibitors/metabolism ; Muscle, Skeletal/*metabolism ; Phosphorylation ; Protein-Serine-Threonine Kinases/*antagonists & inhibitors/metabolism ; Rats ; Rats, Wistar ; Ribonucleotides/pharmacology

Objective To evaluate the impact of the off -pump coronary artery bypass (OPCAB) on left ventricular(LV) function with transesophageal echocardiography(TEE). Methods Blood flow velocities of pulmonary vein (PV) and mitral valve (MV) were performed in 21 patients with coronary heart disease and myocardial infarction two weeks pre-OPCAB, and the left ventricular SV, CO and LVEF were measured by biplane Simpson′s method, the data were compared with the results observed one month post-OPCAB. Results The peak flow velocities of PV had significant difference between pre- and post-OPCAB(P