Objective To explore the effect of the standardized swallowing assessment (SSA) on extubation time for patients with nasal feeding. Methods One hundred patients with nasal feeding in our department from January 2013 to December 2014 were divided into the observation group and control group randomly with 50 in each group. The control group was treated with education on aspiratioin prevention and the right time for extubation was decided following doctor′s order. SSA was used in the observation group with weekly SSA and swallowing function, then the patients took pertinent functional exercises till a right time for extubation was decided. The two groups were compared in terms of incidences of re-intubation and aspiration pneumonia. Result The observation group had significantly lower incidences of re-intubation and aspiration pneumonia than the control one (P<0.01). Conclusions SSA is used to assess the swallowing function as well as the aspiration risks , which helps patients to take functional exercise and helps nurses to decide the right time for extubation. It can effectively lower the incidences of re-intubation and aspiration pneumonia and improve patients′prognosis.

Objective To investigate the influence of Guhong injection (GHI) on ATPase activity and inflammatory response after cerebral ischemia/reperfusion (I/R) injury in rats, and evaluate its protective effects on cerebral I/R injury. Methods Seventy-two male Sprague-Dawley (SD) rats were divided into sham group, I/R group, nimodipine group, and the low-dose (2.5 mL/kg, GHI-L), medium-dose (5.0 mL/kg, GHI-M), and high-dose (10.0 mL/kg, GHI-H) of GHI groups according to the random number table method, with 12 rats in each group. The middle cerebral artery occlusion (MCAO) model was established by the intraluminal suture method to prepare the model of focal cerebral ischemia, and reperfusion was performed after 1.5 hours of occluding the middle cerebral artery; the sham group had the same operation process except inserting the nylon thread. The injection of drug in various drug-treated groups was carried out via a tail vein at 0, 12, 24 hours after the onset of reperfusion, while the sham group and I/R group received the same amount of normal saline. At 12 hours after last drug administration, the scores of neurological deficit symptoms were evaluated; the cerebral infarction was observed by triphenyl tetrazolium chloride (TTC) staining; the Na+-K+-ATPase and Ca2+-ATPase activities in the brain tissue were measured by phosphorus determination; the contents of interleukin-6 (IL-6), monocyte chemotactic factor-1 (MCP-1), nitric oxide (NO) in serum were detected by enzyme linked immunosorbent assay (ELISA). Results Compared with the sham group, the neurological function score was significantly decreased, the cerebral infarction was serious, the activities of ATPase was obviously decreased, and the levels of serum inflammatory factors were significantly increased in I/R group. Compared with the I/R group, the neurological function scores were significantly increased in GHI-L group, GHI-M group, GHI-H group and nimodipine group (9.03±0.63, 10.54±2.55, 12.33±1.87, 12.06±1.89 vs. 8.17±1.05, all P < 0.05), the volumes of cerebral infarction were obviously reduced [(18.51±1.80)%, (15.98±1.34)%, (8.61±1.16)%, (8.09±0.96)% vs. (26.52±2.07)%, all P < 0.01], the activities of ATPase were significantly increased [Na+-K+-ATPase (μmol·mg-1·h-1):5.10±0.30, 5.34±0.26, 6.19±0.17, 5.86±0.31 vs. 3.98±0.35, Ca2+-ATPase (μmol·mg-1·h-1): 3.68±0.44, 4.43±0.29, 5.03±0.27, 4.17±0.30 vs. 1.87±0.46, all P < 0.01], and the levels of serum inflammatory factors were decreased obviously [IL-6 (ng/L): 51.61±5.55, 43.88±4.05, 39.71±2.22, 41.28±2.66 vs. 60.11±6.61, MCP-1 (ng/L): 227.82±7.07, 201.58±13.10, 177.23±10.46, 126.80±8.49 vs. 296.01±12.85, NO (μmol/L): 54.48±3.23, 46.84±2.69, 41.15±2.80, 48.62±2.34 vs. 65.25±3.88, all P < 0.05]. Conclusions GHI not only can improve the energy metabolism of brain tissue in a dose-dependent manner, but also inhibit the inflammatory cascade of damage after cerebral I/R in rats, which might be its protective mechanism on cerebral ischemia injury.

