Objective To study the correlation between blood lactic acid level and PCIS scroing system.To study the relationship between dynamic lactic acid monitoring indexes and prognosis of critical patients.Methods Differences of mortality,incidence of MODS and shock,PCIS score between two groups were compared.The patients were divided into 3 groups by PCIS score to compare pathogenetic conditions prognosis, then to study the were divided into death group and survival group by the hospital prognosis. Differences of their lactic indexes and other clinical indicators which reflected organ/system status were compared, prognostic-significant lactic indexes were selected by mu fti-variable logistic analysis. Results Patients with elevated lactic acid level had more incidence of shock and MODS, higher PCIS scores and higher mortality, the differences had statistical significance compared with the normal lactic acid group. There were significant linear correlation between ICU lactic acid level, peak lactic acid level and PCIS scores respectively. For the patients with elevated lactic acid level, peak lactic acid level, 12h lactic clearance had significant correlation with prognosis. Conclusion PCIS scoring system had a significant linear correlation with lactic acid level. For the patients with elevated lactic acid level,peak lactic acid level,12h lactic clearance were good indicators to evaluate patients' prognosis.

Embodied as an abstract concept as well as concrete regulations and material environment on the campus,the campus culture is the organizational culture among universities,which plays a significant role in enhancing students' quality of career starting.Similar to its social culture,the American campus culture is characterized by a strong personal heroism thus is known as a "cowboy culture".As the so-called "dragon culture",the Chinese culture is a more conservative one and thus lack of innovation-oriented career starting concepts among Chinese university students.Therefore,in order to effectively carry out entrepreneurship education in colleges and universities,the innovation-oriented campus culture should be constructed,students' entrepreneurship conception strengthened,thus students' sense of career starting and mental status be enhanced.

With the rapid development of internet and multimedia technology,the training of visual literacy has gained much more attention.In the teaching of Biochemistry,when confronting numerous visual tools in various ways for biological molecules research and rapid development of subject,teachers and students are required to have higher level of visual literacy.However,it is slighting and retarded to develop visual literacy education in China.Therefore,it is very important to emphasize the improvement of visual literacy in the teaching of Biochemistry,which can improve the ability in teaching design and learning method in this era of graphical interpretation.

Objective To make sure the proper time when using self-designed hemostatic belt to press vein after mainline. Methods Divide the subjects into 8 groups, using different pressing time to different group, and then observe the condition of petechia. Results There are significant differences in the different groups about the condition of petechia, P

Objective To investigate the inhibitory effect and associated mechanism of rapamycin on proliferation and extracellular matrix (ECM) secretion in myofibroblasts stimulated by connective tissue growth factor (CTGF). Methods Primary cultivated myofibroblasts were divided into 6 groups: control, CTGF (100 μg/L), rapamycin 20 μg/L+CTGF 100 μg/L, rapamycin 40 μg/L +CTGF 100 μg/L, rapamycin 20 μg/L, and rapamycin 40 μg/L alone. 5'-bromodeoxyuridine (BrdU) incorporation assay was used to detect the myofibroblast proliferation.Western blot was used to analysis the secretory FN protein in the supernatant medium of cultured myofibroblasts and the ERK1/2 phosphorylation in myofibroblasts. Results CTGF (100 μg/L)incubation significantly increased the number of Brdu positive myofibroblasts(P<0.01) and the level of FN protein secretory (P<0.05) in cell supernatant medium compared with control group,respectively. The number of Brdu positive myofibroblasts markedly decreased by 62% and 70% (P <0.05) in rapamycin 20 μg/L+CTGF 100 μg/L and rapamycin 40 μg/L+CTGF 100 μg/L groups, respectively. The FN protein levels in supernatant were decreased by 15% and 44% compared with CTGF 100 μg/L group, respectively; but the difference of FN protein levels was significant only in rapamycin 40 μg/L group (P<0.05). CTGF could activate ERK1/2 at 10 minutes; but as myofibroblasts were pretreated with rapamycin 40 μg/L for 30 min, it abolished CTGF-induced ERK1/2 phosphoralation. PD98059, the specific inhibitor of ERK1/2, could block the effect of CTGF-induced proliferation (7%±5% vs 85%±7%, P<0.01) and FN secretion (1.0±0.1 vs 1.6±0.3, P<0.05). Conclusions Rapamycin partially suppresses the proliferation and ECM secretion of myofibroblasts induced by CTGF. Its effect may be through inhibiting CTGF-induced activation of ERKI/2 signaling pathway.

Objective To investigate the relationship between metabolic syndrome(MS)and nonalcoholic fatty liver disease (NAFLD)in non-obese and non-diabetic hypertensive patients.Method 84 non-obese and non-diabetic hyperlensive patients were divided into 42 hypertensive patients with NAFLD and 42 hypertensive patients without NAFLD by abdominal ultrasonography examination.Body mass index(BMI),blood pressure,fast and OGGT 2 hour plasma glucose,fast and OGGT 2 hour plasma insulin,plasma lipids and aminotransferase were measured in the two groups.Multivariate logistic regression analysis was used to identify the variables independently associated with MS.Result BMI,triglycerides,fast insulin,2 hour insulin,aminotransferase,HOMA-IB and MS prevalence rate in the group with NAFLD were significantly higher than these in the group without NAFLD.Multivariate logistic regression analysis(forward LR)showed NAFLD:were independently associated with MS.Conclusion MS play a role not only in occurrence of NAFLD but also in liver injury.

