Objective To investigate status quo of illness uncertainty and coping style in family members of patients with severe sepsis of in intensive care unit (ICU),to explore their relationships.Methods A total of 117 family members of patients with severe sepsis of in ICU was chosen by convenient sampling.They were surveyed by the Mishel Uncertainty in Illness Scale-Family version and Simplified Coping Style Questionnaire.Results The uncertainty in illness of family members scored 56 ～ 139 (102.16 ± 14.73).Positive coping style scored 6 ～38 (22.68 ±3.73).Negative coping style scored 4 ～22 (13.08 ±4.12).The total score of uncertainty in illness of family members was negatively correlated with the score of positive coping style,and was positively correlated with the score of negative coping style.Conclusions Illness uncertainty level of patients' families interacts with coping styles.Nurse should take corresponding measures to reduce the patient's family illness uncertainty levels,and help them to take positive coping styles.

Objective To investigate the effect of hypertonic saline (HS) on the permeability of blood-brain barrier in a rat model of intracerebral hemorrhage (ICH).Methods Sixty healthy male Sprague-Dawley rats, aged 8 weeks, weighing 260-300 g, were randomly divided into 4 groups (n=15 each) using a random number table: sham operation group (group S), sham operation+HS group (group HS) ,ICH group, and ICH+HS group.ICH was commonly induced in anesthetized rats by intraparenchymal injection of autologous blood 50 μ1.The equal volume of normal saline was given instead in group S.The neurologic deficits were scored on a five-point scale, and a score of 1-3 indicated successful establishment of the model.At 48 h after establishment of the model, the rats were sacrificed, and brains were removed for determination of brain water content, expression of occludin in brain tissues (by Western blot) , and Evans blue content.Results Compared with group S, the brain water content and Evans blue content were significantly increased, and the expression of occludin was down-regulated in ICH and ICH+HS groups, and no significant change was found in the indices mentioned above in group S+HS.Compared with group ICH,the brain water content and Evans blue content were significantly decreased, and the expression of occludin was up-regulated in group ICH +HS.Conclusion HS can inhibit increase in the permeability of bloodbrain barrier, and reduce the cerebral edema in a rat model of ICH.

Objective To compare the effects of three kinds of dressings (foam dressings,hydrocolloid dressings,homemade gauze dressings)at different periods for preventing nasal and facial pressure ulcers in elderly patients in the intensive care unit with continuous non -invasive ventilation.Methods The study group consisted of 120 patients who were 60 years old in the intensive care unit with continuous non -invasive ventilation.They were randomly divided into A,B,C three groups with random number table.The patients in A group used foam dressings. The patients in B group used hydrocolloid dressings.The patients in C group used homemade gauze dressings.In the first week and the second week,through comparing the incidence of pressure ulcers,we compared the prevention effect of three kinds of dressings on nasal and facial pressure ulcers.Results In the first week,there was no statistical difference about the incidence of pressure ulcers among the three groups(χ2 =2.124,P =0.346).In the second week,the incidence of pressure ulcer of A group was obviously lower than B group and C group(χ2 =5.271,P =0.038).Conclusion When we nurse elderly patients in the intensive care unit with continuous non -invasive ventilation,within 7 days,we can use any one of three kinds of dressings to prevent nasal and facial pressure ulcers. But 7 days later,we should better use foam dressings.

Objective To evaluate the efficacy and safety of percutaneous transluminal angioplasty and stenting of intravascular stenting (PTAS) and internal medicine in the treatment of secondary severe stroke in young patients with severe symptomatic middle cerebral artery stenosis.Methods The clinical data of 77 cases with severe symptomatic middle cerebral artery stenosis(ste nosis rate≥70％)confirmed by digital subtraction angiography(DSA) were collected retrospectively in our hospital from January 2011 to June 2015.The patients were divided into PTAS group and medical treatment group,and the data were collected including the modified Rankin Score (mRS score) at admission,the US National Institutes of Health Stroke volume neurological impairments score (NIHSS score)at admission,as well as mRS score,the recurrence of ischemic stroke,death and intracerebral hemorrhage within 1 year.Results The primary end-point rates within 30 days after enrollment in PTAS group and medical treatment group were 0％ and 5.77％ respectively,and the stroke recurrence rates within 1 year were 4.35％ and 13.46％ respectively,The differ ence was not statistically significant(P＞0.05).Meanwhile,there was no death and intracerebral hemorrhage in both two groups.The rates of mRS≤1 were 91.30 ％ and 69.23 ％ respectively in PTAS group and medical treatment group,and the difference was statistically significant (P＜0.05).The rates of mRS≤2 were 95.65 ％ and 84.62 ％ respectively in PTAS group and medical treat ment group,and the difference was not statistically significant(P＞0.05).Conclusion PTAS is safe for the severe symptomatic middle cerebral artery stenosis,and is more efficient in dectasing the risk of recurrent stroke in young population compared with medical treatment.

