Objective To investigate the clinic application of venturi oxygen therapy heated humidify system on artificial airway management. Methods 30 cases of experimental group used venturi oxygen therapy for humidification and heating, while 30 cases of control group were treated with continuous wet micro-injection pump method for artificial airway care. Humidifying effects, effects of oxygen therapy, incidence of pulmonary complications were compared between the two groups. Results The humidifying effects on experimental group (26 cases) were better than control group (17 cases) (χ2=6.648,P<0.05). The irritating cough (5 cases), airway mucosa injury (1 case) and the formation of sputum crust (2 cases) in experimental group were less than 13 cases, 6 cases, 6 cases in control group (χ2=5.079, 4.043, 7.954,P<0.05). The times of sputum drainage on experimental group was (17.28 ± 5.51) times which was less than (31.22±5.24) times of control group (t=4.312, P<0.01).The effect on oxygen therapy about oxygen saturation in experimental group was 0.932 2 ±0.020 5 when sputum drainage, and 0.982 2± 0.009 4 two minutes later, which was higher than 0.916 7 ±0.011 2 and 0.957 2 ±0.013 6 of control group (t=3.431,6.276, P<0.01). Conclusions Venturi oxygen therapy heated humidify system can reduce the formation of sputum crust, reduce the times of sputum drainage, reduce hypoxia degree and shorten the duration caused by sputum crust, improve the effect of heat and humidification of patient.

Objective To describe the status of nurses′professional identity and the self-concept and to explore the relationship between nurses′professional identity and the self-concept. This will be the base for intervening nurses′professional identity. Methods A convenience sample of 250 nurses from one major hospital in Beijing was recruited. The Macleod Clark Professional Identity Scale and the Professional Self-Concept Instrument were introduced. A standard translation procedure was carried out. Results A total of 250 questionnaires were sent out, 241 questionnaires were withdrawed with an effective rate of 96.4%. The mean score of nurses′professional identity was 42.54±8.70, which was at moderate level. The mean score of nurses′professional self-concept was 86.28 ±22.86, also at moderate level, among which,knowledgescores highest (25.91±6.00), leadership scored 20.84±8.02, inter-personal relationship scored (20.28±4.18), caring scored the lowest (19.25±4.67). There was significant difference among the professional identity in the different departments (P<0.05) , while the same results were not seen in professional self-concept. Nurses′professional identity was positively correlated with professional self-concept′s four dimensions (P<0.05). Conclusions The nurse managers should pay attention to the cultivation of professional self-concept in the training of nurses in order to improve the professional identity of nurses and the whole nurses′development.

AIM:To investigate the effects of the γ-aminobutyric acid(GABAergic)neural pathway from the anterior cingulate cortex(ACC)to the nucleus accumbens(NAc)on the regulation of irritable bowel syndrome(IBS)and its underlying mechanisms in mice.METHODS:(1)A C57BL/6J mice model of IBS was established by using chronic acute combing stress(CACS).The mice were divided into a normal group and an IBS group(n=8).The presence of IBS-like symptoms was determined through behavioural tests,an intestinal motility test and abdominal withdrawal reflex scores.(2)Fluorescence gold(FG)retrograde tracing and immunohistochemistry were used to investigate the ACC-NAc GABAergic neural pathway and to examine the activation of GABA in the ACC in IBS mice(n=8).(3)A total of 1.5 μL of normal saline(NS),GABAA receptor antagonist bicuculline(BIC)or agonist isoguvacine hydrochloride(Isog)was ad-ministered via a preburied catheter into the NAc of mice in IBS and normal groups.The mice were randomly divided into three groups(n=8):NS group,BIC group and Isog group.IBS-like symptoms were assessed.(4)The mice were prein-jected with AAV2/9-mDlx-iCre-WPRE-pA in the ACC and AAV2/2Retro Plus-hSyn-DIO-hM3D(Gq)-eGFP-WPRE-pA in the NAc and subsequently divided into four groups(n=8):NS(intraperitoneal injection)+NS(NAc microinjection)group,NS+BIC group,clozapine N-oxide(CNO)+NS group and CNO+BIC group.The mice who received AAV2/2Retro-hSyn-DIO-hM4D(Gi)-EGFP-WPRE-pA in the NAc were randomly divided into three groups(n=8):NS+NS group,NS+BIC group and CNO+NS group.Enzyme-linked immunosorbent assay(ELISA)was employed to estimate the expression levels of histamine and 5-hydroxytryptamine(5-HT)in colon tissue,and the effects of GABAergic neural pathways from ACC to NAc on IBS were studied.RESULTS:CACS induced IBS-like symptoms in mice.The results of FG retrograde tracing combined with fluorescence immunohistochemistry showed that GABA neurons of ACC could project to NAc.The injection of BIC in the NAc was found to significantly reduce anxiety-like behaviours,diarrheal symptoms and visceral hy-persensitivity in the IBS mice(P<0.05).Chemogenetic inhibition of the ACC-NAc GABAergic neurons ameliorated IBS-like symptoms in mice(P<0.05).CONCLUSION:The GABAergic pathway of ACC-NAc might be involved in the regu-lation of IBS in mice,which may be related to the release of histamine and 5-HT in colon tissue.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.