Objective To clarify the characteristics of shock wave sources generated at different medium interfaces.Methods The experiment used an in vitro adjustable impact pressure shock wave generation and signal acquisition system combined with a flexible PVDF sensor.The waveform of the shock wave generated by the applicator at the interface of different media(soft tissue-mimicking phantom,water and air)was explored.The characteristics of the shock wave source in the time and frequency domains were analyzed.Results When the same impact pressure was applied,shock waveforms generated at the interfaces of the phantom and water exhibited similar characteristics from a time-domain perspective.At the same time,both differed significantly from those generated at the air interface,where the absolute values of the positive and negative pressures were noticeably reduced.The characteristics of the shockwave spectra in various media revealed three distinct peak frequencies,with the modulation frequencies varying in the phantom(12.2 kHz),water(8.5 kHz),and air(7.2 kHz).In contrast,the carrier frequency remained relatively constant(between 82 and 83 kHz).When different impact pressures were applied,there was little influence on the waveform at the same medium interface,indicating that the impact pressure affected only the shockwave amplitude and not the peak frequency.As the impact pressure increases,the absolute values of the positive and negative pressures at the medium interface increase linearly.Conclusions Shockwave sources can be effectively measured using a flexible PVDF sensor.Shock waves generated at different medium interfaces exhibit temporal and spectral differences,indicating that the characteristics of shock wave propagation in air or water cannot be substituted for those in biological soft tissues.These findings provide crucial information for evaluating shockwave devices and formulating treatment protocols in the clinic.

At present, there are no universally accepted hepatoprotective drugs that are recommended for the conventional treatment of nonalcoholic fatty liver disease (NAFLD), and the main prevention and treatment methods for NAFLD include diet control, exercise, and weight-loss surgery. Diet control is the most basic intervention method, and scientific and reasonable dietary guidance is of particular importance. This article briefly summarizes the influence of several kinds of oils commonly contained in diet on hepatic steatosis, inflammation, and oxidative stress of NAFLD, and it is pointed out that fish oil, olive oil, virgin coconut oil, and pine nut oil are beneficial to NAFLD, while excessive intake of lard and palm oil will aggravate NAFLD.

Objective To investigate the mid-term efficacy and complications of bone cement or biotype hemiarthroplasty for the femoral neck fracture in the elderly patients.Methods From January 2011 to January 2014,sixty-seven elderly patients (67 hips) with femoral neck fracture were treated with hemiarthroplasty.All patients were treated with bipolar femoral head prosthesis,and the prosthesis included into bone cement and biologic type,according to the fixation of the femoral stem.The 3 year postoperative Harris score and surgeryrelated complications (joint dislocation,prosthesis loosening,acetabular subsidence,and mortality) were evaluated.Results All patients were followed up for 3 years.The excellent and good rate of Harris score was 87.1％ (27/31) in the bone cement group and 80.6％ (25/31) in the cementless group (X2 =0.47,P＞0.05).There was no significant difference in the complications between the two groups (P＞0.05).Conclusion The hemiarthroplasty is an effective and safe methodfor the treatment of femoral neck fracture in the elderly.The key to achieve excellent results is to choose the femoral prosthesis based on the preoperative planning and operation.

Objective To investigate perioperative nursing of new generation optical coherence tomography (OCT) in the diagnosis of percutaneous coronary intervention (PCI).Methods Nursing methods and clinical data of 42 patients who received OCT during PCI were retrospectively summarized.Results After OCT,the incidence rate of blood vessel complications such as coronary artery spasm,slow coronary blood flow were 7.1％.All the complications were relieved after intracoronary nitroglycerin injection,and no chest pain and ECG changes were observed.No complications such as acute heart failure,malignant arrhythmia,and coronary artery dissection were seen,and no contrast nephropathy after surgery was observed after reasonable hydration and nursing cooperation.Conclusion The new generation OCT can accurately determinate the characteristics of coronary artery lesions without blocking coronary flow,and the skilled coordination and strict observation of perioperative nursing are important factors for OCT examination.

