Objective To observe the negative pressure ball aplication effect of thoracoscopic loectomy in patients.Methods 50 cases of patients with lung resection operation were divided into conventional group (water-sealed drainage bottle) and improved group (negative pressure ball) by random digital table method,and each group had 25 cases.The effect of nursing care and the satisfaction degree of patients were compared between the two groups.Results After different methods of nursing,the postoperative bed time in the improved group was (12.0±0.8) hours,hospitalization time was (8.0±1.5) days,which were significantly lower than (48.0±2.5) hours,(12.0±2.0) days in the conventional group.The difference was statistically significant (t=2.401,2.302,P＜ 0.05);The satisfaction of patients in the improvement group was 92.0％ (23/25) which was significantly higher than 72.0％ (18/25) of the control group,and the difference was statistically significant (x2=4.920,P＜ 0.05).Conclusions Negative pressure ball in thoracoscopic lobectomy patients after application can significantly improve the effect of clinical nursing and patient satisfaction,worthy of promotion and application in clinical work.

ObjectiveTo introduce an improved implantation for urethral stents in patients with infra-sacral neurogenic voiding dysfunction and to evaluate its outcome.MethodsTwelve patients with infrasacral neurogenic voiding dysfunction were treated by implantation of urethral stent according to an improved method.The following objective parameters were used to evaluate the outcome:voiding diary,urine residue volume(URV),renal hydronephrosis and urodynamic tests.ResultsThese parameters were improved significantly after implantation:detrusor leak point pressure,voiding pressure and URV decreased,voiding volume and urine flow increased.The main complications were incontinence,difficult voiding and hematuria,but these were transient and disappeared during a week.ConclusionsThis procedure is effective with fewer complications,protects the function of upper urinary tract and improves the life quality of the patients with infra-sacral neurogenic voiding dysfunction.

OBJECTIVE:To provide reference for clinical rational use of antidiabetic essential medicines. METHODS:Retro-spective analysis was used to sort and analyze the consumption sum,DDDs and DDC of antidiabetic drugs in the outpatient of our hospital from May 1st,2012 to Apr. 30th,2014. RESULTS:The consumption sum and DDDs of insulin and oral antidiabetic drugs had upward trend. The top 3 consumption sum and DDDs of oral antidiabetic drugs were acarbose,metformin and glimepiri-de,and the highest DDDs of insulin was short-acting and premixed recombinant human insulin,all of them were in the National Essential Medicine List (2012 edition);DDDs of Glibenclamide tablets,Glipizide tablets and Chinese patent medicine were rela-tively small;DDC in long-acting insulin analogues was obviously higher than other kinds of insulin. The sales ratio of essential medicines was increased from 10.48% to 67.78% after National Essential Medicine List (2012 edition)carried out. CONCLU-SIONS:The use of antidiabetic drugs in the outpatient of our hospital is basically rational. Acarbose and metformin have the high-est DDDs,and DDDs of insulin analogues grow rapidly.

Objective To explore the concentration of required residual available chlorine dioxide(ClO 2 )and optimun contact time for ClO 2 disinfection in order to ensure the microbiological indexes of waste water of hospital disinfected by ClO 2 qualified.Meth ods The waste water samples collected from hospital,to which were aritificially added with predetermined con-centrations of bacteria,were disinfected by various concentrations of ClO 2 (2?4?6?8?10?12mg /L)with various contact time (5?10?30?60?90min).After disinfection,the concentration of residual ClO 2 and the contents of microorganism in waste water samples were determined.Re sults After30-min disinfection by10.0mg /L ClO 2 ,the waste water sample originally containing1.52?10 2 /L E.coli showed a bactericidal rate of99.99%and a concentration of residual ClO 2 at2.5mg /L.After10-min disin-fection by10.0mg /L ClO 2 ,the waste water samples originally containing1.12?10 10 /L Salmonella showed a bactericidal rate of100%and a concentration of residual ClO 2 at2mg /L.After5-min disinfection by10.0mg /L ClO 2 ,the waste water samples o-riginally containing M.tu berculosis at concentration of++++showed a negative result and a concentration of residual ClO 2 at3.5mg/L.Conclusion After the primary treatment,ClO 2 disinfection with contact time of30minutes and a residual concentration of ClO 2 at2.5mg /L could ensure the germicidal effect for E.coli,Salmonella and M.tu berculosis in waste water of hospital qualified.

