Objective To explore the effect of labels management on high-risk drugs. Methods Labels management group was established, to be responsible for use and storage of high-risk drugs. The management methods included taking analysis on adverse nursing events, designing and making labels in drug storage and use, and making a field survey on adverse nursing events before and after the management. Result After manipulation of the labels management, the number of adverse nursing events of drug use fell from 35 to 0. Conclusion Drug storage and use with special, standard labels is effective in preventing nursing adverse events in high risk drugs.

Objective To investigate the quality of life among residents in Pudong New Area and ananlyze the main influencing factors for quality of life among residents. Methods 3 642 residents over 18 years old in Pudong New Area were investigated by SF-16. Results Their scores of PF, RP, BP, GH, VT, SF, RE and MH were 86.94, 78.03, 73.74, 65.86, 72.93, 86.44, 80.01, and 79.19, respectively, and the total score was 77.17. The sex, age, family income and health payout were the influencing factors for quality of life among residents in Pudong New Area by Logistic Regression. Conclusion The condition of general life quality among residents in Pudong New Area was well and that of male residents was better than that of female ones. The psychosomatic factor was the important one influencing life quality. The women should be the target population in community health works and it should pay more attention on mental health education.

BACKGROUND: Multiple applications of opium medicines can induce the accommodative changes of morphology and function in some intracerebral nerve positions. These accommodative changes are important neurobiological bases inducing drug-desire and re-addiction after detoxification. However, the actual molecular mechanism is unclear at present.OBJECTIVE: To investigate the impacts of the generation of heroin-dependence and detoxification on brain-derived neurotrophic factor (BDNF) in rat to provide a laboratorial gist for the participation of BDNS in heroin-dependence and detoxification.DESIGN: A randomized controlled study by employing experimental animals as subjectsSETTING: Mental health center of a medical university affiliated hospital MATERIALS: The study was conducted in the Laboratory of Pharmacology,Faculty of Pharmacology, Chongqing Medical University between March 2004and July 2004. Totally 30 inbreeding clean male SD rats with a bodymass between 200 g and 250 g were obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA. Rats were randomly divided into blank control group(control group), heroin-dependent group (heroin group), and naloxone detoxification group(naloxone group) with 10rats each.METHODS: Morphine was subcutaneously injected into the rat with dose-increasing method to establish heroin-dependence rat model. Rats of naloxone group received subcutaneously injection of 2 mg/kg of naloxone to excite abstinent symptoms. The same dose of normal saline (NS) was injected in rats of control group. Model rats of each group were observed biologically and behaviorally. BDNF expression at different brain zone of rats in three different groups was tested with immunohistochemistry and digoxin-labeled oligonucleoide probe in situ hybridization technique.Comparison of the evaluation of abstinent symptoms in rats of each group.RESULTS: In the heroin group, the relative content of BDNF protein was higher in frontal lobe cortex, locus caeruleus and hippocampus than that of the control group( P ＜ 0.05); BDNFmRNA relative content was higher in frontal lobe cortex than that of the control group( P ＜ 0. 05) . In naloxone group, BDNF and its mRNA relative contents in frontal lobe cortex, locus caeruleus and hippocampus were higher than that of heroin group and control group ( P ＜ 0.05 ).CONCLUSION: Chronic administration of heroin could affect BDNF protein and its mRNA expressions in the corresponding brain areas of the rats, which suggests that the change of BDNF expression participates in heroin-dependence and detoxification.

Objective To investigate the causes of a suspected outbreak of lower respiratory tract infection (LR-TI)caused by carbapenem-resistant Acinetobacter baumannii (CRAB)in the general intensive care unit(ICU)of a hospital,and provide scientific evidence for effective control of healthcare-associated infection(HAI).Methods Epi-demiological investigation on patients infected with CRAB and on-site monitoring on ICU environmental hygiene from March 4 to 23,2014 were performed,active prevention and control measures were taken.Results A total of 7 patients developed CRAB infection,the total length of stay during epidemic period were 160 days,the infection density of LRTI was 43.75‰(7/160),4 of 5 patients at No.02 bed had CRAB LRTI.Univariate analysis revealed that adopting conventional sputum suction procedure was a risk factor;the qualified rate of bacterial count on the object surfaces was 31 .75% (20/63).CRAB was also isolated from outer frame of suction device of No.02 bed, which had the same antimicrobial pattern as CRAB from 7 patients’sputum.After taking a series of controlling measures,there was no CRAB infection case after March 24,2014,this outbreak was effectively controlled. Conclusion This suspected HAI outbreak may be caused by inadequate disinfection of outer frame of suction device contaminated by CRAB,and horizontally transmitted through manipulation of sputum suction by health care workers.Clean and disinfection of ICU environmental object surfaces is of great importance for preventing HAI.

