Objective To investigate the nalaxone treating first acute right heart failure.Methods52 patients with FARHF were divided into the naloxone group(30cases)and control group(20cases)at random.Patients in control group were given general comprehensively treating.Patients in naloxone group were given naloxone as well as comprehensively treating,were given intravenously 0.8 mg of first dose,if it was necessary,repeated 0.8 mg of dose,and continuously dropped for 1.2 mg was added into liquid 500 mL.After treatment of 24 hours,were compared the changes of HR、SBP、SV and heart function.ResultsIn the naloxone group,the total effective rates were 84.4%,the mortality rates were 6.6%;in control group.The total effective rates were 60%,the mortality rates were 18.3%.The difference of the effective rate of the naloxone group be treatment was statistically significant(P

Objective To explore the preliminary practice of Clinical Scenario Mode in the teaching of surgery. Methods Clinical Scenario Mode was stimulated or rebuilt by the cooperation of teachers and Standardized Patients (SP) to introduce relative theories and raise discussions in the surgery lectures of five-year clinical medicine students in grade 2004 and grade 2005. Results Lectures with the application of Clinical Scenario Mode were reported positively by students from the survey. It improved students’learning motivation,enhanced teaching quality,and optimized the allocation of resources. Discussion With the combination of the advantages of lecture based learning (LBL) and problem based learning (PBL),Clinical Scenario Mode can be considered as the linkage to the widespread use of PBL,and should be widely applied in the medical teaching practice.

Objective To develop a double antibody sandwich ELISA for quantitatively detecting Japanese encephalitis virus(JEV) antigen.Methods The anti-JEV polyclonal antibodies were used to coat ELISA plates.Anti-JEV monoclonal antibodies were used as enzyme-labeled conjugate.A standard curve based on known amounts of JEP antigen was established by the ELISA.Various parameters of the assay were analyzed.Results The optimal linear range was 12.5～200 U/ml(r=0.9989).The quantitation limit was 12.5 U/ml.The recovery rate for the accuracy test was 85.0%～103.3%.The coefficients of variation for intra-assay and inter-assay precision were 4.3%and 5.5%respectively.No cross-reaction was observed with HAV vaccine,influenza vaccine,Vero cell Iysates,newborn bovine serum,or human albumin.Conclusions The data indicate that the ELISA developed in this study has high specificity,precision, accuracy,and stability.The assay should be suitable for quantitative determination of JEV antigen in various vaccine products.

Audiometry, Speech ; Congresses as Topic

Objective To understand the side-effects of cyclophosphamide (CTX) in the treatment of systemic autoimmune diseases and the possible risk factors. Methods Two hundred and forty-one patients with systemic autoimmune diseases were recruited from the Rheumatology Division of Peking University First Hospital during January 1st, 2009 and March 31, 2012. All the patients received oral or intravenous cyclopho-sphamide. The data were collected by medical record review as well as telephone follow-up. Logistic regression analyses were used for statistical analysis. Results Statistical analysis for age, sex, disease, cumulative dose, treatment duration and mode of administration were included in the factor analysis that would impact the CTX related side-effects. Age ( x2=14.8, P=0.002), gender ( x2=11.2, P=0.001), the underlying disease ( x2=26.1, P<0.01), cumulative dose ( x2=9.8, P=0.007) and mode of administration of CTX ( x2=19.5, P<0.01) were all correlated with the incidence of CTX side-effects. Multivariate analysis showed that women [OR=2.32, 95%CI (1.15, 4.70), P=0.02], intravenous-oral sequential use of CTX [OR=5.25, 95%CI (2.30, 11.97), P<0.01] and systemic lupus erythematosus [OR=4.02, 95%CI (2.24, 7.21), P<0.01] as the underlying disease were independent risk factors for CTX side-effects. Conclusion Alopecia, gastrointestinal discomfort and gonads toxicity ware com-monly seen in Chinese patients with systemic autoimmune diseases receiving CTX. Hemor-rhagic cystitis is very rare. Women, intravenous-oral sequential use of CTX and the systemic lupus erythematosus are indepen-dent risk factors for CTX side-effects.

OBJECTIVE: To investigate the effect of Salvia Miltiorrhiza injection (SMI) on peritoneal dialysis solution (PDS) induced injuries of peritoneal structure and function in a rat model, and to observe the relationship between the failure of peritoneal dialysis and expressions of aquaporin-1 (AQP-1) and zonula occluden-1 (ZO-1) in peritoneal tissues. METHODS: Fifty-six SD rats were randomly divided into normal control group, 1.5% PDS group, 4.25% PDS group, 1.5%PDS+1% SMI group, 1.5%PDS+2% SMI group, 4.25% PDS+1% SMI group and 4.25% PDS+2% SMI group. Two-hour peritoneal dialysis test was performed in rats in different groups by intraperitoneal injection for 8-week. Then rats were killed on the 8th week, and the bloods and peritoneal tissues were gathered. The rate of ultrafiltration, clearance rates of urea nitrogen, creatinine and glucose of peritoneum and content of total protein in PDS were detected. Peritoneal membrane histology was evaluated by light microscopy and transmission electron microscopy. Expressions of ZO-1 and AQP-1 proteins in peritoneal tissues were detected by immunohistochemical method, and AQP-1 protein expression was also detected by Western blotting technique. RESULTS: Compared with normal control group, using of 1.5% PDS and 4.25% PDS caused the changes of structure and function in peritoneum, such as pathological change of peritoneum, decreasing of the rate of ultrafiltration (P<0.05), clearance rates of creatinine and glucose (P<0.01) and the expression of ZO-1 protein (P<0.05), and increasing of the expression of AQP-1 protein (P<0.05). Compared with the simple PDS groups, the pathological damage of peritoneum was lessened and the rate of ultrafiltration and clearance rates of creatinine and glucose were increased in the 1.5% PDS+2% SMI group and 1.5% PDS+2% SMI group. Expression of AQP-1 protein was decreased by 1.5% PDS+2% SMI as compared with 1.5% PDS (P<0.05).[JP] CONCLUSION: SMI can relieve the injuries of function and structure of peritoneum by down-regulating the expression of AQP-1 protein.

