The view of the scientific development should be established as the guideline of the political theories education.We should promote the Three Entering of the view of the scientific development by means of constructing a new political theories course system,improving teaching methods,cultivating students in various extracurricular ways,and strengthening the group of teachers,etc.

Objective To explore the clinic values of early goal directed treatment (EGDT)with the target of mixed venous oxygen saturation (SvO2)and difference of mixed venous-arterial partial pressure of carbon dioxide (Pv-aCO2) in monitoring of oxygen metabolism and treatment for patients post open-heart operation. Methods A prospective study was conducted. The adult patients admitted to Third People's Hospital of Chengdu from December 2011 to March 2014 with SvO2<0.65 and blood lactic acid>2 mmol/L when admitted in intensive care unit(ICU)were selected on whom elective open-heart operation and pulmonary artery catheter examination were done. All patients received EGDT with the target of SvO2≥0.65 and Pv-aCO2<6 mmHg (1 mmHg=0.133 kPa)and were divided into three groups by the values of SvO2 and Pv-aCO2 at 6-hour after ICU admission:A group with SvO2≥0.65 and Pv-aCO2<6 mmHg,B group with SvO2≥0.65 and Pv-aCO2≥6 mmHg,and C group with SvO2<0.65. Then the changes and prognosis of the patients in different groups were observed. Results 103 cases were included,44 in A group,31 in B group and 28 in C group. The acute physiology and chronic health evaluationⅡ (APACHEⅡ)score in group A were significantly lower than that in group B or C at 6,24,48 and 72 hours (T6,T24,T48,T72)of ICU admission (T6:11.4±5.8 vs. 13.9±5.4,13.7±6.4;T24:8.8±3.7 vs. 10.8±4.8,11.8±5.4;T48:8.7±4.1 vs. 9.6 ±4.2,10.2 ±5.1;T72:7.5 ±3.4 vs. 8.6 ±2.9,9.2 ±4.2,all P<0.05),and the sequential organ failure assessment (SOFA)showed the same tendency (T6:6.5±4.3 vs. 8.0±3.8,9.1±4.5;T24:6.6±3.6 vs. 8.6±3.9, 8.5±3.3;T48:5.2±3.4 vs. 7.0±3.6,7.6±5.1;T72:4.6±2.4 vs. 5.8±2.5,6.8±3.5,all P<0.05). The values of blood lactic acid (mmol/L)in group A and B were significant lower than that in group C at T6,T24,T48 and T72 (T6:1.60 ±0.95,2.20 ±1.02 vs. 2.55 ±1.39;T24:2.26 ±1.26,2.70 ±1.36 vs. 3.34 ±2.36;T48:2.01 ±1.15, 2.17 ±1.51 vs. 2.42 ±1.63;T72:1.62 ±1.14,1.64 ±0.75 vs. 2.11 ±1.29,all P<0.05). The time of machine ventilation(days)in group A or B was significantly shorter than that in group C(2.8±2.0,3.6±2.3 vs. 5.0±3.1,both P<0.05). ICU day (days)in group A was significant shorter than that in group C (4.6±2.5 vs. 6.5±3.7,P<0.05). The 7-day mortalities after operation in three groups were significantly different. Compared with group A (2.3%),the odds ratio (OR)in group B (22.6%)was 12.5 (P<0.05),group C (25.0%)14.3 (P<0.05). The morbidity and 28-day mortality in three groups were not significantly different. Pv-aCO2 negatively correlated with cardiac index(CI, r=-0.685,P=0.000),but not correlated with blood lactic acid(r=0.187,P=0.080). Conclusions EGDT with the target of SvO2≥0.65 and Pv-aCO2<6 mmHg improved the general condition and tissue hypoxia,shortened the time of machine ventilation and duration of hospitalization in ICU,and decrease the 7-day mortality.

Objective To study the prognosis of neonatal hyperthyrotropinemia (HT). Methods Children with HT were followed up regularly to evaluate the growth index, thyroid function and effectiveness of treatment. Results One hundred and ninety-one neonates with serum TSH level of 5.6~10 mU/L at the screening were followed up until 24 months old. Serum TSH gradually returned to normal range in 182 cases. Serum TSH increased to be>10 mU/L in 5 cases who were treated with levothy-roxine sodium. Serum TSH lfuctuated between 5.6 and 10 mU/L in 4 cases who were continually followed up. Among 44 cases of serum TSH at 10~20mU/L, serum TSH gradually returned to normal range after levothyroxine sodium treatment in 38 cases;se-rum TSH increased to>20 mU/L in 7 cases for whom continuous treatment with levothyroxine sodium was required. In 242 cases of HT neonates, 18 cases had received continuous levothyroxine sodium replacement treatment for 2 years and were followed-up continuously. Conclusions Most of the newborns with HT recover within 2 years, while a few develop thyroid dysfunction and require follow-ups.

