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 serum levels of vascular endothelial growth factor(VEGF)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and make a primary relative study on the relationship between VEGF and pH.Methods Thirty-nine patients with mild to moderate OSAHS,36 patients with severe OSAHS and 18 healthy snorers who had been admitted to the First Hospital Affiliated to Wenzhou Medical College from Feb.2003 to Sep.2004 were enrolled in this study.The serum levels of VEGF were detected in all patients at 7:00 AM the next day after the detection of polysomnography(PSG).Additionally 31 patients with OSAHS were detected by doppler echocardiography to get the values of pulmonary artery pression.Results There was nocturnal hypoxia in patients with OSAHS compared with healthy snorers,and the degree of nocturnal hypoxia was depended with the grade of OSAHS(both achieved statistical difference)by the detection of PSG.The levels of VEGF was significantly higher in patients with severe OSAHS than in healthy snorers(P

[Abstract ] Objective The mechanism of psychological stressi-nduced damage to vascular endothelial cells (VEC) is not yet clear.This study was to investigate the impact of psychological stress on the NO level and NO-related regulatory protein expression in the plasma of rat models of psychological stress-induced VEC injury. Methods Twenty male SD rats were equally randomized into a con-trol group and a model group, the former raised together, with water regularly fed at 9:00 and 21:00 hours for 10 minutes a day, while the latter raised alone, with water regularly fed at the same hours for 10 minutes a day for the first 7 days and then with water or an empty bottle at the same hours for 10 minutes a day according to the random table.Ninety days later,all the rats were intraperitoneally injected with normal saline at 0.2 ml per 100 g body weight twice a day.Then the behaviors of the animals were observed by open field tests, the contents of cortisol (COR),adrenaline (Adr), and endothelin-1 (ET-1) in the plasma measured by ELISA, the NO level detected by the nitrate reductase method, and the expression of NO-related regulatory proteins in VECs determined by LC-ESI-MS. Results Com-pared with the control group, the model rats showed significant increases in the vertical score (7.00 ±0.70 vs 11.28 ±1.79), horizontal score (37.60 ±4.500 vs 56.25 ±1.71), and total score (44.50 ±5.50 vs 67.25 ±2.98) (P<0.01) as well as in the levels of COR ([65.28 ±2.21] vs [83.85 ±1.95] ng/mL ) and Adr ([3.85 ±0.35] vs [15.14 ±3.97] pg/mL) (P<0.01), but a remarkable de-with vacuoles in the VECs in the model group and structural integrity, ridge clarity, and tight pack in the VEC mitochondria in the con-trol. Conclusion Psychological stress induced by empty bottle stimulation can reduce the NO level and the expression of NO-related regulatory proteins in the plasma, which may cause both functional and structural damages to VECs.

Objective To assess the application of MRI in diagnosis of oblique vaginal septum syndrome (OVSS).Methods Clinical and imaging data of 41 patients with OVSS confirmed by surgery from March 2011 to November 2016 were retrospectively analyzed.Results The average age of patients was 20.5 year (10-46 years).The primary clinical symptoms were menorrhalgia (16 cases) and menorrhagia (13 cases).There were 12 cases of type Ⅰ,23 cases of type Ⅱ,5 cases of type Ⅲ and 1 case of type Ⅳamong 41 cases of OVSS.The resections for OVSS were performed in 35 cases.Forty two cases were diagnosed as OVSS by MRI scan,and 41 were confirmed by surgery,the accuracy of MRI diagnosis was 97.6％ (41/42).MRI showed uterus didelphys,hydrocolpos or hematocolpos with varying degrees,and revealed ipsilateral renal agenesis in all 41 cases.Conclusion MRI scan can accurately diagnose oblique vaginal septum syndrome and provide comprehensive information for clinical treatment.

Objective To investigate the prevalence of high urine albumin-to-creatinine ratio (ACR) among health check up population and evaluate the potential predictors for ACR. Methods A cross-sectional study was conducted among health check up population in the Zhongshan Hospital during 2015. Potential participants completed urine ACR test,body mass index (BMI) and blood test. ACR level was divided into two groups according to the K/DOQI recommendation:ACR Group(male:ACR≥17 mg/g;female:≥25 mg/g), Normal Group (male:ACR<17 mg/g;female:ACR<25 mg/g). Univariate and multivariate logistic regression models were performed to evaluate the associations of ACR with potential predictors (including age,sex,over-weight or obesity,hypertension,glucose metabolism disorders, hypertriglyceridemia,hypercholesterolemia,high low HDL-C and hyperuricemia). Result Totally 670 people from the health check up population were screened for ACR test, 54 cases were positive, the prevalence was 8.1％. Age, BMI, waist-to-height ratio, SBP, DBP, blood sugar and uric acid had statistical significance between Normal group and ACR group[Age 47.62 ± 11.29 vs. 53.83 ± 11.93, t=-3.858, P<0.01;BMI (24.05±3.12) kg/m2 vs. (24.94±3.49) kg/m2, t=-1.982, P<0.05;waist-to-height ratio 0.51±0.52 vs. 0.53 ± 0.06, Z=-2.146, P<0.05; SBP (mmHg, 1 mmHg=0.133 kPa) 115.31 ± 15.59 vs. 130.91 ± 23.66, t=-4.755, P<0.01;DBP(mmHg) 72.31 ± 9.16 vs. 80.02 ± 9.81, t=-5.897,P<0.01;blood sugar (mmol/L) 4.64 ± 1.20 vs. 5.57 ± 2.77, t=-2.466, P<0.01;uric acid (μmol/L) 362.99 ± 92.80 vs. 397.76 ± 95.62, t=-2.633, P<0.01]. Age, hypertension, glucose metabolism, HDL reduction were risk factors for urinary albumin/creatinine ratio. In the multivariate logistic regression model, hypertension status was found to be associated with ACR positive [odd ratio (OR): 2.843, 95％ confidence interval [CI, 1.472-5.493, P<0.01], glucose metabolism disorders (OR, 2.132, 95％CI, 1.042-4.365, P<0.05). As the number of risk factors increases, the rate of positive of ACR showed marked increase, comparing persons with no risk factors to those with four or more risk factors , the OR value rose up to 18.281. Conclusion Hypertension and glucose metabolism disorder are risk factors of chronic renal dysfunction. With the increase of risk factors, the rate of positive of ACR was higher. ACR test is recommended routine screening for people over the age of 50.

