Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

Objective To investigate bacterial distribution and antibiotic resistance pattern in NICU of Central Hospital of Anshan,Liaoning province of China.Methods We conducted a retrospective analysis of all the cases admitted to the neonatal intensive care unit(NICU) between November 2011 and November 2013.Culture and sensitivity data of organisms isolated were documented as well.Antimicrobial susceptibility of the isolated pathogens was determined with the use of the Kirby-Bauer disk-diffusion test.Results A total of 73 bacterial strains were isolated from 310 specimens with a 23.5％ positive rate.In total,37 Gram-negative strains were detected and Escherichia coli was the predominant infective organism,far more common than Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive organisms were isolated in 32 cases and the most common pathogen was Staphylococcus aureus,followed by Staphylococcus epidermidis.Fungal isolates were recovered in 4 cases and Candida albicans was the most frequently isolated fungal organism.Carbapenem-resistant was not encountered and Vancomycin-resistant Staphylococcus aureus was not detected.Staphylococcus epidermidis isolates were significantly more resistant than Staphylococcus aureus.Conclusion Escherichia colis,Staphylococcus aureus and Staphylococcus epidermidis were the major pathogens in NICU of our hospital,showing a steep increase in antibiotic resistance.Regular monitoring and rational evaluation of drug resistance may help reduce the spread of antibiotic resistance,and provide the basis for empirical antimicrobial use.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.

AIM:To develop a capillary GC method for determining six components in Heiguidou Oil,?-pinene,eucalyptol,borneol,methyl salicylate,cinnamia aldehyde and eugenol. METHODS:GC was applied to quantitative analysis. Chromatographic conditions consisted of PEG-20M(30 m?0.25 mm?0.25 ?m),flame ionization detector(FID),and programmed temperature; initiation temperature was at 80 ℃ for 7 min; the rate of temperature was 15℃/minute,final temperature was at 180 ℃ for 10 min,bypass rate was 50 ∶1. The sample dissolved in absolute alcohol. The external standard was used. RESULTS:The standard curves of conclusion ?-pinene,eucalyptol,borneol,methyl salicylate,cinnamia aldehyde and eugenol were linear within the ranges of 0.322-32.150 mg/mL,0.202 -20.215 mg/mL,0.126-12.630 mg/mL,0.633-63.290 mg/mL,0.174-17.390 mg/mL,0.633-63.290 mg/mL and 0.203-20.255 mg/mL,respectively.RSD were 0.83%,0.48%,0.48%,0.31%,and 0.53 %,respectively. CONCLUSION:The established method is accurate and it can be applied to the simulta-neous assay of six components.

Objective To study the clinical characteristics,pathogens,drug sensitivity and prevention measures in malignant hematological disease combined with septicemia.Methods The clinical data of 95 malignant hematological disease combined with septicemia patients from January 2009 to June 2013 were retrospectively analyzed.Results One hundred and ten episodes of septicemia occurred in all the 95 patients,among which acute leukemia patients accounted for 69.1％ (76/110),patients with neutrophil counts ＜0.5 × 109/L accounted for 82.7％ (91/110),and patients with agranulocytosis time ＞7 days accounted for 66.4％(73/110).Major pathogenic bacteria was gram negative bacteria,including Escherichia coli 30.9％(34/110),Klebsiella pneumoniae (14.5％,16/110),Pseudomonas aeruginosa (12.7％,14/110).Carbapenems and amikacin was the most sensitive in susceptibility testing.Ninety-eight episodes of septicemia cured or improved,and 12 patients died,with a mortality of 12.6％ (12/95).Fifteen patients had septic shock,of whom 7 patients were dead.Conclusions Septicemia is very serious for malignant hematological patients,which may lead to rapidly progress,high incidence to septic shock and high mortality.Early prevention and treatment is important for patients,and strong anti-infection and supportive treatment is needed.

Objective:To study the expression of E-cadherin and P120ctn in nasopharyngeal carcinoma tissues, and to investigate their relationship and the relation with clinico-pathological features. Methods Two-step immuno-histochemical staining was applied to detect the expression of E-cadherin and P120ctn in formalin fixation and paraffin-embedded specimens from 56 cases with nasopharyngeal carcinoma and 15 cases with normal nasopharyngeal epithelia. Result:The abnormal expression rates of E-cadherin and P120ctn in the 56 cases of NPC tissues were 64.29% and 67.86% respectively, mainly with reduction of expression membrane and with the expression of cytoplasm; 6.67% of the 15 comparative normal cases of nasopharyngitis had abnormal expression of E-cadherin and P120ctn The differences were statistically significant. The abnormal expression rates of E-cadherin and P120ctn in NPC tissues were 71.43% and 85.71% respectively in low differentiated cancer group, which was obviously higher than the rates-42.86% and 36.29%-in high and middle differentiated cancer group. The 80.00% and 85.00% abnormal expression rate in the group with cervical lymph node metastases was higher than that in the group without cervical lymph node metastases(52.78%, 58.33%). The abnormal expression rate of E-cadherin and P120ctn(76. 92%,84.62%) in the third and forth phases was higher than that in the first and second phases (46.66%, 53. 33%). The differences were statistically significant (P<0.05). There were all together 12 co-expression cases of P120ctn and E-cadherin and 28 abnormal co-expression cases in the 56 cases of NPC tissues, which was of obvious consistency and correlation, with the relevant indexes: rs=0.5217 and P<0.01. Conclusion: The abnormal expression of E-cadherin and P120ctn is closely related to the degree of differentiation, clinical stage and cervical lymph node metastasis, and they join in the process of NPC initiation, progression, invasion and metastasis.

Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.

Objective To evaluate the effect on treatment of multiple myeloma complicating femoral neck fracture by surgical intervention combined with drugs.Methods Twelve patients with multiple myeloma complicating femoral neck fracture were treated by cemented total hip arthroplasty femoral head shank.All of patients were received zoledronic acid treatment,at the same time,7 cases of them treated by MPT regimen (melphalan,methylprednisolone and thalidomide),3 by bortezomib combined with dexamethasone,and 1 by autologous peripheral blood stem cell transplantation.Results Twelve patients could tolerate surgery,postoperative pain was significantly reduced.Assessed by using Harris hip function score after 6 months operation,2 cases were excellent,7 cases were good,3 cases were common,excellent and good rate was 75％ (9/12).All patients were followed up for 8 months to 3 years,1 case of local recurrence after 13 months.1-year overall survival rate was 100％,2-year overall survival rate was 83％,and 3-year overall survival rate was 67％.Conclusions Multiple myeloma complicating femoral neck fracture,using bone cement in total hip arthroplasty femoral head shank to clear the local tumor lesions,receive reconstruction capability,rapid postoperative recovery,pain relief,and opportunities for further comprehensive treatments.The bisphosphonate can promote new bone formation and prevent further fractures.The surgical intervention combined with chemotherapy could relieve the symptoms,reduce tumor cell burden,improve quality of life and prolong survival time.

Objective To explore the psychological stress of young nurses facing patients' death. Methods Young nurses in emergency department, ICU and hospice care ward (96 cases, research group) and young nurses in other departments(94 cases,control group)from 8 general hospitals were investigated by self-rating anxiety scale (SAS)and serf-rating depression scale (SDS).The results underwent comparison and analysis. Results SAS and SDS score,incidence of anxiety and depression in the research group were higher than those of the control group (P ＜ 0.05). Conclusions Young nurses who face patients' death frequently have high incidence rate of psychological stress.They show low psychological health level which deserves the close attention of nursing managers.