The PICC application in tumor chemotherapy patients has the advantages of simple operation, long time of implanting catheter, small pain and protect vein. They can ensure the chemotherapy smoothly, and further promotion in the clinical application, but when the patients took the tube back, the complications increased significantly. Health education is the mail channel for patient and family to get the major way to maintain PICC knowledge and skills. Through literature review of PICC health education at home and abroad, in our country, according to the present situation of PICC health education, the health education model, method and effect evaluation were summarized and looked for the problems in the present education of PICC health education. It can provide a basis for exploring new pattern of health education for improving the sevice life of the catheter and the patients’ life quality.

Objective To explore the characteristics of T wave alternans (TWA) in aortic stenosis (AS) in school-aged children. Methods TWA was analyzed in 15 AS patients and 60 age-matched normal children using Microvolt T-Wave Alternans and the incidence of sustained TWA was compared between two groups. Myocardial ischemia during treadmill test was studied in sustained TWA and non-sustained TWA in AS patients. Results Compared with normal children, the incidence of sustained TWA was signiifcantly increased in AS group (P<0.01). In AS school-aged patients, the incidence of myocardial ischemia is higher in sustained TWA than in non-sustained TWA during treadmill test (P<0.05). Conclusions AS school-aged children have electrophysiologic basis for sunstained TWA. TWA is closely related to myocardial ischemia during treadmill test. Sustained TWA could be used as an important electrophysiologic index to assess the cardiac function in children with AS.

Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.

Objective To observe the curative effects of Mailuoning oral liquid combined with Mecobalamin tablets in treating aged diabetic peripheral neuropathy (DPN).Methods Forty-nine patients with DPN were randomly divided into treatment group (n=25) and control group (n=24).The patients in two groups were given Mecobalamin tablets,and the treatment group was added treated with Mailuoning oral liquid.The period of treatment was 3 months.Scores of Toronto clinical scoring system (TCSS) and traditional Chinese medicine (TCM) symptoms quantitative scale were compared between the two groups.The curative effects of all the patients were judged by the TCM symptoms quantitative scores.Results The TCSS levels in two groups after treatment were both significantly lower than those before treatment (all P<0.05).The TCSS level after treatment in treatment group was significantly lower than that in control group (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that before treatment (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that in control group (P<0.05).The total effective rate in treatment group (88%) was significantly higher than that in control group (50%) (χ2=6.631,P=0.01).Conclusion Mailuoning oral liquid combined with Mecobalamin tablets is safe and effective for treating DPN.

The study applied the model of authorized leadership to emergency night nursing in large general hospitals in order to explore the effect of such management. As it turned out, the evaluation of the administrators means of authorization by the three groups of research subjects averaged respectively 20 70,20 62 and 20 05, and the evaluation of the effect of authorization averaged respectively 79 80,78 39 and 83 55. The results indicate that the administrators means of authorization were basically rational and sound and the managerial abilities of those with authorized leadership were appreciated by the emergency night doctors and nurses. Thus management of emergency night nursing by those with authorized leadership may lead to improved efficiency and quality.

AIM: To evaluate the effectiveness of small interference RNA on inhibiting bcl-2 gene expression. METHODS: With Ambion's software and kit, we designed and synthesized siRNA targeted bcl-2, which were transfected into astrocytoma cell line U251 with lipofectamine. The non-transfected cells and treatment with antisense drug G-3139 were taken as controls. MTT was used to detect the inhibitory rate of cell growth. Flow cytometric method was used to detect the change in cycle of the cells. The inhibitory effect of siRNA on mRNA level was detected by RT-PCR and on protein level was by immunohistochemical method. RESULTS: For the living rate of cell, siRNA 2, 3, 5, 6 groups were significantly lower than siRNA 1, 4 groups, lipofectamine and control group at 24, 48, and 96 h. siRNA 1-6 groups only had statistic difference with antisense group at 24, 48 h. As for PCR and immunohistochemical method, the expression of bcl-2 on siRNA 2, 3, 5, 6 groups were significant lower than other groups. The results of flow cytomytric method showed the cells transfected with siRNA 1-6 and antisense were blocked at S stage. CONCLUSION: siRNA inhibited bcl-2 gene expression more than 50%.

OBJECTIVE:To explore the function and approach of clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement.METHODS:The experiences of clinical pharmacists obtained through first-hand practice in the anticoagulation management and pharmaceutical care of the patients who had been discharged from hospital after undergoing mechanical heart valve replacement were introduced by illustrating examples.RESULTS & CONCLUSION:Clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement provide physicians and patients with pharmaceutical information and pharmaceutical care and enhance the effectiveness and safety of anticoagulative therapy accordingly.

Objective To detect the mutations in coding region of the guanosine triphosphate cyclohydrolase Ⅰ (GCH1) gene in Chinese patients with dopa-responsive dystonia (DRD).Methods Two families with five affected family members and six patients with sporadic DRD were examined, as well as their eighteen relatives and twenty normal members. Mutation screening was performed using single-strand conformation polymorphism analysis followed by direct sequencing of the presumably mutated exons; in patients whose results showed a normal pattern on single-strand conformation polymorphism analysis, the entire coding region of the GCH1 gene was sequenced. To confirm the mutation, a pair of primers was designed, which produced a restrictive site for SphI.Results DNA sequencing revealed a new heterozygous A224G missense mutation (Tyr75Cys) located within exon 1 in one family with autosomal-dominant inheritance. The mutation was confirmed with restriction enzyme analysis; it was not present in 20 control alleles. Restriction enzyme analysis also detects two systematic gene mutation carriers. In patients from the other family and patients with sporadic DRD, no alterations in the translated portion of the GCH1 gene were observed. Direct sequencing also showed that there existed gene polymorphisms in intron 1 and intron 3 which neared the exon2 and exon3 respectively in Chinese.Conclusions We describe a new missense mutation (Tyr75Cys) in the GCH1 gene. Mutation in the coding region of the gene might be accounted for a part of patients with DRD.

A mathematical model was established according to fuzzy clustering analysis and weighted synthetic order of arrangement for the comprehensive appraisal of processed toxic Chinese herbal medicine. Six criteria of seven differently processed Radix phytolacca were analysed to illustrate the efficacy of this model.

Objective To summarize the research progress of preoperative staging diagnosis for gastric cancer.Methods Both the domestic and international literatures involving the preoperative staging diagnosis of gastric cancer in recent years were collected and reviewed.Results Transabdominal ultrosonography,EUS,CT,MRI,PET and diagnostic laparoscopy could provide objective evidences,and enhanced the accuracy of preoperative staging diagnosis for gastric cancer.Conclusion With the development of examination methods,the assessment of preoperative staging diagnosis of gastric cancer has been improved,and operation strategy can be made according to the correct preoperative staging.