Objective To establish criteria for determination of sputum retention in elderly patients with non-ar-tificial airway. Methods Interview and Delphi methods were used to preliminarily determine clinical indication of sputum retentionand its classification through two-round expert consultation among 25 experts. Final criteria for de-termination of sputum retention were determined through experts group discussion. Results During the two rounds of consultation,all the questionnaires were collected,the experts' authority coefficients were 0.936 and 0.926 respec-tively,and the coordination coefficient of expert opinion was statistically significant.Criteria for determination of spu-tum retention included ineffective cough plus auscultation phlegm sound,with or without complaining of sputum,de-creased blood oxygen saturation,difficulty breathing and cyanosis. Conclusion Based on expert consultation and ar-gument,the criteria for determination of sputum retention can facilitate clinical nurses to detect sputum retention.

The effects of morphine, pethidine and fentanyl on adenyl cyclase (AC) and phospho- diesterases (PDE) in rabbit bronchial smooth muscle were examined in vitro. The results were as follows: morphine could inhibit the activity of AC which was decreased from 15. 9911 ? 0. 8597u to 15.0463?0. 7989u, P

A protein designated as Flammulina Velutipes (FV) protein was isolated from the cultured mycelium of FV and purified to homogeneity by CM cellulose CM 52 and gel filtration chromatography. The molecular weight of FV protein were found to be 1.75?10~4u with pI 4.3. Amino acid analysis of FV protein indicated the presence of 14 kinds of amino acids, especially rich in Glu, Asp and Thr.Potent inhibitory effect of FV protein on thrombus formation, in the blood was observed in vitro when rats were given intravenously. The length of thrombus was shortened and the dry weight of the thrombus decreased significantly at the dose of 7.5?10~(-7) mol/kg. Thrombus formation was completely inhibited at the dose of 10~()-8 mol/kg. The IC_(50) was found to be 4.4?10~(-7) mol/kg. FV protein was shown to inhibit collegen induced aggregation of rat platelets both in vitro and in vivo. Its concentration for complete inhibition in vitro was 7.5?10~(-5) mol/L. The IC_(50) was found to be 4?10~(-5)mol/ L. However, FV protein dose of 1.25?10~(-5) mol/kg was required for 60% inhibition in vivo

Objective To study MR imaging manifestations of the mesorectum and mesorectal fascia. Methods 100 cases were divided into five groups according to the age. All MR images were retrospectively observed and analyzed by two radiologists.The observing contents included: ①exhibition of the mesorectal fascia, ②the signal intensity of the mesorectum and the pelvic fat and ③the thickness ratio of the mesorectum and the subcutaneous fat in different ages. All data were dealed with SPSS 10.0 software. Results The showing rate of the anterior, posterior, left and right mesorectal fascia respectively were 77, 100, 91 and 93 by MR imaging. The signal intensity of the mesorectum(550.8843) was significantly higher than that(469.8693) of pelvic fat in all five groups(P﹤0.05) and the signal difference between the mesorectum and the pelvic fat could be detected by naked eye. The thickness of the mesorectum and the subcutaneous fat had no association with ages.Conclusion MRI can display the mesorectum and mesorectal fascia clearly. The signal intensity of the mesorectum is significantly higher than that of pelvic fat in five groups. The thickness of the mesorectum and the subcutaneous fat have no association with ages.

Objective To discuss the effective early postoperative fluid management in infant living-donor liver transplantation. Methods From January 2008 to March 2009, 17 cases of infant living-donor liver transplantation were carried out. According to infant postoperative physiological and hemodynamic characteristics, rehydration was properly controlled on the surgery day, the negative fluid balance was achieved as soon as possible in three days. The infant condition changes, vital signs and urine output were closely monitored. At the same time, the nature and volume of fluid infusion was timely adjusted to maintain the infant in a stable environment in accordance with the laboratory tests. Results The early postopera-donortive hemodynamic stability was effectively maintained in 17 cases of infants, no case appeared with the capacity-related complications. Conclusions It is the key to reduce postoperative complications and mortality with effective circulating blood volume and hemodynamic stability and the negative fluid balance state in the postop-erative 3 days.

Objective To screen the optimal medium formula for obtaining high proliferation rate and differentiation rate of protocorm-like body ( PLB) of Dendrobium officinale Kimura et Migo ( D.officinale) . Methods We observed the effect of different concentrations of phytohormones such as 6-benzylaminopurine (6-BA) , 1-naphthaleneacetic acid ( NAA) , 2,4-dichlorophenoxyacetic acid ( 2,4-D) and kinetin ( KT) , or their combinations together with organic additives such as potato extractive ( PE) , banana extractive ( BE) , apple extractive ( AE) and coconut milk ( CM) on the proliferation and differentiation of PLB of Dendrobium officinale Kimura et Migo. Results 6-BA, NAA and KT at certain concentrations were beneficial to the proliferation and growth of PLB, and when the concentration of KT was 1.0 mg/L, 50-d PLB proliferation times reached to 7.20. 2,4-D had obvious inhibitory effect on PLB proliferation and growth. The combination of 6-BA, NAA and KT showed stronger effect on PLB proliferation than the phytohormones used alone, and the combination of 0.5 mg/L 6-BA, 1.0 mg/L KT and 1.0 mg/L NAA had the best effect on PLB proliferation, 50-d PLB proliferation times reaching to 9.52. Certain concentrations of PE and AE could promote PLB differentiation, and 100 g/L PE brought well-grown seedling in test tube and the highest differentiation rate, being up to 92.6% . Conclusion The optimal hormone matching and additives concentration on proliferation and differentiation of PLB of Dendrobium officinale Kimura et Migo have been obtained, which can lay a foundation for its rapid propagation and artificial seed preparation.

