Objective To study the influence of continous ven ovenuous hemofiltration on patients with multiple organ dysfunction syndrome.Methods 64 patients with MODS were divided into CVVH group(34) and IHD group(30)between 1999-12~2003-12.The serum BUN,Cr,iron,blood pressure,ar rhythmia were monitored during treatment and KT/V was also calculated after each therapy.APACHE-Ⅱ score was assessed before and after the treatment and the pr ognosis of each patient was recorded as well.Results CVVH group had more stable hemodynamics than IHD group; there was no significant difference in the removal of BUN and Cr in the two grou ps.The survival time of CVVH group was longer than IHD,and APACHE-Ⅱ score of C VVH group was lower than that in IHD group,17.23?6.86 verse 20.91?5.77 ( P

Objective To explore the effect of cognitive behavior intervention on anxiety and depression of patients with acute myocardial infarction(AMI).Methods Seventy patients with acute myocardial infarction were randomly divided into observation group and control group,35 cases in each group. All cases were cared with routine nursing method. Besides,cognitive behavior intervention was applied in the observation group. The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to measure the patients' mental status before and after the intervention.Result The SAS and SDS scores of the observation group after intervention were significantly lower than those of the control group(P<0.05).Conclusion The cognitive behavioral intervention is effective in alleviating anxiety and depression in patients with acute myocardial infarction,promoting them to establish the correct attitude and keeping calm in face of disease so as to relieve the anxiety and depression of AMI patients.

Objective To study the median effective doses (ED50) of dexmedetomidine to induce adequate sedation in elderly patients undergoing epidural anaesthesia. Methods Seventy-five elderly patients undergoing lower extremity operation under epidural anesthesia were selected, and the patients were divided into 5 groups according to the random digits table method with 15 cases each: D1 group (dexmedetomidine 0.2 μg/kg), D2 group (dexmedetomidine 0.4 μg/kg), D3 group (dexmedetomidine 0.6 μg/kg), D4 group (dexmedetomidine 0.8μg/kg) and D5 group (dexmedetomidine 1.0μg/kg). After 20 min of dexmedetomidine injection, adequate sedation was defines as observer′s assessment of alertness/sedation score (OAA/S score) ≤ 3 scores. The ED50 and 95% effective dose (ED95) of dexmedetomidine and 95% CI in elderly patients undergoing epidural anaesthesia were calculated by probit regression method. The changes of mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO2) and OAA/S score among 5 groups were compared. The incidences of adverse effects such as hypotension, bradycardia, hypoxemia and excessive sedation were compared. Results The ED50 in elderly patients was 0.36 μg/kg (95% CI 0.27 - 0.44 μg/kg); the ED95 was 0.94 μg/kg (95% CI 0.71 - 1.62 μg/kg). After dexmedetomidine injection, the MBP, heart rate, SpO2 and OAA/S scores in 5 groups were decreased, but in the D4 group and D5 group the decreases were more significant. The incidences of hypotension, bradycardia and excessive sedation in D1 group, D2 group and D3 group were significantly lower than those in D4 group and D5 group:2/15, 5/15 and 8/15 vs. 14/15 and 15/15;1/15, 6/15, 7/15 vs. 13/15 and 14/15;0, 0 and 1/15 vs. 5/15 and 7/15, the incidences of hypoxemia in D1 group, D2 group and D3 group were significantly lower than those in D5 group: 0, 0 and 0 vs. 3/15 and 4/15, and there were statistical differences (P<0.05). There were no statistical differences in incidences of adverse effects between D4 group and D5 group (P>0.05). Conclusions The ED50 of dexmedetomidine in elderly patients undergoing epidural anaesthesia is 0.36μg/kg, (CI 0.27-0.44μg/kg). The incidences of adverse effects are increased when single-dose dexmedetomidine is more than 0.8μg/kg.

