Objective To explore the effect of Tracer Methodology on the physical restraint management of the elderly patients. Methods The idea of Tracer Methodology was based on a case study of physical restraint, and then complementary tracking and system tracking. The key problem, which was founded in using Tracer Methodology on the physical restraint management of the elderly patients, could be continuously improved from the regulations, procedures, training, implementation, inspection, feedback, rectification, the implementation and the effectiveness. The normative rate of physical restraint was compared before and after the implementation of this method. Results After using the Tracer Methodology, the rate of physical constraint in the elderly patients was 82% (41/50), which was significantly increased (χ2=5.877,P=0.015) compared with before implementation of this method, which was 60% (30/50). Conclusions Tracer Methodology could improve the normative rate of physical restraint in elderly patients. Meanwhile, it was beneficial for nurses to participate in quality management, and strengthen the team cooperation.

Objective To assess the efficacy and safety of smoking intervention by anesthesiol-ogists in surgical patients.Methods A total of 182 male patients,aged 18-79 years,ASA grade Ⅰ-Ⅲ,scheduled for elective noncardiovascular and nonthoracic surgery,were assessed preoperatively. Patients were randomized to either the control group or the intervention group,n =91 each.The con-trol group did not receive specific smoking cessation intervention.The intervention group received brief counseling by the anesthesiologist,leaflets on smoking cessation,including pictorial health warning labels,smoking cessation clinic’s smokers’hot line and WeChat public number.Anesthesia methods,operation time,treatment time in PACU,the rate of smoking cessation at 30 days postop-eratively,perioperative complications and smoking status at 30 days postoperatively were recorded. Results One hundred and sixty-six patients were included in the analysis finally.There was no signif-icant difference between two groups in 30 days of follow-up postoperatively.Self-reported smoking re-duction in the postoperative 30 days the intervention group was significantly lower than that in the control group (36.9% vs.22.0%,P <0.05).For smokers,there was a relationship between the lev-el of eCO and the smoking cessation rate,it was 83.3% in the intervention group and 40.0% in the control group (P <0.05).There was no significant difference of overall rate of combined intraopera-tive and immediate postoperative complications between two groups.Conclusion Smoking cessation intervention launched by anesthesiologists promotes 30 days of abstinence postoperatively.

Objective To evaluate the risk of pressure ulcers (PU) in older Chinese patients as well the effectiveness of preventive and therapeutic measures for pressure ulcers.Methods Totally 780 elderly patients admitted to the Geriatrics Demonstration Word at Peking Union Medical College Hospital during last four years were retrospectively analyzed.Braden scale was administered to predict the risk of pressure ulcers.Results Pressure ulcers had been prevented effectively in all patients with no new cases occurred.8 patients had pressure ulcers at stage Ⅱ and above on the admission.With implementation of preventive and treatment measures,including functional rehabilitation,individualized chronic disease management,moist wound healing method,proper wound dressings,these pressure ulcers were healed.Conclusions Risk assessment with Braden scale,individualized prevention and treatment appear to be effective for pressure ulcer management.Further studies are needed for evaluation of these measures,in the elderly.

Objective To investigate the clinical features of capillary leakage syndrome ( CLS ) occurring in critically ill newborns in Guangzhou. Methods Three tertiary hospitals in Guangzhou were chosen as research field;critically ill newborns with diagnosis as CLS in NICU of three hospitals were retro-spectively studied from January 2011 to December 2015; and the morbidity,mortality,causes,treatment and outcome of CLS neonates were analyzed. Results There were 49 cases diagnosed as CLS, accounting for 1. 62%(49/3 029)of the total number of critically ill newborns admitted to NICUs in the same period. The common primary factors were preterm low birth weight(34 cases,69. 4%),respiratory distress syndrome(38 cases,77. 5%),congenital anomaly(19 cases,38. 8%),asphyxia(17 cases,34. 7%),and intrauterine infec-tion(12 cases,24. 5%). The 83. 7%(41/49) of CLS occurred within 72 hours after admission. The overall mortality of CLS was 30. 6%( 15/49 ) . The main lethal cause was multiple organ dysfunction syndrome (60. 0%,9/15). Treatment included antibiotics,vasoactive drugs,fluid resuscitation,corticosteroids,and me-chanical ventilation. Conclusion CLS is a common critical illness in NICU with high mortality and poor prognosis. Early prediction and early intervention could improve survival and prognosis in critically ill neonates with CLS.

Objective To summarize key points of nursing patients with cosmetic dermatitis during patch test.Method One hundred and forty one patients with contact dermatitis induced by cosmetics underwent patch test and the nursing care was performed. Results The top five allergens based on the positive rate ranked in descending order were potassium dichromate(43?97%),nickel sulfate (43?26%),cobalt chloride(36?17%),mixture of hydroxy benzoic acid(23?40%)and fragrance mix(20?57%).The positive suspicious cosmetics ranked in ascending order included body spray(80?00%),freckle cream(56?00%),liquid products(38?89%),cleaning supplies (31?58%)and skin care cream(25?62%).Conclusion During the cosmetic patch test for the patients with contact dermatitis,the nurses should conduct mental care,carefully observe the patients and make instructions to them on cosmetic health knowledge.