OBJECTIVE To probe the pathogen′s distribution of ventilator-associated pneumonia(VAP),in order to offer the evidence of clinical therapy,prevent the onset of VAP and apply the antibiotics reasonably.METHODS We applied the methods of etiology,microscopic identification,bacteria culturing etc on 74 mechanical ventilation patients,and analyzed the etiology of early-onset and late-onset VAP in contrast.RESULTS Totally 121 pathogens were cultivated altogether in all 74 VAP patients.In the 36 pathogens which were cultivated from 29 early-onset VAP patients,there were 66.67% of simple culture(24 patients,24 strains) and 33.33% of co-culture(5 patients,12 strains),and in the 85 pathogens which were cultivated from 45 late-onset VAP patients there were 17.64% of simple culture(15 patients,15 strains) and 82.35% of co-culture(30 patients,70 strains).The proportion of co-culture in the late-onset VAP patients was prominantly higher than that in the early-onset ones(?2=27.821,P

A new pyranocoumarin as an analogue of calophyllolide, compound 6, is firstly prepared and reported to have potent anti-inflammatory activity on carrageenin-induced edema in rats.

Objective To explore the effect of the clinical case oriented management model on nurses comprehensive ability, psychological and critical mind. Methods In 2014 on the implementation ofroutine clinical case management modelas the control group, collected 97 cases of clinical cases. In 2015 on the implementation ofthe clinical case oriented management modelas the observation group, collected 110 cases of clinical cases. Compared two methods of management to improve the nurse management theoretical knowledge, clinical practice ability and deal with the size of the case skills help. When/after clinical special case found the influence for nurses, including psychology, work in the nursing work will, enthusiasm, independent ability to deal with related cases and the nurse critical thinking ability, etc. Results The proportion of the nurses thought that it was helpful to improve the management of theoretical knowledge, clinical practice ability and deal with the size of the case skills and the case analysis of satisfaction were 98.79%(244/247), 99.19%(245/247), 98.79%(244/247), 99.60%(246/247) in the observation group, and 88.57%(217/245), 87.35%(214/245), 87.76%(215/245), 90.61%(222/245) in the control group. The differences were statistically significant (χ2=21.390-27.571, P < 0.01). The proportion of the nurse considered that special case on the psychological effects of nursing work, engaged in the willingness and enthusiasm were the main factor were 15.79%(39/247), 13.77%(34/247), 11.34%(28/247) in the observation group, and 31.84%(78/245), 31.02%(76/245), 30.61%(75/245) in the control group. The differences were statistically significant (χ2=17.475, 21.097, 27.611, P < 0.01). After special case, the percentage of nurses to independently handle the case, help others, loss rates were 97.57%(241/247), 2.02% (5/247), 0.40% (1/247) in the observation group, and 85.71% (210/245), 12.24% (30/245), 2.04% (5/245) in the control group. The proportion of nurses to independently handle the case in the observation group was higher than that in the control group, but the ratio of nurses to help others, loss rates in the observation group were lower than those in the control group, the differences were statistically significant (χ2=22.647, P<0.01).Critical thinking score, the observation group of nurses in the search for truth, open mind, analytical ability, system organization, judging thinking self-confidence, curiosity, cognitive maturity, such as total score were respectively (43.24±4.01), (43.03±4.12), (47.66±4.23), (44.21± 3.92), (44.00 ± 4.97), (52.13 ± 4.44), (48.23 ± 4.85), (319 ± 14.57) points. The control group nurses were respectively (39.00±3.56), (38.90±3.28), (43.65±2.47), (40.55±1.99), (39.00±3.40), (47.87±4.01), (41.89± 5.11), (292.23 ± 6.02) points. The differences were statistically significant(t =12.15-24.19, P < 0.01). Conclusions The clinical case oriented management model can improve nurses comprehensive ability, reduce the adverse impact of the special case for nurses, improve the clinical nurses' critical thinking ability, to ensure patient safety.

Objective: To study the impact of ticagrelor on inlfammatory factors in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI).
Methods: Based on conventional medication, a total of 100 UAP patients after PCI were randomly divided into 2 groups for anti-platelet therapy:Treatment group, the patients received aspirin+ticagrelor and Control group, the patients received aspirin+clopidogrel. n=50 in each group, all patients were treated for 12 months. Plasma levels of inlfammatory factors were examined before treatment and 24h, 7d, 28d after the operation. The patients were followed-up for 12 months for ischemic events, bleeding events and adverse drug reactions.
Results: Before treatment, plasma levels of IL-6, IL-18, TNF-α, PDGF were similar between 2 groups (t=0.1356, 0.1668, 0.2473, 0.5780, all P>0.05). At 24h post-operation, the above inlfammatory factors were signiifcantly increased by peaks in both groups and decreased thereafter. At 24h, 7d and 28d post-operation, the levels of IL-6, IL-18, TNF-a, PDGF in Treatment group were all lower than Control group at each corresponding time point (at 24 post-operation, t=2.0856, 2.4399, 2.2217, 2.2053, all P<0.05), (at 7d post-operation, t=6.0978, 5.9705, 4.4631, 4.3963, all P<0.01) and (at 28d post-operation, t=9.3779, 9.7724, 5.5855, 6.1700, all P<0.01). The follow-up study presented that at 12 months post-operation, the ischemic events in Treatment group was lower than Control group (χ2=4.3956, P<0.05);there were no small hemorrhage or major bleeding events occurred;the slight adverse drug reaction was similar between 2 groups (χ2=0.1773, P>0.05).
Conclusion: Compared to clopidogrel, ticagrelor could better decrease plasma levels of inlfammatory factors, it may reduce ischemic events without elevate bleeding events.