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.

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 investigate the efficacy and safety of sirolimus 0.1% ointment in the treatment of facial angiofibromas in children with tuberous sclerosis complex. Methods Sirolimus 0.1% ointment was prepared. Twenty children with tuberous sclerosis complex who had facial angiofibromas were enrolled in this study. Facial angiofibromas were topically treated with the self?prepared sirolimus 0.1% ointment twice a day for 12 weeks. The facial angiofibroma severity index(FASI)was calculated, the degree of satisfaction with the treatment was evaluated, and adverse reactions were analyzed at weeks 4 and 12. Plasma sirolimus concentrations as well as blood biochemical and immunological parameters were measured, blood coagulation activity was evaluated, and routine blood tests as well as urine tests were performed at baseline and week 12. Results The FASI of patients significantly decreased at weeks 4(4.400 ± 1.284)and 12(2.975 ± 1.543)compared with that at baseline(5.750 ± 1.175, both P<0.000 1), and was significantly lower at week 12 than at week 4(P < 0.000 1). The efficacy index was 49.87% ± 22.08% at week 12, significantly higher than that at week 4(24.43%± 10.18%, t=7.338, P<0.01). The color, size and number of lesions significantly decreased in all the patients, and facial angiofibromas completely disappeared in 2 patients at week 12. At week 4, 10 parents were satisfied with the improvement of erythema, 3 parents with that of lesion volume, and 3 parents with that of lesion area. The degree of parent satisfaction increased at week 12 in all the cases. The blood concentration of sirolimus was lower than 1.0μg/L both before and after the treatment. No severe systemic or local adverse reactions were noted in these patients. Conclusion Sirolimus 0.1%ointment is markedly effective and safe for the treatment of facial angiofibromas in patients with tuberous sclerosis complex.

Objective The in vitro studies of indicators in burn patients with complicated infection have been little studied till now.So this study aims to investigate the change of proliferation of CD64 +neutrophils from the peripheral blood of burn patients in vitro. Methods CD64+neutrophils from peripheral blood of healthy people were isolated and purified, which was followed by stim-ulating its proliferation with inactivated Staphylococcus in vitro.We further analyzed the proliferation index with Modfit 2 analysis soft-ware.86 burn patients were divided into two groups, 44 cases with complicated infection assigned to experimental group, 42 uninfected assigned to controls.We further detect the counts of WBC and the percentage of CD64 +neutrophils, and then analyzed the specificity and sensitivity by using the receiver operating characteristic ( ROC) curves. Results This in vitro study, the average proliferation index of CD64 +cells in experimental wells was significantly higher than controls (6.48 ±0.11 vs 2.63 ±0.02), the difference was statistically significant (P<0.05);the percentage of CD64 +cells in the peripheral blood of patients in experimental group(64.25 ± 13.11%) was significantly higher than patients without infection(16.33 ±2.77%);The sensitivity and specificity of diagnostic meth-od of CD64 +cells for the burn infection were respectively 94.2%and 76.8%, which was superior to the traditional diagnostic meth-od of WBC ( 68.5%, 64.7%) according to ROC curves. Conclusion CD64 + cells in peripheral blood of burn patients complicated by infection increased more significantly and earlier when compared with the traditional diagnostic method, which may be used as a useful diagnostic indicator for burns complicated infection.

Objective: To investigate the effect of cold self-blood cardioplegia with ulinastatin on immature myocardial cell apoptosis and protein expressions of Bcl-2, Bax in ventricular septal defect (VSD) infants.
Methods: A total of 60 infants received VSD repairing operation with cardiopulmonary bypass (CPB) in our hospital were summarized. The patients were randomly divided into 2 groups:Test group, the infants received cold self-blood cardioplegia with ulinastatin when aortic cross-clamp was closed. Control group, the infants received cold self-blood cardioplegia when aortic cross-clamp was closed. n=30 in each group. The right atrium tissue was collected before CPB and 10 min after releasing aortic cross-clamp. The index of myocardial cell apoptosis was observed by TUNEL method, and the protein expressions of Bcl-2, Bax were examined by immunohistological method.
Results: Both groups showed the higher index of myocardial cell apoptosis at 10 min after releasing aortic cross-clamp than 5 min before CPB, and the apoptosis index in Test group was lower than that in Control group, all P<0.05. The protein expressions of Bcl-2 and Bax were obviously increased at 10 min after releasing aortic cross-clamp than 5 min before CPB in both groups. Compared with Control group, Test group presented the higher Bcl-2 protein expression and lower Bax protein expression, all P<0.05.
Conclusion: Cold self-blood cardioplegia with ulinastatin could protect immature myocardum from ischemia-reperfusion injury in VSD infants during CPB operation in clinical practice.