Objective To investigate and improve the methods of nasal feeding to reduce the occurrence of complication such as diarrhea and vomiting.Methods We separated 140 patients with heavy craniocerebral injury into the control group (50 patients) and the experimental group (90 patients) according to different nasal feeding methods. For the control group traditional method was used. For the experimental group infusion pump was used to control infusion rate. The incidence of complication was compared between two groups. And within experimental group, the same nutrient solutions in respect of type and volume were infused during 10 hours, 16 hours, and 18 hours respectively. The relationship between infusion rate and the occurrence of complication was observed, analyzed and compared to seek for the most suitable enteral nutrition route which incurred the least complication.Results The incidence of diarrhea and vomiting in the experimental group was lower than that of the control group. And there were no significant differences in the occurrence of complication by using infusion pump at three different infusion rates within the experimental group. Conclusions The application of infusion pump in nasal feeding can reduce the incidence of complication and infusing nutrient solution at a slow rate was not necessary.

Objective To determine the relative factors of the onset of repeated ectopic pregnancy. Methods The clinical data of the first time ectopic pregnancy of 28 cases with repeated ectopic pregnancy were analysed, and compared with those of 56 cases of non-repeated ectopic pregnancy onsetting at the same period. The factors measured included: age at onset of disease, age at first coitus, gravidity, parity, methods of contraception, duration of amenorrhea,duration of vaginal bleeding, serum ?-human chorionic gonadotropin level, volume of intraperitoneal bleeding, types of ectopic pregnancy, methods of therapy and inflammation evidence of fallopian tube. Logistic regression analysis was performed to determine the relative factors for onset of repeated pregnancy. Results The risk factors and its odds ratio (OR) from the multivariate analysis were as follow: anastomosis of the tube(62.74, P=0.043), positive evidence of inflammation of the tube (54.85, P=0.000), no contraception (11.29, P=0.002), contraception by condom occasionally (4.75, P=0.046); the protective factors and its OR were as follow: therapy being salpingectomy and sterilization of the opposite tube(0.06, P=0.049), oral contraception (0.10, P=0.050) and pharmacotherapy (0.33, P=0.002). Conclusions The risk factors of onset of repeated ectopic pregnancy include: anastomosis of the tube, positive evidence of inflammation of the tube, no contraception and contraception by condom occasionally; the protective factors include: therapy being salpingectomy and sterilization of the opposite tube, oral contraception and pharmacotherapy.

Vehicle driver fatigue is an important factor in traffic accidents.This paper introduced three kinds of detecting techniques,namely driver's physical signals and individual characteristics,vehicle parameters,and five detecting devices.But there still are limitations of the mentioned detecting techniques and devices in the paper.The problems and developing trend are briefly analyzed.

[Objective] To summarize the therapeutic and nursing care of vacuum sealing drainage to treat skin avulsion injury. [Methods]We used the method of vacuum sealing drainage combined with split thickness skin graft and pre-and post-operation nursing care to treatment of 21 patients suffering with skin avulsion injury, and compared therapeutic effect with routine therapy group. [Result]Skin graft survival rate in VSD group was higher than in routine therapy group. The dressing change, wound healing time, hospitalization time in VSD group were lower in routine therapy group. [Conclusion] The method of vacuum sealing drainage is good in treatment of intervention skin avulsion injury.

Through analyzing the teaching effect,collected disagreements and suggestions by questionnaire,combining our teaching rules,we proposed efficient innovative methods and suggestions in probation of obstertrics-gynecology.

Objective To investigate the effects of hydrogen gas on the myocardial injury in rats with endotoxemia.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 4 groups (n =12 each ):control group (group C ),hydrogen gas control group (group HC ),endotoxemia group (group E) and hydrogen gas + endotoxemia group (group LH).Endotoxemia was induced by intraperitoneal lipopolysaccharide (LPS) 20 mg/kg in groups E and LH,while the equal volume of normal saline was given in groups C and HC.After LPS administration,the rats were exposed to the air containing 2％ hydrogen gas for 6 h in groups HC and LH,and the rats were exposed to the air for 6 h in groups C and E.Blood samples were taken from the abdominal aorta after 6 h inhalation of hydrogen gas to determine the serum level of cTnI.The hearts were then removed to determine the content of TNF-α and IL-6 and expression of phosphorylated nuclear factor κB ( NF-κB) inhibitory protein (p-IκB-α) and p38 mitogen-activated protein kinase (p-p38MAPK) in the myocardial tissues.Results Compared with group C,no significant change was found in the levels of cTnI,TNF-α and IL-6 and expression of p-IκB-α and p-p38MAPK in group HC ( P ＞ 0.05),and the levels of cTnI,TNF-α and IL-6 were significantly increased and the expression of p-IκB-α and p-p38MAPK was up-regulated in groups E and LH ( P ＜ 0.05).Compared with group E,the levels of cTnI,TNF-α and IL-6 were significantly decreased and the expression of p-IκB-α and p-p38MAPK was down-regulated in group LH ( P ＜ 0.05).Conclusion Hydrogen gas can reduce the myocardial injury in rats with endotoxemia,and inhibition of the p38MAPK and NF-κB pro-inflammatory pathway and reduction of the inflammatory response of myocardial tissues are involved in the mechanism.

