Objective To investigate the early prediction,diagnosis and treatment of thoracic injury complicated by adult respiratory distress syndrome (ARDS).Methods The blood gas,occurrence index of traumatic ARDS,pathogenic bacteria and drug sensitivity in ventilator associated pneumonia (VAP) were analyzed retrospectively in 18 cases of thoracic injury.Results The initial PaCO 2 was (32.1?5.2) mm Hg,PaO 2 (57.7?10.1) mm Hg,the occurrence index of traumatic ARDS (-29.00?11.50) and the mechanical ventilation time 6.4 days on average.Of the infective bacterium of VAP,gram negative bacterium took up 70.6%, gram positive bacterium 17.10%,fungus 12.30% and the mixed infection 31.60% with the total mortality of 16.6%.Conclusion The occurrence index of traumatic ARDS can be used as a parameter of the early prediction and outcome.Meanwhile multiple injuries and shock should be treated correctly,ventilator applied earlier and the mechanical ventilation time shortened.It suggests that more attention should be paid to the prevention of VAP and the reasonable use of antibiotic drugs.

Objective To explore the anxious condition and the influencing factors of chronic hepatitis B patients, and to take appropriate care measures. Methods Self-designed questionnaire for general information of patients, a comprehensive Zung self-rating depression scale(SDS)and Zung self-rating anxiety scale(SAS)were used to investigate 100 patients with chronic hepatitis B patients(the study group), and the results were compared with 80 normal persons(the control group). Results The SDS and SAS score of the study group was significantly higher than the control group. The negative emotion factors of the study group included social context, family, education, self- respect. Conclusions Patients with chronic hepatitis B has obvious negative mood, and are influenced by many kinds of factors. Strengthening the comprehensive psychological intervention can improve the negative emotional state, and promote rehabilitation of patients.

BACKGROUND: Excessive nitric oxide (NO) release can cause the occurrence and development of brain injury and senile dementia due to the apoptosis induction role of NO at high concentration to nerve cells. Therefore one strategy to prevent and treat senile dementia is inhibiting the apoptosis induced by NO.OBJECTIVE: To observe whether acidic peptide will inhibit the neuron apoptosis caused by NO. DESIGN: An cell and molecule observation experiment by comparisons. SETTING: Department of Biochemistry and Molecular Biology of Basic Medical College in Zhengzhou University and the Second Laboratory of Biological Active Peptide Institute in Zhengzhou University. MATERTALS: The experiment was performed between May 2003 and May 2005, in the Second Laboratory of Biological Active Peptide Institute in Zhengzhou University and the cell culture room of Department of Biochemistry and Molecular Biology of Basic Medical College in Zhengzhou University. The newborn SD male rats within 24 hours after birth were provided by the Animal Center of Henan Province (410117).METHODS: On day 11 of primary cultures, hippocampus neurons of the newborn SD rats were pretreated with different dosages of acidic peptide for six hours. Sodium nitroprusside (SNP) of 50 μmol/L final concentration was added to the cells which were incubated for another 24 hours. Cells were collected and adopted in this experiment of five different groups, namely normal control group, group treated with SNP, group of SNP plus 0.037 5 mg/mL acidic peptide, group of SNP plus 0.075 mg/mL acidic peptide, group of SNP plus 0.15 mg/mL acidic peptide. The cell's survival rate wasmeasure by methyl thiazolyl (MTT) method; The neurofilament protein was stained with the method of immunohisto chemistry. The shape of apoptosis was display with acridine orange fluorescent stain. Then DNA ladder zone of apoptosis cells was analyzed with the method of agarose gel electrophoresis. Western Blot and absorbance scan were used to determine the expression level of Bcl-2 protein and Bax protein.MAIN OUTCOME MEASURES: ①Experimental result of cell survival rate with MTT method;②Observation results of nuclear type of apoptosis; ③DNA electrophoresis analysis of apoptosis; ④Western Blot analysis results of Bcl-2 protein and Bax protein.RESULTS: ①Neuron survival rate was 58.9％ for group treated with SNP, 70.0％ for group of SNP plus 0.037 mg/mL acidic peptide, 72.8％ for group of SNP plus 0.075 mg/mL acidic peptide, and 75.3％ for group of SNP plus 0.15 mg/mL acidic peptide. ②Observation results of nuclear type of apoptosis: Significant characteristics of apoptosis were seen in group treated with SNP. The nucleus of hippocampus neuron treated with different concentrations of acidic peptide plus SNP was similar to that of normal control group in morphology. ③The results of DNA electrophoresis analysis of apoptosis: Only the neuron DNA of group treated with SNP showed clear characteristic DNA ladder zone of apoptosis on agarose gel electrophoresis. ④Analysis results of Bcl-2 protein and Bax protein with Western Blot and absorbance scan: The expression level of Bcl-2 protein in SNP treated group was decreased while that of Bcl-2 protein was increased. Bcl2 protein levels in acidic peptide plus SNP group were increased and Bax protein levels were decreased gradually with the increasing concentrations of acidic peptide compared with SNP treated group. CONCLUSION: Acidic peptide can inhibit neuron apoptosis, increase expression level of neuron Bcl-2 protein and decrease expression level of neuron Bax protein.

