By using the procedures of the routinization of risk assessment - implementation - evaluation of result-modification to the risk management and carring out the feasibility exploretion on the application and effect of the ward nursing management, so that care defects, nursing errors and the number of cases of occurrence of accidents has significantly reduced, the patients satisfactory degree has rised from 92.5% to 98.5%, improved the quality of care and ensured the safety of patients, fully enhanced the quality of nursing services.

Objective To identify the Candida species isolated from recurrent vulvovaginal candidiasis( RVVC) pa-tients, and provide etiologic datum of RVVC. Methods All Candida isolates, including those from vulvovaginal candidiasis ( VVC) and RVVC patients, were identified by using CHROMagar chromogenic medium and VITEK2 yeast identification kits. Results The proportions of nonalbicans species from nonpregnant RVVC relapse patients and pregnant VVC patients were both significantly higher than those from nonpregnant VVC patients ( P<0. 05 ) . Among pregnant patients, the percentage of C. albicans isolated from RVVC relapse was couer, but there was no significant difference of C. albicans species percentage between RVVC and VVC patients. Conclusion RVVC may be related to the recurrence of same Candia species and the reinfection of different Candia species. Pregnant women may be more inclinable to suffer from disorder caused by nonalbicans species.

OBJECTIVE To observe the clinical efficacy of two kinds of compound skin disinfectants(compound iodine and Anerdian).METHODS One hundred and twenty recruited patients were divided into three groups randomly,group A(compound iodine group),group B(Anerdian group) and control group(iodine tincture group),40 patients per group.The groups A and B were carried on with one-step skin greasing disinfection.The control group was carried on with routine two-steps skin greasing disinfection.The sampling and detection were carried on by The Technological Specification of Hospital Disinfection published by the Ministry of Health.RESULTS The kill ratio of three groups was(95.44?9.45)%,(95.29?7.21)% and(96.24?11.12)%,respectively.Their disinfection qualification ratio was 97.50%,95.00% and 97.50%,respectively.Comparing the kill ratio and disinfection qualification ratio,there was no significant difference among three groups.CONCLUSIONS The disinfection efficacy of two kinds of the compound skin disinfectants are definite,there is no difference comparing with the traditional iodine tincture and ethanol disinfectants,but they are easy to carry on,safe and practical and the time is shorter,saving the time and the labor.It is helpful to increase the work efficiency of the nurse and deserve to be extended in the clinical application.

Objective To explore therapeutic effects of combinative artificial kidney treatment on renal osteopathy.Methods HD + HP Group composed by 30 urinaemia was treated with hemodialysis and hemoperfusion,and the HD Group was treated only with hemodialysis.Clinical symptoms and lab indicators including osteodynia,itch of skin,blood pressure,appetite,sleep,as well as BUN,SCr,Hb,BPC,Ca,P and iPTH,were compared between the two groups.Results Osteodynia decreased by 67.7% (21/31),and itch of skin by 71.0% (22/31)in HD group.Osteodynia decreased by 96.7% (29/30) ,and itch of skin by 96.7% (29/30) in HD + HP group (P ＜0.01 ).iPTH were (65.5 ± 34.4) pmol/L before treatment and (57.1 ± 21.4) pmol/L after treatment in HD group,and (73.5 ± 44.4)pmol/L and (19.1 ± 17.4)pmol/L in HD + HP group.HD Group eliminated less iPTH (P ＞0.05).HD + HP Group removed more serum poison molecules than HD Group ( P ＜ 0.05 ).Conclusions For patients in maintenance-dialysis stage but with higher iPTH,hemodialysis combined with hemoperfusion removes more poison molecules,consequently decreases incidence of renal osteopathy.