As the dressings currently used in clinic settings unflat shape in general, they can't be fitted completely on occiput, heel, elbow, knee and other body parts unflat. This paper developed one kind of foam dressing of special shape based on local anatomy. The foam dressing is waterproof and air permeable, it can cover the wound closely enough to prevent bacteria from invasion and infection. With a saturated absorption ratio of 1: 8 or higher, it can keep the wound clean and moisture by absorbing large amounts of wound inflammatory secretions and is almost completely permeable to oxygen and carbon dioxide. Assuring safety and effect meanwhile, it has better outcomes than common dressings in the same application settings.
Bandages ; Wound Healing

OBJECTIVE To investigate the clinical degree of satisfaction to sterilizing-supplying center,and to consummate the development of the transition of its decentralized administration to centralized pattern.METHODS We designated the questionnaire of degree of satisfaction(DOS) and carried out the investigation.RESULTS The initiated DOS was 90.6%,the DOS in mid-stage(2006-2007) was 97.3%,and the DOS in the latest stage(2008) was 99.1%.CONCLUSIONS Centralized administration is effective pattern for the development of sterilizing-supplying center and important to ensure the quality of sterile materials and service for clinical medicine.

OBJECTIVE To investigate antibiotic resistance and antibiotics usage of meticillin-resistant Staphylococcus(MRS) and provide reference evidence in antibiotics using.METHODS Antibiotic susceptibility test was performed by biological assay system of VITEK-2.Design questionnaires to get the message of the categories,days,effects of antibacterial drug used.RESULTS Drug sensitive ratio to vancomycin,nitrofurantoin,quinupristin-dalfopristin,linezolid were all over 90.00%.The resistant ratios to some antibacterials in MRS were higher than in meticillin-sensitive Staphylococcus(MSS).The categories of antibacterials used after Staphylococcus species detection were more than before.63.01% patients′ medication was determined by antibiotic susceptibility test.Staphylococcus isolated ratio was 43.75% after antibacterial drug used.CONCLUSIONS The status of MRS is very serious.We should pay more attention to the identification and report of resistant strains and it is important to supervise Staphylococcus efficiently and medication by antibiotic susceptibility test.

Objectives: To assess the feasibility and stability of right ventricular outflow tract (ROVT) pacing under current technology by comparing the results of ROVT pacing with the traditional right ventricular apex (RVA) pacing. Methods: A total of 42 patients (at mean age of 63.5±10.4 years) without structural heart disease were randomly divided into two groups. RVA pacing group (n=14),and RVOT pacing group(n=28). An active fixation lead was implanted in all patients whose pacemaker could automatically measure the pacing threshold every day. The operation time,X-ray exposure time and lead parameters detected during the operation were collected to evaluate the feasibility of RVOT pacing. The complications related to lead and implantation procedure and the trend of threshold change during the follow-up time were used to assess the stability of RVOT pacing.Results: There were no statistic differences between RVA pacing group and RVOT pacing group in terms of operation time,X-ray exposure time and lead parameters. In RVOT group,the change of threshold during acute period was similar to those in RVA group (P=0.23). Chronic pacing threshold was also comparable between two groups,mean threshold at 6 months follow-up time was 0.55±0.11V and 0.54±0.09V at 0.4 pulse width in RVA group and RVOT group respectively (P=0.787).Conclusion: RVOT pacing was feasible and stable in operation time and lead characteristics compared with the conventional RVA pacing under current pacing technology.

Objective To observe the effect and efficacy of DPP-4 inhibitor saxagliptin on nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus.Methods Forty patients with newly diagnosed with type 2 diabetes complicated with NAFLD were divided into two groups:the saxagliptin group and the metformin group.On the basis of dietary and exercise therapies,the saxagliptin group received 0.005 g of saxagliptin daily and the metformin treatment group received 0.85-1.70 g of metformin daily.The levels of glycosylated hemoglobin(HbA1 c),triglyceride (TG),blood pressure (BP),alanine aminotransferase (ALT),liver CT and liver/spleen CT were observed before and 3 months after treatment.Results After treatment for 3 months,the TG,ALT,liver CT and liver / spleen CT of the metformin group and the saxagliptin group were significantly higher than those before treatment(P＜0.05).There was no significant difference in the TG,ALT and liver CT values between the two groups(P＞ 0.05).Conclusion In the state of diabetes mellitus complicate with nonalcoholic fatty liver,saxagliptin has a certain effect on relieving fatty liver.

