Training ability and level of trauma management skills have an straight influence on the results of pre-hospital care and treatment of casualties, and thus are very important to save the life of the wounded and to reduce the mutilation rate. The adoption of a teaching module employing a human analogue significantly improves first aid training level, which can help the students master trauma management skills and gain self-confidences. The application of virtual realty technique and human analogue to such first-aid training is reviewed as the training for dressing, hemostasis, fracture fixation, casualty transport, cardiopulmonary resuscitation and urgent airway management.

Cardiovascular Diseases ; Humans ; Osteoporosis

Objective To compare the durability and economic value of o-phthalaldehyde(OPA)and glutaraldehyde as endoscope disinfectors in continuous use of cleaning machine.Methods Compare the maximal number of endoseopes which could be disinfected by the two disinfectors at its minimal effective concentration,as well as the corresponding costs.The cost-effectiveness of two disinfectors were evaluated with Revenue-Incremental Cost Analysis.Results The number of endoscopes disinfected by OPA were 1.56 times as compared with glutaraldehyde,and an additional 2.95 yuan could be gained with OPA at the cost of 1 yuan.Conclusion When cleaning machine is full loaded,OPA is more durable than glutaraldehyde,and Can gain more benefit at the same cost.

Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

Objective To investigate the influence of endoscopic retrograde cholangiopancreatography (ERCP) on life quality of patients with common bile duct stones. Methods The life quality of 35 patients, who underwent ERCP because of common bile duct stones, were assessed by GIQLI questionnaires before, 2 and 6 weeks after the procedure. Results The mean GIQLI score of patients before ERCP was 99. 9, which was significantly increased to 112. 2 and 121.9 at 2 and 6 weeks after ERCP (P ＜0. 01 ). At 6weeks after ERCP, the GIQLI score was similar to that of normal population. Conclusion ERCP can improve the life quality of patients with common bile duct stones.

Morphine has been reported to suppress human immune response. We aimed to observe the effects of morphine, fentanyl and tramadol on NF-kappa B and IL-2 from both laboratory and clinical perspective. Jurkat cells were incubated with ten times clinically relevant concentrations of morphine, fentanyl and tramadol before being stimulated with PMA. NF-kappa B binding activity and IL-2 levels were measured. In the clinical study, 150 consenting patients were randomized into 3 groups according to the analgesics used in them, namely, group morphine (M), group fentanyl (F) and group tramadol (T). IL-2 was measured preoperatively and 1, 3 and 24 h after operation. Consequently, NF-kappa B activation was suppressed by morphine and fentanyl but not by tramadol. IL-2 was significantly decreased by morphine and fentanyl but not by tramadol in vitro. In the PCA patients, IL-2 was decreased in group M and increased in group F postoperatively. Whereas in group T, IL-2 was unchanged 1 h after operation but was significantly elevated 3 and 24 h after operation. Our results showed that the inhibition of morphine on IL-2 was most probably related to its suppression on NF-kappa B. Fentanyl had different effects on human immune response in vitro and in vivo. Tramadol may have immune enhancing effect.

Objective To investigate the therapeutic effects of embryonic dopaminergic neurons,mesencephalon-derived neural stem cells with or without pre-differentiation as grafts in the treatment of Parkinson's disease(PD) in SD rats.Methods Forty SD Parkinsonian rats were randomly assigned to four groups as follows: normal saline grafted group(A),mesencephalon-derived neural stem cells without pre-differentiation grafted group(B),embryonic dopaminergic neurons grafted group(C) and mesencephalon-derived neural stem cells with pre-differentiation grafted group(D).Normal saline and different cells were transplanted into the rat's striatum by stereotactic technique.Therapeutic effects were evaluated based on the improvement of rat's rotation behavior at 2nd,4th and 8th week after operation and survival of tyrosine hydroxylase(TH)-immunoreactive(TH-ir) cells at 8th week after operation.Results No obvious amelioration in number of rotation was found in group A(F=0.294,P=0.830).In group B,the number of rotation was decreased after operation,but the difference was not significant compared with that before operation(F=0.335,P=0.800).The numbers of rotation were obviously decreased in group C(F=26.838,P=0.000) and group D(F=14.571,P=0.000) at 8th week after operation,but no significant difference was found between the two groups(P=0.764).TH immunohistochemical staining showed that the number of TH positive cells was 665?264 in group D,679?286 in group C,80?36 in group B,and 0 in group A,and no significant difference existed between group C and D(P=0.548).Conclusion As grafts,both embryonic dopaminergic neurons and mesencephalon-derived neural stem cells with pre-differentiation can improve the rotational behavior and cellular morphology of Parkinsonian rats after neural cells transplantation.

