ObjectiveTo investigate the effects of combination of dexmedetomidine and sufentanil preconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts.MethodsForty male SD rats weighing 180-220 g, aged 8-10 weeks, were anesthetized with intraperitoneal 3％pentobarbital 60 mg/kg and heparin 3000 U/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 5 groups ( n =8 each):control group (group C),I/R group,dexmedetomidine preconditioning group (group DP),sufentanil preconditioning group (group SP),and dexmedetomidine + sufentanil preconditioning group (group DS).I/R injury was induced by 30 min of ischemia followed by 120 min of reperfusion.Groups DP,SP and DS received 30 min of perfusion with K-H solution containing dexmedetomidine 2.3 ng/ml,sufentanil 3.77 ng/ml and dexmedetomidine 2.3ng/ml + sufentanil 3.77 ng/ml respectively at 30 min before ischemia.Coronary flow (CF),left ventricular developed pressure (LVDP),± dp/dtmax and HR were measured at 15 min of equilibration,immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion.The superoxide didmutase (SOD) and myeloperoxidase (MPO) activities and the malondialdehyde (MDA) content in myocardial tissues and infarct size were determined at 120 min of reperfusion.Results Compared with group C,CF,LVDP, ± dp/dtmax,HR and SOD activity were significantly decreased,and MPO activity,MDA concent and infarct size were significantly increased in the other 4 groups ( P ＜ 0.05).Compared with group I/R,CF was significantly decreased in groups DP and DS,HR was significantly decreased in groups SP and DS,and LVDP, ± dp/dtmax and SOD activity were significantly increased,and MPO activity,MDA content and infarct size were significantly decreased in groups DP,SP and DS ( P ＜0.05).Compared with group DS,CF was significantly decreased and HR increased in group DP,and SOD activity was significantly decreased,CF,MPO activity,MDA content and infarct size were significantly increased in group SP (P ＜ 0.05 ),and no significant change was found in SOD and MPO activities,MDA content and infarct size in group DP ( P ＞ 0.05).Conclusion Dexmedetomidine combined with sufentanil preconditioning can reduce I/R injury in isolated rat hearts,but the myocardial protection is not further enhanced.

Objective To understand the epidemiological characteristics of HIV infection in voluntary blood donors in Liuzhou city to provide the basis for the blood donation recruit launched by the blood collection and tranfusion service agencies and reduce the risk of transfusion transmitted HIV.Methods The epidemiological investigation on the voluntary unpaid blood donors infected with HIV during 2008-2012 was performed for analyzing the infection characteristics.Results HIV infection in blood donors in Liuzhou city had no statistical difference between different years (P >0.05);the differences in different sexes,age groups,married and unmarried persons had statistically significant differences (P <0.01 );the education background less than middle school ac-counted for 52.94%;56.21% of the infectors were the sexual transmission.Conclusion HIV infection in voluntary unpaid blood donors in Liuzhou city is dominated by young adult men and the persons with the education level less than junior high school,and the heterosexual transmission is predominant.The donor recruitment work should pertinently exclude the persons of high-risk be-havior and collect blood in low risk population as far as possible.

Objective To investigate the clinical and pathological features of primary hepaticepithelioid hemangio endothelioma (EHE) and try to improve the understanding and diagnosis of this disease.Methods From January 2007 to January 2013,the data of 17 patients with hepatic EHE were retrospectively analyzed,which included clinical,pathological and radiological characteristics,treatment and survival condition of these patients.Results Among 17 cases of hepatic EHE,there were 11 female and six male with the mean age of 46.2 years.Seven patients had right upper quadrant pain of dull pain in liver and the left 10 cases were without any symptoms.The liver function of most patients (15 cases) was normal.The admission diagnosis was mostly misdiagnosed as hepatocellular carcinoma (metastatic liver carcinoma six cases,primary liver carcinoma four cases).Extrahepatic metastasis was found in three patients before operation.The major lesion of the tumor was multiple nodules (10 cases) and most of which were under liver capsule.Retraction of the liver capsule was found in the imaging examination.The features of pathology were intracellular lumen and vacuoles formed in small cells,in which single or couple red blood cells could be found.Nuclear deviation was found in single tumor cell which looked like signet ring cells.The results of immunohistochemistry indicated the positive rate of factor vimentin (4/5) antigen and CD34 (15/17) was high.Surgical resection (14 cases) was the main treatment of hepatic EHE.Fourteen patients were still alive followed up for two to 72 months after operation.Conclusions The incidence of hepatic EHE is low,and it was susceptible to middle aged women and without obvious symptom.No obvious abnormality is found in laboratory examination.Surgical resection is the main treatment which enabled a good prognosis.

