Objective To explore effect of two methods for treating extravasation of venous indwelling needles.Methods A total of 96 patients with extravasation at transfusion were randomly divided into experiment and control groups with 48 cases in each group. Magnesium sulfate wet packing was used in the control group and external application of potato chips in the experiment group.The two groups were compared in terms of time for curative effect to occur and time for recovery.Result The time for curative effect to occur and time for recovery in the experiment group were both significantly shorter than those of the control group.Conclusion External application of potato chips is effective in reducing extravasation during venous transfusion.It is simple and free from side effects.

Objective To summarize the perioperative nursing care of the elderly patients with hip fracture.Methods There were 95 elderly patients with hip fractures admitted to hospital and received the fixation of artificial joint replacement and preoperative and postoperative nursing care from June 2010 to September 2013.Results Ninety-five patients were recovered and discharged from the hospital. They had stayed the hospital for 11 to 28 days and the average time was(17.5±2.5)d.One patient had developed pneumonia after surgery and one patient had incision infection.After treatment both patients were cured.Conclusions When the elderly patients with hip fracture stayed in the hospital,the nurses should give them good care.The nurses should provide them with mental care based on their psychological and physiological characteristics,help the patients to prevent the complications,guide the patients through rehabilitation training,enhance daily living and promote the patients’health as soon as possible.

Objective In order to investigate the role of Gap Junction (GJ) in the generation and development of epilepsy,we examined the expression of connexin43 (Cx43)and Cx32 in the epileptogenic lesions and surrounding brain tissues of the patients with refractory temporal epilepsy.Methods Thirty intractable epilepsy patients were performed the resection of epileptogenic lesions under the ECC monitor.The expression of Cx43 and Cx32 in the epileptogenic lesions and the surrounding brain tissues of the patients were examined by immunohistochemical staining(the two step method).The data were statistically analyzed.Results The results from the immunohistochemistry staining showed that Cx43 and Cx32 were expressed in the epileptogenic lesions and the surrounding brain tissues.The expression of Cx43 in the epileptogenic lesions was increased obviously in comparison with the surrounding brain tissues ( U =4.066,P ＜ 0.001 ).There was no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues ( U =1.866,P ＞ 0.05 )Conclusion The expression of Cx43 in the epileptogenic focus is increased in comparison with that in the surrounding brain tissues,indicating that GJ plays an important role in the generation and development of epilepsy.There is no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues,which may be related to the apoptosis of the neurons after multiple seizure attacks.

Objective To study the influence of critical thinking training for nurses on transfusion security in emergency patients. Methods The nurses from the emergency department and outpatient department were trained with critical thinking.The incidence of transfusion safety flaws before training was compared to that after training. Results The total incidence of transfusion safety flaws after training was 10.0%, significantly lower than 35.8% before training(χ2=164.8, P<0.001).Conclusion The training of nurses' critical thinking may not only improve the comprehensive quality of nurses, but ensure the safety of transfusion.

Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.

A 13-year-old girl presented with multiple recurrent cutaneous plaques for more than six months,which had been aggravated with intermittent fever for five months.No obvious systemic abnormality was found.Dermatological examination revealed multiple,non-ulcerative,painless,infiltrative,indurated,poorly marginated,purple subcutaneous plaques measuring 3-1 1 cm in diameter with slight squamation in bilateral buttocks and lower limbs.Laboratory investigations showed bicytopenia with the white blood cell count being (0.03-3.7) × 109/L and red blood cell count being (2.8-4.4) × 1012/L,a normal platelet count,hypofibrinogenemia (1.79 g/L) and low proportion of natural killer cells (4.6％).Bone marrow smear showed active proliferation of cells,decreased proportion of granulocytes,presence of a few indefinitely classified cells,and phagocytosis.Reticulocytes were easily seen in the bone marrow smear.Pathologically,no obvious abnormality was observed in the epidermis or dermis,while the subcutaneous adipose tissue,especially fat lobules and some interlobular septa,was extensively infiltrated by large-to medium-sized lymphoid cells with pleomorphic and twisted nuclei as well as a small amount of cytoplasm; necrosis and phagocytosis of nuclear debris and lymphocytes were visible.The atypical lymphoid cells stained positive for CD3,T-cell intracellular antigen-1,granzyme B and TCRγδ with partial loss of CD5 and CD7,but negative for CD56,CD4,CD8 and TCRαβ.No Epstein-Barr virus-encoded RNA (EBER) was detected by in situ hybridization.Based on these findings,a diagnosis of primary cutaneous γδ-T cell lymphoma with hemophagocytic syndrome was made.

