Objective To investigate the effect of combination therapy with cognitive behavior on the quality of life of patients with gastroduodenal ulcer.Methods The patients with gastroduodenal ulcer treated in our hospital from April 2015 to April 2017 were randomly divided into intervention group and control group according to the order of treatment.Both groups were treated with bismuth-containing quadruple therapy and routine nursing was performed.The intervention group received cognitive behavior on this basis.SF-36 scale was used to evaluate the quality of life of the two groups of patients, and the prognosis of the patients was evaluated.The patient satisfaction was investigated by the self-designed questionnaire of patient satisfaction questionnaire.The clinical efficacy, treatment compliance, quality of life improvement, prognosis and satisfaction were compared between the two groups.Results The total effective rate was 96.67%(58/60) in the intervention group and 81.67%(49/60) in the control group.The total effective rate of the intervention group was significantly higher than that of the control group(P<0.05).The scores of SF-36 scale in the intervention group were higher than those in the control group(P<0.05).The incidence of complications in the intervention group was lower than that in the control group, and the satisfaction rate was higher than that of the control group(P<0.05).Conclusion Cognitive behavioral intervention combined with bismuth quadruple therapy for gastroduodenal ulcer can improve the patient's compliance and efficacy, significantly improve the quality of life of patients, improve patient satisfaction, with clinical application value.

Objective:To investigate the application of Balanced Scorecard (BSC) in the performance evaluation system of government procurement in medical colleges and universities based on the analysis of the current government procurement process.Methods: According to the theoretical and methodological analysis of BSC, the performance evaluation is divided into four major aspects of assessment indicators, learning and growth, business process, customer and finance, which breaks the traditional performance evaluation way of only focusing on the of financial indicators. Delphi method has been involved to determine the weights.Results: Based on the theory of BSC, the specific evaluation index and weight of the government procurement performance evaluation system in medical colleges and universities are put forward and proved by practice.Conclusion: A reasonable evaluation of the performance system established according to BSC will help to improve the beneficial results, efficiency and economy output of the procurement funds, and the management of government procurement in medical colleges.

Objective To investigate the role of PKCδin free fatty acid-induced endothelial cell apoptosis.Methods In addi-tion,we looked for evidence of apoptosis-related PKCδsignal pathway.Human umbilical vein endothelial cells were treated with va-rious concentrations of free fatty acids and transiently transfected with PKCδsiRNA to inhibit PKCδ expression.Cell proliferation was determined through colorimetric assays,and apoptosis was quantified using flow cytometry.Protein expression was determined from cell lysates use Western blots with antibodies against p-PKCδ Tyr512,PKCδ.Statistical analyses were performed.Results Free fatty acids had multiple effects on human umbilical vein endothelial cells,including concentration-dependent inhibition of cell proliferation,induction of apoptosis,increased Fas expression,and increased PKCδ expression and phosphorylation.Inhibition of PKCδmRNA expression by PKCδsiRNA led to a reduction in free fatty acid-induced apoptosis.Conclusion The free fatty acids-induced apoptosis in endothelial cells are possibly mediated by PKCδ.

Objective To examine the application effect of intelligent simulator(SimMan) in comprehensive skill training among doctors and nurses.Methods Totally 168 doctors and nurses were chosen as the training object,6 people (4 doctors and 2 nurses) formed a work team.Comprehensive training course was in accordance with 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science.Real clinical situation was designed by using the third generation SimMan of Norway laerdal company.Trainees were administered two tests before and after training,in which there were two parts containing specialized operation ability and non-technical ability.Overall qualification rate,average mark and treatment time of qualified teams were compared before and after the training.SPSS 16.0 software was used to analyze the data and P ＜0.05 signifies statistically significance.Results Overall qualification rate,average mark and treatment time of qualified teams were 71.43％,(84.70 ± 3.15),and (449.25 ± 77.0) s respectively before training while 100％,(93.55 ± 3.86) and (323.71 ± 42.26) s after training.There were significant differences in results of two groups before and after training (P =0.002,0.000,0.000).Conclusions Application of the third generation intelligent simulator (SimMan) in comprehensive training will obviously improve training effectiveness and cultivate the non-technical ability.

