Objective To investigate the effectiveness of entropy in measuring the level of sedation during target controlled infusion (TCI) of propofol in patients of different ages. Methods Twenty-nine ASA Ⅰ-Ⅱ patients undergoing elective surgery under general anesthesia were divided into two age groups: Ⅰ adult group (20-64 yr) (n = 16) and Ⅱ the aged group (65-85 yr) ( n = 13). The patients were unpremedicated. The level of sedation was assessed using OAA/S scale. Propofol was given by TCI. The effect-site concentration (Ce) of propofol was set first at 1 ?g?ml-1 and then increased step by step by 0.5 ?g?ml-1 every 60 seconds until Ce reached 6 ?g?ml-1. Response entropy ( RE), state entropy ( SE), BP, HR, SpO2 were monitored and recorded at each Ce, before intubation, and immediately and 1, 2, 3, 4, 5, 10 min after intubation. The predictive performance of entropy was evaluated by prediction probability (Pk) .Results The two groups were comparable with respect to sex (M/F ratio), body weight and body weight index (kg?m-2). The RE and SE values decreased as Ce increased. The difference between RE and SE was also reduced. In adult group when Ce reached 2.0 ?g?ml-1, the RE and SE values were lower than the baseline values ( P

Objective To establish a HPLC method for the determination of Ferulic acid in callus of Ligusticum chuanxiong. Methods The separation was performed on ZORBAX 300SB-C18 (250 mm?4.6 mm, 5 ?m) column, using acetonitrile-1% triethylamine (15∶85) as mobile phase, detected at 320 nm. The flow rate was 1.0 mL/min, the column temperature was 27 ℃. Results The linear range of Ferulic acid was 0.93～4.67 ?g/mL, r =0.999 8, the average recovery was 99.98% and RSD was 1.63%. Conclusion The method was rapid, simple, accurate and stability, and can be used for the quantitiative determination of Ferulic acid in Ligusticum chuanxiong callus.

Objective To understand the condition of anxiety and analyze the influencing factors related to anxiety among nurses working in department of infectious diseases.Methods 206 nurses from 6 third class hospitals in Wenzhou were selected by simple random sampling method.A survey was carried out by using the socio-demo-graphic information questionnaire,working conditions questionnaire,self-rating anxiety scale and social support rating scale.Results The SAS score among nurses ranged from 36 to 72 points,and the average score was (48.32 ± 12.06)points,which was higher than the norm SAS value(t=14.39,P<0.01).The percentage of anxiety was about 55.33%.The percentage of moderate and severe anxiety was 16.51%.The main factors related to the anxiety among nurses were age(t=11.34,P<0.01),working years(t=5.68,P<0.01),moonlit night shift(t=4.42,P<0.05), worrying about making mistakes(t=7.18,P<0.01),worrying about occupational exposure(t=19.93,P<0.01) and nursing management of much criticism(t=5.68,P<0.01).Conclusion The condition of anxiety was serious among nurses working in department of infectious diseases.Interventions should be taken to reduce the anxiety level among nurses.

According to the study experience when the author was invited as a visiting scholar in Edinburgh Napier University,also based on the further discussion with local research team members of stroke,the author would like to introduce the multidisciplinary research team with same professional field being established in Scotland,finally in order to give us inspiration how to develop an efficient,long-term and stable research team in China,and which model whether local universities innovative research team or innovative regional research team is much more suitable for our country.The author had participated in stroke team research activities during the Edinburgh Napier University visit;and have some basic understanding to their research ideas and patterns of work after communication and exchanging ideas with team members.Particularly,multidisciplinary research collaboration model based on voluntary organization across entire Scotland is worth to learn for us.It also would inspire the university research terms in their construction in China.

Symptomatic carotid stenosis is closely associated with ischemic stroke,its treatment strategies include risk factor control,medical therapy,and revascularization.This article reviews and summarizes the clinical research of treatment methods in recent years,such as symptomatic carotid stenosis related antiplatelet therapy,antihypertensive treatment,lipid-lowering therapy,carotid endartereetomy and stenting,as well as the treatment strategies recommended by the guidelines.

