Objective:To observe the application of pulse indicator continuous cardiac output (PICCO) system monitoring in the treatment of patients with severe thoracic trauma with the complication of acute respiratory distress syndrome (ARDS).Methods: 60 patients with severe thoracic trauma with complication of ARDS were randomly divided into the PICCO group (30cases) and the PAC group (30cases). The differences of PaO2/FiO2 score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mortality, mechanical ventilation time, ICU stay time and total treatment cost between the two groups were observed.Results: The PaO2/FiO2 of PICCO group in 1d, 3d and 7d were significantly higher than that of PAC group, respectively (t=4.46,t=3.87, t=5.15,P<0.05). In the 7th day, the APACHE II of PICCO group was significantly lower than that of PAC group (t=1.94,P<0.05). Besides, the mechanical ventilation time, ICU stay time and total treatment cost of PICCO group were significantly lower than these of PAC group, respectively (t=3.36, t=2.58,t=5.53,P<0.05). While there was no difference for mortality between the two groups (x2=0,P>0.05). Conclusion: In the treatment for patients with severe thoracic trauma with ARDS, PICCO system monitoring could reduce the mechanical ventilation time, ICU stay time and total treatment costs of patients, and enhance the treatment effect of patients.

[Objective]To seek for a method to rebuild radial head for comminuted radial head fractures,and recommend a new technique of bipolar radial head replacement.[Method]Five patients with fresh comminuted radial head fractures were treated by Tornier cement stem and bipolar radial prothesis.Among them,three were females and two were males,with the average age of 37.4Y(29-48Y).Four cases were to Mason type Ⅲ and one Mason type Ⅳ.All the patients underwent operation within 3-11 days with an average of 6 days after injury.Rehabilitation began in Mason type Ⅲ radial head fracture patients 48 h postoperatively.Both medial and lateral ligaments were repaired in one case of Mason type Ⅳ fracture.Plastic brace were used for 3 weeks during functional rehabilitation.The postoperative elbow joint was evaluated clinically by Broberg and Morrey score.[Result]All the patients healed by first intention were followed up for 7 to 50 months,with an average of 30 months.According to elbow functional evaluation criteria by Broberg and Morrey scores,there were excellent results in three and good in two respectively with an average of 92.2 points.[Conclusion]Cement stem and bipolar radial head prothesis replacement is a good technique for treating comminuted radial head fractures because it meets the designing principle of modern orthopaedics.

Objective To analyze the policy support of rural doctors for the essential medicine system,and explore the main influence factors and mechanism affecting the support degree.Methods 621 rural doctors from five cities in Shandong province were subject to a stratified random sampling for a quantitative questionnaire,to build a hypothesis model of policy support of rural doctors,which is verified using factor analysis and path analysis.Results 59.1% of rural doctors support the essential drugs policy.It was found that the essential medicine factor,the factor to influence the practitioner,and the supporting policy factor had a direct impact on policy support of rural doctors,with the effect of 0.305, 0.1 59 and 0.135 respectively;Essential medicine factor and the supporting policy factor indirectly influence the policy support of rural doctors through the factor to influence practitioners,with the effect of 0.065 and 0.032 respectively.Conclusion The essential medicine system needs to emphasize such rationality as the quality,list and pricing of essential medicines;it is imperative for the government to better oversee the purchase and supply of essential drugs,to cater to the interests of rural doctors,to encourage the enforcement of the system,and promote the development of village clinics.

AIM: To study the effect of Baixiangdan Capsule (Radix paeoniae alba and Rhizoma cyperi) on expression and behavior and sex hormone of rhesus monkey with premenstrual syndrome (PMS) and liver-qi invasion. METHODS: Twenty-four young rhesus monkeys in high rank and in the ovalatory menstrual cycle were isolated and squeezed 7 h a day for 5 d by specifically designed isolating-cage. At the same time Baixiangdan Capsule orally administed was compared with the control group of Jingqianping Granule. The expression and behavior changes of rhesus monkeys were observed and evaluated by The Measure Table of Emotion Evaluation of Female Experiment Macaque. And the levels of prolactin (PRL),estradiol (E2) and progesterone (P) in serum were investigated by radioimmunoassay. RESULTS: The scores of anxiety factors of the model monkeys were higher than the normal and the serum E2,and P levels decreased and PRL level increased significantly in the control group. As compared with the model group,Baixiangdan Capsule reduced the enhancing anxiety factor scores and also could increase the lower E2 and P levels in serum obviously and decrease PRL level. CONCLUSION: The above findings suggest that Baixiangdan Capsule has good regulative effects and makes it to the normal state on the abnormal expression and behavior and serum sex hormones of rhesus monkey with PMS and liver-qi invasion.

