Objective To investigate the clinical effect of treatment of severe carbon monoxide poisoning with Naoxingjing injection combined with naloxone.Methods Emergency department of affiliated theorem clinical college, hospital 70 patients diagnosed with severe carbon monoxide poisoning from emergency department in June 2014 to December 2016, were randomly divided into observation group and control group 35 cases.In the control group were treated with naloxone treatment, observation group were treated based on the use Naoxingjing injection treatment.The two groups were observed and recorded recovery time, mortality, the incidence of delayed encephalopathy, Glasgow Coma Score(GCS)and serum levels of IL-1β.Results The patients in the observation group total effective rate of 97.14% was significantly higher than 77.14%, and the difference was statistically significant(P<0.05);the recovery time was observed in patients(2.25 ± 0.88)h, significantly shorter than the control group(3.46 ± 1.10)h, and the difference was statistically significant(P<0.05);and follow-up observation group mortality rates were delayed encephalopathy(1.43%, 8.57%)than the control group(17.14%, 25.71%), and the difference was statistically significant(P<0.05);④ observation group were GCS score was (12.77±1.89), significantly better than the control group, and the difference was statistically significant(P<0.05);⑤ observed in patients IL-1β is(65.41±9.93)ng / L was significantly lower than the control group(89.86±10.74)ng / L, and the difference was statistically significant(P<0.05).Conclusion Naoxingjing injection combined with naloxone treatment of severe carbon monoxide poisoning exact clinical effect, can effectively reduce patient recovery time, reduce mortality and morbidity.

Objective To investigate the efficacy of scalp acupuncture plus moxibustion in treating post-stroke should hand syndrome. Method Seventy-three patients were divided into two groups. the treatment group of 42 patients received scalp acupuncture plus moxibustion and the control group, conventional acupuncture. The therapeutic effects and pre-and post-treatment Fugl-Meyer upper limb motor function scores were compared between the two groups. Result The total efficacy rate was 88.1%in the treatment group and 74.2%in the control group;there was a statistically significant difference between the two groups (P＜0.01). The total efficacy rate was higher in the treatment group than in the control group. The Fugl-Meyer upper limb motor function score increased in both groups after treatment (P＜0.01). The posttreatment Fugl-Meyer upper limb motor function score was higher in the treatment group than in the control group (P＜0.01). Conclusion The results suggest that scalp acupuncture plus moxibustion has a better therapeutic effect on post-stroke should hand syndrome. The therapeutic effect is better in the patients with disease duration under six months than in those over six months.

Objective To investigate the protective effects of soybean isoflavone(SI) on genetic toxicity induced by di-n-butul phthalate(DBP) in mice.Method(1) Micronucleus test:40 male 7 w old Kunming mice were randomized into 4 groups:High and low dose SI intervention groups,DBP model group,and solvent control group.SI intervention groups were given different doses of SI(50,100mg/kg) for 30 d,meanwhile,the DBP group and solvent group were given 0.5% sodium carboxymethyl cellulose.Then all groups were treated by 0.5g/kg DBP for 5d except solvent group.Mice were sacrificed 6 hour after last treatment,and then counting micronucleated cells in bone marrow.(2) Sperm malformation test:40 male 6w old Kunming mice were grouped and treated the same as micronucleus test.Mice were sacrificed at 35 day after the first treatment,and then sperm quantity,motility,viability and abnormality rate were calculated.Result Micronucleus rate and sperm abnormality rate of SI intervention group were lower than DBP model group,while sperm motility and viability were higher than DBP model group.Conclusion SI can relieve the genetic toxicity induced by DBP in mice.

Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock. Methods 116 patients with severe septic shock were randomly divided into control group and observation group according to the random number table method , 58 cases in each group. The control group was given the basic treatment of western medicine,the observation group was given Shenfu injection on the basis of the treatment of the control group. The patients were treated for 7 days. The heart rate ( HR) ,mean arterial pressure ( MAP) ,central venous pressure ( CVP) ,blood lactate ( Lac) ,urine output, acute physiology and chronic health score ( APACHEⅡ) were observed before and after treatment. The tumor necrosis factor ( TNF- α) , interleukin -6 ( IL -6 ) and C - reactive protein ( CRP ) were measured before and after treatment. The changes of inflammatory cytokines were observed before and after treatment. The 28-day mortality and average length of hospital stay were observed. Results After treatment,the HR of the control group was not improved compared with before treatment[(121. 32 ± 11. 85)beats/min vs. (123. 65 ± 14. 05)beats/min,t=1. 66,P=0. 98]. The HR of the observation group decreased, and there was significant difference compared with before treatment [(96. 55 ± 10. 65) beats/min vs. (123. 60 ± 13. 98) beats/min,t=11. 84,P=0. 00]. The MAP and CVP of the two groups were higher than before treatment,and there were significant differences compared with before treatment ( all P<0. 05). The urine volume of the two groups was higher than before treatment,and that of the observation group was higher than the control group (t=20. 40,P=0. 00). The score of APACHEⅡ,TNF-α,IL-6 and CRP of the two groups were lower than before treatment,which of the observation group were lower than those of the control group ( all P<0. 05). The difference of 28-day mortality rate between the two groups was not statistically significant(13. 79%vs. 22. 41%,χ2 =1. 45,P=0. 23). The average hospital stay of the observation group was shorter than that in the control group [(23. 39 ± 5. 81)d vs. (28. 76 ± 6. 23)d,t=6. 52,P=0. 00]. Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock,reduce the concentration of lactate in blood,improve the level of inflammatory factors and heart index.

Objective The aim of this study was to investigate the mechanism of sanguinarine(SANG)on the inhibitory pro-liferation in ovarian cancer SKOV3 cells. Methods CCK-8 assay was used to detect proliferation of SKOV3 cells. Flow cytometry was used to detect the effect of SANG on apoptosis in SKOV3 cells. The spectrophotometer was used to detect the production of reac-tive oxygen species(ROS)by SANG. The mouse ovarian cancer xenograft model was used to detect the inhibitory effect of SANG on tumor growth. Results SANG promoted apoptosis in SKOV3 cells in a dose-and time-dependent manner. The SANG-induced ap-optosis was associated with the production of ROS,Activated the c-Jun-N-terminal kinase( JNK) and nuclear factor-κB( NF-κB)signaling pathways. In mouse model of ovarian cancer xenografts,after intravenous injection of mice with SANG,SANG was signifi-cantly inhibited the growth of ovarian cancer xenografts when compared to the control group. SANG also significantly induced apoptosis in ovarian cancer xenografts. Conclusion SANG can significantly inhibit the proliferation of ovarian cancer SKOV3 cells,induce ap-optosis,increase the production of ROS,and inhibit the growth of ovarian cancer.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

Objective To analyze the status and influencing factors of job satisfaction of nurses at public hospitals, providing references for the teambuilding strategy of nurses. Methods Questionnaire survey method was used, in October 2017, to study job satisfaction of 1,047 nurses at 13 public general hospitals, for a countermeasure study. Results Job satisfaction of the nurses was found at a medium level. Specifically, their overall job satisfaction score was 3. 68, and the satisfaction scores of the following dimensions from high to low were: on-the-job training (3. 91), hierarchical nurse use (3. 79), performance appraisal (3. 68), promotion evaluation (3. 67), and remuneration (3. 62) respectively. Contents of the five dimensions are strongly related to the overall job satisfaction (r＞0. 6). Job satisfaction scores of nurses with their differences in positions, annual income, and hospital level were significantly different (P＜ 0. 05). The three main influencing factors for talent turnover rate are remuneration, workplace pressure and work environment. Conclusions Higher remuneration, improved hierarchical management system, and greater attention to nursing care at secondary hospitals are very important for effectively improving the job satisfaction of nurses and ensuring the health care industry.

