ObjectiveTo assess the value of the area of ground glass opacities (GGOs) in lungs displayed by high-resolution computed tomography (HRCT) in paraquat (PQ) poisoned patients in evaluating prognosis. Methods Clinical and imaging data of 137 patients with acute PQ poisoning admitted to Affiliated Hospital of the Medical College of Chinese People's Armed Police Forces from January 2012 to August 2014 were analyzed retrospectively. The plasma concentration of PQ on admission and the area of GGOs were compared between two groups. The lung HRCT within 10 days of poisoning was performed every 3 days, and the areas of GGOs were evaluated on five levels, including aortic arch, aortic pulmonary window, left upper lobe bronchial, right inferior pulmonary vein, and left diaphragmatic dome. Receiver operating characteristic curve (ROC) was plotted to evaluate the value of all the parameters for prognosis.Results Among 137 patients, 45 died within 28 days after poisoning, with the mortality rate of 32.85%. The plasma PQ level in the non-survivors was significantly higher than that in the survivors (mg/L:7.06±0.67 vs. 3.51±0.34,t = 5.280,P = 0.000). The areas of GGOs at three time points in the non-survivors were significantly higher than those in the survivors [1-3 days: (32.0±5.0)% vs. (2.5±0.4)%,t = 7.860,P = 0.000;4-6 days: (45.5±5.7)% vs. (2.8±0.5)%,t = 12.420,P = 0.000; 7-10 days: (68.0±4.8)% vs. (3.0±0.6)%, t = 23.950,P = 0.000]. ROC analysis demonstrated that the area under the ROC curve (AUC) of GGOs in 7-10 days was 1.000, which could be used to determine the prognosis, but it was too late for the treatment. The AUC of GGOs in 4-6 days was 0.979, with the threshold of> 12.0%, the specificity of 96.15%, the sensitivity of 85.19%, the positive predictive value of 88.46%, and the negative predictive value of 94.94%, which presented good effect in predicting prognosis in the early stage of acute PQ intoxication. But plasma PQ concentration was relatively poor for determining prognosis, AUC was 0.821, with the threshold of> 1.95 mg/L, the specificity of 34.52%, the sensitivity of 88.64%, the positive predictive value of 41.49%, and the negative predictive value of 85.29%.Conclusions The area of GGOs displayed by HRCT can be used to evaluate the fully developed acute PQ lung injury, and it is superior to plasma PQ concentration. The area of GGOs displayed by HRCT 4-6 days after intoxication can be used for the evaluation of PQ induced pulmonary injury in the early stage and the evaluation of clinical prognosis.

Objective To analyse the clinical characteristics,treatments and prognosis of the chemotheray-induced lung injury in malignant hematological diseases patients.Methods 26 malignant hematological diseasespatients with chemotheray-induced lung injury were collected.The clinical characteristics,chemotherapy regimen,treatments and prognosis of the patiants were retrospectively analyzed.Results Among 26 patients,10 patients were male and 16 patients were famale.The dignosis were nonHodgkin's lymphoma (16 cases),leukemia (9 cases) and multiple myeloma (1 case).The chemotherapy regimens inducing lung injure probably were R-CHOP,R-BEACOP and BEACOP in lymphoma,while they were HA,AA,DA and IA in leukemia.The symptoms of lung injury in these patients were fever,cough,hemoptysis,dyspnea,fatigue,or asymptomatic radiological examination revealed.Pulmonary diffuse infiltration and shadows were showed in CT scan.21 cases were cured by hormone therapy,5 cases died of lung injury,2 cases died of tumor recurrence after lung injury cured.There was no effect on the quality of life in most cured patients.Conclusion The lung injury induced by chemotherapy has no specific clinical characteristics and diagnostic criteria,and it could progress rapidly to cause death.But early dignosis and early hormonal treatment can obtain good therapeutic effect.The occurrence regularity and clinical characteristics should be studied furtherly.

Objective To know the sources of the working stress of head nurses in primary hospitals.Methods A total of 100 head nurses from 14 hospitals were investigated through nurse stressor scale by random cluster sampling.Results The total score of working stress source of the head nurses was 2.60±0.52.The stress sources scores were ranked as job characteristics,organizational structure,family conflict,career,work roles,and interpersonal conflict.Conclusions The levels of stress of head nurses in primary hospitals were at the middle level.Skills and capability of head nurses are necessary to be improved to deal with stress.Meanwhile,administration department and leaders of hospitals need to reduce the stress of head nurses to improve their psychological conditions by improving the working environment,establishing the reasonable incentive measures,and so on.

Objective To assess the effect of three-grade nursing clinical-rounds implemented on new patients with mental disorders.Methods 360 new patients with mental disorders who were selected from ward one to six in our hospital were divided into the experimental group and control group,patients in experimental group who were selected from January to December in 2010 were given three-grade nursing clinical-rounds and patients in control group who were select from January to December in 2009 were given ordinary nursing clinicalrounds.Passing rate of health education,incidence of accident and satisfaction to nursing care in two groups were evaluated.Results Passing rate of health education in experimental group was 96.7％ and 89.4％ in control group,the difference was obvious( x2 =7.264,P ＜ 0.05 ).there was statistically significant difference in the incidence of accident,2.8 ％ in experimental group and 10.6％ in control group ( Z =- 2.726,P ＜ 0.05 ).the satisfaction of patients were 98.9％ and 93.3％ in experimental and control group respectively( x2 =6.020,P ＜0.05).Conclusions Three-grade nursing clinical-rounds have a significant effect on the overall quality of nursing care,and it is worthy of spreading in clinical work.

