AIM To observe the synergical effects of ginsenoside of stem and leaf(GSL)in combination with choline on learning and memory of Alzheimers disease(AD). MEHODS AD animal models were made by damaging nucleus basalis of Meynert with quinolinic acid. One time training passive aviodance step-down and water-maze spatial localization task were used to observe the ability of learning and memory.RESULTS Treatment with combination of GSL(400 mg?kg -1 ?d -1 ,ig) and choline(200 mg?kg -1 ?d -1 ,ig) on AD rats decreased significantly the number of errors on step down (ig for 13 days) and the training times to reach the criterion on water maze (ig for 16 days). The effect of GSL in combination with choline was more remarkable than that of GSL or choline and proved no obvious difference compaired with that of 1,2,3,4-tetrahydroacridine (10 mg?kg -1 ?d -1 ,ig). Value Q was more than one after administrition of both GSL and choline. CONCLUSION GSL in combination with choline may synergically improve the impairement of learning and memory of AD.

Based on the hospital information systems and the hospital network,a software for patients with peripherally inserted central catheter (PICC) was developed and applied in clinical practice,which achieved the share of PICC information within the hospital,saved nursing time effectively,made the clinical data more standardized,systematical and objective.

Objective: To study the protective effect of compound extract of soybean, wolfberry and hawthorn on chemical liver injury in mice respectively. Methods:The mice were randomly divided into 5 groups:control(A), liver injury control(B)and 0.06(C)?0.20(D)?0.60(E) g/(kg?bw) compound extract group. The liver injury models were induced by CCl 4 and ethanol in mice respectively. After 4 weeks, for the former, the serum ALT and AST content were measured and the liver pathological change was observed. For the latter, the liver MDA, GSH, and TG content were measured and fat droplets staining in the ice pathological slice were observed . Results: 1.CCl 4 liver injury models:the content of serum ALT of group D and the AST of group D and E were decreased. Compared with normal group, the hepatic pathological changes of the compound extract group was mainly fatty and ballon degeneration, and that of the CCl 4 group was mainly hepatic cytoclasis. 2.Ethanol liver injury models: the content of liver MDA of group C, E and the TG of group C, D, E were all decreased, and the fatty degeneration scores of group C, D were lower, both compared with ethanol group. Conclusion: Compound extract of soybean, wolfberry and hawthorn has the protective effect on liver injuries induced by both CCl 4 and ethanol in mice.

Objective:To early identify and manage secondary malposition of peripherally inserted central catheter (PICC), and to reduce other PICC related complications.Methods:A total of 8 509 patients were included form January 2017 to December 2018 in intravenous therapy department in the Second Affiliated Hospital of Medical College of Zhejiang University. PICC was implanted and the original tip location was in the superior vena cava (SVC). The function and complications of the catheter were evaluated during the indwelling process. X-ray was taken for every abnormal patient to confirm the route and tip position of the catheter. Tip malposition were adjusted by external manipulation (pulling out part of the catheter, changing body position, external percussion, rapid flushing with 0.9% sodium chloride) when patients’ situation were allowed.Results:A total of 31 cases of PICC secondary malposition were early identified, 27 of them were treated with external manual reduction. Totally 19 cases succeeded, and 8 cases failed. The success rate was 70.4%. There was no other complication during the process. 3 cases were found venous thrombosis, and 1 case was unable to do external manipulation due to his poor situation.Conclusion:X-ray is a simple and easy method to identify secondary malposition of PICC. Using external manipulation to adjust the tip position back to SVC is effective, and the complications are few, which is worthy of clinical application.

Objective: To discuss and summarize the nursing care of a patient with difficult extubation due to asymptomatic thrombosis of PICC. Methods: By observing the local and global conditions, psychological tests, chest X-ray localization and vascular ultrasound, using critical thinking, the causes of difficult extubation were analyzed; after active anticoagulation and thrombolytic therapy, intermittent extubation of PICC; after extubation, continuous nursing was done. Results: After the above nursing measures were implemented, PICC was removed intermittently within 24 hours, and after 3 months vascular ultrasound was showing that the thrombus in the blood vessel had been completely organized. Conclusion When we encounter difficulties in PICC removal, it is not necessary to extubate the PICC forcibly. It is necessary to analyze the causes and implement correct nursing measures to improve the success rate of extubation.

Objective: To detect the effect of the ball compressor method to prevent jugular vein malposition in peripherally inserted central catheter insertion (PICC). Methods: Convenient sampling method was used to recruit 1 358 patients with PICC insertions during October 2017 to September 2018 in Second affiliated hospital Zhejiang University, school of medicine. 681 were included in experimental group, and 677 patients were included in control group. The control group used traditional turning head to the PICC insertion side or fingers compression to block the entrance of jugular vein to prevent jugular vein malposition in control group. While in experimental group, rugby- shape ball compression were used to block jugular vein to reduce jugular vein malposition. The rate of jugular vein malposition in the first try of catheterization was calculated in both groups. Results: The rate of jugular vein malposition in the first try of catheterization was 19.1%(130/681) in experimental group and 23.5% (159/677) in control group respectively. There is statistically significant difference between two groups (χ²=3.917, P=0.047 8). Conclusion Rugby- shape ball compression could reduce jugular vein malposition in the first try of catheterization effectively.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors