Objective:To observe the clinical efficacy of Shenfu Injection for the most gastric resection.Methods: ASA II-III patients undergoing elective surgery for 60 patients with subtotal gastrectomy, were divided into experimental group, control group randomly. The experimental group was divided into Shenfu group (A), the control group treated with dopamine (B). In the A group before induction of anesthesia with intravenous injection of 0.8ml/kg of Shenfu injection,and group B received balanced salt to maintain anesthesia, the disposal of the same. Patients were given dopamine, atropine and other vasoactive drugs, there were recorded before anesthesia(T0), immediately after tracheal intubation (T1), 30min after intubation (T2), 1h after intubation(T3) hemodynamics.Results: Compared with the control group, the experimental group canachieve hemodynamic stability time earlier, smaller influence on the fluctuation of blood pressure.Conclusion: Shenfu Injection on patients with coronary heart disease underwentsubtotal gastrectomy to improve the stability of circulation system.

Objective To study the effects of Multi-Walled Carbon Nanotube with different doses on the cellular proliferation of human embryo kidney 293 cells.Methods The cultured human embryo kidney cell line 293 was seeded into 96-well plates and various concentrations of Multi-Walled Carbon Nanotube were added into different groups of culture.Methyl thiazolyl tetrazolium(MTT)assay were applied to detect the cellular viabilities after being incubated with Multi-Walled Carbon Nanotube for 48 hours and the results were calculated with specific static software to protract the cell viability curve.Results The Multi-Walled Carbon Nanotube had different effects of inhibiting the multiplies of 293 cells depending on its concentrations.In addition,when the concentration of Multi-Walled Carbon Nanotube reached over 0.5ug/ml,the inhibition became significantly.Conclusions Multi-Walled Carbon Nanotube can penetrate the cell membrane of 293 cells to influence the activities of cells and the ability of proliferation will be decreased significantly when the concentration came to some degree.Therefore,the safety dosage of the Multi-Walled Carbon Nanotube on human normal embryo kidney 293 cells were estimated in this research.

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction (AMI) patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group (group1, n=40 cases) and the later onset group (group2, n=48 cases) according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 (P<0.05). The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 (P < 0.05). Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.

Objective To explore the dispassed reason of Anhui provincial health senior titles evaluation.Methods The senior professional titles of the year 2009-2011 assessment results which were announced by the office of personnel titles of Anhui Provincial Health Department and the recorded results of the jury assessment were analyzed.Results In Anhui Province from 2009 to 2011 for three years,a total of 4 523 people participated in the senior title review by staff 3 039 people,by the proportion of 67.2％.2009,2010,2011 pass rate was 69.14％,66.85％,65.89％,respectively.1 484 people did not pass,and the rate was 32.8％.The main reason was the lack of reporting by professional and technical proficiency,non-standard format of application materials,assessment reporting material falsification.Conclusion Increasing the professional title appraisal policy propaganda,assessment focus which should be focused,the RAE quantitative score standards of health senior professional title,the establishment of a senior title of the series of health reporting assessment information system can improve this conditions.

Objective:For the further studies on the physical foundation of medicinal effi cacy of decoction of Fructus Schisandrae,to study its constituents absorbed into blood of rats after oral administration.Methods:Serum pharmacochemistry of Chinese medicine was used,based on the established high performance liquid chromatography analytical method of plasma effective constituents,to identify the constituents originated from the preparation and their metabolites in the serum by comparing fi ngerprint in vitro with that in vivo.Results:Five constituents have been detected in the blood,they were compound 1,2,3,4,5.Conclusion:Compound ⅣandⅤexist originally in Fructus Schisandrae decoction(including schisandrin),compound 1,2and 3 might be the metabolites of original constituents.

