0.05).Among the test group.the number of medium nebulization were significatly more than that in the contrast group(P0.05).Conclusions: Early continuous and administration of oxygen nebulization with 0.45%sodium chloridecan not only decrease the Visco-elasticity of sputum, but aslo sustain the stability of oxygen partial pressure in blood in the study.

Objective To evaluate the effect of community nurse training in peripherally inserted central catheter (PICC) on community nursing quality of tumour patients with indwelled PICC during the intermission of chemotherapy.Methods A prospective study was performed with a total of 220 patients with esophageal or lung cancer enrolled from September 2011 to March 2013 in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University.The 220 patients included 174 males (79.1％) and 46 females (20.9％),at the age of (61.1 ±9.0) years.With the start of community nurse training as the cut-off line,the patients were divided into pre-training group (n =119) and post-training group (n =101).PICC-related complications and patient satisfaction were compared between the 2 groups.Results The overall PICC-related complication rate was 20.9％ (46/220) during community nursing,including,in the order of declining incidence,infection (7.2％,16/220),and venous thrombosis (4.5％,10/220),catheter occlusion (3.6％,8/220),catheter dropping (2.7％,6/220),and leaking/damage (2.7％,6/220).The total complication rate and incidence of infection in the post-training group were both significantly lower than those in the pre-training group (14.9％ vs.26.1％,P =0.047 ; 3.0％ vs.10.9％,P =0.035),and patient satisfaction (including satisfaction for answers to questions about PICC,feelings about PICC indwelling and PICC position,and overall satisfaction) was significantly higher than in the pre-training group (P =0.003,P =0.011,P =0.001).Conclusion Community nurse training programmes have positive effects on improving PICC-related nursing and patient satisfaction in cancer patients with PICC indwelling during intermissions of chemotherapy.

Objective To investigate fluoride-induced inflammation and nuclear factor-κB (NF-κB) signaling pathway in cultured human acute monocytic leukemia cells (THP-1).Methods In vitro cultured THP-1 cells were used as a model of microglia.After cultured with different concentrations of [0 (negative control group),10,50,100,500,1 000 and 5 000 μmol/L] sodium fluoride (NaF) for 48 h,the survival of cells was detected by CCK8.THP-1 cells were divided into 3 groups:control group,low dose and high dose fluoride groups according to the results of CCK8 assay,and then treated with different concentrations of sodium fluoride (0,500,5 000 μmol/L) for 48 h,concentrations of inflammatory cytokines,such as Interleukin-lβ (IL-1β) and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) in THP-1 mononuclear cell culture medium.The protein levels of IκBα,phospho-NF-κB p65 and phospho-IκB-α were detected by Western blotting.Results THP-1 cells were treated with different concentrations of sodium fluoride (500,1 000,5 000 μ mol/L) for 48 h.Fluoride group THP-1 cell survival rate [(73.21 ± 3.67)％,(31.40 ± 4.56)％,(0.40 ± 0.24)％] was lower than that of the negative control group [(100.00 ± 0.00)％,all P ＜ 0.01].Compared to the control groups [(0.36 ± 0.07),(31.07 ± 0.81)ng/L],significant increases of the inflammatory cytokines IL-1β [(1.42 ± 0.79),(19.47 ± 2.90)ng/L] and TNF-α [(61.06 ± 2.20),(172.72 ± 2.29)ng/L] were detected in culture medium in low-fluoride and high fluoride groups,respectively.Interestingly,compared to the control groups [(100.00 ± 5.48)％,(100.00 ± 14.82)％],significant increases of phospho-NF-κB p65 [(113.71 ± 8.99)％,(134.74 ± 1.93)％] and phospho-IκB-α [(152.61 ± 14.16)％,(176.91 ± 7.95)％] were observed in both low-fluoride and high fluoride groups.Meanwhile,the protein level of IκBα in high fluoride group [(63.53 ± 9.67)％] was significantly lower than that of the control group [(100.00 ± 10.99)％,P ＜ 0.01].Furthermore,significant positive correlation was detected between increased IL-1β,TNF-α and phospho-NF-κB p65 (r =0.74,0.72,all P ＜ 0.05).Conclusions Excessive fluoride can induce microglial cells to release inflammatory cytokines and activate nuclear factor-κB signaling pathway.The release of inflammatory cytokines and activation of the signaling pathway may be one of the mechanisms of the damage of the central nervous system caused by sodium fluoride.

