Objective To explore the methods of training emergency nurses under the Trinitarian Mode.Methods 77 emergency nurses were distributed to different groups and received different training contents and assessment criteria stratifiedly as well as in phases according to their working ages.The training content contained emergency capability,emergency specialist skills,evidence based nursing,nursing scientific research,and clinical practice,etc.Results Through the on-the-job training,their emergency caring ability were overall improved,the human resource was effectively utilized,and the overall ability for coping with public health emergencies had made great progress.Conclusions Under the Trinitarian emergency treatment mode,a diversified on-the-job training for the emergency nurses will promote the development of emergency care,as well as help keep pace with the rapid development of emergency medical sciences.

Objective To study the protective role of continuous veno-venous hemofiltration (CVVH) in cardiac insufficiency refractory to diuretic therapy after acute myocardial infarction.Methods A total of 104 acute myocardial infarction patients admitted from march 2012 to march 2016 were recruited.According to their wishes,the patients were divided into two groups,continuous veno-venous hemofiltration combined with routine therapy as experimental group (n =52) and conventional treatment as control group (n =52).Mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,ventilator usage and urine output volume were documented.Then the difference in BW between pre-and post-treatment was determined for evaluation of fluid retention,and blood plasma C-reactive protein (ΔCRP),interleukin 6 (ΔIL-6),interleukin 8 (ΔIL-8),tumor necrosis factor-α (ΔTNF-α) and left ventricular ejection fraction (ΔLVEF) were measured and calculated.A multiple linear regression model to predict ΔLVEF was established.Data recorded at different intervals in the same group were analyzed by ANOVA.Data of the monitoring biomarkers,the mean length of ICU stay,the mean length of hospital stay of two groups were recorded at the same given intervals were analyzed by t test.Data of mortality rate within one month,drugs and ventilator usage in two groups were analyzed by x2 test.P value less than 0.05 was considered statistically significant.Results There were significant differences in mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,and the duration of ventilator usage between the two groups (P ＜ 0.05).Total volume of fluid output (urine and ultrafiltration volume) was higher in experiment group than that in control group in 48 hours after the treatment (P ＜ 0.01).The levels of CRP,IL-6,IL-8 and TNF-α decreased significantly (P ＜ 0.05) in experiment group after treatment but not in control group (P ＞ 0.05) as compared with those before the treatment.BW was decreased and LVEF was increased in both groups after treatment (P ＜ 0.05) compared with those before the treatment.Levels of CRP,IL-6,IL-8 and TNF-α were lower in experiment group than those in control group after treatment (P ＜ 0.05).BW was meagerly lower and LVEF was meagerly higher in experiment group than those in control group without statistical significance (P ＞ 0.05).However,the degrees of ΔLVEF andΔBW were greater in experiment group than those in control group (P ＜ 0.01).In experiment group,significantly positive correlations were found among ΔBW,ΔCRP,ΔIL-6,ΔIL-8,ΔTNF-α and ΔLVEF (P ＜0.05).Multiple linear regression analyses showed that ΔBW and ΔTNF-α were the independent factors forΔLVEF and ΔBW was the main independent factor for ΔLVEF in control group.ΔLVEF was positively correlated with ΔBW (P＜0.01) but had no correlation with ΔCRP,ΔIL-6,ΔIL-8 and ΔTNF-α (P ＞0.05).Multiple 1inear regression analyses showed that only ΔBW was the independent factor for ΔLVEF.Conclusion CVVH plays protective role in acute myocardial infarction patients with consequent cardiac insufficiency refractory to diuretic therapy by clearance of inflammatory cytokines and removal of retained fluid,and the removal of retained fluid is the most import mechanism to protect heart function.

