OBJECTIVE:To study the pharmacokinetics effects of naloxone combination on Shenmai injection in rats in vivo. METHODS:12 rats were randomly divided into monotherapy group (Shenmai injection 9.00 ml/kg,iv) and combination group (Shenmai injection 9.00 ml/kg+naloxone 1.80 ml/kg,iv). The blood samples were collected before administration and 0.083,0.25, 0.5,0.75,1,1.5,2,3,6,12,24,48,96 and 144 h after administration. HPLC was adopted to determine the plasma concentra-tions of ginsenosides Rg1,Re and Rb1,and DAS 2.0 software was used to calculate the pharmacokinetic parameters. RESULTS:Compared with monotherapy group,the plasma concentration of ginsenosides Rg1 in combination group was increased,CL was de-creased,t1/2 and MRT were prolonged,and AUC0-144 h was increased;the plasma concentration of ginsenosides Re was increased,Ke was decreased,t1/2 was prolonged,MRT was shortened,and AUC0-144 h was increased;the plasma concentration of ginsenosides Rb1 was decreased,Ke was increased,t1/2 and MRT were shortened,and AUC0-144 h was decreased,with significant differences(P<0.01 or P<0.05). CONCLUSIONS:Shenmai injection combined with naloxone can slow down the removing of ginsenosides Rg1 and Re in vivo,and obviously the plasma concentration of Shenmai injection is higher than monotherapy group;speed up the removing of ginsenosides Rb1,and the plasma concentration of Shenmai injection is lower than monotherapy group obviously.

Objective To explore the effect of designing and applying project teaching scheme in higher vocational nursing clinical curriculum. Methods Sophomores of nursing major in grade 2009 and 2010 were selected as experiment subjects. Lecture-based traditional teaching method was applied in tradition group (121 students in grade 2009) while project teaching was applied in reorga-nization group (128 students in grade 2010). The teaching method was evaluated through thoretical exam, vocational skill test, professional quality test and questionnaine surrey. Data were input by us-ing SPSS17.00. T-test and Ranksum test were applied. Results Vocational skill test results of tra-dition group and reorganization group were (76.67 ±13.072) and (85.48 ±10.085) respectively;professional quality test results were (74.77±13.865) and (87.04±8.982), respectively. Differences in both groups had statistical significances (P<0.001). Evaluation on the teaching method was carried out in both groups through a questionnaire. (716/1408) of students in reorganization group thought that project teaching can improve 11 items including comprehensive quality. Except for the item of the-oretical knowledge comprehension, the rest 10 items of both groups had statistical significances (P<0.001). Conclusion Implementation of project teaching in nursing clinical curriculum helps to im-prove students' professional core competence.

Objective To investigate the job burnout status of nurses in a third-grade and A-level general hospital in Zhengzhou,and analyze the relationship between job burnout and presenteeism.Methods 300 nurses were surveyed with questionnaires by convenience sampling,including nurses' demographic data,Nurse Job Burnout Scale and Work Limitations Questionnaire.Results The scores in three dimensions of job burnout of nurses were respectively EE (25.92±11.56) points,DP (10.63±6.82) points,and PA(26.30±9.11) points.The job burnout rate in nurses was 76.2％,the rates of low,moderate,and high degree of burnout were respectively 30.4％,28.7％,and 17.4％.The scores of presenteeism for low,moderate,and high degree of work limitations were respectively (2.29±1.60)points,(5.90±3.03)points,(7.89±3.12)points.Conclusions Nurses' burnout can results in presenteeism.The more serious job burnout is,the more critical the presenteeism is.

OBJECTIVETo evaluate the influence of small-dose dexmedetomidine infusion on recovery of patients undergoing vertebral operation.

METHODSSixty ASA I-II patients undergoing vertebral operation were randomly divided into two groups (n=30). In group I, dexmedetomidine infusion was pumped at the rate of 0.5 µg·kg(-1)·h(-1) from tracheal intubation to incision suture, and in group II, 0.9%saline was pumped instead. The mean arterial pressure, heart rate, Riker Sedation-Agitation Scale and Ramesay sedation score were recorded at the time points of autonomous respiration (T1), eye opening (T2), extubation (T3), 1 min after extubation (T4), 10 min after extubation (T5), and 30 min after extubation (T6).

