Objective To investigate the application value of BIS monitoring and Ramsay score in the prevention of unplanned tracheal extubation in ICU patients.Methods 93 patients were enrolled in this study,they were divided into the experimental group(47 cases)and the control group(46 cases) using random number method.They received sedation regimens with BIS monitoring and Ramsay score or Ramsay score respectively.Occurrence rate of unplanned extubation was compared between the two groups.Results The occurrence rate of unplanned extubation was significantly lower in the experimental group than that of the control group.Conclusions BIS monitoring and Ramsay score is a suitable ways for the management of sedation of intubated patients.

[ ABSTRACT] AIM:To study the effects of soybean isoflavones on mitochondrial ultrastructure, neuronal apopto-sis and expression of cytochrome C, caspase-9 and caspase-3 in the rats with cerebral ischemia/reperfusion.METHODS:Adult healthy SD rats ( n=60 ) were randomly divided into 3 groups: sham group, ischemia/reperfusion injury ( I/R ) group and soybean isoflavone ( SI) pretreatment group.Soybean isoflavones (120 mg· kg-1 · d-1 ) were fed by gastric lav-age for 21 d.The global ischemia/reperfusion model of the rats was established by blocking 3 vessels, and then reperfused for 1 h after 1 h of ischemia.The morphological change of the cerebral cortex cells was observed under light microscope. The mitochondrial ultrastructure of the cerebral cortex cells was determined by transmission electron microscope.The apop-totic rate of the cerebral cortex cells was detected by flow cytometry.The expression of cytochrome C, caspase-9 and caspase-3 in the cerebral cortex cells was determined by semi-quantitative RT-PCR and immunohistochemical techniques. RESULTS:Disintegration of mitochondria membrane and disappearance of the mitochondrial cristae were seen in I/R group.Compared with I/R group, the change of ultrastructure of mitochondria was significantly improved by soybean isofla-vone pretreatment, and the neuronal apoptotic rate was also significantly decreased (P<0.01).The mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in I/R group were obviously higher than those in sham group ( P<0.01).Compared with I/R group, the mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in SI group were significantly decreased (P<0.01).CONCLUSION: Soybean isoflavones attenuate cerebral ischemia/reperfusion injury by stabilizing the structure of mitochondria, preventing cytochrome C release to the cytoplasm, inhibiting the activation of caspase-9 and caspase-3 and decreasing cell apoptosis.

The relatively independence and separation in the teaching of clinical medicine and basic medicine limits the ability training of students,and the combination of basic and clinic medicine in teaching has become the core issues and trends in medical teaching reform.So the conventional teaching patterns were reformed in pathophysiology by applying combination of basic and clinic medicine in teaching.In order to accelerate medical students to early exposure to clinical medicine Bengbu medical college changed the teachers' teaching ideas,promoted the local integration of the courses of basic and clinical medicine and the combination of basic and clinic medicine teachers in teaching,reformed mechanisms in teaching management and teaching operation.We also tested the preliminary reform effects by way of students' evaluation of the teaching and examination,and discussed the unfavorable factors affecting the educational reform and thought out some countermeasures.

Objective:To evaluate ward nurses′ understanding of nuclear medicine and assess whether they can prepare for scintigraphy procedures and answer patient′s questions about nuclear medicine examinations.Methods:An online questionnaire was provided to nurses in 11 wards of Wuxi Second Hospital Affiliated to Nanjing Medical University where nuclear medicine examinations were frequently undergone. The questionnaire contained 3 parts: general data, self-assessment, objective testing of knowledge about nuclear medicine. Professional titles, educations, working years, self-assessment and objective testing for knowledge of nuclear medicine for patients′ preparation and question of involvers were collected. Results of objective knowledge test among different professional titles, educations and the results of self-assessment were analyzed using one-way analysis of variance and independent-sample t test. Pearson correlation analysis was used to evaluate the correlation between objective testing results and working years. Results:The effective receiving rate of questionnaire was 96.4%(267/277). There were 96.3%(257/267) involvers did not receive any specific training in nuclear medicine, and only 4.9%(13/267) considered they knew nuclear medicine well. There were 50.2%(134/267) involvers thought that their knowledge of nuclear medicine was enough to prepare nuclear medicine examination for patients and 49.8%(133/267) involvers thought that they were able to explain nuclear medicine examination for patients. In objective knowledge test, (14.6±2.8) questions answered correctly for each person, with a correct rate of (54.9±10.5)%. There were (14.1±2.8), (15.5±2.3) and (16.8±3.9) questions answered correctly in involvers with primary title, mid-level title and senior title respectively ( F=9.789, P<0.001), and (15.8±2.5), (14.2±2.8) in involvers with bachelor degree or above and college degree ( t=3.477, P<0.001). There was only subtle correlation between objective testing results and working years ( r=0.257, P<0.01). The main way that involvers obtained nuclear information was through experience-based teaching methods such as introductions from colleagues(57.7%, 154/267) and department education(18.0%, 48/267). Conclusions:Lacking of formal nuclear medicine orientation is common in ward nurses, and their understanding of nuclear medicine examinations is insufficient. Working characteristics and learning patterns of ward nurses should be considered when providing information on nuclear medicine treatments for them.