Objective To find out an optimal anesthesia and the d osage used in painless gastroscopy, and to evaluate its efficiency. Meth ods 200 patients undergoing painless gastroscopy were divided into 4 gr oups randomly. 2?g/kg iv of propofol was used in group Ⅰ, fentani 1?g/kg + pr opofol 2?g/kg in group Ⅱ, rimifentani 0.5?g/kg + propofol 1.5?g/kg in grou p Ⅲ, and rimifentani 0.75?g/kg + propofol 0.75?g/kg in group Ⅳ. Observed o bjects induced starting time and depth of anaesthesia, HR, R and SpO2 during o peration, side effects such as cough reflex and larynx spasm, time of regaining consciousness, postoperative side effects such as nausea and vomiting. R esult Significant differences (P≤0.01) were found between group Ⅳand the other 3 groups in starting time and depth of anaesthesia, side effects , time of regaining consciousness and suppression of respiration during operatio n. Conclusion Combined rimifentani 0.75?g/kg + propofol 0.75 ?g/kg are optimal anestheties in painless gastroscopy if side effects are preve nted.

Objective: To determine 17 types of phthalic acid esters (PAEs) in drinking water using solid-phase extraction coupled with gas chromatography-mass spectrometry (GC-MS) in multiple reaction monitoring (MRM) mode. Methods: One litre of commercially available bottled water was purified using an HLB solid-phase extraction column, and was eluted with ethyl acetate, dichloromethane and average methanol. Seventeen types of PAEs were detected using a triple quadrupole gas chromatography-mass spectrometer in MRM mode. By optimizing the temperature programming and adjusting the mass spectrometry collision energy, collection efficiency was improved and matrix interference was reduced. The precision and accuracy of this method were assessed by determining the standard curves, detection limits, quantification limits, relative standard deviations (RSD) and average spiked recovery rates for the 17 types of PAEs. Results: The 17 types of PAEs showed good linear relationships between mass concentration and chromatographic peak areas in the range of 0.02 to 1.0 mg/L, with correlation coefficients all greater than 0.999 1. The detection limits ranged from 0.002 9 to 0.009 7 mg/kg, the quantification limits ranged from 0.008 7 to 0.029 1 mg/kg, the RSD ranged from 0.8% to 3.0%, and the average spiked recovery rates ranged from 88.8% to 111.8%. Conclusion Solid-phase extraction coupled with MRM of GC-MS can better determine low concentrations of PAEs in drinking water.

Objective To review the experience of perioperative management and effect of coronary artery bypass grafting (CABG) for patients of aged＞80 years.Methods We studied 118 cases with CABG for patients of age＞80 years from January 2002 to December 2012.The other 1034 cases with CABG for patients aged 60-80 years were enrolled as control group.Logistic regression analysis was used to assess the effect of age on operative mortality and morbidity.Results The recent mortality was higher in group aged＞80 years [6.8％(8 cases) vs.3.1％(32 cases)].Through multivariate logistic regression,the patients aged＞80 years versus control were concerned about some postoperative adverse events as follows:higher mortality (OR =3.45,95 ％ CI:2.86-4.23),dialysis (OR=3.56,95％CI:3.01-4.32) and re-intubation(OR=3.87,95％CI:3.45-4.87),delayed healing of incision(OR=4.05,95 ％ CI:3.47 5.74),prolonged mechanical ventilation(OR=3.76,95 ％ CI:3.435.01),prolonged ICU stay (OR =2.98,95 ％ CI:2.67 4.12),prolonged hospital stay (OR =2.87,95％CI:2.36-3.96).Conclusions Age＞80 years is an important factor of postoperative mortality and morbidity for CABG.We need pay more attention to perioperative management.

