Objective To observe the Influence of improved ICU checklist on instrument management. Methods Reformed and improved the instrument delivery project in ICU checklist. The transfer situation from November 2014 to April 2015 as the control group.The situation from May to October in 2015 as the observation group.Compared the two groups of items of the transfer situation,the condition of nurses′ mastery of instrument parameters,the number of adverse events associated with the instrument and the satisfaction degree of the doctor on nursing work. Results Experimental instrument handover items in succession rate, incidence of adverse events, the doctor to nurse job satisfaction were 25.3% (278/1098), 6 cases, 93% (27/29), the control group were 59.6% (655/1098), 20 cases, 81% (17/21), the difference was statistically significant (χ2 = 264.868, 7.629, 70.046, P < 0.05 or 0.01). Conclusions Improved ICU checklist on instrument management can effectively promote nurses′mastery of instrument parameters, reduce the occurrence of nursing adverse events, ensure patient safety, improve the doctors′ satisfaction on nursing job, and provide an important basis for nursing safety management department.

Objective To investigate the feasibility and safety of laparoscopic surgery of giant hysteromyoma.Methods A total of 56 cases of giant hysteromyoma(at least 1 lesion ≥ 9 cm in diameter) underwent laparoscopic operations from January 2003 to August 2006 in this hospital.There were 30 cases of laparoscopic myomectomy(LM),10 cases of laparoscopic-assisted vaginal hysterectomy(LAVH),1 case of total laparoscopic hysterectomy(TLH),and 15 cases of laparoscopic supracervical hysterectomy(LSH).Results All of the operations were successfully performed under laparoscope.No conversion to open surgery was needed.The operation time was 40～100 min(mean,52 min),and the hemorrhage volume was 10～100 ml(mean,45 ml).Postoperatively,ureterovaginal fistula was observed in 1 case,which was cured by a re-operation of laparoscopic ureteroneocystostomy.Conclusions Laparoscopic operation for giant hysteromyoma is safe and feasible.

Objective To evaluate efficacy and safety of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock.Methods One hundred and thirty women with hemorrhagic shock due to ectopic pregnancy underwent laparoscopic surgery from January 2003 to August 2006,including salpingectomy in 80 cases,partial ovariotomy in 8 cases,uterus wedge resection in 15 cases,salpingotomy in 19 cases,and tubal lesion clearance in 8 cases.Results Laparoscopic surgery was successfully performed in all the cases.Intra-abdominal blood loss was 1000 to 3500 ml,with an average of 1500 ml.The operation time was 30-60 minutes(mean:40 minutes).No postoperative complication occurred.Follow-up was conducted in 106 cases,once in a week in the first month after discharge.Serial ?-hCG levels decreased gradually and reached the normal level 1-2 weeks after operation.Persistent ectopic pregnancy was not found in the studied cases.Conclusions Laparoscopic surgery is a safe and effective treatment for hemorrhagic shock due to ectopic pregnancy,given the skill of an experienced laparoscopist with the aid of optimal anesthesia and advanced cardiovascular monitoring.

Objective Study of peripherally inserted central catheter (PICC) for low birth weight infant parenteral nutrition effect. Methods A total of 100 low birth weight infants were selected, and then divided into the study group and the control group with 50 cases in each group according to random number table method. The study group used PICC for intravenous nutrition support treatment, the control group using external support for the treatment of indwelling needle for nutrition week vein. Comparing the two groups of one-time success rate of catheterization, average operation time, indwelling time, incidence of complications and nutritional support before and after the treatment, the children of weight. Results The one-time success rate of catheterization between the two groups had no significant difference (P >0.05). The operation time and the indwelling time in the study group was(30.65±9.87) d, (23.47±6.38) d respectively, while in the control group was (3.26±1.09) d, (4.15±1.52) d respectively, the difference was significant between the two groups (t=19.054 and 20.829, P<0.01). The incidence of complications in the study group was 8.00%(4/50), while in the control group was 24.00%(12/50), the difference was significant between the two groups (χ2=4.76, P<0.05). There was no significant difference about weight between the two groups before and after the nutritional support treatment (P > 0.05). Conclusions Parenteral nutritional support by PICC for low birth weight infant is a more ideal way with longer indwelling time and fewer complications.

