Objective To investigate the effect of comparison-type computer-assisted teaching system in the teaching of emergency nursing.Methods 130 students participated in emergency nursing training in emergency department in 2010 were chosen as the control group,another 130 students in 2011 were chosen as the experimental group.The control group used traditional teaching mode,while the experimental group was given comparison-type computer-assisted teaching system mode.The test results and the satisfaction degree of teachers were compared.Results The test results of the control group was(86.70 ±7.63),lower than (90.09 ± 7.78)of the experimental group.The satisfaction degree of teachers was higher in the experimental group than that in the control group.The evaluation to comparison-type computer-assisted teaching system was good.Conclusions The application of comparison-type computer-assisted teaching system can improve the teaching mode,reduce the workload of teachers,increase the interest of autonomous learning for students and enable them to master first aid skills accurately,it has a certain value in application.

OBJECTIVE:To investigate the use and trend of lipid modifying agents in 83 Shanghai hospitals during the period 2004～2006.METHODS:Lipid modifying agents used in 83 Shanghai hospitals were analyzed statistically in respect of the kinds,consumption sum and DDDs etc.RESULTS:During the period 2004～2006,the use of lipid modifying agents increased year by year,with mean annual incremental rate of 15.40% in consumption sum and 15.37% in DDDs,but the average daily costs had no significant change.Leading the list in terms of consumption quantity were simvastatin,pravastatin and fenofibrate.CONCLUSION:The development trend of lipid modifying agents is promising.

Objective We aimed to assess effectiveness of Risk Score Scale (RSS) for aortic Dissection (AD) in early triage stage.Methods A total of 251 patients with acute chest or back pain complaints were allocated by triage nurses according to the pre-established RSS from 2011 to 2013.87 cases were assessed to have 5 points or more,and 80 cases were assessed to have 6 points or more from 95 patients diagnosed as aortic dissection (the diagnosed group) by CT angiography and magnetic resonance imaging while excluded 156 cases of control after discharge (control group).The general conditions,distribution of aortic dissection risk factors,aortic dissection risk score,sensitivity and specificity of RSS between two groups were compared.The misdiagnosis rate,missed diagnosis rate,RSS triage sensitivity and specificity and OR value were compared between RSS ≥5 points and RSS ≥6 points.Results There was significant differences in abrupt onset of severe pain intensity,ripping or tearing pain,pulse deficit or systolic blood pressure differential between extremities [upper extremity≥20 mmHg (1 mmHg=0.133 kPa) or lower extremity≥ 10 mmHg],x2 value was 62.6,94.2 and 20.2.RSS≥5 points had high sensitivity and specificity,lower missed diagnosis rate and high OR value for triage application.Conclusion RSS≥5 points could serve as a reliable evidence for early triage of aortic dissection.

Objective To summarize the nursing key points in nursing ovarian cancer patients with early postoperative inflammatory intestinal obstruction after non-surgical treatment value. Method The nursing data of 32 ovarian cancer patients with early postoperative inflammatory intestinal obstruction in our department in January 2010 to October 2016 were retrospectively analyzed. Results About 32 patients were treated with non-surgical treatment, cure time within 2~30d, averaged (7.80 ±5.98)d. No intestinal obstruction happened after resuming to normal exhaustion, defecation and dieting. Conclusion Such nursing measures as psychological nursing, gastrointestinal decompression nursing, nutrition support nursing and auxiliary therapy like promoting peristalsis recovery are key to the increase of cure rate of early postoperative inflammatory intestinal obstruction.

Objective:To find out the current situation of and objectively evaluate the use of the antidiabetic agents so as to provide reference information to the departments of production, sales and consumption of the agents. 　Methods:A analytic review of 6,639 020 prescriptions during the period of 1995～1999 was made regarding the costs and DDDs.　Results: In recent 5 years, the annual increase rate of the expenses for was(36.03±11.92)%; and that of DDDs was 20.05%. The order of expenses for various antidiabetic agents from high to low was as follows: glicalazide, acarbose, glipizide and metformin, while that of DDDs was glicalazide, glipizide, metformin and acarbose. The percentage of expenditure for oral versus the injection antidiabetic agents was(87.08±3.50)% to(12.92±3.50)%. 　Conclusion: The antidiabetic agents is a kind of common drugs with a bright future of development.

