Objective To compare the quality of Rheum palmatum L. in different areas and ages in Gansu Province by comparing five components in Rheum palmatum L. through fingerprints and QAMS (quantitative analysis of multi-components) methods; To determine the most suitable growing areas and the best development areas in Gansu Province. Methods The water content, total ashes, and water-soluble extract content in 15 batches of Rheum palmatum L. from different areas and ages in Gansu Province were determined according to the approaches listed in the Chinese Pharmacopeia. The contents of five index components were determined through HPLC and the quality of 15 batches of Rheum palmatum L were evaluated by fingerprint and QAMS method. Results The results from 15 batches of Rheum palmatum L. showed that the water content was less than 15％, total ashes less than 10％, and water-soluble extract content less than 25％, conforming to Pharmacopoeia. There were 23 common peaks in the fingerprints of 15 batches of Rheum palmatum L.. Five of them were identified as aloe-emodin, rhein, emodin, chrysophanol and physcion, which showed good linear relationship in the range of 0.0122–0.7344 μg (r=0.9999), 0.00714–5.7120 μg (r=0.9999), 0.0088–0.7040 μg (r=1.0000), 0.1224–3.6720 μg (r=0.9999) and 0.0148–5.9200 μg (r=0.9997), respectively. There was no significant difference between the calculated value and the measured value by using the relative correction factor (RCF), and the reproducibility of RCF was good. The quality of Rheum palmatum L. from different areas and ages in Gansu Province significantly differed (P<0.05). Two year old Rheum palmatum L. from Pingxiang village of Li county and Rushu village of Tanchang county had the best quality, and that of three years old was better than two years old from Tanchang county. Conclusion The established fingerprints and QAMS method is accurate, feasible, and can be used for the quality comparison of Rheum palmatum L. from different areas and ages in Gansu Province. Li County and Tanchang County areas in Gansu Province can be used as suitable planting areas and development industry. Therefore, it is recommended to select more than two yeas old Rheum palmatum L. from Tanchang County and Li County in Gansu Province for medicinal application.

Objective To build scientific and sensitive nursing quality indicators on hepatic encephalopathy, so as to provide and promote the improvement of nursing quality. Methods The hepatic encephalopathy nursing-sensitive quality indicators was eventually built through literature reviews、evidence classification、indicators selected、experts consultations、data analysis. Results Eighteen hepatic encephalopathy nursing sensitive quality indicators, such as percentage of driving risk disclosure, percentage of nutritional assessment regularly were identified. The positive coefficients in the two rounds of expert consultation were 78.95% and 93.33%. And the authoritative coefficients were 0.930 and 0.945. The coefficients of variation ranged from 0.00 to 0.29. Conclusions The hepatic encephalopathy nursing-sensitive quality indicators are scientific and practical,which can be applied to clinical utilization.

Objective To discuss the clinical effects and safety of different ratios of intermittent noninvasive mechanical ventilation and continuous noninvasive mechanical ventilation in the treatment of typeIIrespiratory failure. Methods A total of 94 patients with acute attack of chronic obstructive pulmonary disease complicated with type II respiratory fail-ure were selected. They were randomly assigned to intermittent group A of 32 patients, intermittent group B of 31 pa-tients and continuous group of 31 patients. They received 3:1 intermittent noninvasive mechanical ventilation, 1:1 inter-mittent noninvasive mechanical ventilation and continuous intermittent noninvasive mechanical ventilation respectively on the basis of regular treatment. Results The pH value, PaO2 and PaCO2 in the three groups in 6 h, 24 h and 72 h after treatment were all significantly different with those before treatment (P<0.05). The pH value, PaO2 and PaCO2 in 24 h and 72 h after treatment were all significantly different with those in 6 h after the treatment (P<0.05). The pH val-ue, PaO2 and PaCO2 in 72 h after treatment were all significantly different with those in 24 h after the treatment (P<0.05). The pH value, PaO2 and PaCO2 in the three groups before the removal of ventilator, 6 h and 12 h after the removal were not significantly different (P>0.05). Duration of mechanical ventilation in intermittent group A and intermittent group B were both significantly lower than those in the continuous group (P<0.05). Incidences of flatulence, tracheal intubation, ventilator-associated pneumonia and facial pressure sores in intermittent group A and intermittent group B were all sig-nificantly lower than those in the continuous group (P<0.05). Conclusion The two intermittent ratios of noninvasive me-chanical ventilation and continuous noninvasive mechanical ventilation have similar effects as the removal of ventilator. Intermittent mechanical ventilation is able to obviously shorten the duration of mechanical ventilation and hospitaliza-tion time, and lower the incidence of complications. 1:1 intermittent noninvasive ventilation has the optimal safety, which is considered to be the ideal choice of noninvasive mechanical ventilation.

Objective To observe the curative effects of noninvasive mechanical ventilation in the treatment of acute left heart failure. Methods All 86 patients with acute left heart failure who were admitted to EICU in our hospital from January 2010 to June 2014 were selected. They were randomly assigned to observation group and control group, with 43 patients in each group; the observation group was given noninvasive ventilator on the basis of conventional medical treatment, and the control group was given conventional medical treatment and oxygen uptake. Heart rate, respiratory rate, ABG index and clinical effects between the two groups 4 hours after the treatment were compared. Results The differences of heart rate, respiratory rate, oxygen partial pressure and oxygen saturation before and after the treatment in the two groups were both statistically significant (P<0.01); curative effects in the observation group were signifi cantly better than those in the control group,and the difference was statistically significant(P<0.01); the difference of total effective rate in the two groups was statistically significant(P<0.05). Conclusion Noninvasive mechanical ventilation is able to rapidly improve the symptoms of acute left heart failure and correct hyoxemia, which has significant curative effect.