Objective To investigate the relationships between serum procalcitonin (PCT) level and APACHE Ⅱ score as well the prognosis of septic patients.Methods Ninety patients with sepsis were collected from emergency and critical care department of Third Hospital,Peking University,Beijing.Within 24 hours after admission,the serum PCT,hypersensitive C-reactive protein (hs-CRP),leucocyte count (WBC) and lactic acid were examined,and APACHE Ⅱ score were calculated.According to APACHE Ⅱscore,the septic patients were divided into three groups of high,median and low scores.Based on the 28 -day outcomes of patients,the patients were divided into survival group and death group.The differences in PCT,APACHE score,WBC and lactic acid between the survival group and the death group were detected.Results The serum levels of PCT were significantly higher ( P ＜ 0.01 ) in patients with high APACHE Ⅱ score ( ＞ 20) than that in patients with median score (10-20) and low score ( ＜ 10 ).There was significant correlation between PCT level and APACHE Ⅱscore ( r =0.58,P ＜0.01 ).Conclusions There is a good correlation between serum PCT level and APACHE Ⅱ score.The serum PCT and APACHE Ⅱ can be used for predicting the outcomes of septic patients.

Objective To understand the injuries state of inhabitants in County MEI of Shanxi Province and their degree of harmfulness. Methods The detailed data of all cases from three hospitals at different levels of the injury surveillance during Jan 1st to Dec 31st 2006 in County Mei of Shanxi Province were collected.All the cases met the criteria of National Injury Surveillance Program. Results 2 469 cases were collected from the three hospitals.It was showed that men(68.29%) were more often injured than women(31.71%).Most sufferers were 25~44 years old,which accounted for 39.25%.The leading causes for injuries were traffic injury by motor vehicles(29.16%),falls(24.79%) and blunt injury(15.43%).Most injuries were slight,which accounted for 58.08%. Conclusion The top three causes of injuries in County Mei of Shanxi Province were traffic injury by motor vehicles,falls and blunt injury in 2006.Young males are the high-risk population prone to injuries.We should take counter measures to prevent and control injuries based on surveillance data analysis.

We have enhanced the quality and efficiency of nursing through the management of the work by means of standard quantized integration. The measures include formulation in the first place of various quantized standards and detailed assessment rules and then the working out of assessment methods. The adoption of these measures in our hospital has led to the improvement of its managerial expertise, the enhancement of its nursing personnels quality and competition awareness, the stimulation of its staffs enthusiasm, and the strengthening of its nursing work in teaching and research management. As a result, nursing in the hospital has become more scientific and efficient.

Objective To analyze the psychological characteristics of stroke patients and the effects of psychological interventions on their functional rehabilitation.Methods A total of 180 stroke patients with hemiplegia were randomly assigned to the control group ( n =90) or the treatment group ( n =90 ).Those of the control group received conventional drug therapy and rehabilitation programme,and those of the treatment group were additionally given psychological intervention.Symptom checklist (SCL-90) and the WHO QOL-100 checklist were used to assess the effect of psychological intervention on mental health of the participants.Results Before the treatment,the difference of SCL-90 results was not statistically significant between the two groups ( P ＞ 0.05 ).At 3 months,SCL-90 results of the treatment group was lower in comparisou with the baseline level ( 120.3 ± 21.2 vs 133.1 ± 34.1 ) and the control group ( P ＜ 0.05 ).However,there was no statistical significance in the control group before and after the treatment ( P ＞ 0.05 ).SCL-90 and the WHO QOL-100 checklist results in the treatment group were significantly different before and after the treatment ( P ＜ 0.05 ).The SCL-90 showed no significant difference in the control group before and after the treatment (P ＞ 0.05 ).Conclusion Timely and appropriate psychological intervention could improve the functioning,reduce disability and improve the quality of life of stroke patients.