ObjectiveTo explore the causes and countermeasures for extravasation of intravenous fluids in children. Methods726 cases of intravenous infusion in pediatric surgery department from May to December 2011 in our hospital were observed. ResultsThere were 30 cases with extravasation of intravenous infusion in the 726 cases,the leakage rate was 4.13％.The specific causes of fluid extravasation included:younger age of children,not cooperating with the infusion in 18 cases,accounting for 60.00％,followed by non standardized fixation methods in 5 cases,accounting for 16.67％,and accompanying family members refused to be disturbed accounted for 13.33％,Nursing visits to owe in a timely manner accounted for 6.67％.The rate of younger age of children and lack of cooperation leading to fluid extravasation were significantly higher than other causes,the difference was statistically significant. ConclusionsChildren age,fixation method,cooperation of family members,inspections and other factors can be controlled.Along with the continuous improvement of medical standards and a variety of active and effective implementation of the measures,these factors can be controlled effectively.Strengthening the training of nurses and vocational skills to enhance their own sense of responsibility,to give standardized infusion operation and fixation,and give predictable observation and treatment,can effectively prevent the occurrence of extravasation of intravenous fluids.

Objective To investigate the role of sitting-up-straight position in correction of peripherally inserted central catheter(PICC)heterotopia.Method Eighteen cases with PICC heterotopia were instructed to take the position of sitting up straight. Result All of the patients had the PICC heterotopia corrected.Conclusions The sitting-up-straight position can effectively correct the PICC catheter heterotopia.This method is simple and feasible and thus worthy of clinical application.

Objective:Try to study the effect of short-term psycho-intervention on mental status,medical coping mode,social supports and mood states in patients with maintance hemodialysis(MHD).Methods:61 MHD patients from Nol Wuhan Hospital were divided into intervention group and control group.The short-term psycho-intervention included healthy education,supportivc psychotherapy,circumstance therapy and education to patient's relatives.All patients' social psychology status were assessed at baseline and end of intervention by three questionnaires,such as Medical Coping Mode Questionnaire (MCMQ),Social Support Ouestionnaire and Profile of Mood States.Results:After intervention,most psychology indexes of intervention group improved. Acceptance-Resignation score decreased from 12.5?3.7 to 9.3?2.5,avoidance score decreased from 16.5?2.9 to 14.4?2.7,subjective support score increased from 16.2?5.6 to 21.6?5.1,support using score increased from 6.4? 2.3 to 8.8?2.8,Total support score increased from 32.5?8.1 to 38.9?6.7.Tension-Anxiety score decreased from 14.1?6.7 to 10.1?5.2,Depression-Dejection score decreased from 22.9?14.5 to 16.2?10.2, Anger-Hostility from 16.6?10.1 to 11.5?8.6,Confusion-Bewilderment decreased from 11.9?4.8 to 9.1?4.2,but Vigor-Activity increased from 10.3?6.2 to 15.1?5.4.There was no significant change in control group.Conclusion:Short-term psycho-intervention can improve medical copying mode,social support and mood states in MHD.

Objective We make a retrospective analysis , to compare to COPD group and discuss the risk factors and the clinical features in acute exacerbation in patients with ACOS to follow-up the exacerbating frequency after regular treatment in both two groups in one year. Methods There were 56 patients with ACOS and 80 patients with COPD from 2013 to 2015 in our hospital in 30%≤FEV1<80% in the stable phase. The common data of the enrolled patients included the age,sex,smoking, and allergic rhinitis or other allergic diseases in family. We analyzed laboratory index including PaO2,PaCO2,CRP,white blood cells,IgE of serums and compared the proportion of antibiotics,system used of glucocorticoid and noninvasive ventilation in hospitalization of acute exacerbation and followed up exacerbating frequency after using ICS united LABA/LAMA. Results The age and smoking index in the ACOS group were lower than the COPD group (P < 0.05). The allergic rhinitis or other familial allergic diseases,lower age of 60,the high IgE in serum were risk factor, in ACOS. In acute exacerbation, the PaCO2,IgE and WBC in serum were higher than that of the COPD group(P <0.05). The midian length of stay in hosipital was 12 days in the ACOS group and 8 days in the COPD group. The proportion of antibiotics,systemic administration of glucocorticoid and noninvasive ventilation in hospitalization of acute exacerbation in the ACOS group were higher than that of the COPD group (P < 0.05). The exacerbating frequency was decreased after using ICS united LABA/LAMA(1.2±0.6 vs 3.8±1.3,P < 0.05)in both ACOS and COPD groups. Conclusions The allergic diseases may participate in ACOS, in which it has familial tendency. In acute exacerbation, ACOS patients had even more inflammation and faster course than COPD patients. Using ICS united LABA/LAMA can reduce exacerbating frequency in ACOS.