OBJECTIVE To investigate the pathogens in the early period after heart transplantation and analyze their drug-resistance.METHODS The pathogens in the early period after heart transplantation were identified and their drug-resistance was analyzed.RESULTS From all of the 121 pathogens,the rate of G-bacilli was 73.6%,the rate of G+ cocci was 17.4%and the rate of fungi was 9.1%;G-bacilli mainly consisted of Klebsiella pneumoniae,Enterobacter cloacae,Acinetobacter baumannii,Pseudomonas aeruginosa and Escherichia coli.G-bacilli showed higher sensitive rates to sulbactam/cefoperazone,cefepime,piperacillin/tazobactam and ceftazidime than to cefotaxime.All G-bacilli showed sensitive to imipenem except Pseudomonas aeruginosa.G+ cocci mainly consisted of negative coagulase Staphylococcus,Staphylococcus aureus and Enterococcus.Fungi mainly consisted of Candida,and they were sensitive to fluconazole,itraconazole and amphotericin B.CONCLUSIONS To observe the pathogens in the early period after heart transplantation and analyze their drug-resistance are important to control and prevent the infection efficiently for the heart transplantation recipients.

Objective To study the ability of standard strain and clinical isolates of Ureaplasma spp. to form biofilms in vitro and to compare the antibiotic susceptibility of sessile cells and their planktonic counterparts. Methods A total of 21 Ureaplasma wealyticum(Uu) isolates recovered from female patients diagnosed with cervicitis and Uu serovar 3 and Uu serovar 8( Uu3, Uu8) were included. Scanning electron microscope and confocal scanning laser microscopy were used to identify biofilm formation. Conventional antibiotic susceptibility tests and biofilm susceptibility assays for tetracycline, erythromycin and ciprofloxacin were carried out. The paired rank sum test and was applied to analyze the statistical differences between the MIC and the minimal biofilm inhibitory concentration. The x2 test was applied to analyze the statistical differences of global resistance percentages between planktonic cells and sessile cells. Results Uu3, Uu8 and 21 Uu isolates all can form biofilms in vitro. Minimal inhibitory concentration of sessile cells compared with planktonic cells were obviously higher for tetracycline, erythromycin and ciprofloxacin (P <0.001). Global resistance percentages between planktonic cells and sessile cells were different for erythromycin (9.52% vs 61.90% , P < 0. 001), ciprofloxacin ( 80. 95% vs 100% , P = 0. 035 ) and tetracycline (4. 76% vs 14.29% , P =0.293). Conclusion Uu isolates and Uu1, Uu8 all can form biofilms in vitro, and biofilm formation can strengthen resistance of Uu to antibiotics, even multidrug resistance was observed.

BACKGROUND:In recent years, calcium alginate dressing has been widely used in surgical hemostasis, traumatic hemostasis, postoperative nasal hemostasis and puncture site hemostasis,etc.; however, there are few reports on their hemostatic mechanisms. OBJECTIVE: To preliminarily study the hemostatic mechanism of calcium alginate dressing. METHODS: Human anticoagulant blood was respectively dropped on sodium alginate dressing, nasopore dressing and medical cotton gauze. After 2 minutes, the interaction between materials and blood was observed at the room temperature using scanning electron microscopy. Calcium alginate dressing, nasopore dressing and medical cotton gauze were added in human red blood cel suspensions respectively. After 15 minutes, the interaction between materials and red blood cels was observed using scanning electron microscopy. The red blood cels were suspended by different concentrations (10, 5, 2.5 g/L) of alginate dressing extracts. The erythrocyte sedimentation rate was observed at different time points (30, 60, 120 minutes). Platelets rich plasma was incubated with different concentrations (10, 5, 2.5 g/L) of alginate dressing extract at 37℃, then CD62P positive platelet percentage was measured by flow cytometry after 10 minutes of incubation. RESULTS AND CONCLUSION: Dense fibrin network was formed after calcium alginate dressing contacting with an anticoagulant. A large number of blood cels were recruited. There were only a smal amount of red blood cels and platelets adhesion in the nasopore dressing and medical cotton gauze groups. After the calcium alginate dressing interacting with red blood cels, red blood cel deformability was visible, with a pseudopodia-like change. The red blood cel morphology was unchanged in the nasopore dressing and medical cotton gauze groups. The calcium alginate dressing extract dose-dependently and time-dependently increased the red blood cels aggregation, comparative differences between groups was statisticaly significant(P < 0.01). The calcium alginate dressing extract dose-dependently enhanced the CD62P positive platelet percentage, comparative differences between groups was statisticaly significant (P< 0.01). These results demonstrate that calcium alginate dressing promotes hemostasis and coagulation process by releasing of calcium ions, causing red blood cel aggregation and deformation and activating platelets.

