By using the procedures of the routinization of risk assessment - implementation - evaluation of result-modification to the risk management and carring out the feasibility exploretion on the application and effect of the ward nursing management, so that care defects, nursing errors and the number of cases of occurrence of accidents has significantly reduced, the patients satisfactory degree has rised from 92.5% to 98.5%, improved the quality of care and ensured the safety of patients, fully enhanced the quality of nursing services.

Objective To evaluate the effects of different concentrations of dexmedetomidine on large-con-ductance Ca2+-activated K+ (BKca) channels in the rat mesenteric arterial smooth muscle (MASM) cells.Methods Sprague-Dawley rats of both sexes,weighing 180-220 g,were used in this study.Single MASM cell was freshly isolated from mesenteric arteries in two steps.Ten cells were chosen and studied.When holding potential was 40 mV and the concentration of free calcium ions was 10-7 mol/L,inside-out patch-clamp technique was used to record the single BKCa channel current before and after application of different concentrations of dexmedetomidine (0,10-9,10-8,10-7,10-6,10-5 mol/L).Total open probability (NPo),amplitude (Am),mean open time (To) and mean close time (To) of single BKca channel were observed and recorded.Results Compared with the baseline value,dexmedetomidine 10-7,10-6 and 10-5 mol/L increased NPo in a concentration-dependent man-ner,and dexmedetomidine 10-9,10-8,10-7,10-6,10-5mol/L shortened Tc (P ＜0.05 or 0.01).Compared with the value obtained when the concentration of dexmedetomidine was 10-9 mol/L,Tc was significantly shortened when the concentration of dexmedetomidine was 10-8 mol/L (P ＜ 0.05),and no significant change was found in Am and To obtained when different concentrations of dexmedetomidine were applied (P ＞ 0.05).Conclusion Dexmedetomidine 10-7,10-6 and 10-5 mol/L activate BKca channels in rat MASM cells in a concentration-depen-dent manner,which is one of the mechanisms of decrease in blood pressure by dexmedetomidine.

Objective To investigate the imaging manifestations and clinical features of hepatic and renal angiomyolipoma. Meth-ods The clinical data and imaging findings of hepatic and renal angiomyolipoma in a 51-year-old woman was retrospectively ana-lyzed with literature review. Results CT scan showed a large polymorphous hypodense mass in the right lobe of liver. After contrast -enhanced CT scan, the mass was enhanced gradually from periphery to ceritre. Bilateral kidneys obviously enlarged and appeared as alveolate appearance mixed density with spotty and stripped fat structures. At contrast-enhanced scan, the normal structures of cor-tex and medulla were disappeared, the alveolate walls were enhanced obviously. The arteries and veins of bilateral kidneys were com-pressed and displaced. Conclusion The imaging features of liver and kidney are of certain characteristic compared with other benign and malignant masses,but the final diagnosis of it is still depending on pathology mostly.

Objective To explore therapeutic effects of combinative artificial kidney treatment on renal osteopathy.Methods HD + HP Group composed by 30 urinaemia was treated with hemodialysis and hemoperfusion,and the HD Group was treated only with hemodialysis.Clinical symptoms and lab indicators including osteodynia,itch of skin,blood pressure,appetite,sleep,as well as BUN,SCr,Hb,BPC,Ca,P and iPTH,were compared between the two groups.Results Osteodynia decreased by 67.7% (21/31),and itch of skin by 71.0% (22/31)in HD group.Osteodynia decreased by 96.7% (29/30) ,and itch of skin by 96.7% (29/30) in HD + HP group (P ＜0.01 ).iPTH were (65.5 ± 34.4) pmol/L before treatment and (57.1 ± 21.4) pmol/L after treatment in HD group,and (73.5 ± 44.4)pmol/L and (19.1 ± 17.4)pmol/L in HD + HP group.HD Group eliminated less iPTH (P ＞0.05).HD + HP Group removed more serum poison molecules than HD Group ( P ＜ 0.05 ).Conclusions For patients in maintenance-dialysis stage but with higher iPTH,hemodialysis combined with hemoperfusion removes more poison molecules,consequently decreases incidence of renal osteopathy.

Objective To improve recognition and diagnosis of primary non-obstructive megaureter.Methods The authors analyzed the X-ray findings of intravenous urography and B-ultrasonographic manifestations of 28 cases with primary non-obstructive megaureter proved by varied examinations and operations.Results The X-ray and B-ultrasonographic manifestations as follows:in the terminal ureter,there was a short segment,less than 3 cm in length,with normal caliber but adynamic to micturition and the ureter proximal to the adynamic segment was secondarily dilated remarkably.The terminal end of the dilated ureter appeared as drumstick shaped,spindle-shaped,snakehead shaped or rattail shaped.On right time fluoroscopy and B-ultrasonographic observation,a decrease of peristalsis frequency,increase of peristalsis range,interrupted downward convey of peristalsis wave could be noted.Conclusion The contrast urography is the main method,B-ultrasonography and cyctocopy are helpful for the diagnosis of primary non-obstructive megaureter.

Objective To study the clinical and X-ray manifestations of primary non-Hodgkin's lymphoma(PNHL)of bone so that to suppy the valuable informations for clinical diagnosis and treatment of this disease.Methods 14 cases with PNHL of bone confirmed by clinic and pathology were analyzed retrospectively.There were 9 male and 5 femal,age ranged from 20 to 60 years with average of 35 years,and average history of disease was 11 months in all cases.Results Of all cases single bone involved in 11 cases,multiple bone involved in 3 cases,most of them the flat bone and the distal end of long bone were involved.The appearances of the lesion on X-ray were bony destruction with slight sclerosis at the margin of destructive area,there were periosteal reaction,soft tissue masses and destruction of joint manifestations,PNHL of bone can be classified as four typers:osteolytic(n=8),sclerotic(n=2),mixed(n=3)and cystic(n=1)lesions by the form and feature of bone destruction.Conclusion PNHL of bone has characteristic X-ray manifestations comparatively.The correct diagnostic rate can be improved if we concern about clinical data.

