Objective To investigate the attitude of clinical nurses to the practice of holistic nursing and provide basis for establishing harmonious relationships between patients and nurses.Methods primary nurses were randomly selected and underwent investigations on quality check of nursing work quarterly by serf-designed inventory.Results 24 nurses considered it necessary to carry out holistic nursing but 70 of them were reluctant to undertake it.They thought it boring because of the high requirement of holistic nursing and much literal document in practice.Conclusion Nursing services calls out seeking truth and dealing with concrete matters at present.The holistic nursing is not equipped with professional title since serious shortage of nursing staff.The emaphasis should be focused on the health education according to different situations in hospitals.Besides we should practice holistic nursing step by step instead of by the modality.

Cardiac arrest (CA) is an acute critical illness with the high occurrence in the world. The directions of cardiopulmonary resuscitation (CPR) development are to improve CA patients' survival rate and to decrease the poor prognosis. β-blockers can selectively block the neurotransmitter or receptor agonists. They offer beneficial pharmacological properties and have been widely used in the treatment of cardiovascular diseases. Based on the search result of the domestic and foreign medical databases, the usage of β-blockers including clinical research, animal experiments and clinical work of CPR patients was summarized. Finally, the CPR research progress of β-blockers in recent years was reviewed in the article.

Pediatric acute liver failure is a severe and sudden onset of hepatocyte dysfunction,leading to synthetic and detoxification failure,which could progress to multi-organ failure and death.Mortality is predominantly high due to the raised intracranial pressure,infections and multi-organ failure.The mainstay of management is supportive care in an intensive care unit.The intensive care managements include immediate measures,etiology,management of complications and liver assist device,liver transplantation.Liver transplantation is an important life saving procedure for children with acute liver failure.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) patients who are return of spontaneous circulation (ROSC) on scene. Methods According to Utstein style,we collected the clinical data of OHCA patients who are ROSC on scene from the pre-hospital on the call of 120 of Henan Provincial People ' s Hospital from January 2012 to December 2016. We analyzed the data by SPSS 20.0 software. Results Among a total of 29 patients were enrolled,9(31.03%)were ROSC ≥ 6h,and 20 (68.97%)were ROSC < 6 h. There were no significant difference in the two groups in patients' age,sex,arrest location,witnessed by bystander,bystander CPR,initial arrest rhythm,etiology,the use of epinephrine. None of patients were survival in the group of ROSC≥6 h. The average length of hospital stay was(44.15 ± 34.16)hours, while the shortest length of hospital stay was 12.08 hours and the longest length of hospital stay was 125.75 hours. The ratio of emergency response time to the return to hospital time were 4.55 min ± 2.46 min vs 6.45 min ± 3.60 min,P=0.014 in all patients. The emergency response time consumes more time. Conclusion The hospitalized survival rate of ROSC patients is low. The occurrence of OHCA needs early prevention. The short-term survival(6 h)is not affected by the patients' basic situation and the first-aid situation.

Acute kidney injury(AKI)is a syndrome with many different causes and can occur at different stages throughout critical illness.Renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation: (1)assessment of intrinsic causes of AKI, (2)distinguishing acute from chronic kidney diseases, (3)detection of the causes of obstruction.The resistive index in patients with AKI will be reviewed with attention to its use for predicting the development and prognosis of AKI.Meanwhile, combined application of cardiopulmonary ultrasound and evaluation of hemodynamics are helpful to evaluate the etiology, supervision and guiding treatment of AKI.

Naphazoline,Diphenoxylate, Over-the-counter (OTC) cough and cold medications, widely used for the symptomatic relief of nasal obstruction, diarrhea or common cold symptoms. But these medicines might cause poisoning even if utilized in recommended doses for treatment. The side effects of these medicines were neglected when they were used much more commonly. The clinical manifestation of these medicine poisoning were delitescence and children' s parents couldn't provide the whole history, so these medicine poisoning were often misdiagnosis, even lead to treatment failure. We explore the toxicities of these medicines ,discuss their mechanisms and clinical manifestation, and suggest why physicians should be more vigilant in specifically inquiring about them when evaluating an ill child.

