Objective To investigate the effects of 3% hypertonic saline (HTS) on cerebrospinal fluid pressure (CSFP), hemodynamics and electrolytes and the feasibility of reducing intracranial pressure (ICP) with 3% HTS in patients with brain tumor. Methods This study was approved by our institutional ethics committee. Forty consenting ASA Ⅰ or Ⅱ patients of both sexes (23 males, 17 females) undergoing elective surgical excision of supratentorial glioma were randomly divided into 2 groups (n =20 each):3% HTS group and 20% mannitol group. The patients were fasted for 12 h before operation and premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 1.5-2.0 mg, fentanyl 3 ?g?kg-1,2.5% sodium pentothal 4-6 mg?kg-1 and vecuronium 0.1 mg?kg-1. The patients were mechanically ventilated (VT= 8-10 ml?kg-1, RR = 12 bpm, PETCO2 = 30-35 mm Hg) after tracheal intubation. Anesthesia was maintained with isoflurane inhalation and vecuronium infusion at 0.05 mg?kg-1?h-1. A bolus of fentanyl 4 ?g?kg-1 was given i.v. 5 min before incision. Before induction of general anesthesia a 17 G catheter was inserted into subarachnoid space at L3,4 for measurement of CSFP. Left radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. When end-tidal isoflurane concentration was maintained at 1 MAC and hemodynamics stabilized for 15 min,3% HTS 5.35 ml?kg-1 or 20% mannitol 1 g?kg-1 was infused i.v. over 15 min. MAP, HR, CVP and urine output were measured and recorded and arterial blood samples were taken for blood gas analysis and determination of plasma Na+ and K+ concentrations, pH and plasma osmotic pressure before infusion (T0 , baseline) and 15, 30, 60, 90 and 120 min after infusion (T1-5). CSFP was measured at T0-4 and cerebral perfusion pressure (CPP) was calculated (CPP = MAP - ICP).Results The two groups were comparable with regard to sex, age, body weight and the extent of cerebral midline deviation (

Objective To explore the nursing effect of strengthened psychological intervention on patients with abortion receiving assisted reproductive technology.Methods 180 patients with abortion receiving assisted reproductive technology from January 2009 to December 2011 were chosen as the research object.They were randomly divided into the control group and the observation group with 90 patients in each group.The control group adopted conventional methods of care for nursing,the observation group received strengthened psychological intervention on the basis of the control group.The assessment results of SCL-90 scale and IDA scale before and after five-day nursing were compared between the two groups.Results The scores of SCL-90 scale and IDA scale after five-day nursing in the observation group were lower than those of the control group,there was significant difference.Conclusions Strengthened psychological intervention for abortion patients receiving assisted reproductive technology demonstrated good effect.It can significantly improve adverse psychological state of these patients.

Objective To study the characteristics and regularities of Chinese drugs preparations ADR in order to improve the rational drug use.Methods A total of 112 cases of TCM ADR reports collected in 2009～2011 which have been presented to the Guangzhou ADR Monitoring Center.Results Of the 112 cases,26 kinds of drugs were involved,quinquagenarian were the main crowd,intravenous infusion was the main route of administration,the main types of TCM ADR were lesions of skin and accessories.Conclusion Great importance should be attached to TCM ADR monitoring to promote rational drug use in the clinic.

