Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding(AUGIB) with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P<0.05). ② On the time of symptom disappearance:the disappearing time of vomiting, dark stools and occult blood test in the treatment group was obviously shorter than the control group after the treatment(t=6.628、14.052、21.706,P<0.05 or 0.01). ③ On body symptom changes: after the treatment, the systolic pressure, heart rate, hemoglobin, and blood urea nitrogen [(114.3±12.1)mmHg,(78.6±11.4)/min,(98.1±10.5)g/L,(5.9±1.1)mmol/L] in the treatment group were all obviously improved than those [(106.3±11.2)mmHg, (88.7±12.1)/min,(88.2±11.7)g/L,(6.9±1.4)mmol/L] in the control group;body temperature returned to normal in both groups, and there was no statistical difference score was either in or between groups(P>0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.

Objective To investigate the sleep status, quality of life, activities of daily living and the serum levels of interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) in insomnia patients after meridian-collateral stroke treated by the new family rehabilitation program, a combined therapy including traditional family rehabilitalion, acupoint massage and ear point application. Methods A total of 80 cases of insomnia patients after meridian-collateral stroke were enrolled. Subjects were evenly divided into treatment group ( treated with new family rehabilitation program) and control group ( treated with traditional hospital health education and family rehabilitation). Clinical effects of the two groups were evaluated with the Pittsburgh Sleep Quality Index (PSQI), the brief version of WHO Quality of Life Assessment (WHOQOL-BREF) and activities of daily living ( ADL) . The serum levels of IL-1β and TNF-α were monitored before and after therapy and measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) After treatment for 28 days, the scores of total PSQI, sleep time, sleep efficiency and sleep disorder incidence in the treatment group were significantly lower than those in the control group ( P<0.01) . ( 2) The scores of physiological, psychological, social relation, environmental dimensions of WHOQOL-BREF in the treatment group were significantly higher than those in the control group ( P<0.01) . ( 3) ADL scores were significantly higher in the treatment group than those in the control group (P<0.01) . (4) Serum levels of IL-1βand TNF-αwere increased in the treatment group as compared with those in the control group (P<0.01). Conclusion Compared with the traditional hospital health education, the new family rehabilitation program can effectively improve the quality of sleep, quality of life, as well as the activities of daily living. And the mechanism may be associated with the up-regulation of the serum levels of IL-1βand TNF-α, which are relevant to the sleep status.

Objective To have SD rats inhaled with different drugs,and observe their lung pathological change of lungs through light microscopy,in order to evaluate the safety of different drugs inhaled by natural rats. Methods A total of 40 rats were randomly divided into 8 groups,and every group had 5 rats,including blank control groups,9 g/L saline group,Salbutamol group,Dingchuantang group,Shuanghuanglian group,Centamicin group,Danshen group,Silicon dioxide group,twice a day,last 56 days totally. Then,blood and bronchoalveolar lavage fluid were collected and analyzed for cell count,percent of each type of cell,to measure the severity of the inflammation. Additionally,histopathology re-vealed the lungˊs pathological change and the number of dust cell;while immunohistochemistry revealed CD163 respon-ding. Results (1)White blood cell count:blank control group(3. 96 ± 0. 36)×109/L,9 g/L saline group(4. 66 ± 0. 58)×109/L,Salbutamol group(4. 06 ± 0. 86)×109/L,Dingchuantang group(8. 98 ± 1. 08)×109/L,Shuanghuang-lian group(7. 10 ± 0. 88)×109/L,Centamicin group(6. 14 ± 0. 89)×109/L,Danshen group(9. 84 ± 2. 33)×109/L, Silicon dioxide group(8. 99 ± 2. 48)×109/L,and comparative analysis of the 8 groups had significant difference(F＝14. 530,P<0. 05);the differences among blank control group,9 g/L saline group and Salbutamol group were not sig- nificant(all P>0. 05). White cell count in BALF:blank control group(2. 16 ± 1. 04)×109/L,9 g/L saline group (3. 94 ± 0. 67)×109/L,Salbutamol group(4. 36 ± 1. 15)×109/L,Dingchuantang group(14. 58 ± 2. 93)×109/L, Shuanghuanglian group(19. 68 ± 6. 29)×109/L,Gentamicin group(11. 74 ± 1. 03)×109/L,Danshen group(44. 75 ± 10. 8)×109/L,Silicon dioxide group(53. 54 ± 14. 25)×109/L,and comparative analysis of the 8 groups had signifi-cant difference(F＝40. 616,P<0. 05);the differences among blank control group,9 g/L saline group and Salbutamol group were not significant(all P>0. 05). Lymphocyte count in BALF:blank control group(18. 70 ± 9. 00)×108/L, 9 g/L saline group( 36. 01 ± 5. 99 )×108/L,Salbutamol group( 38. 95 ± 11. 69 )×108/L,Dingchuantang group (132. 70 ± 26. 94)×108/L,Shuanghuanglian group(173. 56 ± 57. 6)×108/L,Gentamicin group(106. 60 ± 16. 76)× 108/L,Danshen group(340. 63 ± 70. 97)×108/L,Silicon dioxide group(495. 63 ± 131. 95)×108/L,and comparative analysis of the 8 groups had significant difference(F＝41. 980,P<0. 05);the differences among blank control group, 9 g/L saline group and Salbutamol group were not significant(all P>0. 05).(2)Number of lung dust cell count in 10 sight of high light microscopy:blank control group 12/10 HP,9 g/L saline group 26/10 HP,Salbutamol group 17/10 HP,Dingchuantang group 262/10 HP,Shuanghuanglian group 133/10 HP,Gentamicin group 109/10 HP,Danshen group 96/10 HP,Silicon dioxide group 315/10 HP,and comparative analysis of the 8 groups had significant difference (F＝69. 915,P<0. 05);the differences among blank control group,9 g/L saline group and Salbutamol group were not significant(all P>0. 05).(3)Hematoxylin-eosin staining of lung:blank control group,9 g/L saline group and Sal-butamol group had no pathological change in the lung,but Salbutamol group,Dingchuantang group,Shuanghuanglian group,Gentamicin group,Danshen group and Silicon dioxide group had pathological changes in different degrees.(4) Immunohistochemistry of CD163 responding:blank control group,9 g/L saline group and Salbutamol group had negative expression,Salbutamol group,Dingchuantang group,Shuanghuanglian group,Gentamicin group,Danshen group and Sili-con dioxide group had positive expression in different degrees. Conclusions 9 g/L saline,salbutamol for atomized inhalation does not cause lung tissue damage;Long-term use of non-atomized drugs in atomization can cause lung tissue injury in SD rats,and the severity varies with specific drugs.