OBJECTIVE: To explore the possible mechanism of Huoxue Qianyang Formula (HXQYF), a compound traditional Chinese herbal medicine, in reversing the left ventricular hypertrophy (LVH) of spontaneous hypertensive rats (SHRs) by analyzing the expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle. METHODS: The experimental study was carried out in SHRs, the sex- and age-matched Wistar-Kyoto (WKY) rats were served as normal control (n=5, normal saline 10 ml/kg daily). Twenty-five SHRs were randomly divided into five groups: untreated group (n=5, normal saline 10 ml/kg daily), high-dose HXQYF-treated group (n=5, 0.84 g/ml HXQYF, 10 ml/kg daily), medium-dose HXQYF-treated group (n=5, 0.42 g/ml HXQYF, 10 ml/kg daily), low-dose HXQYF-treated group (n=5, 0.21 g/ml HXQYF, 10 ml/kg daily) and cilazapril-treated group (n=5, 1 mg/ml cilazapril, 10 ml/kg daily). The drugs were intragastrically administered once daily for 14 weeks. The expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle were detected separately by in situ hybridization histochemical method and immunohistochemical method. RESULTS: Compared with the normal control group, the expressions of mRNAs and proteins of proto-oncogenes c-fos and c-myc in left ventricular muscle were significantly increased in untreated group (P<0.01). After treatment, the expressions of c-fos and c-myc mRNAs in left ventricular muscle in HXQYF-treated groups were significantly down-regulated as compared with those of the untreated group (P<0.05). The expressions of c-myc protein were also significantly decreased in high- and medium-dose HXQYF-treated groups as compared with the untreated group (P<0.05), but it had no significant effects in protein expression of c-fos in the three HXQYF-treated groups. CONCLUSION: HXQYF can inhibit the expression of c-myc in ventricular hypertrophy tissue, which may be the mechanism in treating LVH of hypertension.

Objective To investigate the influences on the femur cortex of the rabbit after ovariectomy and its mechanism.Methods Eighty 6 months-old female pure New Zealand rabbits were divided into two groups:40 rabbits in ovariectomy group and 40 in sham-operation group.The weight averaged 2.2±0.28 kg.Four weeks and 8 weeks after operation,a series of tests were performed in both groups concerning the number,the volume,the rate and the maximal load of cortical bone porosity.The number,the length and the density of linear crack in rabbit femur cortex were documented after repetitive application of minor trauma.Results Micro-CT demonstrated that both on week 4 and 8 after operation,the number,the volume and the rate of cortical bone porosity were all significantly higher in ovariectomy group than that of the control group.Four weeks after operation,the biomechanical test showed the significantly lower average maximal load of rabbit femur in ovariectomy group (1 892.60±59.09) than that of in control group (1 949.25±53.12) (P=0.003).Eight weeks after operation,the average load of both groups decreased to some extent,which was 1 944.55±41.76 in control group and 1 692.40±85.08 in ovariectomy group respectively (P=0.000).However,the average maximal load of ovariectomy group decreased more significantly.Having application of repetitive minor trauma to the bone,the number,the length and the density of linear crack of cortical bone were 3.40± 1.67,216.80± 17.60 μm and 0.40±0.08/mm2 in ovariectomy group,and 2.00± 1.17,160.45± 16.89 μm and 0.29±0.13/mm2 in control group 4 weeks later.And after 8 weeks,they were 5.15±1.18,334.60±13.94 μm and 0.35±0.10/mm2 in ovariectomy group,and 3.10±1.37,182.10±9.80 μm and 0.24±0.09/mm2 in control group.The number,the length and the density of linear crack of cortical bone were all significantly higher in ovariectomy group than that of in control group both on week 4 and on week 8 after operation.Conclusion Ovariectomy increases the porosity of cortical bone of rabbit,destroys its biological property,accelerates the fatigued damage and delays the healing process.These changes may be attributed to fracture and delayed union after fracture.

Pediatric urinary incontinence (PUI) is common in clinical practice and seriously affects the quality of life as well as physical and mental health of patients. PUI is a multi-factorial related abnormality, very complex in etiology and types. The occurrence of PUI is mostly associated with abnormal vesicourethral function. Urodynamic examination (UDS) is the golden standard to assess voiding function and diagnose the type of bladder and urethral function in children with PUI. UDS of PUI is of great clinical value in determining the cause, making treatment protocol as well as evaluating the therapeutic response. However, UDS in children has not been popularized in China, which seriously affects the diagnosis and treatment of PUI. This article reviews the research progress in the clinical application of UDS in the evaluation of PUI, in order to provide reference for improving the diagnosis and treatment of this disease.