OBJECTIVE:To evaluate the economic effectiveness in different pharmacotherapeutic schemes for Hp infection in children.METHODS:To analyze four therapeutic schemes for Hp infection in children with cost - effectiveness analysis.RESULTS: The cost- effectiveness ratios of four therapeutic schemes were 14.92,8.85,8.37 and 8.58 respectively. CONCLUSIONS: scheme C(clarithromycin + bismuth potassium citrate + metronidazole)is the best one.

Objective To study the clinical significances of serum lipoprotein (LP),high sensitivity C- reactive protein (hs CRP),cystatin (Cys-C),apolipoprotein (Apo) in type 2 diabetic mellitus (T2DM) patients with early renal impairment.Methods Totally 96 patients were divided into two groups:50 cases in simple diabetic group (DM) aged 60-73 years,46 cases in diabetic nephropathy group (DN) aged 61-72 years,and 50 healthy persons as normal control group aged 61-68 years.Serum levels of LP(a),hs-CRP,Cys-C,ApoA1 and ApoB were detected.Results Serum levels of LP (a) [(214.8±182.3) mg/L vs.(113.1±76.2) mg/L],Cys-C[(0.95±0.16)mg/L vs.(0.46±0.17) mg/L],hs-CRP (2.57± 1.84) mg/L vs.(1.07±0.38)mg/L] and ApoB [(1.12±0.18) g/L vs.(0.81 ±0.15) g/L ]were higher in T2DM patients than in normal control group(all P＜0.01),while ApoA1 level was lower than in control[(1.02±0.17)g/L vs.(1.27±0.14)g/L,P＜ 0.01].The levels of LP (a) (455.6 ± 263.5 ) mg/L,Cys-C (2.14 ± 0.68 ) mg/L,hs-CRP (7.24±4.55)mg/L and ApoB(1.22±0.17)g/L in DN group were increased compared with DM group (all P＜0.01).Serum levels of ApoA1 were decreased in DN group compared with DM group [(0.88±0.17) g/L vs.(1.02±0.17) g/L,P＜0.01].The serum levels of LP (a) (r=0.487,P＜0.05),Cys-C(r=0.55,P＜0.05),hs-CRP(r=0.478,P＜0.01) and ApoB(r=0.505,P＜0.05) were positively correlated with urinary mAlb in T2DM patients,while ApoA1 was negtively related with mAIb(r=-0.52,P＜0.05).Conclusions The serum LP (a),Cys C,Apo and hsCRP could be sensitive markers of early renal impairment,and their combinatorial measurement offers more value in patients with T2DM.

Objective To evaluate the feasibility and safety of laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion.Methods In performing this procedure,first dissect the right hepatic portal,and under selective hemihepatic inflow occlusion,laparoscopie Peng's multifunctional operative dissector (LPMOD) was used to transect the hepatic parenchyma by stepwise curettage and aspiration.Results Procedures were successful in all six patients of benign liver diseases,though a small subcostal auxiliary incision was needed in one case to control the middle hepatic vein branch hemorrhage.Operation time was 300-540 min[mean,( 399 ± 75 ) min].The time of hepatic portal dissect was 30-75 min[mean,(51 ± 16) min].The time of liver parenchyma transection was 60-160 min[mean,( 116 ± 32) min].Intraoperative blood loss was 600-3000 ml[mean,( 1486 ± 809 ) ml].The level of ALT increased to (302-557) U/L[mean,(386 ± 85 ) U/L]after the operation,and back to normal level in 5-11 d[mean,( 7.1 ± 2.0) d].The postoperative hospital stay was 10-18 d[mean,( 12.4 ± 2.6 ) d].No severe complication occurred after the operation.Conclusions Laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion is safe and feasible.

