Objective:To analyze the effects of SBAR(namely situation, background, assessment and recommendation) communication mode-guided scenario simulation exercise on the quality of shift change of practice nurses and the incidence of nursing risks.Methods:From May 2017 to December 2018, 46 nurses interning in the Department of Cardiovascular Medicine of Guangyuan Central Hospital were selected as the control group, and received practice guidance according to the conventional shift change mode; 46 nurses were selected as the research group having the SBAR communication mode-guided scenario simulation exercise from January 2019 to June 2020 in the same department. The evaluation results of the quality of nurses' shift change, the evaluation results of the quality of nurses' succession, and the satisfaction of nurses were compared between the two groups. SPSS 22.0 was used for t test and chi-square test. Results:The evaluation results of 7 items of nurses' handover quality in the research group were better than those in the control group ( P<0.001). The evaluation results of 6 items of nurses' succession quality in the research group were better than those in the control group ( P<0.001). The scores of 5 dimensions in the research group were higher than those in the control group ( P<0.001). Conclusion:The implementation of SBAR communication mode-guided scenario simulation exercise can improve the quality of nurses' shift change and the satisfaction of practice nurses.

Objective To summarize the experience of the trans-unilateral nasal and sphenoidal approach to pituitary denomas.Methods 20 cases of pituitary adenomas were removed by the trans-unilateral nasal and sphenoid approach under operating microscope,of which there were 2 microadenoma patients,16 macroadenoma patients;2 giant pituitary adenoma patients.Results Of all the 20 patients,12 had total resection of tumor;4 had subtotal resection of tumor and 4 had part resection of tumor.All cases showed improvement.After the operation,3 had diabetes insipidus and 2 had CSF rhinorrhea,which had been cured by the time they left the hospital.Conclusion this method is minimally invasive with short operative distance,time and fewer complications.

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

Objective To investigate the distribution modes of NOS nerves and interstitial cells of Cajal (ICCs) in myenteric plexus of human fetal intestine. Methods Small intestine samples from 12 fetuses were collected for the preparation of whole mount preparations and cryo sections examined by immunocytochemistry for c kit receptor tyrosine kinase and histochemistry for NADPH diaphorase. Results ICCs associated with the myenteric plexus in the fetal small intestine were observed in the shape of spindle or ovoid with two to three slender processes forming an independent and complete cellular network. While NOS positive nerves, which constitute the main neuronal component of ganglia, connecting strands, and nerve fibers, were found within the circular muscle layer and myenteric plexus of the small intestine and the latter was especially rich of this kind of nerves. Most of these positive neurons were Dogiel I type neurons and they often gathered in cluster in the ganglia. Each ganglion contained several to dozens of NOS positive neurons. Although no colocalization of ICCs and NOS positive nerves was found by double staining of whole mount preparations and cryo sections, they were closely distributed. Conclusion Our results indicate that NO released by myenteric plexus, an inhibitory neurotransmitter, may possess the function of regulating ICCs and smooth muscle in late stage of the fetus.

Objective To summarize the experiences of Nuss procedure with thoracoscope for repairing pectus excavatum.Methods 21 cases of pectus excavatum were treated by Nuss procedure with thoracoscope.In these patients,10 had symmetric pectus excavatum and 11 had asymmetric one.Results The operation in all patients were successful.The mean operating time wag(70.7±9.6)min and the mean intraoperative blood loss was(20.3±10.9)ml.The average hospital length of stay was(5.3±1.1)days,the average durante dolors was(6.9±4.0)days.The exceUent rate was 81.0%(17/21),including 90.0%(9/10)in symmetric pectus excavatum and 72.7%(8/11)in asymmetric pectus cxcavatum.Conclusion Nuss procedure is easy to perform,with minimal invasion,short operating time,and less blood loss.Nuss procedure is suitable for the symmetric pectus excavatum.

AIM:To observe the effects of cholecystokinin octapeptide (CCK-8) and its receptor antagonists on cAMP response element binding protein ( CREB) and phosphorylated CREB ( pCREB) expression in frontal cortex and hippocampus of morphine withdrawal rats , which aim to explore the post-receptor mechanism through which CCK-8 regu-lates morphine withdrawal .METHODS: After the morphine dependence and naloxone-precipitated withdrawal animal models were established, the effects of CCK-8, L-364718 (CCK1 receptor antagonist) and LY-288513 (CCK2 receptor an-tagonist) pretreatment on CREB and pCREB expression in frontal cortex and hippocampus were observed by Western blot -ting and immunohistochemistry .RESULTS:In rat frontal cortex neuron , CREB was expressed in both cytoplasm and nu-cleus, but pCREB was only highly expressed in the nucleus .In the pyramidal cell layer of hippocampal CA 1 region, CREB showed high expression in the cytoplasm and low expression in the nucleus , while pCREB was only expressed in the nu-cleus.No obvious change of CREB was observed after either chronic morphine treatment or naloxone withdrawal .The pCREB expression was increased after chronic morphine treatment and further increased after naloxone withdrawal .Com-pared with the withdrawal group , chronic pretreatment with CCK-8, L-364718 and LY-288513 had no effect on CREB expression in the frontal cortex , but obviously decreased the pCREB expression .In the hippocampus , pretreatment with L-364718 and LY-288513 decreased CREB and pCREB expression , but only the pCREB expression was decreased after CCK-8 treatment.CONCLUSION:CCK-8 and CCK receptor antagonists may alleviate morphine withdrawal symptoms by regulating CREB , with specificity in different brain regions .

