Objective To Summariz and discuss the adverse reactions of Niuhuang-Jiedu pill (NJP) in the treatment.Methods Retrieved ADR report literatures through Chinese Medical Journal Database (CMJD) and WANFANG DATA from 1970 to 2012 with NJP as the key words,got and analyzed datas including patient age,gender,dosage,medication time and ADR type.Results Sixty-eight literatures with seventy-seven ADR report cases were retrieved.Adverse action induced by NJP was mainly allergic response,including arseniasis,gastrointestinal,uropoiesis reactions.Among 77 ADR cases,47 cases were considered as allergic response,61.0％ of the total,one death and thirteen shock cases were included.The number of arseniasis,gastrointestinal,uropoiesis reactions cases were respectively 14.3％,11.7％,6.5％ of the total.Conclusion The ADR of NJP should not be ignored.Allergy history,dosage and medication time should be pay more attention to to prevent the ADR of NJP to the fullest extemt.

Objective The purpose of this study is to evaluate the relevance of the recovery of proprioception function and the reservation of residual torn ligamentous fiber in the anterior cruciate ligament (ACL)reconstruction.Methods A retrospective study was carried out in 65 cases of ACL injury,who were treated with double-bundle ACL reconstruction and tibial remnant preservation and tensioning.All the patients were divided into four groups according to the degree of tibial residual fiber observed in the operation,no residual fiber was found(Group A),the length of the residual fiber was less than one third of the normal ACL(Group B),the length of the residual fiber was more than one third less than two thirds of the normal (Group C),the length of the residual fiber was more than two thirds of the normal(Group D).After one year follow-up,the passive angle reproduction test was performed with magnetic angle instrument in 3 flexion ranges(flexion of 90°-60°,60°-30°,and 30°-0°).All the results were contrasted among the four groups by statistical methods.Results In the passive angle reproduction test of the 3 flexion ranges,Group A and B showed a significant difference between the test side and control side(P＜0.05),and Group C showed a significant difference between the test side and control side at the flexion of 30°-0°(P＜0.05),but Group D showed no significant difference at the 3 flexion ranges(P＞0.05).Conclusion During double-bundle ACL reconstruction,with the reservation of tibial residual tom ligamentous and tensioning may have a good effect on the recovery of proprioception function of the knees,which ensure a better functional outcome in the reconstructed knee.

Recently animal experiments and clinical trials indicates that statins are available for sepsis,which have been obtained unexpected effects.Now relevant experiments are reviewed and statins mechanisms probably include protecting heart function,inhibiting endothelium to dysfunction and apoptosis,anti-acute-phase response,anti-oxidative stress,etc.

The JCI-based PDCA cycle makes continued quality improvement its comerstone.Its use in ICU human resource management consists of assurance of HR quantity,assurance of HR quality,and scientific use of human resources.Its application in ICU nursing care consists of creating excellent environment and providing high quality nursing items,with emphasis on quality nursing service in detail.Conversion of working mode,rationalized HR deployment,high quality nursing care,all contribute to raising the quality and social reputation of the hospital and the department,to standardized management,enhanced teamwork,better nursing care quality,and to higher satisfaction of the patients in the end.

Adolescent ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Lymphohistiocytosis, Hemophagocytic ; genetics ; Mutation ; Signaling Lymphocytic Activation Molecule Associated Protein

Objective To discuss the intraoperative and postoperative effects of conbercept combined with pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients.Methods From January 2016 to December 2016,123 PDR patients (149 eyes) aged 41-65 years old with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) were enrolled in this study.According to whether preoperative intravitreal injection conbercept,the patients were divided into two groups:Conbercept group (64 cases,78 eyes),Control group (59 cases,71 eyes).Conbercept group was treated with intravitreal injection of Conbercept 0.50 mg (0.05 mL) at 3 days before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed if no significant complications after the injection of conbercept.The operation time,intraoperative bleeding,iatrogenic retinal hole,use of endodiathermy and silicone oil,and postoperative complications were recorded and analyzed.The visual acuity and macuiar thickness were compared before and 1 month after the surgery.Results Two groups had no difference on age,sex,HbA1 C,duration,VH ≥ three degree(56/78,45/71),TRD.Conbercept pretreatment could significantly reduce the bleeding during PPV (43/78,49/71),the probability of iatrogeuic retinal holes (11/78,21/71),reduce intraocular electrocoagulation using (57/78,62/71) and silicone oil (43/78,51/71),and then shorten the operation time (58.63 ± 21.66)s and (72.69 ± 22.48)s,and it could significantly improve the postoperative visual acuity (0.23 ± 0.15,0.16 ± 0.11) and macular edema thickness (260.95 ± 27.44) μm and (330.81 ± 36.62)μm,while reduce the incidence of second bleeding (3/78,10/71).Conclusion Conbercept pre-treatment combined with PPV for PDR is a positive and effective treatment,which has good clinical application significance.