Objective:To assess the consequences of switching aspirin dosage from 100 mg/d to 40 mg/d on cardiovascular benefit,bleeding risk and platelet aggregation in very elderly patients. Methods:Arachidonic acid induced platelet aggregation(AA-Ag)was measured in 537 patients aged 80 or older treated with aspirin (100 mg/d).In the study,100 patients with low on-treatment platelet ag-gregation and at high risk of bleeding and low risk of cardiovascular events,were switched to aspirin (40 mg/d)and their platelet aggregation was measured again 7 days later.Their bleeding and upper gastroin-testinal symptoms were also recorded in following 3 months.Results:The study observed a heterogeneous distributed aspirin 100 mg/d AA-Ag (range:0.42% to 28.78%)in the 537 very elderly patients.Aspi-rin 100 mg/d AA-Ag before the switch in aspirin 40 mg/d group was 5.00% ±2.32% and the rate of the patients with low on-treatment platelet aggregation was 71.00%.The rates of melena or occult blood positive,other minimal bleeding,upper gastrointestinal symptoms and a history of gastrointestinal bleeding in 40 mg/d group were higher than those in 100 mg/d group.On a regimen of aspirin 40 mg/d,AA-Ag increased to 11.21% ±4.95%(range:2.12% to 28.84%)with 95.00%of the patients with AA-Ag<20%and the rate of the patients with low on-treatment platelet aggregation was 15.00%.Multiple vari-able analysis revealed that aspirin 40 mg/d AA-Ag was significantly influenced by aspirin 100 mg/d AA-Ag,BMI and platelet counts.The rate of gastrointestinal bleeding decreased from 12.00% to 5.00%, and upper gastrointestinal symptoms decreased from 59.00% to 21.00% after the switch in 40 mg/d group.Conclusion:Switching aspirin dosage from 100 mg/d to 40 mg/d reduces the bleeding events and improves upper gastrointestinal symptoms,thus inhibiting platelet aggregation effectively in very elderly patients.

Objective To construct a self-assessment system of patient safety by nurses.Methods Using self-designed questionnaires of self-assessment system of patient safety by nurses,29 nursing safety management experts were selected.Delphi method was adopted to carry out two rounds of interview.The self-assessment system of patient safety by nurses was built.The importance of the indicators went on weight analysis with specialist sorting.Results The system included 3 first-level indicators,9 secondlevel indicators,48 third-level indicators.The coefficient of variation of the indicators was ＜ 0.20,and the coordination coefficient was 0.25.Conclusions The initial construction of system of self-assessment patient safety by nurses has the advantages of focused expert advice,with scientific results,and is reliable.It can be used for nurses' self-assessment of the security situation in patients.

Objective To investigate the effects of cold preservation on the expression of GATA in intrahepatic bile duct.Methods The intrahepatic bile duct tissues of SD rats were obtained by collagenase perfusion combined with mechanical separation.After being cut into fragments,the intrahepatic bile duct tissues were cultured in rat tail collagen gel for 48 hours before experiment.All the rats were divided into the control group,cold preservation 1 hour (CP1 h) group and cold preservation 12 hours (CP12 h) group.There were 5 rats in each group.The mRNA and protein expressions of GATA were detected by Real-Time polymerase chain reaction and Western blot.Measurement data with normal distribution were presented as (x) ± s.Comparison among 3 groups was done by ANOVA and pairwise comparisons were done by LSD test.Results The mRNA expressions of GATA3,GATA4,GATA6 were detected,while the mRNA expressions of GATA1,GATA2 and GATA5 were undetectable in intrahepatic bile duct tissue of the control group.The mRNA expressions of GATA4 in the CP1 h group,CP12 h group and the control group were 0.72 ± 0.08,0.56 ± 0.07 and 0.96 ± 0.06,with significant difference among the 3 groups (F =38.981,P ＜0.05).The mRNA expression of GATA4 in the CP12 h group was significantly lower than that in the CP1 h group and the control group,and the mRNA expression of GATA4 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The mRNA expression of GATA6 in the CP1 h group,CP12 h group and the control group were 0.83 ± 0.07,0.68 ± 0.12 and 0.98 ± 0.12,with significant difference among the 3 groups (F =10.175,P ＜ 0.05).The mRNA expression of GATA6 in the CP12 group was significantly lower than that in the CP1 h group and the control group,and the mRNA expression of GATA6 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The mRNA expressions of GATA3 in the CP1 h group,CP12 h group and the control group were 0.92 ± 0.06,0.89 ± 0.05 and 0.98 ± 0.11,with no significant difference among the 3 groups (F =1.674,P ＞ 0.05).The protein expressions of GATA4 in the CP1 h group,CP12 h group and the control group were 0.78 ± 0.07,0.64 ± 0.06 and 0.99 ± 0.10,with significant difference among the 3 groups (F =24.211,P ＜ 0.05).The protein expression of GATA4 in the CP12 h group was significantly lower than that in the CP1 h group and the control group,and the protein expression of GATA4 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The protein expressions of GATA6 in the CP1 h group,CP12 h group and the control group were 0.90 ± 0.04,0.75 ±0.06 and 0.98 ±0.11,with significant difference among the 3 groups (F=11.651,P＜0.05).The protein expression of GATA6 in the CP12 h group was significantly lower than that in the CP1 h group and the control group (P ＜ 0.05).Conclusion The expressions of GATA4 and GATA6 in the intrahepatic bile duct tissues are decreased significantly after cold preservation,which indicate that GATA4 and GATA6 might be involved in the pathophysiological process of the bile duct after cold preservation.