Objective:To investigate the correlation between ultrasonic elasticity score ,elasticity coefficient and autoimmune thyroid function in patients with HT ( hashimoto thyroiditis ) .Methods: Used GE LOGIQ3 type Color Doppler Ultrasound Diagnostic System to acquire satisfactory elastosonography from 216 patients with HT,and evaluated the elasticity score and elasticity coefficient;to detecte the thyroid function and the titer of Thyroid peroxidase antibody ( TPOAb ) , Thyroid globulin antibody ( TgAb ) by chemiluminescence ,respectively investigated the correlation between ultrasonic elasticity score , elasticity coefficient and autoimmune thyroid function.Results:Serum Thyroid stimulating hormone (TSH),TGA and TPO in 216 patients with HT increased significantly , TgAb and elastic coefficient were positively correlated , r=0.54 , P<0.01;TgAb and elasticity score were positively correlated , r=0.496 ,P<0.01;TPOAb and elastic coefficient were positively correlated ,r=0.77 ,P<0.01 ,TPOAb and elasticity score were positively correlated,r=0.73,P<0.01.Conclusion: Real-time ultrasound elastography in combination with measurement of autoimmune thyroid function was helpful to diagnosis of HT .

Matrix metalloproteinase 3 is one of matrix metalloproteinase family members, which degrades a wide range of components of the extracellular matrix and participates in tissue morphogenesis, wound healing and inflammation. In addition, matrix metalloproteinase 3 is involved in pathogenesis and progress of a spectrum of diseases and malignant tumors, such as rheumatic arthritis, arteriosclerosis, breast cancer, and so on. Recent studies have demonstrated that matrix metalloproteinase 3 may be a novel signaling proteinase from apoptotic neuronal cells to microglia, which results in degeneration of neurons in Alzheimer's disease and Parkinson's disease by activating microglia. There is also an association between genetic polymorphisms of matrix metalloproteinase 3 at promoter region 5A/6A and susceptibility of myocardial infarction. Decrease in serum concentration of matrix metalloproteinase 3 after myocardial infarction may be a useful parameter for diagnosing sudden death due to myocardial infarction in forensic practice. Expression of matrix metalloproteinase 3 varies with different types of brain injuries, suggesting that it may contribute to synaptic plasticity during functional recovery. To elucidate the time-dependent expression of matrix metalloproteinase 3 may provide a new way for wound age determination in the brain.

Objective To summarize theskill practice as the coremethods and training effect in tumor specialist nurse training , and to explore the suitable effective methods and pattern of China′s national conditions of specialist nurse training in China, for providing a reference for conducting cancer specialist nurse training. Methods Reviewed and analyzed tumor specialist nurse training method to make clear the training effect from 2012 to 2013, 100 students was investigated by using questionnaires , which contain 15 aspects, before and after the training respectively. designskill practice as the coreof the training content (160 hours) and theoretical classes (80 hours), established training evaluation criteria and the organization management system. Results All 100 students had grasped maintenance technology, observation of the complications of treatment, infusion port of the maintenance, the use of chemotherapy drugs, health education for patients with PICC catheter, and the use of effective order, the grasp rate was 100%. Complications rate was decreased significantly after using PICC catheter, (the rate of catheter related blood stream infections and the rate of thrombosis was reduced from the top 35%and 12%before training to 4%and 1%after training respectively (P<0.05). Conclusions In order to train more practical clinical nurse specialists, reduce the complications, raise the overall level of nursing profession, and improve the quality of nursing after using PICC catheter. Skill practice as the core methods in tumor specialist nurse training should be advocated.

