Objective To establish the evidence-based nursing educational programme for preventing ventilator-associated pneumonia (VAP) and evaluate the effects in critical care nurses. Methods The evidence-based nursing practice guidelines for preventing VAP from 2008 American Association of Critical Care Nurses was used as training materials,which guided the curriculum design. Seventeen critical care nurses were trained. The difference of the nurses' knowledge and practice was evaluated before and after training by an evaluation scale of nursing quality criteria for preventing VAP. Results After the training,nurses' knowledge and practice of preventing VAP were improved(Z=-3.624,P=0.000). Except the factor score of handwashing,there were significant differences on the factor scores of body position care,endotracheal tube care,enteral nutrition,maintaining the tube cuff pressure,oral care and ventilator equipment management (P<0.01). Conclusion The educational programme of evidence-based nursing for preventing VAP can improve the nurses' knowledge and practice of preventing VAP. Furthermore,it can promote the application of evidence-based nursing for preventing VAP,and thereby to improve the quality of nursing,and provide guidance for the training of critical care nurses and continuing education.

The latest progress of modern radiotherapy techniques in the management of breast cancer after breast-conserving surgery was introduced first.Then the clinical effect and the adverse effect of these advanced techniques were analyzed.Finally,in order to provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer,the importance of how to choose appropriate patients for these advanced techniques was discussed.

Objective To investigate pulmonary circulation effects of protamine different infusion ways on the acyanotic congeni -tal heart disease(CHD) patients with pulmonary arterial hypertension(PAH) after extracorporeal circulation surgery .Methods Se-lect 80 cases of the CHD patients prepared for extracorporeal circulation surgery ,according to the different routes of administration and with or without PAH ,80 patients are divided into 4 groups (n= 20) :A1(non-PAH ,aortic root administration) ,A2(non-PAH , central venous administration) ,B1(PAH ,aortic root administration ) ,B2 (PAH ,central venous administration) .pulmonary artery pressure(PAP) ,pulmonary venous pressure (PVP) ,central venous pressure (CVP) ,peak airway pressure (Ppeak) ,plateau airway pressure(Pmean ) at the time point of preoperative(T0) ,before infusion of protamine (T1) ,1 minute after infusion of protamine (T2) ,3 min (T3) ,5 min (T4) ,10 min (T5) ,15 min (T6) and 25 min (T7) were recorded .The level of venous blood thromboxane B2(TXB2) was detected .Results After infusion protamine ,the PAP ,PVP ,CVP ,Ppeak and Pmean of group A2 and group B2 are higher compared to group A1(P< 0 .05) and group B1(P< 0 .01) respectively ;Compared with preoperation (T0) ,the TXB2 in 4 groups increased obviously after infusion protamine (T2 to T7) (P< 0 .05) ;Compared with group A1 and group B1 ,the TXB2 of group A2 and group B2 increased more significantly (P< 0 .01) .Conclusion Patients with congenital heart disease after intracardi-al surgery with extracorporeal circulation use trace pump infusion protamine through the aortic root ,which have little effect on pul-monary circulation ,can significantly reduced TXB2 release compared with central vein administration ,it can avoid a high concentra-tion of protamine directly into the pulmonary circulation that can strongly stimulate the pulmonary vascular and tracheal smooth muscle .Especially in the CHD patients with PAH .

Objective To study the effect of perioperative psychological nursing on living-related liver transplantation. Methods The following measures were adopted according to the donors' concrete condition: using nursing procedure in holistic nursing, to assess and determine the main problems in perioperative period, nurses mastered psychological nursing knowledge and skills in individualized psychological nursing, giving pertinent and individualized health education to patients in accordance with their psychological problems during the perioperative period. Results The donors could face the operation with good psychological state after being given fully-integrated and whole-system psychological nursing. Conclusions Psychological nursing is important for living-related liver transplantation during the perioperative period.

Objective To investigate the protective effect of losartan on acute ischemia-reperfusion(I/R)(injury) of pancreas in rats.Methods Seventy-two Wister rats were randomly divided into 3 groups:(1)(Control group);(2)Ischemia-reperfusion group:the anterior mesenteric artery and the celiac artery were(occluded) for 15 min,30min and 60min followed by 6 hours reperfusion;(3)Losartan group:losartan(40mg/kg)were administered by gavage at 12h and 1h before arterial occlusion.The pathologic changes of pancreatic tissue were observed under light microscopy;TUNEL was used to detect apoptosic of pancreatic cells;Bcl-2 expression in the pancreatic cells of rats was analyzed by immunohistochemistry technique.(Results) Losartan treatment reversed the histological abnormalities including infiltration of inflammatory cells and atrophy of acinar cells.Compared with losartan group,pancreatic tissue of I/R group exhibited increased MDA[((20.1?1.2))nmol/g and((34.9?2.6)) vs(17.9?2.1)nmol/g and(25.2?3.3)nmol/g,P

