Objective To investigate the value of brainstem auditory evoked potential (BAEP) in early diagnosis of severe hand,foot and mouth disease (HFMD) with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years (n =80).Group B included the severe cases who were younger than three years(n =94).Group C included the general cases who were three years or older(n =38).Group D included the severe cases who were three years or older(n =85).The electroencephalogram (EEG) and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results (1) The BAEP abnormal rate of group B (18/94,19.15％)was higher than that of group A (3/80,3.75％),and the BAEP abnormal rate of group D (13/85,15.29％) was higher than that of group C (1/38,2.63％) (P ＜ 0.05).(2) The EEG abnormal rate in group B was low(2/94,2.13％) and there was no case with abnormal EEG in group A.(3) The EEG abnormal rate of group D (49/85,57.65％) was higher than that of group C (6/38,15.79％) (P ＜0.05),and higher than the BAEP abnormal rate of group D.(4) The MRI abnormal rate of group B (9/94,9.57％) was higher than that of group A (1/80,1.25％) (P ＜ 0.05),and the MRI abnormal rate of group D (9/85,10.59％)was higher than that of group C (0).(5) The BAEP abnormal rate of the children with severe HFMD (31/179,17.32％) was higher than the MRI abnormal rate (18/179,10.06％) (P ＜0.05).Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.

Objective To investigate the changes of liver function and white blood cell of patients with liver cirrhosis,portal hypertension and secondary hypersplenism underwent laparoscopic splenectomy(LS) and open splenectomy(OS).Methods We analyzed 76 clinical data of patients with liver cirrhosis,portal hypertension and secondary hypersplenism,among those 27 underwent LS,49 OS from Mar 2003 to Mar 2006 retrospectively.Blood samples were obtained and analyzed preoperatively and postoperatively on days 1,3, and 7,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),directed bilirubin(DBil) and white blood cell(WBC).Results Between LS and OS,the serum levels of Tbil and Dbil had significant difference on the 1st postoperative day(P

The development of the minimally invasive targeted ablation tendency creates a new therapy for lung cancer. This treatment is featured with considerably extensive indication ,excellent local control and survival time, low incidence and controllable complications. There are many strong proofs of clinical efficacy and safety in this field presently.

Objective Discuss how to develop nurse arrange in groups mode in basic level hospital, resolve more effectively the problem of nurse delayed on duty to ensure nursing care quality and patients' safety.Methods Divide nurses of different level, different working ability and work experience into several groups to carry on arranges in groups.According to the quantity of patient in ward, the nursing work load, nurse establishment and so on, arrange groups with different number of nurse to attend duty.Results Realized nurse level management, the senior nurse's sense of responsibility strengthened, the work value feeling promoted, nurse delayed on duty rate reduced 89.5%;has realized three satisfactions, namely doctor, nurse, the patient were satisfied.Conclusion Basic level hospital, according with practical work characteristics, develop arranges in groups pattern continuously, and thus has safeguarded the noon and at night patient's safety well, has manifested truly take the patient as the center service idea;reduced times of handover, effectively save time of work, raises the working efficiency, reduces the safe hidden danger;realized nurse level management, enhanced nurse the value feeling.

OBJECTIVE To discuss the management experience of protective measures for emergently admitted influenza H1N1 patients in our hospital who were converted from general ward into isolated ward in no more than three hours.METHODS Laying out the guideline of the work,personal training and personal protective measures were taken to manage the staff who working in the isolated ward.RESULTS There was statistically significant difference in hand washing,wearing mask and head wear,taken off gloves,mask and clothes among medical staff who worked in the isolated ward,in comparison with staff from other ward and non-medical staff From 14 points of suruey.there were 8 points were over 80% pass rate.The use of protective equipment was correct.without any cross infection.CONCLUSIONS Management of protective measures plays an important role in control of cross infection in treatment of H1N1 patients.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

