Objective To study the effects of sucking sputum with face upwards and neck raised in order to supply a new method for sputmn sucking.Methods One hundred and twenty-three patients were randomly divided into the experimental group(n=61)and the control group(n-62).The experimental group adopted modified mode:cleaned up the sputum within the mouth and nasal cavities with the traditional manner firstly,then the patients lay down,the nurses raised the patients'neck softly with one hand,removing the pillows,while putting the hypothenar of the other one on his forehead,kept the airway open to suck sputum.The control group adopted common mode,but using the modified method when the common mode failed.Results There was significant difference in phlegm sucking effect between the two groups(P＜0.01).Besides,the first-time success rate d tube insertion,incidence of trachcotomy,mucosal injury and hemorrhage and satisfaction degree of patients'family were statistically different between the two groups(P＜0.01).Conclusion Sucking sputum with face upwards and neck raised waS superior to the traditional one.

Objective To investigate protective of umbilical cord-mesenchymal stem cells ( UC-MSC ) on idiopathic pulmonary fibrosis ( IPF ) experimental mode was induced by bleomycin in mice .Methods IPF experimental mode induced by bleomycin with intratracheal injection , and then the fourth generation UC-MSC was injected in caudal vein.The lung tissues were obtained to evaluate the influence of UC-MSC on IPF by the observation of histological evaluation(HE) and Masson staining, the detection content of hydroxyprine(HYP), superoxyde dismutase(SOD) and malonaldehyde ( MDA) .Results The HE and Masson staining showed that bleomycin +UC-MSC group could alleviate inflammatory cell infiltration and pulmonary interstitial collagen deposition.bleomycin+UC-MSC group could decline the content of HYP(P<0.01), MDA(P<0.05) and improve the content of SOD(P<0.01)compared with bleomycin group.Conclusion UC-MSC exhibits an protective effect on IPF experimental mode induced by bleomycin in mice.

Objective To explore the role of astrocytes transient receptor potential channel 6(TRPC6) in rat brain injury (TBI).Methods Thirty-nine male Sprague-Dawley(SD) rats were divided into the sham operation group,injury group and deferoxamine(DFX) group(n=13).According to the previous model construction scheme established by our research group Feeney method,the rat brain impact injury model was established.The Morris water maze test was performed and the defected brain volume was measured.The immunofluorescence was adopted to detect the co-expression of TRPC6 and GFAP.Then Western blot was performed.Results The defected brain volume after TBI in the DFX group was significantly decreased compared with the injury group [(115.35 ± 13.70)mm3 vs.(209.99 ± 16.70)mm3]] (P＜0.05).The Morris water maze test found that the platform search strategy and search time in the DFX group were(3.13 ± 0.35) and(36.15 ± 26.63)s,which were significantly improve d compared with (2.13±0.64) and(110±47.34)s in the injury group(P＜0.05).The immunofluorescence found that GFAP in the DFX group was highly expressed,moreover the co-expression with TRPC6 was increased.Western blot found that TRPC6 in the DFX group was significantly down-regulated(P＜0.01).Conclusion In rat TBI early stage,strocytes are activated after DFX treatment and TRPC6 is highly expressed,playing a neuroprotective role.

Objective To discuss the practice of nursing management model of stroke unit based upon the international standards implemented in the neurological unit.Methods The experiences of the stroke unit management were summarized and applied to instruct the clinical practice.Results After the implementation,the average hospitalization days,the proportion of drugs,medical cost,and mortality rate decreased.The satisfactory degree of patients with the stroke unit increased.Conclusions The nursing management model of stroke unit not only improved the quality of nursing service to stroke patients,but also decreases the mortality and disability rate,shortened the length of hospital stay,and enhanced the satisfaction degree of patients and their family members.

Objective: To explore the mechanisms of emodin in protecting intestinal mucosal barrier in rat with severe acute pancreatitis (SAP). Methods: Sixty SD rats were randomly divided into three groups: sham-operation group, untreated group, and emodin group. SAP in rats of the untreated group and the emodin group was induced by retrograde pumping of 3.0% sodium cholate to the common bile duct. Specimens were obtained 24 hours after the severe acute pancreatitis was induced. Serum level of leptin, serum activity of amylase and plasma content of endotoxin were measured. Ileum mucosa from ileocecal junction was observed by light microscopy and electron microscopy to measure pathological and ultrastructural changes. Apoptosis of ileum mucosal cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method, and expression of Bax in ileum mucosal cells was measured by immunohistochemical method. Results: Compared with the sham-operation group, there was significant increase in the levels of leptin, endotoxin, the activity of amylase, apoptosis index and Bax expression in the untreated group (P<0.01). Compared with the untreated group, the level of endotoxin, apoptotic index and Bax expression level in the emodin group were significantly reduced (P<0.01) and the leptin level was increased (P<0.05). More severe pathological changes appeared in the untreated group than in the sham-operation group under the light and electron microscopes; meanwhile less severe damage was observed in the emodin group as compared with the untreated group. Conclusion: Emodin can inhibit the apoptosis of intestinal mucosa cells and up-regulate the serum leptin content to protect the intestina1 barrier function and prevent the translocation of bacteria and endotoxin.