Objective: To explore the effect of suberoylanilide hydroxamic acid (SAHA) improving cardiac hypertrophy via inhibiting histone deacetylases (HDAC) in experimental mice and to provide a new idea for prevention and treatment of cardiac hypertrophy. Methods: Cardiac hypertrophy mice model was established by thoracic aorta ligation. A total of 60 Kunming mice were randomly divided into 4 groups: Normal control group, Sham operation group, Cardiac hypertrophy (CH) group and CH+SAHA group. There were 6 mice used in each group. Myocardial cell morphology was observed by HE staining, cardiac function was assessed by echocardiography, mRNA and protein expressions of HDAC5 (the isoform of HDAC) and β-MHC were examined by RT-PCR and Western blot analysis. Results: The mice in CH group had myocardial cell hypertrophy, disordered arrangement and hyperchromatic nucleus. Compared with Sham operation group, CH group showed decreased left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic volume (LVEDV) and increased thickness of inter-ventricular septum (IVS), allP<0.05; CH group presented elevated mRNA and protein expressions of HDAC5 and β-MHC,P<0.05. SAHA obviously decreased HDAC5 expression, down regulated cardiac hypertrophy related β-MHC gene expression, improved cardiac function and hypertrophy, all P<0.05. Conclusion: HDAC were involved in myocardial hypertrophy; SAHA could inhibit HDAC expression and therefore,improved myocardial hypertrophy in experimental mice.

Objective To analyze the related factors of nursing risk in department of nephrology and to explore strategies of risk management.Methods Risk management was implemented to 39 nurses in department of nephrology of our hospital.The KAP scores,the incidence of nursing risk events,nursing complaints and patients' satisfaction degree before and after the implementation of nursing risk management were compared.Results After the implementation of nursing risk management,nurses' KAP score was significantly higher; the incidence of nursing risk events and complaints significantly reduced; patients' satisfaction degree to nursing were significantly higher compared with those before the implementation.Conclusions The implementation of nursing risk management can effectively improve the quality of nursing and reduce the incidence of nursing risk events.

Objective To observe characters of sputum of patients with tracheotomy by heat and moisture exchanger(HEM)undergoing hyperbaric oxygen therapy(HBOT)in multi-person chamber.Methods In randomly block design,239 patients were selected and received HBOT using HEM combined with L-shape tube(group HEM,n=128)and by L-shape tube(group L,n=111)respectively.The characters and volume of sputum,times of sucking sputum and cases of sealing/extubation of tubes were assessed over first and tenth sessions of HBOT.Results The times of sucking and volume of sputum over first session of HBOT in the group HEM were more than those in group L.The sputum was changing from ropiness over first session to tenuity over tenth sesion(P＜0.01).Cases with sealing/extubation of tubes in group HEM were more than those of group L(P＜0.01).Conclusions It is helpful to humidify and discharge deposited sputum of patients over routine hyperbaric oxygen by HEM.And the case8 of sealing/extubation of tubes are also reduced.

Objective To investigate the diagnosis and treatment of aggressive fibromatosis after thyroidectomy.Methods One patient who were admitted into our hospital on January 16,2014 were discovered to have left cervical mass at the regular follow-up 8 months after opertaion.The ultrasonic examination showed that there were low echo area of 58 mm ×30 mm in the 3 ~5 muscular layer at the left neck. And it was diagnosed as aggressive fibromatosis through the puncture disease inspection.Whereafter,the patient were readmitted into hospital and recieved radical resection of the tumor on left side of the neck.The clinical,pathological and radiological data of the patient were collect-ed and analyzed so ao to discuss the diagnosis and treatment experience combined with related literatures.Results Postoperative pathologic examination confirmed that it was aggressive fibromatosis.The patient was actively cooperated with perioperative treatment,and the postoperative recovery was good with no local recurrence during the follow-up up to now.Conclusion Early diagnosis and surgical treatment are needed for patients with aggressive fibromatosis after thyroidectomy.