Objective To evaluate the clinical diagnostic value of magnetic resonance cholangiopancreatography ( MRCP ).Methods MPCP data of 42 cases with pancreatic and bile duct lesion proved by operation and pathology were analyzed retrospectively.MRCP was performed using single-shot-radio SE sequence (SSH/RAD). Of all cases included bile duct lithiasis in 19 , inflammation in 3,congenital cyst in 6 , carcinoma in 12,jaundice caused by diverticulitis of duodenum in 1 and Mirizzi syndrome in 1 .Results MRCP was succeeded at one time in all cases . On MRCP , the visual rate of intrinsic and extrinsic hepatic bile duct was 100% and that of common pancreas duct was 80.58%.The localized and qualitative diagnosis of lesions were up to 100%,88.2% respectively.Conclusion SSH/MRCP/RAD plays an important role in diagnosis of the pancreatic and bile duct lesion in clinical practice.

Objective To analyse the CT features of hepatic abscess in different stages of pathology so that to improve the accuracy of CT diagnosis.Methods The plain CT and triphase contrast-enhanced CT findings of hepatic abscesses in 50 cases proved by surgery or other clinical methods were retrospectively analysed and compared with CT findings of hepatic carcinoma,hepatic metastases and hepatic hemangiomas.Results CT features of hepatic abscesses were divided into three types according to different stages of pathology.Early pyogenic hepatic abscess(10 cases)had two types:small cavitation(9 cases)and mass(1 case).Typical pyogenic hepatic abscess(38 cases)and granulomatous hepatic abscess(2 cases).Conclusion CT findings of liver abscesses are different in different stage of pathologic changes,triphase contrast-enhanced CT is specific in diagnosing hepatic abscess.

Objective To investigate the recent curative effect and adverse reactions of radiotherapy combined with temozolomide in non-small cell lung cancer (NSCLC) patients with brain metastases.MethodsThe clinical date of 51 NSCLC patients with brain metastases were retrospective analyzed in Department of Radiation Oncology of Affiliated Hospital of Hebei University.Patients were divided into experimental group (n=26) and control group (n=25) according to the different treatment methods.The experimental group underwent whole brain and local tumor radiotherapy plus temozolomide.The control group only received whole brain and local tumor radiotherapy.The recent curative effect and adverse reactions of the two groups were analyzed.Results The Karnofsky performance status score of patients in the experimental group was obviously improved than that in the control group (76.2±6.4 vs.72.8±5.3), with a significant difference (t=2.06, P=0.04).The total effective rate in the experimental group was higher than that in the control group (80.8% vs.64.0%), but there was no statistically significant difference (χ2=1.80, P=0.18).Compared with the control group, the incidences of nausea and vomiting (80.8% vs.28.0%) and bone marrow suppression (84.6% vs.24.0%) in the experimental group were significantly higher, with significant differences (χ2=14.33, P=0.00;χ2=18.91, P=0.00).There were similar incidences of headache (69.2% vs.60.1%), liver and kidney damage (73.1% vs.64.0%) in the two groups, with no significant differences (χ2=0.47, P=0.49;χ2=0.47, P=0.49).Conclusion Radiotherapy combined with temozolomide can improve the quality of life in NSCLC patients with brain metastases, which has controllable and tolerable adverse reactions.

Objective To investigate the effect of hydromorphone postconditioning on ischemiareperfusion (I/R) injury in isolated rat hearts and the role of mitochondial permeability transition pore (mPTP).Methods Male Sprague-Dawley rats, aged 2-3 months, weighing 250-320 g, were used in the study.The rats were heparinized and anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The hearts were excised, and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each)using a random number table: control group (group C), group I/R, hydromorphone postconditioning group (group H), and hydromorphone postconditioning + mPTP opener lonidamine group (group HL).Group C was continuously perfused with K-H solution for 120 min.Group I/R was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group I/R was perfused with K-H solution for another 30 min.Group H was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group H was perfused with K-H solution containing 0.3 μmol/L hydromorphone for 10 min, and then with K-H solution for 50 min.Group HL was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group HL was perfused with K-H solution containing 0.3 μmol/L hydromorphone and 30 μmol/L lonidamine for 10 min, and then with K-H solution for 50 min.At 30 min of equilibration (T0), and 30 and 60 min of reperfusion (T2,3), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP) , ±dp/dtmax, heart rate (HR), and coronary flow (CF) were measured.The concentrations of lactic dehydrogenase (LDH), creatine kinase-MB (CK-MB) , and troponin-T (Tn-T) in the coronary effluent were determined at T0 and T3.The coronary effluent was collected at T0 and 15 min of reperfusion (T1),nicotinamide-adenine dinucleotide (NAD+) concentrations were measured using enzyme-linked immunosorbent assay to reflect the degree of mPTP opening.The myocardial infarct size was determined at T3 by TTC staining.Results Compared with group C, LVDP, HR, ±dp/dtmax and CF were significantly decreased, and LVEDP was increased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were increased in group I/R (P＜0.05).Compared with I/R and HL groups, LVDP, ±dp/dt CF and HR were significantly increased, and LVEDP was decreased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were decreased in group H (P＜0.05).Conclusion Hydromorphone postconditioning can reduce myocardial I/R injury in isolated rat hearts, and the mechanism is related to inhibition of mPTP opening.