Objective To explore the significance and important measure of integrative treatment of multiple trauma patients with severe craniocerebral injury in emergency center. Methods One hundred and forty-eight multiple trauma patients with severe craniocerebral injury in emergency center from November 2002 to February 2006 were analysed retrospectively. Result In total 148 cases, 72 were cured and 26 dead, 7 were in status of plant man, 17 experienced severe deformity, and 26 did mild deformity. Conclusion Multiple trauma patients with severe craniocerebral injury usually experience a serious situation and rapid development. Therefore emergency doctors are required for organizing salvage of such patients, at the same time treatment and diagnosis are implemented. Firstly the most important key to successful salvage is appropriate disposal of fatal injury and early elimination of shock. Proper surgical choice, especially at the first time, inspection and protection of visceral functions, and attention to nutritional support are other vital methods to gain more successful salvage. ICU is also emphasized for its essentiality.

AIM To study the chemical constituents from Buthus martensii Karsch.METHODS The dichloromethane and 70％ methanol fractions of B.martensii extract were isolated and purified by silica,ODS,Sephadex LH-20 and mid-pressure preparative column,then the structures of obtained compounds were identified by physiochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as cholest4-en-3-one (1),cholesterol (2),uracil (3),1-stearyl-2-lyso-sn-glycero-3-phosphatidylcholine (4),glycerol (5),oleic acid (6),proline (7),alanine (8),leucine (9).CONCLUSION Compounds 1,4,5 are isolated from B.martensii for the first time.

Objective:To investigate the role of scavenger receptor BⅡ(SR-BⅡ) in the oxidized low density lipid(ox-LDL) induced foam cells formation promoted by porphyromonas gingivalis(P.g).Methods:Peritoneal macrophages were stimulated with P.g and ox-LDL,and then foam cells formation were checked.The expression of SR-BⅡ was detected by Western blot and real-time PCR.Next,siRNA targeting SR-BⅡ was used to detect the change of foam cells formation.Results:After being stimulated with P.g and ox-LDL,the foam cells formation was significantly increased.During the process of foam cells formation,P.g infection increased the expression of SR-BⅡ.And the knockdown of SR-BⅡ by siRNA significantly reduced the foam cells formation.Conclusion:P.g infection can increase the expression of SR-BⅡ and the regulation of SR-BⅡ expression can change the foam cells formation.

The main causes of early mortality after the earthquake are traumatic shock, hemorrhage and dehydration, and the ratios of shock and hemorrhage are high in patients with abdominal injuries. Prompt triage is very important to persons with abdominal injuries who were rescued in 48 hours after the earthquake. Primary triage should be carried out in the rescue field, and then followed by the secondary triage in the hospital. We improved the efficiency and accuracy of triage by following the principle of "5 steps, 3 categories and 1 indication". Nineteen persons with identified abdominal injuries and unstable vital signs received operation. The false positive rate was 5% (1/19), and the successful rate of the operation was 95% (18/19). During the process of rescue, the lives of the injured persons should be put in the first place. The operation should be performed under the principle of simpleness, rapidity and safeness.

Objective To investigate the protective effect of GSH on lung injury in rats with severe acute pancreatitis(SAP) and investigate the mechanism of severe acute pancreatitis associated lung injury. Methods Fifty-four Spragwe Dawley rats were randomly divided into three groups: control group, model(SAP)group and herbal group. Rats in model group and herbal group were induced pancreatitis by retrograde injection of 5% sodium taurocholate into the pancreatobiliary duct. Animals were killed at 3h, 6h, 12h after injection. The serum amylase was examined at 3h, 6h, 12h after injection. Pulmonary tissue fluid content was measured.The expression of pulmonary TNF-α mRNA and LIF mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Results The serum level of amylase was lowered significantly in herbal group in comparision with that in model group (P<0.05) and pulmonary tissue fluid content in herbal group was reduced compared with model group (P<0.05). Similarly, the level of pulmonary TNF-α mRNA and LIF mRNA expressions was both significantly reduced in herbal group compared with model group (P<0.05). LIF mRNA was not examined in normal control group. Conclusion Treatment with GSH can prevent lung injury of rats with SAP.