This paper summarizes the systematic management of artificial airway for 36 postoperative patients with laryngeal cancers. A full-time nurse is responsible for the systematic artificial airway management to implement respiratory care,endotracheal tube care,infection prevention and control,nutritional support and health education. As a result,the incidence of fever,frequent cough,and bloody sputum was 2.12%. Pharyngeal fistula and pulmonary infection occurred in one patient,respectively. All the patients recovered well after intensive care. It is suggested that systematic artificial airway management can effectively reduce complications,improve the quality of nursing and increase patient satisfaction.

Objective To evaluate the short-term and long-term efficacy of conservative laparoscopic surgery combine with goserelin in treatment of severe ovarian endometriosis.Methods From January 2004 to December 2008,206 patients with severe ovarian endometriosis underwent laparoscopy surgery in Nanjing Drum Tower Hospital,Affiliated Nanjing University Medical School were enrolled in this retrospective study.According to the revised classification American Fertility Society (r-AFS), 123( 123/206,59.7％ ) cases were at stage Ⅲ and 83 ( 83/206,40.3％ ) patients were at stage Ⅳ.Among 138 cases presented pelvic pain.All the patients underwent laparoscopic cystectomy,of which 117 patients with childbearing preserving underwent hysteroscopy and hydrotubation examination,including 7 cases with bilateral salpingectomy,2 cases with bilateral tubal obstruction and 108 cases with normal reproduction.After surgery,all cases were administered by goserelin treatment at dose of 3.6 mg per 28 days for 3 to 6 months.At 1 to 5 years following up,pelvic pain,pregnancy and recurrence were observed,those factors associated with pregnancy rate and endometriosis recurrence were analyzed.Results (1)Pelvic pain:complete remission rate of pelvic pain was 76.1％ ( 105/138 ) at 1 to 5 years after surgery.(2) Pregnancy:total pregnancy rate was 70.4％ (76/108),spontaneous pregnancy rate was 68.8％ (66/96) and pregnant rate of in vitro fertilization and embryo transfer (IVF-ET) was 10/12.Pregnancy rate at 1 year was 57.3％( 55/96 ) and accounting for 83.3％ ( 55/66 ) in all pregnant womon.Live birth rates of spontaneous pregnant and IVF-ET were 86.4％ ( 57/66 ) and 9/10,respectively.( 3 ) Recurrence:the total recurrence rate was 8.3％ ( 17/206 ) at 1 to 5 years.The recurrence rates and the cumulative recurrence rates were 3.9％(8/206) and 3.9％ (8/206) at the first year after operation,2.0％ (3/149)and 6.7％ ( 10/149 )at the second year,1.0％ (1/99) and 8.0％ (8/99) at the third year,10.9％ (5/46)and 17.4％ (8/46) at the fourth year,0 and 2/18 at the fifth year,respectively.Conclusion It was suggested that conservative laparoscopic surgery combined with goserelin in treatment of stage Ⅲ or Ⅳ ovarian endometriosis could reduce the recurrence risk of severe ovarian endometriosis and improve the pregnant rate of endometriosisassociated infertility.

Objective To evaluate effects of different laparoscopic procedures for hydrosalpinx on ovarian responses to superovulation induction during in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 65 patients with infertility derived from hydrosalpinx underwent 67 cycles of IVF-ET from January 2002 to January 2005.Before the IVF-ET,the patients were given bilateral laparosocpic salpingectomy(Group A,n=47,48 cycles) or laparosocpic proximal tubal ligation and distal tubal salpingostomy(Group B,n=18,19 cycles).Another 58 patients with proximal tubal occlusion without hydrosalpinx were simultaneously included for 58 cycles of IVF-ET(Group C).Results The fertilization rates,cleavage rates,implantation rates,and clinical pregnancy rates were 85%?21%,95%?17%,49%(55/113),and 79%(38/48) in the Group A,83%?17%,98%?7%,47%(21/45),and 68%(13/19) in the Group B,and 81%?22%,92%?16%,41%(57/140),and 66%(38/58) in the Group C,respectively,without statistically significant difference among the 3 groups(F=0.48,P=0.620;F=1.22,(P=0.297);?~2=1.691,P=0.429;?~2=2.471,P=0.291).The doses of gonadotrophin,the duration of stimulation,and the number of retrieved oocytes were 29.4?10.3 vials,9.4?1.7 d,and 11.4?5.6 in the Group A,24.7?7.7 vials,9.0?1.8 d,and 12.8?6.1 in the Group B,and 28.4?8.8 vials,9.1?1.8 d,and 11.4?5.3 in the Group C,respectively,without statistically significant difference among the 3 groups(F=1.77,P=0.174;F=0.52,P=0.593;F=0.51,P=0.599).Conclusions Laparosocpic salpingectomy or laparosocpic proximal tubal ligation with distal tubal salpingostomy for hydrosalpinx does not impair ovarian responses to the superovulation induction.Both of the procedures may be considered for the treatment of hydrosalpinx prior to IVF-ET.

OBJECTIVE:To study the effect of over the counter dispensing model on hospital pharmaceutical work quality improvement and its social benefits. METHODS: The practice of over the counter dispensing model in the outpatient dispensary in our hospital was compared with the traditional model of drug dispensing through a small window. RESULTS: Over the counter dispensing service model can help improve the work efficiency in outpatient dispensary, strengthen pharmacists' consciousness on pharmaceutical care. CONCLUSION: Over the counter dispensing model can be applied in large and medium-sized hospitals.