Objective To investigate the change in blood lymphocyte levels and lymphocyte percentage in critical patients,including those with non-infectious systemic inflammatory response syndrome (SIRS),sepsis and severe sepsis.Methods Clinical data of 423 patients admitted to intensive care unit (ICU) of Department of Emergency of Peking University Third Hospital from January 2011 to September 2013 were retrospectively analyzed.Among these patients,there were 54 with non-infectious SIRS,177 with sepsis and 192 with severe sepsis.150 of them died,and 273 survived.The white blood count (WBC),neutrophil (N),lymphocyte count,lymphocyte percentage,lactic acid,serum high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined at admission,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was estimated.The patients were divided into different groups according to diagnosis and prognosis to compare the value of the indexes,and the correlation between lymphocyte count and other markers were analyzed by Spearman relative analysis.Results The older the patients,the more severe the disease.In the non-infective SIRS,sepsis and severe sepsis groups,APACHE Ⅱ scores (7.78 ± 3.72,13.85 ± 7.22,24.00 ± 9.79),time of stay in hospital [days:6.0 (1.0,9.0),12.0 (8.0,22.0),19.5 (7.0,29.0)],the mortality rate (0,10.2％,52.6％),WBC (× 109/L:7.59 ± 3.27,8.94 ± 3.95,10.32 ± 5.50),N (0.685 ± 0.132,0.778 ± 0.135,0.831 ±0.086),hs-CRP [mg/L:4.60 (2.80,7.52),23.58 (13.49,49.22),59.77 (19.36,110.62)] andPCT [μg/L:0.05 (0.05,0.05),0.09 (0.05,0.61),0.63 (0.10,5.25)] showed gradually increasing tendency (all P=0.000).Serum lymphocyte count levels [× 109/L:1.53 (0.89,1.88),0.90 (0.65,1.42) and 0.80 (0.50,1.12)],lymphocyte percentage (0.225 ± 0.122,0.138 ± 0.097,0.106 ± 0.070) showed gradually decreasing tendency (P＜0.05 or P＜0.01).There was significant difference in blood lactic acid among three groups [blood lactic acid were 2.40 (1.30,5.10),1.10 (0.80,2.00) and 1.40 (1.00,2.50) mmol/L in the non-infective SIRS,sepsis and severe sepsis groups respectively,P=0.000].Age (years old:76.71 ± 12.21 vs.73.21 ± 14.49),APACHE Ⅱ score (24.69 ± 9.58 vs.13.91 ± 8.41),time of stay in hospital [days:12.0 (4.0,28.0) vs.11.0 (8.0,22.0)],WBC (× 109/L:10.29 ± 5.82 vs.8.89 ± 3.98),N (0.809 ± 0.130 vs.0.776 ± 0.120),lactic acid [mmol/L:1.80 (1.10,2.90) vs.1.30 (0.90,2.49)],hs-CRP [mg/L:50.94 (19.21,97.13) vs.21.71 (6.39,54.40)] and PCT [μg/L:0.74 (0.13,5.83) vs.0.08 (0.05,0.59)] levels in the death group were higher than those in the survival group (P＜0.05 or P＜0.01),serum lymphocyte count levels [× 109/L:0.90 (0.50,1.29) vs.1.05 (0.70,1.54)],lymphocyte percentage (0.123 ± 0.098 vs.0.143 ± 0.097) level in the death group were obviously lower than those in the survival group (P＜0.01 and P＜0.05).Serum lymphocyte count levels were negative correlated with N (r=-0.597,P=0.000),hs-CRP (r=-0.298,P=0.000),PCT (r=-0.304,P=0.000),APACHE Ⅱ (r=-0.124,P=0.000),and positively correlated with lymphocyte percentage (r=0.691,P=0.000),and non correlations was found with WBC (r=0.082,P=0.091) and lactic acid (r=0.073,P=0.132).Conclusion The serum lymphocyte levels in the critically ill patients are related with the severity of sepsis,and monitoring the change in lymphocyte may be an indicator for evaluating the illness and effect of treatment.

Objective To study the alexithymia and personality characteristics in patients with somatoform disorders.Methods Totally 60 patients with somatoform disorders and 60 normal controls were tested with Toronto alexithymia scale (TAS) and Minnesota Multiphasic Personality Inventory (MMPI).Results The patients with somatization disorders showed alexithymia and personality base.The total and factor scores of TAS of study group((86.20 ± 11.15),(21.12 ± 3.28),(26.08 ± 3.86),(18.21 ± 4.69),(23.44 ±5.60)) were higher than controlled group((65.00 ± 10.12),(12.43 ±5.18),(15.64 ±5.57),(15.56 ±3.16),(18.71 ±4.30)) with significant difference (t =2.11-6.22,P =0.000-0.042).The MMPI scale scores of Hs (hypochondriasis),D (depression),Hy(hysteria),Men-Nancy(Mf),paranoid(Pa),psychotic(Pt) were higher in patients with somatoform disorders ((72.79 ± 10.50),(68.46 ± 13.63),(79.03 ± 12.12),(51.72 ± 7.74),(57.98 ± 10.60),(54.98 ±8.83)) than those in normal controls ((51.66 ± 10.11),(47.96 ±9.42),(51.47± 11.90),(43.66 ±8.77),(47.67 ± 6.69),(47.48 ±8.67)) with significant difference (t =2.56-6.86,P =0.000-0.015),especially the scale scores of Hy and Hs were the most significantly among those (T ＞ 70).There was close correlation between personality traits and alexithymia.Factor Ⅰ was positively related to depression,paranoid and psychotic,the relevancy was 0.454(P =0.023),0.405 (P=0.044),0.477 (P=0.016) respectively,besides Factor Ⅱ was also positively related to depression,and the relevancy was 0.437(P=0.029).Conclusion Patients with somatoform disorders have the alexithymia and the personality characteristics,and there are close relationship between them.

