Objective To investigate behavioral disposition of nurses in emergency room and analyze influential factors.Methods A total of 200 nurses from the emergency room participated in the survey using demographic questionnaire and the nursing behavior questionnaire.Results The total average score of the nursing behavior was(3.13±0.54),and the influential factors included the level of hospital,the time span for the job and the continued education on the infectious diseases(all P<0.01).Conclusions The nursing behaviors was at the medium level.The nursing administrators should provide the nurses with personal protection apparatus,strengthen education on infectious diseases and use incentive mechanism so as to improve the ER nurses' nursing behavior.

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) and the efficacy of proton pump inhibitor (PPI) in treating gastroesophageal reflux. Methods Fifty-eight CAPD patients with good clinical and complete dialyzed eondition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire (RDQ). The patients who had RDQ≥6 and <12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment.Results The common symptom was regurgitation (64.70%), followed by acid reflux (52.9 %), non-cardic chest pain (47.1. %) and heart burn (17. 6%). After 4-week treatment, the RDQ was significantly decreased (P< 0. 05). But there was no difference in outcome of treatment between patients with RDQ≥ 12 and RDQ< 12 (P=0. 059). Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.

OBJECTIVE:To observe the efficacy and safety of alprazolam by progressive dose increasing in the treatment of chronic tinnitus. METHODS:Totally 50 patients with chronic tinnitus were included. They were orally treated with Alprazolam tab-let 0.4 mg in the first 1 and 2 week(s),once every night at bedtime;0.4 mg in 3 and 4 weeks,once in the morning and once in the evening;0.4 mg in 5 and 6 weeks,three times a day. If the treatment of tinnitus was invalid,then the gradual withdrawl was conducted by twice a day for continuous 3 d,0.4 mg each time;then once a day,0.4 mg each time,for continuous 3 d. The re-sponders were maintained 12 weeks,and gradual withdrawal was conducted,and followed by follow-up for 3 months. The clinic data was observed,including the clinical efficacy,tinnitus disability scale(THI)score,visual analogue scale(VAS)score,tinnitus loudness(TI)and incidence of adverse reactions before and after treatment. RESULTS:The effective rate was 66.67%;after treat-ment,the scores of THI and VAS,and TI were significantly lower than before,with significant differences(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:The alprazolam by progressive dose increasing has obvious effica-cy in the treatment of chronic tinnitus,with good safety.

Objective To evaluate the performance of transfection with a complex plasmid encoding green fluorescent protein tagged CatD (GFP-CatD)in researches on chronic photodamaged fibroblasts. Methods Human dermal fibroblasts (HSFs)were irradiated with ultraviolet A (UVA)at 25 J/cm2 once a day for 21 consecutive days to establish a chronic photodamaged cell model. A plasmid encoding GFP-CatD was constructed and transfected into some chronic photodamaged fibroblasts (experimental group). The photodamaged HSFs receiving no treatment served as the blank control group, and those transfected with the negative plasmid encoding GFP only as the negative control group. After additional culture, fluorescence microscopy and Western-blot analysis were performed to observe and measure the expression of GFP-CatD in HSFs respectively, flow cytometry and methyl thiazolyl tetrazolium (MTT)assay to evaluate the apoptosis and proliferation of chronic photodamaged fibroblasts respectively. Results Fluorescence microscopy showed the expression of GFP-CatD in cytoplasm of chronic photodamaged fibroblasts at 96 hours after transfection with the GFP-CatD-encoding plasmid. Western-blot analysis revealed that the expression of CatD in the experimental group was 1.28 times that in the blank control group. There were no significant differences in the apoptosis rate(4.29% ± 1.30%vs. 3.03% ± 1.70% , P > 0.05)or proliferative rate (45.20% ± 4.70% vs. 43.60 ± 3.90% , P > 0.05)between the experimental group and blank control group. Conclusion CatD could be traced in chronic photodamaged fibroblasts with no changes in biological activity or cell cycle after transfection with the GFP-CatD-encoding complex plasmid.

Objective To explore the curative effect of 308 nm excimer laser on child vitiligo and nursing measures. Method Fourty-eight children with vitiligo were treated with 308 nm excimer laser and nursed with targeted psychological treatment, skin and diet nursing.Result After treatment,6 of them got recovered(12.5%),24 remarkably improved(50%),15 slightly improved(31.2%)and 3 ineffectively treated(6.2%).Conclusions 308 nm excimer laser is effective for the treatment of child vitiligo.High quality nursing can ensure and improve the efficiency of the 308 nm excimer laser.