Objective To investigate the effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion.Methods Forty patients with distal lower extremity orthopedic surgery (ASA Ⅰ or Ⅱ) were divided into two groups by random digits table method with 20 cases each:butorphanol group and control group.Epidural anesthesia was selected in all patients.In butorphanol group,patients were given butorphanol 0.04 mg/kg intravenously 15 min before tourniquet.In control group,equal volume of normal saline was infused at the same time.Blood samples were taken from jugular vein before tourniquet (T0),then 5 min(T1),2 h (T2),6 h (T3),12 h (T4) and 24 h (T5) after the second reperfusion of tourniquet.The serum creatine kinase isoenzyme MB (CK-MB),cardiac troponin Ⅰ (cTnI),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) levels were determined.Results Compared with those at T0,the serum C K-MB levels were increased at T2-T5,the serum cTnI,MDA,TNF-α levels were increased at T1-T5 in control group,and there were significant differences (P ＜ 0.05).Compared with those at T0,the serum CK-MB levels were increased at T3,T4,the serum TNF-α levels were increased at T1-T3,the serum cTnI levels were increased at T1-T5 in butorphanol group,and there were significant differences (P ＜ 0.05).Compared with those in control group,the serum CK-MB levels were decreased at T2-T5 [(20.2 ± 5.0) U/L vs.(35.3 ±6.8) U/L,(32.3 ±3.7) U/L vs.(48.6 ±8.5) U/L,(29.5 ±5.4) U/L vs.(51.5 ±8.0) U/L,(22.2 ±4.8) U/L vs.(33.7 ±6.7) U/L],the serum cTnI,TNF-α levels were decreased at T1-T5 [(0.158 ± 0.016) μg/L vs.(0.278 ±0.021) μg/L,(0.169 ±0.036) μg/L vs.(0.332 ± 0.062) μg/L,(0.357 ±0.049) μg/L vs.(0.623 ±0.083) μg/L,(0.178 ±0.045) μg/L vs.(0.383 ±0.059) μg/L,(0.138 ±0.016) μg/L vs.(0.263 ±0.023) μg/L; (1.63 ±0.13) μg/L vs.(2.12 ±0.08) μg/L,(1.69 ± 0.08) μ g/L vs.(2.28 ± 0.09) μ g/L,(1.63 ± 0.09) μ g/L vs.(2.25 ± 0.07) μ g/L,(1.23 ± 0.14) μμg/Lvs.(1.93±0.12) μg/L,(1.13±0.15) μμg/Lvs.(1.79±0.07) μμg/L],theserumMDAlevelswere decreased at T1-T4 [(4.82 ±0.53) nmol/L vs.(6.68 ±0.67) nmol/L,(4.99 ±0.61) nmol/L vs.(7.59 ±0.72) nmol/L,(5.02 ±0.43) nmol/L vs.(7.54 ±0.63) nmol/L,(4.52 ±0.55) nmol/L vs.(6.52 ±0.47) nmol/L] in butorphanol group,and there were significant differences (P ＜0.05).Conclusion Butorphanol pretreatment can improve the serum CK-MB,cTnI levels,and has a protective role for myocardial injury induced by limb ischemia/reperfusion.

ObjectiveTo investigate the correlation of radial artery and serum osteoprotegerin (OPG) expression and vascular calcification in patients with end stage renal disease.MethodsDiscarded radial arteries were gathered from 43 patients with end stage renal disease(end stage renal disease group)during arterial venous fistula plasty,including 24 patients with no calcification,13 patients with mild to moderate calcification and 6 patients with severe calcification,20 patients with dialysis and 23 patients without dialysis.Discarded arteries from 9 patients with upper limb trauma were chosen as control group.The yon Kossa staining,alizarin red staining and OPG immunohistochemical staining were taken and serum OPG level was measured for all the patients.ResultsSerum OPG level was significantly higher in end stage renal disease group than that in control group [(216.47±83.78) ng/L vs.(57.15±23.22) ng/L,P＜ 0.01 ].Serum OPG level in patients with no calcification,mild to moderate calcification and severe calcification[ ( 152.21±32.21 ),(248.31±53.86),(368.44±53.57) ng/L] and OPG staining value ( 1,2,4 scores) were increased gradually as vascular calcification more serious (P＜ 0.01 ).There was a positive relationship between serum OPG and vascular calcification value(alizarin red staining:r =0.517,P ＜ 0.01 ; yon Kossa staining:r =0.677,P＜ 0.01 ).Serum OPG level and OPG staining value in patients with dialysis were higher than those in patients without dialysis [ (283.57±79.02 ) ng/L vs.( 152.46±30.89 ) ng/L,2 scores vs.1 score,P ＜ 0.01 ].ConclusionsThere is relationship between serum OPG level,OPG expression of radial artery and vascular calcification.