Objective To investigate the effect of pulmonary surfactant on neonatal with acute respiratory distress syndrome.Methods98 cases with neonatal respiratory distress syndrome inthe fourth hospital of Ningbo were randomly divided into experimental group and control group, 49 cases in each group.All patients were given warm, anti infection, and maintain the internal environment stability, prevention of bleeding and other conventional treatment.The control group were treated with mechanical CPAP, the experimental group were given pulmonary surfactant 70mg/kg, concentration is 35mg/mL.Pulmonary surfactant was injected slowly by tracheal intubation at supine, lateral(left, right) and semi recumbent position.The drug was distributed evenly in the lung of the patients who were given the drug 1-2 times.Respiratory frequency (RR), pH, oxygen partial pressure (PaO2), partial pressure of carbon dioxide (PaCO2) levels and the incidence of complications, clinical effective rate of the tthe two groups were observed and compared.ResultsCompared with pre-treatment, RR and PaCO2 levels were decreased, pH and PaO2 levels were increased after treatment in the two groups, the differences were statistically significant (P<0.05);compared with the control group, RR, PaCO2 level were lower, pH and PaO2 levels were higher in the experimental group, the differences has statistical significance (P<0.05);compared with the control group, the experimental groupwith a low incidence of complications, clinical effective rate is higher, the difference was statistically significant (P<0.05).ConclusionPulmonary surfactant can reduce the respiratory frequency in neonatal with acute respiratory distress syndrome, improve arterial blood gas levels, which get better clinical curative effect.

Objective To establish the questionnaire of nursing assistant requirements of county hospital, test and analyze its reliability and validity. Methods According to the nursing assistant requirements framework had been constructed, document literature and interview to develop a questionnaire item pool, then established the prequestionnaire after research group discussion and expert evaluation. 250 clinical nurses were selected for investigation. Then item analysis,factor analysis, correlation analysis and reliability analysis were applied to test the scale′s validity and reliability. Results The effective questionnaire was 224 copies. Questionnaire of nursing assistant requirements was consisted of 44 items, the factor analysis of the questionnaire identified six principal factors and explained for 53.225% total variances. Correlation coefficient between each dimension and the total scale was 0.532-0.794, the Cronbach α coefficient of each dimension was 0.789-0.910,the Cronbach α of whole scale and split- half coefficient were 0.923 and 0.868. Conclusions The questionnaire of nursing assistant requirements of county hospital has high reliability and validity.It can provide a scientific basis for county hospital to carry out nursing assistance.

Objective To investigate and analyze the nursing assistance requirements and the influencing factors of county hospital of Nanchang city.Methods A total of 327 nurses in 6 country-level hospital of Nanchang city were surveyed by the self-made questionnaire.Results The total demand score of county hospital was (4.29±0.47) scores,which was in a high level.The helping content demand was the highest,the form of assistance needs was the lowest.From the specific items of view,prevention of incision infection,nursing training,critically ill patients with bedsore nursing were higher in the content of assistance.Send a nurse to support education,nursing training,hospital experts on-site guidance were higher in the form of assistance.Long term assistance for 1 years,short-term assistance for 4-6 months were the highest in demand of helping times.The main factors of influencing county hospital nursing assistance were work area,department,degree,title etc.The work area was the important influencing factor of nursing assistance of county hospital.Conclusion The relevant departments are recommended to develop personalized assistance scheme according to the recipient hospital needs.

Objective To determine whether hemostatic agents directly injected into injury sites under the guidance of contrast-enhanced ultrasound(CEUS)can effectively control hemorrhage from hepatic or splenic trauma. Methods Healthy adult dogs were impacted by a impactor to create hepatic or splenic trauma. Among 32 dogs,28 had hepatic or splenic injury of grade Ⅲ～Ⅳ according to Injury Scale of the American Association for the Surgery of Trauma(AAST),which were divided into two groups,the treatment group and the control. In the treatment group,hemocoagulase and α-cyanoacrylate were injected respectively into the injury site and transected micro-vessel tinder the guidance of CEUS,while in the control group,normal saline was injected. Results All animals of the two groups survived after the injection. CEUS demonstrated that active hemorrhage disappeared in treatment group but still existed in the control group.In the treatment group,laparotomy showed that hepatic or splenic injury had been covered and adhered with clot and glue membrane of hemostatic agents and free intraperitoneal blood volume was significantly less than that in the control group(P=0.000),while in the control group injury bleeding did not stop after injection. Conclusions Hemostatic agents injected under the guidance of CEUS can effectively control hemorrhage from hepatic or splenic trauma of grade Ⅲ～Ⅳ. This therapy was simple,convenient and effective. It may be performed immediately after hepatic or splenic injury was diagnosed.