Objective:To explore the application of the task-driven method combined with the "7E" learning cycle mode in nurse refresher training on endoscopic retrograde cholangiopancreatography (ERCP).Methods:We assigned 54 nurses who received refresher training on ERCP in the Department of Hepatobiliary Surgery of The First Affiliated Hospital of Army Medical University from January 2019 to December 2022 into control group (28 nurses from January 2019 to December 2020) to shadow and practice ERCP in a traditional way or experimental group (26 nurses from January 2021 to December 2022) to be taught using the task-driven method combined with the "7E" learning cycle method. At the end of training, the two groups undertook a theoretical and practical examination and a questionnaire survey. SPSS 25.0 was used to perform the t test, Wilcoxon test, chi-square test, and Fisher's exact test. Results:After training, compared with the control group, the experimental group had significantly higher scores of theory [87.50 (85, 90) vs. 90.51 (89, 92), P<0.05], and practice [84.11 (82.75, 85) vs. 90.52 (89, 92), P<0.05]. The proportions of trainees rating teaching methods excellent in the experimental group and control group were 76.92% ( n=20) and 42.86% ( n=12), respectively, and the proportions of teachers rating teaching effects excellent in the experimental group and control group were 84.62% ( n=22) and 42.86% ( n=12), respectively, both showing significant between-group differences (both P<0.05). Conclusions:The combination of the task-driven method and the "7E" learning cycle mode can mobilize learning initiative and enthusiasm, improve collaboration ability, promote learning interest and comprehensive practical ability for ERCP in nurses, which is suitable for ERCP training and teaching.

OBJECTIVE： To study lung tissue injury induced by long-term aerosol inhalation of 4 kinds of non-aerosol drugs in healthy SD rats， and to evaluate the safety of aerosol inhalation of non-aerosol drugs. METHODS： Totally 40 healthy SD rats （♂） were randomly divided into 8 group， i.e. blank control group， normal saline group （solvent control）， budesonide group （non-aerosol drug control， 0.1 g/L） ，silicon dioxide group （lung injury drug control， 40 g/L）and 4 kinds of non-aerosol drugs [Dingchuan decoction group （15 g/mL， calculated by crude drug）， cefatriaxone group （200 g/L）， Qingkailing group （stoste） and Tangreqing group （stoste）]， with 5 rats in each group. Except that blank control group didn’t received any treatment， other groups received aerosol inhalation， 10 mL， twice a day， for consecutive 56 days. After medication， the number of white blood cells in peripheral blood were counted and classified， and the number of white blood cells in bronchus alveolar lavage fluid were counted. The pathological changes of lung tissue were observed by HE staining and the number of dust cells was counted. The expression of leukocyte differentiation antigen 163 （CD163） in lung tissue were determined by immunohistochemical method. RESULTS： The white blood cells in peripheral blood mainly included lymphocyte and neutrophil， of which lymphocyte is the main one. Compared with blank control group， there was no statistical significance in the number of white blood cells， lymphocyte or neutrophil in peripheral blood， the number of white blood cells in alveolar lavage fluid or the number of dust cells in lung tissue of rats in normal saline group （P＞0.05）； the structures of bronchus and lung tissue were intact， and the expression of CD163 was negative. Compared with normal saline group， there was no statistical significance in the above indexed of rats in budesonide group（P＞0.05）， the structures of bronchus and lung tissue were intact， and the expression of CD163 was negative， while the number of white blood cells， lymphocyte or neutrophil in peripheral blood， the number of white blood cells in alveolar lavage fluid or the number of dust cells in lung tissue of rats in other 5 groups were all increased significantly （P＜0.05）； alveolar wall thickening and alveolar interstitial edema occurred in different degrees in lung tissue. The expression of CD163 was positive or strongly positive. CONCLUSIONS： The long-term aerosol inhalation of 4 kinds of non-aerosol drugs can induce pathological changes of lung tissue and increase the number of inflammatory cell and dust cell in alveolin in healthy SD rats.