Objective To summarize the nursing experience of combination therapy of highly agglutinative staphylococcin (HASL) with cisplatin for patients with malignant pleural effusions. Methods After fully draining of pleural fluid in 62 cases with malignant pleural effusion through pleural puncture through central venous catheters and simply suction bottles, we injected HASL and cisplatin into the patients' pleural cavities. During the therapeutic process, firstly, we drained the pleural fluid fully before injection, secondly, we directed the patients to cooperate well and alter the positions properly, and thirdly, we closely observed the patients' condition and adverse reactions. Results 54 of 62 cases were effective after the therapies. The effective rate was 87.1%.Conclusions In order to achieve a satisfled curative effect and reduce the adverse reactions, we need the cooperation of the patients, fully draining of the pleural fluid before injection and proper alternation of the patients' positions during the treatment process.

Objective To investigate prognostic value of the CHA 2 DS2-VASc score [ congestive heart failure , hypertension , age≥75y (doubled), diabetes mellitus, stroke (doubled)-vascular disease, age 65~74 and sex category (female)] in an initial car-dioembolic stroke with atrial fibrillation .Methods A total of 346 initial cardioembolic stroke patients with atrial fibrillation was en-rolled.The clinical feature, the National Institutes of Health Stroke Scale (NIHSS) score on admission, and clinical outcome [modi-fied Rankin Scale (mRS) score after 90 days] were obtained and evaluated retrospectively according to the CHA 2DS2-VASc score. Results The rate of female, smoking, hypertension, congestive heart failure, anticoagulation and the level of age, NIHSS score, and CHA2 DS2-VASc score were significantly different between two prognostic groups ( P <0.05 ) .A positive correlation was observed be-tween CHA2DS2-VASc score and NIHSS score on admission (ρ=0.324, P <0.01), CHA2DS2-VASc score and mRS score (ρ=0.228, P <0.01).Logistic regression analysis showed that age , smoking, anticoagulation, the CHA2DS2-VASc score, and the NIH-SS score on admission were related to clinical outcome independently .Conclusions The CHA2 DS2-VASc score may be useful for not only evaluation of stroke risk but also prediction of clinical outcomes after stroke .

Objective:To explore the effect of irbesartan in the treatment of the patients with hypertension complicated with diabetes mellitus and its influence on urine trace albumin. Methods:Totally 62 cases of patients with hypertension complicated with diabetes mel-litus were divided into the observation group and the control group randomly with 31 patients in each. The patients in the control group were given the conventional blood sugar and blood pressure control, and the patients in the observation group were treated with irbesartan additionally. The treatment course was 3 months. The changes of blood pressure and urine trace albumin of the patients in the two groups before and after the treatment were compared, and the effect of blood pressure control and the adverse effects were evaluated as well. Re-sults:The total effective rate of the observation group was 96. 8%, which was much higher than that of the control group (83. 9%, P<0. 05) , and the difference had statistical significance (P<0. 05). After the treatment, the systolic blood pressure and diastolic blood pressure of the patients in the two groups were reduced significantly (P<0. 05), and the urinary albumin excretion rate (UAER) and the level of urine trace albumin (mAlb) of the patients in the two groups were obviously lowered (P<0. 05), and the decrease in the obser-vation group was more notable than that in the control group (P<0. 05). No significant difference in the incidence of adverse reactions was shown between the two groups(P>0. 05). Conclusion:The clinical effect of irbesartan in the treatment of patients with hypertension complicated with diabetes mellitus is promising with low incidence of adverse effects,which can effectively protect renal function as well.

A glucose biosensor was fabricated from a glucose oxidasE-immobilized by chitosan and oxygen electrode. The effects of concentration of chitosan(0.3%), enzyme loading(0.8 mg), pH 7.0, phosphate buffer concentration(300 mmol/L), and temperature 25 ℃ for the response of the biosensor were investigated. The glucose biosensor has a linear response range of 0.016-1.10 mmol/L with a detection limit of 8.0 μmol/L(S/N=3). The response time was less than 60 s. The biosensor showed extremely good stability with a shelf-life of at least 3 months. The biosensor exhibited good repeatable response to a 0.25 mmol/L glucose olution with a relative standard deviation of 2.5%(n=10). The precision of fabrication of the biosensors using four different membranes was good with a RSD of 4.7%. Some common potential components in sample such as niacinamide, vitamin B6, vitamin B12, vitamin E, Ca2+, Mg2+, K+ and Zn2+ showed no interferences on the response of the glucose biosensor. The biosensor was successfully applied to determine the glucose in commercial beverage samples.