Objective:To optimize the forming technology of Zuojin concentrated pills. Methods: Single factor test was used to optimize the types of excipients and wetting agents with the shaping result as the index. Orthogonal test was used to optimize the forming technology taking the dissolution time,shaping rate and appearance quality as the evaluation indices,and the proportion of excipients, the rate of drugs to excipients and wetting agent amount as the investigation factors. Results: The best forming technology of Zuojin concentrated pills was as follows:MCC and PVP-K30 were used as the excipients with the ratio of 3:1,the ratio of drugs to excipients was 1:1,5% water was used as the wetting agent to obtain the damp mass,and then Zuojin concentrated pills were prepared in a pill machine. Conclusion:The optimized forming technology is stable with good reproducibility,and the pills are round and smooth with u-niform color,whose quality meets the requirements described in Chinese Pharmacopoeia(2015 edition,partⅣ,page 0108 for concen-trated pills). The study provides reference for the further study.

Objective To explore the effects of hospital-based critical episodes training on self-efficacy of general nurses .Methods Convenient sampling was used and 24 general nurses were enrolled from a tertiary hospital in Wuhan city .All the participants attended 24-weeks training program about emergency and critical nursing.A self-designed questionnaire on self-efficacy was completed before and one month after the training program.Results After the training program , the score of general level of self-efficacy, fundamental nursing skills, assessing skills of emergency and critical patients , emergency and critical nursing skills , execution or organization of rescue skills and communication skills were (3.70 ±0.36), (3.92 ±0.14), (3.67 ±0.24), (3.46 ±0.34), (3.43 ±0.47) and (3.77 ±0.40), respectively, which were significantly higher than those scores of (3.08 ±0.50), (3.52 ±0.44), (3.10 ±0.51), (2.82 ±0.55), (2.67 ±0.84) and (3.19 ± 0.71 ) , respectively , before the training program .The differences were significant ( Z =4.29 , 3.84 , 4.29 , 4.20 ,3.56 ,3.88 , respectively;P<0.05 ) .Conclusions The hospital-based critical episodes training program had a positive effects on the self-efficacy among the general nurses .It also can promote the attitude on the performances of involving emergency and critical nursing .

OBJECTIVETo observe the short- and long-term efficacy of acupuncture combined with biofeedback in the treatment of functional anorectal pain (FARP).

METHODSClinical data of 142 patients who met the functional gastrointestinal disorders and functional anorectal pain based on criteria of Rome III( undergoing acupuncture with biofeedback therapy from August 2010 to November 2015 in Pelvic Floor Center of The Third Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed. Telephone and outpatient clinic recheck were used as standard follow-up. The clinical effect of short-term and long-term data collected from the disease-based database was evaluated with visual analogue pain scale (VAS) (0-10 points), short form health survey questionnaire (SF-36) (0-148 points). The overall satisfaction and effectiveness (VAS was >30%) were evaluated at the end of treatment (short-term) and during follow-up (long-term).

RESULTSThe effective follow-up data were obtained from 71.1%(101/142) of patients and the median follow-up time was 28(3-67) months. The VAS of 101 cases was 6.09±1.78, 1.99±1.89 and 3.55±2.60 before treatment, at the end of treatment and during follow-up respectively. Though the VAS during follow-up was higher than that at the end of treatment, but still significantly lower than that before treatment(P<0.05). The SF-36 score of 31 patients was 82.0±16.9, 94.0±15.1 and 88.1±15.3 before treatment, at the end of treatment and during follow-up respectively. Though the SF-36 score during follow-up was lower compared to at the end of treatment, but still significantly higher compared to before treatment (P<0.05). The effective rates were 85.9%(122/142) at the end of treatment and 75.2%(76/101) during follow-up, and the satisfactory rates were 92.3%(131/142) and 84.2%(85/101), respectively.

CONCLUSIONAcupuncture with biofeedback has significant short-term and long-term efficacy in treating functional anorectal pain, and its degree of satisfaction is high.