Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.

AIM To investigate the protective effect of daidzeid (DZ) on cerebral ischemia and it mechanism in mice METHODS Cerebral ischemia was induced by cutting heads and bilateral carotid arteries were completely or incompletely ligated RESULTS The stroke index score in ischemic mice was reduced by DZ, an the persistent time of gasping of mice by decapitation and survival time of mice by bilateral carotid arteries ligation were prolonged by DZ DZ could reduce the content of brain lactic acid while improve the brain superoxide dismutase activity CONCLUSIONS The results indicate that DZ has the protectiveeffect on cerebral ischemia injury Its mechanism may be related with its effect of decreasing of lactic acid content and reducing of free radicals production

Objective To study changes of dielectric properties of gastrocnemius caused by simulated weightlessness.Methods Male Sprague-Dawley rats tail suspended for 10 wk were observed together with its normal control.AC impedance of isolated gastrocnemius was measured with an impedance analyzer(Agilent 4294A).Effects of simulated weightlessness on electric properties of cells in isolated rat sural muscle were also observed by analyzing the dielectric numerical characters of the dielectric spectra,the Cole-Cole plots,spectrum of loss factor and loss tangent,as well as spectrum of conductivity imaginary part.Results It was found that simulated weightlessness could induce certain changes:both relative permittivity at low frequency ?L and relative permittivity increment ??,as well as conductivity at high frequency ?h and conductivity increment ?? were all reduced.The first characteristic frequency fC1 decreased,while the second characteristic frequency fC2 increased.Peak of loss factor,peak of loss tangent and the maximum of conductivity imaginary part were also reduced.Conclusion Changes of dielectric property of gastrocnemius induced by simulated weightlessness can be observed effectively by frequency domain impedance technique.

10mg/L(n=22) group,and CRP10mg/L group with CRP10mg/L group and the concentration of CRP inverse correlation with serum ALB,Fe,Hb levels.Conclusions The elevated concentration of CRP is considered to be the most common cause of decreased EPO or hyporesponsiveness to EPO in CRF anemia patients. CRP level can predict whether CRF anemia,dificult or easily degree of the anemia correction for CRF patients,all that provide evidence for improving CRF anemia.

Objective:To analyze the effects of SBAR(namely situation, background, assessment and recommendation) communication mode-guided scenario simulation exercise on the quality of shift change of practice nurses and the incidence of nursing risks.Methods:From May 2017 to December 2018, 46 nurses interning in the Department of Cardiovascular Medicine of Guangyuan Central Hospital were selected as the control group, and received practice guidance according to the conventional shift change mode; 46 nurses were selected as the research group having the SBAR communication mode-guided scenario simulation exercise from January 2019 to June 2020 in the same department. The evaluation results of the quality of nurses' shift change, the evaluation results of the quality of nurses' succession, and the satisfaction of nurses were compared between the two groups. SPSS 22.0 was used for t test and chi-square test. Results:The evaluation results of 7 items of nurses' handover quality in the research group were better than those in the control group ( P<0.001). The evaluation results of 6 items of nurses' succession quality in the research group were better than those in the control group ( P<0.001). The scores of 5 dimensions in the research group were higher than those in the control group ( P<0.001). Conclusion:The implementation of SBAR communication mode-guided scenario simulation exercise can improve the quality of nurses' shift change and the satisfaction of practice nurses.

AIM: To study the effects of Huoxue Huayu and Yiqi Wenyang compound prescription (composition; ginseng, radix astragali, plantaginis semen, lignum sappan, chuanxiong, salvia miltiorrhiza, radix aconiti lateralis preparata, bitter orange, cassia twig) of TCM on the congestive heart failure in rats. METHODS:The rats were given doxorubicin hydrochloride by intraperitoneal injection to establish the model of congestive heart failure and were randomly divided into control group, congestive heart failure model group, Xinbao treatment group ( XB treatment) and Huoxue Huayu and Yiqi Wenyang compound prescription treatment group (QXYTM treatment). Normal saline, liquid medicine Xinbao and liquid medicine Huoxue Huayu and Yiqi Wenyang compound prescription were administered respectively to four groups by gavage. Radioimmunoassay, semi - quantitative RT - PCR and flow cytometry methods were used to determine the expressions of plasma atrial natriuretic peptide ( ANP) , renal medulla aquaporin - 2 ( AQP2 ) and heat shock protein70 (HSP70) in congestive heart failure rats before and after treatment. RESULTS: In congestive heart failure rats treated with Huoxue Huayu and Yiqi Wenyang compound prescription, the cardiac output and left ventricle systolic pressure increased significantly, the left ventricular end diastolic pressure decreased, and the maximum ascending and declining rate of left ventricular pressure ameliorated, thus the hemodynamics was effectively improved. Meanwhile, the level of plasma cardionatrin decreased, the abnormal expression of renal medulla AQP2 was markedly restored, and the transcription and expression of HSP70 gene were also increased. CONCLUSION: Huoxue Huayu and Yiqi Wenyang compound prescription promotes the recovery of the pathogenetic conditions of congestive heart failure in rare. The mechanism may be in association with a decrease in plasma ANP level, correction of renal medulla AQP2 abnormal expression and enhancement of HSP70 expression.