Professor LI Zhi-dao, according to acupoint selection of syndrome differentiation in TCM basic theory, concluded a new therapy, namely "tonifying three qi" that is mainly based on three acupoints in the Conception Vessel. This method is consisted of Danzhong (CV 17), Zhongwan (CV 12) and Qihai (CV 6) in the Conception Vessel, which could successively nourish clear qi, stomach qi and original qi. In clinic, according to the severity of symptoms of three qi, the acupoints are selected flexibly, which could respectively treat deficiency of heart-lung qi, deficiency of stomach-spleen qi and deficiency of original qi. Some examples are also given in the article.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Qi

OBJECTIVE: To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap. METHOD: The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap. RESULT: The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery. CONCLUSION The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Dermatologic Surgical Procedures ; Face ; surgery ; Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Wound Healing

AIM: To investigate the effects of PAR-2 agonist peptide on the proliferation and cytosolic calcium concentration ([Ca~(2+)]_c) in human hepatoma cells HepG2. METHODS: Human hepatoma cell line HepG2 was cultured. The cells were treated with PAR-2 agonist peptide SLIGKV-NH_2 and the reverse PAR-2 agonist peptide VKGILS-NH_2, respectively. The [Ca~(2+)]_c of hepatoma cells were measured by microfluorimetric techniques based on calcium indicator fura-2/AM. The influences on proliferation of hepatoma cells were determined by MTT method. The changes of cell cycle were evaluated by flow cytometry, and the changes of cyclin D1 mRNA expression were detected by RT-PCR. RESULTS: After treated with 50 μmol/L SLIGKV-NH_2, a rapid rise of [Ca~(2+)]_c in HepG2 cells was induced (P<0.01), percent S phase, G_2/M phase and proliferation index (PI) of HepG2 cells were elevated (P<0.01), and cyclin D1 mRNA expression was significantly upregulated (P<0.01). The proliferation rates of HepG2 cells treated with 1-50 μmol/L SLIGKV-NH_2 were significantly increased, and the effect was in a dose-dependent manner (P<0.01 or P<0.05). No statistical significance of the difference between VKGILS-NH_2 and control group was observed (P>0.05). CONCLUSION: PAR-2 agonist peptide induces the rise of [Ca~(2+)]_c in HepG2 cells, upregulates the expression of cyclin D1 mRNA, accelerates the progress of cell cycle, promotes the synthesis of DNA and the proliferation of hepatoma cells via activating PAR-2 in vitro.

Objective To measure the current environmental radioactivity levels in some districts of Yunnan Province,and to estimate the external doses to local residents.Methods The surface soil,aerosol and water samples were collected and analyzed by HPGe gamma spectrometry.Based on the estimation model selected by Ministry of Health in the nationwide soil survey,the doses to local residents from 238U,226Ra,232Th,40K and 137Cs in environmental samples were estimated.CARI-6 software issued by FAA (Federal Aviation Administration ) was used to estimate cosmic radiation dose to the local population.Results The external annual dose rate to the local people was 1.13 mSv per year,of which 0.52 mSv per year was contributed by natural radionuclides in soil,0.6 μ Sv per year by 137 Cs in soil and 0.61 mSv per year by cosmic radiation.Conclusions The cosmic radiation and natural radionuclides in soil might contribute 99.95％ of external exposure dose,while artificial radionuclide 137Cs contribute 0.05％ of external exposure dose.

Objective To test a full range of processes of sample collection,preparation,measurement and analysis by conducting the intercomparison of gamma-ray spectrometry measurement and analysis of radionuclides among key laboratories,so as to facilitate the development of gamma-ray spectrometry measurement and analysis technology.Methods To complete the collection and preparation of soil samples by Chinese Center for Disease Control and Prevention (CDC) laboratory and to measure and analyze the content in two soil samples of 214Pb,214Bi,208TI,228Ac,40K and 137Cs by three laboratories using gamma-ray spectrometry.Results The value calculated by any two laboratories were less than 1 in terms of assessment standards agreed by these three laboratories and based on the activity concentrations and the total uncertainty reported from them.The measurement results from our lab were acceptable.Conclusions Measurement results from these three laboratories are in agreement to some extent.This intercomparison activity has tested the analytical ability of the three laboratories and raised the level of our laboratory in testing homogeneity of sample preparation.

Objective To analyze the popular characteristic and drug resistance of Pseudomonas aeruginosa in a hospital of Guiy-ang from January 201 1 to December 2013.Methods The distribution characteristic and drug resistance of Pseudomonas aeruginosa isolated from clinical samples from January 201 1 to December 2013 were analyzed retrospectively.Results A total of 642 strains of Pseudomonas aeruginosa were isolated for three years in our hospital from January 201 1 to December 2013,there was 57.0% isola-ted from sputum specimens,and 27.9% isolated from excreta of wound.The infected endemic area distribution was made up of Or-thopedic Surgery,ICU,Geriatrics Department and Respiratory Department accounting for 22.9%,20.1%,18.8% and 1 5.9% re-spectively.Pseudomonas aeruginosa was most sensitive to polymyxin bacillosporin.The drug resistance rates to Trimethoprim,Am-picillin and Cefazolin were all 100.0%.The drug resistance rates to Ampicillin/sulbactam and Ceftriaxone were 90.0%. Conclusion Pseudomonas aeruginosa is the main cause of lower respiratory tract infections in patients and wound infection and show serious multi-drug resistant,so it is necessary to use drugs reasonably according to the drug susceptibility results.