Objective To study the relation between chronic stressful, the neural changes in prefrontal cortex and depression. Methods Adapt chronic unpredictable stress with separate model to make depression model rats. After 22 days all the rats were killed and use immunohistochemistry method and computer image analysis to detect BDNF. To analysis the date with SPSS11.5 software. Results After 21 days stress, body weight ( t =2.915, P < 0.05), ambulation ( t = 6. 245, P < 0. 01 ), rearing( t = 2.693, P < 0. 05 ) and grooming ( t = 2. 685, P<0.05) decreased and stopping time in center( t=2. 388, P<0. 05) ,defecation( t =3. 846, P<0. 01 ) increased in experimental group. BDNF expressed obviously in control group and the prefrontal cortex expressed highly than that of the experimental group. BDNF expressions of experimental group were lower than that in control group ( P< 0.01 ) especially in right prefrontal cortex. Conclusion There was no difference of BDNF distribution in prefrontal cortex between both groups ,but after 21 days stress ,the BDNF levels of experimental rats obviously descent,especially in right prefrontal cortex.

Objective To analyze the pressure source and effect of comprehensive intervention in type 2 diabetes mellitus patients. Methods 200 diabetes patients were randomized into the observation group and the control group with 100 cases in each group. Comprehensive intervention was introduced into the observation group and the control group underwent routine treatment. The pressure source was investigated after intervention by questionnaires and the results were compared. Results Fearing of serious complications bocame the most common cause of pressure. The scores of Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)were lower and the biochemical index was also better in the observation group than those in the control group as well as those before intervention in the observation group(P＜0.05).Conclusion The depression, anxiety status and biochemical index in patients with type 2 diabetes mellitus were effectively controled by corresponding and comprehensive intervention measures according to the sequence order of pressure source.

Objective To set up a novel clinical method for storage of oocytes by slowly freezing and successful pregnancy by intracytoplasmic sperm injection (ICSI). Methods The frozen oocytes (n=33) in metaphase Ⅱ (28),which were normal in morphology,were denuded of their cumulus-corona complex.The protective freezing solution contained 1,2-propanediol (1.5 mol/L) and sucrose (0.35 mol/L) and the process was slow for freezing and rapid for thawing.The recipients of these oocytes received hormone replacement therapy (HRT). Results A high survival rate of oocytes (32/33) was obtained when the sucrose concentration was 0.35 mol/L.ICSI induced a higher fertility rate (23/28),a good embryo cleavage rate (21/23) and a satisfactory embryo morphology for thawed oocytes.Embryo transfers were performed in 6 cycles/6 cases. Four cases got clinical pregnancy by demonstration of four gestation sacs on B ultrasonic examination 7 weeks after ICSI,1 fetal was first trimester spontaneous abortion,another 3 survival fetal were ongoing pregnancy and the first case gestation week is 17 weeks. Conclusions This study is the first successful application of human oocyte cryopreservation in China and this method can increase the survival rate of freezing oocytes.It’s easy to carry out,low in cost and high in the recovery rate of oocytes after thawing.

Objective To determine if the shortened exposure of oocytes to sperm can influence the insemination rate and the results of IVF-ET. Methods A total of 217 women were included.They were divided into study group (105 cases) and control group (112 cases). In study group the shortened insemination was used.The oocytes were washed 2 hours after the insemination and transferred into the fresh medium.In control group the classical procedure was used.The oocytes were inseminated by ICSI.The number of retrieved oocytes,fertilized oocytes,the number of embryos were counted and the pregnancy rate was evaluated. Results There was no statistically significant difference between the study and control group in the number of retrieved oocytes (1163 vs 1752),number of embryos (1084 vs 1097),and pregnancy rate ( 42.9% vs 42.9%). Conclusions The shortened exposure of oocytes to sperm is a simple and effective way in IVF-ET.

Objective To demonstrate the value of eombined application of prenatal ultrasonography with fetal magnetic resonance imaging(MRI) in the diagnosis of monochorionic muhifetal realformations. Methods Fourteen cases of muhifetal malformations,detected by prenatal ultrasonography,received MRI within 48 h afterwards.All diagnosis were confirmed after delivery or mid-term termination.All imaging results of the 14 cases were retrospectively reviewed. Results Among the 14 cases,there were 7 acardias,5 Conjoined twins and 2 demise of multifetuses.Comparing ultrasound with MRI,we found that:(1)In cases with acardia and demise of multifetusea,ultrasound could diagnose correctly and be an important tool for follow-up,while MRI could demonstrate organs and structures of the acardiac recipient more clearly and detect the secondary changes of brain in the donor and survived fetus.(2)In Conjoined twins,ultrasound was superior to MRI in demonstrating the structure and function of cardiovascular system : and equivalent to MRI in identifying stomach,kidney,bladder and limbs;but inferior to MRI in identifying esophagus,lung,liver and intestinal,especially in the brain. And MRI could demonstrate two fetuses and the relationship between them in COnjoined twins simultaneously. Conclusions Prenatal ultrasonography and MRI have their own advantages and disadvantages in diagnosing monochorionic multifetal malformations.But the combination of prenatal ultrasonography and fetal MRI may be more valuable.