Objective To determine the predictive value of central venous oxygen saturation (ScvO2) in volume response by comparing the relationship between variation of ScvO2 and cardiac output (CO) variability before and after volume expansion in elderly patients with septic shock.Methods Forty-five patients who diagnosed septic shock were enrolled in the study,inserted CVC and were carried out continuous cardiac output monitoring(PICCO) before volume expansion.Every patient was treated by rapid intravenous infusion of 250 mL physiological saline,then take blood gas analysis before and after treated which the blood samples were collected from central venous catheter.The value of ScvO2 and the value of cardiac output was recorded.Degree of variation between two sets of data were tested by Student t-test.The correlation was determined by using Pearson's correlation test.Operating characteristics curve analysis was used to test their ability to distinguish R and NR.Results The mean arterial pressure (MAP)、heart rate(HR)、CO、ScvO2 were demonstrated and have statistical significance (P＜ 0.05) compared with before treated.CO and ScvO2 indexes were positively correlated (P＜0.01) before and after volume expansion.ScvO2 variations after VE were significantly correlated with CO changes after VE (r=0.781,P＜0.01).Conclusion ScvO2 dynamic changes can be used as a criterion for determining the fluid responsiveness.

Objective To investigate the efficacy of flurbiprofen cataplasms to muscle strain in patients with gastrointestinal diseases.Methods Patients with muscle strain were divided into flurbiprofen cataplasms group (with gastrointestinal diseases,20 cases) and flurbiprofen tablets group (without gastrointestinal diseases,22 cases).Before and 1,2,4 and 7 days after treatment,the numeric rating score (NRS) were evaluated and pain relief (PR),effective rate (ER) and satisfied rate (SR) were calculated and side effects were observed.Results There was no significant difference between flurbiprofen cataplasms group and flurbiprofen tablets group at 1,2,4 and 7 days after treatment [ER:80％ (16/20) vs.82％(18/22),90％(18/20) vs.100％(22/22),95％(19/20) vs.100％(22/22),95％(19/20) vs.95％(21/22)；SR:60％ (12/20) vs.82％ (18/22),90％ (18/20) vs.95％ (21/22),90％ (18/20) vs.95％ (21/22),95％(19/20) vs.95％ (21/22),P ＞ 0.05].There was no side effects in two groups.Conclusion Flurbiprofen cataplasms may alleviate the muscle strain effectively,especially suitable for patients with gastrointestinal diseases.

Objective To explore the nursing cooperation in use of lung inflation system for video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax. Method The key nursing points in nursing 42 patients with spontaneous pneumothorax undergoing VATS were analyzed. Results The operations were all successful. One patient contracted lower left atelectasis but it was cured after the tracheal tube was re-adjusted. On day one, there were two cases of gas leakage during thoracic closed drainage:one was of diffuse pulmonary bulla, and the gas leakage stopped on the second day; In the other cases, the gas leakage stopped 2 days after the tube was withdrawn by 3cm probably because the drainage tube was inserted too deep at the beginning. 6-30 months follow-ups showed no recurrence of pneumothorax in the operated site. Conclusions The lung inflation system is safe during VATS for spontaneous pneumothorax. Careful preoperative preparation of the equipment and skillful nursing cooperation at all procedures are critical for the success of VATS.

Individual Chinese herbal medicines and the active ingredients have certain effects of anti-pulmonary fibrosis. Chinese herbal medicine with the effects of benefiting qi and activating blood circulation are commonly used in clinic. This article reviewed the experimental researches on Chinese herbal medicines with the effects of benefiting qi and activating blood circulation and the active ingredients in treating pulmonary fibrosis, with a purpose to find the target spot of the TCM treatment for pulmonary fibrosis and provide references for clinical treatment.

Objective To explore a surgical therapy on close depressed fracture of the skull.Methods Ni-Ti form memory-alloy cramps were fixed on between the depressed bone and the normal surrounding skull in 16 patients with close depressed fracture of the skull.Results The follow up was 5～54 months(average 26 months).It indicated that there was no displacement and depressing of the fixed bone, no subcutaneous collection of fluid, no reject reaction and inflammation, and no erosion. The fixed bone and skull density showed normal by X ray and the fixed cramp did not disturb CT and MR scaning. All patients declared no mental burden and felt safe.Conclusion The Ni-Ti form memory-alloy cramp has a good mechanical restoration force and a good plastic effect,but no complication,it can increase the ability to resist external force in fracture region, and the surgical procedure is very simple, therefore it is ideal to treat the depressed fracture of skull.

Objective: to study the effect of stress management training for mental health of teachers in primary school. Method: 35 teachers and 39 teachers were used as the intervention group and the control group respectively. The teachers of intervention group got stress management training for 6 times in 12 weeks. The intervention included the knowledge of stress, cognitive restructure, coping strategies etc, and SCL-90 Scale was used for effect evaluation. Result: although the scores of SCL-90 all raised, the control group raised higher than the intervention group, and there were significant differences in factors of somatization, interpersonal sensitivity and anxiety. Conclusion: stress management training can alleviate the teacher's stress.