Objective To investigate the correlation between plasma D-dimer with delayed encephalopathy (DE) in patients with acute carbon monoxide poisioning(ACOP).Methods According to the severity of disease,100 patients with ACOP were divided into mild group (27 cases),moderate group (31 cases),severe group (42cases).And depending on whether DE occured,all patients were divided into DE group(20 cases) and no DE group (80 cases).4 venous blood samples were obtained separately from each subject in 1,7,14 days after their admission to hospital by using latex immunoturbidimetry.The levels of blood plasma D-dimer of patients in each group were detected by immune turbidimetry and analyzed,1th,7th and 14th day after admission.Results The plasma D-dimer level of the mild group at different time points was in the normal range,and the difference was not statistically significant(all P ＞ 0.05) ;The plasma D-dimer level of the severe group and moderate group was significantly higher than that of the mild group(all P ＜0.01),and it reached a peak in one week(7 days),and showed a downward trend after two weeks(14 days).The DE all occurred in the moderate and severe group.The plasma D-dimer levels of the DE group were higher than those of no DE group from admission to the 7 th and 14 th day (all P ＜ 0.01).Conclusion The dynamic monitoring plasma D-dimer is helpful in assessing to the severity and prognosis of ACOP,and could surpport positive clinical significance for the prevention and treatment of DE.

Humans ; Pneumoconiosis ; diagnostic imaging ; Radiographic Image Enhancement ; Radiography ; methods

Objective To evaluate development of gastro-esophageal reflux (GER) during laparoscopic surgery in lateral jack-knife position under general anesthesia through comparing with reverse Trendelenburg/ Trendelenburg position in the patients lying supine.Methods Ninety patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were randomly divided into 3 groups (n =30 each):lateral jack-knife position group (group L),Trendelenburg position group (group T) and reverse Trendelenburg position group (group Tre).Anesthesia was induced with midazolam,sufentanil,propofol and cisatracurium besylate and maintained with propofol and remifentanil given by target-controlled infusion.A pH-sensitive probe was inserted through nose into the lower esophagus and pH value was continuously recorded until 1 min after extubation.GER was defined as pH value ≤ 4 lasting for ≥ 1 min in the lower esophagus during surgery.The development of GER during surgery and the lowest pH value in the lower esophagus when GER developed were recorded.Results Compared with group Tre,the incidence of GER (27％) and total number of times GER had occurred were significantly increased in group L,and no significant changes were found in the indices mentioned above in L and T groups.When GER developed,the lowest pH value in the lower esophagus was 2.1 ± 1.3,2.6 ± 1.2 and 3.5 in L,T and Tre groups,respectively.Conclusion The incidence of GER is 27 ％ during laparoscopic surgery when the patients are in lateral jack-knife position and it is higher than that obtained with reverse Trendelenburg position in the patients lying supine.

ObjectiveTo analyze the clinical characteristics of Behcet's disease with intracardiac thrombus.MethodsThe data of 8 patients diagnosed as Behcet's disease with intracardiac thrombus in Peking Union Medical College Hospital from January,1990 to January,2011 were studied retrospectively.ResultsBehcet's disease with intracardiac thrombus was found in 8 patients (5 men and 3 women) with a median age of 28.5 years.Most of them were young men.Thrombus was mostly found in the right side of the heart.Most of the patients had pulmonary thromboembolism with negative anticardiolipid antibody and basically normal C-reactive protein and erythrocyte sedimentation rate.ConclusionIntracardiac thrombus associated with Behcet's disease most commonly occurs in young men and usually involves the right side of the heart.