20 patients with paralysis at thoracic or lumbar level were randomly divided into twogroups. Patients in the lst group receive thiopental, pancuronium, fentanyl in small dose and nifedipine10mg before intubation.Patients in the 2nd group receive thiopental and pancuronium. Hemodynamic indices and serum catecholamine concentrations were measured at different time intervals pre and post-intubation.The results show that each variables of hemodynamic indices and serum concentration in the lst groupare approximate or lower than the values of pre--intubation,but each value of the 2nd group at post--intubation increase significantly.The study demonstrated that nifedipine and fentanyl in small dosage may effectively ameliorate thestress response during intubation.

Objective To investigate the incidence of the aspirin resistance in secondary prevention of cerebral infarction, and the relationship between the aspirin resistance and the cerebral infarction recurrence or other vascular events during the follow-up periods.Methods Aspirin were taken from the first day of admission in 600 patients with cerebral infarction.The platelet aggregation rate was measured after 7-10 days to screen the patients with aspirin resistance or aspirin sensitivity.All patients were followed up for 6 to 24 months and the cerebral infarction recurrence and other vascular events were recorded.Logistic regression model was used to estimate the risk factors of aspirin resistance, vascular events and prognosis.Results Of 600 patients, 150 (25.0% ) patients were resistant to aspirin and 450 (75.0% ) patients were sensitive to aspirin.The proportion of female and diabetes patients, and the level of low density lipoproteins (LDL) in the aspirin resistance group were higher than those in the aspirin sensitivity group.Diabetes (OR = 2.58, 95% CI 1.37-4.85, P=0.003) and high LDL level (OR = 1.89, 95% CI 1.21-2.93, P = 0.005 ) were independent risk factors of aspirin resistance.The incidence of cerebral infarction recurrence and myocardial infarction and all-cause mortality in the aspirin resistance group were all higher than those in the aspirin sensitivity group.Diabetes ( OR = 2.47, 95% CI 1.36-4.65, P = 0.003 ) , atherothrombosis cerebral infarction (OR = 2.13, 95% CI 1.24-3.95, P = 0.023) and aspirin resistance (OR = 3.86,95% CI 1.79-5.87, P = 0.002) were independent risk factors of vascular events during the following-up period.In the patients with aspirin resistance, the risk of the recurrence of vascular events increased 3.86 times.Conclusions The incidence of aspirin resistance is high in secondary prevention of cerebral infarction.Aspirin resistance is closely correlated with cerebral infarction recurrence and other vascular events.

OBJECTIVE To investigate the incidence of nosocomial infection in ICU patients and its risk factors to take measures to prevent from infection. METHODS The nosocomial infection of ICU patients in 12 hospitals from Oct to Dec 2007 using the method of target monitoring was investigated. The nosocomial infection rate was regalated by the method of ASA. The invasive procedure and the associated infection rate were analyzed. RESULTS Among 2087 inpatients in ICU,236 suffered from nosocomial infection,The nosocomial infection incidence was 11.31%,and the nosocomial infection rate per day was 2.38% after regulated by the method of ASA. The patient incidence of nosocomial infection was 3.57%,and the nosocomial infection rate per day was 0.67%. CONCLUSIONS The patients in ICU are susceptible population of nosocomial infection,target monitoring in ICU is an effective surveillance method to reduce the prevalence of nosocomial infection.

Objective: To understand the status of awarences and the influencing factors of food safety among medical students in Shangdong Province,and to provide a reference for improving a healthy eating habit among students on their knowledge about food safety,attitude and behavior. Methods: A total of 2 322 students from 2 medical colleges and universities in Shandong province selected through stratified cluster sampling were investigated with questionnaires. Results: Univariate analysis of variance showed that food safety knowledge differed by gender, grade, major, origin of student, whether learned nutrition knowledge, monthly cost on food (&chi;2/H=20.48, 128.02, 98.61, 36.50, 77.60, 171.03,P<0.01). In multiple Logistic regression analysis, results showed that gender, major,origin of student, monthly cost on food and the attention of food affect college students’ food safety awareness (P<0.05). Conclusion Food safety awareness among medical students in Shandong Province is relatively high but varies by multiple factors. It is necessary to improve food safety awareness of medical students through various channels.

Objective To evaluate the influence of handshake and consolation combined with breathing direction on the pain during dressing changes for the burn patients.Methods 64 patients were randomly divided into the experimental groups and the control groups according to their time of hospitalization,with 32 cases in each group.Patients in the experimental group were given the handshake and consolation combined with breathing direction during the dressing changes,while the control group was given routine care.Two groups used the same dressing method by the same physician,and cared by the same nurse before and after dressing.Pain scores (visual analogue scale VAS) were compared between the two groups before and after dressing changes.Results Before dressing,the pain scores of patients in the two groups were respectively (3.79 ± 2.27) and (3.85 ± 2.46),and there was no significant difference (t =0.147,P ＞ 0.05).After dressing,the pain scores of the experimental and the control groups were respectively (2.17 ± 1.53)and(4.30 ± 2.98),and the difference was statistically significant (t =6.796,P ＜ 0.01).Conclusions The handshake and consolation combined with breathing direction can effectively ease pain in the burns patients during dressing changes.

