Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Organophosphate Poisoning ; Pancreatitis, Acute Necrotizing ; etiology ; Pesticides ; poisoning ; Retrospective Studies ; Young Adult

OBJECTIVE:To investigate the role of clinical pharmacists in anti-infective treatment for the patient with septic shock. METHODS:Clinical pharmacists participated in anti-infective treatment for a patient with septic shock,assisted physicians to formulate individual regimen based on empirical anti-infective treatment,ESBLs producing Escherichia coli and anti-fungal treat-ment. Clinical pharmacists suggested using Itraconazole injection 200 mg,ivgtt,qd,for anti-fungal treatment;Itraconazole cap-sules 200 mg,po,bid,instead of fusidinic for anti-fungal treatment;meropenem 0.5 g,ivgtt,q6 h,for anti-infective treatment. RESULTS:Physicians adopted the suggestion of clinical pharmacists;the infection had been controlled after 16 d treatment and then the patient discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in clinical treatment,and assist phy-sicians to make a decision and formulate individual regimen,so as to promote rational drug use.

In the paper,in vitro degradation of DL polylactic acid (PDLLA) film was studied.Regulation and tendency of degradation were showed by molecular weight regulator and monomer ration mass lossing.Degradation mechanism was discussed in light.It was thought that degradation of PDLLA in vitro was a simple hydrolysis reaction.The hydrolysis reaction was self catalytic reaction caused by terminal carboxyl group.

Objective To provide the basis for scientific research management and promote innovation of knowledge service in hospital library , understand the level of academic development of hospital library , we analyzed the papers published by hospital li-brary in Jiangsu province . Methods Using bibliometric method to analyze papers published by hospital libraries in Jiangsu from 1990-2014 . Results In the 25 years, 415 papers were published , but with only 17.1%published in the core journals and thesis influence was not high .Most authors were from tertiary hospitals .The academic influence of papers was not high .Most papers were written by librarians independently , while 2.4%of papers were co-authored with other libraries or clinical departments .Thesis topic was almost traditional , so that the research was lack of innovation . Conclusion Hospital library research level is not balanced and high.We should make further effort to strengthen the continuing education , research cooperation, development of qualified personnel , and improve paper quality in order to promote the common development of hospital library in Jiangsu province .

Objective: To evaluate sensory recovery in noninnervated radial forearm free flap after tongue reconstruction. Methods: Sixty-five cases of tongue reconstruction by using free radial forearm flaps were analyzed. Flap sensations to touch, sharp vs dull, two-point discrimination and warmth vs cold was evaluated in each of these patients at 6 months and 12 months after treatment. Results:Twenty-nine flaps (44.6%) showed good sensory recovery, thirty-two flaps (50%) recovered partly, four flaps (6.1%) was anesthetic. Conclusion: Spontaneous recovery of flap sensation can be re-established after reconstruction. Delay or failure of sensory recovery in flap reconstruction could be caused by radiation therapy.

Objective To investigate the number and activation status of circulating mucosal associated invariant T (MAIT) cells in patients with sepsis.Methods Flow cytometric method was used to determine the number and percentage of MAIT cells and their expression of activation molecule CD69.Results The circulating MAIT cells dropped significantly at early stage of sepsis in septic patients.The MAIT cells in the sepsis group continued to express high levels of CD69 on day 1 and day 3 after admission to ICU.Conclusions Remarkable decrease of circulating MAIT cells may portend the possibility of sepsis in patients with severe infection.

