Objective Through discussing application of case analysis to improve the comprehensive quality of nursing staff,and promote their implementation of high quality nursing care for the patients.Methods all 61 nurses in general wards were trained by daily half-hour case analysis method.After the training,questionnaire was given to investigate the nursing staff's evaluation on case analysis training,and at the same time compared before and after the training,the patients' satisfaction survey result,the monthly examination result of the nursing department,nursing paper quality and the number of nursing adverse events.The relevant data was done by t test orx2 test.Results After the implementation for half an hour case analysis training,most nurses think their own various ability was improved.After the training,the patient satisfaction was (t=-0.391),the monthly assessment score of the nursing department(t=3.823),the quality of care increased(x2=5.495),while the nursing adverse events reduced(x2=6.441),and the difference was statistically significant compared with before the training(P＜0.05).Conclusion Daily half-hour case study method can improve the nursing staff comprehensive quality and scientific research ability,the patients' satisfaction,and reduce the nursing adverse events,which is helpful to clinical practice.

Objective To explore the efficacy and safety of fondaparinux combined with tirofiban in patients with high risk unstable angina (UA) undergoing complex percutaneous coronary intervention (PCI).Methods A total of 389 patients were enrolled and randomized into two groups receiving either fondaparinux with tirofiban or enoxaparin with tirofiban.Bleeding,thrombosis and main adverse cardiovascular events (MACE) were compared between the two groups during hospitalization,at week 2 and week 4 after discharge.Results No severe bleeding was observed during hospitalization in the both groups,while lower rate of mild and minor bleeding was shown in the fondaparinux group (0 vs 1.5％ and 18.2％ vs 34.5％,P =0.04 and P ＜0.001 respectively).No difference was found between the two groups in the rate of MACE during hospitalization,at week 2 and week 4 weeks after discharge.The rates of death,recurrent myocardial infarction,refractory myocardial ischemia and target vessel revascularization were 0.5％ vs 1.0％,0.5％ vs 1.0％,1.6％ vs 1.0％ and 2.1％ vs 1.5％ during hospitalization;0 vs0,1.0％ vs 0.5％,1.0％ vs 1.5％,0.5％ vs 1.0％ at week2 after discharge; 0.5％ vs0.5％,0.5％ vs0.5％,2.6％ vs 2.0％,0 vs 0.5％ at week 4 after discharge (all P values ＞ 0.05).Conclusion The combination therapy of fondaparinux and tirofiban is of good safety and efficacy in high risk UA patients undergoing complex PCI.

To investigate the cellular immunity abnormalities of patients with rheumatoid arthritis(RA), peripheral blood lymphocytes subpopulations, interleukin 2 (IL-2) production and natural killer (NK) cell activity were determined in 9 patients with RA. The results showed that there were a remarkable decrease in NK cell activity and poor response to IL-2 stimlulation. IL-2 production and.the expression of membrane-bound IL-2 receptor were increased in RA patients. The percentage of T4 positive cells and the ratio of T4/T8 were also increased in patients with RA. The results indicate that there are severe cellular immunity abnormalities in patients with RA.

The intestinal flora in patients with leukemia is significantly different from healthy people. Some studies have found that intestinal flora can participate in leukemia progression by regulating the body's immune system and hematopoietic system and affecting the metabolic function, but the underlying molecular mechanism is not clear. Maintaining the intestinal microecological balance and exploring intestinal microbes that can be used as therapeutic targets have a profound significance for prolonging the survival of leukemia patients.

Objective To evaluate the short-term efficacy and safety of sevelamer hydrochloride in treating maintenance hemodialysis (MHD) patients with hyperphosphemia.Methods A multicenter,open-labeled,self-control study was performed.Phosphate binders were discontinued during a two-week washout period.Patients with more than 1.78 mmol/L serum phosphorus after two-week washout period were eligible for the trial.The dose was adjusted every two weeks as necessary to achieve serum phosphorus control. Sevelamer hydrochloride was administered to 138 MHD patients for 10 weeks and a second two-week washout period followed.Results A total of 111 from 138 patients fulfilled the whole 14-week study. Mean serum phosphorus and calcium-phosphate products starte to decline after two-week sevelamer hydrochloride treatment. By the end of 10-week sevelamer hydrochloride treatment, mean serum level of phosphorus [(1.85±0.50) vs (2.57±0.54) mmol/L,P＜0.01],calcium-phosphate product [(4.16± 1.72) vs (5.79 ± 1.50) mmol2/L2,P＜0.01 ] and low density lipoprotein [(1.64±0.76) vs (2.31 ±0.87) mmol/L,P＜0.01] were significantly decreased,while the adjusted serum level of calcium and serum intact parathyroid hormone kept steady.Both serum phosphorus and calcium-phosphrus product increased after the second washout period, but the levels were still lower as compared to pre-treatment [(2.26±0.71) vs (2.57±0.54) mmol/L; (5.12±1.63) vs (5.79±1.50) mmol2/L2,P＜0.01].Of the 138 patients involved,214 episodes in 106 patients and 121 episodes in 89 patients were reported as adverse events and adverse drug reaction respectively. Gastrointestinal symptoms,of which most were mild or moderate,happened to 68.1％ (94/138) patients. Conclusions Sevelamer hydrochloride can control serum phosphorus and reduce the levels of calcium-phosphorus product and cholesterol.Slight gastrointestinal symptoms like constipation are common during the treatment.