Objective:To investigate the relevance between spatial learning and memory impairment and the changes of inducible nitric oxide synthase (iNOS) activity,superoxide dismutase (SOD) activity and malondiadehyde (MDA) content in hippocampus from Type 1 diabetic mice.Methods:Sixty male mice were randomly assigned into a control group (NC group,20 mice) and a Type 1 diabetic group (DM group,40 mice).Type 1 diabetic mouse models were established by a large dose intraperitoneal injection of streptozotocin (100 mg/kg).The spatial learning and memory abilities of mice were assessed by Morris water maze (MWM) test.After MWM test,we chose 20 mice (diabetic encephalopathy mice) with the worst spatial learning and memory abilities from diabetic model group,and detected the iNOS activity,SOD activity and MDA content in hippocampus in both groups.Results:Compared with the NC group,the escape latency was significantly extended and platform crossings were significantly declined in diabetic mice (P＜0.01).Furthermore,the activity of iNOS and the content of MDA were markedly increased,and the activity of SOD was significantly decreased in hippocampus of diabetic encephalopathy mice (P＜0.01).Conclusion:The established Type 1 diabetic mice show symptoms of cognitive dysfunction,which might be related to the increase of oxidative stress in hippocampus.

Objective To explore the application of evidence-based nursing in patients with coronary atherosclerosis heart disease (CHD)who received percutaneous coronary intervention (PCI)in selected days.Methods A total of 85 CHD patients undergoing PCI in selected days were randomly divided into observation group (43 cases)and control group (42 cases).Control group was treated with routine nursing while observation group with evidence-based nursing.Re-sults The compliance rates of observation group was 95.35%,evidently higher than the 78.57%in control group (P <0.05).Self-rating anxiety scale (SAS)and self-rating depression scale (SDS)scores decreased markedly in both groups after interventions than intervention before, which were apparently lower in observation group than in control group,and there was significant difference (P <0.05).One month after operation,observation group was obviously higher in seat-tle angina questionnaire (SAQ)than control group (P <0.01).Conclusion Evidence-based nursing can increase the therapeutic compliance,promote the negative emotions and improve the postoperative quality of life of CHD patients with PCI.

Objective To explore the clinical application value of a small sealed bottle in the pseudoaneurysm after coronary arteriography .Methods Sixty-four with pseudoaneurysm after coronary arteriography selected in second people ’ s hospital of Wuxi city were randomly divided into observation group and control group , 32 cases in each group .Control group received elastic bandage pressing arterial puncture part , while observation group received small sealed bottle pressing .Hamilton anxiety scale ( HAMA) was applied to evaluate the anxiety symptoms of patients in two groups , and the healed time , hospital stays and postoperative satisfactory degrees were also compared .Results The healed time [(2.7 ±0.6) d], hospital stays [(4.8 ±1.6)d] and anxiety symptom scores (1.9 ±0.8) in observation group were significantly shorter/lower than in control group [(5.4 ±1.3) d, (7.2 ±2.1) d, (2.7 ±1.1)], and all the differences had statistical significance (t=10.668,5.142,3.327,respectively;P<0.01).Besides, the satisfactory degree of patients in observation group (93.6%) was evidently higher than that in control group (65.6%), and statistically significance difference was presented (χ2 =7.819,P<0.01).Conclusions The local part bound up by elastic bandage in combination with a small sealed bottle pressed the arterial puncture part can obviously shorten the healed time and hospital stays of patients with pseudoaneurysm after coronary arteriography , promote the surgical limb recovery , alleviate anxiety symptoms and improve the patients ’ satisfactory degree , so it deserves to be popularized and promoted in clinic .

Objective To explore the application of evidence-based nursing in patients with coronary atherosclerosis heart disease (CHD)who received percutaneous coronary intervention (PCI)in selected days.Methods A total of 85 CHD patients undergoing PCI in selected days were randomly divided into observation group (43 cases)and control group (42 cases).Control group was treated with routine nursing while observation group with evidence-based nursing.Re-sults The compliance rates of observation group was 95.35%,evidently higher than the 78.57%in control group (P <0.05).Self-rating anxiety scale (SAS)and self-rating depression scale (SDS)scores decreased markedly in both groups after interventions than intervention before, which were apparently lower in observation group than in control group,and there was significant difference (P <0.05).One month after operation,observation group was obviously higher in seat-tle angina questionnaire (SAQ)than control group (P <0.01).Conclusion Evidence-based nursing can increase the therapeutic compliance,promote the negative emotions and improve the postoperative quality of life of CHD patients with PCI.

Vitrectomy with inert gas or silicone oil tamponade is an effective surgical treatment of complicated retinal detachment.Maintaining the passive position after the surgery related to the success of the operation.If there is no suitable head-resting table,patients will have a lot of symptoms due to long time sitting with head bowed.In this paper,we developed a special head-resting table for patients of sitting position with head bowed after vitrectomy.It can adjust the head position more accurately,increase patient comfort,ensure the maintenance of the correct body position for a long time,and effectively reduce the various symptoms of the prone position,improve the success rate of surgery.