Objective:To determine the expression of matrix metalloproteinase 13 (MMP13) in patients with psoriasis, and to evaluate the effect of tazarotene and narrow-band ultraviolet B (NB-UVB) on the expression of MMP13 in mice with psoriasis-like dermatitis.Methods:Lesional skin tissues and normal skin tissues were collected from 18 patients with psoriasis vulgaris and 10 healthy controls respectively, who were enrolled from General Hospital of Tianjin Medical University between May 2019 and August 2019, and serum samples were collected from all the subjects. A total of 25 specific pathogen-free (SPF) male BALB/c mice were randomly divided into control group, imiquimod group, imiquimod+NB-UVB group, imiquimod+tazarotene group and imiquimod+tazarotene+NB-UVB group. The control group received topical vaseline cream on the back once every morning; imiquimod group and imiquimod+NB-UVB group received imiquimod cream on the back once every morning; imiquimod+tazarotene group and imiquimod+tazarotene+NB-UVB group received imiquimod cream on the back once every morning, and tazarotene cream on the back once at night; imiquimod+NB-UVB group and imiquimod+tazarotene+NB-UVB group received NB-UVB irradiation on the back every other day at noon, with the dose being 300 mJ/cm 2 in the first session and increasing by 50 mJ/cm 2 in every session. The modeling lasted 7 days. After successful modeling, blood samples were obtained from the eyeballs of the mice, and skin tissues were resected from the back of the mice after being sacrificed by cervical dislocation on day 8. Changes in the epidermal thickness and pathological manifestations were observed by hematoxylin and eosin (HE) staining, protein expression of MMP13 in skin tissues was determined by immunohistochemical study, and the serum level of MMP13 was detected by enzyme-linked immunosorbent assay. Comparisons between 2 groups were performed by using two-independent-sample t test, comparisons among several groups by using one-way analysis of variance, multiple comparisons by using least significant difference- t test, and comparisons of enumeration data by using chi-square test. Results:The skin lesions of the patients with psoriasis were strongly positive for MMP13, and the MMP13 expression levels in the epidermis and serum (84.11±17.16, 13.29±3.95 μg/L, respectively) were significantly higher in the patients with psoriasis than in the healthy controls (11.98±4.08, 7.46±1.58 μg/L, respectively, both P< 0.01) . Compared with the control group (1.26±0.04 μm, 25.40±2.34, 185.76±7.22 μg/L, respectively) , a significant increase was observed in the epidermis thickness (7.93±0.59 μm, P< 0.01) , as well as MMP13 levels in the epidermis and serum in the imiquimod group (147.14±5.53, 215.98±15.17 μg/L, respectively, both P< 0.01) . Compared with the imiquimod group, the imiquimod+tazarotene group, imiquimod+NB-UVB group, and imiquimod+tazarotene+NB-UVB group all showed significantly decreased epidermal thickness (3.56±0.37 μm, 3.83±0.39 μm, 2.14±0.34 μm, respectively, all P< 0.05) , MMP13 levels in the epidermis (120.42±3.23, 91.08±0.46, 71.12±7.11, respectively, all P< 0.05) and serum (197.39±3.92 μg/L, 196.13±11.76 μg/L, 183.21±14.99 μg/L, respectively, all P< 0.05) . Conclusions:MMP13 protein expression markedly increased in the skin lesions and sera of patients with psoriasis, and decreased in skin lesions and sera of mice with psoriasis-like dermatitis after the treatment with tazarotene and NB-UVB. MMP13 may be involved in the development of psoriasis, and tazarotene and NB-UVB may inhibit the development of psoriasis by reducing the expression of MMP13.

Objective To discuss the influence of individual cognitive on medical personnel blood-borne occupational exposure protection action from the angle of behavior operation.Methods Medical staff of 14 hospitals in zunyi were investigated by questionnaire designed based on the theory of health belief model,and analyzed the data by structural equation model.Results Sample data and the assumption model was ideal,the blood-borne occupational exposure protective behavior of medical staff could be explained variance of 87％ by susceptibility,severity,behavioral benefit and barrier cognition.The order of influencing factors from high to low were behavioral benefit,severity,behavioral barrier and susceptibility to cognition,and path coefficients were 0.39,0.27,-0.21,0.03.Conclusions Susceptibility,severity and behavioral benefit cognition have positive effection on protective behavior,the behavioral benefit cognition have more influence on blood-borne occupational exposure protective behavior of medical staff,and behavioral barrier cognition have negative effection,the results of health belief model can explain blood-borne occupational exposure protective behavior of medical staff better.