AIM and METHOD: In terms of difference value between bleeding blood volume that caused hemorrhagic shouk (HS) and residual blood volume at 2 h after HS, showed that HS at 5.3 kPa level was compen- satory and at 4.0 kPa level was decompensatory. Comparing some blood changes between HS two levels and their changes while pretreated with captopril (Capt. ) to reduce the release of angiotensin Ⅱ (Ang-Ⅱ), so as to inveshgate the significance of Ang - Ⅱ during HS. RESULTS: The residual blood volume in 4.0 kPa HS + Capt. group are again from near "zero" value in simple 4.0 kPa HS group. In both two HS level groups found blood dilution and was not influenced by pretreating with Capt.; contents of K+ and aldosterone increased, but Na+ had no changes, in Capt. + HS group, the former two contents reduced and Na+ had no changes comparing with each HS group. In two HS groups, the bind lactate, lactic dehydrogenase (LDH), blood urea nitrogen (BUN) increased and had more increment in 4.0 kPa HS group. All these changes could be prevented by pretreating with Capt. The blood glucose in 5.3 kPa HS group increased markedly and Capt. had no influence on it, but decreased extremely in 4.0 kPa HS group and Capt. could make it re - increased. CONCLUSIONS: Artery blood pressure (ABP) at 5 .3 kPa level was compensatory HS and ABP at 4 .0 kPa level was decompensatory HS, some changes on decompensatory HS were more serious and severe than compensatory HS, Capt. has protective effects on some changes during HS and could prolong the survival time of decompensatory HS, all that indicated the increment of Aug - Ⅱ is an important pathogenetic factor during HS.

AIM: To examine and compare the ability of serum IgA 1, from both the patients with IgA nephropathy (IgAN) and the healthy control, to bind to human mesangial cells (HMC). METHODS: Serum IgA was isolated with jacalin column, heated to aggregated form (aIgA 1) and labeled with [ 125 I]. Binding capacity of aIgA 1 to primary HMC was evaluated by radioligant binding assay, specificity of binding was determined by competitive inhibition, and relative affinities was compared by cross competitive inhibition. RESULTS: Both aIgA 1 from normal control and patients with IgAN bound to MC in a dose-dependent, saturatable manner, but the binding of aIgA 1 from patients was saturated at approximately 200 pmol while that from healthy was at 400 pmol. The Scatchard analysis revealed a Kd of (8 9?2 1)?10 -8 mol/L for patient's aIgA 1 versus (4 3?1 2)?10 -7 mol/L for normal aIgA 1 ( P

AIM: To study and compare the pathophysiological effects of serum IgA 1 from both the patients with IgA nephropathy (IgAN) and healthy controls on human mesangial cells (HMC). METHODS: Serum IgA 1 was isolated with Jacalin affinity chromatography and heated to form aggregates (aIgA 1). Primary HMC were cultured and passage 3 and passage 4 of the cells were used. Intracellular calcium release was assayed with confocal analysis. Expression of TGF-? mRNA and the content of supernatant fibronectin were tested by RT-PCR and indirect competitive ELISA, respectively. RESULTS: aIgA 1 from patients with IgAN was shown to induce release of intracellular calcium, up-regulation of expression of TGF-? mRNA and secretion of fibronectin in HMC in a similar time-dependent manner as aIgA 1 from healthy controls, but the effects of the former were much stronger and the durations was much longer (P

Obsessive-compulsive disorder (OCD) is a chronic,disabling,mental disorder,which has been linked to significant abnormalities in certain brain areas,including the orbital frontal cortex and the anterior cingulate cortex.Neuroimaging studies have also shown that brain areas related to the decision-making function include the orbital frontal cortex and the dorsal prefrontal lobes.Furthermore,the association between OCD and decision-making function has been consistently demonstrated from a neurobiological perspective.Clinically,impaired decision-making ability is commonly observed in OCD patients,and there is a correlation between OCD and abnormal decision function.Decision-making tasks are typically divided into two types,decision-making under risk and decision-making under ambiguity,with the former commonly evaluated using the Iowa Gambling Task (IGT) and the latter using the Game of Dice Task (GDT).In this article the neural mechanism and evaluation methods of decision making in OCD were reviewed.

Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter in bipolar Ⅱ disorder and its relation with executive function.Methods Thirty bipolar Ⅱ disorder patients and twenty healthy controls were evaluated with Multi-Voxel proton magnetic resonance spectroscopy (1H-MRS)scans on prefrontal white matter to assess the N-acetyl-aspartate (NAA),Choline (Cho),Creatine (Cr) and myoinositol (MI),and then the ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/Cho and NAA/Cho + Cr were calculated.All subjects were assessed for executive function using the Wisconsin Card Sorting Test (WCST).Results NAA/Cr in right prefrontal white matter(1.43 ± 0.26) and NAA/Cr,NAA/Cho,NAA/Cho + Cr in left prefrontal white matter (separatelyl.40 ± 0.29,1.13 (1.53,0.24),0.62 ± 0.12) were lower than healthy controls (separately 1.58 ±0.18,1.59,0.23,1.30 (0.53 ± 0.29),0.71 ± 0.08) (P ＜ 0.05).The correct trials and the number of categories of WCST in Bipolar Ⅱ disorder (separately 26.97 ± 8.97,3(6,3)) were less than in healthy controls(separately 36.35±4.85,5 (3,2)),and perseverative errors and random errors were more in patients (separately 12.77 ±5.73,7 (21,5)) than healthy controls (separately 7.35 ± 3.01,4 (13,2)).NAA/Cho and NAA/Cho + Cr in left prefrontal white matter were positively correlated with correct trials,number of categories,and negatively related with perseverative errors (P＜0.05).Conclusions Bilateral prefrontal white matter fiber damage occurs to bipolar Ⅱ disorder.And left prefrontal white matter fiber damage in bipolar Ⅱ disorder may lead to executive impairment.