Objective To explore the clinical effect of application of hospital information system in bedsore nursing process analysis.Methods To combine process management and continuous quality improvement organically,establish a complete set of the pressure ulcer management monitoring process,which was completed,networking,continuous for improvement and this process was used for the implementation of high-risk bedsore warning screening and bedsore informing,hospitalized patients with pressure ulcers online report system and level 3 monitoring system,bedsore nursing consultation system and pressure ulcer nursing intervention.Results The application of informatization in the pressure ulcer management process could effectively reduce the incidence of pressure ulcers,prompt bedsore nursing management level to be more standardized,scientific,and modernization.At the same time,it improved the patients' satisfaction degree with nursing work,meanwhile it let managers found that carrying out of pressure sores extended nursing service was imperative.Conclusions Application of hospital information system in bedsore nursing process analysis is satisfying,which is worthy of further development.

Objective To explore the application effect of implementing the accountability nursing mode in pediatric surgical ward.Methods On the basis of the transformation of nursing concept and the improving of understanding of High Quality Nursing Service Demonstration Project activities,strengthening basic nursing,establishing two-level nurse management framework,implementing the accountability nursing mode.The satisfaction degree of children's parents before and after the implementation was compared.Results The satisfaction degree of children's parents after the implementation of accountability nursing mode significantly improved.Conclusions After implementing accountability nursing mode in pediatric surgical ward,the satisfaction degree of children's parents improved,the harmonious development of nurse-patient relationship was promoted,the professional identity of nursing personnel was enhanced,and guaranteed the continuous improvement of quality of care.

Objective To analyze the correlative factors that affect the main complications caused by peripherally inserted central catheter puncture (PICC) on low birth weight infant with different puncture sites,in order to reduce the incidence of complications and achieve the purpose of indwelling safely.Methods A total of 431 infants with different PICC puncture sites were recruited in this study from January 2008 to January 2013,261 cases of them were punctured in the elbow upper extremity veins, 147 cases were in the elbows downward veins,5 cases were in the superficial temporal veins, 12 cases were in the axillary veins,and 6 cases were in the femoral veins.The complications occurring in the period of indwelling catheter were analyzed, and the effective treatments or preventive nursing measures were taken.Results 431 cases were punctured successfully.The sites of puncture were mainly in the veins of the upper arm,and the main complications were phlebitis,extremities swelling,jamming pipe and infection.The incidence of phlebitis, extremities swelling in the elbows downward veins were lower than those in the elbow upper extremity veins: 10.89％(16/147) vs.3.83％(10/261), 17.69％(26/147) vs.4.98％(13/261), and the differences were significant, x2=7.840, 17.561, P＜0.05.Conehusions The veins in the elbow and elbow downward are mainly selected.It is necessary to assess the complications promptly that may occur and to take effecdve measures,and good catheter maintenance consciousness also has important significance to the reduction of complications.

AIM To study the effects of endothelin 1(ET 1) on ClC 3 chloride channel protein expression in cultured bovine cerebrovascular smooth muscle cells (CSMC). METHODS Cell culture and Western blot. RESULTS ① The endogenous ClC 3 expression was found in basilar artery, middle cerebral artery, and microvessel; ② The molecular weight of expressed ClC 3 chloride channel protein was about 95 ku; ③ ET 1 enhanced ClC 3 protein expression which was inhibited by nifedipine and SK&F96365. Cyclopiazonic acid(CPA) increased the expression of ClC 3 protein in a concentration dependant manner, and enhanced ET 1 effect on this protein expression. CONCLUSION ET 1 stimulated ClC 3 chloride channel protein expression in cultured bovine cerebrovascular smooth muscle cells. The intracellular Ca 2+ plays an important role on signal transduction pathway in ClC 3 protein expression process.