Objective To explore the diagnostic approach and the idea of timely treatment for the spontaneous rupture of the esophagus (SRE) for improvement of the level of clinical diagnosis and treatment.Methods The relative clinical data and operation method of 16 cases SRE (4 cases of midpiece SREs and 12 cases of lower SRE) collected from February 1999 to June 2011 were analyzed retrospectively.There were one place breach in 16 cases of SRE with a broken length of 1.5 ～5 cm (2.6 ± 1.1 )cm,including 11 cases broken into the left breast,2 into right chest,and 3 no chest broken into.The main symptoms included intense thoracoabdominal pain,fever,difficulty in breathing,and shock.Ten cases of hydropneumothorax and 5 cases of subcutaneous emphysema were found with physical examination.Results Eleven cases were repaired within 24 hours and 5 cases were repaired after 24 hours.The esophaguses of 16 cases were sutured disconnectedly by absorbable suture line,to which omentum majus were sutured and fixed.Improved resisting backflow operation was carried out for 16 cases which got through the perioperative period smoothly and no deaths.There was no esophageal narrow in follow-up visit,otherwise,there were 2 refluxes that relieved significantly through conservative treatment.Conclusions It is the key to treat SRE that early diagnosis and exploration operation through cutting thorax after definite diagnosis,closing broken hole in order to rebuild the alimentary canal on which omentum majus was covered and fixed for the purpose of insuring continuity of digestive tract.

Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P<0.05). The speed of pumping fluid had no influence in a shout time(10 min),with significant difference(P>0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.

