Objective:To investigate the efficacy of magnesium sulfate combined with labetalol on severe preeclampsia and the effects on serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF) and pregnancy associated plasma protein-A (PAPP-A).Methods:Eighty-five patients with severe preeclampsia who received treatment in Jinhua Municipal Central Hospital between January 2019 and June 2020 were included in this study. They were randomly assigned to receive treatment either with magnesium sulfate (control group, n = 42) or magnesium sulfate combined with labetalol (observation group, n = 43). Before and after treatment, 24-hour dynamic blood pressure, 24-hour urinary protein excretion and umbilical artery hemodynamics were determined. In addition, serum levels of sICAM-1, VEGF and PAPP-A were detected. Results:After treatment, 24-hour mean arterial pressure, 24-hour urine protein excretion in the control and observation groups were significantly decreased compared with before treatment. After treatment, the 24-hour mean arterial pressure [(116.45 ± 9.63) mmHg vs. (120.74 ± 9.48) mmHg] and 24-hour urine protein excretion [(1.85 ± 0.52) g vs. (2.33 ± 0.75) g] were significantly lower than those in the control group ( t = 2.069, 3.436, both P < 0.05). The umbilical artery resistance index in the control group, and the peak systolic velocity/end-diastolic velocity ratio and the umbilical artery resistance index in the observation group were significantly decreased after treatment compared with before treatment (all P < 0.05). After treatment, the peak systolic velocity/end-diastolic velocity ratio in the observation group was significantly lower than that in the control group [(2.80 ± 0.50) vs. (3.01 ± 0.45), t = 2.034, P < 0.05]. After treatment, serum sICAM-1 and PAPP-A levels were significantly decreased, and serum VEGF level was significantly increased, in each group (all P < 0.05). After treatment, serum levels of sICAM-1 [(548.52 ± 102.74) mg/L vs. (647.52 ± 124.15) mg/L, t = 4.009, P < 0.05] and PAPP-A [(111.74 ± 28.52) U/L vs. (134.24 ± 35.96) U/L, t = 3.200, P < 0.05] in the observation group were significantly lower than those in the control group, and serum VEGF level in the observation group was significantly higher than that in the control group [(32.12 ± 7.45) ng/L vs. (28.17 ± 6.23) ng/L, t =2.659, P < 0.05]. There was no significant difference in the incidence of poor pregnancy outcome between the control and study groups ( P > 0.05). Conclusion:Magnesium sulfate combined with labetalol exhibits good therapeutic effects on severe preeclampsia. The treatment method can improve umbilical artery hemodynamics, and its mechanism may be related to its effect on vascular endothelial function.

Objective To establish the HPLC fingerprint of cultured Cordyceps militaris. MethodsHPLC Method was used for the determination of C. militaris on Agilent ZOBAX SB-Aq C18 column (250 mm?4.0 mm, 5 ?m), and measuring with methanol 5%—60% in 30 min as elution detective wavelength at 260 nm, injection sample of 1.0 ?L and flow rate of 1.0 mL/min. The systematic optimized design of the chromatographic conditions, such as supersonic extraction, mobile phase, and detective wavelength as well was carried out. Results Fingerprint consisted of 11 common peaks and the result of methodology determination fitted to the related standards. The evaluation of cultured C. militaris by systematically comparing chromatograms with a professional analytical software recommended by National Institute for the Control of Pharmaceutical and Biological Products has been established. Conclusion The method is accurate, simple, and useful for the quality control of cultured C. militaris.

Objective To discuss the position nursing for neonates with type three congenital esophageal atresia after operation. Methods We selected 10 patients with type three congenital esophageal atresia from September 2004 to May 2007.The respirator, trachea catheter was removed after operation and the SpO2 was lower than 95% through head mask.Then the SpO2 was compared in different positions of patients,that is face forward,face lateral, face forward with hypsokinesis,face lateral with hypsokinesis. Results All the ten patients survived the operation.The Sp02 in the four positions under oxygen inhalation were (90.30±0.95)%, (89.90±0.74)%, (96.80±1.48)%, (95.90±0.88)%.The former two results were statistically different from the latter two results (P ＜ 0.01). Conclusions The position of face forward with hypsokinesis and face lateral with hypsokinesis facilitated the transition to natural respiration for patients with type three congenital esophageal atresia after remove of respirator and trachea catheter.This could prevent the incidence of complications and the probability of reuse of respirator.