BACKGROUND:Whether there are breast cancer stem cel microspheres in the breast cancer tissues and whether these microspheres have an impact on isolation and culture of breast cancer stem cel s after different cycles of neoadjuvant chemotherapy are stil unclear. OBJECTIVE:To explore the proliferation and differentiation of breast cancer stem cel s in breast cancer tissues after different cycles of neoadjuvant chemotherapy. METHODS:Breast cancer stem cel microspheres were isolated from the breast cancer tissues after different cycles of neoadjuvant chemotherapy to drawn a cel growth curve. Immunocytochemical method was used to detect ALDH1 expression. RESULTS AND CONCLUSION:Microspheres could be obtained from the specimens of neoadjuvant chemotherapy for two, three and four cycles rather than one cycle. At 3 days prior to culture, there was no difference in the number of cel s isolated after two-and three-cycle neoadjuvant chemotherapy;but after 3 days, the cel s from the three-cycle neoadjuvant chemotherapy proliferated faster than those from the two-cycle neoadjuvant chemotherapy;after 6 days, the cel growth curve of two-cycle neoadjuvant chemotherapy was in the plateau stage, and the proliferation of cel s from the three-cycle neoadjuvant chemotherapy showed a rapid increase trend. The positive expression of ALDH1 in the microspheres from the three-cycle neoadjuvant chemotherapy was higher than that from the two-cycle neoadjuvant chemotherapy. These findings indicate that breast cancer stem cel s from the specimens of two-and three-cycle neoadjuvant chemotherapy both have proliferation and differentiation potentials, and the specimens of three-cycle neoadjuvant chemotherapy or above are preferred.

Objective:To establish the methods for the determination of Mg,Al,K,Ca,Cr,Cu,Zn,As,Se,Ag,Cd,Sn,Ba,Pb,Na and Hg in water for injection. Methods:The sixteen metallic elements in water for injection were determined by ICP-MS. The collision cell technology ( CCT) was used to minimize the multiple atomic interference, and the matrix effect and signal drift were compensated by using Li, Sc, Ge, In, Ir and Bi as the internal standards and the samples were directly acidified to detect the metallic elements. Results:The detection limit range of the 16 metallic elements were from 0. 009 to 0. 165 ng·ml-1. The calibration curves showed good linearity (r≥0. 999 0). The recoveries were within the range of 80%-120%(n=6). Conclusion:The method is simple, rapid and accurate. It can be used to determine the contents of metallic elements to reduce the potential exceeding limit risk of toxic metal el-ements in water for injection. The methods also can provide reference for the more strict quality evaluation of water for injection.

Objective:To discuss the external factors causing medical equipment malfunction and the way to reduce it.Methods:Based on years of maintenance experience,this paper made an analysis from four aspects.Resuits:In order to keep medical equipment working normally,one should not only provide appropriate environment,steady power supply,good quality grounding,but also use and maintain the equipment correctly.Conclusion:Almost 80%of medical equipment failures are related to working condition,operation procedure service,power supply and grounding.

Objective To summarize the strategies for perioperative nursing of the patients with radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy.Method Eighteen patients with radical resection of esophageal carcinoma were treated with a combination of thoracoscopy and laparoscopy and their histories were retrospectively reviewed.Results Before the operation,nursing care focused on psychological nursing and preparations of operating room and various operating instruments.During the operation,the key nursing points included position care,proper cooperation with doctors,strict aseptic procedures and non-tumor techniques to reduce postoperative infections and dissemination of tumor cells.All the patients lived through the successful operations,their recovery satisfactory.The blood loss ranged from 100 mL to 300 mL,averaged(225.00±24.30)mL. Conclusions Radical resection of esophageal carcinoma under the combination of thoracoscopy and laparoscopy is technically feasible and safe.The perioperative nursing care is important for the improvement of operative success.