Objective To assess the clinical feasibility and safety of coronary artery angiography(CAG) and intervention through transradial approach. Methods 134 patients received coronary artery angiography and interventions through transradial approach were selected. The complications such as hematoma, thrombus were observed. Results Transradial puncture succeed in 126 cases, the successful rate of transradial coronary intervention was 94.0%.The complication occurred in 12 patients (8.9%). Conclusion This investigation demonstrated the safety and feasibility of transradial approach for coronary angiography with less procedure complications and pain for patient.

Objective To study the influence of the early ambulation on postoperative patients' comfort and complications with the femoral artery puncture interventional therapy.Methods After searching for related literatures with computer,we evaluated the quality of the literatures and screened them.12 random controlled trials met the inclusion criterion.Using RevMan 5.1.2 software,we respectively made Meta analysis for patients with sense of comfort and complications after operations.Results Compared with the control groups,the experimental groups were better in back pain,abdominal pain,limb numbness and acid bilges,sleep disorder,dysuria and urinary retention than those of the control groups.And the difference in the site of puncture bleeding and hematoma had no statistical significance between the two groups.Conclusions It can improve comfort for patients without increasing incidence rate of complications by lying in bed and rest for 12 hours after interventional therapy.It reflects the patient-centered nurs-ing service concept and can improve the patients' quality of life.

Objective To observe the preventing effect of optimal programs (improving turn over postures and elongating the turn over intervals)in preventing pressure sore occurrence in patients with acute stroke. Methods Acute stage stroke patients (time from on-set less than or equal to one week)were selected and divided randomly into 4 groups, one group adopted 2.0 hours turn over intervals as the routine group, others adopted 2.5 hours, 3.0 hours, 3.5 hours turn over intervals as the study groups. The incidence of pressure sores and complications were recorded. Results None of the groups (2.0 h, 2.5 h,3.0 h, 3.5 h)suffered from pressure sores. The incidence of complications including malnutrition, pulmonary infections and constipations was not increased in the study groups either. Conclusions Optimal turn over nursing programs including elongating turn over intervals to 2.5h, 3.0h, 3.5h and adopting 30 degree lateral posture can effectively prevent occurrence of pressure sores in acute stroke patients.

Objective To investigate the diagnostic value of conventional and dynamic gadolinium-enhanced T1-weighted (T1W) MRI in benign and malignant endometrial polypoid lesions. The pathologic basis of MRI features was also evaluated. Methods The conventional and dynamic contrast enhanced MRI features in 48 cases with clinicopathologically-proved endometrial polypoid lesions were retrospectively analyzed, including 26 cases with malignant tumors (23 eases with endometrial carcinoma and 3 cases with endometrial sarcoma) and 22 cases with benign polypoid lesions (12 cases with endothehal polyps and 10 cases with submucons leiomyomas). The occurrence probability of central fibrous core, intratumoral cysts and intact junctional zone were evaluated by Fisher's exact test. Results Benign and malignant endometrial polypoid lesions had specific characteristics on MRL Endometrial carcinomas usually appeared as homogeneous intermediate or slightly high signal-intensity masses on T2-weighted images, and relatively homogeneous hypedense masses on contrast-enhanced images with myometrial invasion (P < 0.05). An irregular central fthrous core and small non-enhanced intratumoral cysts were seen more frequently in endometrial polyps (P < 0.05) than others. All 3 cases with uterine sarcomas showed obviously inhomageneous intensity on T2WI and demonstrated areas of early and persistent marked enhancement.Submucous leiomyomas demonstrated isodense or slightly low-density masses with defined outline on T2 WI and the endomerium was displaced. The diagnostic sensitivity, specificity and accuracy of malignant polypoid masses were 92.3% (24/26), 83.3% (20/24) and 95.8% (46/48) respectively. Conclusion Conventional and dynamic contrast-enhanced MRI are valuable in characterizing the benign and malignant endometrial polypoid lesions.

ObjecfiveTo compare the sensitivity of diffusion weighted imaging(DWI)with dynamic contrast enhanced(DeE)MRI for the detection of small breast caJlcers and to evaluate the clinical value of DWI.MethodsForty-eight patients with benign(n=25)and malignant(n=45)small breast lesions(≤2 cm)proved by pathology underwent DWI and DCE MRI.The DCE MRI was performed using FLASH sequence and the time-signal intensity chive was drawn.The DWl was performed using GRAPPAEPI sequence with different b values(800,1000 s/mm2) and the ADC values of lesions were measured.The sensitivity and specificity of DWI for the detection of small breast cancers were compared with DCE MRI. ResultsForty of 45 small breast cancers and 19 of 25 small benign breast lesions were corrlectly diagnosed using DCE MRI.The sensitivity and positive predictive value of TIC were 88.9%(40/45)and 87.0%(40/46).With b values of 800 s/mm2 and 1000 s/mm2,the avemge ADC values of small breast cancers were(1.153±0.192)× 10-3 and(1.079±0.186)× 10-3 mm2/s,while those of benign ones were (1.473±0.252)×10-3 and(1.419±0.255)×10-3 mm2/s,respeetively. There was no significant difference for the ADC values with different b values in the same group(P＞0.05),while there was a signiticant difference between the malignant and the benign lesions(P＜0.05)Thirty-nine of 45 small breast cancers and 19 of 25 small benign breast lesions were correctly diagnosed using DWI with b value of 1000see/mm2.Both the sensitivity and positive predictive value of diagnosis were 86.7%(39/45).The abilities of DWI and DCE MRI for the diagnosis of small breast cancers werle the same. The sensitivity(93.3%)and positive predictive value(91.3%)were improved with the combination of DCE MRI and DWI. Conclusion DWI has a high sensitivity for the detection of small breast cancers,the ADC value can provide valuable information in the differential diagnosis.