This study was aimed to extract and separate fibrauretine from Chinese herbal medicine Fibraurea recisa Pierre. and to prepare tetrahydropulmatine with fibrauretine. Extraction method of fibrauretine were optimized by the L9(34) orthogonal arrays as experimental designs. Then, elution chromatography method was studied with the macroporous adsorption resin chromatography technology. At last, tetrahydropulmatine was prepared by the reaction of sodium borohydride hydrogenating fibrauretine. The results showed that the content and yield of obtained fibrauretine were 36.40% and 3.17%, respectively. The reflux exacted methods of fibrauretine were with 10 times amount (v/w) of 50%ethanol solution for 2 hours and 3 times. Then, HPD-300 macroporous resin was used to absorb fibrauretine, and purify water. The 20% and 60% ethanol solution was used for elution. The content and yield of obtained fibrauretine were 65.47% and 82.44%, respectively. And the content and yield of obtained tetrahydropulmatine were 98.31% and 72.04%, respectively. It was concluded that the method can obtain fibrauretine with relative high content and yield. Using this material can obtain tetrahydrofibrauretine with relative high content and yield.

Objectives: To investigate the treatment effect of enteral nutrition rich in diet fiber in diarrhea because of bacteria disorder after severe brain injuries.Methods:20 cases with severe brain injuries were supported with enteral nutrition rich in diet fiber after the occurrance of diarrhea because of bacteria disorder as clinical treatment group.20 cases with the same conditions were treated with traditional methods as control.Results: Diarrhea of all patients in clinical treatment group had been controlled during 7-10 days,and the feeding quantities reached total calories.The nutrition state was improved,and the body internalenvironment was stable during the 20 days. Conclusion: Enteral nutrition rich in fiber can treat diarrhea caused by bacteria disorder after severe brain injuries.

OBJECTIVE:To establish a method for content determination of rosmarinic acid and total polysaccharide in Hysso-pus. offcinalis. METHODS:HPLC was conducted to determine the content of rosmarinic acid in H. offcinalis. The column was Shim-pack VP-ODS with mobile phase of acetonitrile-0.5% formic(17:83,V/V) at flow rate of 1.0 ml/min,detection wavelength was 330 nm,column temperature was 30 ℃,and the injection volume was 10 μl. UV-visible spectrophotometry was conducted to determine the content of total polysaccharide,detection wavelength was 620 nm. RESULTS:The linear range was 10.86-54.30 μg/ml (r=0.999 8)for rosmarinic acid and 1.996-15.97 μg/ml for total polysaccharide(r=0.999 6);RSDs of precision,stability and re-producibility tests were lower than 1.0% and 2.0%,respectively;recoveries were 98.20%-101.79%(RSD=1.68%,n=6) and 96.62%-101.68%(RSD=1.88%,n=6). CONCLUSIONS:The method is simple and reproducible,and can be used for the con-tents determination of rosmarinic acid and total polysaccharide in H. offcinalis.

Objective To explore the effect of health education and comprehensive nursing intervention on quality of patients with lung cancer.Methods One hundred lung cancer patients who were treated with chemotherapy from February 2010 to February 2013 in our hospital were selected and assigned to the intervention group (n=50) and the control group (n=50).The participants in the control group received conventional anti-cancer drug and routine primary care,however those of the intervention group additionally obtained health education and comprehensive nursing intervention.The Zung Anxiety Scale (SAS),Depression Rating Scale (SDS) and the core quality of life questionnaire (QLQ-C30) were used to evaluate the quality of life of the patients.Paired samples t test and ANOVA were used for data analysis.Results Differences of age,gender,disease duration,SAS,SDS score and EORTC QLQ-C30 score were not statistically significant between the two groups (all P＞0.05).After the intervention,SAS and SDS scores of the control subjects were 58.8±7.6 and 49.5±10.1 respectively,and SAS and SDS scores of the intervention group were 46.5±7.8 and 37.4±9.2 respectively (t velues were 5.347 and 6.215,respectively; both P＜0.05).Quality of life scores in the intervention group were as followed:general condition 57.2± 18.3,physical fitness 63.0±25.9,mutual affection 67.3±23.3,cognitive score 75.4±28.2,social role 67.7±24.8 and function scores 58.5±22.3.Quality of life scores in the control group were as followed:general condition 47.3±23.0,physical fitness 54.9±26.6,mutual affection 60.4±19.1,cognitive score 66.2±25.8,social role 54.1±26.2 and function scores 49.4±21.5 (t values were 5.725,6.144,5.021,5.702,7.137 and 6.357,respectively; all P＜ 0.05).Conclusion Health education and comprehensive nursing intervention for lung cancer patients may reduce their anxiety and depression symptoms and improve the quality of life.