To explore the observation and nursing of complications in operative patients with massive and rapid transfusion,32 cases were studied,the author summarized that the observation and nursing experience in prevention and treatment of some complications,such as overloading circulation、bleeding tendency、hypokalemia and hypothermia.

Objective To investigate the function of serum soluble intercellular adhesion molecule-1(sICAM-1) in acute pancreatitis(AP).To study the significance of continuous monitoring sICAM-1 in differential diagnosis of AP.Methods A total of 60 patients were investigated;36 patients with acute edematous pancreatitis(AEP),and 24 with acute haemorragic necrotic pancreatitis(AHNP).The concentrations of sICAM-1 in the patients' serum were measured serially over a period of 7d by enzyme-linked immunosorbent assay(ELISA).Results There was significant difference between AEP group and AHNP group(P

Objective To explore a clear picture of the health human resources allocation in tertiary general hospitals in Beijing ,and propose strategies to optimize the configuration of human resources at the same level hospitals ,so as to improve the medical service quality for society. Methods Basic operational data and human resources configuration of 16 tertiary general hospitals with more than 800 beds in Beijing were col?lected by using clustering sampling and literature review ,and then a descriptive analysis of the human resource configuration data at the same level hospitals was carried out by SPSS18.0 and Excel2010. Results The number of patients increased year by year,but the average days of hospitaliza?tion showed a downward trends during 2009?2011. According to the previous way of beds to determine personnel ,there was significantly different from the actual situation. A significant quantitative correlation was foung between the physicians and the nurses,pharmacists,medical laboratory technician,and the ratio between physicians and these staffs is stable. Conclusion With the development of hospital service and increase of health human resources,health manpower ratio has changed significantly in tertiary general hospitals. A stable proportion of physicians can be used as the reference standard for hospital human resources configuration at the same level hospitals.

Toenhance the humanityeducation for our student nurses,in recent years,our col-lege has done innovation on humanity courses by increasing its proportion,enhancing the penetration of humanity education into other courses. We have strengthened the cultivation of humanity emotion bypaying attention to the development of recessive courses and constructing the fantastic humanity environment by the means of practical activities.

AIM: To observe the effects of norepinephrine (NE) on the cardiopulmonary and lung injury in goats with acute respiratory distress syndrome (ARDS) induced by endotoxin. METHODS: A model of septic ARDS was induced by intravenous infusion of low dose endotoxin in six goats. Then 40?10~ -6 NO inhalation was applied to the animals. After 30 min, combined intravenous infusion of NE at concentration of 0.5 mg?kg~ -1 ?min~ -1 was conducted. The dynamic changes in gas exchange and hemodynamics were measured with the aid of Swan-Ganz catheter. Arterial blood gas analysis before and after the onset of ARDS, 30 min after NO inhalation and combined NE was detected. Histology of the lung was also observed. RESULTS: Inhalation of NO rapidly reduced mean pulmonary arterial pressure (MPAP), increased PaO_2, decreased P_ (A-a) O_2 and Qs/Qt in septic ARDS goats. These decrease and increase were more significant than those in NO inhaled alone when animals received NE. The combination of NO inhalation and NE injection resulted in increase in mean arterial pressure. NO inhalation did not ameliorate lung injury and combined NE intravenous injection ameliorated lung injury. CONCLUSION: Injection of low dose norepinephrine improves the beneficial effects of inhaled nitric oxide on lung gas exchange and ameliorates lung injury in goats with acute respiratory distress syndrome induced by endotoxin.

Objective MRI and MR hydrogen proton spectroscopy (1H-MRS) were used to detect the abnormal signal and alteration of metabolites, in order to explore the efficacy of these method in evaluating the damages of central nervous system (CNS) induced by occupational manganese exposure.Methods Eighteen workers exposed to manganese without any manganism symptoms, 12 workers with slightly chronic manganese poisoning, and 19 healthy workers were scanned using routine MRI sequence and 1H-MRS.The blood manganese concentration was also collected for each subject.On cerebral axial T1 WI,the signal intensities of ipsilateral globus pallidus and frontal white matter were measured in the visually brightest area (try to select the signal homogeneous region), and the globus pallidus index (PI) was then calculated.The 1H-MRS data was calculated to get the values of the peak height of N-acetylaspartate (NAA), choline (Cho), inositol (mI) and creatine (Cr) and the ratios of NAA/Cr, Cho/Cr, and mL/Cr were also calculated.One way ANOVA was used to compare the values of PI, NAA/Cr, Cho/Cr, mI/Cr and MnB among the three groups, and the correlations between PI and the time span of manganese exposure or blood manganese concentration were analyzed by Pearson correlation analysis.Eight workers exposed to manganese were followed up one year, and their PI , NAA/Cr before and after follow-up were compared by t test.Results Fourteen of 18 cases exposed to manganese without any manganism symptoms showed symmetrically high intensity signal on T1 WI, while the T2 WI were normal.No high signal intensity was observed on T1WI in any of the healthy workers or manganese poisoning workers.We found that the average PI in manganese exposed group (1.16 ±0.09) was significantly higher (F =24.79 ,P =0.O00)than those of the poisoning ( 1.05 ± 0.07 ) and control groups ( 1.01 ± 0.05 ).The blood manganese concentration in manganese exposed group, the poisoning group and the control group were (0.051 ±0.024), (0.047 ±0.018 ), ( 0.043 ± 0.020 ) μg/ml respectively, which was not significantly different ( F = O.623, P =0.541 ) and did not exceed the upper limit of normal reference value ( < 0.10 μg/ml ).There was a significantly correlation between PI and the time span of manganese exposure ( r = 0.67, P = 0.002 ),however, there was no correlation between PI and blood manganese concentration ( r = 0.20, P = 0.427 ).Furthermore, the NAA/Cr ratio decreased variously in the manganese poisoning group ( 1.22 ± 0.07 ) which was significantly lower( F = 4.120, P = 0.023 ) than those of the poisoning( 1.33 ± 0.13 ) and control groups ( 1.31 ±0.13).No statistical significanees were found in the ratios of Cho/Cr and mI/Cr among these three groups(P>0.05).No obvious changes of the PI and NAA/Cr were found in the 8 manganese exposed workers after 1 year follow-up.Conclusion Manganese exposure could lead to the high intensity signal on T1 WI, therefore the increased PI may be the biomarkers of central nerve system damages caused by the occupational manganese exposure.

BACKGROUND:Studies about low-frequency pulsed electromagnetic fields interfering with bone marrow mesenchymal stem cells proliferation and differentiation are many, but the Raman spectra of single stem cells irradiated in electromagnetic fields analyzed by surface Raman spectroscopy analysis are rarely reported. OBJECTIVE:To compare the difference in Raman spectra of bone marrow mesenchymal stem cells with or with no irradiation of 3 000 Hz pulsed electromagnetic fields. METHODS:Bone marrow mesenchymal stem cells isolated from Sprague-Dawley rats were cultured and identified. Passage 3 cells were inoculated into 6-wel plates and divided into two groups:pulsed electromagnetic field irradiation group and blank control group. After cultured for 7 days, cells in the two groups were transferred to physiological saline, and 30 cells were randomly col ected from each group. Four Raman spectra were harvested from each celland the average relative intensity of Raman spectra was calculated and compared between two groups. RESULTS AND CONCLUSION:There were the same Raman peaks in the two groups, and the waveforms were basical y same in the two group based on the curve mapping by origin 7.0 software. The peak value in the irradiation group was decreased compared with the blank control group. Laser optical tweezers Raman spectroscopy can be applied to study the biochemical changes of a single stem cellat the molecular level. The Raman spectra of bone marrow mesenchymal stem cells irradiated by 3 000 Hz pulsed electromagnetic fields differ from those without irradiation, and the peak also lowered after irradiation.

OBJECTIVETo assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.

METHODSWe divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.

RESULTSAmong 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.

CONCLUSIONNeuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.

Adult ; Aged ; Diabetic Foot ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; methods ; Predictive Value of Tests ; Risk Assessment

OBJECTIVETo investigate the sesquiterpene lactones of the aerial parts of Inula helianthus-aquatica.

METHODCompounds were isolated and purified by silica gel, Sephadex LH-20 and preparative HPLC. On the basis of physicochemical properties and spectroscopic data, their structures were identified.

RESULTSeven sesquiterpene lactones and four other compounds were obtained and identified as 2-desoxy-4-epi-pulchellin (1), 6-acetoxy-4-hydroxy-1, 10H-pseudoguaia-11 (13)-en-12,8-olide (2), 4-acetoxy-6-hydroxy-1, 10H-pseudoguaia-11(13)-en-12,8-olide (3), 8-epi-inuviscolide (4), 2,3,11,13-tetrahydroaromaticin (5), 11,13-dihydro-ergolide (6), 4-epipulchellin-2-O-acetate (7), 7-epiloliolide (8), loliolide (9), beta-sitosterol (10) and daucosterol (11).

CONCLUSIONAll the compounds were isolated from this plant for the first time.

Drugs, Chinese Herbal ; chemistry ; Inula ; chemistry ; Lactones ; analysis ; chemistry ; isolation & purification ; Sesquiterpenes ; chemistry

Objective To investigate the clinicopathological features of early gastric cancer ( EGC) with micropapillary pattern. Methods In 447 consecutive EGC patients at Changzhou No. 2 People′s Hospital admitted from January 2006 to December 2016, 8 ( 1. 8％) with micropapillary adenocarcinoma (≥5％) were enrolled in the observation group and the remaining 439 were included in the control group. Clinicopathologic features including age, gender, gross pattern, tumor location, size, invasion depth, lymphovascular invasion, lymphatic metastasis and pathological stage were analyzed and compared between the two groups. Results There were no significant differences between the two groups in age, gender, gross pattern, tumor location or size (all P>0. 05). The observation group showed significantly more frequent submucosal invasion ( 100. 0％, 8/8 ) , lymphovascular invasion ( 62. 5％, 5/8 ) , lymphatic metastasis (62. 5％, 5/8), and higher pathological stage (Ⅱ+Ⅲ 25. 0％, 2/8) compared with those in the control group, which were 52. 4％ ( 230/439 ) , 9. 1％ ( 40/439 ) , 13. 9％ ( 61/439 ) , and 5. 9％ ( 26/439 ) , respectively ( all P<0. 05 ) . Conclusion EGC with micropapillary pattern is rare with a high liability to lymphovascular invasion, lymphatic metastasis, and higher pathological stage, compared to EGC without micropapillary pattern.