Objective Based on the Chinese full version of the Temperament Evaluation of Memphis Pisa Paris and San Diego-Auto questionnaire ( TEMPS-A) , we aimed to validated a short version of TEMPS-A for Chinese adoles-cents.Methods Taking into account the item factor loading from our previously validated full version TEMPS-A, cultur-ally-determined items, and sexual activity related items, we derived a 60-item Chinese TEMPS-A for adolescents.The internal consistency and structural validity of the Chinese TEMPS-A for adolescents was evaluated in 822 participants aged 11~17 years old.Results The Cronbach’ s alphas coefficients for depressive, cyclothymic, hyperthymic, irritable and anxious subscales were 0.67, 0.78, 0.76, 0.77 and 0.83, respectively.The anxious, irritable, hyperthymic factors were effectively distinguished by exploratory factor analysis, while the depressive and cyclothymic factors tended to correlate.The males scored significantly higher on the hyperthymic subscale than the females [(5.407 ±2.842) vs.(4.852 ±2.963), P<0.01].The females scored significantly higher on the depressive [(3.521 ±2.221) vs.(3.144 ±2.295)], cyclothy-mic [(4.484 ±2.922) vs.(3.917 ±2.823)] and anxious [(5.236 ±3.719) vs.(4.366 ±3.658)] temperaments than the males ( P<0.05) .The scores of depressive subscale and cyclothymic temperaments subscale were significantly correla-ted (r=0.625, P<0.001), so did the scores of anxious subscale and irritable temperament subscale (r=0.628, P<0.001).Conclusions The Chinese Adolescent version of TEMPS-A is a reliable and valid instrument for investigating af-fective temperaments for adolescents.

Objective To evaluate the feasibility of prospective electrocardiogram(ECG)-gating computed tomography coronary angiography(CTCA).Methods Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating.Multi-planar reconstruction (MPR),curved-planar reconstruction(CPR),maximum intensity projection(MIP)and volume rendering (VR)were used to demonstrate the coronary arteries.The image quality and radiation dose was evaluated.Results The mean effective radiation dose was(2.7±0.2)mSv.93.3%(720/772)segments of all coronary arteries were of diagnostic image quality,44.2%(341/772)Was classified as excellent and 49.1%(379/772)was good.Non-diagnostic coronary segments were found in 6.7%(52/772)of all coronary arteries.Therewere 5(8.3%)cases with severe coronary stenosis(＞75%)or occlusion,17(28.4%)cases with moderate stenosis(50%-75%),18(30.0%)cases with mild stenosis(＜50%)or irregular lumen,20(33.3%)cases with normal coronary artery.Conclusion With a low radiation dose,prospective electrocardiogram(ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis,especially for excluding coronary artery disease.

Objective To explore the intervention effect of evidence-based nursing on the health behavior of elderly hypertensive patients in the community.Methods 187 elderly hypertensive patients who were hospitalized in December 2015 and met the inclusive criteria were divided into observation group (n=93) and control group (n=94).The observation group received evidence-based nursing according to the evidence-based medical system evaluation while the control group was given regular nursing both for 6 months.The clinical efficacy of two nursing modes was observed and the differences between pre-intervention and pose-intervention and groups were recorded and analyzed with a self-designed questionnaire, drug compliance questionnaire and health behavior scale.Results In the observation group, the blood pressure was effectively controlled or reduced, treatment compliance was significantly increased and body mass index (BMI) was within the ideal range 6 months later.Scores of unhealthy behaviors such as those in living habits and mental stress were lower than those in the control group, which showed significant difference (P<0.05).There was no significant difference in activity participation between the two groups (P>0.05).Conclusion Evidence-based nursing intervention can effectively control the hypertension, improve the treatment compliance of the community elderly hypertension patients and help lead them to a more positive and healthier life style.