Objective To investigate the experience and needs of caregivers of patients with hematopoietic stem cell transplantion (HSCT) , in order to provide the basis for targeted intervention. Methods Using qualitative phenomenological research methods, semi- structured interviews of 10 caregivers of HSCT patients were conducted, then the data were summarized and analyzed. Results Four themes were extracted: heavy caregiving burden, adaptation to the caregiving role, professional support needs, humanistic care needs. Conclusions The medical staff should strengthen the health education on HSCT caregivers to improve their ability and their own health concerns, alleviate their psychological pressure, and mobilize social forces to reduce the burden of care.

Objective To observe the impact of improving the compliance of ventilator bundle on morbidity of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients undergoing mechanical ventilation (MV) guided by context of Joint Commission International (JCI) settings, and to study the oral care efficacy of suction tube sponge brush. Methods A prospective study was conducted. The patients who needed MV admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Xiamen University from January 2013 to December 2016 were enrolled. In the context of JCI settings, necessary measurements were taken to enhance the compliance of ventilator bundle each year. In 2013, the preventive measures were set up and the education was strengthened. In 2014,the compliance of hand hygiene and bedside elevation was strengthened. In 2015, a control study was conducted to evaluate the effect between the traditional cotton dipped in chlorhexidine and the suction tube sponge brush rinsed with chlorhexidine on oral health impact parameters. The suction tube sponge brush rinsed with chlorhexidine oral care was introduced to improve compliance. In 2016, electronic bundle checklist for daily self-audits was conducted. The annually morbidity of VAP through the software of hospital and ICU was collected and calculated. The annual incidence of VAP was indicated by the VAP cases per 1000 MV days. Based on the VAP incidence rate in 2013 as 1, the VAP incidence-rate ratio (IRR) of each year was calculated. Results During the study period, a total of 2733 patients admitted to the ICU, including 1403 patients undergoing MV. Ninety-four of the 1403 patients with community-acquired pneumonia (CAP), aspiration pneumonia, back elevation ban, incomplete information, and withdrew from the study were excluded. 1399 patients undergoing MV were enrolled in the final analysis, with total MV days of 11012 days, and 94 patients occurred VAP. The annual incidence of VAP was progressively declined from 2013 to 2016, and the VAP cases per 1000 MV days were 17.0, 10.0, 5.9, 3.5 cases, respectively. Based on the VAP incidence rate in 2013, the IRR of VAP from 2014 to 2016 was also progressively declined, which was 0.59 [95% confidence interval (95%CI) = 0.35-0.98], 0.35 (95%CI = 0.18-0.64), and 0.21 (95%CI = 0.09-0.41), with statistical significance (all P < 0.05). In 2013, ICU patients had the lowest rates of bedside elevation and hand hygiene compliance, which were 28.57% and 54.29%, respectively. Compared with 2013, by the implementation of two quality control circle (QCC) projects for bedside elevation and hand hygiene, the rates of bedside elevation and hand hygiene compliance were improved significantly in 2014, which were 82.35%, 91.18%, respectively (both P < 0.05). In 2015, the compliance of chlorhexidine oral care which was the worst performed in 2014 had been improved by the method of QCC, and the rate of the compliance was significantly higher than that in 2013 (87.10% vs. 62.86%, P < 0.05). Compared with 2013, bundle compliance was significantly increased in 2016, except for the sterile operation of the suction tube [daily wake and weaning: 95.00% vs. 71.43%, bedside elevation for over 30°: 92.50% vs. 28.57%, hand hygiene: 97.50% vs. 54.29%, chlorhexidine mouth care once per 6-8 hours:95.00% vs. 62.86%, turned back and posture drainage: 97.50% vs. 80.00%], the differences were statistically significant (all P < 0.05). The incidences of bad breath, dirt residue and plaque were significantly lower in the group of oral care by using suction tube sponge brush with chlorhexidine (30 cases) compared with the group of traditional cotton pad with chlorhexidine (30 cases; bad breath: 10.0% vs. 40.0% %, dirt residue: 16.7% vs. 70.0%, plaque: 3.3% vs. 30.0%, all P < 0.05). There was no significant difference in the incidence of oral ulcers between the oral brush group and the traditional group (10.0% vs. 30.0%, P > 0.05). Conclusion Ventilator bundle can effectively reduce the morbidity of VAP in the context of JCI settings, and the oral care by using suction tube sponge brush and chlorhexidine can effectively improve oral hygiene.

