Objective To investigate the present status of the emergency nursing training to form the curricula system for emergency nursing training of nurses (including course projects,class hour,teaching form,training aim).Methods Based on the actual investigation,literature research,using Delphi method,the training course system of emergency nursing was established.Results Cronbach's α coefficient was 0.943 and the expert authority coefficient was 0.868.Emergency training should be included in the nursing training program,and the four modules courses were built.With reference to emergency management requirements of home and abroad and the training model of foreign troops as well as combining the reality of our country to set up the training objectives,to improve class hour,enrich teaching form,and adjust the training content to set up the emergency training evaluation model.Conclusions The results of this study supply basic guarantee for nurses to increase coping ability of emergency affairs as well as training basis and reference with clear structure and content,reasonable design and reliable results.

Objective To observate the effects and reliability of azithromycin and ambroxol hydrochloride and glucose Injection in treatment of children with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins. Methods 56 cases of children with acute lower respiratory tract infection for whom penicillin and cephalosporins were treated with azithromycin and ambroxol hydrochloride and glucose injection(group A) and other 100 cases without penicillin and cephalosporins contraindication were randomly divided into group B(treatment with cephalosporin) and group C (treatment with azithromycin). The clinical efficacy and adverse reactions of 3 groups after treatment in children were compared. Results In group A and group B, fever, cough, wheezing and other clinical symptoms, positive signs of the disappearance time of the lung were significantly shorter than those in the group C. The clinical efficacy of the two groups had significant difference as compared with group C (P0.05). Conclusion It is a good treatment with azithromycin and ambroxol hydrochloride and glucose injection to cure children cases with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins, and it' s curative effect is equivalency with cephalosporin. It is worth to use this treatment in clinical practice.

Objective To summarize the experience in endovascular repair of De Bakey type Ⅲ aortic dissection in recent years and summarize the prevention and management of the related perioperative complications.Methods From January 2009 to January 2011,49 cases of endovascular repair for De Bakey type Ⅲ aortic dissection were performed under general anesthesia in our department.There were 45 male and 4 female.The follow-up was performed in the outpatient department or by telephone.Results There was no inhospital death and no paraplegia events.Severe complication included:coma,2 cases ( 4.1％ ) ; endoleak,2 cases (4.1％ ) ; upper limb ischemia,2 cases (4.1％ ).Recurrent proximal aortic dissection,1 case.Fever was occurred in most of those cases.Conclusion Endovascular repair of aortic dissection improves the outcome of aortic dissection patients.But more attention should be pay to prevent the severe complications,It will help to improve the prognosis and life quality by reducing the risk of retrograde dissection,acute brain ischemia and endoleak.

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Objective To analyze the chemical constituents of kumquat essential oil(KEO)and the acute toxicity of KEO in mice. Methods The chemical constituents of KEO were analyzed by GC-MS. After preliminary test, KM mice were randomly divided into control and KEO groups with 20 mice in each group(10 male and 10 female). The doses of KEO were designed with ratio 0.758 between the 100% and 0% mortality amount as 10, 7.60, 5.70, 4.40, 3.30 and 2.50 ml/kg. The acute toxicity was evaluated by examination of the mice for 14 days after single administration of KEO. Results The principal constituents in KEO were α-pinene(0.46%), β-phellandrene(0.11%), β-myrcene(2.34%), D-limonene(95.62%), geranyl acetate(0.10%), β-copaene(0.67%), and γ-elemene (0.13%), which accounted for 99.43% of the total chemical content of KEO. The half-lethal dose(LD50)of KEO in mice by the acute toxicity test was 6.24 ml/kg with the 95% confidence limit of(5.39-7.33)ml/kg in female mice and 5.73 ml/kg with the 95% confidence limit of(4.91-6.79)ml/kg in male mice. The possible toxic target organs were liver, spleen and gastrointestinal tract. Conclusion KEO with the content of D-limonene was obtained from kumquat for the first time, and the toxicity of the KEO was low according to the toxicity classification standard of World Health Organization.

AIM:To explore the corneal biomechanical properties of the elderly with different axial length(AL)and corneal curvature by Corneal Visualization Scheimpflug Technology(Corvis ST).

METHODS: A cross-sectional study. A total of 220 patients(426 eyes)undergoing phacoemulsification were collected in this study. One of them whose the AL was 22-24 mm and the corneal curvature was 42-44 D were divided into male and female groups(44 eyes and 49 eyes, respectively). One of them whose the corneal curvature was 42-44 D were divided into 22-24 mm, 24-26 mm, and more than 26 mm groups according to AL(99 eyes, 22 eyes and 12 eyes, respectively). One of them whose the AL was 22-24 mm were divided into 42-44 D, and more than 44 D according to corneal curvature(88 eyes, 102 eyes, respectively). Corvis ST was used to measure the biomechanical parameters of the cornea. The differences in the parameters between different groups were analyzed using the independent-samples t-test or one-way analysis of variance and correlation analyses were performed using Pearson correlation analysis.