Objective To explore the clinic values of intraoperative fluid overload in evaluating the perioperative prognosis of patients after cardiopulmonary bypass cardiac operation. Methods A prospective observational study was conducted. The adult patients admitted to the Third People's Hospital of Chengdu from April 2014 to March 2016 for selective cardiopulmonary bypass cardiac operation monitored by pulmonary artery catheter or pulse-indicated continuous cardiac output (PiCCO) were selected. All patients received therapy with restrictive fluid management strategy after admission to the intensive care unit (ICU) and were divided into two groups based on the value of intraoperative fluid accumulation ratio at the time of admission to the ICU: group A with intraoperative fluid accumulation ratio of less than 10% and group B with equal to or more than 10%. Then the changes and different prognosis of the patients in groups were observed. Risk factors affecting the prognosis were analyzed using logistic regression, and the predictive values of various parameters on prognosis were analyzed using receiver operating characteristic curve (ROC). Results 224 cases were included, with 172 in group A and 52 in group B. No significant differences were found between both groups in gender, age, pre-operative scores by European system for cardiac operative risk evaluation (EuroScore), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA), operation ways, operation time, cardiopulmonary bypass time and blood loss (all P > 0.05). Both APACHE Ⅱ score and SOFA score in group B were significantly higher than those in group A at admission and 24, 48 and 72 hours after ICU admission (APACHE Ⅱ: 24.5±4.1 vs. 21.8±3.5, 14.8±6.5 vs. 9.9±3.9, 12.3±5.4 vs. 9.4±3.7, 10.9±5.0 vs. 8.9±3.3, SOFA: 12.3±2.9 vs. 10.6±2.1, 8.8±2.8 vs. 5.7±1.7, 7.2±3.0 vs. 5.0±2.0, 6.4±3.6 vs. 5.2±1.7, all P < 0.05). Compared with group A, incidence of combination with acute kidney injury (AKI) was significantly increased in group B (92.3% vs. 68.6%, P < 0.01), the level of post operation cardiac index (CI) was significantly lower in group B (mL·s-1·m-2: 40.67±4.00 vs. 49.84±7.50, P < 0.01). Both the duration of mechanical ventilation and the length of stay in the ICU in group B were significant longer than those in group A (days: 3.2±2.1 vs. 1.8±1.3, 5.0±1.7 vs. 3.6±1.2, both P < 0.01). The post-operation complications, 7-day and 28-day mortality in group B were all significantly higher than those in group A (65.4% vs 30.2%, 19.2% vs. 1.7%, 26.9% vs. 3.5%, all P < 0.01). Logistic regressive analysis showed that after controlling the influence of postoperative AKI and CI on mortality, the intraoperative fluid accumulation ratio at ICU admission was still an independent risk factor [odds ratio (OR) of 7-day mortality = 1.380, 95% confidence interval (95%CI) = 1.019-1.869, P = 0.037; OR of 28-day mortality = 1.302, 95%CI = 1.026-1.654, P = 0.030]. The area under the curve of ROC (AUC) in predicting the 28-day mortality of patients after operation using intraoperative fluid accumulation ratio was 0.874 (P = 0.000), with a sensitivity of 95.0 % and a specificity of 78.4% at the optimal threshold value of 7.5%. Conclusions Intraoperative fluid overload in patients admitted to the ICU would aggravate their condition, prolong the duration of mechanical ventilation and the length of ICU stay, and increase post-operative complications morbidity and mortality. After controlling the influence of AKI and cardiac insufficiency on mortality, the fluid overload was still an independent risk factor for the death of patients after cardiopulmonary bypass cardiac operation.

Objective To explore the temporal expressions of TIMP-1 and their relationship with injury time during electric injuris of hearts of rats.Methods Immunohistorichemical and image-analysis techniques were employed in 220V-electric injury of hearts during different time.ResultsWeak expression of TIMP-1 are deteced at 0.5h after electric injury,which increased subsequently,and peaked at 24~72h post-injury.Then decreased to pre-injury level at 12d.Conclusion The time-dependent expression of TIMP-1 during electric injury may be used for the estimation of injury time.