Objective To establish a reproducible rat model of acute rectal mucosal injury induced by acetic acid. Methods Fifteen healthy Sprague-Dawley rats were randomly divided into the control group (3 rats) and experimental group (12 rats).Acute rectal mucosal injury was induced by 4%acetic acid using a cotton swab inserted into the rat rec-tum for 1 min to a depth of 3 cm.The morphological characteristics were analyzed by the naked eye and histology at 0.5 h and 1, 4, and 6 days after acetic acid intervention.Results All rats survived 6-day study period.The successful rate of model establishment was 100%.From 0.5 h to 1st day after acetic acid intervention, the gross morphology of recta showed congestion, edema and ulcer to ulcer complicated with hemorrhage.The histology showed necrosis and hemorrhage of the epithelial tissue of the mucosa to complete and extensive necrosis of the mucosa.The glandular structure showed partial to complete loss.The submucosa showed edema to edema complicated with hemorrhage and congestion.The interstitial tissues showed vasodilatation and congestion to inflammatory cell invasion.From 4 to 6 days after acetic acid intervention, the rectal mucosal changes were obviously improved.Epithelial and glandular regeneration and inflammatory granulation occurred, but not fully recovered, some edema and redness, partial lack of glands were still present.Conclusions 4%acetic acid for 1 min can be used to successfully induce rat model of acute rectal mucosal injury.This procedure is easy to operate, with a high success rate,reproducible, and the alterations are lasting more than 6 days.This animal model is very suitable for rapid screening of topical drugs for the treatment for rectal mucosal injury.

Purpose:The aim of this study was to investigate the diagnostic value of color Doppler Ultrasound in Budd-Chiari Syndrome (BCS) with hepatic venous(HV) outflow obstruction.Materials and Methods:The features of ultrasonography in 138 patients of Budd-Chian Syndrome were analyzed and compared with that of angiography.Results:83 patients had membranous obstruction and 45 segmental occlusion of HV.10 patients had HV stenosis.The ultrasound was able to reveal stenosis,atresia,emboli,or membranous obstruction in hepatic venous outflow tract.Collateral branches could be seen between the hepatic veins with short hepatic vein expanded.Both HV and IVC were involved in 35 cases,with thrombus in IVC in 11 and HV in 7.There was two false positive cases and 3 false negative in ultrasound diagnosis.Conclusion: The position and type of occlusion in HV could be accurately detected by color Doppler ultrasound,and so was the existence and degree of collateral circulation,which were of aid for the operation and follow-up.

Objective To compare the value of contrast-enhanced ultrasonography (CEUS) with that of laparoscopic ultrasonography (LUS) in localization diagnosis of insulinoma. Methods Thirty-three patients with insulinoma,who received operation, were retrospectively reviewed. All cases were examined by both CEUS and LUS before the tumor removed. Both imaging modalities in diagnosis of insulinoma were analyzed. Results By this study the sensitivity and accuracy of CEUS were 92.31% and 90.0% respectively. Those of LUS were consistent with pathologic findings completely. The accuracy of CEUS was not different with that of LUS (χ2 = 4.21, P = 0. 04). Conclusions CEUS can be used for location diagnosis of insulinoma. For the patients expecting laparoscopic treatment, combination of CEUS with LUS will be suggested before insulinoma is removed.

