Objective To investigate the cause of refractory hiccups. Method 34 patients with refractory hiccups admitted to our hospital from January 1996 to December 2003 were examined with gastroscopy. The correlation of hiccups with reflux esophagitis and the efficacy of omeprazole treatment were studied. Results 10 patients were proven endoscopically to have esophagitis and duodenal ulcer, and the other 24 were suffering from esophagitis. According to Tokyo classification, 14 cases were having grade III esophagitis, and 20 were grade IV. All patients received omeprazole 20mg twice daily and cisapride 10mg thrice daily, and hiccups disappeared after 3 days. Conclusion Refractory hiccups may be the initial or primary symptom in moderate-severe esophagitis in aged people. Proton pump inhibitor therapy is effective in stopping refractory hiccup.

OBJECTIVE: To valuate the antibiotic effects in vitro of Pazufloxacin combined with Cefoperazone/Sulbactam against 90 common pathogenic bacteria from hospital acquired infection. METHODS: The protocol was designed by checkerboard method. The MIC of two antibiotics alone or in combination against 90 strains (including 30 staphylococcus aureus, 30 Escherichia colis, 30 Pseudomonas aeruginosas) were detected by broth dilution method and the FIC index was calculated according to MIC values. RESULTS: The MIC of Pazufloxacin combined with cefoperazone/sulbactam against 90 strains was reduced significantly. The percentage of the FIC index maintained at less than 0.5, 0.5～1, 1～2, above 2 were 60.7%～80.0%, 20.0%～33.3%, 3.3%～6.6%, and 0% respectively. CONCLUSION: The antibiotic activity of Pazufloxacin combined with cefoperazone/sulbactam against 90 common iatrogenic strains from hospital acquired infection was enhanced significantly. Their antibacterial action in vitro was characterized by synergism and additive action instead of antagonistic effect.

Objective To investigate treatment of caesarean scar pregnancy (CSP) and associated problem.Methods From January 2011 to January 2013,57 cases with CSP undergoing treatment in Affiliated Hospital of Hebei University were studied retrospectively.Among 57 patients,it was divided into 12 cases treated by curettage (curettage group) ;22 cases treated by uterine artery embolization(embolization group) ;8 cases treated by laparotomy(laparotomy group) and 15 cases treated by transvaginal debridement (transvaginal group).Results (1) Successful rate of curettage group,embolization group,laparotomy group and transvaginal group were 12/12,86％ (19/22),7/8,13/15.(2) The intraoperative blood loss and the hospital stay were 20 (17-28) ml,(5.1 ± 1.9) days in curettage group,10 (5-15) ml,(10.2 ± 3.2) days in embolization group,200 (80-300) ml,(11.3 ± 3.3) days in laparotomy group,50 (45-100) ml,(6.8 ± 1.2) days in transvaginal group.There was statistically different between curettage group and embolization group (P ＜ 0.05).There was statistically different between laparotomy group and transvaginal group (P ＜ 0.05).Conclusions Curettage,uterine artery embolization,abdominal and transvaginal scar debridement surgery can be used in treatment of the CSP.It should be carefully chosen with surgical intervention,if myometrium was implanted greater than 1/2,or near to serosa.It should be carefully chosen with vaginal surgery,if the blood flow signals was rich around the lesion.

Objective To explore the anti-inflammatory and antipruritic effects of Chushizhiyang ointment in a mouse model. Methods A total of 40 male 8-week-old BALB/c mice were included in this study, and randomly and equally divided into 4 groups. A mouse model of atopic dermatitis (AD)was established in three groups of mice by repeated application of 2,4-dinitroflurobenzene (DNFB)to shaved abdominal skin for sensitization and to shaved dorsal skin for stimulation. After establishment of the AD model, the three groups were topically treated with sodium chloride physiological solution (model group), hydrocortisone cream (hydrocortisone group)and Chushizhiyang ointment (Chushizhiyang group)respectively for 14 consecutive days. The remaining group receiving no sensitization or treatment served as the normal control group. All the mice were sacrificed 12 hours after the final treatment, and the dorsal skin of mice was resected followed by the determination of skin thickness and weight as well as hematoxylin-eosin(HE)staining and toluidine blue staining for the counting of leukocytes and mast cells respectively. Moreover, enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of interferon-gamma(IFN-γ), tumor necrosis factor alpha(TNF-α), interleukin 4(IL-4)and IL-5 in dorsal skin lesions. In addition, a local skin itching model was induced by histamine phosphate in Hartley guinea pigs, which was used to explore the effect of Chushizhiyang ointment on itch thresholds. Results Compared with the model group, both the Chushizhiyang group and hydrocortisone group showed reduced thickness and weight of dorsal skin in mice (all P < 0.01), numbers of infiltrating lymphocytes and mast cells (all P < 0.01)and levels of IFN-γ, TNF-α, IL-4 and IL-5 in skin lesions (P < 0.05 or 0.01)on day 15 after the start of treatment. The thickness and weight of dorsal skin in mice were significantly decreased in the hydrocortisone group (P <0.01), but experienced no significant changes in the Chushizhiyang group compared with the normal control group. Additionally, Chushizhiyang ointment could significantly increase itch thresholds in guinea pigs induced by histamine phosphate(P < 0.01). Conclusions Chushizhiyang ointment can significantly inhibit DNFB-induced AD in mice, likely by restoring the balance between Th1 and Th2 type cytokines. Moreover, Chushizhiyang ointment could markedly relieve itching induced by histamine phosphate in guinea pigs.