OBJECTIVE:To investigate the incidence of adverse drug reactions(ADRs),the ratio of irrational drug use and the average daily drug costs after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injections in the outpatient department.METHODS:By a controlled prospective study,500 patients in the intravenous center in outpatient department whose records were in line with inclusion criteria were included before intervention as controls,and after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injection in the outpatient department,500 patients meeting the inclusion criteria were enrolled as trial group.A database was established and the results were analyzed statistically.RESULTS:The irrational drug use was noted in 52 cases in the control group versus 21 cases in the trial group and the ADRs or adverse drug events were noted in 18 cases for the control group versus 9 cases for the trial group.The daily mean drug cost reduced by 29.84 yuan after intervention.CONCLUSION:The intervention measures contributed to the reduction in incidences of irrational drug use and ADRs and drug costs.

OBJECTIVE:To improve the safety of antibiotic injections in outpatient department. METHODS:In a prospective randomized control study,outpatients treated with antibiotic injections in 2007 were chosen to be the subjects. The subjects were randomized into control group and intervention group. Education,administration intervention and inspection were adopted in clinical intervention considering the factor of drug combination. The rationality of drug combination and the incidence of ADR before and after intervention were observed. RESULTS:As compared with control group,the rationality of drug combination in intervention group was improved obviously(P

OBJECTIVE: To analyze the chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics so as to formulate corresponding policies for intervention. METHODS: The patients who had been treated i.v with antibiotics from Mar. 2006 to Mar. 2007 were enrolled: 105 in trial group showed ADR, another 105 in control group showed no ADR. The ADR influencing factors were compared between the two groups from aspects of patients, nursing, and medication to find out the significant differences. RESULTS: The chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics included the indications of drugs, dosage, dosing interval, drug combination, and availability of medication guidance. CONCLUSION: The outpatient intravenous use of antibiotics is far from rational, which needes further intervention.

Objective We evaluate if supplementary grading system can refine patient selection and accurately predict neurological outcome in BAVM. Methods We retrospectively study 221 BAVM patients who were treated micro?surgically by our hospital. The score of pre and post operation mRS and relative clinical, radiology data were collected. Two different logistic models (Spetzler-Martin, Supplementary Spetzler-Martin grading model) were constructed to com?pare the area under ROC. Results Some factors are significant different between worse outcome patients and good out?come patients:Non-hemorrhagic presentations prior surgery, AVM bigger than 3cm, diffuse shape of AVM and the elder patients. Predictive accuracy was higher for the supplementary model (ROC area, 0.91), than the Spetzler-Martin model (ROC area, 0.774). So the predictive accuracy of supplementary model was significantly better than that of the Spet?zler-Martin model (P=0.0362). Conclusions Supplementary Spetzler-Martin model can improve preoperative risk pre?diction and subgroup the patients more efficiently. When the score less than 5(including 5) in supplementary Spet?zler-Martin patients seem to have lower risk relative to surgery.

Objective The present study was to investigate the feasibility of use of high resolution magnetic reso?nance vessel wall imaging(HR-VWI)in evaluation of intracranial aneurysms. Methods We prospectively collected data from patients who had intracranial aneurysms and received HR-VWI scan before surgical treatment or conservative treatment. Aneurysms were divided into ruptured group (n=12) and unruptured group (n=88). Aneurysm site, size, neck, aspect ratio(AR), daughter sac and aneurysmal wall enhancement scale were analyzed in both groups. Univariate and multivariate Logistic regression were performed to evaluate the risk factors of aneurysm rupture. Subgroup analysis was also performed to study symptomatic and asymptomatic unruptured aneurysms. Results Aneurysm size(t=2.187,P=0.031),AR(t=3.164,P=0.002),incidence of daughter sac(P=0.012) and aneurysmal wall enhancement scale(P<0.001)were higher in ruptured aneurysm group. Multivariate Logistic regression showed that aneurysmal wall enhance?ment scale was the only independent risk factor of ruptured aneurysms(P=0.002). Subgroup analysis showed aneurysm wall enhancement scale(P<0.001) and AR(t=3.939,P<0.001) were higher in symptomatic unruptured aneurysms. Conclusion Aneurysm wall enhancement on HR-VWI is more frequently seen in ruptured aneurysms and symptomatic unruptured aneurysms. Histological study is needed for better understanding of the mechanism of aneurysm wall enhance?ment.

This paper is aimed to study a method and feasibility of early diagnostic system using hypoxic ischemic encephalopathy (HIE) in the newborns. Fifteen non-invasive indicators with high sensitivity and specificity were selected for the early diagnosis of HIE on the basis of related researches from the literature and the researches in our laboratory. The diagnostic test was done with 140 cases with the HIE, using the fussy BP neural network experiment system. The initial results showed that the accuracy rate was 100% for the training set and 95% for the testing set, and the error rate was 5%. The data suggested that the fuzzy back-propagation neural networks, with the clinical comprehensive indicators, exhibited a high accuracy for the early diagnosis of HIE. This method provides an objective and convenient new way for the early clinical diagnosis of the HIE.
Algorithms ; Diagnosis, Computer-Assisted ; methods ; Early Diagnosis ; Female ; Fuzzy Logic ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Male ; Neural Networks (Computer) ; Pattern Recognition, Automated ; methods ; Reproducibility of Results ; Sensitivity and Specificity