Objective To investigate the effect of hydromorphone postconditioning on ischemiareperfusion (I/R) injury in isolated rat hearts and the role of mitochondial permeability transition pore (mPTP).Methods Male Sprague-Dawley rats, aged 2-3 months, weighing 250-320 g, were used in the study.The rats were heparinized and anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The hearts were excised, and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each)using a random number table: control group (group C), group I/R, hydromorphone postconditioning group (group H), and hydromorphone postconditioning + mPTP opener lonidamine group (group HL).Group C was continuously perfused with K-H solution for 120 min.Group I/R was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group I/R was perfused with K-H solution for another 30 min.Group H was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group H was perfused with K-H solution containing 0.3 μmol/L hydromorphone for 10 min, and then with K-H solution for 50 min.Group HL was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group HL was perfused with K-H solution containing 0.3 μmol/L hydromorphone and 30 μmol/L lonidamine for 10 min, and then with K-H solution for 50 min.At 30 min of equilibration (T0), and 30 and 60 min of reperfusion (T2,3), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP) , ±dp/dtmax, heart rate (HR), and coronary flow (CF) were measured.The concentrations of lactic dehydrogenase (LDH), creatine kinase-MB (CK-MB) , and troponin-T (Tn-T) in the coronary effluent were determined at T0 and T3.The coronary effluent was collected at T0 and 15 min of reperfusion (T1),nicotinamide-adenine dinucleotide (NAD+) concentrations were measured using enzyme-linked immunosorbent assay to reflect the degree of mPTP opening.The myocardial infarct size was determined at T3 by TTC staining.Results Compared with group C, LVDP, HR, ±dp/dtmax and CF were significantly decreased, and LVEDP was increased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were increased in group I/R (P＜0.05).Compared with I/R and HL groups, LVDP, ±dp/dt CF and HR were significantly increased, and LVEDP was decreased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were decreased in group H (P＜0.05).Conclusion Hydromorphone postconditioning can reduce myocardial I/R injury in isolated rat hearts, and the mechanism is related to inhibition of mPTP opening.

Objective:To observe the effects of static 70° head-up tilted standing and of repeated body repositioning on hemodynamics in healthy young and middle-aged persons.Methods:The hemodynamics of 24 middle-aged and 23 younger persons were studied. Both groups were requested to perform static 70° head-up tilted standing and to repeatedly change their body position from 0° to 70° of tilt at a velocity of 1°/second for ten minutes in a random order. Before, between and after each test the subjects rested supine for ten minutes. Hemodynamic variables and blood pressure were recorded non-invasively.Results:The average heart rate (HR) increased significantly in both groups when rising from supine to the testing positions. In 70° tilted standing the average HR of the youth group, 84.0±9.5bpm, was significantly higher than that in the other position and that of the middle-aged group in the same position. The average HR of the middle-aged group in 70° tilted standing was also significantly higher than in the other position. Among the middle-aged group, the average stroke volume (SV) in the testing positions was significantly lower than when resting. Significant differences were observed in the average diastolic blood pressure (DBP) between the testing and rest positions for both groups, with the average DBP of the middle-aged group significantly higher than that of the youth group in all three positions. Among the youth group, the average SV, CO and systolic blood pressure (SBP) of the males were significantly higher than among the females in all of the different body positions.Conclusions:Young persons mainly rely on an increased heart rate to maintain cardiac output while middle-aged participants appear to achieve this through increased peripheral resistance. Repeated position changes have less impact on hemodynamics than 70° inclined standing, making it a safer and more stable training method. However, the long-term effects of such intervention need to be confirmed in further studies.

Objective To find a model of long-term postoperative cognitive dysfunction by hav-ing a splenectomy operation or cardiopulmonary bypass.Methods Sixty Sprague-Dawley rats,aged 18 months,were randomly divided into 3 groups (n =20):splenectomy group (group A),cardiopul-monary bypass group (group B)and control group (group C).From 31 st to 35 th days after the opera-tion,the learning and memory capability of rats were observed through the Morris water maze,the Shuttle box text and Open field test.Results Compared with group C,the frequency of crossing the original platform [(5.2±2.2)times vs.(8.6±3.2)times],the times of initiative avoiding were sig-nificantly reduced [(12.3±2.7)times vs.(1 5.2±1.8)times],the latency of the initiative avoiding was significantly prolonged [(9.50±2.31 )s vs.(5.14 ± 1.43 )s],the number of standing on the back legs [(6.8±1.5)times vs.(10.2±1.7)times]and rearing were significantly reduced [(13.8± 2.6)times vs.(1 9.5±2.2)times],and the time that animals spent in the central square [(7.78 ± 1.5 1)s vs.(5.34±0.72)s]and escape latency were significantly prolonged in group B (P <0.05). Compared with group A,the time that animals spent in the central square in group B was significantly prolonged [(7.78±1.5 1)s vs.(6.06 ±1.67)s,P <0.05].Conclusion The model by having car-diopulmonary bypass operation is an ideal model of postoperative cognitive dysfunction after cardio-vascular anesthesia,for the learning and memory capability is remarkably changed.

Objective To explore the effect of dronedaronel on hyperpolarization-activated cyclic-nucleotide-gated(HCN) channel expression by detecting the change of HCN channel mRNA and protein level before and after giving dronedarone in neonatal rat ventricular myocytes.Methods Neonatal rat ventricular myocytes were separated and digested by type Ⅱ collagenase,and then single ventricular myocytes were collected through differential sticking wall separation method.According to the concentrations (0.1,0.5,1.0,5.0,10.0,20.0 μmol/L of dronedaronel for treating myocytes for 48 h) and time(10 μmol/L of dronedaronel for treating myocytes for 1,6,12,24,48 h)the gradient grouping was conducted.The levels of HCN2 and HCN4 channel mRNA and protein level were determined by real-time PCR and Western blot.Results The HCN2 mRNA and HCN4 mRNA expression levels in concentration gradient group and time gradient group were lower than those in the control group(P＜0.05);compared with the control group,the protein level in the 10 umol/L dronedaronel treatment for 12 h group was significantly down-regulated(P＜ 0.01).Conclusion Dronedaronel could inhibit the expression of HCN2/HCN4 channel mRNA and protein,moreover its action shows the concentration dependency and reaches the maximum at 12 h after medication.

Objective To establish a molecular typing system of Staphylococcus aureus by using resolution melting for food-poi-soning fast tracing.Methods Primers were designed and synthesized according to the literature of VNTR in Staphylococcus au-reus ,and were used to perform molecular typing on the strains which had detected by PFGE,then 4 types of VNTRs were with higher discriminatory power were selected.On this basis,we established a molecular typing system for the detection of 59 Staphy-lococcus aureus isolated from food poisoning.Results The molecular typing system has good precision for detection.The standard deviation(s)of within-batch repetitive experiments were 0.03 -0.05 ℃,between-batch repetitive experiments were 0.04 -0.06℃,between-day repetitive experiments were 0.04-0.06 ℃.At the same time,the 59 strains of Staphylococcus aureus were divided into 19 types which were 11 epidemic clones and 8 sporadic clones.The correlation coefficient of Simpson was 0.916 4.Conclusion The molecular typing system for Staphylococcus aureus based on resolution melting was simple,fast and repeatable.It can be ap-plied to fast tracing and screen of Staphylococcus aureus in food poisoning.

Objective:To investigate the efficacy and safety of SIMPLE regimen in the treatment of extranodal NK/T-cell lymphoma (ENKTCL).Methods:The clinical data of 11 patients with ENKTCL who were admitted to the University of Hong Kong-Shenzhen Hospital from January 2012 to January 2022 were retrospectively analyzed. The patients received 4-6 courses of SIMPLE (cisplatin, gemcitabine, ifosfamide, etoposide, dexamethasone, and pegasparaginase) regimen chemotherapy, and stage Ⅰ and Ⅱ patients who also received local radiotherapy after 2 or 3 courses of chemotherapy. Patients were evaluated for mid-treatment and end-of-treatment outcomes, and the adverse effects of patients were evaluated in each treatment cycle. The Kaplan-Meier method was used to analyze the progression-free survival (PFS) and overall survival (OS) of the 11 patients.Results:All 11 patients were nasal type, with the median age of 41 years old (26-67 years old), including 5 males and 6 females, 3 relapsed cases and 8 newly treated cases. Of the 10 patients evaluated for efficacy, 9 achieved complete remission and 1 achieved at least partial remission (efficacy was assessed based on follow-up). All 11 patients were followed up for a median time of 50 months (15-72 months) and 2 relapsed patients died due to disease progression. The expected 5-year PFS rate and OS rate of 11 patients were both 90.0%, and the expected 5-year OS rate was 100.0% and 66.6% in newly treated and relapsed patients, respectively. Common adverse effects were hematologic adverse reactions, infections, gastrointestinal symptoms, elevated transaminases, and hypofibrinogenemia, all of which were curable. There is no treatment-related death.Conclusions:The SIMPLE regimen for the treatment of ENKTCL has a high remission rate, the patients have long survival time, and the regimen is moderately well tolerated.