Objective The aim of the study was to compare the mid-and long-term results between mitral valve repair and mitral valve replacement in mitral regurgitation due to infective endocarditis.Methods From January 2005 to December 2014, 225 patients with mitral regurgitation due to infective endocarditis underwent surgical treatment at our institution.159 patients(70.7%) were male, and the mean age was(42±15) years(13-76 years).Among them, mitral valve repair was performed in 89 patients(repair group) and mitral valve replacement in 136 patients(replacement group).Preoperative clinical profiles, perioperative details and follow-up data were reviewed retrospectively.Results There was no operative death in both groups.Compared to replacement group, patients undergoing mitral valve repair suffered significantly less embolism events(9.0% vs.22.8%, P<0.05) and central nerve complications(6.7% vs.17.6%, P<0.05).Patients with mitral valve vegetation were significantly less in repair group as well(59.6% vs.89.0%, P<0.05).The mean cardiopulmonary bypass time[(87±30) min vs.(86±33) min, P>0.05] and aorta clamp time[(52±21) min vs.(51±23) min, P>0.05]were similar between repair group and replacement group.Intensive care stay was significantly shorter in repair group[(1.4±0.7)days vs.(1.9±1.3)days, P<0.05] and hospital stay was shorter in repair group as well[(8.3±4.5)days vs.(9.5±5.3)days, P=0.09].Perioperative cerebral hemorrhage was observed in no patient in repair group and 2 patients(1.5%) in replacement.There was no in-hospital death in repair group.2 in-hospital(1.5%) deaths occurred in replacement group and the causes of death were cerebral hemorrhage and low cardiac output syndrome.The mean follow-up time was(40±35) months(3-134 months), and follow-up was complete in 85% patients.10 years over follow-up, freedom from heart related adverse events was 88% in repair group and 86% in replacement group(P>0.05).Conclusion Mitral valve repair was safe and feasible in mitral regurgitation due to infective endocarditis, with good mid-and long-term outcomes.Thorough excision of infective tissue and vegetation was necessary to perform mitral valve repair.Yet mitral valve replacement was a viable option in patients for whom repair was infeasible due to severe damage of valve.

Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.

Objective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.

OBJECTIVE:To study the effects of rhei radix and astragali radix on renal protection and intestinal barrier function in rats with chronic renal failure(CRF),and analyze its pharmacological mechanism from the theory of"gut-renal axis"in TCM. METHODS:Rat models of CRF were established by 5/6 nephrectomy. Rats were randomly divided into sham operations group (group J,n=6),model group(group M,n=8),and administration groups(n=9),which included benazepril group(group Y, positive control,2 mg/kg),rhei radix high-dose,medium-dose,low-dose groups(group DH,DM,DL,calculated by crude drug as 3,1.5,0.75 g/kg),and astragali radix high-dose,medium-dose,low-dose groups (group HH,HM,HL,calculated by crude drug as 6,3,1.5 g/kg). After 1 week of modeling,rats in each administration group were intragastrically administrated,once a day,for 5 weeks. Rats in group J,M were intragastrically administrated equal volume distilled water. After 12 h of administration, the 24 h urine protein(Upr),serum levels of creatinine(SCr),urea nitrogen(BUN),uric acid(UA)and plasma endotoxin level were detected,and kidney index was calculated. Changes in renal tissue,villi of small intestinal mucosal tissue and crypt depth were observed by microscope. RESULTS:Compared with group J,24 h urine volume and 24 h water drinking volume of rats in group M were increased,24 h Upr,serum levels of SCr,BUN,UA,plasma endotoxin level,and kidney index were increased, with statistical significances(P<0.05 or P<0.01). Most glomerular volume were increased and rigid in group M,showing intersti-tial infiltration in large number of inflammatory cells;villus length,villus width,mucosal thickness and villus length/crypt depth ra-tio of intestinal mucosa were decreased (P<0.05 or P<0.01),and crypt depth was increased (P<0.01). Compared with group M,24 h urine volume in group DM,DL,HM,HL was decreased;24 h water drinking volume in group HM was decreased;24 h Upr,serum levels of SCr,BUN levels,and kidney index of rats in each administration group were decreased. Except for group HH,serum UA levels in other administration groups was decreased;and except for group HH,HM,HL,plasma endotoxin level in other administration groups was decreased,with statistical significances(P<0.05 or P<0.01). The pathological morphologies of renal tissue,intestinal mucosal tissue and intestinal villi in each administration group were improved to varying degrees. CONCLU-SIONS:Both rhei radix and astragali radix can effectively reduce the metabolic toxin levels of rats,improve filtration function of glomerular and enhance the exclusion of metabolic trash,which may be restoring the intestinal function to achieve the goal of treat-ing CRF. And both show optimal effect in medium dose.