Objective To deepen and promote the development of nursing higher education internationalization through the analyzation of the status,existing problems and future trends of research about nursing higher education.Methods Searching literatures in China National Knowledge Infrastructure (CNKI),VIP and WANFANG databases from 1984 until 2014.Results 79 references were selected from 44 journals and the numbers increased each year.69.62％ (55/79) of them were accepted by statistical source core journals and 54.43％ (43/79) of them were funded.The authors came from 19 provinces.There were only 4 articles reported international education about graduates and most of them were about undergraduate students.The main reformation measures included curriculum and english teaching reform et al.Conclusions The educator paid more attention to nursing higher education internationalization than before,also the policy's support and the quality of literatures were optimistic.However,the breadth,depth and integrity of research should be strengthened in future.

Objective:To investigate the efficacy of nourishing feeding in patients with acute respiratory failure.Methods:One hundred patients with acute respiratory failure who received treatment in the First Affiliated Hospital of Wenzhou Medical University, China from December 2018 to March 2020 were included in this study. They were randomly divided into a control group and an observation group ( n = 50/group). After admission, all patients were actively treated and given enteral nutritional support. The gastric tube was indwelled. The head of the bed was elevated by 30-40°. The control group was given enteral nutrition which could reach the target dose within 2 days. The observation group was given nourishing feeding. Before and after 7 days of treatment, serum levels of hemoglobin (Hb), albumin (ALB) and total plasma protein as well as white blood cell and lymphocyte counts were determined. Intestinal tolerance was monitored during the treatment period. Mechanical ventilation time, length of intensive care unit stay, total hospital stay, and infection were compared between the control and observation groups. The number of deaths within 60 days after admission was recorded. Results:After treatment, serum levels of ALB, Hb and total plasma protein in the observation group were (49.86 ± 2.41) g/L, (134.96 ± 9.23) g/L, (54.18 ± 3.96) g/L, respectively, which were significantly higher than those in the control group [(42.34 ± 2.29) g/L, (127.49 ± 6.11) g/L, (42.86 ± 2.88) g/L, ( t = 15.99, 4.77, 16.35, all P < 0.01). After treatment, serum levels of ALB, Hb and total plasma protein in each group were significantly increased compared with before treatment (all P < 0.05). After treatment, white cell count in the observation group was significantly lower than that in the control group [(7.96 ± 1.06) × 10 9/L vs. (10.27 ± 2.35) × 10 9/L, t = 6.34, P < 0.01]. Lymphocyte count in the observation group was significantly higher than that in the control group [(1.19 ± 0.47) × 10 9/L vs. (1.02 ± 0.34) × 10 9/L, t = 2.07, P = 0.04]. After treatment, white cell count in each group was significantly decreased, and lymphocyte count in each group was significantly increased compared with before treatment (both P < 0.05). Intestinal intolerance rate in the observation group was significantly lower than that in the control group (22.0% vs. 52.0%, χ2 = 9.65, P < 0.01). The duration of mechanical ventilation, intensive care unit stay and total hospital stay in the observation group were (14.75 ± 5.36) d, (15.81 ± 6.28) d and (24.94 ± 7.18) d, respectively, which were significantly shorter than those in the control group [(18.69 ± 8.64) d, (27.96 ± 8.44) d and (29.84 ± 8.65) d, t = 2.74, 8.17 and 3.08, all P < 0.01]. The infection rate in the observation group was significantly lower than that in the control group (24.0% vs. 44.0%, χ2 = 4.46, P = 0.03). Conclusion:Nourishing feeding for enteral nutrition in patients with acute respiratory failure can better improve the nutritional status, reduce the level of systemic inflammation, improve the immune function, can be tolerated by the intestine, avoid infection, and promote the rehabilitation of patients with acute respiratory failure.

