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Coronary microvascular dysfunction （CMD） is one of the important causes of myocardial ischemia and non-obstructive coronary artery ischemic symptoms. However， effective diagnostic methods and targeted treatment strategies for CMD are currently lacking. According to traditional Chinese medicine （TCM）， the comorbidity theory of "blood-vessel-cardiac collaterals" plays a central role throughout the entire development process of CMD. It suggests that in the clinical diagnosis and treatment of CMD， the treatment of blood， vessels， and cardiac collaterals should not be neglected. In light of this， insect medicines， known for their efficacy in promoting blood circulation， resolving stasis， and alleviating spasms， hold promise as a potential treatment for CMD. However， there is currently no research or summary on the use of insect medicines for the treatment of CMD. Therefore， this article took the comorbidity theory of "blood-vessel-cardiac collaterals" as the starting point and divided the pathogenesis of CMD into five evolution stages： Beginning in the blood （changes in blood components and hemorheology）， progressing in the vessels （atheromatous plaque formation and unstable plaques）， occurring in the cardiac collaterals （microvascular endothelial damage and microvascular constriction and spasms）， ending in the cardiac collaterals （microvascular remodeling）， and resulting in energy metabolism disorders throughout the process， so as to explore the pathogenesis and evolution of CMD. In addition， based on the modern pharmacological research on insect medicines， this article discussed the clinical application of insect medicines in the treatment of CMD from four aspects： Promoting blood circulation and removing blood stasis to relieve vessels' obstruction， relieving spasms to alleviate pain， combating poison with poison to disperse stagnation， and tonifying cardiac collaterals to nourish the heart， which aims to provide a theoretical basis for the use of TCM in treating CMD， broaden the scope of medication， and improve clinical efficacy.
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Heart failure refers to a group of clinical syndromes caused by structural or functional abnormalities of the heart that lead to impaired ejection or filling of the ventricles. The traditional Chinese medicine （TCM） theory of cardiac and renal coordination holds that the kidney governs water and plays a key role in maintaining the balance of fluid metabolism. Therefore， the treatment of water retention in heart failure can start from the heart and kidney. The basic pathogenesis of heart failure is kidney deficiency， blood stasis， and water stagnation， and the therapies including dredging the heart and kidneys， warming yang and excreting water， tonifying kidneys and activating blood， and dredging meridians and collaterals. Aquaporins （AQPs）， the key molecular basis of water metabolism， are involved in the pathogenesis of water retention in heart failure together with the arginine vasopressin system （AVP）， renin-angiotensin-aldosterone system （RAAS）， and diuretic resistance. Studies have shown that herbal medicines that regulate the heart and kidney can alleviate water retention in heart failure by targeting AQPs， thereby delaying or even reversing the progression of heart failure. This paper expounds the TCM name and pathogenesis of heart failure from the theory of cardiac and renal coordination， the role of AQPs in the pathogenesis of water retention in heart failure， and the modern connotation of the therapy of tonifying heart and kidney for heart failure， aiming to provide ideas for the prevention and treatment of water retention in heart failure by TCM.
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The controversy over the ultrasonic testing of thyroid volume (TVOL) in children exists in some aspects, mainly focusing on the measurement errors caused by different testing personnel, instruments and techniques. Moreover, with the development of children growth higher than before, the influence of physiological factors on TVOL and relevant correction methods should be paid attention. This paper reviews domestic and foreign literatures. Firstly, through describing the TVOL reference values of international recommended, foreign country and China, we clarify the differences between them, and analyze the current situation and characteristics of each. Secondly, by studying the ultrasonic testing methods and physiological factors which affect TVOL, this paper analyzes the importance of various factors, discusses the availability of several measurement methods and compares several TVOL correction methods. Some suggestions are put forward for further improving the reference value of TVOL of children in China.