Objective To explore job satisfaction of nurses in the pediatric department and the influential factors.Methods Four hundred and fifty four nurses from children’s hospital in Guangzhou involved the study.The Minnesota Satisfaction Questionnaire Short-Form(MSQ20)was used to measure their satisfaction.Results The score on job satisfaction was 70.41±9.28,with the inner satisfaction(3.62±0.45),the extrinsic satisfaction(3.30±0.60)and general satisfaction(3.52±0.46).Salary was one of the important factors affecting job satisfaction.Conclusions The job satisfaction of the nurses of pediatric departments or hospitals can be improved by raising their salary level and benefits and improving their educational level.

Objective To analyze the correlations between pediatric intersive cave unit (PICU) nurses′job satisfaction and their perception of job characteristics. Method One hundred and thirty-six PICU nurses from a women and children′s hospital of Guangzhou participated in the study and the job diagnostic survey (JDS) and Minnesota satisfaction questionnaire short-form (MSQ20) were used to investigate the relationship between the job characteristics and job satisfaction. Results The average score on general satisfaction was (3.57 ± 0.41). The dimensions like skill variety, task integrity, feedback from job and feedback from others, had a significant positive impact on general satisfaction (all P<0.05). Conclusion Nurses generally have a relatively middle level of job satisfaction and measures should be taken to improve their job satisfaction as well as the quality of nursing.

Objective To study the diagnostic and distinguishing diagnostic value in primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC)by the serum sialic acid (SA)detection.Methods During January 2012 to June 2014, 100 cases of patients with PHC,91 cases of patients with MHC,155 cases of benign liver disease patients,and 139 healthy people in Wuyi Traditional Chinese Medicine Hospital were included into the study.The concentration of serum SA and AFP were detected by chemical enzymatic method and chemiluminescence method,SPSS1 9.0 was used to analysis the results.Re-sults The concentration of serum SA in PHC patients (701.08±189.33 mg/L)were significantly higher than benign liver disease patients (588.38±98.51 mg/L)and healthy people (572.37±89.13 mg/L),there was statistical significance (P=0.000),the significantly statistical differences were also in MHC (790.20±162.29 mg/L)and PHC patients (P=0.027). Serum SA in the diagnosis of MHC sensitivity,specificity and AUC were 84.6%,85.2% and 0.895,compared with serum AFP (sensitivity 22.2%,specificity 29.6% and AUC 0.301)had statistically significance (P=0.000).Conclusion The se-rum SA has important clinical significance in the diagnosis and distinguishing diagnosis of PHC and MHC.

Objective To evaluate the clinical effect of regulating expiratory airway pressure of noninvasive ventilation(NIV)to treat overlap syndrome(OS)with respiratory failure by pressure titration in monitor during sleep.Method Individuals who met the following criteria were selected for the study:(1)OS with respiratory failure confiemed by polysomnogram(PSC)and pulmonary function tests;(2)ability to tolerate PSG tests all night;(3)lucid consciousness and spontaneous breathing upon awaken and(4)ability to tolerate NIV.The criteria of exclusion were:(1)frequent expectoration of blood or hemoptysis;(2)spontaneous pneumothorax;(3)severe prosopo-trauma or facial ulcer and(4)large amount of secretion in the airway.From August 2005 to Decentber 2008,27 patients were selected with two patients excluded.The remaining 25 patients treated with noninvasive bi-level positive airway pressure(BiPAP)were randomly assigned to titration group or control group.During sleep,the patients of titration group were put under the optimal expiratory airway pressure[EPAP,(8.8 ± 0.5)cmH2O]which was got from titration by AutoCPAP ventilator and the EPAP decreased immediately to 5 cmH2O when the patients wake up next day.In the patients of control group,the EPAP was maintained at 5 cm H2O round the clock.The degree of apnoea and the hypopnea index(AHI),the results of arterial blood gas analysis(pH,PaO2,PaCO2)in the morning,the lowest pulse oxygen saturation(SPO2LOW)and the arterial blood gas level at 10 am before and after ventilation,duration of taking off ventilator at night,complications of NIV,incidence of air leakage and invasive ventilation after NIV were comparatively analyzed between the two groups.Results Compared with the control group,the titration group showed a notably increase in the value of SPO2LOW[(25.9± 11.3)%vs.(14.9±8.4)%;P＜0.05].The PaO2 level was significantly higher in the titration group(29.4±4.4)mmHg than that in the control group(22.6 ± 2.1)mmHg(P＜0.0001);however,the PaCO2 level in the titration group(16.8 ±7.3)mmHg was not significant different from that in the control group(20.0±6.3)mmHg(P＞0.05).The PaO2 level at 10am in the titration group(28.9 ± 6.7)mmHg was not significant different from that in the control group(31.3 ± 7.7)mmHg(P＞0.05);however,the PaCO2 level in the titration group(23.3 ±5.7)mmHg was higher than that in the control group(18.2 ±5.0)mmHg(P＜0.05).Conclusions Regulating EPAP of NIV to treat overlap syndrome with respiratory failure by pressure titration in monitor during sleep was more effective at improving hypoxemia and carbon dioxide retention than traditional methods without adjusting the EPAP to the optimal level.The optimal didn't increase carbon dioxide retention at night,confirming that the method was safe.