Objective To explore the imaging(Ultrasonography and CT)characteristics of endodermal sinus tumor of the ovary.Methods US and CT images of endodermal sinus tumor of the ovary in ten patients were analyzed proved by operation and pathology retrospectively and the imaging characteristics were discussed correlated with their pathology.Results All ten patients underwent sonography.In addition,five patients underwent CT scans.On sonography,five showed solid echo,two showed cystic-solid echo and the other two showed cystic echo.The blood flow of solid parts were abundant.In local part,honeycomebed appearance could be seen.On CT,one presented as solid mass with large irregular hyperdense necrotic area,two presented as cystic-solid mass with irregular and blurred cystic area,the other two presented as predominantly cystic mass with multiple internal septations.Conclusion Endodermal sinus tumor of the ovary has their characteristic sonography and CT features,particularly for CT.These imaging characteristics with the patients' age and serum a-fetoprotein levels can be helpful in presurgical accurate diagnosis.

Objective To explore the practice and efficacy of multidisciplinary collaborative management in the prevention and control of multidrug-resistant organism(MDRO)healthcare-associated infection(HAI).Methods MDROs isolated from clinical specimens and MDRO infection in hospitalized patients in April 2012-March 2013(before intervention)and April 2013-March 2014(after intervention)were analyzed retrospectively.Since April 2013,multidisciplinary collaborative management has been implemented,isolation of MDROs and MDRO HAI in hospitalized patients before and after intervention were compared and analyzed.Results 798 and 833 MDRO strains were isolated before and after the intervention respectively,isolation rate of MDROs after intervention was lower than that before intervention(25.71%vs 31.89%,P<0.001).After the implementation of multidisciplinary collaborative management,incidence of MDRO HAI decreased from 0.94%before intervention to 0.63%;hand hygiene compliance rate of health care workers(HCWs)increased from 36.44%before intervention to 53.51%;compliance rate of contact isolation increased from 65.29%before intervention to 90.88%;rational usage rate of antimicrobial agents increased from 64.93%before intervention to 72.53%;specimen detection rate in patients with therapeutic antimicrobial use increased from 41.36%before intervention to 58.72%,differences were all statistically significant(all P<0.001).Conclusion The practice of multidisciplinary collaborative management can effectively implement the prevention and control measures of MDRO HAI,effectively reduce the occurrence of MDRO HAI.

Objective: To study the nursing care of patients had stent placement for constriction of pancreatic duct.Methods: 34 patients performed stent placement for constriction of pancreatic duct were given preoperative psychological nurse and preparation, close cooperation in process, careful postoperative observation, and discharge instruction.Therapeutic efficacy was evaluated by symptom remission rate. Results: Symptom remission rate was 100%. Conclusion:Nursing care before, in, and after operation is important for stent placement.

We carried out a dietary investigation of pupils aged 10 - 11 in Mei county in Shaanxi with level-based community random sample method. The result showedthat the average intake of daily food was mainly grain. That of energy was less than 70% of RDA and 60% of WHO. That of the protein was less than 70% of RDA in male and 60% of RDA in female. That of the other nutrients was less than 60% of RDA except iron, nicotinic acid and thiamine. Energy allocation among three mels was not adequate in male pupils. There waas higher energy in breakfast and supper, not sufficent at lunch.

Objective:To analyze the correlation betWeen clinical features at admission and recent prognostic outcome in patients With acute myocardial infarction (AMI).Methods:The data of 108 patients admitted because of primary AMI Were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE)or not after discharge,they Were divided into event group (n=61)and non-event group (n=47).Clinical features such as Gender,age etc.of tWo groups Were collected,analyzed and compared.After one-year folloW-up,correlations betWeen clinical feature indexes and MACE incidence Were analyzed.Results:Compared With non-event group, there Were significant increase in mean age,mean arterial pressure (MAP),left ventricular end-diastolic dimension (LVEDd),percentage of> Killip class 2,Grace score and multi-vessel coronary disease,and significant decrease in left ventricular ejection fraction (LVEF)in event group,P<0.05~<0.01. Single factor correlation analysis indi-cated that age,MAP,LVEF,percentage of > Killip class 2,Grace score and multi-vessel coronary disease rate Were correlated With MACE incidence rate (P<0.05~<0.01);multi-factor Logistic regression analysis indicated that age (OR=0.827),LVEF (OR=0.624),Grace score (OR=0.589)and multi-vessel coronary disease rate (OR=0.461)Were risk factors for MACE in AMI patients,P<0.05 all.Conclusion:Advanced age,loW left ven-tricular ejection fraction,higher Grace score and more multi-vessel coronary disease are high risk factors for recent occurrence of major adverse cardiovascular events in patients With acute myocardial infarction.