BACKGROUND:The relationship between the occurrence time and clinical symptoms of bone marrow edema in nontraumatic femoral head necrosis is stil controversial. OBJECTIVE:To evaluate the relationship of bone marrow edema in nontraumatic femoral head necrosis with Association Research Circulation Osseous (ARCO) staging and pain grading. METHODS: Forty-eight patients with nontraumatic femoral head necrosis (58 hips) were confirmed to have bone marrow edema on MRI T1 weighted images and T2 fat suppression images. Then, the patients were graded according to the MRI Classification Method reported by Zhao Pei-rong, the ARCO Staging System and Harris hip score for pain grading. We analyzed the correlation of bone marrow edema with ARCO staging and pain grading. RESULTS AND CONCLUSION:The incidence rate of bone marrow edema in ARCO I-III was increased in sequence, and the difference was statisticaly significant (χ2=27.69,P=0.001); the average rank of bone marrow edema in ARCO I-III was increased significantly (χ2=19.947,P=0.000). The incidence rate of bone marrow edema also increased among different pain grading, and the difference was statisticaly significant (χ2=57.0, P=0.000); the average rank of bone marrow edema among different pain grading was increased significantly (χ2=174.0,P=0.000). The presence and aggravation of bone marrow edema indicate the enlargement of necrosis area and the aggravation of symptoms in patients with nontraumatic femoral head necrosis, which can be used as an auxiliary index for the appraisal of disease progression.

Objective To explore the bone mineral density (BMD) status and its influencing factors in schizophrenia patients in order to provide basis for risk assessment in psychiatric nursing.Methods A total of 1,139 hospitalized schizophrenia patients were recruited and assigned into the medication group (n=652) and the non-medication group (n=487) according to previous antipsychotic drug history.T-score and Z-score of BMD were determined using Sunlight Omnisense 7000S Bone Densitometry.Blood calcium,blood phosphorus and serum prolactin levels were measured using fasting blood of ulnar vein.Results Differences in age,BMD,milk intake,level of activity,level of smoking,history of fall,history of fracture,serum Ca2+ and PRL were statistically significant between two groups(P＜0.05);there were significant differences in BMD rank distributions among schizophrenia patients with different courses of disease and lengths of taking antipsychotics (P＜0.001);multiple linear regression showed that influencing factors of BMD with statistical significance were courses of disease,lengths of taking antipsychotics,serum Ca2+,serum PRL,milk intake,level of activity,and level of smoking.Conclusion The BMD was lower in the medication group than that in the non-medication group,and the development of osteoporosis was correlated to various factors.Clinical nurses should master high-risk factors thoroughly and adopt intervention measures in a timely manner.

This paper summarizes the 10 cases weaning from mechanical ventilation with proportional pressure support(PPS).The nursing care focus on dynamic monitoring of PPS,asphyxia ventilation,system airtight care,etc.Ten patients were successfully remove the respirator.

10.3969/j.issn.2095-4344.2013.26.019

Objective To investigate the effect of continuous venous-venous hemofiltration (CVVH) and continuous venous-venous hemodialysis (CVVHD) on patients with lactic acidosis.Methods A total of 137 cases with lactic acidosis were included in this prospective randomized control study.lhe patients were collected from the University of Hong Kong-shenzhen Hospitall and the First Affiliated Hospital of Shantou University Medical College from April 2009 to April 2013.Inclusion criteria were patients with lactic acidosis.Exclusion criteria were patients with end-stage malignancy or terminal stage of illnesses.The patients were randomly divided into two groups:CVVH group and CVVHD group,and patients of both group were intervened with conventional treatments as well.For each group,the lactic acid and blood gas analysis were tested before CRRT,and at 4 hours,8 hours,12 hours,24 hours,and 48 hours of CRRT.The patients' mortality and length of ICU stay time were analysed and recorded.Statistical analysis was performed using SPSS 15.0software.Results When the length of time for treatment was the same,the efficacy between CVVH group and CVVHD group showed no difference in blood lactic acid level [4 h:(11.65 ± 3.39) mmol/L vs.(11.12±2.65) mmol/L; 8 h:(8.78±2.35) mmol/L vs.(8.59±2.09) mmol/L; 12 h:(6.91 ±1.67)mmol/Lvs.(6.74±1.76) mmol/L;24h:(1.66±0.39) mmol/Lvs.(1.51±0.30) mmol/L; 48 h:(0.95 ±0.24) mmol/L vs.(0.66 ±0.20) mmol/L,P ＞ 0.05) and pH value [4 h:(6.93 ±0.14) vs.(7.05±0.09);8h:(7.04±0.10)vs.(7.12±0.05); 12h:(7.13±0.07)vs.(7.20±0.04);24h:(7.30±0.03) vs.(7.38±0.04); 48h:(7.41 ±0.03) vs.(7.46±0.02),P＞ 0.05].There are also no difference in the hospital mortality (11.4％ vs.10.4％,P=0.854) and length ofICU stay time [(9.5 ±2.4) d vs.(8.8 ± 2.9) d,P =0.329].Conclusions Both CVVH and CVVHD can effectively correct hyperlactemia,enhance acid-base balance,contributing no differences in length of ICU stay time and patients' hospital mortality.

Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3 × 109/L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups , while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g/(kg·d) for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients’ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group. Moreover , the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts , shorten the in-ICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia (PLT count < 30 × 109/L).

Novel aminopropyl-functionalized periodic mesoporous organosilicas (APMO) were successfully prepared by co-condensation of 1,2-bis (triethoxysilyl) ethane (BTSE) and 3-aminopropyltriethoxysilane (APTES) with the template of cationic surfactants cetyltrimethylammonium chlorine (C_(18)TAC) in basic medium.With the characterization measurements of powder X-ray diffraction (XRD),FT-IR and scanning electron microscopy (SEM) so on,APMO had such advantages as good monodisperse microshperes,uniformly orderd mesopore and large specific surface areas.These mesoporous materials were directly considered to be the chromatographic stationary phases and analyzed by HPLC evaluation.During the research,the as-prepared APMO column had better permeability and three polycyclic aromatic compounds realized separation.In addition,the as-prepared APMO column had certain advantages in fast analysis.

Objective To investigate the toxicity of urban PM2.5 in Guangzhou on PC-12 cells.Methods PM2.5 was collected in Guangzhou city.PC-12 cells were cultured in vitro and divided into several groups,including the control group,PM2.5 groups with different concentrations and NAC pretreated group (pretreaed with 10 μmol/mL NAC followed with 100 μg/mL PM2.5 exposure).Cells were incubated with indicated stimulator for 24 h,then cell viability was checked with cell counting Kit-8 assay,the level of intracellular ROS was labeled using H2DCFDA fluorescence probe,cell apoptosis was measured by the flow cytometry and the expression of apoptosis-related proteins,including Cytochrome C,Caspase 9,Caspase 3 and PARP,were detected by Western Blot assay.Results PM2.5 has a strong toxicity on PC-12 cells when its concentration is over 25 μg/mL.After exposure for 24 h,the cell viability was markedly decreased.The results of flow cytometry and Western blot assay showed that PM2.5 enhanced the apoptosis of PC-12 cells with the upregulatios of Cytochrome C,Caspase 9,Caspase 3 and PARP.Pretreatment with NAC could significantly diminish PM2.5-induced PC-12 cell toxicity,decreased ROS generation and apoptosis of PC-12 cells,with the down regulations of apoptosis-related proteins.Conclusion PM2.5 can cause apoptosis of PC-12 cells by inducing oxidative stress,upregulating the Cytochrome C expression and activating Caspase9/3,which may be one of the mechanisms underlying PM2.5-induced neurotoxicity.

Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.

Objective:To investigate the association between pulse pressure(PP) and new-onset diabetes in overweight and obese people.Methods:A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria. PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile. The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan- Meier method and compare by Log- Rank test. The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes. Results:During an average follow-up of 8.45 years, 8 922 diabetes was identified. The cumulative incidence rate of the Q1, Q2, Q3, and Q4 groups were 22.12%, 24.48%, 27.97%, and 33.44% respectively, which were statistically different( χ2=368.16, P<0.01). Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors, compared with Q1 group, the hazard ratio for diabetes in Q2, Q3, and Q4 groups were 1.07(1.00-1.14), 1.13(1.05-1.21), and 1.17(1.09-1.27) respectively. And the HR of diabetes event in pulse pressure(per 1 SD increase) was 1.04(1.02-1.07). Similar results were found in participants who were over-weight, obese, with normal blood pressure or hypertensive without drugs use. Conclusion:PP is positively correlated with the new-onset diabetes. High PP is one of the risk factors for developing diabetes in overweight and obese people.