AIM: To investigate the effect of chronic intermittent hypobaric hypoxia (CIHH) on the activity of adrenergic receptor(AR) in rabbit sino-atrial node (SAN) by intracellular recording.METHODS: New Zealand rabbits were randomly divided into three groups: control group (Con), 14 d CIHH treatment group (CIHH14) and 28 d CIHH treatment group (CIHH28). The CIHH rabbits were exposed to a simulated 5 000 m (oxygen 11.1%) hypobaric hypoxia in hypoxic chamber for 14 d or 28 d (6 h/d), respectively. SAN preparation was used and the transmembrane action potential was recorded by micropipettes. Isoproterenol hydrochloride (ISO, agonist of β-AR) and phenylephrine (PE, agonist of α_1-AR) at different concentrations (0.01, 0.1 and 1 μmol/L) were applied cumulatively to investigate the electrophysiological effect of the drugs on the rabbit SAN among Con, CIHH14 and CIHH28 groups, respectively. RESULTS: (1) CIHH didnt change the parameters of action potential of SAN recorded under basic condition. (2) ISO changed some parameters of AP significantly in a dose-dependent manner, including increases in the amplitude of AP (APA), maximal rate of depolarization (V_(max)), the velocity of diastolic (phase 4) depolarization (VDD), and rate of pacemaker firing (RPF). (3) The response of AP to ISO in CIHH rabbits was decreased significantly compared to that in Con animals. Under 1 μmol/L of ISO, the increases in VDD, RPF, APA and V_(max) in CIHH animals were smaller than those in Con animals (P<0.05). (4) No effect of PE (0.01, 0.1 and 1 μmol/L) on the parameters of action potential was observed. CONCLUSION: CIHH decreases the reactivity of β-AR, but has no effect on α_1-AR in SAN of rabbit.

Objective To evaluated the application value of two kinds of mass spectrometer(MS)and Vitek MS system in the i-dentification of routinely isolated bacteria in clinic.Methods 149 strains of common bacteria(including 14 genera and 30 species)i-solated from blood,urine,cerebral spinal fluid,secretion and sputum samples in our hospital from March 2012 to January 2013 were collected and simultaneously identified by 2 kinds of matrix-assisted laser desorption ionization-time of flight mass spectrometer (MALD-TOF-MS).The identification results were compared with those identified by the conventional biochemical identification (Vitek2 compact).The strains with the inconsistent results identified by 3 kinds of method were confirmed by 16S rDNA gene se-quencing.Results Among 149 common bacteria,the correct identification rates of genus and species by the Bruker Biotyper MS were 98% and 96% respectively and which by the Vitek MS system were 97% and 95% respectively.There were no misidentified bacterial strains by these two kinds of MS.Conclusion No statistical difference in the identification results was observed between these two kinds of MS system(P >0.05).Both exhibit excellent identification level and are suitable for the routine laboratory iden-tification of clinical microorganism.

Objective To improve hand hygiene compliance among health care workers(HCWs)through continu-ous quality improvement,and effectively reduce the incidence of healthcare-associated infection(HAI).Methods Continuous quality improvement was performed by adopting plan-do-check-action(PDCA)cycle,all HCWs were trained,hand hygiene was stressed,periodical and random checking was conducted.Results After the implementa-tion of PDCA cycle,the acknowledge rate of hand hygiene enhanced from 48.00% to 63.99%;hand hygiene com-pliance rate enhanced from 65.11% to 82.40%,the difference were both significant(χ2=12.75,259.65,respective-ly,both P<0.05).The daily consumption of instant hand antiseptic per 1 000 bed day increased obviously,which was 2.95-fold of pre-implementation.Conclusion Continuous quality improvement through PDCA cycle can effec-tively improve hand hygiene compliance rate of HCWs.

Objective To investigate the status of nurses' resilience and to explore the related factors.Methods 1356 nurses from 11 level Ⅱ and level Ⅲ hospitals of Guangzhou were assessed by using the general information questionnaire and the Chinese version of Conner-Davidson resilience scale.Results The score of nurses' resilience was(59.99±13.59)points and it was significantly lower than that of the domestic norm.There was statistical difference of the score of nurses' resilience on different genders,educational background,professional titles,hospital level and night shifts.There was a positive correlation among educational background,night shifts and nurses' resilience,and a negative correlation between hospital level and nurses' resilience.The hospital level,night shifts and educational background were the influencing factors of nurses' resilience.Conclusions The level of nurses' resilience is low.The higher hospital level and educational background,and the less night shift,the higher of nurses' resilience.

10.3969/j.issn.1000-3606.2013.06.010