To set up a new rapid method for the rapid determination of influenza virus H5N1 and H7N9 basing on the Multi-Analyte Suspension Array (MASA) technology. Sequence analysis and design of degenerate primers and specific probes were set in the comparison and analysis of H5, N1, H7 and N9 genes. In combination with MASA technology, these primers and probes were used for the determination of samples of H5N1 and H7N9 and other subtypes ( H1N1, PH1N1, H5N2, H3N2 and H9N2). We developed a rapid determination method. This method had high specificity and sensitivity that could detect H5N1 and H7N9 at one time, and could detect samples that containing 10 copies of H5N1 and H7N9. This determination method could be used for rapid determination of influenza virus H5N1 and H7N9 at one time.
Humans ; Influenza A Virus, H5N1 Subtype ; classification ; genetics ; isolation & purification ; Influenza A Virus, H7N9 Subtype ; classification ; genetics ; isolation & purification ; Influenza, Human ; virology ; Oligonucleotide Array Sequence Analysis ; methods

Objective To explore the association between toll-like receptor 7 (TLR7) single nucleotide polymorphisms (SNP) and susceptibility of hand, foot and mouth disease caused by enterovirus (EV)71 infection.Methods The genotype of SNP (rs179019 and rs3853839) was determined in 775 EV7l-infected cases (including 439 mild cases and 336 severe cases) and 748 healthy control cases with TaqMan assay.The difference of allele frequencies was compared.The difference of TLR7 mRNA expression in peripheral blood mononuclear cells (PBMCs) derived from different SNP genotype carriers was detected.PBMCs derived from different SNP genotype carriers were stimulated by imiquimod and the TLR7-specific interferon-α(IFN-α) and interleukin-6 (IL-6) secretions were detected.Logistic regression was used to analyze for genotype frequency.Results The frequencies of rs3853839 genotype CC and CG in female patients of severe group were significantly higher than mild group (rs3853839 GC: OR=0.36,95%CI:0.14-0.82, P=0.01;rs3853839 CC: OR=0.19,95%CI:0.11-0.69,P=0.01).In addition, the frequency of rs3853839 genotype C in severe male group was significantly higher compared with that in mild group (OR=0.35,95%CI:0.19-0.63, P=0.01).Female carriers with rs3853839 genotype CC had significantly lower TLR7 mRNA expression than genotype GC and GG (CC vs GG: P=0.005;CC vs GC: P=0.016).Male carriers with rs3853839 genotype C also had significantly lower TLR7 mRNA expression than genotype G (C vs G: P=0.004).After stimulation of imiquimod, the expression of IFN-α (CC vs GG, P=0.001;CC vs GC: P=0.026) and IL-6 productions (CC vs GG: P=0.001;CC vs GC: P=0.011) were significantly lower in female carriers with rs3853839 genotype CC.The same patterns were observed in male carriers with rs3853839 genotype CC (IFN-α: P=0.003;IL-6: P=0.018).Conclusions The rs3853839C allele is the risk factor of severe infection of EV71, which may be due to specific cytokine profiles in rs3853839C allele carriers in children.

Humanistic doctor-patient communication is an essential capability for medical workers and is as impor -tant as medical technology .Its education has been getting more and more attention in recent years .However , the training and evaluation of humanistic doctor-patient communication as a practical other than theoretical capability has been difficult .A new method , clinical scenery drama , based on psychodrama and role theory , is developed by Dept.of Psychological Medicine , Peking Union Medical College Hospital from recent 10 years of medical doctor and student training .In clinical scenery drama , medical students are thrown to different roles to empathize with their feelings and conflicts , try to resolve clinical dilemma with humanistic communication technique besides medi-cal technology .Then the sharing and comments from teachers and observers help students to understand the situa -tion from other perspectives and think about other possible solutions .