OBJECTIVE:To establish a RP-HPLC method for the determination of baicalin and jasminoidin in Qingkailing Injection.METHODS:It was performed on DiamonsilTM C18 column with acetonitrile-20 mmol?L-1 sodium dihydrogen phosphate solution (20:80)as mobile phase.The flow rate was 1.0 mL?min-1.The detection wavelength was 238 nm.RESULTS:The liner range of baicalin was 1～50?g?mL-1,(r=0.999 5)and the average recovery was 100.75%(RSD=1.75%);The liner range of jasminoidin was 0.1～10?g?mL-1(r=0.999 7)and the average recovery was 100.63%(RSD=1.35%).CONCLUSION:This method is rapid,simple,accurate and sensitive.It can be used for quality control of Qingkailing Injection.

OBJECTIVE To observe the effect of baicalin on Aβ25-35 induced learning and memory deficits and changes in autophagy-related genes in mice so as to explore the related mechanisms of Alzheimer disease (AD) treatment . METHODS C57 mice were administered with 3μL Aβ25-35 3 mmol·L-1 by intracerebroventricular injection to establish an AD model. Baicalin was given by intracerebroventricular injection at the dose of 25, 50 and 100 mg · kg-1 for 15 d, respectively. The total distance and the central grid residence time were measured in the open-field test. The escape latency and the time to reach the platform were monitored in the Morris water maze trial. The autophagic vacuoles in the hippocampus of the mice were observed by transmission electron microscopy before the protein expressions of microtu?bule-associated protein 1 light chain 3 (LC3) and Beclin1 in brain tissue were analyzed by Western blot?ting assay. RESULTS Intracerebroventricular injection of Aβ25-35 could reduce the total distance from (3984±321)cm to (2790±306)cm and extend central grid residence time from (3.6±1.2)s to (8.8±2.9)s in the open-field test. The escape latency of water maze also increased from (22.0 ± 1.9)s to (38.8 ± 2.2)s. Autophagic vacuoles or late autophagic vacuoles and increased Beclin1 and LC3 and protein level were observed in the hippocampus after Aβ25-35 injection. Intraperitoneal injection of Baicalin 50 and 100 mg · kg-1 for fifteen consecutive days extended the total distance in open-field test to (3705 ± 337)cm and (3968 ± 448)cm, respectively, while the central grid residence time was reduced to (5.6 ± 1.8)s and (3.9±1.5)s, respectively. The total time taken to reach the platform in water maze test was reduced to (28.6± 1.9)s, (22.9 ± 1.7)s. Mitochondrial swelling, vacuolar membrane structure or autophagic vacuoles were visible in the hippocampus. LC3 and Beclin1 protein expression was significantly up-regulated(P<0.01). CONCLUSION Baicalin shows protective effect against Aβ25-35 induced learning and memory deficits, and this effect may be related to the activation of autophagy in the mouse hippocampus.

Objective To establish a molecular typing system of Staphylococcus aureus by using resolution melting for food-poi-soning fast tracing.Methods Primers were designed and synthesized according to the literature of VNTR in Staphylococcus au-reus ,and were used to perform molecular typing on the strains which had detected by PFGE,then 4 types of VNTRs were with higher discriminatory power were selected.On this basis,we established a molecular typing system for the detection of 59 Staphy-lococcus aureus isolated from food poisoning.Results The molecular typing system has good precision for detection.The standard deviation(s)of within-batch repetitive experiments were 0.03 -0.05 ℃,between-batch repetitive experiments were 0.04 -0.06℃,between-day repetitive experiments were 0.04-0.06 ℃.At the same time,the 59 strains of Staphylococcus aureus were divided into 19 types which were 11 epidemic clones and 8 sporadic clones.The correlation coefficient of Simpson was 0.916 4.Conclusion The molecular typing system for Staphylococcus aureus based on resolution melting was simple,fast and repeatable.It can be ap-plied to fast tracing and screen of Staphylococcus aureus in food poisoning.

