Objective To explore the application effect of 4R crisis management in patients with mechanical ventilation in intensive care unit(ICU).Methods 88 patients with mechanical ventilation in ICU were selected as the study subjects,by random number table method they were divided into observation group and control group, 44 cases in each group.The control group was treated with basic nursing intervention,the observation group received 4R crisis management of nursing intervention.After the implementation of different nursing intervention,the incidence of pressure ulcers,prevention effect and nursing satisfaction,crisis event occurrence and the quality of care were com-pared between the two groups.Results The incidence rate of pressure ulcers of the observation group was 2.27%, effectively preventive rate was 95.45%,the crisis event occurrence rate was 4.55% and nursing satisfaction rate was 97.73%,nursing quality score was (93.78 ±3.19)points,which were significantly better than those of the control groups[20.45%,68.18%,47.73%,75.00%,(87.91 ±2.75)points](χ2 =5.53,9.24,19.07,7.82,t =9.25,all P <0.05).Conclusion 4R crisis management nursing intervention can effectively improve the ICU mechanical ven-tilation patients crisis events,improve the quality of nursing and nursing satisfaction.

Objective To explore the diagnosis value of CTA on posterior inferior cerebellar artery ( PICA ) aneurysm.Methods The clinical data of 2 patients with PICA aneurysms were analyzed retrospectively .Results Two patients were elderly,acute onset,CT confirmed subarachnoid hemorrhage ,CTA of the first time were negative within 3 h after the onset .After the treatments of preventing cerebral vasospasm , increasing blood volume , protecting brain cells and etc for 3-7 d, one case improved ,one case were invalid .Given CTA examination again then found 3 aneurysms, one case with 2 aneurysms located on the left side of the PICA , accompanying with hydrocephalus ,and the other case with 1 aneurysm located on the left side of the PICA .Two patients obtained a good image evaluation and rich information .Conclusions In view of the particularity of the PICA aneurysms , CTA can be used as the preferred method of examination , which can provide comprehensive imaging data .When CTA examination of the first time is negative , giving CTA again remains an ideal choice after short-term treatment .

The effect of Liu Wei Di Huang Wan(LWDHW)and Rehmannia glutinosa Libosch(RGL)on the immune function of normal and immune-suppressed mice were observed.The results showed that the two medicinal herbs given orally can correct the suppres-sive effect of cyclophosphamide on spleen and thymus weight,serum specific antibodylevel and lymphocyte transformation.They can also improve the phagocytic activity ofperitoneal macrophages and enhance peripheral blood ANAE~+ lymphocyte ratio of mi-ce.Under the same conditions,no obvious effect of LWDHW and RGL on the normalmice was found except that RGL can increase the antibody level of normal mice.Theresults implicate that LWDHW and RGL may have some immunomodulatary effect.

Objective To study the effective interference methods in the patients of Coronary Heart Disease costipation, Methods All patients with Coronary Heart Disease constipation (124 cases) were randomly divided into control group (56 cases) and intervention group (68 cases). By using self -design questionnaire, defecation, meal and sports were evaluated. The patients in the control group were only subjected to routine nursing care, while those in the intervention group to nursing intervention. A period was 7 weeks. Results There was significant difference in defecation, meal and sports between control group and intervention group (P

Objective To explore the relationship between psychosocial stress and the occurrence and development of gestational diabetes mellitus.Methods 40 patients with gestational diabetes mellitus(study group) and 40 normal pregnant women(control group) from Mar.2000 to Jan.2001 in our hospital with type A behavior pattern(TABP),life events scale(LES) and state-trait anxiety inventory(STAI).Results(1)There were 27 cases(67.5%) of type A behavior in the study group,whereas 13 cases(32.5%) in the normal controls,the difference being significant(P

Objective To investigate the relationship between the platelet activation and cor pulmonale cerebral thrombosis. Methods Platelet-activating markers CD 62p and P 10 on platelet surface were assayed using FCM, and cerebral CT were also performed at the same time. Results The patients with cor pulmonale had abnormal platelet activation, which had significant difference compared with the control group(P