OBJECTIVE To investigate the susceptibility of Enterococcus faecalis and E.faecium isolated from system and urinary tract infected patients and provide data for anti-infection therapy.METHODS The susceptibility(MIC) of 249 Enterococcus strains was tested by agar dilution method.RESULTS All 249 strains of Enterococcus(117 strains of E.faecalis and 132 strains of E.faecium) were isolated from urinary tract or systemic infection patients.The isolated rate of E.faecalis(68.4%) was higher than that of E.faecium(50.0%) in urinary tract isolates.Meanwhile,the isolated rate of E.faecium(50.0%) was obviously higher than that of E.faecalis(31.6%) in systemic infection isolates.The drug susceptibility rate of E.faecalis was higher than that of E.faecium to gatifloxacin,ciprofloxacin,penicillin,ampicillin and high-level gentamicin but lower for minocycline.All Enterococcus were susceptible to vancomycin,teicoplanin and linezolid.They were almost 100.0% resistant to erythromycin.The susceptibility rate of E.faecalis(39.5%)was higher than E.f aecium(15.3%) to high-level gentamicin.The susceptibility rate of E.faecalis isolated from blood was higher than the strains isolated from urinary tract to all antibiotics.E.faecium isolated form blood was almost 100% resistant to gatifloxacin,ciprofloxacin,penicillin,ampicillin and erythromycin.CONCLUSIONS The drug susceptibility of E.faecalis and E.faecium which cause systemic and urinary tract infection is different.The available therapy project should be selected based on the resistance character.At present,vancomycin,teicoplanin and linezolid are the best choice for treatment against the infection caused by Enterococcus.

Objective To shorten the turn around time of positive blood culture results by optimizing the blood culture positive specimen processing flow.Methods In January 26,2015,the microbiology department started the blood culture positive specimen processing flow optimization project,and applied the Lean Six Sigma method in the microbiological process management.The TAT data of 124 positive blood cultures containing Enterobacteriaceae were collected before and after the start of the project in about two months.We analyzed the turnaround time median,mean and standard deviation and reference Z value,process performance index,millions of error opportunities.We decompose the turnaround time into six time periods to find the key points of the process improvement and the influencing factors,and then put forward the reform measures to optimize the blood culture inspection process.MiniTab17.0 statistical software was used to process capability analysis and double sample t test.Results After the implementation of the project,the average turnaround time of the blood culture was shortened from 77.10 h to 64.03 h,improved by 13.06 h(16.94％).Process performance greatly improved in Ppk value increased from 0.49 to 0.88,the benchmark Z value increased from 1.48 to 2.63.After the improvement,except the positive alarm time of blood culture,the mean of the other decomposition time was significantly shorter than before.Conclusions The application of Six Sigma in process management can greatly improve the work efficiency and process performance.This project can save a lot of manpower,material and financial resources,reduce the waiting,shorten turnaround time,that achieve the desired results.

Objective To explore the bioactive constituents of Gentiana rhodantha for its serum pharmacochemistry research.Methods The blood migrating constituents of Gentiana rhodantha were determined by comparing the HPLC fingerprints of the aqueous extracts,drug contained serum and blank serum.Results Twenty compounds were detected in drug contained serum,four among which were original constituents of Gentiana rhodantha,the rest might be metabolites of the original ingredients.Conclusion These twenty constituents absorbed in blood could be the bioactive components of Gentiana rhodantha.Further studies will be useful to clarify the bioactive constituents and action mechanisms of Gentiana rhodantha.