Objective To study the relationship between C reactive protein ( CRP) and postoperative deliri-um of elderly patients after hip fracture , and to explore the possible mechanism of delirium .Methods A total of 186 elderly patients with hip fracture who received operation were included in the study .24h after operation,according to the patients'awareness of ICU fuzzy evaluation method ,the patients were divided into the delirium group and non delirium group .The levels of CRP and procalcitonin were detected and compared .Results The CRP levels in the de-lirium group and non delirium group were (207 ±86)mg/L,(87 ±42)mg/L,there was significant difference between two groups (t =2.427,P <0.01).The procalcitonin levels in the delirium group and non delirium group were (0.32 ±0.11)μg/L,(0.27 ±0.13)μg/L,the difference between the two groups was not significant (t=0.347,P>0.05).Conclusion CRP may be related with delirium.Inflammatory response without systemic infection may be one of the mechanisms of delirium .

Different maternal positions and movement are utilized gradually in clinic while today it appears that the majority of women in the world birth in supine position or lithotomy position. To know the current situation and progress of the studies concerning different maternal positions and movement during labour and to explore the current relevant problems in clinic. The search strategy was designed to identify the relevant literature. The search was limited to the last 20 years as current literature was sought. Thirty eight papers were identified as relevant and included in this literature review. The majority studies is concerning about the outcome of mother and fetus. There is no unitized clinical pathway currently, and the objects implemented are limited. There is no study related to the requirement of implementing different maternal positions and movement during labor in clinic and the effect of pelvic floor function after parturition. The positive effect of implementing different maternal positions and movement during labor can be sure for the process of parturition and the outcome of mother and baby. Childbirth in different maternal positions and movement is the trend in the future. Therefore, how to utilize different maternal positions and movement during labor well, it is still a huge challenge for medical staff. And more convincing studies and information are needed as evidence in clinic.

AIM:To prepare the Lyophiled Royal Jelly Soft Capsule and study its stability and Influential factors.METHODS:The suspending agent and processing method were optimized using sedimentation volume rate as the index.Soft capsules were prepared and product stability under high temperature and high humidity environment was studied according to the determination of the content of 10-HAD by HPLC.RESULTS:The finished product yield in pilot test was more than 90%,the soft capsule products stored in cold were stable,while those stored under room temperature or high temperature and high humidity were unstable with a noticeable decrease in quality.Water content in capsule shell affects the 10-HDA content of the finished product.CONCLUSION:The preparative process is feasible and the products should be storaged in cold enviroment.

Objective To investigate the effect of detail management in ward drug administration.Methods Details management for ward drug management were applied,including the standardization of the drug storage,storage method,to carry out new knowledge learning,to strengthen the drug management,to set up the standardized nursing medication process identification and optimization measures.Results details management,the incidenues of drug mixed and delayed delivery were lower;the time of checking drug was significantly shorter(P<0?001).Conclusions The details management are the effective measures to ensure drug quality and safety.

Radiation-induced lung injury (RILI) is a common complication after radiotherapy for lung cancer and alternative thoracic malignant tumors, while ferroptosis is a regulated cell death triggered by iron-dependent membrane lipid peroxidation. In this article, the relationship between RILI and ferroptosis was investigated from oxidative damage induced by reactive oxygen species, antioxidant network and iron homeostasis regulated by nuclear factor erythroid 2-related factor 2(Nrf2) as well as transforming growth factor involved in the inflammatory response, aiming to mitigate or inhibit the occurrence of RILI through regulating ferroptosis, thereby improving clinical prognosis of patients undergoing radiotherapy.

The antibacterial activity and mechanism of the antimicrobial peptide mutant Cbf-14-2 against NDM-1 carrying recombinant bacteria (E.coli BL21 (DE3)-NDM-1) was investigated in this study.The minimum inhibitory concentration (MIC),minimum bactericidal concentration (MBC) and killing curves (KCs) in vitro were determined by the broth microdilution method.Mice septicemia model was established by interaperitotoneal injection of E.coli BL21 (DE3)-NDM-1 to evaluate the antibacterial activity of this peptide in vivo.Results showed that Cbf-14-2 exhibited a potent antibacterial activity with MIC of 16 μg/mL and killed almost all recombinant bacteria within 120 min.Meanwhile,it significantly improved the survival rate of infected mice up to 70％ with the decreasing of bacterial load in mice lung,liver,spleen and kidney.This powerful clearance ability of Cbf-14-2 against bacteria mainly related to its enhanced membrane penetration ability through neutralizing the negative charges and disrupting the integrity of the bacterial cell membrane.Therefore,Cbf-14-2 is expected to be a potential antimicrobial agent for the treatment of infection induced by multi-drug resistant bacteria,especially for the NDM-1carrying bacteria.