Objective To know the perception and experience of respiratory specialized nurses on clinical practice training,and provide references and basis for perfecting the scheme of clinical practice training in further.Methods Personal in-depth interviews were conducted on 16 graduated respiratory specialized nurses and the subjects were refined as well.Results Six themes were obtained:clinical practice training time was insufficient;training content was rich but lack of novelty;flexible and diverse forms of training were expected;qualifications for the clinical teachers were required;traditional single clinical competency assessment methods,and specialist knowledge,the clinical skills,scientific research,teaching abilities could be improved.Conclusion In order to cultivate high-quality respiratory specialized nurses,clinical practice training scheme should be further modified and perfected.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

Objective:To investigate the clinical therapeutic efficacy and safety of domestic imatinib mesylate in treatment of chronic myeloid leukemia (CML).Methods:The clinical data of 87 CML-chronic phase patients treated by domestic imatinib between December 2013 and March 2018 in the Affiliated Hospital of the Southwest Medical University were retrospectively analyzed. The clinical therapeutic efficacy and safety of imatinib was analyzed.Results:The completely hematologic reaction (CHR) rate was 95.4% (83/87), 97.7% (85/87) and 100.0% (87/87), respectively after treatment at 3, 6 and 12 months. The completely cytogenetic reaction (CCyR) rate was 31.0% (27/87), 42.5% (37/87) and 64.4% (56/87), respectively at 3, 6 and 12 months. At 3-month, BCR-ABL/ABL IS value was equal to or less than 10% in 44 patients (50.6%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 4 patients (4.6%). At 6-month, BCR-ABL/ABL IS value was equal to or less than 1% in 39 patients (44.8%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 13 patients (14.9%). The major molecular response rate at 12-month was 35.6% (31/87). The major hematologic adverse reaction was grade Ⅰ-Ⅱ hemacytopenia. The common non-hematology adverse reactions were edema, muscular and joints soreness, nausea and vomiting and diarrhea. Most patients didn't have severe adverse reactions. Conclusions:The clinical efficacy of CML patients treated with domestic imatinib is sure; CML patients are well-tolerated and the adverse reactions are mild. It is worthy of wide application in clinical treatment.

Objective:To investigate the knowledge, attitude and practice of adult oxygen inhalation therapy among nurses and analyze its influencing factors.Methods:A self-designed questionnaire was used to investigate the status of knowledge, attitude and practice of adult oxygen inhalation therapy among 1 410 nurses from many tertiary, secondary and lower hospitals in Chongqing, Jiangsu, Sichuan, Shanxi and other provinces and cities from December 2020 to January 2021 by convenient sampling method.Results:The score of nurses′ knowledge of adult oxygen inhalation therapy was 1-39 (23.10 ±4.82) points, the standard score was (44.42 ±9.27) points, the score of excellent was 0, the score of moderate was 1.8%(25/1 410), the score of poor was 98.2%(1 385/1 410). The score of nurses′ attitude of adult oxygen inhalation therapy was 6-30 (25.06 ±4.37) points, the standard score was (83.53 ±14.58) points, positive attitude accounted for 42.9%(605/1 410), neutral attitude accounted for 54.6%(770/1 410), negative attitude accounted for 2.5%(35/1 410). The score of nurses′ practice of adult oxygen inhalation therapy was 9-54 (33.82 ±6.32) points, and the standard score was (75.12 ±13.99). Positive practice accounted for 21.2%(299/1 410), neutral practice accounted for 70.4%(993/1410) points, negative practice accounted for 8.4%(118/1 410). The knowledge and attitude of nurses to adult oxygen inhalation therapy were positively correlated with practice( r=0.193, 0.554, both P<0.01). Multiple linear regression analysis showed that nurses′ knowledge, attitude and training frequency were the influencing factors of adult oxygen inhalation therapy practice( t=3.17, 23.33, 8.64, all P<0.01). Conclusions:Nurses should strengthen the study and training of adult oxygen inhalation therapy, correct attitude and improve practice, reduce or avoid the occurrence of excessive oxygen therapy and oxygen therapy complications, standardize clinical oxygen therapy to ensure the safety and effectiveness of oxygen therapy.

We have shown that myosin light chain kinase (MLCK) was required for the off-contraction in response to the electrical field stimulation (EFS) of feline esophageal smooth muscle. In this study, we investigated whether protein kinase C (PKC) may require the on-contraction in response to EFS using feline esophageal smooth muscle. The contractions were recorded using an isometric force transducer. On-contraction occurred in the presence of NG-nitro-L-arginine methyl ester (L-NAME), suggesting that nitric oxide acts as an inhibitory mediator in smooth muscle. The excitatory composition of both contractions was cholinergic dependent which was blocked by tetrodotoxin or atropine. The on-contraction was abolished in Ca2+-free buffer but reappeared in normal Ca2+-containing buffer indicating that the contraction was Ca2+ dependent. 4-aminopyridine (4-AP), voltage-dependent K+ channel blocker, significantly enhanced on-contraction. Aluminum fluoride (a G-protein activator) increased on-contraction. Pertussis toxin (a Gi inactivator) and C3 exoenzyme (a rhoA inactivator) significantly decreased on-contraction suggesting that Gi or rhoA protein may be related with Ca2+ and K+ channel. ML-9, a MLCK inhibitor, significantly inhibited on-contraction, and chelerythrine (PKC inhibitor) affected on the contraction. These results suggest that endogenous cholinergic contractions activated directly by low-frequency EFS may be mediated by Ca2+, and G proteins, such as Gi and rhoA, which resulted in the activation of MLCK, and PKC to produce the contraction in feline distal esophageal smooth muscle.
4-Aminopyridine ; Aluminum ; Aluminum Compounds ; Atropine ; Azepines ; Benzophenanthridines ; Contracts ; Esophagus ; Fluorides ; GTP-Binding Proteins ; Muscle, Smooth ; Myosin-Light-Chain Kinase ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Pertussis Toxin ; Protein Kinase C ; rhoA GTP-Binding Protein ; Tetrodotoxin ; Transducers