Objective Toll-like receptor ( TLR) gene family is the most important pathogen recognition receptor and animal experiment have found TLR4 mice is inclined to infect aspergillosis ( IA) .The study was to investigate the variation of TLR4 gene in Chinese Han nationality and its relation with the susceptibility of IA. Methods 25 patients diagnosed with proven IA from June 2011 to December 2012 in our hospital were enrolled, among which 17 were males.Their average age was 52.4 ±12.3, and 12 pa-tients had underlying diseases, the others had no underlying diseases.The control group consisted of 103 normal persons, among which 70 were males.Their average age was 56.0 ±17.2.All of the subjects were Chinese Han population.DNA was extracted from periph-eral blood.Polymerase chain reaction ( PCR) was applied to amplify the coding sequence of TLR4 gene followed by sequencing.The sequencing result was compared with TLR4 coding sequence in NCBI GenBank along with the analysis on amino acid change caused by genetic mutation and its effect on protein function.Comparison analysis was made on genetic mutation rate between IA group and con-trol group. Results Two missense mutations,TLR4 219 C>G and 1420 C>T, were identified in TLR4.The prediction result of protein structure showed 219 C>G resulted in the change of functional area for TLR4 to recognize pathogen and 1420 C>T caused no change in domains.The variation rate of TLR4 in IA group was 8%( 2/25 ) and both the patients had no underlying diseases. No mutation has been founded in control group and the difference between two groups was of statistical significance (P=0.037). Conclusion Two missense mutations (219 C>G and 1420 C>T) have been detec-ted in encoding area of TLR4 gene of IA patients.Variation in the cod-ing region of TLR4 gene may increase the susceptibility to IA.

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Objective To investigate the application of radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy in the diagnosis of peripheral pulmonary lesions (PPLs),assess its safety and diagnostic value,and explore the influencing factors.Methods Clinical data of 140 patients who underwent R-EBUS transbronchial biopsy (TBB) and brush biopsy in our department of respiratory endoscopy from January 2015 to March 2017 were collected and retrospectively analyzed in the study.Eighty-three cases were diagnosed as PPLs.The detection rate,ability to locate the peripheral lesions,and influencing factors of EBUS were analyzed.The incidence rate of complications was observed to assess its safety.Results Of the 83 PPLs patients,they were 55 males and 28 females,and at a mean age of 59.81 ± 11.85 years.The total success rate of EBUS-guided bronchoscopic diagnosis was 59.04％ (49/83),and the diagnostic rate was 50.94％ (27/53) for malignant lesions,and 73.33％ (22/30) for benign diseases.The rate of EBUS-TBB (56.92％,37/65) was significantly higher than that of brush biopsy (30.12％,25/83,Chi square =10.76,P =0.001).EBUS-guided diagnostic methods had an accuracy of 60.00％ (45/75),while the EBUS-guided bronchoscopy had a rate of 50.0％ (4/8),but no significant difference was seen between the 2 methods (Chi square =0.03,P =0.87).The sizes of the lesions ranged from 10.0 to 52.4 mm,and the diagnostic yield for PPLs ≤20 mm in diameter (36.84％,7/19) was lower than that for those ＞20 mm (65.62％,42/64,Chi square =5.02,P =0.003).There was no significant difference (Chi square =10.05,P =0.07)in the diagnostic yield for different sites,with that of right upper lobe of 46.15％ (12/26),right middle lobe 100.00％ (8/8),right lower lobe 53.85％ (7/13),left upper lobe 37.50％ (3/8),left lingula lobe 63.64％ (7/11),left lower lobe 70.59％ (12/17).But the detection rate was obviously lower in the upper lobe (22/45,48.89％) than the middle/lower lobe (27/38,71.05％,Chi square =5.02,P =0.003).Of all the 83 patients,74 ones (89.16％) were successfully identified using radial probe EBUS,but the lesions were not found in 9 patients.When the radial probe position was within the target lesion,the diagnostic yield was 81.58％ (31/38),notably higher than that when the probe was positioned adjacent to the lesion (50.00％,18/36,Chi square =8.24,P =0.004).Mild bleeding was observed when performing biopsy under bronchoscope,and no pneumothorax,or other serious complications were observed.Conclusion Radial EBUS is a safe and feasible nethod to accurately identify PPLs and improve its diagnostic rate.EBUS-guided bronchoscopy has higher positive detection rate for PPLs,and is cost saving.The relationship of the probe and the site of lesion is the main factor influencing the diagnostic rate.