Objective To evaluate the operation methods and effects of transforaminal wedge osteotomy (TWO) combined with intervertebral grafting bone for correcting the rigid thoracolumbar kyphosis.Methods From January 2003 to June 2013, treatment of 52 cases of the rigid thoracolumbar kyphosis by TWO combined with intervertebral bone graft were studied (including 33 males and 19 females, and the age range was from 15 to 72 with average age of 42.3 years old).In these 52 cases, there were 17 cases of ankylosing spondylitis, 25 cases of obsolete thoracolumbarvertebral fractures, 7 cases of chronic thoracolumbar tuberculosis and 3 cases of congenital vertebral malformations.52 cases presented as lumbar kyphosis, low back pain aggravated,with an average VAS score of 8.6;24 cases were accompanied with different extent of neurological dysfunction which obviously influenced daily life or work.Osteotomy was located at thoracolumbar intervertebral disc.Pedicle screws internal fixation system combined with intervertebral grafting bone was used to compress the vertebra and fuse after TWO for correction.Preoperative and postoperative low back pain was evaluated by visual analog score (VAS), Frankel score and Oswestry disability index(ODI) in patients with neurological dysfunction.The above indexes were compared with the PSO osteotomy group.Results Preoperative mean kyphosis Cobb angle was 65.6°(31°-137°).The average post-operative kyphosis Cobb angle was 19.2° (8°-35°), and the average correction rate was 68.4％.The mean operation time was 3.8 h (2.2-5.3 h), and the mean intraoperative blood loss was 1220ml (500-2 900 ml).Preoperative VAS score was 8.6± 1.2 while the last follow-up was 1.8±0.5;preoperative Oswestry dysfunction index was 75.6±8.2 while the last follow-up was 18.4±8.1.The results were statistically significant.The spinal function was 4 cases of Frankel C and 20 cases of Frankel D before operation, all of which dropped to E level after operation.52 patients were followed up with the average time of 41 months (from 6 to 60 months).The bony fusion rate was 94.23％ at 6 months after operation.All of the patients were fused in 3 years after operation.The average loss of kyphosis Cobb angle was 5.5°(4°-12°).Compared with PSO, the average operation time, the amount of bleeding and the improvement of neurological function after surgery all had some advantages.Conclusion Transforaminal wedge osteotomy has many advantages, such as less bleeding wounds, less nerve interference and limited multi-segmental osteotomy, with little trauma and high bony fusion rate.

Objective To investigate the distribution and antimicrobial resistance of gram-negative bacilli isolated from wound specimens of orthopedic patients,and provide reference for the rational use of antimicrobial agents. Methods 682 isolates of gram-negative bacilli were collected from orthopedic department in a comprehensive hospi-tal between January 2011 and December 2013, antimicrobial susceptibility testing results were analyzed. Results The main gram-negative bacilli isolated from wound specimens of orthopedic patients were Pseudomonas aeruginosa (P .aeruginosa)(16.72%),Escherichia coli (E.coli)(15.40%),and Enterobacter cloacae (E.cloa-cae)(12.76%).The detection rates of extended-spectrum beta-lactamase-producing E.coli and Klebsialla pneu-moniae (K .pneumoniae)were 54.29%(57/105)and 31 .43% (22/70)respectively,and mainly distributed in the trauma orthopedic department,accounting for 49.12% and 45.45% respectively.The susceptibility rates of E.coli, K .pneumoniae ,and E.cloacae to meropenem and imipenem were all 100.00%.The susceptibility rates of E.coli and K .pneumoniae to amikacin,piperacillin-tazobactam and amoxicillin/clavulanic acid were all >80%.Suscepti-bility rate of E.cloacae to most antimicrobial agents were 71 .26% -100.00% except for piperacillin(64.37%). Susceptibility rates of P .aeruginosa to most antimicrobial agents were >85% except for cefepime (78.95%)and aztreonam (65.79%).Conclusion Gram-negative bacilli are the most common pathogens in wound infection of or-thopedics patients.In order to use antimicrobial agents rationally and improve clinical treatment effect,it is impor-tant to realize the distribution of pathogens and antimicrobial resistance.

Objective To explore the correlation between the cancer-related fatigue and uncertainty in illness among breast cancer inpatients. Methods Totally 90 patients with breast cancer were involved in the study by cancer fatigue scale (CRS) and Mishel's uncertainty in illness scale-adult (MUIS-A). The correlations were analyzed. Results Approximately 100.00%patients experienced fatigue during hospitalization. The total score of uncertainty in illness was 107.51 ± 21.26. There was a positive correlation between each fatigue dimension and uncertainty in illness (P<0.001). Conclusions Cancer-related fatigue is widespread among breast cancer inpatients and sense of uncertainty in illness of patients is at a moderate level. Nursing staff can help patients to reduce disease uncertainty and improve the life quality of patients by strengthening health education , providing comprehensive information support, fully mobilizing patients' social support system.

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.