Objective To explore the effects of nursing intervention in the clinical emergency of organic phosphorus pesticide poisoning. Methods Fifty-six patients with organic phosphorus pesticide poisoning, who were admitted to the Department of Emergency in the Affiliated Hospital of Zhejiang Normal University from May 2012 to May 2013, were selected. They were assigned into observation group and received nursing intervention on the basis of regular nursing care. 56 patients with organic phosphorus pesticide poisoning, who were admitted to the same hospital from April 2011 to April 2012 and received only regular emergency nursing care, were selected as control group. Volume of gastric lavage, duration of gastric lavage, number of cases with overflow of gastric contents during a surgery, and complications were collected in the two groups. The satisfaction rates of patients and their families from the two groups were also sur-veyed after the nursing care. Results The volume of gastric lavage, duration of gastric lavage, cases with overflow of gastric contents during a surgery and the incidence of complications in observation group were all less than those in control group. The satisfaction rate in observation group was 96.4%, in which 28 patients were very satisfied, 26 fairly satisfied, 2 unsatisfied. The satisfaction rate in control group was 75.0%, in which 20 patients were very satisfied, 22 fairly satisfied, 14 unsatisfied. The difference of satisfaction rates between the two groups was statistically significant (P<0.05). Conclusion Strengthening of diet and mental nursing for emergency patients with severe organic phosphorus pesticide poisoning helps safeguard patients ’ life at the meantime, wins high recognition.

Objective To explore the effects of inhospital emergency process ~engineering for patients with acute poisoning.Methods Emergency Department of the Affiliated Hospital of Hangzhou Normal University implemented inhospital poisoning emergency process reengineering in March 2016.This implementation optimized original emergency process and applied it in patients with acute poisoning beginning with 6 aspects including refining precheck patients,assessment of poisoning emergency response group,fast gastrolavage,transportation,gastrolavage combined with blood purification group rapid preparation,emergency intensive care unit preparation.We compared the rescue efficiency of patients with acute poisoning before (from March 2015 to February 2016) and after (from March 2016 to February 2017) process reengineering.Results After process reengineering,the time from being admitted to hospital to beginning gastrolavage and the duration of gastrolavage was (8.91 ± 5.29)min and (31.86 ± 8.42)min respectively shorter than those before process reengineering with significant differences (t=3.397,4.028;P ＜ 0.01).After process reengineering,the time from being admitted to hospital to opening blood purification tubes (176.59 ± 88.73)min and from being admitted to hospital to starting blood perfusion (229.35 ± 108.79)min were significantly sooner than those before process reengineering (t=3.600,3.550;P ＜ 0.01).Conclusions The inhospital emergency process reengineering is scientific and convenient.It is propitious to improve rescue efficiency of patients with acute poisoning.

Objective? To explore the knowledge demand on disaster nursing of nurses so as to provide the countermeasure and suggestions for improving the knowledge on disaster nursing of nurses. Methods? From August to October 2016, a total of 510 nurses at a ClassⅢ Grade A hospital in Hangzhou City were investigated with the Disaster Nursing Training Needs Questionnaire for the nurses. The SPSS 21.0 was used to data analysis. A total of 510 questionnaires were sent out and 479 valid questionnaires were collected with 93.92% for the recovery rate. Results? A total of 479 nurses were with the high demand for the professional knowledge and management knowledge of disaster nursing along with 4 and above for the scores of all terms. In the demand of professional knowledge, the highest demand term was the self-protection knowledge (4.70±0.54). Among 9 training modes with multiple choices by 479 nurses, the highest demand for the training mode was theoretical teaching. Among different training modes, 36.7% to 54.9% of nurses selected theoretical teaching. There were statistical differences in the training contents demands among nurses with different departments (P＜ 0.05). Conclusions? Hospitals should strengthen training for the disaster nursing events capability of nurses. Different disaster nursing knowledge and skills should adopt suitable training modes. Nurses with no rescue experience need to attend more effective organizational management training in the disaster.

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.

OBJECTIVETo investigate the effects of different concentrations of paraquat (PQ) poisoning on the expression of voltage-dependent anion channel (VDAC) and caspase family in the mitochondria of rat lung tissue, and to explore possible mechanisms of acute lung injury induced by acute PQ poisoning.

METHODSTwo hundred healthy adult Wister rats with equal numbers of male and female ones were randomly and equally divided into control group and poisoned group. The control group received one-time gastric lavage with 1 ml of normal saline, and the poisoned group with PQ (50 mg/kg) diluted in 1 ml of normal saline. Twenty rats were collected at 1, 24, 72, 120, and 168 h after lavage with normal saline or PQ and dissected after anesthesia. Mitochondria were separated from rat lung tissue, and the content of VDAC and caspase-3, -8, and -9 were determined.

RESULTSThe expression of VDAC and caspase-3, -8, and -9 in the poisoned rats were significantly higher than that in the control group (P < 0.001). At 1, 24, 72, 120, and 168 h after exposure, acute diffuse damages were found in alveolar capillary endothelial cells, alveolar epithelial cells, and pulmonary interstitial cells. Inflammatory cell infiltration in the pulmonary interstitium, alveolar structural disorder, and substantially increased fibroblasts were also found in rat lung tissue.

CONCLUSIONPQ poisoning can up-regulate the expression of VDAC and caspase-3, -8, and -9 in mitochondria of rat lung tissue to induce acute lung injury.

Acute Lung Injury ; chemically induced ; pathology ; Animals ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Caspases ; metabolism ; Female ; Lung ; drug effects ; pathology ; Male ; Mitochondria ; drug effects ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley ; Voltage-Dependent Anion Channels ; metabolism