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 explore the effect of discharge planning mode on growth and development in prematures.Methods 62 premature cases were randomly divided into the control group and the observation group with 31 cases in each group respectively.The control group accepted routine nursing care,the observation group was given comprehensive detailed discharge planning mode on basis of conventional premature nursing.All the research objects were monitored about the height and body weight,and also the Bayley Infant Development Scale was adopted to evaluate the psychological behavior development when their corrected gestational age was 3,6,12 months respectively.Results The height,weight and Mentality Development Index (MDI),Psychomotor Development Index(PDI) of the prematures in the observation group when their corrected gestational age was 3,6,12 months respectively were all higher than those of the control group.Conclusions Application of discharge planning mode in premature infants is helpful to the physical and mental developmental of them.

Objective To increase the normative follow-up rate of organ transplant recipients,and to improve their long-term survival rate of patients and their life quality.Methods Establish a normative follow-up management system of organ transplantation,improve the follow-up rules and link management,strengthen the whole-course health education and provide comfort and warm service for patients.Results ( 1 ) The results of patients/renal survival rates at different times indicated that the 1 year,3 year and 5 year patients/renal survival rates in the normative follow-up group were significantly higher than that in the random follow-up group,P ＜ 0.05.( 2 ) The 1-year follow-up results for the outpatients indicated that no difference in one-year follow-up rate were observed in both groups (98.4％ vs.97.5 ％,P =0.128).And the 3 year and 5 year follow-up rates in the normative follow-up group were statistically significantly higher than that in the random follow-up group (90.1％ vs.85.5％,88.3％ vs.55.3％,P ＜ 0.001 ).Conclusion Establishment of the sound and normative follow-up management system of organ transplantation was helpful to improve the long-term survival rates of patients and their life quality.

ObjectiveTo explore the effect of JNK-c-Jun signal pathwayon connexin 43 (Cx43) expression and its role in renal tubular epithelial-myofibroblast transition (TEMT) induced by TGF-β1.Methods Normal rat kidney tubular epithelial cells(NRK-52E) were cultured in Dulbecco's modified eagle medium(DMEM) with 10％ fetal bovine serum,then were randomly divided into 3 groups: control group,TGF-β1 group (treated with TGF-β1 10 μg/L),and TGF-β1+SP600125 (selective JNK inhibitor,50 μmol/L) group. The protein expressions of JNK,c-Jun,α-SMA,Cx43 and E-cadherin were assayed by immunocytochemistry and Western blotting.The Cx43mRNA was assayed by RT-PCR.Gap junction intercellular communication(CJIC) was measured by fluorescence recovery after photobleaching assay(FRAP).Results TGF-β1increased the expressions of JNK,c-Jun and α-SMA(P＜0.05),reduced the expressions of Cx43 and E-cadherin (P＜0.05),and inhibited GJIC of NRK-52E(P ＜0.05).SP600125 could alleviate the above expressions changes and enhanced GJIC induced by TGF-β1.Conclusion JNK-c-Jun signal pathway induces TEMT ofNRK-52E treated with TGF-β1 viadown-regulation of connexin 43expression and inhibition of GJIC.

Objective To investigate the value of quantitative TB‐DNA test ,interferon gamma release test and the detection of tuberculosis antibodies for the diagnosis of active pulmonary tuberculosis .Methods 51 patients were diagnosed as tuberculosis from 2013 July to 2014 June in the hospital ,whose sputum smear microscopy for acid fast bacilli were positive .Then TB‐DNA quantitative test ,interferon gamma release test (T‐SPOT .TB)and tuberculosis antibody detection were performed for those pa‐tients .All the result were retrospectively analysed .Results The positive rate of T‐SPOT .TB was 90 .1% ,the positive rate of quan‐titative TB‐DNA test was 74 .5% and the positive rate of tuberculosis antibody detection was 37 .3% .Conclusion Because the re‐sult of T‐SPOT .TB is not affected by the process of specimen collection ,it is the most sensitive test of the three tests at present , and has higher value in the auxiliary diagnosis of active pulmonary tuberculosis than the other two .

Objective To explore the correlation between cholecystectomy and colorectal adenoma.Methods A total of 981 patients who underwent colonoscopy between January 2007 to December 2012 at Wuhan Central Hospital were enrolled in the study according to the inclusion criteria.The patients were divided into cholecystectomy group (n=216) and control group(n=765) in terms of cholecystectomy or not.The incidence of colorectal adenoma ,gender ,age ,location and pathological type of ade-noma were analyzed in the two groups.Results Significant differences were noted in the incidence and location of colorectal ad-enoma ,and gender between the two groups (P< 0.05).The incidence of colorectal adenoma was higher in cholecystectomy group than in control group ;the number of female patients with colorectal adenoma was greater than that of male patients ;the incidence of proximal colorectal adenoma was higher than that of distal adenoma.But the average age of patients with adenoma was not significantly associated with the pathological types of adenoma in both groups (P>0.05).Conclusion Cholecystecto-my is closely associated with the occurrence of colorectal adenoma.Screening for colorectal adenoma should be considered in the patients with gall bladder removal.

