Objective To investigate the application and nursing care of bronchoalveolar lavage (BAL)by fiberoptic bronchoscopy in patients with mechanical ventilation. Methods 64 patients with mechanical ventilation in RICU were randomly divided into the control group and the observation group with 32 patients in each group. The patients in both groups were accepted anti-infection, atomization inhalation and other supportive treatments. The patients in the observation group were treated with BAL, and the patients in the control group accepted routine treatment. The therapeutic effects in the two groups were evaluated and compared. Results There was significant difference in the recovery rate and effective rate, the blood gas analysis compared with the control group was significantly improved, the time of pulmonary infection control window, mechanical ventilation, length of stay were shorter than the control group. The case number to remove ventilator successfully, organs failure and hospital mortality were less than the control group. Conclusions Fiberoptic bronchoscopy with BAL treatment could be safety and efficacy for patients with mechanical ventilation. Nursing intervention plays an important role and a good therapeutic effect for improving achievement ratio of BAL.

Objective To study the effects of D-Ala2-Leu5-enkephalin(DADLE) preconditioning on rabbit donor heart preservation and protective mechanism.Methods 24 rabbits were randomly divided into 4 groups. In group B, after preconditioning with DADLE(1mg?kg -1 ), the donor hearts were then arrested and preserved with Krebs-Henseleit buffer at 4℃ for 4h,and group A without conditioning as controls. Then the donor hearts were transplanted into the abdomen of recipient rabbits. Recovery situation of contraction of the donor heart was compared. The left ventricular tissues were obtained from the donor hearts after 2h of transplantation.The contents of free radicals and ATPase activity were determined and cardiac ultrastructure were observed.Results After 4h cold storage, the heart undergoing DADLE preconditioning in group B showed better recovery of left ventricular development pressure (LVDP).The activity of sodium-potassium ATPase in group B were higher than that in group A. DADLE increased free radical production 2-fold versus group A. Group B showed slighter injury in transmission electron microscopy observation than that in group A.Conclusion Our study demonstrated opioid preconditioning has protective function to rabbit heart injury caused by long term cold storage. The protective mechanism maybe related to increase of free radical content.

Objective Vertebral benign and malignant tumors were intractable in the treatment. Previous treatment methods had their own deficiency. The introduction of percutaneous vertebroplasty brought a breakthrough in the treatment. The initial experience of the treatment of vertebral malignant and benign tumors with percutaneous vertebraplasty was analyzed in this clinical research.Methods and materials The treatment of seven cases of vertebral hemangiomas and 11 cases of vertebral malignant tumors were reported. Unipedicular or bipedicular approaches were used in 17 cases, and in one case of cervical hemangioma, the cervical anterior-lateral approach was adopted. 15-20% of bone cement was mixed and injected into the vertebral lesions and made to distribute and cast in the lesions. Results Good results were got in all the 18 cases. After 0.5-7ml of cement was injected into the lesions. The complete relief was got in 10 cases and sub-complete relief was achieved in 6 cases and medial relief was got in two cases. One to nine months of postoperative follow-ups found no recurrences.Conclusions The treatment of vertebral benign and malignant tumors with percutaneous vertebraplasty was mini-invasive, safe, and effective.

The authors briefly introduced the management of clinical test for new drug development, clinical trials for drugs prepared in hospital and post-market drugs, and other types of clinical trials. The mechanism of WHO International Clinical Trial Register Platform (WHO ICTRP), Chinese Clinical Trial Register (ChiCTR) and Chinese Clinical Trial Registration and Publishing Collaboration (ChiCTRPC) were also introduced. The authors suggested the trialists to practice the basic philosophy of evidence-based medicine as the rules of their thought and action, and considered that this is the inner guarantee system for the validity of clinical trials.