Objective To investigate perioperative nursing of new generation optical coherence tomography (OCT) in the diagnosis of percutaneous coronary intervention (PCI).Methods Nursing methods and clinical data of 42 patients who received OCT during PCI were retrospectively summarized.Results After OCT,the incidence rate of blood vessel complications such as coronary artery spasm,slow coronary blood flow were 7.1％.All the complications were relieved after intracoronary nitroglycerin injection,and no chest pain and ECG changes were observed.No complications such as acute heart failure,malignant arrhythmia,and coronary artery dissection were seen,and no contrast nephropathy after surgery was observed after reasonable hydration and nursing cooperation.Conclusion The new generation OCT can accurately determinate the characteristics of coronary artery lesions without blocking coronary flow,and the skilled coordination and strict observation of perioperative nursing are important factors for OCT examination.

Objective To investigate the effect of dexmedetomidine on renal function in the patients undergoing cardiac valve replacement under cardiopulmonary bypass.Methods Fifty patients with rheumatic heart disease were randomly divided into the dexmedetomidine group (group D,n=25) and control group (group C,n=25).Arterial blood samples were collected before operation (T0),at postoperative 24 h (T1),48 h (T2),72 h (T3) and 96 h (T4) respectively.Serum Crea,blood urea nitrogen,cystatin C(Cys-C) and glomerular filtration rate(GFR) were detected by the Hitachi7600 automatic biochemical analyzer.Results Compared with T0,the levels of BUN and Cys-C at postoperative various time points were significant increased,while GFR was decreased,the differences were statistically significant (P<0.05).The levels of BUN and Cys-C started to gradually decrease and GFR started to increase from T2,the difference compared with that at T0 was statistically significant(P<0.05).But the levels of various indicators at T4 did not recovered to those before operation;compared with T0,serum Crea level had no statistical difference among postoperative various time points(P>0.05).Serum Crea level at T2-T4 in the group D was significantly lower than that at T0,the difference was statistically significant (P<0.05).There was no statistically significant difference in Crea,BUN,Cys-C and GFR between the two groups(P>0.05).Conclusion Dexmedetomidine can promote the recovery of postoperative renal function in the patients with cardiac valve replacement under cardiopulmonary bypass and has a certain protective effect on kidney.

Objective: To evaluate the consistency of transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) method in monitoring cardiac volume load and cardiac hemodynamic indexes.Methods: A total of 45 patients undergoing coronary artery bypass grafting in our hospital were selected.The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV) and right ventricular ejection fraction (RVEF) were monitored during surgery by TEE and PAC respectively.Consistency of monitored data was compared between two methods.Results: Both TEE and PAC indicated that compared with baseline level, after loading, there were significant rise in RVEDV [TEE: (38±6)ml vs.(51±9ml), PAC: (153±17)ml vs.(188±19)ml], RVESV [TEE: (19±4)ml vs.(33±5)ml, PAC: (92±16)ml vs.(110±23)ml], P<0.01 all, but there was no significant change in RVEF, P>0.05.Before therapy, RVEDV, RVESV and RVEF monitored by PAC and TEE showed significant positive correlation, and all relevant coefficients were >0.8 (r=0.844, 0.862, 0.916, P<0.01 all);after therapy, correlation of RVEDV and RVESV significantly reduced to <0.6 (r=0.552, 0.579, P<0.05 both), but RVEF correlation remained >0.8 (r=0.892, P<0.01).Conclusion: In clinical monitor, the consistency of TEE and PAC is high,the former is non-traumatic,and is more convenient for clinical use.