Objective Acute necrotizing pancreatitis (ANP) may cause lung injury.This study explores two factors that are associated with lung damage from ANP,the expression of tumor suppressor factor CYLD and nuclear factor-kappa B (NF-κB).Methods 72 adult Sprague-Dawley rats were randomly divided into 3 groups:sham operation,ANP,and GdCl3 treatment groups (n=24 for each group).A retrograde injection of 5％ sodium taurocholate into the biliopancreeatic duct of rats induced ANP,and the animals were killed 1,3,6,and 12 hours after the ANP induction.AMs were harvested by bronchoalveolar lavage technique,and TNF-a and IL-1β levels in bronchoalveolar lavage fluid (BALF) were evaluated.Lung tissue was checked with histological examinations,and the activity of NF-κB and CYLD in AM were measured by western blot.Results TNF-α and IL-1β secreted by AM were gradually elevated,peaked on the sixth hour,had maximums of (491.3 ±20.3)ng/L and (178.83±11.32)ng/L respectively,and decreased on the twelfth hour.The levels of TNF-α and IL-1β in the ANP group were significantly higher than the sham operation group (P＜0.05),and the GdC13 group levels were obviously lower than ANP group.In the sham operation group,the expression of NF-κB was low and CYLD was high.In the ANP group,when compared to the sham operation group,the expression of NF-κB rose after 3 hours and continued to rise with time progression (P＜0.05).In contrast,CYLD protein expression in the ANP group dropped after 3 hours and continued to gradually decrease (P＜0.05).The CYLD and NF-κB protein expression in GdCl3 groups had similar trends as the ANP group.GdCl3 group CYLD levels began to rise at 6 hours (P＜0.05),and NF κB levels began to fall at 1 hour (P＜0.05).The expression of NF-κB and CYLD possessed a negative correlation in both the ANP and GdCl3 groups (r =-0.918,r=-0.723,P＜ 0.01).Conclusions Therefore,in acute lung injury associated with acute pancreatitis,CYLD expression decreased with evident phases,such as a decrease in levels after 3 hours,and NF κB expression increased.Also,GdCl3 may be responsible for upregulation of CYLD expression and downregulation of NF-κB expression,and confirmed that CYLD had a negative effect on NF-κB.Perhaps GdCl3 could be used in the future to ameliorate the lung injury associated with ANP.

OBJECTIVE:To investigate the recent use of immunosuppressive agents for renal transplantation patients during our hospital.METHODS:Case history of124renal transplantation patients in our hospital in2004was reviewed ret-rospectively,and the categories and the associated costs of immunosuppressive agents were statistically analyzed,which were compared with that of2000.RESULTS:In2004,patients’mean hospitalization cost was74462.77yuan and mean immuno-suppressive agents cost was25809.93yuan,increased by75.12%and175.35%,respectively as compared to2000.Of the total drug costs,the immunosuppressive agents accounted for61.37%in2004and46.4%in2000.Dominated the first3places in the list of DDDs of immunosuppressive agents in2004were Methylprednisolone,ciclosporin A and dehydrocortisone,respec-tively.CONCLUSIONS:As compared with2000,the application categories and costs of neotype immunosuppressive agents for renal transplantation patients in our hospital increased in2004,thus to find a more effective immunosuppressive remedy that of less adverse drug reaction and lower cost is of great significance.

Objective To investigate the validity and reliability of Item Erectile Function Scale (I-EF) for neurogenic erectile dysfunc-tion (ED). Methods 104 patients with spinal cord injury were assessed with I-EF. They were measured with pudendal somatosensory ner-vous evoked potential (SEP), bulbocavernosus reflex potential time (BCR) and nocturnal penile tumescence (NPT) detection. 34 patients ac-cepted medicine for ED, and were assessed with I-EF after treatment. 21 patients with medium ED were assessed by 2 testers, and retested 2-4 weeks later. Results The patients who recorded their potential of SEP and BCR got the scores of Q1, Q2 above 7, and the absence with the scores of 3. Those found NPT 1-3 times got the score of Q3 above 7, and the absence with the scores of 3. The incidence of reflex erec-tions and NPT were more in complete suprasacral ones than in complete sacral ones (P<0.05). There was significant improvement after med-ication in patients with mild to medium ED (P<0.05). The interclass correlation coefficient (ICC) was 0.93 between testers and 0.90 between test-retest. Conclusion I-EF can be used to assess neurogenic erectile dysfunction for rehabilitation.