Objective: To explore the clinical value of transvaginal ultrasonography in diagnosis of ruptured ovarian cyst. Methods:Retrospective analysis the 46 cases of ruptured ovarian cyst diagnosis by transvginal ultrasonography in our hospital which confirmed by surgery and pathology. Results: In the among 46 cases, 39 cases were the corpus luteum cyst, 14 cases were the endometriotic cyst, were all confirmed by surgery and pathology, the diagnostic accurate rate of corpus luteum cyst is 92.3%, the rate of endometriotic cyst is 57.1%. Conclusion:Transvaginal ultrasonography is accurate, rapid and convenient, provides the reliable basis for the diagnose and different diagnose acute abdominal disease.

Objective To evaluate the effects of aerobic combined strength and balance exercise on cognitive function and satisfaction in patients with cognitive impairment no dementia. Methods Four hundred and twenty patients with cognitive impairment no dementia were divided into control group (200 cases) and experimental group (220 cases) by random digits table method. The control group received general health education and rehabilitation training. The experimental group received aerobic combined strength and balance exercise. The patients were assessed with Montreal Cognitive Assessment (MoCA) to evaluate their cognition before training, as well as after training. And the patients′satisfaction with the questionnaire was evaluated. Results The total scores of MoCA, scores of name, attention, language, memory and directionafter training were (23.47 ±2.38), (2.77 ±0.42), (5.09 ±0.86), (2.50 ±0.65), (3.42 ±0.68), (5.03 ± 0.10) points in the experimental group, and (21.20±2.55), (2.31±0.76), (4.71±1.10), (2.35±0.70), (2.23±0.81), (4.48±0.96) points in the control group, and there were significant differences, P<0.05. There were no significant differences in the space and abstract thinking between experimental group and control group:(3.61±0.91) points vs. (3.45±1.09) points, (1.83±0.76 ) points vs. (1.72±0.52) points, P>0.05. The scores of satisfaction in the experimental group was significantly higher than that in the control group:(49.33 ±1.57) points vs. ( 48.20 ±2.14) points, P<0.01. Conclusion The application of aerobic combined strength and balance exercise could improve the cognitive function and patients′satisfaction.

Objective To investigate the effect and perioperative nursing experience of surgical operation on patients with incomplete cervical spinal cord injury caused by traumatic cervical spine fracture. Method Fifty-nine patients with traumatic cervical spine fracture in our hospital from January 2011 to 2014 were nursed perioperatively, including before operation , training accttenty with swallowing and blowing balloons besides basic nursing care , and after operation , mental care , close observation and functional exercises postoperatively. Results The operation time was (110.5+13.0) min, the amount of bleeding was (155.6+7.5)mL. Three patients developed hematoma compression, 13 patients developed high fever. All patients were cured after treatment and nursing. Conclusion Preoperative training of swallowing and blowing balloon is fundamental for ensured surgical effect and intraoperative surgical cooperation and close observation together with postoperative mental care, close obsersation and functional exercise are the guarantee for surgical effect.

Objective To study on the relationship between insulin resistance and thyroid nodule in the patients of normal glucose metabolism. Methods The clinical data of 105 patients of normal glucose metabolism were analyzed. The patients were divided into nodules group (54 patients) and non- nodules group (51 patients). The age, sex, body mass index (BMI), fasting plasma glucose (FPG), postprandial 2 h blood glucose (2 h PG), fasting insulin (FINS), postprandial 2 h (2 h INS), fasting C peptide (FC-P), postprandial 2 h C peptide (2 h C-P), glycosylated hemoglobin (HbA1c), blood uric acid (BUA), homeostatic model assessment insulin resistance index (HOMA-IR) were compared between two groups. According the level of HOMA-IR, 105 patients were divided into different subgroups, the detection rate of thyroid nodules was compared. The influencing factors of thyroid nodules were analyzed by multi-factor Logistic regression analysis. Results The age and sex between two groups had no significant differences (P>0.05). The levels of BMI, BUA, HOMA-IR, FPG, FINS, 2 h INS, FC-P, 2 h C-P and HbA1c in nodules group were significantly higher than those in non-nodules group (P<0.05). The detection rate of thyroid nodules in HOMA-IR 3. 01- 4.00 group (12/14) and HOMA-IR > 4.00 group (20/20) was higher than that in HOMA-IR 0- 1.00 group (0), HOMA-IR 1.01- 2.00 group (39.5%, 17/43) and HOMA-IR 2.01-3.00 group (5/17), there were significant differences (P<0.01). Multi-factor Logistic regression analysis showed that the detection rate of thyroid nodules had positive correlation with levels of HOMA-IR, BUA and BMI (OR=0.278, 0.004 and 0.115, 95%CI 1.695-5.043, 1.001-1.015 and 1.046-1.644). The detection rate of thyroid nodules had no correlation with level of FPG (P>0.05). Conclusions The detection rate of thyroid nodules in HOMA-IR>3.00 patients is significantly higher. The insulin resistance, higher BMI and hyperuricemia are the independent risk factors of thyroid nodules.