Objective To use self-efficacy theory to intervene patients with chronic obstructive pulmonary disease (COPD),and assess its efficacy on the self management level of COPD patients.Methods 106 COPD patients hospitalized in the respiratory department of a certain hospital from October 2011 to April 2012 were randomly divided into the control group and the intervention group.Each group consisted of 53 patients.Two groups of patients received routine respiratory treatment and nursing.But patients in the intervention group were also systematically intervened under the guidance of Bandura self-efficacy theory.The self-management level of both groups of patients were assessed before the treatment and six weeks after the treatment respectively.Results The self-management level of the intervention group were significantly better than that of the control group after intervention.Conclusions Self-efficacy theory can improve the self-management level of patients with COPD.

The aim of this study is to improve liposome encapsulation efficiency of water soluble drug ATP-2Na with hydrophobic ion pairing method, and evaluate its effect on tissues energy state in myocardial ischemia mice. Ion pair complex of ATP-2Na with HTAB was prepared first; then the liposomes were prepared by ethanol injection method. The size and zeta potential of ATP-2Na liposome were investigated. Its effect on tissues energy state in myocardium ischemia mice was evaluated by detecting ATP-2Na concentration in tissues and blood after injection in comparison to ATP-2Na solution. The diameters and zeta potential of ATP-2Na liposomes were (144.0 +/- 2.7) nm and (+16.2 +/- 1.6) mV, respectively. The encapsulation efficiency was (85.02 +/- 2.31) %. The in vitro drug release pattern from liposomes matches with Weibull equation. Compared with ATP-2Na solution, ATP-2Na liposome increased the ATP concentration of blood in myocardial ischemic mice very significantly; compared with blank, ATP-2Na liposome increased ATP content of myocardium and liver in myocaridal ischemic mice significantly, but ATP-2Na solution didn't show this effect. ATP-2Na liposome might have an advantage in improving tissue energy state on myocaridal ischemic animals.

Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.

Objective To investigate the effect of ethanol on level of the main hippocampal subtype of muscarinic receptor(M1)in mice,and evalu?ate whether the content change on this receptor could be linked with alterations in cognition,so as to further reveal the mechanism of brain damage in?duced by ethanol. Methods Sixty female mice were randomly divided into four groups. The model mice were induced by intragastric administration of ethanol at dose of 8%,16%,and 32%respectively of 0.2 mL/10 g for 8 weeks according to the protocol,and control group were treated with intra?gastric administration of distilled water. The capability of learning and memory were examined by Morris water maze,and ELISA method was used to measure the M1 receptor content in hippocampus in each group of mice. Results Compared with first day,the mean escape latency period on the fifth day was significantly shortened in each group. There was no significant difference between ethanol and control group for the mean escape latency period on the fifth day. Compared with the control group,the active time in the target quadrant was significantly shortened in 16%and 32%ethanol group. M1 receptor content in hippocampus formation was significantly decreased in all the ethanol group mice. The ethanol concentration was nega?tive correlated with the M1 receptor content. Conclusion Chronic alcoholism can induce the memory impairment in mice,which might be associat?ed with the low level of M1 receptor subtype in hippocampus of mice.

ObjectiveTo evaluate the effects of ventilator circuit change frequency on ventilatorassociated pneumonia (VAP).MethodsMeta-analysis of effects of ventilator circuit change frequency on VAP was conducted with study-level data from 1995 to 2010 in Pubmed,Embase,Web of Science databases.ResultsNine articles were included (sample size:20 326 mechanically ventilated patients).Analysis of six articles showed that the incidence of VAP in ventilator circuit change every 2 or 3 days was 4.05％,while 3.65％ in ventilator circuit change every 7 days.Compared with change ventilator circuit every 2 or 3 days,the risk ratio (RR) of VAP in weekly changes was 0.77 [0.54,1.09] ( P =0.14 ).Analysis three articles showed that compared to ventilator circuit change every 7 days with 15.89％ incidence of VAP,the incidence of VAP in circuit change more than 14 days was 14.9％,and RR was 0.98 [0.69,1.39](P =0.91 ).ConclusionsRegular ventilator circuit change frequency in various intervals can't difference in the incidence of VAP in mechanical ventilation patients.