Objective To explore the effects of bundle airway management on the airway nursing in patients with severe inhalation injury. Methods Totally 32 patients with severe inhalation injury who were admitted and treated in the Department of Burns Surgery, the First Hospital of Jilin University between June 2013 and December 2014 were selected as a control group, who received conventional nursing, while another 35 patients with severe inhalation injury who were admitted and treated from January 2015 to June 2016 were selected as an observation group, who received nursing based on bundle airway management, including airway assessment and emergency treatment, diagnosis and treatment of suffocation, position management, sputum aspiration management, suction under glottis, airway humidification, aerocyst management, nursing with aircasing, nursing of incised part, nursing of breast and chest, mouth care, management of respiratory tube, and infection control in medical environment. Patients in the two groups were evaluated in arterial blood analysis indexes (pH, PaO2, PaCO2, Lac), oxygenation index and oxygen saturation (SaO2) at day 1, 6 and 12; sputum density in week 2 and 3; and the number of cases with positive results in sputum cultivation in week 2 and 3. Results There were statistically significant differences between the patients in the two groups in pH, PaO2, Lac,PaCO2and SaO2values at day 6 (P< 0.05); oxygenation index at day 12 (P< 0.05); and sputum density and the positive rate of sputum cultivation in week 2 and 3 (P<0.05). Conclusions Bundle airway management can effectively improve the oxygenation sputum density in patients with inhalation injury, and reduce their pulmonary infection.

Objective:To explore the effects of two dimensional gray-scale blood flow imaging (hereinafter referred to as " B-flow" ) combined with color Doppler flow imaging (CDFI) in guiding arterial puncture and catheterization through wounds in patients with large burns.Methods:Sixty-seven patients with large burns who met the inclusion criteria and hospitalized in the First Hospital of Jilin University from January 2017 to January 2019 were enrolled in the prospectively randomized control study. According to the random number table, CDFI alone group was allocated with 35 patients (23 males and 12 females) and B-flow+ CDFI group with 32 patients (22 males and 10 females), aged 19-60 and 18-58 years, respectively. According to the progress of the disease, arterial puncture and catheterization were performed in the right time. During the operation, CDFI was used alone for guidance in patients of CDFI alone group, while B-flow and CDFI were used together for guidance in patients of B-flow+ CDIF group. Based on the first time of catheterization, the catheterization location, one-time catheterization success rate, post-back stitching re-catheterization success rate, catheterization failure rate, catheterization duration, and incidences of wound sepsis, catheter-related bloodstream infection, and arterial thrombosis within post catheterization day (PCD) 3 of patients in the two groups were recorded. Data were statistically analyzed with the independent-sample t test, chi-square test or Fisher′s exact probability test. Results:(1) All the patients underwent catheterization through wounds, and there was no statistically significant difference in catheterization location of patients between the two groups ( &chi;2=0.574, P>0.05). The one-time catheterization success rate of patients in B-flow+ CDFI group was 81.25% (26/32), which was obviously higher than 51.43% (18/35) in CDFI alone group ( &chi;2=6.594, P<0.05). The catheterization failure rate of patients in B-flow+ CDFI group was 3.12% (1/32), which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). The post-back stitching re-catheterization success rate of patients was similar between the two groups ( &chi;2=1.029, P>0.05). (3) The catheterization duration of patients was (15.7±1.1) min in B-flow+ CDFI group, which was obviously shorter than (17.1±2.2) min in CDFI alone group ( t=11.316, P<0.01). (4) Within PCD 3, the incidences of wound sepsis and catheter-related bloodstream infection of patients in CDFI alone group were 2.86% (1/35) and 0, close to 0 and 3.12% (1/32) in B-flow+ CDFI group ( P>0.05); the incidence of arterial thrombosis of patients in B-flow+ CDFI group was 0, which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). Conclusions:Compared with CDFI alone, B-flow combined with CDFI can improve the success rate of arterial puncture and catheterization through wounds in large area burn patients, shorten the catheterization duration, and effectively reduce the incidence of arterial thrombosis after catheterization, with a good clinical application value.

[Abstract] Objective: To search valuable candidate molecular markers for LSCC by screening and identifying differentially expressed long non-coding RNAs (lncRNAs) in metastatic laryngeal squamous cell carcinoma (LSCC) with high throughput gene microarray technique. Methods: Four pairs of LSCC tissues and corresponding para-cancer tissues that pathologically confirmed with lymph node metastasis were collected from Bio-sample lab of Otorhinolaryngology Department, the Second Hospital of Hebei Medical University. After total RNA extraction, the SBC-lncRNA (human 4x180k) chip assay was then applied to detect the differentially expressed lncRNAs and mRNAs, and Fold-change and Student's t-test methods were used to identify differentially expressed genes; the Fold Change (linear)≤0.5 or≥2.0, P<0.05 was used to identify the differentially expressed genes. The reliability of the chip results was confirmed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Results: The gene expression profiles of metastatic LSCC tissues and corresponding para-cancer tissues were significantly different. There were 3 073 differentially expressed lncRNAs, including 1 967 up-regulated and 1 106 down-regulated lncRNAs in cancer tissues. There were 2 809 differentially expressed mRNAs, including 1 791 up-regulated and 1 018 down-regulated mRNAs in cancer tissues. The differentially expressed lncRNAs were mainly involved in cell proliferation and apoptosis, immune response biological process, and were associated with cytokine and cytokine receptor interaction, chemokine signaling pathway, cell cycle regulation, P53 signaling pathway, etc. In addition, 10 significantly differentially expressed lncRNAs were chosen and validated by qRT-PCR in 25 cases of LSCC tissues, and the results were in agree with microarray detection. Conclusions: There were obvious differences in lncRNAs expression between metastasis LSCC and corresponding para-cancer tissues; in-depth analysis of these differences may has important significance on clarifying the mechanisms of invasion and metastasis of LSCC, which can provide the theoretical basis for biomarker screening and effective targeted therapy for LSCC.·