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Objective:To investigate the effects of thyroxine (T 4) and propylthiouracil (PTU) on nitric oxide synthase expression in human umbilical vein endothelial cells (HUVEC cells). Methods:HUVEC cells were cultured in vitro, the experiment was divided into 6 groups: control (without T 4 and PTU), 10 -9, 10 -7, 10 -4 mol/L T 4, PTU (5 μg/ml PTU), and 10 -4 mol/L T 4 + PTU, the action time was 24 h. CCK-8 method was used to detect cell activity; nitrate reductase method was used to detect nitric oxide (NO), total nitric oxide synthase (TNOS) and endothelial nitric oxide synthase (eNOS) contents; Western blotting was used to detect eNOS protein expression level. Results:The differences of cell survival rates [(100.00 ± 0.00)%, (96.73 ± 1.17)%, (86.20 ± 7.54)%, (47.37 ± 9.10)%, (53.37 ± 5.47)%, (53.40 ± 8.84)%] among the 6 groups were statistically significant ( F = 29.42, P < 0.05). Compared with the control group, the cell survival rates of 10 -7, 10 -4 mol/L T 4, PTU, and 10 -4 mol/L T 4 + PTU groups were significantly reduced ( P < 0.05). There were statistically significant differences in the contents of NO and TNOS among the 6 groups ( F = 3.93, 3.46, P < 0.05). Compared with the control group, the TNOS content in PTU group was significantly reduced ( P < 0.05); compared with the 10 -4 mol/L T 4 group, the NO contents in PTU and 10 -4 mol/L T 4 + PTU groups were significantly reduced ( P < 0.05). There were no significant differences in eNOS content and protein expression level among the 6 groups ( F = 0.24, 0.17, P > 0.05). Conclusions:High concentration of T 4 can cause damage to the activity of HUVEC cells cultured in vitro, and PTU can alleviate it by regulating NO and TNOS. The specific mechanism of action still needs to be further studied in molecular biological experiments.
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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.
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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 he althy 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 (x2 =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.
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Objective To establish a knowledge management skills evaluation tool for nursing undergraduates and then try to provide an objective basis for evaluation of their knowledge management skills.Methods After reviewing literature and research group discussion,defining the theoretical dimensions of the knowledge management skills system and developing this evaluation tool.A total of 1 139 nursing undergraduates were picked out and investigated.The data were analyzed with the SPSS 20.0 and AMOS 7.0 statistic software packages,including exploratory factor analysis,confirmatory factor analysis,reliability and validity analysis.Results The knowledge management skills evaluation tool of nursing undergraduates was a multilayered and multidimensional system,including 3 subscales (knowledge management cognition,knowledge management attitude,knowledge management behavior),8 factors (the cognition of knowledge management connotation,the intention and the belief of knowledge management,the ability of obtaining,storing,sharing,applying and innovating knowledge),36 items.Exploratory factor analysis showed that all items' factor loading were 0.433-0.851.Confirmatory factor analysis displayed a good degree of fitting.The total scale's Cronbach α was 0.933,sub-scales were 0.807-0.892.The total scale's split coefficient was 0.873,sub-scales were 0.700-0.870.The correlation coefficient between 3 sub-scales score and the total scale score were 0.875-0.912.Conclusions Because of its good reliability and validity,nursing undergraduates can evaluate their knowledge management skills by using this evaluation tool.
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Objective To explore the affecting factors of nursing interns' personal knowledge management (KM) ability and analyze the correlation between their KM ability and clinical practice ability.Methods A total of 345 nursing interns' KM ability and clinical practice ability were investigated by using two scales.Results Affecting factors of nursing interns' KM ability included being a cadre and being interested in nursing specialty or not.Factors affecting nursing interns' clinical practice ability were practice period,academic records,being a cadre,intention to have a nursing job,interest to be a nurse.It also showed significant positive correlation between their KM ability and clinical practice ability (r=0.761); KM ability could explain 59％ of variability of clinical practice ability(R2=0.599).Among the dimensions of KM ability,the highest positive correlation was knowledge management cognition (r=0.741).Conclusions To enhance nursing interns' clinical practice ability,we need cultivate nursing interns' interest to nursing specialty,ability to be a cadre and improve their knowledge management cognition ability.