Abstract: The activities of four CYP450 enzymes (CYP3A, 1A2, 2El and 2C) and the mRNA expression levels of CYP1A2, 2El, 2Cll and 3A1 in rat liver were determined after Wistar rats were orally administered with brucine (BR) at three dosage levels (3, 15 and 60 mg.kg-1 per day) and the high dose of BR combined with glycyrrhetinic acid (GA, 25 mg.kg-1 per day) or liquiritin (LQ, 20 mg.kg-1 per day) for 7 consecutive days. Compared with the control, brucine caused 24.5% and 34.6% decrease of CYP3A-associated testosterone 6beta-hydroxylation (6betaTesto-OH) and CYP2C-associated tolbutamide hydroxylation (Tol-OH), respectively, and 146.1% increase of CYP2El-associated para-nitrophenol hydroxylation (PNP-OH) at the high dose level. On the other hand, (BR+GA) caused 51.4% and 33.5% decrease, respectively, of CYP2El-associated PNP-OH and CYP1A2-associated ethoxyresorufin-O-de-ethylation (EROD) as compared with the high dose of BR group. Meanwhile, (BR+LQ) caused 41.1% decrease of CYP2El-associated PNP-OH and 37.7% increase of CYP2C-associated Tol-OH. The results indicated that the co-administration of BR with GA or LQ had effect on mRNA expression and activities of the CYP450 enzymes mentioned above to some extent, and the in vivo antagonism of LQ on BR-induced CYPs adverse effects and the in vivo inhibitory action of GA on CYP2E1 and 1A2 might play an important role in the detoxification of Radix Glycyrrhizae against Strychnos nux-vomica L.

BACKGROUND:There are some controversies on the choice of immediate or delayed weight-bearing schemes of implants.
OBJECTIVE: To explore the weight bearing scheme for Bego implants based on implant stability quotient (ISQ) measured by Osstel, and to analyze the factors which influence implants’ stability.
METHODS:Seventy-four single Bego implants with ISQ≥ 50 in 62 patients were selected and randomly
divided into test group (36 single Bego implants in 31 patients) and control group (38 single Bego implants in 31 patients). Patients in the test group were given immediate loading, and patients in control group were given
delayed loading. Two groups’ ISQ of Bego implants after loading (1, 2, 3, 4, 6, 8 and 12 weeks) were compared, and factors which influence implants’ stability were analyzed.
RESULTS AND CONCLUSION:The lowest ISQ for immediate loading of the test group appeared in 2-3 weeks after loading, and that of the control group appeared in 3-4 weeks. There was no statistical difference between two groups on ISQ of Bego implants after bearing (1, 2, 3, 4, 6, 8 and 12 weeks) (P > 0.05). Multiple regression analysis showed that the factors including age, types of osseous substance and implant length were positively related with stability of Bego implants, yet oral hygiene was negatively related with stability of Bego implants. Immediate loading and delayed loading have similar stability to single Bego implants with ISQ≥ 50 measured by Osstel, so individualized weight bearing scheme may be selected according to patient’s own condition under the guidance of Osstel, further to improve implants’ success rate after loading.