BACKGROUND: The rehabilitation outcome varies in stroke patients,and there are differences in the literatures about the influence of factors on the functional recovery in such patients.,OBJECTIVE: To evaluate the pre-rehabilitative and post-rehabilitative effects of stroke patients by functional independence measure (FIM) that is widely used, and analyze the influence of gender, age, motor and cognitive functions at admission, time interval from stroke onset to arrival at rehabilitative admission, comorbidity occurrence, laterality of lesion on the functional recovery of stroke patients.DESIGN: Before-after control observationSETTING: Center of Rehabilitation Medicine, Shandong Provincial Hospital; Faculty of Rehabilitation Medicine, Capital University of Medical SciencesPARTICIPANTS: From March 2000 to December 2002, 55 stroke patients were selected from Shandong Provincial Hospital. They were all first episode, and patients whose bilateral cerebral hemisphere were involved were excluded.METHODS: After the vital signs were steady, the stroke patients got through risk phase (31-75 days) and were treated with medicine improving microcirculation and providing neurotrophic factor for nerves. In addition, they accepted comprehensive rehabilitation training of Bobath technique, PNF technique and Rood method mainly, with 1-2 hours per day and five times per week.MAIN OUTCOME MEASURES: The patients were evaluated within 7days after admission and reassessed 3 days before discharge using FIM,including 18 items of motor and cognitive functions and 126 total scores (108-126 as elementarily or completely independent, 72-107 as mildly dependent, 54-71 as moderately dependent, 36-53 as severely dependent,18-35 as extremely or completely dependent). Multiple stepwise regression equation was applied to analyze the relation of above factors and functional recovery (increased value of FIM total score).RESULTS: Totally 55 patients were involved into the result analysis.①FIM total score of patients was significantly higher at discharge than at admission (93.8±12.0, 68.8±11.6, P ＜ 0.001), and motor function and cognitive function at discharge also increased compare with at admission (P ＜ 0.001).②Mean value of FIM motor score increased everyday was identical with that of total score (0.56±0.21, 0.59±0.21), and higher than mean value of cognitive score (0.03±0.03).Multiple stepwise regression analysis showed,scores of motor and cognitive status at admission, age, time interval from stroke onset to arrival at rehabilitative admission all affected the increased value of FIM total scores. No significant association between gender, comorbidity, laterality lesion of paralysis and functional recovery was observed (P ＞ 0.05). The most influential factors were orderly motor function,cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitation admission.CONCLUSION: Motor and cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitative admission have a no table relationship with functional recovery of stroke patients, especially motor function at admission is positively related. Thus we should not neglect the influence of these factors when conducting rehabilitative treatment.

Objective To observe the influence state of asarone injection for the pulmonary surfactant proteins and oxygen supply state of newborns with pneumonia. Methods 72 newborns with pneumonia were selected as the study object, and they were randomly divided into control group (36 cases) and observation group (36 cases), the control group were treated with conventional treatment of pneumonia, the observation group were treated with asarone injection on the treatment method of control group, then the pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of two groups before and after the treatment were respectively detected and compared. Results The pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of two groups before the treatment all had no significant differences, while the pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of observation group at first, second and fifth day after the treatment were all significantly better than those of control group, all P<0.05, there were all significant differences. Conclusion The asarone injection can significantly improve the pulmonary surfactant proteins and oxygen supply of newborns with pneumonia, so its application value in the treatment of newborns with pneumonia is higher.

In order to describe the epidemiological features and explore the risk factors of colon cancer, a population-based case-control study involving 476 cases of colon cancer and 857 controls matched by age and sex was carried out from Sep. 1988 to Aug. 1989. In this paper the risk factors related to colon cancer are reported as follows; The major risk factors of colon cancer in the area were generally in accordance with the prevalent hypothesis, colon cancer in Shanghai urban area may present the characteristics of low risk areas. Analysis of single and multiple factors of food intake frequency and quantity indicated that most vegetables usually cast a protective effect. Males in the highest quartile of intake of vegetables had a OR of 0.4 (P trend

Objective To share the data of Fully Automatic Biochemistry Analyzer SINNOWA -B300 with Hospital Information System (HIS). Methods The main characters and functions of the Data Pipeline of PowerBuilder were analyzed,and designed application program to connect Access Database of analyzer and Oracle Database of HIS. Results The analyzer can input automatically into Oracle Database of HIS. Conclusion The use of PowerBuilder data pipeline object combined with programmer achieves real-time data sharing,the simple and reliable technology can provide a technical reference for the development of LIS of hospitals.