Objective To study the application value of serum umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Methods 1 200 cases of healthy newborn were selected,whose mothers were type O blood and fathers were not type O blood.According to the situation of maternal and infant blood type,they were divided into the same maternal and child blood type group with 539 cases and different blood type group with 661 cases;According to the umbilical cord blood bilirubin concentration range was divided into five groups,and analyzed umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Results (1) The concentrations of umbilical cord blood bilirubin,the incidence of ABO-HDN,the incidence of hyperbilirubinemia in the maternal-fetal blood(O-A/B) group were (38.1 ± 10.3) μmol/L,47.35％,26.02％,respectively,which were all significantly higher than (33.4 ± 7.9)μmol/L,15.21％,14.66％ in the maternal blood type (O-O) group (t =5.8,x2 =120.7,x2 =20.1,all P =0.000) ; (2) When the concentrations of umbilical cord blood bilirubin was higher,the incidence of hyperbilirubinemia was higher,but the sensitivity and the specificity both were bad; (3) According to the result of hemolysis three to predict the neonatal hyperbilirubinemia,when the concentrations of umbilical cord blood bilirubin was less than 21μmol/L or more than 55μmol/L,the positive predictive value and the specificity both were 100.00％,and the sensitivity was not low(75.00％ and 86.96％).Conclusion Detection of umbilical cord blood bilirubin and hemolysis three test in the maternal-fetal blood group incompatibility could predict early hyperbilirubinemia of newborn,which had certain clinically practical value.

ObjectiveTo investigate the role of Nav1.7 in dorsal root ganglia (DRG) in a rat model of diabetic neuropathic pain (DNP).MethodsThirty-two female Wistar rats aged 3 months weighing 180-220 g were randomly divided into 4 groups ( n ＝ 8 each):control group ( group C),sham operation group ( group S),DNP group and ProTx- Ⅱ (a selective Nav1.7 blocker) group (group E).Diabetes mellitus was induced by intraperitoneal streptozocin 65 mg/kg.Blood glucose level and mechanical paw withdrawal threshold (MWT)to von Froy filamentstimulation were measured 2 weeks later.DNP was confirmed by blood glucose level ≥ 16.0 mmol/L and MWT decreased by more than 50％ of the baseline value.Intrathecal catheter was implanted at L5,6 interspace on day 10 after successful induction of DNP.On day 4 after placement of the intrathecal catheter,ProTx- Ⅱ 10 μg/kg was injected intrathecally in group E,while the equal volume of normal saline was given in groups DNP and S.MWT and never conduction velocity (NCV) were measured 1 h after intrathecal injection.The rats were then sacrificed and DRGs of the lumbar segment (L4-6) were removed for determination of Nav1.7 protein expression (by immuno-histochemistry and Western blot) and Nav1.7 mRNA expression (by RT-PCR).ResultsThe MWT and NCV were significantly lower and the Nav1.7 mRNA and protein expression was significantly higher in groups DNP and E than in group C.ProTx- Ⅱ significantly attenuated the diabetes-induced changes in MWT,but had no effect on NCV and Nav1.7 mRNA and protein expression.ConclusionNav1.7 in DRG is involved in the maintenance of DNP in rats.

Objective: To observe the clinical effects of Zhu Lian's type Ⅰ excitation needling technique for postpartum urinary retention. Methods: A total of 60 cases with postpartum urinary retention were recruited and divided randomly into an observation group and a control group, 30 cases in each group. The control group was treated with routine acupuncture, and stimulated with sparse and dense wave of electric acupuncture for 15 min after arrival of needling sensation, and then the needles were taken out. The observation group was treated with Zhu Lian's type Ⅰ excitation needling technique, by inserting the needles with the quick inserting method, swift and temporary lifting and thrusting technique for shallow insertion for 5 times, by an in-and-out technique, without retaining the needles. Results: The total effective rate was 96.7% in the observation group and 83.3% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). After the treatment, the first urination time was shorter in the observation group than that in the control group, with a statistical significance (P<0.01). After the treatment, the volume of residual urine after the first urination was less in the observation group than that in the control group (P<0.01). Conclusion: Zhu Lian's type Ⅰ excitation needling technique can effectively promote the voluntary urination and bladder emptying in patients with postpartum urinary retention, and it takes effect faster.