Objective To investigate theeffect of ischemic postconditioning (IPO) on ischemia/reperfusion injury via mitochondrial pathway.Methods Male Sprague-Dawley rats were divided into three groups by means of random number table.Rats in IRI group and IPO group received liver transplantation.The portal vein in IRI group was opened immediately after liver implantation to restore the blood supply.The graft rats in IPO group received IPO before the portal vein was completely opened: 60-s ischemia and 60-s reperfusion of the portal vein,repeated 6 times).The rats in the sham-operation group were only subject to dissociation of the liver ligament.Six h after portal vein reperfusion,liver function was tested.The expression of Bcl-2 mRNA and Bax mRNA was detected by using real time-PCR.The protein expression of Cyt-c was detected by using Western blotting.The apoptosis and necrosis of liver tissue and the mitochondrial transmembrane potential were detected by using flow cytomertry.The changes of mitochondrial structure were observed under an electron microscope.Results The liver functions in IRI group and IPO group were significantly worse (P＜0.05),the levels of Bax mRNA were significantly higher (P＜0.05),the levels of Bcl-2 mRNA were significantly lower (P＜0.05),the levels of Cyt-c protein were significantly higher (P＜0.05),the levels of apoptosis and necrosis were significantly higher (P＜0.05),and mitochondrial transmembrane potential (MTP) of liver cells was significantly lower (P＜0.05) than in sham operation group.The changes of all the parameters in IRI group were more significant than in IPO group (P ＜ 0.05).The morphological changes of the liver mitochondria were also significantly aggravated in IRI group as compared with IPO group.Conclusion IPO reduced IRI by inhibiting the mitochondrial signaling pathway in rats undergoing liver transplantation.

AIM To study the effects of protein tyrosine kinase inhibitor and protein tyrosine phosphatase inhibitor on cultured bovine cerebrovascular smooth muscle cells (CSMC) Ca 2+ store operated Ca 2+ influx. METHODS Cell culture and single intracellular free Ca 2+ concentration was measured in fura 2/Am flueorescence probe by MetaFluor Fluorescence ratio imaging system. RESULTS (1) protein tyrosine kinase inhibitor (genistein,2.5,5,10 ?mol?L -1 )decreased Ca 2+ influx significantly induced by endothelin 1(ET 1),ATP,cyclopiazonic acid(CPA) in concentration dependent manner; (2) Protein tyrosine phosphatase inhibitor (vanadate,2,4,8 ?mol?L -1 ) increased Ca 2+ influx significantly induced by ET 1,ATP,CPA in concentration dependent manner. CONCLUSION Protein tyrosine kinase inhibitor and protein tyrosine phosphatase inhibitor have effects on Ca 2+ store operated Ca 2+ influx induced by ET 1, ATP, CPA. Protein tyrosine phosphorylation participats in the signal transduction of Ca 2+ store operat Ca 2+ influx in cerebrovascular smooth muscle cells.

Objective: To explore the effect of family need-based health education mode on family members under stress caused by transferring their children out of pediatric intensive care unit(PICU). Methods: A total of 40 family members of children transferred from PICU of Shengjing Hospital of China Medical University from July to December 2017 were selected as the control group, and 40 family members of children transferred from April to September 2018 were selected as the observation group. In the control group, daily routine health education mode were implemented by nurses on the relatives, while in the observation group, nurses provide the family members of children with corresponding graphic and text materials of health education according to the 2 copies of Critical Care Family Needs Inventory completed by their relatives within 24 hours and 72-96 hours of admission, and implement the daily health education combined with the Flipped Classroom method. The level of uncertainty in illness, stress in transfer and the satisfaction for family-centered nursing were compared between the groups. Results: In the observation group, the total score of the family members′ level of uncertainty in illness and stress in transfer were (80.05 ± 3.96) and (39.65 ± 2.41) points respectively, which were lower than those in the control group (99.70 ± 3.78) and (67.15 ± 2.38) points, and all the differences were statistically significant (t=-22.60, -50.21, P<0.01). The satisfaction for family-centered nursing in the observation group was higher than the control group, and the difference was statistically significant (P < 0.05). Conclusions The implementation of health education mode based on family needs is beneficial to reduce the level of uncertainty in illness of the family members of critically ill children transferred out of PICU, relieve the stress in transfer, and thus improving the family-centered high-quality nursing services in PICU.