RESULTSThe recovery time of autonomous respiration and eye opening time in group I were significantly longer than those in group II, and the extubation time was significantly shorter in group I (P<0.05). Riker Sedation-Agitation Scale scores in group II were significantly higher than those in group I at T2 and T4, and Ramesay sedation scores in group I were significantly higher than those in group II at T1, T2 and T5 (P<0.05). The mean arterial pressure and heart rate at each time point was significantly lower in group I than in group II (P<0.05), especially at T3 and T4 (P<0.01). In both groups, the mean arterial pressure and heart rate at T3 and T4 were significantly higher than those at rest (P<0.05).

CONCLUSIONSSmall-dose dexmedetomidine infusion can reduce dysphoria and lower the risks during recovery from general anesthesia following vertebral operation.

Adult ; Aged ; Anesthesia Recovery Period ; Dexmedetomidine ; administration & dosage ; pharmacology ; Humans ; Middle Aged ; Spine ; surgery

Objective To study the range of central venous pressure (CVP) in very low birth weight (VLBW) infants within the first week after birth.Method From February 2014 to February 2018,50 VLBW infants without serious diseases during the first 7 days of life received umbilical venous catheters were prospectively enrolled.CVPs were measured every 4～6 h.The trend of CVP and the correlation of CVP (within 24 h) and birth weight,gestational age were analyzed.Result A total of 50 VLBW infants and 1 291 CVP measurements were included.The CVP increased slightly within 48 h after birth,and then declined.The 95％CI of CVPs were 3.67～4.21,4.03～4.49,3.90～4.33,3.67～4.19,3.29～3.97,3.14～3.94 and 2.64～ 3.55 cmH2O from day 1 to day 7.No significant correlation existed between CVP in the first day and birth weight,nor gestational age (r=-0.267,P=0.073;r=0.106,P=0.762).Conclusion The CVP of VLBW infants increased slightly within 48 h after birth,and then declined.There was no significant correlation between CVP in the first day and birth weight,nor CVP and gestational age.

Objective To study the characteristics of fluid intake and central venous pressure (CVP) within 4 days after birth in very low birth weight (VLBW) premature infants complicated with bronchopulmonary dysplasia (BPD).Method From February 2015 to March 2019,VLBW preterm infants without serious complications were enrolled in two hospitals.Their CVP were measured every 4 ～ 6 hours after birth.They were assigned into BPD group and non-BPD group,and the fluid intake and CVP within 4 days after birth were compared between these two groups.Result A total of 45 VLBW preterm infants were included,including 17 in the BPD group and 28 in the non-BPD group.The fluid intake in the BPD group showed no significant difference with the non-BPD group within 4 days after birth (P ＞ 0.05).No significant correlation existed between the mean liquid intake and the mean CVP in 1 ～ 4 days after birth (r =0.093,P=0.542).From day1 to day4,the CVPs of the BPD group were (3.97 ± 0.68),(4.49 ± 0.75),(4.55 ± 0.66),(4.02 ± 1.05) cmH2O,and the non-BPD group were (3.66 ± 1.09),(3.96 ±0.76),(3.81 ± 0.69),(3.91 ± 0.65) cmH2O.The differences between the BPD group and the nonBPD group were statistically significant (P ＜ 0.05).The CVP of the BPD group was increasing from day 2 to day 3 (P ＜ 0.05).Conclusion VLBW premature infants complicated with BPD may have higher CVP at the early stage of life,which may not be related with the fluid intake.

BACKGROUNDInsulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.

METHODSThis cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.

RESULTSTriglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.

CONCLUSIONTG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.

Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholesterol, HDL ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; Female ; Humans ; Insulin Resistance ; physiology ; Liver ; enzymology ; Male ; Middle Aged ; Triglycerides ; blood