County hospitals function as comerstones in China's health system,as their sustainable development plays a key role for the ongoing health reform.Disciplines are the most primary functional units of a hospital,and their disciplinary culture characteristic of the county hospital' s disciplines and fitting their current development status are definitely the most important and fundamental factor for sustainable development of the discipline.Based on extensive research,authors identified no less than eight cultural elements,namely values of life,self-confidence,a comprehensive model of talent development,safety first,teamwork,communication,scientific pursuit and health management.This study aimed at providing thoughts for the current county hospital development.

Objective To observe the clinical effect of Jiawei Zuojin Pills combined with western medicine on reflux esophagitis with liver-stomach disharmony syndrome. Methods Totally 90 cases were divided into observation group (45 cases) and control group (45 cases). The control group was given rabeprazole sodium enteric-coated capsule and domperidone tablets, and the observation group was given Jiawei Zuojin Pills additionally for four weeks. The clinical effect, TCM syndrome score and endoscopic improvement were observed. Results The total effective rate of observation group was 95.5%(43/45), control group was 93.3%(42/45), with no significant difference between the two groups (P>0.05). The excellent rate of observation group was 77.8% (35/45), control group was 57.8% (26/45), with significant difference (P<0.05). TCM syndrome score was improved in both groups (P<0.001), and the degree of improvement in the observation group was better than control group (P<0.05). The total effective rate rate under endoscopic of observation group and control group was 96.5% (43/45) and 77.8% (35/45) respectively, with significant difference (P<0.05). Conclusion Jiawei Zuojin Pills combined with western medicine has obvious efficacy in treating reflux esophagitis with liver-stomach disharmony syndrome.

Objectives:B type ultrasonic diagnosis instrument is used to measure the sebum thickness and the relevance vs evaluated with sebum thickness calipers in sebum thickness determination. Methods:The study included 219 healthy adult persons and 11 cases of corpse dead of non disease reason for less than 10 hours.The measurements of sebum thickness were made by B type ultrasonic diagnosis instrument and sebum thickness calipers respectively. Results:The measurement results of two different methods were not significantly different. Conclusions:It is feasible to use B type ultrasonic diagnosis instrument for the measurement of the sebum thickness in clinic.

Objective To discuss the clinical characteristics for central compartment lymph node metastasis in stage cNO papillary thyroid microcarcinoma and significance and feasibility of preventive dissection,aimed to provide reference for clinical treatment.Methods Reviewed the clinical data of 277 patients with stage cNO papillary thyroid microcarcinoma from Jul.2011 to Dec.2015 underwent surgery in the Department of General Surgery of Lianyungang East Hospital.Evaluated the necessity of prophylactic central lymph node dissection.Adopted chi square test and Logistic regression to analyze its relationship with patients' gender,age,tumor number,tumor size,enveloped infiltration,single and bilateral tumor.All 277 patients underwent primary radical resection with ipsilateral central lymph node dissection.The specimen of resection was analyzed by routine pathology.Results The positive rate of thyroid papillary microcarcinoma lymph node metastasis was 36.8 ％ (102/277).The elements of male patients (P =0.023),age ＜ 45 years (P ＜ 0.001) and tumor diameter ＞ 0.5 cm (P =0.019)had high positive rate.The multivariable analysis showed that male patients (OR =2.63,P ＜ 0.001),age ＜ 45 years (OR =2.25,P =0.016),tumor diameter ＞ 0.5 c m (OR =2.13,P =O.009) were independent risk factors for CLN metastasis.Forty-three (15.5％) cases had transient parathyroid function.No Permanent recurrent nerve paralysis and hyperparathyroidism occurred in this group.Conclusions Prophylactic central lymph node dissection is helpful for accurate staging of tumor classification and risk assessment,has important significance,on the follow-up of patients after treatment of choice.For male patients,age ＜ 45,tumor diameter ＞ 0.5 cm,enveloped infiltration,the central compartment lymph node dissection may be necessary.