The comparative analysis of the biological characterization and the genetic background study of EV71 circulating strains is commonly recognized as basic work necessary for development of an effective EV71 vaccine. In this study, we sequenced five EV71 circulating strains, isolated from Fuyang, Hefei, Kunming and Shenzhen city of China and named them FY-23, FY-22, H44, K9 and S1 respectively. The sequence alignment demonstrated their genotypes be C4. The genetic distance of the VP1 gene from these isolates suggested that they were highly co-related with genetic identity similar to other previously reported EV71 strains in China. Additionally, these strains were identified to display some obvious proliferation dynamics and plaque morphology when propagated in Vero cells. However, a distinctive difference in pathogenic ability in neonatal mice was found. Some differences in cross neutralization test & immunogenic analysis were also found. All these results are related to the biological characterization of circulating EV71 strains in China and aid in the development of an EV71 vaccine in the future.

Objective To provide a comprehensive reference index for different mouse models of herpes simplex virus 1 (HSV-1) infection by investigating the related clinical manifestations, pathological features and characteristics of viral distribution in tissues and organs of BALB/c mice infected with different HSV-1 strains by using different strategies.Methods Acute infection models were established by challenging BALB/c mice at age three or six weeks with HSV-1 17+ and McKrae strains via intranasal and corneal administrations.Correspondingly, chronic infection models were established with BALB/c mice through subcutaneous and foot pad injections.Results Although all experimental mice showed trichiasis and roachback, there were differences in weight and fatality rate among different groups.Results of the quantitative PCR detection indicated that the proliferation of HSV-1 in the nervous tissues (brain, spinal cord, trigeminal ganglion) varied among different groups.The pathological examination indicated that in the acute infection groups, significant pathological changes only occurred in the brain tissues, while in the chronic infection groups, pathological injuries only occurred in the trigeminal ganglia.Although a key index latency-associated transcript (LAT) was not detected in the trigeminal nerve tissues of mice in the chronic infection groups, co-culturing the tissues with Vero cells resulted in infectious lesions in the cells.Conclusion This study indicates that there are significant differences in weight and fatality rate among different BALB/c mouse models of HSV-1 infection.Varied replication dynamics of HSV-1 were observed in different tissues or organs of the BALB/c mice in different groups.Therefore, different indexes should be adopted to evaluate different HSV-1 infection models.

Objective To explore the value of contrast-enhanced ultrasonography ( CEUS ) breast predictive model in the optimization of BI-RADS classification of breast lesions . Methods A total of 1049 BI-RADS 4 ,5 breast lesions were obtained from 1039 patients in 8 centers . CEUS examination was performed prior to biopsy or surgery . According to the classification of the model ,class 3 ,4A ,4B and 4C were selected as biopsy thresholds ,and the ROC curve was drawn . The diagnostic sensitivity ,specificity , accuracy ,positive predictive value ,negative predictive value and Jordanian index were calculated for the biopsy threshold . The biopsy rate of breast lesions before and after angiography ,cancer detection rate , follow-up cases of malignant risk were compared . Results There were benign lesions 586 ( 55 .9％ ) , malignant lesions 463 (44 .1％ ) in the 1049 breast lesions . The area of ROC with thresholds of 3 ,4A ,4B and 4C were 0 .695 ,0 .838 ,0 .847 and 0 .757 ,respectively ( all P < 0 .01) . Ultrasonography had a certain diagnostic effect on benign and malignant breast lesions . The diagnostic sensitivity ,specificity ,accuracy , positive predictive value and negative predictive value with class 4A after CEUS set as the biopsy threshold were 93 .32％ ,75 .65％ ,82 .75％ ,75 .57％ and 93 .35％ ,respectively ,and the Jordanian index was 0 .690 . When chass 3 after CEUS was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 76 .74％ ,the detection rate was increased from 44 .23％ to 56 .77％ ,and the risk of cancer was only 0 .67％ in the follow-up cases . When class 4A was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 55 .58％ after CEUS . The detection rate of cancer increased from 44 .23％ to 74 .44％ . The risk of cancer was 2 .96％ . Conclusions The biopsy rate of breast lesions in category 4 and 5 would be reduced and cancer detection rate of them would be increased after CEUS ,however ,the risk of malignancy in the follow -up cases would be controlled as low as category 3 and 4A in previous BI-RADS . Thus ,CEUS has a good prospect of in optimizing BI-RADS and reducing biopsy rate in unnecessary lesions .