Objective To evaluate the combination treatment effects of bisoprolol,perindopril and spirono-lactone on chronic cardiac failure caused by rheumatic heart disease.Methods 92 patients were randomly divided into the control group (n=45) and observation group (n=47).The observation group received combination usage of bisoprolol,perindopril and spironolactone,while the control group was given regular treatment.Cardiac functions were measured in both two groups.Results The left ventricular end diastolic diameter ( LVEDD) and left ventricular end systolic diameter (LVESD) were significantly decreased in the observation group(t=4.217,5.842,P<0.05),while left ventricular ejection fraction (LVEF) was significantly increased compared with the control group (t=3.164,P<0.05).Conclusion The combination treatment effects of bisoprolol,perindopril and spironolactone has the privilege effects on chronic cardiac failure caused by rheumatic heart disease,which mainly improves cardiac remodeling.

Pulse contour cardiac output (PiCCO) monitoring is a new type of invasive hemodynamic monitoring technology, which is more and more often applied in perioperative period and the patients suffering from multiple injuries, septic shock, and extensive burn. With PiCCO one is able to monitor patients' hemodynamic indexes safely, timely, accurately, and continuously to provide reference for judgment of patients' condition and proper quality and quantity of fluid administration. This technique has a good prospect in clinical application.
Cardiac Output ; physiology ; Fluid Therapy ; methods ; Hemodynamics ; Humans ; Monitoring, Physiologic ; instrumentation

Metabolic disorder is one of the most obvious pathophysiological characteristics of patients with severe burn or trauma, which leads to high mortality of patients with severe burn or trauma. Metabonomics is a newly developed subject which provides new research concepts and ideas for studying the changes of metabolism in a disease condition. Based on the analysis of group indicators, metabonomic technique not only can systematically study the change rules of metabolites, which helps to further clarify the pathophysiological mechanism of burn or trauma, but also is helpful to find some significant biomarkers with important clinical value so as to provide new insight for the therapy of burn or trauma. This paper reviews the research progress of application of metabonomics in the treatment of severe burn or trauma in recent years.

Objective: To identify the impeding and promoting factors of role definition in nursing handoff, in order to increase the quality of nursing handoff. Methods: Two nursing managers, 22 head nurses and four nurses were recruited by purpose sampling. Data were collected by using focus group study, and analyzed using content analysis. Results: According to the framework of role transition theory, the factors could be classified as individual factors (37 items, 23.72%), organizational factors (105 items, 67.31%), effectiveness of role definition (11 items, 7.05%), and problems of role definition (3 items, 1.92%). Conclusions Role definition in nursing handoff helping the coming nurse check the performance of the last shift and transfer the nursing responsibility, contributes to the improvement of nursing quality, but there are still many factors affecting the role definition in nursing handoff.