OBJECTIVE:To study the effect and mechanism of tandospirone citrate (TC) on blood pressure in spontaneously hypertensive rats (SHR). METHODS:SHR were divided into model group,positive control group (Levamlodipine besylate tab-lets,2.5 mg/kg),TC high-dose,medium-dose,low-dose groups(TC capsules,40,20,10 mg/kg),8 in each group. Other 8 nor-mal rats were chosen as normal control group. The rats were intragastrically administrated medicines,once a day,for 28 d. Systolic blood pressure(SBP)before first administration and after 0.5,1,1.5,2,3,4 h of administration in each group were measured, and SBP after 1 h of administration were measured once every 7 d. After last administration,nitric oxide(NO)content in serum, endothelin,renin,angiotensin Ⅱ(Ang Ⅱ) and norepinephrine (NE) contents in plasma were detected. RESULTS:In single ad-ministration,compared with model group,SBP in 0.5,1 h in positive control group and TC groups after first administration were obviously decreased (P<0.05 or P<0.01),then SBP were obviously decreased only in positive control group and TC high-dose group (P<0.05 or P<0.01). In multiple administration,compared with model group,SBP in 7th,14th,28th day of administra-tion in positive control group and TC high-dose,medium-dose groups were obviously decreased(P<0.05 or P<0.01). Compared with model group,NO content in serum in positive control group,TC high-dose group were obviously increased;endothelin,re-nin,Ang Ⅱ and NE contents in plasma were obviously decreased (P<0.05 or P<0.01). Compared with positive control group, NO content in serum in TC groups was obviously decreased;endothelin,renin,Ang Ⅱ and NE contents in plasma were obviously increased in TC medium-dose group (P<0.05). CONCLUSIONS:TC can obviously decrease the blood pressure of SHR. The mechanism may be associated with adjusting the balance of NO and endothelin,and decreasing renin,AngⅡand NE contents.

Objective:To investigate the risk factors and prognostic effects of intolerance of early enteral nutrition after surgery for gastric cancer.Methods:The clinical data of 75 patients with gastric cancer who were admitted in the Shoukang hospital and received early enteral nutrition after surgery were retrospectively retrived and analyzed.Patients were divided into the tolerance group and the non-tolerance group according to whether the patients developed the symtoms of nausea,vomiting,abdominal pain,distention and diarrhea after early enteral nutrition.Results:51 patients (68％) showed enteral nutrition intolerance after early enteral nutrition postoperatively,whereas 24 (32％) were in the tolerance group.The activity time out of bed on the first postoperative day,the time of initiation of enteral nutrition,and nutrition pump were significantly different between two groups.Logistic analysis revealed that the activitity time and nutrition pump were independent favourable factors.Besides,patients with intolerance had longer time to exhaust and defecation,and postoperative hospital stay.Conclusion:Insufficient postoperative activity time and nonuse of nutrition pump are risk factors of intolerance of early enteral nutrition,which may slow the recovery of patients.

Objective Recently, the role of TREK-1 in anti-depression and neuroprotection was demonstrated definitely.In this paper,a systematic review about the functional structure of TREK-1 as well as the underlying mechanisms which involved in depression resistance and nerve protection was made for purpose of providing new ideas for the treatment of clinical diseases.Methods The electronic search of Medline/PubMed,CNKI,CBM and Wanfang Data were performed to collect the introduction of TREK-1 and the studies of depression and nerve protection in which TREK-1 participated from inception of each database to October 2015 ,besides the relevant references of the included studies were also retrieved.Results 30 studies were included in this paper.14 studies were about the interpretation of TREK-1's structure, distribution and the regulatory factors, and the number of researches regarding the involvement of TREK-1 in anti-depression and neuroprotection was 13 and 7 respectively.Based on these studies,it was easily to conclude that inhibition or blocking of TREK-1 channels can produce obvious antidepressant effect, however, activation of TREK-1 channels will induce the dilation of local cerebral vascular and silence hyperactive neurons.Conclusion Some achievements about the antidepressant and neuroprotective effect of TREK-1 channels in vivo have been made gratifyingly,thus future research should focus on exploring the best TREK-lactivation ratio in different brain regions to gain the best balance between anti-depression and neuroprotection.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.