Objective To investigate the status of clinical nutrition management in patients in PICU,and to provide data for promoting the improvement and development of clinical nutrition of pediatric critically ill patients.Methods A questionnaire survey was conducted on PICU specialists.The nutrition assessment,nutrition intervention and nutrition management of critically ill children in PICU were investigated.The results were summarized and analyzed.Results A total of 39 PICU specialists were involved in this survey.The nutritional assessment methods and guidelines in domestic PICU were not unified.Twenty-five respondents (64.1%) believed that both clinical performance and the scales as the basis can decide whether the patients should be fed or not;all respondents believed that nutritional assessment and intervention time need to be determined by the needs of the patients;23 respondents(58.9%) used weight only as their nutritional monitoring indicators.Twenty-eight respondents(71.8%) considered that gastric tube was the first choice way to feeding for the critically ill children;20 respondents(51.3%) believed that critically ill children should be fed within 24 hours.Twelve respondents (33.3%) believed that critically ill children should be fed between 24 to 48 hours.Thirty-three respondents(84.6%) advocated early enteral nutrition;36 respondents (92.3%) considered that the main reasons of fasting in critically ill children were vomiting or abdominal distension or gastrointestinal bleeding.Twenty-eight respondents(71.8%) believed that according to the results of gastrointestinal function evaluation,they made decisions whether the patient to fast or not.Twenty-three respondents(59.0%) considered that specialists in PICU were the decision maker of the clinical nutrition in critically ill children.Twenty-four (61.5%) of the respondents believed that we needed to establish our own routines in management of nutrition in PICU.Conclusion At present in China,a lot of achievements have been made in the nutritional assessment,monitoring,early enteral nutrition intervention and management in critically ill children,but it is not enough.We need to make more effort to enhance the critically nutrition level in PICU,and we have a lot of research to do about nutrition assessment and nutrition intervention mode.It is recommended to establish Chinese guidelines or consensus to enhance the level of nutritional treatment of critically ill children.

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

Objective To investigate the extracellular polysaccharide distribution and components of Ureaplasma urealyticum (Uu) after biofilm having been developed in.Methods The standard serotype 3 and serotype 14 belong to biovar Parvo,and the standard serotype 4 and serotype 8 belong to biovar T960 were employed to form biofilrns in vitro.Scanning electron microscope and confocal laser scanning microscope were used to analysis the biofilms and extracellular polysaccharide.We used combination of two different labeled lectins,Canavalia ensiformis(FITC-ConA) and Erythrina cristagalli(ECA) which bind to specific polysaccharide residues to visualize extracellular polysaccharide in biofilms,and average uorescence intensity was evaluated Results All the strains can form the biofilmsin vitro.The biofilm was honeycomb-Like structures mainly,and extracellular polymeric substances accounts for majority of proportions.All the extracellular polysaccharide could be combined with FITC-ConA and ECA,and the total average fluorescence intensity of FITC-ConA was higher than ECA( P＜0.001 ).Conclusion Ureaplasma urealyticum biofilm is honeycomb-like structures mainly.The extracellular polysaccharide contains,galactose,and N-acetyl glucan residual,and the glucose,mannose residual are the main components.