Objective To observe the preventing effect of optimal programs (improving turn over postures and elongating the turn over intervals)in preventing pressure sore occurrence in patients with acute stroke. Methods Acute stage stroke patients (time from on-set less than or equal to one week)were selected and divided randomly into 4 groups, one group adopted 2.0 hours turn over intervals as the routine group, others adopted 2.5 hours, 3.0 hours, 3.5 hours turn over intervals as the study groups. The incidence of pressure sores and complications were recorded. Results None of the groups (2.0 h, 2.5 h,3.0 h, 3.5 h)suffered from pressure sores. The incidence of complications including malnutrition, pulmonary infections and constipations was not increased in the study groups either. Conclusions Optimal turn over nursing programs including elongating turn over intervals to 2.5h, 3.0h, 3.5h and adopting 30 degree lateral posture can effectively prevent occurrence of pressure sores in acute stroke patients.

Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,

Objective To investigate the feasibility of using problem-based learning in nursing clinical teaching in the obstetrics and gynecology department.Methods Sixty-six nursing students were randomly divided into PBL group and lecture-based learning(LBL)group .At the end of their internship,the two groups were compared in terms of examination performance,learning attitude and aptitude,and their feedback on the two learning modes.Results The students in the PBL group were significantly better than those in the control group in terms of examination performance,learning attitude and aptitude,and their feedback on the learning mode(P<0.001).Conclusions PBL may be effective in the improvement of their attitude to learning and aptitude,the comprehensive ability.It can provide an environment to promote internal learning motivation for students.

Objective To investigate the clinical effect and safety of tigecycline on in patients with complicated intra-abdominal infections. Methods 52 cases of patients with complicated intra-abdominal infection were selected and randomly divided into 2 groups.26 cases in the control group were given routine anti-infection treatment, and 26 cases in the treatment group were treated with conventional anti-infection combined with tigecycline.The CD molecules and NK cell level, serum lactate and procalcitonin levels, and the clinical efficacy and safety were compared after the treatment between two groups.Results The effective rate of control group ( 69.23%) was lower than the treatment group ( 92.31%) with statistical significance (P<0.05), the levels of CD3 +, CD4 +/CD8 +, CD4 +and NK cells of the treatment group after treatment were higher than the control group, the level of CD8 +was lower than the control group after treatment, procalcitonin and serum lactate levels were lower than the control group, with statistical significance ( P<0.05 ) , there was no difference in adverse reactions between the two groups.Conclusion Tigecycline could improve the therapeutic effect of complicated intra-abdominal infections, reduce the lactate and procalcitonin levels with high safety.

Objective To observe hemodynamic changes in patients with primary hypertension with wave intensity (WI). Methods Carotid arteries of 36 patients with primary hypertension and 30 age-matched normal controls were examined with imaging technique of WI. The following parameters were measured: the first wave peak in early ejection (W1), the second wave peak in late ejection (W2), the negative area during the mid-ejection (NA), the interval between the R wave of the ECG and the first peak of W1 (R-1st), the interval between the first peak and the second peak (1~(st)-2~(nd)), the ratio of R-1st and a cardiac cycle time R-1_(HR)~(st)) and the ratio of 1~(st)-2~(nd) , as well as one cardiac cycle time (1~(st)-2(_(HR)~(nd)). Results ①W1 in primary hypertension group increased compared with those of normal controls (P＜0.01), while no significant difference of W2, NA, R-1st, 1~(st)-2~(nd), R-1_(HR)~(st), 1~(st)-2_(nd)~(HR) was detected (P＞0.05). ②Both W1 and W2 correlated positively with pulse pressure (PP) and systolic blood pressure (SBP) (r=0.66, 0.55, P＜0.01;r=0.62, 0.44, P＜0.01). W1, W2 and age, DBP were not related significantly (P＞0.05). Conclusion The hemodynamic parameters of WI technology provide a new way to evaluate the dynamics of the heart and vascular system and their interaction.

lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

Objective:To establish a method for the determination of 11 trace elements in white vaselin. Methods:The contents of Mg,Al,Fe,Co,Ni,Cu,Zn,As,Cd,Hg and Pb in white vaselin were determined by inductively coupled plasma mass spectrome-try (ICP-MS). The parameters of ICP-MS were as follows:the Argon gas pressure was 0.6 MPa,the helium pressure was 0.12 MPa, the scan times were 200,the flush time was 45 s,the sampling time was 45 s and the internal standard was added online. Results:The linear relationship between concentration and response value of each element standard solution was within the range of 0-100 ng· m L-1. Except the correlation coefficients of Mg and Fe were 0.998 and 0.997,that of the other elements was all above 0.999. The recoveries of Mg,Fe,Ni,Zn,As and Pb were 74.9%-83.0%,those of Cd and Hg were 87.5%-94.4%,and those of Al,Co and Cu were 107.6%-118.7%. The detection limit of Mg, Al, Fe, Co, Ni, Cu, Zn, As, Cd, Hg and Pb was 1.9,0.59,0.61,0.16, 0.33,1.5,1.7,0.09,0.12,0.70 and 1.6 ng·ml-1,respectively. Among the 67 samples,the contents of Mg,Al,Fe,Ni,Cu, Zn, As and Hg were all detected out,while those of Co,Cd and Pb were only detected out in some samples. Conclusion:The method has the advantages of simple operation and high sensitivity,which can satisfy the determination of trace elements. It is suggested to se-lect 4 elements (Mg,Al,Fe and Ni) as the evaluation indices for white vaselin.

Objective To develop norms for the rapid automatic naming and rapid alternating stimulus tests (RAN/RAS tests)on school children.Methods A multi－stage sampling procedure was used to select primary school students randomly from 8 schools in Nanjing,aged from 7 to 12 years old.The RAN/RAS tests included 6 classes of stimuli:objects,colors,numbers,simplified Chinese characters,numbers and simplified Chinese characters mixture,numbers and simplified Chinese characters and colors mixture. Results (1)A total of 1 048 students were randomly selected to participate in the study in 6 groups,with sex ratio of 1.001.04.(2)The scores of the boys and girls did not differ sig-nificantly by any of the methods(objects,colors,numbers,simplified Chinese characters,numbers and simplified Chinese characters mixture,numbers and simplified Chinese characters and colors mixture)(all P＞0.05).(3)On any of the measures in all groups,the scores decreased as the age increasing(P＜0.001).(4)Compared with the three－item scores (objects,colors,numbers)between Chinese and English,there were significant statistical differences among all age groups (all P＜0.001).(5)Time reliability correlation coefficient ranged from 0.84 to 0.92,and retest reliability correlation coefficient ranged from 0.98 to 0.99.The validity test showed that the correlation coefficient was statistically significant (P＜0.05).Conclusions The scores of RAN/RAS tests norms have nice reliability and validity and are in line with the law of development.The norms derived in this study are recommended as the norm RAN/RAS scores for Chinese children.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.