BACKGROUND: Many experiments have proved that heavy-load movement training causes the acute increase of free radicals. The increase of endogenous free radicals and caused cellular and subcellular lipid peroxidation strengthening injure the structure and function of tissue cells, thereby, decrease motor ability. Sleep deprivation also causes the increase of oxygen free radicals.OBJECTIVE: To observe the changes in malondialdehyde (MDA) and glutathione (GSH) levels as well as superoxide dismutase (SOD) activity in serum of acute exhaustive exercise rats following different time periods of sleep deprivation.DESIGN: A randomized controlled animal experiment.SETTING: Laboratory of Exercise Sciences & Sports Medicine, Physical College, Hunan Normal University.MATERIALS: Thirty healthy male SD rats of clean grade, weighing about (220±13)g, provided by Experimental Animal Center of Hunan Agricultural University, were involved in this study.METHODS: This experiment was carried out in the Laboratory of Exercise Sciences & Sports Medicine, Physical College,Hunan Normal University from April 2006 to May 2006. Thirty rats were randomized into 5 groups: blank control group,simple exercise group, sleep deprivation 24 hours group, sleep deprivation 48 hours group and sleep deprivation 72 hours group, with 6 rats in each group; Rats in the blank control group were allowed to sleep normally, but not do exercise; Rats in the simple exercise group were allowed to sleep normally and executed after acute exhaustive exercise; Rats in the sleep deprivation 24, 48 and 72 hours groups were deprived their sleep for 24, 48 and 72 hours,respectively, then they were executed after acute exhaustive exercise. Method of gentle handling was used in creating rat models of sleep deprivation; Rats in the simple exercise group and sleep deprivation groups were forced to do exercise according to the rat exercise model project established by Bedford: treadmill gradient 10°, speed 19.3 m/min, all the exercise rats were exhaustive (Exhaustion criteria: At the end of exercise, rats reached 1/3 of runway over 3 times;Various stimulations for expelling were invalid. After running, rats presented with breathlessness, expression lassitude,ventral decubitus, slow stimulus response, weaker escape response in being captured). After experiment, rats in each group were executed under the anesthetic state, and their blood was taken out, and centrifuged after natural clotting.Supernatant fluid was taken for detecting MDA and GSH levels as well as SOD activity.MAIN OUTCOME MEASURES: Changes in MDA and GSH levels, and SOD activity in rat serum.RESULTS: Thirty rats were involved in the final analysis. ① MDA level in the simple exercise group was higher than that in the blank control group (P＜ 0.01). MDA level in the sleep deprivation 24 hours, 48 hours and 72 hours was higher than that in the simple exercise group, respectively (P ＜ 0.01). MDA level in the sleep deprivation 72 hours was statistically higher than that in the other sleep deprivation groups, respectively (P ＜ 0.01). ②GSH level in the simple exercise group was lower than that in the blank control group (P ＜ 0.01). GSH level in the sleep deprivation 24 hours group was higher than that in the simple exercise group [(P ＜ 0.01). GSH level in the sleep deprivation 24 hours and 48 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.05, 0.01). There were statistical differences in GSH level among sleep deprivation groups (all P＜ 0.01). ③ SOD activity in the simple exercise group was lower than that in the blank control group (P ＜ 0.01); SOD activity in the sleep deprivation 24, 48 and 72 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.01); SOD activity in the sleep deprivation 48 and 72 hours groups was significantly lower than that in the blank control group, respectively (P ＜ 0.01); There were statistical differences in SOD activity among sleep deprivation groups (P ＜ 0.01).CONCLUSION: Sleep deprivation can cause serumal oxidative stress injury of rats; With elongation of time of sleep deprivation and exhaustive exercise, oxygen free radical production in serum of rats accumulates more and more, ability to get rid of oxygen free radical becomes weaker and weaker, and injury to body is more and more obvious.Serumal oxidative stress status of acute exhaustive exercise rats following sleep deprivation

Objective To explore the effect of nursing students' factors on the teaching effect of nurse patient communication experience . Methods A questionnaire survey was conducted among 208 nursing students who received nurse-patient communication experience teaching. Research content included nursing students' subjective factors and objective factors, and non-technical expertise. The training effect factors affecting the personal factors questionnaire, self-made demographic characteristics questionnaire andnursing soft skills assessment scale were adopted to make evaluation and SPSS 17.0 was used to make correlation analysis to the obtained data. Result For respondents, the factors such as one-child in general demographic characteristics and social work experience had correlation with the teaching effect (r=0.270, 0.725; P=0.000, 0.010). Nursing students' non-professional and technical capacity, personal characteristics and the teaching effect were correlated with the teaching effect, among which the nursing students' interper-sonal relationship, organization and management skills, self-efficacy, learning power had the correlation coefficients with the teaching effect of 1.000, 0.725, 0.192 and 0.470, P<0.05, respectively. Conclusion In the teaching process, it has positive effect on the teaching effect to create the practice condition, increase the favorable factors, and guide the self awareness of nursing students.

Objective To analyze and summarize the clinical effect of peripherally inserted central catheters (PICC) guided by B-ultrasound,and to discuss the catheterization skills of PICC guided by B ultrasound.Methods Retrospectively analyzed the clinical data of 102 patients recieved PICC guided by ultrasound in neurosurgery department of Chongqing emergency medical center from January 2016 to May 2017.The success rate of one-time puncture, the success rate of one-time catheter delivery and the number of complications were analyzed, and the causes and treatment methods of complications were analyzed.Results Of the 102 cases,94 cases were successfully punctured in one time,6 cases were punctured twice,and 2 cases were punctured more than 2 times.The one-time puncture success rate was 92.16%.Catheter misplacement occurred in 5 patients,and postoperative complications occurred in 2 patients.Conclusion Mastering the related angiotomy and imaging knowledge of PICC and using the B-ultrasound guidance system to insert the catheter can improve the success rate of catheterization and reduce the postoperative complications.