Objective To investigate the changes and clinical significance of platelet parameters and the hemorheological parameters in patients with diabetic kidney disease(DKD). Methods One hundred and eight patients with diabetics were divided into simplicity diabetes mellitus ( SDM ) group with 41 cases, early diabetic nephropathy( EDN) group with 36 cases and clinical diabetic nephropathy( CDN) group with 31 cases according to 24 hours urine albumin excretion rate( UAER) ,and 26 healthy persons were included into this study as control group. The platelet parameters(including mean platelet volume(MPV),platelet volume distribution width(PDW),platelet volume(PCT),and PLT) and hemorrheology were measured in all groups. Results Levels of MPV,PDW,PCT and PLT in diabetics group were (9.80±1.14) fl,(18.00±0.99) fl,(0.21 ±0. 05)% and (186±47)×109/L respectively,in control group were(7. 70±1. 11) fl,(13. 90±1. 02) fl,(0. 16 ±0.05)% and (234±51)×109/L respectively,the differences were significant(P=0.043,0.039,0.040, 0. 035). Levels of MPV,PDW,PCT and PLT in SDM group were (8. 40±1. 07) fl,(16. 40±0. 79) fl,(0. 19 ±0. 04)% and (195±49)×109/L respectively,in EDN group were (10. 20±1. 23) fl,(18. 30±1. 02) fl,(0. 20 ±0. 06) % and (188±52)×109/L respectively,in CDN group were (11. 40±1. 14) fl,(19. 60±1. 21) fl,(0. 25 ±0. 05)% and (172±40)×109/L respectively,the differences were significant between the groups( P=0. 032,
0. 039,0. 041,0. 008). The levels of erythrocyte aggregation index,capillary plasma viscosity,low/medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index in diabetics group were 1. 86±0. 13,1. 40±0. 14,(13. 83±1. 62) mPa·s,(7. 79±0. 84) mPa·s,(6. 46±0. 77) mPa·s,7. 54±1. 03,4. 73±0. 74,4. 16±0. 69 and 0. 55±0. 03 respectively,in control group were 1. 38±0. 05,1. 21±0. 08,(9. 35±1. 22) mPa·s,(5. 88±0. 87) mPa·s,(5. 02±0. 86) mPa·s, 4. 00 ±0. 75,3. 12±0. 65,2. 76±0. 56 and 0. 68±0. 06 respectively,the differences were significant between the two groups( P=0. 034,0. 020,0. 018,0. 044,0. 016,0. 014) . Furthermore,the results of erythrocyte aggregation index, capillary plasma viscosity, low /medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index were significantly different in sub group of diabetes( P=0. 004,0. 002,0. 001,0. 004,0. 003,0. 041,0. 025,0. 009,0. 042) . Conclusion It is important to measure the platelet parameters and hemorrheology in diabetes kidney disease patients. The platelet parameters and hemorrheology may be the early indicators to diagnosis the diabetic nephropathy.

Objective To explore the influence of various concentrations of amino acid on the stability of neonatal parenteral nutrition solutions .Methods Five formulations were designed with 5 different amino acid concentrations containing the same components .The final amino acid concentrations of admixtures were 0%, 1%, 2%, 3%, and 3.5%, respectively .The appearance , pH, and osmolality were observed or meas-ured after preparation (0 hour) and at 12, 24, 48 and 72 hours after preparation.The average size and the size distribution of the lipid globules were also evaluated by laser nanometer particle size analyzer .Results There was no observable alteration in color , phase separation , precipitate , and flocculation in any admixture at any of the observation time points.The mean pH values for all groups were between (5.49 ±0.01) to (6.19 ±0.01) within 72 hours.The mean osmolalities for all groups were between (774 ±3) to (1106 ±13) mOsm/kg.The mean diameters of lipid globules for all groups were between (280.6 ±0.7 ) mm to (332.2 ±2.0 ) nm.The mean polydispersity for all groups were between (0.200 ±0.011) to (0.245 ±0.012).The enrichment of ami-no acid concentration was linked to lower pH ( P=0.000 ) , higher osmolality ( P=0.000 ) and larger average lipid globules size ( P=0.000 ) .However , there was no distinct linear dependence between amino acid concen -tration and polydispersity value ( P=0.628 ) .Conclusion After 72 hours of storage at room temperature , the appearance, pH, osmolality, and the average lipid globules diameter of the parenteral nutrition solutions are within the safe range when the amino acid is not contained or the concentrations are no more than 3.5%.