Objective To explore an effective way to improve the quality of life of elderly rheumatoid arthritis (RA) patients by a survey about their present living conditions and analyze the effect of some related factors. Methods This was a descriptive study and convenient sampling survey were adopted. Seventyfive elder patients with RA were investigated with self-developed questionnaire, self-mana-gement scale,family function questionnaire, DAS28, 36 question scale health survey questionnaire (SF-36). The demographic data, elderly RA related knowledge and attitudes, self-management, family function and quality of life were also investigated. Univariate analysis was used to analyze the relationship between the quality of life of elderly RA and the affecting factors. Results The score of SF-36 was (66±12). The SF-36 scores was associated with joint function (r=0.705, P＜0.01 ), and DAS28 (r=-0.712, P＜0.01 ). The SF-36 score was positively associated with the understanding of the deterioration of symptoms, the attitude of patients towards their diseases, satisfactory to the help from their families, the access to medical care and the degree of selfmanagement (r=0.515, 0.485, 0.540, 0.575, 0.545, P＜0.01); while it was negatively associated with the duration of disease course (r=-0.312, P＜0.01 ). In addition, this study also discovered that the quality of life declined with the decline of their economic status, but tended to improve with the increase of education level.Conclusion The life quality of elderly RA patients is not ideal. It is associated with DAS 28 score, the duration of disease course, the understanding of their diseases, the attitude towards their disease, selfmanagement, family support and other facotrs

Objective:To study the effect and applicability of interventianal therapy using elemene emulsion with gastric carcinoma in the advanced period or relapse after operation.Methods:The embolization of advanced gastric carcinoma in 68 cases via left gastric artery,arteria mesenterica superior and arteria coeliaca in 296 patients using elemene emulsion was done with the method of LEF,ELP pand EAP,the indexes of the angiogram before and after treatment,GI and CT were studied for evaluating the effect with the intervals ranging from 2 to 4 months.The regression rate of carcinoma,the retained time of embolism,the survival stage,the survival rate and histopathology were observed.Results:The survival rate of one year was 63.2%,of two years 29.4% and of three years 7.4%.the average survival time of liver metastasis and non-metastasis was 9.6 and 15.6 months respectively,the regression rate of the carcinoma was 64.8%.These figures were higher than those of other interventional radiology and chemotherapy.Conclusion:The embolism with elemene emulsion is a hopeful method to treat the advanced gastric carcinoma of being unable to operation.

Objective: To analyze the elcctrophysiological and clinical features of 68 common and 9 refractory atrioventricular nodal reentrant tachycardia(AVNRT) cases,thereby to seek safe and effective strategies for the treatment of refractory AVNRT with radiofrequency catheter ablation(RFCA). Methods: Ablation at lower zone is customarily applied in AVNRT,if noneffective,ablation electrode can be gradually moved upward,and radiofrequency energy can be delivered at a midpoint or upper position of His Bundle even with small H waves.The movement of the ablation electrode must be carefully monitored lest His bundle be eroded mistakenly.For those both atrioventricular nodal dual pathways(AVNDP) and atrioventricular accessory pathways(AVAP) are present,we always ablate AVAP first. Results: All 68 common AVNRT cases are simple slow-fast type.Among the 9 cases of refractory AVNRT,2 cases were combined with concealed left postseptal AVAP and concealed right AVAP respectively,while 1 case with atrioventricular nodal three pathways. Conclusion: X-ray anatomical position and intraventricular local mapping should be analyzed for the use of RFCA in refractory AVNRT.Safe and effective mapping should be: small A wave and big V wave,shattered A wave with width≥68 ms,A/V= 0.1-0.25,no H or H≤(0.02?0.03) mV.If lower position and middle position method are noneffective,linear ablation at mid-level of Koch's triangle seems to be a satisfactory alternative,which could avoid complications of atrioventricular block in the upper position ablation.

The test panels are combined for the clinical application according to the principle of the evidence-based medicine, which involves the strict evaluation for the technical performance, diagnostic performance, the result of patients and the economic properties. The guideline for the clinical application of the test panels is established in light of different diagnostic objectives and diseases, providing the best diagnostic service for the physicians and benefiting the patients the most.