Objective To study the protective effect of intraaortic protamine injection on lung in infants undergwent opening heart operation by cardiopulmonary bypass surgery. Methods Sixty infants (age ≤ 1 year,weight ≤ 10 kg)who accepted opening heart operation by cardiopulmonary bypass surgery were randomly assigned into 2 groups ( n = 30 in each group) reciving intra-aortic and intra-venous protamine injection respectively. P-peak, P-plate, CL, Oxygenation Index, the number of WBC and neutrophil segregated in lungs were compared between two groups before injecting protamine and 10 minutes, 1 hour, 3 hours after injecting protamine. The time of mechanical ventilation were compared as well. Results P-peak, P-plate, the number of WBC and neutrophil segregated in lungs of intra-aortic injection group significantly decreased than intra-venous injection group at 1 hour, 3 hours after injecting protamine (t =2.743, 3.512; 3.218, 3.469; 3.716, 5.243; 3.853,4. 783 respectively, Ps ＜ 0. 05 ), while the CL and Oxygenation Index increased significantly ( t = 3. 976,4. 267; 4. 557,4. 265 respectively, P ＜ 0. 05 ). The duration of mechanical ventilation follow operation in intraaortic injection group ( [8. 03 ± 5. 14] h ) was shorter compared with intra-venous injection group ( [10. 56 ±6.95]h) (t =2.599,P＜0.05). Conclusion By intra-aortic protamine injection the lung injury decreased significantly. It shows good protective effect on lung in infants underwent opening heart operation by cardiopulmonary bypass surgery.

Objective To investigate the effects of ulinastatin-containing autologous cold blood cardioplegic solution on the cardiac function of infants after cardiopulmonary bypass surgery.Methods Sixty infants younger than 10 months old,who underwent ventricular septal defect repair under cardiopulmonary bypass,were randomized into autologous cold blood cardioplegia group (30 patients,Group A)and ulinastatincontaining cold blood cardioplegia group (30 patients,Group B).CI,SI and LCWI were monitored 1 and 6 hours after opening the aorta.The time and rate of cardiac resuscitation,as well as the dependence on the inotropic drugs,were intraoperatively monitored.Results The automatic resuscitation rate in two groups was not siynificantly ( P ＞ 0.05).The time for automatic resuscitation were (34.2 ± 4.7) s and (52.1 ± 6.5 ) s for Group B and Group A,respectively ( P ＜ 0.05 ).The rate of dependence on inotropic drug were 40.0％ (12/30) and 66.7％ (20/30)for Group B and Gro~p A,respectively (P ＜ 0.05).Mter the operation,the CI,SI and LCWI of group B were higher than that of group A ( P ＜0.05 ).Conclusion Ulinastatin-containing autologous cold blood cardioplegic solution is beneficial to the functional cardiac recovery of the infants after heart bypass surgery by protecting the immature myocardium.

Objective To compare the different features of contrast enhanced ultrasound(CEUS) and CT angiography (CTA) in abdominal aortic remodeling after thoracic endovascular aortic repair (TEVAR)of DeBakey type Ⅲ aortic dissection(AD),and to investigate the application value of CEUS in the follow-up of DeBakey type Ⅲ AD after TEVAR.Methods CEUS was performed in 28 patients with DeBakey type Ⅲ AD after TEVAR,in which 8 cases type Ⅲ a (simple type) were not involved of abdominal aorta,20 cases Ⅲ b(complex type) were involved in the abdominal aorta,all patients were performed CTA examination of aorta.The functional and morphological changes of abdominal aortic remodeling were observed by two methods in DeBakey type Ⅲ AD after TEVAR.Results There was no new rupture of the abdominal aorta in 8 cases type Ⅲ a AD,but 20 cases of type Ⅲ b AD showed the situation of ruptures,thrombosis,trues and falses lumen after 3 months of follow-up.CEUS was less than CTA in detecting the number of ruptures (P＜0.05),CEUS and CTA results were similar in the measurement of true and false lumen diameter (P＞0.05),but CEUS clearly showed the hemodynamic characteristics of abdominal aortic intimal tear,the size and position of rupture,moving blood flow of rupture,and true or false lumen,which provided more accurate data for the long term abdominal aortic remodeling of DeBakey type Ⅲ AD after TEVAR.Conclusions CEUS and aortic CTA can play a complementary role in DeBakey type Ⅲ AD after TEVAR of long-term follow-up,it is worth promoting.

Objective Investigate the effects of early application of noninvasive respiratory support on very low birth weight infant(VLBWI). Method A total of 65 VLBWI(born during September 2015 to September 2016 with 28-32 weeks gestational age;1000 g ≤ birth weight < 1500 g;exclusion of combination with congenital deformity)were randomly divided into the early application of noninvasive respiratory support as observation group (n = 33) and the application of endotracheal intubation with gen respiratory support as control group (n = 32). Comparison of two groups was carried out by SPSS in terms of incidence of endotracheal intubation,BPD,pulmonary infection,pneumothorax,and necrotizing enterocolitis,together with rescue ratio,total oxygenation time and hospitalization. Results No significant difference was found on incidence of pneumothorax,necrotizing enterocolitis and rescue ratio between two groups. The incidence of endotracheal intubation,BPD,pulmonary infection and total oxygenation time was markly decreased in observation group. Conclusion Early application of noninvasive respiratory support benefits VLBWI via reducing incidence of endotracheal intubation,BPD,pulmonary infection, total oxygenation time.