Objective To investigate the effect of the modified surgery for spontaneous rupture of esophagus (SRE) so as to improve treatmeut level.Methods Clinical data and surgical methods of 16 SRE patients including four patients with mid-esophagus ruptures and 12 with lower esophagus ruptures treated between February 1999 and June 2011 were analyzed retrospectively.All patients had only one laceration with the gap length of 1.5-5 cm (median 2.5 cm).Eleven patients had rupture into the left breast,two had rupture into the right chest,with no rupture into the chest in three patients.Ten patients suffered from hydropneumothorax and five from subcutaneous emphysema.Thc esophageal mucosas rathcr than muscular layers of all patients were sutured disconnectedly with absorbable thread.Omentum majus were embedded and fixed to muscular layer on the edge of esophagus rupture site.Fundus ventriculi were suspended and fixed to the dome of diaphragm.In the meantime,diaphragmatic hiatus were reconstructed above the esophagus rupture site for lower esophagus ruptures.Results The time from SRE attack to operation ranged from one hour to three days.Eleven patients were repaired within 24 hours of SRE onset and five patients were repaired after 24 hours of SRE onset.All patients got through the perioperative period smoothly and survived the operation with cure rate of 100％.The median hospital stay was 18.5 days.No esophageal narrow or canceration were found during follow-up (range,1-10 years),but two patients suffered from reflux which were relieved significantly after conservative treatment.Conclusion For treatment of SRE,interrupted suture for esophageal mucosal layers,omentum majus embedding instead of esophageal muscular layer suture and simultaneous anti-reflux operations can significantly reduce incidence of complications like esophageal fistula,stenosis and reflux and improve the cure rate.

Objective To investigate the effect of early coronary artery bypass grafting (CABG)to the left ventricular wall motion state and the significance of CABG to awake hibernating myocardial in dogs with acute myocardial infarction.Methods The anterior descending coronary of all thirty dogs were ligated into MI model.According to the operation date,the experimental groups included the 1 st week (n =6),the 2nd week (n =4),the 4th week (n =6) and the 6th week (n =6) CABG,and established control group (n =2) for every experimental group.Operators marked hibernate myocardial and determined the room wall motion score by means of dobutamine ultrasound load test (DSE) combining with tissue doppler imaging (DTI)technology before CABG and after eight weeks CABG through thoracotomy surgery for the experimental group and the control group.Every dog was executed and detected the area of MI.Results Four dogs of experimental group and all dogs of control group survived to the end of the study.The change of ventricular room wall motion score in the 1st and the 2nd week CABG was smaller than that in the 4th and the 6th week CABG and MI group(0.03 ±0.06,0.05 ±0.09,0.23 ±0.08,0.27 ±40.06,0.32 ±0.05,P ＜0.05).The change of room wall motion score in all CABG groups was smaller than that in MI group(1.195 ±0.09,1.25 ±0.18,1.30 ±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05).The hibernate myocardial were more awaken in all CABG groups than that in MI group (0.27 ± 0.12,0.22 ± 0.04,0.31 ± 0.09,0.23 ± 0.03,0.03 ± 0.04,P ＜ 0.05).The area of MI became smaller in 1 and 2 weeks CABG than that in 4 and 6 weeks CABG and MI group(20.75 ± 2.63,21.25 ± 2.5,27.25 ± 1.71,27.75 ± 2.22,P ＜ 0.05).Conclusions Early CABG surgery for dogs acute MI could improve the ventricular room wall motion obviously and wake up more hibernate myocardial.Especially,CABG surgery among two weeks could lessen the effect of MI to the ventricular room wall motion and reduce the scope of myocardial infarction maximatily.