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

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 study the roles of TLR2 and TLR4 in the progress of invasive pulmonary aspergillosis(IPA) in experimental mice.Methods The mice were divided into three groups including the group of normal mice,the group of normal mice infected with A.fumigatus and the group of IPA mice.The mice were sacrificed at four time points(8 h,24 h,48 h and 72 h) after infection.The lung tissues from each group were collected for pathological analysis and RT-PcR for detecting the expression level of,TLR2,TLR4 and β-tublin.The ratio of density value of band of each PCR product on electrophoresis to the density value of β-tublin was used to evaluate the expression level of each gene like TLR2.TLR4 and TNF-α.Re-suits The pathological analysis showed the normal structure and no inflananatory reaction in the lungs in the group of normal mice.The infiltration of inflammatory cells,weak injuries and no germination of spore into hypha in the lungs of normal mice infected with A.fumigatus,and serious injuries like destruction of alveolar structure,bleeding,infiltration of inflammatory cells and germination of spore into hypha in the lungs of IPA mice.The expression level of TLR4 at 8 h,24 h,48 h and TNF-α at 24 h and 48 h were lower in IPA mice than that in healthy mice with infection(P<0.05).Conclusion There was low expression of TLR4 and TNF-α in IPA mice lung tissues.Typical pathological injuries in the lungs and germination of spore into hy-pha in IPA mice were observed by the microscope.

Rotundine (1 micromol L(-1)) was incubated with a panel of rCYP enzymes (1A2, 2C9, 2C19, 2D6 and 3A4) in vitro. The remained parent drug in incubates was quantitatively analyzed by an Agilent LC-MS. CYP2C19, 3A4 and 2D6 were identified to be the isoenzymes involved in the metabolism of rotundine. The individual contributions of CYP2C19, 3A4 and 2D6 to the rotundine metabolism were assessed using the method of total normalized rate to be 31.46%, 60.37% and 8.17%, respectively. The metabolites of rotundine in incubates were screened with ESI-MS at selected ion mode, and were further identified using MS2 spectra and precise molecular mass obtained from an Agilent LC/Q-TOF-MSMS, as well as MS(n) spectra of LC-iTrap-MS(n). The predominant metabolic pathway of rotundine in rCYP incubates was O-demethylation. A total 5 metabolites were identified including 4 isomerides of mono demethylated rotundine and one di-demethylated metabolite. The results also showed that CYP2C19, 2D6 and 3A4 mediated O-demethylation of methoxyl groups at different positions of rotundine. Furthermore, the ESI-MS cleavage patterns of rotundine and its metabolites were explored by using LC/Q-TOF-MSMS and LC/iTrap-MS(n) techniques.

Objective To investigate the change of plasma marinobufagenin (MBG) level and the expression of its receptor Na+-K+-ATPase (NKA) in renal biopsy specimens of chronic glomerulonephritis (CGN) patients. Methods Twenty-eight CGN patients and 14 healthy people were enrolled in the study. The plasma MBG concentration was measured by competitive inhibition ELISA system. Immunofluorescence and immunohistochemistry staining were applied to detect the expression of NKA in renal biopsy specimens of 28 CGN patients and analyzed by semi quantitively. Results Compared with healthy controls, CGN patients had significant lower plasma MBG concentration [(0.579±0.214) nmol/L vs (0.715±0.154) nmol/L, P＜0.05], without further significant difference between CGN patients with hypertension and with normal blood pressure [(0.595±0.231) nmol/L vs (0.557±0.197) nmol/L, P＞0.05]. Meanwhile, proximal tubular staining of NKA was decreased compared with normal controls. The NKA positive staining area of the CGN group was lower than that of normal controls [2.1% (0.5%-6.2%) vs 5.6% (3.5%-10.8%), P＜0.01] and correlated with 24-hour urinary sodium excretion (r=0.551, P＜0.01).Conclusion Decreased plasma MBG level and its receptor expression on proximal tubules may play a role in the regulation of sodium in CGN.

OBJECTIVE:To establish a method for the content determination of chlorogenic acid,protocatechuic acid and total phenolics in Chaenomeles sinensis,compare the content of total phenolics and 2 phenolic acids from different areas. METHODS:Wavelength switching HPLC method was conducted to determine the chlorogenic acid and protocatechuic acid. The column was Shim-pack CLC-ODS(M)with the mobile phase of acetonitrile-0.1% phoephoric acid(15∶85,V/V),the detection wavelength was 259 nm(for protocatechuic acid)and 325 nm(for chlorogenic acid)and the switching time was 14 min. With the index of proto-catechuic acid,Folin-Ciocalteau colorimetric method was conducted to determine the total phenolics. RESULTS:The 2 methods of quantitative analysis showed that the precision,repeatability,recoveries and standard curves were all validated by methodology. The mass fraction of total phenolics was 0.87%-3.77% with the average of 2.16%;the chlorogenic acid was 0.053%-0.387% with the average of 0.192% and the protocatechuic acid was 0.024%-0.541% with the average of 0.087%. The order of total phenolics content in C. sinensis from different areas was Yunnan>Anhui Xuancheng>Sichuan>Hubei and the order of total amount of chlo-rogenic acid and protocatechuic acid from different areas was the same as the total phenolics. There were differences among the con-tents of C. sinensis from different areas,however,the positive correlation was found between the content of total phenolics and the total amount of chlorogenic acid and protocatechuic acid with the pearson correlation coefficient of 0.719(P<0.01).CONCLU-SIONS:The established method is simple,accurate and reproducible and can be used for the content determination of chlorogenic acid,protocatechuic acid and total phenolics in chaenomelis fructus.

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.