Objective To investigate the influence of limonin on the malignant biological behavior of non-small cell lung cancer (NSCLC) cells by regulating the protein tyrosine kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway. Methods CCK-8 method was applied to detect the survival rate of A549 cells treated with different concentrations of limonin (0, 5, 10, 25, 50, 75, 100 μmol/L). A549 cells were separated into normal culture (NC) group, low-dose limonin group (treatment with 10 μmol/L limonin for 24 h), medium-dose limonin group (treatment with 25 μmol/L limonin for 24 h), high-dose limonin group (treatment with 50 μmol/L limonin for 24 h), coumermycin A1 group (treatment with 10 μmol/L JAK2 activator coumermycin A1+50 μmol/L limonin for 24 h), and AG490 group (treatment with 10 μmol/L JAK2 inhibitor AG490+50 μmol/L limonin for 24 h). Clone formation assay was applied to detect the clones of each group of cells. Transwell assay was applied to detect cell migration and invasion, and flow cytometry was applied to detect apoptosis. Western blot analysis was applied to detect the protein expression levels of JAK2, p-JAK2, STAT3, p-STAT3, E-cadherin, N-cadherin, and vimentin in each group. Results The viability of A549 cells decreased significantly in a limonin concentration-dependent manner (P < 0.05), with IC₅₀ of 45.16±1.66 μmol/L. Concentrations of 10, 25, and 50 μmol/L were selected for subsequent experiments. The numbers of clones, migration, and invasion of A549 cells and the protein expression levels of IL-6, p-JAK2, p-STAT3, N-cadherin, and vimentin in the low-, medium-, and high-dose limonin groups significantly decreased, compared with those in the NC group, and the apoptosis rate and E-cadherin protein expression significantly increased (P < 0.05). The JAK2 activator coumermycin A1 attenuated the ability of limonin to inhibit the proliferation, migration, invasion, and other malignant biological behavior of A549 cells and attenuated the apoptosis ability. The JAK2 inhibitor AG490 enhanced the ability of limonin to inhibit the proliferation, migration, invasion, and other malignant biological behavior of A549 cells and enhanced the apoptosis ability. Conclusion Limonin can inhibit the malignant biological behavior of NSCLC cells, such as proliferation, migration, and invasion, by inhibiting the JAK2/STAT3 pathway.

ObjectiveTo evaluate the accuracy of EUS,EUS-guided fine needle aspiration ( EUSFNA) and targeted biopsy in the diagnosis of wall-thickened gastric lesions with negative malignant results ofendoscopic biopsies.MethodsA retrospective study was carried out in 57 patients who were found with thickened gastric wall of negative malignant endoscopic biopsies and underwent EUS from January 2008 to December 2010 in our hospital.Compared the EUS findings with the surgical results and follow-up status.The diagnostic yield of EUS was characterized by the disappearance of the layers or the changes of thickness of gastric wall,the characteristics of echo imaging,and the results of EUS-FNA or EUS targeted biopsy were recorded to evaluate the value of EUS.ResultsOf 57 cases,gastric cancer was confirmed in 19,lymphoma in 10,dysplasia in 1,Menetrier's disease in 1 and inflammatory changes in 26.EUS could clearly demonstrate the changes of gastric wall including the thickness and the changes of layers,with the accuracy rate of 73.07％ ( 14/19 ) on gastric cancer.EUS diagnosed gastric cancer in 26 cases,in which 14 (53.8％) were confirmed by pathology.Gastric lymphoma was suspected by EUS in 20 cases,in which 10 (50.0％ ) were proved.EUS-FNA was conducted in 19 cases,with positive result in 9 (accuracy rate 50％ ).EUS-guided targeted deep biopsy or piece-meal biopsy were performed in 10 cases,with 8 malignant results.ConclusionEUS with/without EUS-FNA is not a golden standard for the diagnosis of gastric lesions in thickened gastric wall,yet it still has some significance.

Objective:To evaluate the nutritional status of patients in intensive care unit (ICU) by using nutritional risk screening 2002 scale (NRS2002), subjective general assessment (SGA) and critical illness nutritional risk score (NUTRIC), and to compare the characteristics and applicability of three scoring tools.Methods:A cross-sectional survey was conducted. 315 patients admitted to the comprehensive ICU of Affiliated Qingdao Municipal Hospital of Qingdao University from April 2018 to July 2019 were enrolled. Basic information of patients was collected, and patients were divided into two groups with 65 years old as the standard to compare the nutritional status of patients among different genders and ages. The nutritional status of patients were assessed by NRS2002, SGA, and NUTRIC. Height, weight, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC), leg circumference (LC), and other related parameters of human nutrition were measured. Total protein (TP), albumin (Alb), prealbumin (PA), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglyceride (TG), total number of lymphocytes (LYM), hemoglobin (Hb), C-reactive protein (CRP) and other blood biochemical indicators were performed. Spearman rank correlation analysis was used to analyze the correlation between the three nutrition evaluation scales and other objective nutrition parameters. Binary multivariate Logistic regression analysis was used to evaluate the influencing factors of nutritional status with three scales of patients in ICU.Results:Among 315 patients in ICU, 183 were male and 132 were female. There were 143 patients < 65 years old and 172 ≥ 65 years old. In male patients, the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, age and BUN of patients aged ≥ 65 years old were significantly increased, and the height, weight, BMI, TSF, AC, LC, Alb and PA were significantly lowered as compared with those aged < 65 years old, while the difference in other indicators was not statistically significant. In the female patients, the APACHEⅡ score, age, SCr and BUN of the patients aged ≥ 65 years old were significantly increased, the height, Alb, PA and Hb were significantly decreased as compared with those aged < 65 years old, and the difference in other indicators was not statistically significant. The proportion of patients with nutritional risk evaluated by NRS2002 (NRS2002 score ≥ 3) was 87.62% (276/315). SGA showed that the proportion of malnourished patients (SGA was grade B or C) was 62.86% (198/315). NUTRIC showed 66.03% of patients (208/315) in high nutritional risk (NUTRIC score ≥ 5). Spearman rank correlation analysis showed that there were significant correlations among NRS2002, SGA and NUTRIC of patients in ICU ( rNRS2002 with SGA = 0.522, rNRS2002 with NUTRIC = 0.392, rSGA with NUTRIC = 0.442, all P < 0.01). Among the three assessment tools, SGA had the best correlation with blood biochemical indicators and body measurements to assess nutritional status, followed by NRS2002, and NUTRIC had the worst correlation. Binary multivariate Logistic regression showed that APACHEⅡ score, BMI, AC, BUN and TG were factors influencing NRS2002 assessment of nutritional status in ICU patients [odds ratio ( OR) were 2.535, 0.404, 1.438, 0.858, and 2.391, respectively, all P < 0.05]; APACHEⅡ score, age, weight, TP, BUN, LYM and CRP were influence factors of SGA for evaluating the malnutrition of patients in ICU ( OR values were 1.074, 1.038, 0.921, 0.947, 1.077, 1.625 and 0.991, respectively, all P < 0.05); APACHEⅡ score, age, LYM and CRP were the influence factors of NUTRIC assessment for malnutrition of patients in ICU ( OR values were 1.159, 1.049, 0.715 and 0.995, respectively, all P < 0.05). Conclusions:The nutrition status of ICU patients evaluated by NRS2002, SGA and NUTRIC was simple and easy to operate, and the positive screening rate of NRS2002 was the highest, which was suitable for patients with mild conditions in ICU. SGA is the most valuable tool to evaluate the nutritional status of ICU patients. NUTRIC has a poor correlation with objective indicators reflecting nutritional status, while its indicators are objective and easy to obtain, which is suitable for ICU patients with critical condition and unclear consciousness. Nutritional assessment tools should be integrated with the patient's gender, age, anthropometric and biochemical indicators.