RESULTS: When comparing the corneal biomechanical parameters, no statistically significant differences were found between male and female groups(P>0.05). The first applanation length and second applanation length among different corneal curvatures were statistically significant(P<0.05). There was statistically significant only for the difference of the second applanation length and central cornea thickness between two groups of 22-24 mm and 24-26 mm(P<0.05). There was statistically significant for the difference of the second applanation length, deformation amplitude, central cornea thickness, the first applanation time, intraocular pressure and corrected intraocular pressure between the two groups of 22-24 mm and more than 26 mm(P<0.05). But there was no statistically significant differences of the parameters between groups of 24-26 mm and more than 26 mm(P>0.05). The patient's AL was positively correlated with deformation amplitude, intraocular pressure and corrected intraocular pressure(r=0.263, P=0.002; r=0.463, P=0.000; r=0.449, P=0.000), and there is negative correlation between the patient's AL and central cornea thickness, the second applanation length(r=-0.240, P=0.006; r=-0.344, P=0.000).

CONCLUSION: The corneal curvature and ocular AL may be the factor affecting the corneal biomechanical properties. The longer AL, the thinner corneal thickness, the more easily the corneal is deformed, and with the increase of the AL, intraocular pressure also increases. When discussing whether the preparation of the cataract incision is affected by the patient's own factors, the different corneal curvatures and AL shall be considered.

This study aimed to explore Semaphrin4D (Sema4D) expression and clinical significance in non-small cell lung cancer (NSCLC), and to define the roles and mechanisms of Sema4D in regulating the malignant behaviors of A549 cells by small interfering RNA (siRNA). Firstly, immunohistochemistry revealed that Sema4D was more frequently expressed in NSCLC than in lung benign lesion (P<0.05) and its overexprssion was associated with low differentiation (P<0.05), poor pTNM staging (P<0.05) and occurrence of lymph node (LN) metastasis (P<0.05). Endogenous Sema4D expression was suppressed by Sema4D siRNA in A549 cells overexpressing Sema4D. Protein levels of Sema4D, total Akt and p-Akt were examined by Western blotting. Cell proliferation, migration and invasion abilities were measured by MTT assay and Transwell assay respectively. Results showed that Sema4D siRNA significantly suppressed phosphorylation of AKT in A549 cells, but it did not alter total AKT expression. In addition, efficient down-regulation of SemaD significantly inhibit cell proliferation (P<0.05), migration (P<0.05) and invasion (P<0.05) in A549 cells. These findings suggest that Sema4D might serve as a reliable tool for early prediction of NSCLC poor prognosis. Sema4D could play an important role in promoting tumor proliferation, migration and metastasis in the NSCLC, by influencing the Akt protein phosphorylation. Inhibition of Sema4D may be a useful approach for the treatment of NSCLC.

Objective To summarize our experience in endovascular repair of 83 cases with type B aortic dissection.Methods A retrospective analysis was performed in 83 cases of type B aortic dissections who were treated in our hospital.Results The surgical procedure was successful for all the patients.Two patients died peri-operatively.One case encountered a coma,but no post-operative paraplegia occurred.Conclusion Endovascular repair for type B aortic dissection is a micro-invasive,safe and effective technique.Long-term follow-up is required to give a comprehensive evaluation.

Objective To describe the treatment experience of post-operative complications after total arch replacement for acute type A aortic dissection in 34 cases.Methods The subjects were 34 consecutive patients (Twenty-eight males and 6 females,age 34.0 -60.0 yrs) who received total arch replacement for acute Stanford type A aortic dissection from Jan.2005 to Oct.2010 in our hospital.The duration from the onset of the symptoms to the hospitalization ranged from 4 - 18 hrs.Pre-operative 2-D Echo revealed aortic valve regurgitation in 8 patients and mitral valve regurgitation in 1 patient.Results Three patients died after operation ( mortality 8.8％ ).Severe complications included acute kidney injury in 13 cases,respiratory dysfunction in 12 cases,paraplegia in 1 case,mental disorder in 10 cases and excessive post-operative bleeding in 2 cases.Conclusion The incidence of the complications after total arch replacement is still high and severe.Intensive care should be stressed peri-operatively and early diagnosis and treatment for post-operative complications are important procedures.

Objective To evaluate the clinical significance of the change of serum matrix metalloproteinases (MMP)-1,-2,-3 and -9 in acute and chronic aortic diseases and acute myocardial ischemia.Methods The blood serum levels of MMP-1,-2,-3 and -9 were detected in 30 patients with acute aortic dissection,19 patients with chronic aortic dissection,19 patients with aortic aneurysm and in 12 patients with acute myocardial ischemia,as well as in 16 healthy individuals who served as the control group.Serum MMP levels were measured by using an ELISA technique.Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection ( [19.10 ± 3.11 ] μg/L vs [11.89 ± 1.31 ] μg/L,P =0.02).Significantly lower levels of MMP-1 were found in healthy controls compared to the groups of patients ( [1.30 ± 0.56 ] μg/L vs [2.99 ± 0.78 ] μg/L in acute aortic dissection,P =0.03,[3.12 ±0.78] μg/L in chronic dissection,P =0.02,[3.01 ± 1.01 ] μg/L in thoracic aortic aneurysm,P =0.03 and [5.01 ± 0.98 ] μg/L in acute myocardial ischemia,P =0.01 ).Higher levels of M MP-1 and MMP-3 were detected on males.There was a positive correlation between MMP-1 and increasing age ( r =0.38,P ＜ 0.05 ).In patients operated for acute type A aortic dissection,the levels of MMP-1,MMP-3 and MMP-9 increased immediately after surgery,while the levels of MMP-2 decreased.Twenty-four hours after surgery levels of MMP-1,-2 and -9 were almost equal to the preoperative ones( P ＞ 0.05 ).Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia,when evaluated in combination with imaging techniques.