Objective To investigate the interfractional and intrafractional prostate motion during hypofractionated precise radiotherapy for prostate cancer. Methods From 2013 to 2016, twenty?eight patients who received 5 Gy radiotherapy in 9 fractions for prostate cancer were enrolled as subjects. Every patient had three gold fiducials implanted into the prostate by transrectal ultrasound guidance two weeks before computed tomography ( CT) simulation. All patients underwent CT scans in the supine position with full bladders and rectal balloons filled with 60 ml air. The Pinnacle planning system was used to design the treatment plans. Twenty?three patients were treated with a Synergy accelerator. Those patients underwent cone?beam CT ( CBCT) scans prior to treatment. The set?up error was recorded by bone alignment between CBCT images and planning CT images. The prostate displacement was then recorded by gold fiducial alignment. The interfraction prostate displacement was defined by the difference between the above two parameters. The other 5 patients were treated with a Novalis accelerator. Based on gold fiducial alignment,the real?time tracking of gold fiducials was carried out by the ExacTrac system to evaluate the intrafractional prostate displacement. Results A total of 207 measurements of interfractional prostate displacement were made in the 23 patients before treatment. The mean interfractional prostate displacements in the left?right (LR),superior?inferior (SI),and anterior?posterior (AP) directions were (0.05±0?10),(0.20±0?22),and (0.19±0?18) cm,respectively. The displacements larger than 0?3 cm in the above three directions were observed in 1,52,and 49 measurements,respectively,while the displacements larger than 0?5 cm in the three directions were observed in 1,29,and 16 measurements,respectively. A total of 225 measurements of gold fiducial displacement were made in the 5 patients during treatment. The mean intrafractional prostate displacements in LR,SI,and AP directions were (0.61±0?50),(0.68±0?69),and (0.70±0?67) mm, respectively. The displacements larger than 3 mm in the three directions were observed in 0, 1, and 1 measurement, respectively. Conclusions In hypofractionated precise radiotherapy for prostate cancer, the interfractional prostate displacement is significantly larger than the intrafractional prostate displacement. The interfractional prostate displacement must be corrected before radiotherapy. In order to avoid off?target irradiation due to postural changes in patients,the tracking of the intrafractional prostate displacement is still necessary although the displacement is relatively small. The rectal balloon can help immobilize the prostate.

Objective To investigate the application effect of continuous quality improvement of multi-sectoral cooperation in the operating room equipment management.Methods The operating room equipments were divided into the control group ( from June to December 2011, n=128) and the observation group ( from January to June 2012, n=137) according to time period. Equipments in the control group were managed by conventional equipment management process, while equipments in the observation group were managed by the PDCA cycle method and“3+1” training mode. The usage rate, maintenance rate, failure reported loss rate of equipment in two groups were compared. Nurses′equipment operation examination in the Operating Room and physician satisfaction rate before and after the quality management were compared between two groups. Results The equipment usage rate in the observation group was significantly higher and the maintenance rate was significantly lower than that in the control group ( P<0.01);for the reported failure rate of equipment, the observation group was relatively lower compared to the control group, but there was no significant difference (P>0.05). The data in the observation group significantly increased compared to the control group in nurses′equipment operation examination rate and physician satisfaction rate in Operating Room (P<0.01).Conclusions The use of PDCA cycle method in equipment management can effectively mobilize multi-sectoral coordination and management efficiency, improve the comprehensive capacity of nursing equipment management and improve the quality of nursing in the Operating Room.

Background:Conventional gastrointestinal endoscopy is incapable of determining the deriving layers,size and nature of submucosal lesions,however,mini probe ultrasonography(MPS)is effective for mural stratification and determining the deriving layers and nature of lesions within gastrointestinal wall,and is considered to be an optimal examination for suspected submucosal tumors before endoscopic or surgical operation. Aims:To assess the diagnostic value of MPS for gastrointestinal submucosal lesions and the significance of MPS-assisted endoscopic therapy. Methods:A total of 69 patients with presumed gastrointestinal submucosal protruded lesions were retrospectively enrolled. All of them underwent MPS and then endoscopic therapy,such as cyst incision,high frequency electric snare resection,endoscopic mucosal resection and endoscopic submucosal dissection were performed according to the deriving layers,size and nature determined by MPS. The ultimate diagnosis was confirmed by histopathological examination. Results:In the 69 cases of lesions,MPS showed that 15 were derived from muscularis mucosa,40 from submucosa,and 14 from muscularis propria;10 of them were considered as cyst,18 were stromal tumor,8 were leiomyoma,6 were ectopic pancreas,15 were neuroendocrine tumor,and 12 were lipoma. Compared with pathological diagnosis,an overall coincidence rate of 91. 3%(63 / 69)was achieved by MPS. Conclusions:The accuracy rate of MPS is high for determining the deriving layers and nature of gastrointestinal submucosal protruded lesions prior to the attempting of endoscopic removal. It might be helpful for selecting treatment modalities for this kind of lesions.