AIM: To verify the bioequivalence between sustained released tablet of nepopam and normal one. METHODS: 18 volunteers were randomly devided into two groups. Double periodical crossed design was used, and poly dose of nefopam was administered to 18 volunteers following single dose after one week interval. The concentration of nefopam hydrochloride in serum was determinated by HPLC, and the related parameters came out through 3p97 programme. RESULTS: In the single dose test the drug concentration of sustained released tablet maitained 2040 mg?L -1 for 10 h ,c max was ( 45.8 ?15.7) mg?L -1 ,t peak was ( 3.4 ? 0.8) h , and the corresponding parameters of normal tablet were over 20 mg?L -1 for 7.5 h ,( 72.7 ?26.0) mg?L -1 ,and ( 1.6 ? 0.6) h . The AUC was ( 363.4 ? 107.1 ) and ( 374.8 ?125.7) mg?h?L -1 respectively, and F was ( 1.02 ? 0.25 ). In the poly dose test the c max of sustained released and normal one was ( 31.50 ? 12.65 ) and ( 33.68 ?10.51) mg?L -1 ,c min was ( 13.4 ? 4.4 ) and ( 10.9 ?5.4) mg?L -1 , t peak was ( 2.6 ? 0.6 ) and ( 1.22 ? 0.46) h , and FI was ( 0.77 ? 0.26 ) and ( 1.04 ? 0.18 ) respectively. CONCLUSION: The sustained released tablet is credible and the two types of tablet are equieffective in AUC.

Objective To evaluate the effects of dexmedetomidine on perioperative pulmonary compliance and the expression of Toll?like recep?tor(TLR)?2 and TLR?4 in the peripheral blood during perioperative period in patients undergoing open colorectal cancer radical surgery. Meth?ods Twenty patients with colorectal cancer underwent elective general anesthesia,with ASA gradeⅠ?Ⅱand body mass index(BMI)<30 kg/m2, aged 30 to 68 years old,were enrolled for the study. They were randomly divided into control group(group C,n=10)and dexmedetomidine group (group D,n=10). In group D,dexmedetomidine was infused at a rate of 0.4μg·kg-1·h-1 from the beginning of surgery till 30 min before the end of surgery. The patients in group C received same manipulation as in group D except dexmedetomidine was replaced by normal saline. The mean ar?terial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),30 min(T2),60 min(T3),and 90 min(T4)after the beginning of surgery,extubation(T6),and 3 min after extubation(T7). Airway pressure and lung dynamic compliance were recorded at T1?T7 time points,respectively. Vein blood samples were drawn to analyze the TLR?2,TLR?4 and tumor necrosis factorα(TNF?α)concentration at T0,T4,T7 and the day after operation(T8),respectively. Results Compared with group C,MAP and HR increased in group D at T6(P<0.05);lung dynamic compliance increased in group D at T4(P<0.05);TLR?2 and TLR?4 concentration in serum decreased in group D at T4, T7 and T8(P<0.05);TNF?αconcentration in serum decreased in group D at T4,T7 and T8(P<0.05). Conclusion Continuous infusion of 0.4μg·kg-1·h-1 dexmedetomidine can help to stabilize hemodynamics,relieve inflammatory stress response,maintain the relative stability of intra?operative hemodynamic parameters,and also can improve the pulmonary dynamic compliance of patients.

Objective To improve hand hygiene compliance among health care workers(HCWs)through continu-ous quality improvement,and effectively reduce the incidence of healthcare-associated infection(HAI).Methods Continuous quality improvement was performed by adopting plan-do-check-action(PDCA)cycle,all HCWs were trained,hand hygiene was stressed,periodical and random checking was conducted.Results After the implementa-tion of PDCA cycle,the acknowledge rate of hand hygiene enhanced from 48.00% to 63.99%;hand hygiene com-pliance rate enhanced from 65.11% to 82.40%,the difference were both significant(χ2=12.75,259.65,respective-ly,both P<0.05).The daily consumption of instant hand antiseptic per 1 000 bed day increased obviously,which was 2.95-fold of pre-implementation.Conclusion Continuous quality improvement through PDCA cycle can effec-tively improve hand hygiene compliance rate of HCWs.

Objective To describe the distribution and spatial clustering of active pulmonary tuberculosis patients in Funing county of Jiangsu Province,China,and to determine the rules of recent transmission in TB patients and help establish the strategy of TB control with the results of genetic typing of Mycobacterium tuberculosis (M.TB).Methods Newly reported and retreated tuberculosis patients registered in Funing county,Jiangsu Province between Jun 1,2009 and Nov 30,2010 were recruited as research subjects.Geographic information system was applied to analysis the spatial clustering of tuberculosis patients.The M.TB isolates were genotyped by mycobacterial interspersed repetitive units (MIRU).Cluster was defined as two or more patients' M.TB isolates harboring identical MIRU genotype.Results During the study period,there were a total of 681 active pulmonary tuberculosis patients reported.Global Moran's I value and local Moran's I value indicated a random and sporadical manner instead of global spatial clustering of tuberculosis patients in Funing county.Spatial scan statistics (SaTScan) showed that the patients in Guoshu town was statistically significant in spatial clustering (RR=1.85,P=0.036).Among 169 strains of M.TB,27 strains distributed in 12 clusters,which indicated recent transmission among patients within the cluster.Conclusions In rural areas with high tuberculosis incidence,it is less likely to have massive tuberculosis outbreak.Sporadic transmission of tuberculosis may have played an important role in the transmission of tuberculosis in high prevalence area.