Objective To study an improved automated method for isolation and purification of large amounts of human pancreatic islets from large mammals,and try to create conditions for preparation and isolation of large amounts of human islets.Methods An improved automated system was used to isolate and purify panreatic islets of sogs.Under the general anaesthesia(GA) condition,the pancreas of the dogs was via in situ vascular perfused using cold HC-A solution and then removed en bloc with duodenum and spleen.Then they were placed in cold UW aolutian.Intraductal collagenase-Ⅴ and pefabloc(4 ℃) was delivered with controlled perfusion.lslets were dissociated in system of Ricordi Chamber and purified islets separated with Ficoll density gradient centrifugation under controlled temperature.Digestion time,islets remaining trapped in exocrine tissue,final islet purity,insulin and C-pep secretory activity,and islet recovery were observed.The purified islets were observed under light microscope and electronic microscope after 24 h culture.Results The digestion time rate was(25.0?6.0) min,islets remaining trapped in exocrine tissue was(9.4?2.4)%,final islet purify rate was(89.7?3.5)%,islet recovery after digestion was(17.2?3.6)?104 IEQ/pancreas.Islet recovery after purification was(8.3?2.0)?104IEQ/pancreas.Insulin and C-pep secretory activity of the purified islets and their ultrastructure after 24 h culture were ideal.Conclusions Our improved automated method and facilities for isolation of canine pancreatic islets are reliable,The morphology and function of the procured islets are excellent and they can foreseeably be used for large-scale preparation of huma islets for clinical use.

Objective To study the therapeutic efficacy and toxicity of Bevacizumab combined with Chemotherapy in patients with advanced and metastatic cancer.Methods Fifty-nine patients of advanced metastatic cancer (Forty-two patients of refractory metastatic colorectal cancer and 17 advanced adenocarcinoma) were treated with normalized chemotherapy combined with Bevacizumab.Patients with refractory metastatic colorectal cancer were treated with Bevacizumab combined with FOLFIRI or FOLFOX4,and patients with advanced adenocarcinoma of NSCLC were treated with Bevacizumab in combination with docetaxel and cisplatin for 4-6 cycles,Bevacizumab was used until progressive disease (PD).During treatment,adverse effect were assessed with Common Toxicity Criteria V3.0 developed by National Cancer Institute.Results Among the 42 patients of metastatic colorectal cancer,27 were treated with First-line 1 with complete remission (CR),13 partial response(PR),4 stable disease(SD) and 9 PD,the effective rate (ER) was 51.9％ ( 5/15 ),disease control rate(DCR) was 66.7％ (18/27);Fifteen patients were treated with second-line PR,of which 5 PRD,4 SD,6 PD.ER was 33.3％ (5/15),and DCR was 60.0％ (9/15).The effective rate were slightly higher in the First-line treatment group than that in the second-line treatment group,however,the difference was not statistically significant (x2=1.335,P=0.248 ).Among the 17 patients of NSCLC,of which 1 CR,7 PR,5 SD,4 PD.RR was 47.1％ (8/17),and DCR was 76.5％ (13/17).The major toxicities were one grade 3 hemoptysis observed in one patient,grade 3 thrombosis was observed in one patient.Other common adverse effects,were epistaxis,hemoptysis,hypertension and proteinuria,which were not severe and could be well tolerated.Conclusion Bevacizumab Combined with Chemotherapy was effective in short term for the patients with advanced and metastatic cancerMost patients could tolerate the side effects.Further studies should be done to prove the long-term effects.

Objective To explore tolerance-related factors of enteral nutrition(EN) by nasogastric (NG) tube in ICU patients, and to provide several nursing strategies for improving the patients' tolerance. Methods 83 patients using EN with NG tube in ICU were collected.Tolerance-related factors of EN were analyzed by multivariate Logistic regression analysis. Results Among the 83 patients, 36 patients (43.3%) could tolerate very well, 47 patients (56.6%) couldn't tolerate.After treatment 27 patients' tolerance was fair, the other was poor.Multivariate Logistic regression analysis showed that age, APACHE-Ⅱ score, the time of beginning EN, albumin level, drug administration by NG tube or not were the major factors affecting tolerance of NG tube feeding. Conclusions Patients' feeding with NG tube was well-tolerated in ICU.Besides the factors from patients as the severity of disease status and level of serum albumin,the time of beginning EN, drug administration by NG tube were significantly correlated with tolerance.

To investigate the relationships between constitutional types of traditional Chinese medicine (TCM) and hypertension so as to provide epidemiological evidence for the theory of correlation between constitution and disease.

Objective: To explore the effect and mechanism of Longzhu ointment in the treatment of allergic contact dermatitis.Methods: Allergic contact dermatitis mouse model was induced by dinitrobenzene (DNFB) and the mice were randomly divided into the model group, matrix group, Longzhu ointment group and hydrocortisone butyrate group.0.5% DNFB was used for sensitization on abdomen of mice one and two days before the administration, and 0.2% DNFB was used on the right ears of mice after 6-day administration to establish mouse ACD model.A day after the excitation of dermatitis, the ear swelling degree was determined, the changes of histopathology was observed, and the immunohistochemical methods were performed to quantify the expression of TNF-γ and macrophage surface markers CD68 in the tissue samples.Results: The ear swelling degree in the group treated with Longzhu ointment was significantly reduced (P <0.01).Compared with the postive control group,the difference was not statistically significant(P＞0.05).HE staining showed that tissue edema decreased obviously.The immunohistochemistry analysis revealed that the expression of INF-γ in Longzhu ointment group was obviously reduced.Under the microscope with magnification of 200 times, CD68 positive cells in Longzhu ointment group was significantly reduced than those in the model group(P＜0.01).The expression of CD68 positive cells in butyric acid hydrocortisone group was not significantly different from that in Longzhu Ointment group.Conclusion: Longzhu ointment can inhibit allergic contact dermatitis obviously, and the mechanism may be related to the inhibition of lymphocyte secretion INF-γ and the reduction of macrophage infiltration.