Objective To study the biological characteristics of dendritic cells (DCs) derived from peripheral blood mononuclear cells (PBMCs) of patients diagnosed with syphilis. Methods PBMCs were isolated from 16 patients clinically and serologically diagnosed with syphilis, and from 16 healthy human controls, then cultured with GM-CSF and IL-4. On day 10, the monocyte-derived dendritic cells (MoDCs)of the patients and controls were collected and subjected to the detection of surface molecules by flow cytometry; TpN17 was used to stimulate MoDCs from the controls, the expression of phosphorylated ERK was detected by Westem blotting 20 minutes following the stimulation. Results The positivity rate of CD80 was significantly increased in the patients with syphilis than that in the controls (51.90% vs 33.67,P ＜ 0.05), while no significant difference was observed in the expressions of CD83, CD86 or HLA-DR be tween the two groups (16.53% vs 15.99%, 66.13% vs 59.32%, 91.29% vs 90.51%, all P 0.05). The ex pressions of CD80 and CD83 on the surface of MoDCs were enhanced in a dose-dependent manner after ex-posure to TpN17. The expression of cytoplasmic phosphorylated ERK was observed in MoDC stimulated by TpN17, but not in those without the treatment. Conclusions Antigenic stimulation with Treponema pal-lidum may be a reason for phenotypic abnormality of MoDCs derived from patients with syphilis. TpN17 may stimulate the maturation of DCs through the ERK signal transduction pathway.

AIM: To study the pharmacokinetics of phenolic acids from Mailuoning injection in rats. METHODS: SD rats were given a single i.v. administration dose of Mailuoning injection 10 mL/kg, plasma and urine were collected before and after injection. Phenolic acid components in plasma and urine were measured by LC/MS. Pharmacokinetic parameters were determined from the plasma concentration-time data and urinary excretion-time data with the DAS software package. RESULTS: After i.v. of Mailuoning injection, chlorogenic acid (CGA), 1, 5-dicaffeylquinic acid (1,5-DCQA), 3, 4-dicaffeylquinic acid (3,4-DCQA), 3, 5-dicaffeylquinic acid (3,5-DCQA) and caffeic acid (CA) were quickly excrectioned. The t1/2 of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were 0.649, 0.334, 0.479, 0.486 and 0.330 h, respectively. AUC0-∞ were (22.522±2.716), (0.353±0.062), (3.620±1.246), (5.287±1.627) and (2.257±0.360) mg·L-1·h, respectively. After i.v. of Mailuoning injection, CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA can all be detected in the urine. The amounts of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA excreted from urine during 0-24 h were (122.22±26.49)%, (3.30±1.26)%, (0.24±0.11)%, (1.93±0.77)% and (18.61±4.99)% of dose given in rats, respectively. CONCLUSION: After i.v. of Mailuoning injection, phenolic acids can be excreted quickly. Only a small quantity of 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were excreted from urine. 3,4-DCQA and 3,5-DCQA may be metabolized into CGA in the rat plasma.

Objective To compare the effects of no-rinse skin cleanser and warm water with paraffin oil in first brush bath of the new-born. Methods About 42 newborns who were born from January to March 2016 were set as control group and used warm water with paraffin oil in first brush bath. About 43 newborns who were born from April to June 2016 were set as observation group and used no-rinse skin cleanser in first brush bath. The cleaning time and effect ,the rectal temperature before and after sponge and dermatitis were compared. Results Both groups did not develop dermatitis. But the observation group had better cleaning satisfaction , less cleaning time, faster rewarming than those of the control group with statistical significance (all p<0.05). Conclusion No-rinse skin cleanser used in the first brush for the new-born can reduce cleaning time and difference of temperature, which is safe for clinical application.

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Objective To explore the application of arm infusion port in breast cancer patients with chemotherapy and the effect of remote management. Methods From May 2016 to September, 25 cases of female breast cancer patients treated with chemotherapy in our hospital were studied. Implanted arm port for chemotherapy drug infusion, the patient's bedside guidance given by a case nurse during hospitalization, after the discharge from the hospital to accept the management of arm port remote education and consultation project group. Results A total of 25 patients implanted with arm port have not occurred phlebitis, deep vein thrombosis, central venous catheter infection and other complications;Patient′s satisfaction degree of quality of life were 100%(25/25);patients and their families on the nursing staff to track service satisfaction were 100%(25/25), too. Conclusions The application and remote management of arm port in patients with breast cancer chemotherapy is worthy of clinical research.