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.

Objective To observe the clinical effects of different fluid therapies in treating severe preeclampsia complicated by ascites. Methods Between Jan. 2010 and Dec. 2012, patients with severe preeclampsia complicated by ascites in Shenzhen Maternity and Child Healthcare Hospital were included in this study. The treatment group ( n=55 ) were given intravenous drip of 6% hydroxyl starch 130/0. 4 plus furosemide, and the control group (n=52) received intravenous drip of 5%human serum albumin plus furosemide. The mean arterial pressure, respiratory rate, heart rate, oxyhemoglobin saturation, colloid osmotic pressure, hematocrit and the incidence of acute pulmonary edema were observed and compared between the two groups. Results Twenty-four hours after cesarean section, the mean arterial pressure of the treatment group was significantly lower than that of the control group, whereas heart rate and oxyhemoglobin saturation were significantly higher (all P<0. 05). The incidence of acute pulmonary edema of the control group was 17. 3%, while no patient in the treatment group developed acute pulmonary edema. On the 5th day after surgery, the hematocrit and 24 h proteinuria were significantly lower in the treatment group, while colloid osmotic pressure was higher (all P<0. 05). There was no difference in serum albumin level between the two groups (P>0. 05). The average duration of edema after treatment was significantly shorter in the treatment group [(2. 43±0. 37) d versus (3. 74±0. 59) d, P<0. 01]. Conclusion 6% hydroxyl starch 130/4. 0 plus furosemide can effectively elevate the colloid osmotic pressure, resolve edema, improve hypovolemia, sustain oxygen supply to the organs and decrease the complication of pulmonary edema in patients with severe preeclampsia complicated by ascites.

Objective To evaluate the clinical effect of ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment in managing postpartum bleeding due to pernicious placenta previa. Methods Clinical data of 227 patients with pernicious placenta previa, admitted to Shenzhen Maternity and Child Healthcare Hospital between June 2010 and June 2013, were retrospectively analyzed. Eight-two women,who were admitted between June,2010 to December,2011, receiving B-Lynch sutures combined with uterine lower segment packing after delivering the baby and placenta during cesarean section were assigned as the control group. Another 145 cases, who were admitted between January 2012 to June 2013, receiving ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment, were defined as the observational group. Several indicators during and after the operation were compared between the two groups. T-test or Chi-square test were applied for statistics. Results The duration of operation in the observational group was shorter than in the control [(92±26) vs (106±32) min, t=3.579, P<0.01]. The estimated blood loss during the operation, the total blood loss during the first 24 h after delivery and the blood loss during the operation for placenta percreta in the observational group were all lower than in the control [(1 230±481) vs (1 858±632) ml, (1 475±236) vs (2 482±364) ml, and (2 131±515) vs (2 587±498) ml, t=8.413, 25.295 and 6.484, all P<0.01]. The adjusted postoperative hemoglobin values of the observational group were significantly higher than that of control [(82±21) vs (69±19) g/L, t= - 4.634, P<0.01]. Besides, significant differences were found between the observational and control group on the rates of hysterectomy, blood transfusion, and uterine artery embolization [1%(2/145) vs 7%(6/82), 40%(58/145) vs 66%(54/82), 2%(3/145) vs 12%(10/82), χ2=5.408, 13.945 and 9.904, P < 0.05 or 0.01]. The dosage of Carboprost Tromethamine required was smaller in the observational group [(573±104) vs (729±128) μg, t=9.971, P<0.01]. Conclusions Ligation of descending branch of uterine artery and compression sutures in the lower uterine segment during cesarean section in women with pernicious placenta previa is an effective and simple method to control bleeding resulting reduction of blood loss and the hysterectomy rate.