Objective To demonstrate the clinical characteristics and prognosis of invasive pulmonary aspergillosis (IPA) in respiratory intensive care unit (ICU), for early diagnosis and treatment. Methods The clinical features, treatment and outcome of 17 patients diagnosed as IPA in RICU from May 2015 to April 2018 were analyzed retrospectively. Results The basic diseases of 17 patients were mostly chronic respiratory diseases (14 cases, while 11 cases were chronic obstructive pulmonary disease). One case was proven by IPA criteria, 13 cases were probable and 3 cases were possible. All patients were treated with broad-spectrum antibiotics during hospitalization, and 6 patients were treated with glucocorticoids (oral/intravenous) within 3 weeks of admission and during hospitalization. The main clinical symptoms included cough sputum, dyspnea and fever, among which 4 cases had hemoptysis. Infiltrates were seen in 8 cases, multiple nodules with cavitary lesions in 4 cases, multiple small nodules along the bronchi in 2 cases, and left upper lobe consolidation in the proven case. Sixteen patients were treated with voriconazole alone or in combination with caspofungin. Fourteen patients were tested for voriconazole serum concentration, while 4 were in normal range, 10 were elevated (2 cases were significantly elevated, ＞10 μg/L). Serum concentration of bilirubin did not increase significantly in all paitents after treatment. Serum concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated in 4 cases with elevated serum concentration of voriconazole and 2 cases with normal serum concentration of voriconazole. Patients with elevated voriconazole concentration did not show significant difference in prognosis compared with those with normal concentration. Eight cases were improved and discharged and 9 gave up and died due to the worsening of the disease. Eight patients received mechanical ventilation (6 cases were invasive and 2 cases were non-invasive), 7 of them eventually gave up treatment and died. Conclusions The clinical features of chronic respiratory diseases with IPA are atypical, however, the patient is critically ill with high mortality. Elevated serum concentration of voriconazole might be more common in severe patients. For those who have a history of systemic application of glucocorticoids, clinical symptoms with hemoptysis, short of breath, radiology with infiltrates, nodular and/or with cavity, and with no response to antibiotics, clinicians should actively seeking evidence of IPA, for early diagnosis, standardized treatment, and improve the prognosis of patients with chronic respiratory diseases complicated with IPA.

Objectives To provide reliable information concerning the presence or the absence of Histoplasma capsulatum (H. capsulatum) infection in China, and data concerning this respect.Methods Three hundred normal people and 435 hospitalized patients, who lived in Hunan and Jiangsu provinces, and the Xinjiang Autonomous Region, were tested with yeast-phase histoplasmin (ALK/Berkerley Biologicals Laboratories, USA) and human pure protein derivative of tuberculin (PPD) on the volar surface of the forearm. Any reaction to the antigens over 5.0?mm in diameter of induration at 48-72?hours was considered positive. Results A total of 138 subjects (18.8%) in 735 patients reacted to histoplasmin with 5.0-45.0 (9.1±4.3)?mm indurations. Significant differences of positive skin reaction rates in normal subjects were found in Hunan, Jiangsu and Xinjiang (8.9% vs 15.1% vs 2.1%). The overall positive rate of patients was 25.5%. Patients with tuberculosis [31.7% (78/246)] had a significantly higher positive skin reaction rate in comparison with those suffering from pneumonia [17.7% (11/62)], lung cancer [20.9% (9/43)], chronic obstructive pulmonary disease [17.3% (9/52)] and other diseases [12.5% (4/32)] (P<0.01). Of 562 cases, 292 cases (52.0%) reacted to PPD with indurations of 5-50 (13.7±4.9)mm in diameter, 63 cases (11.2%) reacted to both histoplasmin and PPD, while 38 cases (6.9%) reacted to histoplasmin but not to PPD.Conclusions The data suggest that there is H. capsulatum herd infection in China. The infection rate in Southeast China is higher than that in the Northwest, and the infection rate of patients with pulmonary tuberculosis is higher than that of normal persons and other pneumonopathy patients.