Aim To evaluate the effects of gavage with lactococcus lactis(L.Lactis) recombinant heme oxyge-nase-1(HO-1) gene on alleviation of intestinal inflammation and protection of the intestinal mucosa in rats with endotoxemia.Methods A model of rats with endotoxemia was produced in 24 healthy SD male rats.The rats were randomly divided into the L.Lactis recombinant HO-1(LL-HO-1)gene group(HO-1 group,n=8),L.Lactis group(LL group,n=8) and glutamine group(Glu group,n=8).The rats received 1 ml(5?1010 CFU?ml-1)?d-1LL-HO-1,1 ml(5?1010 CFU?ml-1)?d-1 L.Lactis or 1 g?kg-1?d-1 glutamine for four days before LPS intraperitoneal injecion.Twenty hours after LPS injection,the full-thickness distal ileum was harvested.The mortality,myeloperoxidase(MPO) activity,the pathological changes,the contents of HO-1,tumor necrosis factor-?(TNF-?) and interleukin-10(IL-10) in the intestine were determined.Results When the results of HO-1 group was compared with those of LL group,the survival rate was significantly elevated in the former(P

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication.

Objective To investigate the effects of electroacupuncture (EA) pretreatment on the expression of phosphorylated signal transducer and activator of transcription 3 (pSTAT3) in cortical neurons in a rat model of focal cerebral ischemia/reperfusion (I/R) injury.Methods Forty-five adult male Sprague-Dawley rats,weighing 280-320 g,were randomly divided into 3 groups (n =15 each):sham operation group,I/R group and EA pretreatment group.Focal cerebral ischemia was induced by middle cerebral artery occlusion for 120 min,followed by 24 h of reperfusion.EA of Baihui acupoint lasting 30 min was performed and then the model of focal cerebral I/R was established 24 h later in EA group.Neurological function was assessed and scored at 24 h of reperfusion.The rats were then sacrificed and brains removed for detection of the cerebral infarct volume and expression of pSTAT3 (Ser727) in cortical neurons in ischemic penumbra by immunofluorescence and Western blot.Results Compared with sham operation group,the neurological function score was decreased,the infarct volume was increased,and the expression of pSTAT3 (Ser727) was up-regulated in groups I/R and EA (P ＜ 0.05).Compared with I/R group,neurological function score was increased,the infarct volume was decreased,and the expression of pSTAT3 (Ser727) was up-regulated in group EA (P ＜ 0.05).Conclusion EA pretreatment reduces focal cerebral I/R injury through up-regulating pSTAT3 expression in cortical neurons in rats.

Objective To explore the effect of workshop on postoperative function of affected limb in patients with breast cancer. Meth-ods From August, 2015 to June, 2016, 70 patients with breast cancer after modified radical mastectomy were randomly divided into control group (n=35) and observation group (n=35). The control group was instructed by the primary nurse bedside based on the traditional method, while the observation group was guided with workshop mode. Results Ten days and one month after surgery, the range of motion of the shoulder joint in the observation group was superior to the control group (t>2.030, P<0.01);the incidence of lymphedema of the affected limb in the observation group was lower than that in the control group (u=2.195, P<0.05). Conclusion Functional exercise guided with work-shop mode could improve postoperative function of affected limb in patients with breast cancer.