Objective To establish a real‐time fluorescent polymerase chain reaction and detect 16S rRNA gene of Legionella strains isolated from sputum specimens of patients with pulmonary infection by using this method .Methods 16s rRNA gene of Le‐gionella was used to design primers and probes .The reaction system and reaction conditions were optimized and the specificity ,sen‐sitivity and repeatability of this method were verified by detecting Legionella pneumophila ,non‐Legionella pneumophila and other bacteria .A total of 557 sputum specimens of patients with pulmonary infection were detected ,and PCR‐digestion identification method was carried out as control .Otherwise ,sequences of 16S rRNA were verified in patients with positive detection results .Re‐sults The results showed that all reference strains of Legionella were positive ,while all of other bacteria were negative ,and the sensitivity was 102 CFU/mL .Among sputum specimens collected from 577 cases of patients with pulmonary infection ,the positive rate of Legionella detected by using real‐time fluorescent PCR and PCR‐digestion identification method was 23 .1% and 19 .9% re‐spectively ,while the positive rate was 17 .2% by verifying the sequences of 16s rRNA .There were no statistically significant differ‐ences of positive rate among the three methods(P>0 .05) .Conclusion The real‐time fluorescent PCR is fast and convenient in de‐tection of Legionella strains isolated from sputum specimens of patients ,which could be an assisted method for clinically diagnosing Legionella infection .

Objective: To evaluate the self-developed intelligent assist order system for parenteral nutrition on the control of concentration exceeding standard of positive ions.Methods: The special comments, pharmacist audit and information control were used to intervene the concentration exceeding standard of positive ions in parenteral nutrition orders and the effect of the three intervention methods were evaluated.Results: For the intervention of concentration exceeding standard of positive ions in parenteral nutrition orders, the information control was better than the special comments and pharmacists audit.Conclusion: The intelligent assist order system for parenteral nutrition can solve the problem of concentration exceeding standard and promote the rational application of parenteral nutrition in hospitals.

Objective: To construct the management model for intravenous drug use based on index system in a hospital.Methods: A three-level organizational framework was established, the KPI assessment method was used to set control index and observational index respectively for outpatients and inpatients.The completion of the clinical department indicators were monitored and analyzed with the help of the hospital information systems, and regulated by pharmacy and management tools.Results: After the application of the hospital intravenous drug use management model, the qualification rate of intravenous medication orders was improved in December 2015 (89%) when compared with that in December 2014 (68%), and the difference was statistically significant(P＜0.05).The indices of intravenous drug use of inpatients and outpatients in 2015 were significantly improved when compared with those in 2014.Conclusion: The hospital intravenous drug use management model based on index system construction can effectively reduce unnecessary intravenous medication and promote the rationality of intravenous medication.

AIM:To investigate the effect of puerarin on acute high glucose-induced attenuation of ACh relaxation in isolated rat aortic rings, and to elucidate its underlying mechanism. METHODS: The thoracic aortic rings with endothelium of male Sprague-Dawley rats were mounted on a bath system. Isometric relaxation of aortic rings was measured. RESULTS: ① After incubation with high concentration of glucose (44 mmol/L), the vascular relaxation responses to ACh decreased. ② After coincubation with puerarin (10-10-10-8 mol/L) and high glucose, the high glucose-induced attenuation of ACh relaxation responses of artery was partly inhibited in a dose-dependent manner. ③ After incubation with puerarin for 2 h, the HO-1 activity of thoracic aorta increased. ZnPPIX (an inhibitor of heme oxygenase-1) abrogated the protective effect of puerarin. CONCLUSION: Puerarin prevents the acute high glucose-induced attenuation of endothelium-dependent relaxation in aortic rings. The mechanism might be involved in the activation of heme oxygenase-1.

With the wide application of acupuncture in the world, the research results of neurosciences have made scientific approval on some of efficacy and mechanism of acupuncture, and the concept of western medical acupuricture (WMA) is gradually developed. During the spread of Chinese acupuncture into western countries, WMA is an adaptive improvement when facing basic theories of western medicine including anatomy, physiology and pathology as well as evidence-based medicine system. WMA which is based on theory of muscle trigger point has obvious efficacy on muscular fasciae pain, which attracted wide attention. But when Chinese acupuncture spreads into western world, the theories of Chinese acupuncture such as meridian and specificity of acupoint are questioned due to the results of western clinical study. In this paper, the origin, theory development, stimulating location and method, and categories of diseases of WMA are compared with Chinese acupuncture, and the enlightenment of this difference on Chinese acupuncture research is analyzed.
Acupuncture Points ; Acupuncture Therapy ; methods ; Evidence-Based Medicine ; Humans ; Meridians ; Trigger Points

Objective To access evaluate the efficacy and safety of on-line hemodiafiltration for treating a-cute cerebrovascular disease (ACVD) patients complicated with hyperosmolar nonketotie diabetic coma (HNDC).Method Totally 11 patients of ACVD complicated with HNDC were observed for this prospective control study.All of them underwent on-line hemodiafiltrafion for 90 minutes using Fressnius 4008S Hemodialysis Machine withONLILNEplus TM and F60 one hour after final diagnosis was made. The bicarbonate ultrafiltrate rate was set at 500ml/min and blood flow at 150 ～ 180 ml/min; and the substitute fluid were infused with post-dilution at 50 ～ 60ml/min. The symptom of brain edema and cardiac insufficiency during the same course of treatment was observed.Blood were taken from the patients to detect serum kalium, serum glucose, serum natrium, BUN and plasma os-motic pressure at one hour before treatment and six hours after treatment, respectively. The change of in conscious-ness and adverse effects were evaluated at 24 hours after treatment. Results All patients were treated successful-ly. The blood glucose, serum natrium, serum kalium, BUN and plasma osmotic pressure were decreased after on-line hemodiafiltration. Among the 11 patients, consciousness was improved obviously in 8 patients, 3 patientsdied, accounting for 73% of successful effectiveness. Conclusions The on-line hemodiafiltration was effectiveand safe for treating ACVD patients complicated with HNDC.