Objective To explore the effects of mechanical ventilation on the treatment of acute severe left heart failure.Methods While the routine drug therapy was used,25 patients with severe acute left heart failure received mechanical ventilation treatment.The changes of their artery blood gas,vital signs and clinical symptom were observed before and after mechanical ventilation.Results The parameters of their blood gas and clinical symptom were dramatically improved after the mechanical ventilation therapy in 21 patients(P＜0.01).19 patients were saved successfully and 6 patients died.Conclusion The mechanical ventilation could effectively improve the clinical symptoms and respiratory function of patients with acute severe left heart failure,which is an effective method in the adjuvant treatment of patients with acute severe left heart failure.

Objective To evaluate the accuracy of spectral entropy including response entropy(RE)and state entropy(SE)as a new electroencephalographic measure of depth of sedation during general anesthesia.Methods Twenty ASA Ⅰ or Ⅱ patients aged 20-55 yr undergoing elective abdominal surgery were studied.Anesthesia Was induced with intravenous propofol,fentanyl and vecuronium.After tracheal intubation anesthesia was maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and vecuronium.BP,HR,SpO2,spectral entropy(Datex-Ohmeda)and BIS(Aspect Medical)were monitored during anesthesia.Loss of eyelash reflex and unresponsiveness to verbal stimulus and mild prodding and shaking were considered to be signs of loss of consciousness(LOC).The time of regaining consciousness Was defined as the time when patients started responding to verbal commands.RE,SE and BIS were recorded before anesthesia(baseline),10 min before LOC,immediately after LOC,immediately after tracbeal intubation,1 h after skin incision,10 min before regaining consciousness immediately after consciousness was regained and 10 min after extubation.Results There were sisnificant changes in RE,SE and BIS during the transition from consciousness to LOC.The RE,SE and BIS values for LOC were 76,73 and 68 with sensitivity of 94%,95%and 92%and specificity of 92%,94%and 91%respectively.The accuracy of RE.SE and BIS in predicting LOC was 93%,95%and 94%respectively.The RE,SE and BIS values for regaining consciousness were 82,75 and 70 with sensitivity of 95%,95%and 91%and specificity of 93%,96%and 93%respectively.The accuracy in predicting regaining of consciousness was 98%,96%and 97%respectively.Conclusion Entropy index Can accurately monitor level of sedation during general anesthesia.

0.05).Furthermore,logistic regressive equations of prediction probability and RE,SE,BIS were calculated as ln [Pk/(1-Pk)]=-19.825+0.243x,ln [Pk/(1-Pk)]=-18.012+0.236x and ln [Pk/(1-Pk)]=-21.780+0.316x,respectively.From the perspective of sensitivity/specificity,RE,SE and BIS had threshold values for regaining consciousness of 83,76 and 71 with sensitivity/specificity of 0.90/0.85,0.89/0.80 and 0.88/0.78,respectively.RE was 30s earlier than BIS in predicting regaining consciousness.Conclusion Compared with BIS,entropy index seems to be a more accurate and sensitive electroencephalographic measure,and is promising in clinical application.

0.05),while the entropy index showed significant differences between the two groups(P

0.05).Conclusion:There was likely no association between the polymorphism at the serotonin transporter gene and autism. The serotonin transporter gene polymorphism might not play a causal role in the development of autism.

Objective To observe the effect of different energy levels of pulsed Nd∶YAG laser irradiation on the changes of NO and NOS levels in ulcer tissue of oral ulcer model.Methods Forty-eight Sprague-Dawley rats were inflicted with oral ulcer,and then randomly and equally assigned to 6 groups,that is,oral ulcer group,1% iodine glycerin group and the rest 4 groups receiving pulsed Nd∶YAG laser irradiation at 1.5 W 40 mJ,1.5 W 60 mJ,1.5 W 80 mJ or 1.5 W 100 mJ(once per day,for 3 consecutive days).The other 8 rats served as normal control.In 24 h after last treatment,4 rats from each group were sacrificed and their cheek pouches were taken out for NO and NOS levels in the mucosal tissue by spectrophotomentry.Ulcer healing were observed 24 h after the last treatment for 8 consecutive days.The efficiency of Nd∶YAG laser irradiation at different powers were evaluated.Results Irradiation groups had significantly shorter healing time compared with iodine glycerin group.Level of NO and NOS activity in 1.5 W 60 mJ and 1.5 W 80 mJ groups was evidently lower than the ulcer group(P

