Objective To explore the anticoagulation effect of low molecular weight heparin (LMWH) combination with warfarin at the early stage at the treatment of intracranial venous sinus thrombosis.Methods 80 cases of intracranial venous sinus thrombosis patients in people's hospital of Xinjiang Uygur autononous region from January 2010 to December 2014 were chosen to be analyzed retrospectively.37 cases in observation group were treated with low molecular heparin (LMWH) in combination with warfarin, and 43 cases in control group were treated with warfarin.The clinical curative effect between two groups was compared post-treatment.Results The effective rate in observation group was 91.89%, which was significantly higher than 67.44% in control group (P<0.05) .The recanalization rate of involved intracerebral venous in observation group was 89.19%, which was significantly higher than 67.29% in control group(P<0.05).After treatment, the prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) were higher and fibrinogen (FBG) in both groups was lower than those pre-treatment(P<0.05).The PT and APTT was higher and FBG was lower in observation group than those in control group(P<0.05).Conclusion Low molecular weight heparin in combination with warfarin worked well than single warfarin in the treatment of intracranial venous sinus thrombosis.

Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.

BACKGROUND: With the increase of senile population, it needs to further improve their mental health when improving their physical health. To study the depressive status of retired elderly people in order to provide basis for effective community nursing intervention.OBJECTIVE: To investigate and analyze the depression incidence among retired elderly people and conducted correlative factors analysis in order to improve the nursing service to aged people's mental health.DESIGN: Cross-sectional sampling study towards retired senior people.SETTING: Nursing department of a medical college.PARTICIPANTS: This study was completed in Nursing Department of North China Coal Medical College during September to December 2002. It conducted questionnaire survey to 1 000 retired people in Tangshan city by family visit. There were 574 male and 426 female who aged from 60 to 88years old with mean age of 67 years.METHODS: To adopt geriatric depression scale and general condition questionnaire investigation to individuals.MAIN OUTCOME MEASURES: Depression scale score, depression incidence and frequency of correlative factors RESULTS: Mild depression accounts for 17.2% while moderate and severe depression account for 5% among retired elderly people. There is close relationship between factors such as retired veterans, female, low education,lack of social support, empty life, lack of exercise and poor self-assessed health and depression incidence(x2 = 9.80 - 175.93, P ＜ 0. 05).CONCLUSION: The incidence of senile depression among retired elderly people is pretty high so that it is important to pay attention to mental care towards retried people when doing community nursing, especially to divorced, widowed, female and low educated retired people.

Objective:To investigate and analyze the current status of patient satisfaction and the influencing factors at private hospitals in Guizhou Province,and thus to provide a scientific basis for the management of medical service at private hospitals.Methods:The satisfaction scores were statistically described and analyzed by the factor analysis and multiple linear regression analysis.Results:The overall satisfaction score of patients was (3.87 ± 0.85),of which the satisfaction of medical technology,drug price,inspection fee,and medical facilities was lower.The factor analysis showed that satisfaction of patients at private hospitals could be classified into the environment,the quality of service,medical expense,and service flow.Multivariate linear regression results showed that its standardized partial regression coefficient by the parameter descending order followed as medical expense,the environment,the quality of service,and then service flow.Conclusions:Private hospitals should set up a fair medical expenditure mechanism,improve the environment and quality of medical services,and optimize service flow in order to improve patient satisfaction.

Objective To investigate the influence of pure intercostal nerve block combined with hydromorphone hydrochlo-ride intravenous analgesia on the occurrence of postoperative cognitive function and analgesia in elder patients with thoracic surger-y.Methods Ninety-six ASA I?Ⅱ elder patients with elective thoracic operation were divided into intercostal nerve block group (A),intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia group (B)and hydromorphone hydrochloride intravenous analgesia group(C)according to the random number table method,32 cases in each group.The patient-controlled intravenous analgesia(PCIA)with sufentanyl was postoperatively performed in all cases.When analgesia effect was poor, dezocine 0.1mg/kg was intravenously injected.The mean artery pressure(MAP),heart rate(HR),respiratory rate(RR),visual ana-logue scale (VAS)score and mini mental state examination (MMSE)score were recorded at postoperative 2,6,24,48 h in 3 groups.Results The MMSE score in the group B was higher than that in the group A and C,the VAS score was lower than that in the group A and C,the difference was statistically significant(P <0.05).Postoperative MAP and HR in the group B were more sta-ble than those in the group A and C,the difference was statistically significant(P <0.05).RR in the group C was more fast and had smaller range than those in the group A and B,the difference was statistically significant(P <0.05).Conclusion Intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia can achieve better postoperative analgesic effect with sta-ble postoperative blood dynamics and low occurrence rate of early postoperative cognitive dysfunction.

Objective To study a monitoring instrument of multiple physiological parameters being capable of wireless long-distance transmission,low in power dissipation and price and small in size.Methods In combination of embedded technology and mobile communication technology,S3C2410 based on ARM9 core was used as main chip,ARM-Linux as embedded operation system and SIM300 as communication module connected to Internet,to complete wireless long-distance transmission of multiple physiological parameters.Results Tele-monitoring system of embedded multiple physiological parameters based on GPRS was realized.Conclusion The instrument is small,easily-expanded and reliable in the process of transmitting data,facilitating tele-monitoring and data sharing.

Objective To investigate the feasibility of reconditioning post-sclerotherapy basifacial depressions for venous malformations with the axis platysma-fascial flap including submental artery.Methods Fifteen cases of post-sclerotherapy depressions of venous malformations were treated from Dec.2008 to Oct.2013.Preoperative color Doppler ultrasonography was routinely performed to localize and mark sublingualissubmental artery.Upper hind neck incision was made to dissociate depressed and donor area,after which reconstruction were performed with axis platysma-fascial flap including submental artery.3 months to 2 years' follow-ups were conducted to observe clinical effects.Results All the flaps were alive in all the 15 cases.Satisfacfory recovery archeived because the depressed area appeared well-stacked wihtout secondary depression in the neck.Conclusions It is recommended that axis platysma-fascial flap should be the first chioce of reconditioning basifacial postsclerotherapy depressions for venous malformations,as the operations can be peformed easily under concealed incision with abundant tissues supply and high survival rate.

ABSTRACT AIM To investigate the effect of ch-itosan on protein kinase C (PKC) activitives and diacyl glycerol(DAG)concentration in murine peritoneal macrophages. METHODS A new ion-pair reversed-phase high liquid chromatography and ra-dioimmunoassay were used to determinate the activity of PKC and the concentration of DAG respectively. RESULTS ( 1) Chitosan induced activation and translocation of PKC in murine peritoneal macrophages. The peak time was 25 min and the activity of PKC came back the basic level at 1. 5 h. (2)Chitosan increased the production of DAG in murine peritoneal macrophages. The peak time was 30 s and the concentration of DAG came back the basic level at 3 min. CONCLUSION The im-munopoteniating effect of chitosan may be associated with the channel of DAG /PKC.

Objective In order to analyze of poisoning causes,a new method was established utilizing hydrophilic liquid chromatography-tandem triple quadrupole mass spectrometer (HILIC-MS/MS) coupled with dispersive solid phase extraction for rapid qualitative and quantitative analysis of tetrodotoxin in nassarius and shellfish.Methods Sample (1.0 g) was extracted with 0.1％ acetic acid in boiling water bath,purified by dispersive solid phase extraction with 50 mg hydrophilic-lipophilic balance (HLB),5 mg graphitized carbon black (GCB) and protein precipitation with acetonitrile,and then filtered through a polytetrafluoroethylene (PTFE) membrane.The analytes were separated on a HILIC column,and detected in selected reaction monitoring (SRM) mode via positive electrospray ionization.The matrix matching and external standard method was used for quantification.Results Tetrodotoxin showed good linearity in the concentration range between 2.0 and 40.0 ng/ml,the correlation coefficient was higher than 0.999.The detection limit of tetrodotoxin in seafood was 10.0 pg/kg.The rates of recovery varied between 74.2％ and 87.9％ with relative standard deviations from 2.3％ to 9.1％ at spiked concentrations of 25,100 and 200 pg/kg.The proposed method was applied in the detection of tetrodotoxin in shellfish and nassarius from coastal cities of Zhejiang Province.Conclusion The method was accurate,fast,easy to operate,which could meet the requirements of public health emergency testing or routine testing.

Objective To explore the circadian rhythm of interleukin (IL)-6 in collagen induced arthritis (CIA) rats and investigate the effectiveness and safety of methotrexate (MTX) administered according to IL-6 rhythm.Methods Serum IL-6 concentrations of CIA and normal rats at different time points were measured by enzyme-linked immunosorbent assay (ELISA).CIA rats were randomly divided into the experimental group A,experimental group B and control group.MTX (1/7 mg·kg-1 ·d-1) was administered once a day when the IL-6 level began to increase or decrease in the experimental group,while MTX (1 mg/kg) administered once a week in the control group.Arthritis scores and leukocyte counts were observed.The production of IL-6 and C reactive protein (CRP) levels in the serum were measured.Moreover,histological changes in the ankle joint were examined.One-way analysis of variance (ANOVA),two independent sample t test were used to evaluate the experimental data.Results The plasma IL-6 levels in CIA rats were different at different time points,which began to increase at 18:00 and decrease at 6:00.Arthritis score in the experimental group A (4.8±0.7)was lower than that in the control group (5.8±1.0,t=2.256,P=0.0406) and experimental group B (5.5±0.5,t=2.393,P=0.0313).The levels of TNF-α [(185±21) ng/L],IL-6 [(99±6) ng/L],IL-1β[(20.1±1.6) ng/L] and CRP[(1251±282) μg/L] in the experimental group A were significantly lower than those in control group [TNF-α:(207±10) ng/L,t=2.726,P=0.016 4;IL-6:(100±6) ng/L,t=2.669,P=0.0183;IL-1β:(22.0±1.3) ng/L,t=2.814,P=0.0138;CRP:(1 417±278) μg/L,t=2.369,P=0.0327].The level of IL-6 in the experimental group A[(93±6) ng/L] was lower than that in the experimental group B [(99±6) ng/L,t=2.323,P=0.0358].Compared with the control group [(9650±1062)/μl],the counts of leukocyte in the experimental group A [(4595±603)/μl,t=3.841,P=0.0064] and experimental group B [(3833±585)/μl,t=4.442,P=0.003] were significantly lower.Compared with the control group (9.1 ±2.0),histopathology scores in the experimental group A (6.6±1.3,t=2.606,P=0.015) and experimental group B (7.4±1.3,t=3.857,P=0.0007) were significantly lower.Conclusion The plasma IL-6 levels in CIA rats have shown evident circadian rhythm.There-fore,once a day administration is better than once a week.The therapeutic effect of RA may be improved by administering MTX at the time points according to the circadian rhythm of IL-6.