Objective To investigate the teaching effect of heuristic teaching in medical psychology teaching.Methods Totally 104 students (2010 grade higher vocational nursing class) were divided into experiment group (n=52) and control group (n=52).Heuristic teaching model and conventional teaching model were applied respectively.t test was used to compare the final exam scores of two groups; self-made evaluation sheet was used to evaluate the teaching effect and x2 test was employed to compare the results between two groups,with P＜0.05 standing for statistical significance.Results Final exam scores of experiment group (87.48 ± 3.18) was better than control group (81.43 ± 4.89) (P=0.016).Teaching evaluation was better in experiment group than in control group.Conclusions Heuristic teaching is helpful in improving students' study enthusiasm and training their scientific thinking.

OBJECTIVE To explore the interventions for ventilator-associated pneumonia(VAP) caused by Acinetobacter baumannii by making investigation to the ICU patients on ventilators.METHODS Bacteria culture of bronchial discharge of patients on ventilators was conducted and followed by causation analysis of VAP caused by A.baumannii.RESULTS The prevalence of VAP caused by A.baumannii was 8.7%.The main reasons for VAP caused by A.baumannii were inappropriate use of antibiotics,long duration of mechanical assisted ventilation,contaminated ventilator and its accessories,unable to perform proper aseptic technique,and severity of the underlying illness.CONCLUSIONS For patients on ventilator,effective nursing interventions and sterilization and isolation techniques can reduce the infection and promote the treatment effects.

A high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) method was developed and validated for the determination of mizoribine in human serum using thiamphenicol as internal standard (IS). The serum samples of mizoribine were precipitated with acetonitrile and separated by HPLC on a reversed phase C18 column with a mobile phase of 0.1% ammonium acetate water solution-methanol (47:53, v/v). Mizoribine and IS were detected in the multiple reaction monitoring mode with precursor/product ion transitions of m/z 258.2/126.0 and 354.1/185.2, respectively. The calibration curves were linear over the range of 0.02-2 microg mL(-1) for mizoribine. The limit of quantification (LOQ) was 0.02 microg mL(-1) with acceptable precision and accuracy. The validated method was successfully applied for the evaluation of a bioequivalence study on Chinese healthy volunteers. The main pharmacokinetics parameters after oral administration of 100 mg mizoribine test or reference formulation were as follows: Cmax (1.00 +/- 0.21), (1.00 +/- 0.22) microg mL(-1); AUC(0-infinity) (6.72 +/- 1.39), (6.48 +/- 1.44) microg h mL(-1); t1/2 (2.77 +/- 0.26), (2.66 +/- 0.29) h; tmax (2.95 +/- 0.78), (2.84 +/- 0.50) h.

Objective To observe the clinical outcomes and safety of continuous negative pressure irrigation (NPI) and endoscopic necrosectomy(ED) for treating infected pancreatic necrosis(IPN). Methods A retrospective review of the data of 163 severe acute pancreatitis(SAP) patients with IPN who were treated by four-step drainage from January 2012 to December 2013 at the SAP therapy center of Nanjing General Hospital was performed. All patients were divided into 7 groups including PCD alone, PCD+NPI, PCD+NPI+ED, PCD+ON, PCD +NPI +ON, PCD +ED +ON and PCD +NPI +ED +ON group based on the drainage strategy of percutaneous catheter drainage(PCD),NPI, ED and open necrosectomy(ON), and the feasibility and safety were analyzed. Results All the patients underwent PCD therapy. Each patient underwent a median of 3 drainage procedures and the median total drainage duration was 11 days. No significant procedure-related complication was observed. Around 40% of the patients recovered after receiving PCD alone. Thirty-four patients(20.9%) underwent ON. The mean hospitalization duration was 38 days and the mean ICU stay was 19 days. There were 25 cases with new-onset organ functional failure,26 patients with sepsis,32 patients with gastric and intestinal fistula,34 patients with intra-abdominal bleeding,8 patients with portal vein thrombosis and 3 patients with gastric outlet obstruction. 28 patients(17.2%) died. Conclusions This four-step approach is effective in treating IPN when compared with other step-up strategies. NPI and ED could offer distinct clinical efficacy without adding no extra risk to patients.

[Abstratct] Objective To investigate the preventive effect of atomization inhalation with mixture of baikal skullcap root and light yellow sophora root for proventing invasive fungal infection on lower respiratory tract infection after chemotherapy. Methods A total of 60 cases of patients with lower respiratory tract infections after chemotherapy were selected and randomized into control groups and treatment groups, there were 30 cases in every group, anti-infection was taken in two groups according to drug sensitivity test,atomamdation inhalation with mixture of baikal skullcap root and light yellow sophora root was taken in treatment groups in addition, clinical effect was contrasted, incidence rate and time of fungal infection were contrasted between control group and treatment group,and index of blood gas analysis was contrasted between control group and treatment group after two weeks. Results Clinical efficiency was 86.67% in treatment group and was 70.00% in control group,clinical efficiency was higher in treatment groups than in control group,incidence rate of fungal infection was 6.67% in treatment group and was 23.33% in control group,incidence rate of fungal infection was lower in treatment group than in control goup,time of fungal infection was (11.58±1.31)days in treatment group and was (9.41±1.10)days in control group,time of fungal infect was later in treatment group than that in control group. There were no significant differences of the levels of pH,SaO2,PaCO2 and PaO2 between the two groups before treatment, the levels of pH,SaO2,and PaO2 were higher and PaCO2 was lower in treatment group than that in control goup after treatment. Conclusion Atomization inhalation with mixture of baikal skullcap root and light yellow sophora root could improve clinical curative effect of lower respiratory tract infection after chemotherapy,and im-prove respiratory function,provent invasive fungal infections and has good clinical effect.