Objective:To explore the experience and needs of perioperative symptom management in lung cancer patients, so as to provide reference for further developing self-management interventions for symptom clusters in lung cancer patients.Methods:This study was descriptive and qualitative. From February to March 2023, purposive sampling was used to select 18 lung cancer patients who underwent surgery at the Shanghai Pulmonary Hospital Affiliated to Tongji University as the research subject, and semi-structured interviews were conducted on them. The thematic analysis method was used for data analysis.Results:Four themes were extracted, including the heavy burden of perioperative symptoms, the negative impact of symptom clusters on patients, obstacles to symptom management, and the need for symptom self-management.Conclusions:Lung cancer patients face various burdens during the perioperative period, causing serious distress to the patients. Patients have obstacles and different needs in symptom self-management. Medical and nursing staff should adopt targeted interventions and improvement strategies to enhance patient symptom self-management ability, reduce symptom burden, and improve quality of life.

Objective? To summarize the nursing experience for extracorporeal membrane oxygenation therapy (ECMO) waiting for lung transplantation. Methods? Totally 4 patients waiting for lung transplantation who received ECMO in Shanghai Lung Hospital from May 2017 to June 2018. Nursing management strategies included: building a multidisciplinary medical and nursing team, using "awake" ECMO strategies in early stages, employing high flow nasal cannulae oxygen therapy to improve oxygenation, monitoring coagulation and anticoagulation, and careful in-hospital transfer process management. Results? After careful therapy and nursing care, 3 patients were safely transferred to the operation room for lung transplantation, and 1 died. Conclusions? Careful nursing management during ECMO can improve the survival rate of critical patients and guarantee successful lung transplantation and better prognosis.

Objective To study the impact of chronic hypoxia on white matter (WM) injury and brain development delay using a neonatal rat model, and to explore its value in simulating chronic hypoxic brain damage in cyanotic congenital heart disease (CHD). Methods Three-day-old Sprague-Dawley (SD) rats were randomly distributed to an experiment group (n=36, FiO2 10.5%±1.0%) and a control group (n=36, FiO2 21.0%±0.0%) and were raised for 12 days. (1) Body weight of SD rats was recorded every day and fresh brain weight was measured on P14. (2) H&E staining was performed on sections of brain tissue to observe pathological changes and ventricular size. (3) Immunohistochemistry (IHC) was applied to reveal alterations of oligodendroglial progenitor cells (OPC), preoligodendrocytes (PreOL) and myelin basic protein (MBP) in brain WM area. (4) Protein was extracted from 50 mg of brain tissue in WM area and expression of MBP was determined using Western blotting. (5) Motor function and coordination of rats (P30) were assessed via rotation experiment. Results (1) Body weight and brain weight were significantly less in the experiment group compared with the control group on P14 (body weight 14.92±1.26 gvs. 30.26±1.81 g, t=7.51, P<0.01; brain weight 0.68± 0.05 gvs.0.97±0.04 g, t=13.26, P<0.01); (2) HE staining: Sections of brain tissue from the experiment group showed ventricular size enlargement with a statistical difference (P<0.01), disordered cell organization, local neuronal death and leukomalacia. (3) The number of OPC and PreOL in the experiment group were significantly less than those in the control group (64.8±6.3vs. 126.2±8.4, t=11.19, P<0.01; 19.1±7.6vs. 46.7±9.5, t=7.28, P<0.01, respectively). MBP distribution was sparse and disorganized in the experiment group. (4) Western blotting: Expression of MBP was less in the experiment group (P<0.01). (5) Behavioral test: Time on rotarod was less in the experiment group with a statistical difference (P<0.01). Conclusion Chronic hypoxia can result in WM injury and brain development delay in neonatal rats, with features comparable to those seen in infants with cyanotic CHD.