Objective:To establish the reference range of red blood cell parameters within 24 hours after birth of premature infants with different gestational ages and genders.Methods:According to the inclusion criteria and exclusion criteria, a retrospective analysis was performed in premature infants who were admitted to the neonatal intensive care unit from January 1, 2018 to December 31, 2019. These newborns were delivered in the obstetrics department of our hospital or came from other parts of Jilin Province. All of their radial artery blood were collected within 24 hours after birth. According to the blood examination results, we analyzed reference range of red blood cell parameters of these premature infants.Results:With the increase of gestational age, the number of RBC, HGB, HCT, MCHC gradually increases and the number of MCV, MCH gradually decreases. There are differences in some red blood cell parameters of premature infants with 34 week≤gestational age<37 week between different genders. Compared with boys, the number of RBC, HGB, HCT and MCV in girls were higher. The number of RBC in premature infants with 23 week≤gestational age<28 week and 28 week ≤ gestion age<34 week are 2.58×10 12-5.45×10 12/L and 2.97×10 12-5.86×10 12/L respectively. In the group of premature infants with 34 week ≤gestion age<37 week, the number of RBC in boys is 3.38×10 12-5.83×10 12/L, while the number of RBC in girls is 3.18-5.89×10 12/L. There're no difference in RDW among preterm infants with different gestational ages and genders, which is 14.8%-20.6%. Conclusions:The study established the reference range of red blood cell parameters of 23 w≤gestational age<37 w premature infants within 24 hours after the birth and explored the differences in red blood cell parameters of premature infants with different gestational ages and genders.

Objective To evaluate the effects of long-term high-fat diet on skin wound repair in mice, and to explore its related mechanism. Methods A total of 16 ten-week-old C57BL/6J wild-type mice were randomly and equally divided into two groups to be fed a high-fat diet(HFD group)and a standard diet(SD group)respectively for 8 weeks. Then, an 8-mm full-thickness skin wound was created on the back of each mouse by using a biopsy punch. The degree of wound healing was observed, wound healing rate and epithelialization level were evaluated every day. The weight of mice was measured before feeding, after 8-week feeding and on day 14 after the operation. Peripheral blood samples were obtained from these mice for the determination of total cholesterol(TC)and triglyceride(TG)levels after a 12-hour fast on day 14 after the operation. Then, all the mice were sacrificed, and wound tissues were resected from the dorsal skin of mice for a histological study. The two-sample t test was used to compare the thickness of new epidermis in the wound surface, collagen deposition rate in the wound bed, count of new vessels, levels of cell proliferation and degree of inflammatory cell infiltration between the two groups. Results The average weight of mice was significantly higher in the HFD group than in the SD group after 8-week feeding(27.3 ± 0.7 g vs. 21.2 ± 0.6 g, t = 21.98, P < 0.001)and on day 14 after the operation (28.8 ± 0.7 g vs. 23.1 ± 1.1 g, t = 25.22, P < 0.001). Similarly, there was a significant increase in the levels of TC(1.35 ± 0.32 mmol/L vs. 0.99 ± 0.28 mmol/L, t = 2.24, P < 0.05)and TG(4.21 ± 0.41 mmol/L vs. 2.71 ± 0.31 mmol/L, t = 6.49, P < 0.05)in the HFD group compared with the SD group 14 days after the operation. Compared with the SD group, the HFD group showed shorter healing time (13.5 ± 0.5 days vs. 12.6 ± 1.1 days, t = 1.99, P < 0.05), lower thickness of newborn epidermis on the wound surface (47.8 ± 13.8 μm vs. 95.7 ± 13.7 μm, t = 5.68, P < 0.001), decreased number of CD31-positive vessels(8 ± 1 vs. 13 ± 3, t = 4.1, P < 0.001)and count of ki-67-positive cells(21 ± 4 vs. 49 ± 10, t = 3.33, P < 0.001), but increased count of infiltrating macrophages and mast cells (both P < 0.05). No significant difference was found in collagen deposition rate in the wound bed between the two groups (P > 0.05). Conclusion Long-term high-fat diet can affect wound healing and delay skin wound repair in mice.