Objective:To understand the current situation of nursing practice environment and clinical innovation ability of pediatric nurses and to explore the effect of nursing practice environment on clinical innovation ability of clinical pediatric nurses.Methods:A cross-sectional survey method was adopted to select 478 pediatric nurses from the Children's Hospital of Nanjing Medical University as the research objects from May to June 2019 by the convenient sampling method. The general data questionnaire, profession practice environment-nursing work index (PES-NWI) and innovation ability of clinical pediatric nurse scale were used to analyze the effect of nursing practice environment on clinical innovation ability of clinical pediatric nurses.Results:The total score of PES-NWI of pediatric nurses was (90.73±13.02) , and the total score of innovation ability of clinical pediatric nurse scale was (120.79±10.84) . There was a positive correlation between the nursing practice environment and the innovation ability score of pediatric nurses ( P<0.05) . The results of stratified regression analysis showed that nurses' participation in hospital affairs and provision of high-quality nursing services in the nursing practice environment of pediatric nurses had a predictive effect on the innovation ability of pediatric nurses ( P<0.05) . Conclusions:The innovation ability of pediatric nurses is at a medium level, and the nursing practice environment has a predictive effect on innovation ability. Nursing managers should pay attention to the improvement of nursing practice environment and take effective measures to improve their innovative ability.

Objective:To investigate the effectivensess of intraoperative S-ketamine infusion in alleviating postoperative sleep disorders of patients during open reduction and internal fixation for traumatic long bone fractures.Methods:A prospective randomized controlled study was conducted to analyze the clinical data of 84 patients with traumatic long bone fracture admitted to General Hospital of Southern Theatre Command of PLA from October 2022 to April 2023. The patients undergone selective open reduction and internal fixation were divided into S-ketamine group and saline group according to the random number table. Pittsburgh sleep quality index (PSQI) scores and hospital anxiety and depression scale (HADS) scores were compared between the two groups before surgery, at 24, 48, and 72 hours after surgery. Visual analogue scale (VAS) scores were compared between the two groups before, at 3, 6, 12, 24, 48, and 72 hours after surgery. The number of times the patients pressed the pump of patient-controlled intravenous analgesia postoperatively and adverse reactions such as nausea, vomiting, hallucinations or nightmares were recorded.Results:A total of 60 male and 24 female patients with traumatic long bone fracture were included, aged 18-65 years [36.5(25.5, 54.8)years]. The S-ketamine group ( n=42) received intravenous infusion of S-ketamine at a rate of 0.5 mg·kg -1·h -1 until the end of surgery, while the saline group ( n=42) received intravenous infusion of saline of the same volume until the end of surgery. All the patients were followed up for 4-9 days [6.0(5.0, 7.0)days]. No significant differences in PSQI scores were found between the two groups before surgery ( P>0.05), while PSQI scores at 24, 48, and 72 hours after surgery were 7.5(7.0, 9.0)points, 4.0(3.0, 5.3)points, and 1.0(1.0, 2.0)points respectively in the S-ketamine group, significantly lower than those in the saline group [10.0(8.0, 12.0)points, 7.0(5.0, 8.0)points, and 2.0 (1.0, 3.0)points] ( P<0.05 or 0.01). There were no significant differences in HADS scores between the two groups before surgery and at 48 and 72 hours after surgery ( P>0.05), while HADS score at 24 hours after surgery in the S-ketamine group was 2.0(0.0, 3.0)points, significantly lower than that in the saline group [3.0(2.0, 5.0)points] ( P<0.01). There were no significant differences in VAS scores between the two groups before, at 6, 12, and 72 hours after surgery ( P>0.05), while the VAS scores at 3, 24, and 48 hours after surgery in the S-ketamine group were 3.0(2.0, 4.0)points, 2.3(2.0, 3.0)points, and 2.0(1.0, 3.0)points respectively, significantly lower than those in the saline group [4.0(2.8, 5.0)points, 3.0(2.5, 4.0)points, and 3.0(2.0, 3.7)points] ( P<0.05). There were no significant differences in the number of times the patients pressed the pump of patient-controlled intravenous analgesia postoperatively and the incidence of nausea and vomiting between the two groups ( P>0.05). In the S-ketamine group, transient hallucination upon awakening was found in 2 patients and intraoperative nightmare in 1, who showed no abnormalities after returning to the ward. Conclusion:Intraoperative S-ketamine infusion can significantly alleviate postoperative sleep disorders of patients during open reduction and internal fixation for traumatic long bone fractures, with simultaneous alleviation of anxiety, depression as well as pain.

Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P ＞ 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.