Objective To analyze the effect and safety of cerebral protection filter in carotid artery and stenting(CAS) for the treatment of severe symptomatic carotid artery stenosis.Methods Elective CAS with the use of cerebral protection filters were undergone in 26 consecutive patients with severe carotid artery stenosis.The filter devices were advanced through lesions and opened distal to the lesions followed by CAS.The incidence of cerebral ischemic events and the debris collected in the filters were observed and analyzed.Results In all the patients,it was feasible and successful to position the filters devices in the internal carotid artery.After the filter devices were positioned,CAS were performed successfully in all the 26 patients.Thrombus or plague debris were found in 14 out of 26 retrieved filters(54%).There was no death or symptomatic cerebral thromboembolic event during the CAS procedure.Asymptomatic cerebral embolization lesions were detected in 3 patients by the means of diffusion-weighted magnetic resonance imaging after 1-6 days of the CAS.No major cerebral or cardiovascular ischemic events were recorded in all patients during their follow up period of 6-12 months.Conclusion Carotid artery stenting is an effective microinvasive therapy for severe carotid artery stenosis which effect and safety can be enhanced with the use of cerebral protection filter.

Objective To estimate the arterial-to-end-tidal carbon dioxide tension difference (Pa-ET CO 2 )in children with cyanotic or acyanotic congenital heart diseases;evaluate whether hyper-ventilation can reduce the tension difference or not;analyze the effect of sevofleurane on Pa-ET CO 2 . Methods One hundred and twenty patients (male 60 cases,female 60 cases,aged 1 month-6 years, ASA class Ⅱ or Ⅲ)undergoing selective cardiac surgery were randomly divided into 6 groups (n =20 each)based on right-to-left or left-to-right intracardic shunts:group A1,cyanotic with sevoflurane of 0.5 MAC;group A2,cyanotic with sevoflurane of 1.0 MAC;group B1,acyanotic with sevoflurane of 0.5 MAC;group B2,acyanotic with sevoflurane of 1.0 MAC;group C1,cyanotic with no inter-vention factors;group C2,acyanotic with no intervention factors.All the children received general an-aesthesia after placing an intravenous and arterial catheter.The value of PET CO 2 ,SpO 2 ,PaCO 2 , SaO 2 ,Hct and temperature(nasopharyngeal temperature and rectal temperature)were obtained before operation,after hyperventilation(the control groups without hyperventilation)and five minutes before surture sternum.Results The values of Pa-ET CO 2 were more than the normal one in six groups before operation.The value of Pa-ET CO 2 in group B1 was less than that in group A1,that in group B2 was less than that in group A2 and that in group C2 was less than that in group C1 before operation (P <0.01).Compared with the time point before operation,the values of Pa-ET CO 2 in groups A1,A2,B1 and B2 decreased significantly after hyperventilation (P < 0.05 or P < 0.01 ).Moreover, this reduction was more significant in groups B1 and B2.Compared with the time point before operation, the values of Pa-ET CO 2 in groups B1,B2,C2 increased significantly (P <0.01)and that in groups A1, A2,C1 decreased significantly (P <0.05)at 5 minutes before surture sternum.There was no statisti-cal difference at three different time points between group A1 and A2,B1 and B2.Conclusion The value of Pa-ET CO 2 in cyanotic children increased more significantly than that in acyanotic children.Hy-perventilation can reduce the value of Pa-ET CO 2 especially in acynanotic children with pulmonary con-gestion.The concentration (from 0.5 MAC to 1.0 MAC)of sevoflurane had little effect on the value of Pa-ET CO 2 .