Objective·To establish a reliable alcoholic liver disease mouse model (ALDNM) that mimics the drinking pattern of alcoholic liver disease (ALD) patients.Methods·Using the self-designed feeding tubes and liquid diet,ALDNM model was developed through chronic feeding combined with acute gavage of ethanol based on Lieber-DeCarli model and Gao-Binge model.C57BL/6 mice were administered with control liquid diet for adaptation for first 5 d,and then divided into pair-fed group and ethanol-fed group (10 mice each group).Ethanol-fed mice were fed with the liquid diet in which ethanol accounts for 30％ of total energy,while the pair-fed mice were fed with the control diet for 10 d.At the 16th day,ethanol-fed mice and pair-fed mice were respectively gavaged a single dose of 31.5％ ethanol or isocaloric maltose dextrin,and euthanized 9 h later.Sera and livers were collected.The general physiological condition,hepatic tissue pathological changes and serum indexes between Lieber-DeCarli models and ALDNM models were compared.The liver lipids of ALDNM mice were determined by Oil red O (ORO) staining and hepatic triacylglyceride (TAG) test.Meanwhile,the mRNA levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),fatty acid synthase (Fas),long chain fatty acid elongase 6 (Elovl6) and stearyl-CoA desaturase (Scdl) were detected by real-time PCR in ALDNM models.Western blotting was used to detect the changes of phosphorylated signal transduction and transcriptional activator (p-STAT3) in the livers.Results·Lieber-DeCarli model mice were generally in poor condition,and there was no significant change in serum glutamic-pyruvic transaminase (GPT) and glutamic-oxaloacetic transaminase (GOT) compared to pair-fed group.However,in ALDNM models,H-E staining showed that the hepatocytes of ethanol-fed mice were extremely swollen with round volume,increased cytoplasm and filled with large amounts of fat vacuoles.ORO staining analyses showed obvious microsteatosis in the liver cells from all ethanol-fed mice.The hepatosomatic index,liver TAG content,serum GPT and GOT of ALDNM models were significantly higher than those in the pair-fed group,while the serum HDL significantly decreased compared to the pair-fed group.Moreover,the expression levels of both lipid synthesis pathways and inflammatory signaling pathways related genes in livers significantly increased in the ethanol-fed mice of ALDNM model.Conclusion·ALDNM model was successfully constructed.This model is cost-and time-efficient.Moreover,ALDNM model mimics the drinking pattern and pathogenesis of ALD patients with the advantages of stable food intake,good repeatability,and obvious liver damage.

The harmonious medical cooperation based on mutual respect and mutual trust is an important part of modern ICU medical care activities,throughout the whole process of ICU medical and nursing work.Whether the relationship between doctors and nurses is harmonious or not directly affects the prognosis of ICU patients.With the change of medical model,the relationship between doctors and nurses is changing. This paper analyzed the influencing factors of doctor nurse cooperative relationship and the significance of good doctor nurse communication and cooperation,summarized the methods and strategies to promote cooperation between doctors and nurses at home and abroad,which would provide reference for clinical cooperation between doctors and nurses in theory and practice.

Objective: To monitor the hemodynamics of children with congenital heart disease after operation by using ultrosonic cardiac output monitor (USCOM) to understand the changes of cardiac function in children with congenital heart disease after operation. Methods: Twenty-four children with congenital heart disease underwent operation in the pediatric intensive care unit of Shengjing Hospital Affiliated to China Medical University from January 2017 to March 2018 were selected.Cardiac index (CI), lactate (Lac) concentration, central venous oxygen saturation (ScvO₂), heart rate (HR) and mean arterial pressure (MAP) were recorded at four time points after operation by USCOM. Results: The CI reached the highest level of 6.5L·min^-1·(m²)^-1 in 4h, the lowest level of 5L·min^-1·(m²)^-1 in 8h, and the same level in 24h as that in 1h.ScvO₂ was correlated with CI: P values of 1h, 4h, 8h and 24h were 0.003, 0.02, 0.034 and 0.03, respectively (all P<0.05), while ScvO₂ was not correlated with HR, MAP and Lac (P>0.05), and could not be used to judge the cardiac function of children with early congenital heart disease after operation. Conclusion USCOM is a non-invasive method for monitoring cardiac output, which can reflect the changes of cardiac function in children with congenital heart disease after operation.