OBJECTIVETo analyze the relationship between the pulse pressure (PP) and atherosclerotic renal artery stenosis (ARAS) in middle-age and eldery paients with hyperensio, so as to provide the basis for the diagnosis and treatment of ARAS.

METHODSWe tetro spectively analyzed the data of 257 patients with hypertension undergoing renal arteriography at General Hospital of PLA between 2009 and 2014. Their mean age was (64.09 +/- 7.81) years. According the results of arteriography, they were divided into two groups: ARAS group (n = 145), and non-ARAS group (n = 112). Their PP and multinomial clinical indexes with ARAS were statistically analyzed.

RESULTSSingle factor correlation and Logisitic analysis showed that age, PP, serum creatinine (SCr) levels, and new onset of hypertension after 50 years of age were strongly positively related to ARAS. The age and PP and SCr was a team of continuous variable.

CONCLUSIONPP was the first new risk factor of ARAS in middile-aged and elderly patients with hypertension. It is suggested that PP may be a early predictive indicator and a new therapeutic target for ARAS.

Angiography ; Arteriosclerosis ; physiopathology ; Blood Pressure ; Humans ; Hypertension ; Middle Aged ; Renal Artery ; physiopathology ; Renal Artery Obstruction ; Risk Factors

In the present study, the AC impedance of rat blood was measured with Agilent 4294A impedance analyzer in the frequency range of 10(4)-10(8) Hz, and the effect of simulated weightlessness (SWL)on electrical properties of rat blood was investigated by analyzing the data characteristics with the use of electrical impedance spectroscopy, the Bode diagram, the Nyquist diagram and the Nichols diagram. The results demonstrated 60 days SWL caused some changes: (1) the electrical impedance of rat blood were reduced, mainly in the real part of complex impedance (Z'o and Z'infinity), the electrical impedance modulus amplitude (|Z*|o and |Z*|infinity), the impedance relaxation strength (deltaZ', delta|Z*|) and the logarithm of impedance modulus amplitude at low frequency (Log |Z*|o) were lower than that in the control (CON) group; (2) the characteristic frequency of the electrical impedance spectrum of rat blood and the phase angle were increases, mainly in the characteristic frequency (fc1, fc2) and the phase angle [theta(p) (degree), theta(p) (radian)] increased compared with that in the CON group. These data indicate that SWL leads to reduced resistivity and enhanced conductivity of blood.
Animals ; Blood ; Blood Physiological Phenomena ; Dielectric Spectroscopy ; methods ; Electric Impedance ; Male ; Rats ; Weightlessness Simulation

Adult ; Aircraft ; Angiotensinogen ; analogs & derivatives ; blood ; Hot Temperature ; adverse effects ; Humans ; Male ; Neuropeptides ; blood ; Noise ; adverse effects ; Occupational Exposure ; adverse effects ; Stress, Psychological ; blood ; etiology ; Time Factors

Objective To understand the coronary characteristic of acute coronary syndrome patients with ischemic J wave. Methods Comparison was made between 60 acute coronary syndrome patients with ischemic J wave and 60 acute coronary syndrome patients without ischemic J wave. All patients were examined by Holter monitoring electrocardiogram and coronary arteriongraphy. To distinguish the stenosis degree was defined in three degree based on Genisini score of 0, 1-80, and 81-160. Plaque types were divided into Ⅰ,Ⅱ, Ⅲ by Ambrose classification,the coronary and plaque characteristics of acute coronary patients were observed with ischemic J wave. Results There were no significant difference of stenosis degree between the two groups ( U = 3. 0686, P = 0. 0022), whereas there were significant difference of plaque types (x2 =16. 0890, P = 0. 0003) and coronary vessel numbers(x2 =12. 1045, P = 0. 0024). The degree of stenosis, the plaque types, and number of stent in coronary vessel were positively correlated with ischemic J wave(r =0. 44,0. 34,0. 31 ;P <0. 05). Conclusions The acute coronary syndrome with ischemic J wave patients is often not only accompanied with serious coronary stenosis and high incidence rate of multivessel disease,but also high probability of unstabilized plaque. Ischemic J wave can be a predictor of super-acute ischemic of myocardium.