BACKGROUND: Geriatric depressive disorder is a common psychological disorder in elderly people, and it can lead to the decline of various organic functions, and it also does great harm to elderly people and their family.OBJECTIVE: To investigate the influencing factors of depressive disorder in retired cadres and people, so as to provide basic evidence for enhancing the mental nursing in retired cadres and people and reducing the prevalence of geriatric depressive disorder.DESIGN: A sampling survey.SETTING: Department of Nursing, North China Coal Medical College.PARTICIPANTS: Between August and December 2002, 1 000 retired cadres and people living in the urban area of Tangshan city were investigated. There were 574 males and 426 females, aged from 60-88 years, the average age was 67.04 years, 851 of them were married, 10 were divorced and 139 had lost their spouses: the educational level was primary school and below in 159 cases, junior middle school in 362 cases, senior middle school in 280 cases, university and above in 199 cases.METHODS: The elderly people were investigated with the geriatric depression scale (GDS) and individual general information inventory by means of family visit. The investigative purpose and methods were introduced to the subjects before the investigation, and they all signed the informed consent, the form of without recording name was used. The strictly trained investigators were qualified by examination, which ensured the concordance of the investigative results. The pretesting was performed before the investigation to detect whether there were words,sentencesand items hard to understand, so as to avoid the information bias. The questionnaires were filled by the elderly people themselves or by the investigator if there was any difficulty for the elderly people in writing according to the their choice after reading the questions for them.in retired cadres and people of different age, gender and educational level:ferent marriage status.RESULTS: Totally 1 000 questionnaires were sent out, and 1 000 valid der was obviously higher in females than in males (27.0%, 18.6%, P ＜ 0.05).ple with the educational level of primary school and below, junior middle school, senior middle school, university and above were 33.9%, 22.1%,20.0%, 16.1% respectively, and it was decreased with the elevation of emarkedly higher in retired people than in retired cadres (25.4%, 13.6%,higher than in those having or had lost spouse (50.0%, 21.2%, 26.6%, P ＜ 0.05).CONCLUSION: The prevalence of depressive disorder is higher in retired cadres and people. More attentions should be given to the mental health care and social support of retired cadres and people, especially for the divorced ones.

Objective To evaluate the value of angled insonation technique in obtaining the volumes of the fetal palate and in three-dimensional post-processing.Methods Five hundred and sixty-six cases of 20~28 weeks fetuses with normal face were confirmed by systemic ultrasound examinations and post-natal examination.The volumes in the standard midsagittal plane and angled midsagittal plane were obtained,then post-processed these data by 4D-View software.The same technology was used for volume data acquisition and processing to 1 case of cleft lip and palate fetal.Results In 566 fetuses,two groups of volume data were successfully acquired in 458 cases (standard midsagittal plane group) and 411 cases (angled midsagittal plane group).Fetal primary palate in the standard group and the angled group can be both well visualized(100%).Axial plane of hard palate can not be reconstructed in the standard group.Only 36% of the fetal hard palate's coronal plane and transoral oblique coronal plane can be reconstructed.The visualization rate of soft palate was 87% in the standard group,which was slightly higher than the angled group (82%).The visualization rate of hard palate's axial plane,coronal plane and transoral oblique coronal plane was 100% respectively in the angled group.Cleft alveolar process involving the secondary palate can be clearly visualized in 1 case of cleft lip and palate fetus.Conclusions By using the angled insonation technique,which is based on clearly visualizing secondary palate to obtain volumes,using three-dimensional post-processing technique can obtain the conventional three orthogonal planes and any other section of the whole palate.By using it we can assess the integrity of fetal palate,diagnose cleft lip with or without cleft palate and classify the cleft palate,even make prenatal diagnosis of the isolated cleft palate possible.

Objective To observe the effects of ketamine on the patients with depression re-ceiving modified electric conulsive therapy (MECT).Methods Sixty patients with depression were randomly divided into ketamine group and propofol group (n =30 each group).Atropine 0.5-1.0 mg, propofol 1.0 mg/kg or ketamine 0.8 mg/kg i.v.were given before MECT,Scoline 0.7-1.0 mg/kg i. v.was given after the eyelash reflex disappeared.Hamilton Depression Rating Scale (HAMD)was completed after the 2 nd ,4 th and 6 th MECT,the time of convulsion,twitch index,energy percentage, respiratory recovery time and adverse reactions were recorded.Results The total score of HAMD was significantly decreased with the increasing times of MECT in both groups,compared with propo-fol group,ketamine group's HAMD total score decreased faster,especially after the 4th MECT,the score decreased significantly in ketamine group (P <0.05).The time of convulsion,twitch index,en-ergy percentage, respiratory recovery time, adverse reactions all had no statistical significance between the two groups.Conclusion Compered with propofol,ketamine,as an anesthetic of MECT, can effectively lower the score of HAMD.