Objective To investigate how surgical patients are assessed regarding pressure ulcer risks and the usage of evaluation tools in different stages during perioperative period.Methods Totally 210 nurses from operating rooms and surgical wards in 7 tertiary hospitals of Jiangsu Province were investigated with self-designed questionnaire.Results Operating room nurses of 7 hospitals used different kinds of scales for pressure ulcer risk assessment,the same scale document was used during the different stages of operation,the frequency and time for pressure ulcer risk assessment varied from one to three times,preoperative visit to handover in surgical ward were different;the Braden scale was used by surgical nurses to evaluate pressure ulcer risk after operation,while most surgical nurses believed that the existing scale lacked specificity and intraoperative risk factors that should be considered when assessing postoperative patients.Conclusion The frequency and time of pressure ulcer risk assessment of patients during perioperative period are not standardized,the content of scale is limited and lacks specificity,the assessment of pressure ulcer risk during perioperative period is discontinuous and non-dynamic.There are no specific risk assessment scales targeting preoperative,intraoperative and postoperative pressure ulcer risk assessment.

BACKGROUND:The micro-ecological environment has been broken when the ocular prosthesis was inset into the conjunctival sac. The recede of self cleaning function is more conducive to the microbial growth and colonization. The cleaning of plaque biofilm on ocular prosthesis surface affects the patient's wearing comfort and quality of life. It is necessary to seek an effective cleaning method. OBJECTIVE:To compare the clearance effect of five cleaning methods on the palque biofilm on ocular prosthesis surface. METHODS: The conjunctival secretions from 84 patients who were subjected to ocular prosthesis repair were taken for bacterial culture and identification. Fifty pieces of self-curing resin and thermosetting resin artificial eyes were produced. The artificial eyes in each group were randomly divided into five groups, and were cleaned respectively with clear water, volume fraction of 75% ethanol, Boston SIMPLUS, polident and toothpaste. After the completion of the cleaning, the test piece was conducted residual biofilm culture. The clearance effects of different processing modes were evaluated using colony counting method. RESULTS AND CONCLUSION: Eighty-four specimens were submitted for inspection, of which 49 were positive. The Staphylococcusaureus separation rate was 14.29%.Staphylococcus epidermidis separation rate accounted for 13.10%. Maxwel Corynebacterium separation rate accounted for 7.14%. When water, Boston SIMPLUS and toothpaste were used for cleaning, theStaphylococcus aureus colony number in the self-curing resin group was higher than that in the thermosetting resin group (P< 0.05); when ethanol and polident were used for cleaning, there was no difference in the Staphylococcus aureus colony number between these two groups. In self-curing resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). The colony count in the ethanol treatment group was lower than that in the Boston SIMPLUS group (P < 0.05). There was no significant difference in the colony count between other groups. In thermosetting resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). There was no significant difference in the colony count between other groups. These results demonstrate that ethanol, Boston SIMPLUS, polident and toothpaste have better cleaning effects onStaphylococcus aureusbiofilms on the surface of two kinds of ocular prostheses than the clear water rinse. Overal, it is encouraged to clean the artificial eyes using polident and Boston SIMPLUS, in order to avoid the occurrence of microbial infection in the conjunctival sac after wearing ocular prosthesis.

Objective:To understand the management status of breast cancer-related lymphedema, and to provide a basis for the formulation of prevention and treatment plans for breast cancer-related lymphedema.Methods:Using accidental sampling, a questionnaire designed by the research team was used to survey nurses in 58 hospitals in Jiangsu Province.Results:This study surveyed a total of 58 hospitals, of which 53 were general hospitals and 5 specialized hospitals. Only 11 hospitals (18.97%) had treatment rooms dedicated to conservative treatment of lymphedema, 9 hospitals (15.52%) had opened lymphedema clinics, and 15 hospitals (25.86%) had professional international lymphedema therapists. All the 58 hospitals had different degrees of prevention and management of breast cancer-related lymphedema.Conclusions:The comprehensive management of lymphedema has not yet been achieved, and the management standards of lymphedema also need to be further improved. It is important to establish a unified and standardized management plan and practice standards.

OBJECTIVE: To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment. METHOD: A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed. RESULT: All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found. CONCLUSION Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.
Diplopia ; etiology ; therapy ; Endoscopy ; Enophthalmos ; etiology ; therapy ; Humans ; Maxillary Sinus ; surgery ; Nose ; Ophthalmologic Surgical Procedures ; methods ; Orbital Fractures ; complications ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies