Objective To evaluate the effect of different doses of aspirin on the platelet inhibition rate by thremboelastography.Methods One hundred and eighty patients with ischemic stroke or transient cerebral ischemic attack (TIA) were randomly divided into aspirin 100 mg/d group (60 patients),aspirin 200 mg/d group (60 patients) and aspirin 300 mg/d group (60 patients) according to the order of treatment.The platelet inhibition rate which arachidonic acid pathway induced was measured by thromboelastography and compared at different time points (before medication; 7 days,6 months,1 year after medication).Results There were significant differences in the platelet inhibition rate after medication at different time points compared with that before medication in three groups (P ＜ 0.05).After medication at different time points,the platelet inhibition rate of aspirin 100 mg/d group and aspirin 200 mg/d group was gradually decreasing.On the contrary,that of the aspirin 300 mg/d group showed gradually increasing.Cross-sectional comparison of the three groups at different time points showed that there was no significant difference in the platelet inhibition rate among three groups before medication,7 days,6 months after medication (P ＞ 0.05).However,there was significant difference at 1 year after medication (P ＜ 0.05).The platelet inhibition rate inaspirin 300 mg/d group [(93.8 ± 18.6)％] was higher than that in aspirin 200 mg/d group [(83.7 ± 11.2)％]and aspirin 100 mg/d group [(76.6 ± 12.8)％] (P ＜ 0.05).During medication there were 9 patients of less than 50％ platelet inhibition rate in aspirin 100 mg/d group,5 patients in aspirin 200 mg/d group,3 patients in aspirin 300 mg/d group,and 2 patients of peptic ulcer bleeding in aspirin 300 mg/d group.Conclusions The appropriate dose of aspirin (100,200,300 mg/d) can play a very good anti-platelet effect.Increasing the dose on the basis of 100 mg/d,the platelet inhibition rate shows no increase in the short-term (≤6 months),but in the long-term (1 year) there may be differences.It may be associated with less aspirin resistance and the relative increasing bleeding risk.

Objective To observe the clinical effect of inserted central catheter (PICC) tip localization guided by ultrasound combined with endocaridal electrogram (ECG).Methods A total of 115 PICC catheter patients were as research objects, and ultrasound combined with endocaridal electrogram guided PICC tip positioning were carried out for these patients, which was compared with tube X-ray results, its application value in the location of the tip of PICC was analyzed.Results Ultrasound combined with intracavitary electrocardiogram guided PICC tip localization rate was 95.7%, ectopic rate was 4.3%, while the X-ray results suggested that the PICC tip localization rate was 97.4%, and ectopic rate was 2.6%, but there was no statistically significant difference (P>0.05);P wave prediction and X-ray coincidence rate of ultrasound combined with intracavitary electrocardiogram guided PICC tip positioning was 98.3%, Kappa test showed a better consistence(P<0.05).Conclusion The success rate of PICC tip localization guided by ultrasound combined with endocaridal electrogram is high, which can reduce the adverse effects of the tip dislocation, and it can be used as priority.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

Objective To analyze the preventive effect of the targeted nursing intervention on lower limb venous thrombosis in patients with hemiplegia after stroke.Methods A total of 120 stroke cases from October 2014 to December 2015 in department of neurology in our hospital were divided into control group and intervention group according to random number table method.The control group was given routine nursing,and the intervention group was given targeted nursing intervention on the basis of the control group.After nursing,the compliance rate of two groups before and after nursing,mastery of disease related knowledge,the incidence of lower limb venous thrombosis and nursing effect were compared.Results There was no significant difference in medication compliance between the two groups before nursing intervention (P ＞ 0.05).In the intervention group,the correct medication,reasonable diet,regular physical examination,smoking cessation,functional exercise,mood control compliance rate were significantly improved,and there was significant difference compared with the control group (P ＜ 0.05).The awareness rate of the intervention group was significantly higher than that of the control group (P ＜ 0.05).The nursing effective rate was significantly higher in the intervention group than that of the control group,(43.10％ vs.85.94％,P ＜ 0.05).There were 3 cases(13.79％) with deep vein thrombosis in the control group,and 1case(1.61％) in the intervention group,there was significant difference in deep vein thrombosis (P ＜ 0.05).Conclusion The nursing intervention of department of neurology for stroke patients can significantly improve the compliance rate and disease related knowledge,reduce the incidence of venous thrombosis,improve the nursing effect,so it is worthy of promotion in clinical nursing work.

Objective To analyze the preventive effect of the targeted nursing intervention on lower limb venous thrombosis in patients with hemiplegia after stroke.Methods A total of 120 stroke cases from October 2014 to December 2015 in department of neurology in our hospital were divided into control group and intervention group according to random number table method.The control group was given routine nursing,and the intervention group was given targeted nursing intervention on the basis of the control group.After nursing,the compliance rate of two groups before and after nursing,mastery of disease related knowledge,the incidence of lower limb venous thrombosis and nursing effect were compared.Results There was no significant difference in medication compliance between the two groups before nursing intervention (P ＞ 0.05).In the intervention group,the correct medication,reasonable diet,regular physical examination,smoking cessation,functional exercise,mood control compliance rate were significantly improved,and there was significant difference compared with the control group (P ＜ 0.05).The awareness rate of the intervention group was significantly higher than that of the control group (P ＜ 0.05).The nursing effective rate was significantly higher in the intervention group than that of the control group,(43.10％ vs.85.94％,P ＜ 0.05).There were 3 cases(13.79％) with deep vein thrombosis in the control group,and 1case(1.61％) in the intervention group,there was significant difference in deep vein thrombosis (P ＜ 0.05).Conclusion The nursing intervention of department of neurology for stroke patients can significantly improve the compliance rate and disease related knowledge,reduce the incidence of venous thrombosis,improve the nursing effect,so it is worthy of promotion in clinical nursing work.

Objective To observe the clinical effect of inserted central catheter (PICC) tip localization guided by ultrasound combined with endocaridal electrogram (ECG).Methods A total of 115 PICC catheter patients were as research objects, and ultrasound combined with endocaridal electrogram guided PICC tip positioning were carried out for these patients, which was compared with tube X-ray results, its application value in the location of the tip of PICC was analyzed.Results Ultrasound combined with intracavitary electrocardiogram guided PICC tip localization rate was 95.7%, ectopic rate was 4.3%, while the X-ray results suggested that the PICC tip localization rate was 97.4%, and ectopic rate was 2.6%, but there was no statistically significant difference (P>0.05);P wave prediction and X-ray coincidence rate of ultrasound combined with intracavitary electrocardiogram guided PICC tip positioning was 98.3%, Kappa test showed a better consistence(P<0.05).Conclusion The success rate of PICC tip localization guided by ultrasound combined with endocaridal electrogram is high, which can reduce the adverse effects of the tip dislocation, and it can be used as priority.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

OBJECTIVEA sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method has been developed and validated for the determination of brucine and strychnine in rat plasma.

METHODSamples were extracted by ethyl acetate-n-butanol (7: 3). Chromatographic separation was operated on ZORBAX XDB-C18 column with gradient elution of acetonitrile-methanol-water (0.05% acetic acid and 10 nmol x L(-1) ammonium formate contained), followed by LC-MS/MS in positive electrospray ionization. Quantification was carried out on multiple reaction monitoring (MRM) of the transition m/z 395.2/324.2, m/z 335.2/184.2 and m/z 199.1/171.1 for brucine, strychnine and tacrine (internal standard), respectively.

RESULTThe method was linear in the range of 0.195-100 and 0.07840 microg x L(-1) for brucine and strychnine, with coefficient correlation 0.994 and 0.996 respectively. The recoveries of extraction were 78.9% - 102.4% for brucine and 95.2% - 106.1% for strychnine. Precision, accuracy, stability and matrix effect of the analytes met the requirement. The method was applied to a pharmacokinetic study of brucine and strychnine after cutaneous administration of Semen Strychni niosome gel. The C(max) were (26.20 +/- 5.81) and (12.50 +/- 3.00) microg x L(-1) while the AUC(0-infinity), were (193.75 +/- 39.43) and (98.25 +/- 28.54) microg x h x L(-1) of the two components.

CONCLUSIONWe conclude that the niosomes may reduce the systemic exposures and prolong the local release of brucine and strychnine.

Administration, Cutaneous ; Analgesics ; analysis ; pharmacokinetics ; Animals ; Chromatography, Liquid ; Convulsants ; analysis ; pharmacokinetics ; Female ; Gels ; chemistry ; Liposomes ; chemistry ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Seeds ; chemistry ; Semen ; chemistry ; Specific Pathogen-Free Organisms ; Strychnine ; analogs & derivatives ; analysis ; pharmacokinetics ; Strychnos nux-vomica ; chemistry ; Tandem Mass Spectrometry

Objective To study the risk of bloodstream infection in relation with peripherally inserted central venous catheter (PICC) in hospitalized non-cancer patients.Methods Clinical data of 172 non-cancer patients admitted to our hospital for PICC were collected.The risk of PICC-related bloodstream infection (CRBSI) in domestic hospitalized non-cancer patients was analyzed and systematically assessed.Results Of the 183 PICCs placed in 172 patients included in this study,61.7％ were placed in general wards,38.3％ were placed in ICU,87.8％ were placed in combination with indwelling urinary catheter,29.7％ were placed in combination with mechanical ventilation.The median PICC indwelling time was 35 days.CRBSI occurred in 6 patients with an incidence of 0.6/1000 PICCs/day.The risk of CRBSI was centralized in domestic tumor patients after PICC.The reported CRBSI was significantly different in hospitalized non-cancer patients (0.26-33.10/100 PICC).Conclusion The risk of CRBSI is lower in hospitalized patients after PICC placement than after traditional central venous catheter placement.Further studies are needed to assess its value in ICU.

Objective:To form the expert consensus on nursing care of adults with status epilepticus (SE), promote nurses to provide standardized and safe first aid, monitoring and support to SE patients, and effectively prevent and control complications, with a view to controlling seizures as soon as possible.Methods:The medical and nursing evidence on SE was retrieved, evaluated and summarized, and the retrieval time limit was from the establishment of the database to March 31, 2022. Recommendations and studies were extracted to form a first draft of consensus. A total of 31 experts were selected to conduct two rounds of Delphi expert consultation and expert demonstration meetings to analyze, revise and improve the experts' suggestions and form a consensus final draft.Results:The expert positive coefficient was 100.00% (31/31), the expert judgment coefficient was 0.93, the familiarity degree was 0.87, and the authority coefficient was 0.90. Kendall's harmony coefficient was 0.25 to 0.27 ( P<0.05). The final consensus included adult SE identification, first aid, monitoring and support, complication prevention and control, and effect evaluation of terminating SE. Conclusions:This consensus is practical and provides guidance for clinical nursing practice and quality control of SE patients.