Objective To analyze the influence factors of medical staff blood-bome occupational exposure by structural equation modeling,in order to improve medical staff of blood-borne occupational exposure protection performance of the system to provide the theory basis for operation.Methods The influence factors of medical staff blood-borne occupational exposure and their correlation were analyzed by exploratory factor analysis and structural equation modeling fitting.Results Model fitting was ideal,hospital decision-makers and department management directly affected the behavior intention of medical staff,department management greatly influenced by the behavioral intention to the medical personnel,path coefficient was 0.27.Hospital decision-makers of behavioral intention to the medical personnel directly affect smaller,path coefficient was 0.03,but its indirect impact on behavioral intention by department management.Behavioral intention of occupational exposure protection action,the path coefficient was 0.80,behavioral intention determined the basic medical personnel blood-borne occupational exposure protection behavior.Conclusions Hospital should improve the system of standards and to establish effective communication channels,at the same time enhance the care ability.Enforcement departments should improve the standard system,equipped with adequate safety equipment,for the medical staff to provide the best working environment,so as to improve the medical staff of blood-borne occupational exposure protection behavior compliance.

Objective To explore the clinical efficacy of erythromycin combined with azithromycin in the treatment of mycoplasma pneumonia in children.Methods 98 children with mycoplasma pneumonia were selected.According to the digital chart,the patients were randomly divided into the observation group and control group,with 49 cases in each group.On the basis of routine treatment,the control group was treated with azithromycin,and the observation group received erythromycin combined with azithromycin.After treatment,the disappearance time of the disease (fever,cough,pulmonary rale),hospitalization time and adverse reactions were observed in the two groups,and the clinical efficacy of the two groups was compared.Results The total effective rate in the observation group was 95.91％,which was significantly higher than that in the control group (79.5％),and the difference was statistically significant (x2 =4.721,P ＜ 0.05).Compared with the control group,the disappearance time (fever,cough,pulmonary rales) and hospitalization time of the observation group were significantly decreased (t =1.965,1.943,1.987,1.952,all P ＜ 0.01).The incidence rate of adverse reactions in the control group was 8.16％,which in the observation group was 12.24％,there was no statistically significant difference between the two groups (x2 =0.445,P ＞ 0.05).Conclusion Compared with azithromycin alone,erythromycin combined with azithromycin is effective and safe in the treatment of children with mycoplasma pneumonia.It is beneficial to shorten the course of treatment and improve the efficacy,and is worthy of further popularization and application.

ObjectiveTo elucidate the association of immune response to hepatitis B vaccination with HLA-DRB1 * 12 allele as well as the level of IL-4 and IFN-γ.MethodsSeventy-four healthy college students from Guangxi province who had non- or hypor -response to recombinant hepatitis B vaccination and 64 medium- or hyper-responders with the conditions of similar were selected randomly and involved in this study.HLA-DRB1 * 12 was detected by PCR-SSP,the level of IFN-γ and IL-4 cytokines were examined by ELISA.Results(1)The allelic frequencies of HLA-DRB1 * 12 was lower in the non- or hypor-responders than that in the medium- or hyper-responders ( 10.8％ vs 32.8％,P=0.002) ; (2)The expression level of IFN-γ in the non- or hypor-responders ( 7.21±7.92 ) ng/ml was much less than that of the medium- or hyper- responders ( 16.36± 11.00) ng/ml ( P=0.000).(3) The expression level of IL-4 in the non- or hyporresponders (3.18±4.45) ng/ml was much less than that of the medium- or hyper- responders (7.76±5.71 ) ng/ml(P=0.000).(4)No significant differences was seen between the expression level of IFN-γ in the HLA-DRB1 * 12 positive ( 13.18± 11.24) ng/ml and the negative ( 11.00± 10.29 ) ng/ml ( P =0.349 ).(5)No significant differences was seen between the expression level of IL-4 in the HLA-DRB1 * 12 positive (5.947±4.530) ng/ml and the negative (5.132±5.800) ng/ml (P=0.423).ConclusionHLA-DRB1 * 12 might be the allele enhanced immune response to hepatitis B vaccination.The expression levels of IFN-γand IL-4 correlating to Thl/Th2 cells might affect on the immune response to hepatitis B vaccination.

Objective:To construct an early comfort assessment and management plan for ICU patients with high flow nasal cannula, and to provide reference for clinical nursing practice and management.Methods:The domestic and foreign databases were retrieved, and the literatures on high flow nasal cannula were obtained and evaluated. The first draft of the early evaluation and management scheme of nasal high-flow humidification oxygen therapy was developed. Two rounds of expert consultation were conducted by Delphi method.Results:The early comfort assessment and management plan for ICU patients with high flow nasal cannula was formed, including 3 primary indicators, 12 secondary indicators, and 32 tertiary indicators. The authoritative coefficients of 2 rounds of expert consultation were 0.915 and 0.931, respectively. The coordination coefficients were 0.221, 0.130 and 0.278( χ 2 values were 8.000, 27.140, 163.824, P<0.05 or 0.01). Conclusions:The early comfort assessment and management plan of ICU patients with high flow nasal cannula are consistent with the advice of experts at all levels. The enthusiasm and authority of the experts is high, which provides a basis for the scientific management of ICU patients with nasal high-flow humidification oxygen therapy.