Objective Patients in the intensive care unit (ICU) are at high risk for multi-organ failure and death. Few well-established scoring systems have been used in the cardiac surgery. We try to identify a feasible score system for the risk assessment after CABG. Methods 1028 consecutive patients who had received CABG and staying in a single cardiac postoperative intensive care unit of Anzhen hospital were enrolled in the prospective study between October of 2007 and May of 2008 and assessed daily with three score systems, the multiple organ dysfunction score (MODS), the sequential organ failure assessment (SOFA) and our postoperative score for cardiac surgery (PSCS). Four new variances were added to PSCS system, which were Euroscore, IABP, ECMO and dialysis. Euroscore was considered as a preoperative factor which provided the preoperative information of the patient. IABP and ECMO were considered as assistant factors to support circulatory system. The dialysis was also considered as an assistant factor to support renal system. The differences with the respects of sensitivity and specificity among the three systems were compared with Hosmer-Lemeshow goodness-of-fit and receiver operating characteristic (ROC)curve. Results The new variances added to PSCS system were shown to be associated with mortality in a multivariate logistic regression analysis. The EXP(B) value for Euroscore was 3. 803, the EXP(B) value for IABP was 1. 645, the EXP(B) value for ECMO was 3.803, and the EXP(B) value for dialysis was 1.605. In discrimination analysis, ROC values of the operative day score were 0.602 for MODS, 0.571 for SOFA, and 0. 821 for PSCS; ROC values of the maximum score were 0.847 for MODS, 0.830 for SOFA, and 0.929 for PSCS; ROC values of the maximum score during the first 3 days were 0.838 for MODS, 0.814 for SOFA, and 0.919 for PSCS; score changes of ROC value between the third day and the first day were 0.767 for MODS, 0.779 for SOFA, and 0. 780 for PSCS. In calibration analysis, we compared the x2 values, P values and overall corrected percentage of the three different systems. x2 values of the three systems were 6. 763 for MODS, 4. 101 for SOFA, and 1.687 for PSCS; P values of the three systems were 0.454 for MODS, 0. 848 for SOFA, and 0. 975 for PSCS; overall corrected percentages of the three systems were 98.1%, 98%, and 98.3% respectively. Conclusion The sensitivity and specificity of PSCS were superior to MODS and SOFA in predicting death risk after CABG.

Objective To learn the status quo of core competency of registered nurses in tertiary level first-class hospitals in Liaoning Province and compare the level and characteristics of core competency of registered nurses in different working years in order to supply evidence to establish contrapuntal training protocol.Methods "The Competency Inventory for Registered Nurse scale"(CIRN,by LIU Ming)was distributed to investigate the core competency of registered nurses,the data underwent analysis.Results The overall score of core competency level was (174.11±31.89),the score of the nurses with 16～20 years of working experience was the highest,while the score of nurses working for 1～5 years was the lowest.The core competency varied with working years,evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for registered nurses from five tertiary level first-class hospitals in Liaoning Province.They are competent enough to provide health care.With the increasing length of working time,nurses' core competency level will strengthen gradually.

Inservice Training ; Integrative Medicine ; Physicians ; organization & administration ; Professional-Patient Relations

Objective:To investigate the effect ofGuilong Kechuanning tablets combine with antibiotic drugs on pulmonary infection after chemotherapy in patients with lung cancer,so as to reduce the incidence of pulmonary infection in hospital.Methods:A total of 120 patients with lung cancer complicated with pulmonary infection,who underwent chemotherapy in Baoji Hospital of Traditional Chinese Medicine from August 2013 to August 2015,were selected and randomly divided into control group (n=60) and experiment group (n=60).The control group was treated with Ceftizoxime,based on which,the experiment group was added oral Guilong Kechuanning tablets.The course oftreatment of the two groups was 2 weeks.Inflammation indicators of the two groups were compared before and after treatment,and the clinical effect,hospitalized time,antifebrile time,time significantly reduced of cough and expectoration,disappearance time of lung rales and the pulmonary bacterial clearance rate were observed between the two groups.Results:The total effective rate (91.67％) of experiment group was significantly higher than that(73.33％) of control group (x2=13.121,P=0.004).Before treatment,there were no significant differences in WBC,CRP and NEUT levels between the two groups (P＞0.05);while after treatment,the levels of WBC,CRP and NEUT were all lower than those before treatment in both groups (all P＜0.05),and the levels of WBC,CRP and NEUT in the experiment group were lower than those in the control group(P＜0.05).After treatment,the bacterial clearance rate (99.09％) of the experiment group was significantly higher than that (86.94％) of the control group (x2=54.876,P=0.000).Conclusion:Guilong Kechuanning tablets combined with antibiotic drugs can effectively control the pulmonary infection after chemotherapy in the patients with lung cancer,and can improve the clinical symptoms and inflammatory reaction,which is worthy of clinical application.