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 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 explore the expression and clinical significance of constitutive androstane receptor(CAR)in placenta syntrophoblast from patients with intrahepatic cholestasis of pregnancy(ICP).Methods Placenta were collected from women with ICP who delivered from April 2009 to March 2010 in First Affiliated Hospital of Chongqing Medical University.According to the severity of ICP,patients were classified into mild ICP group(n=10)and severe ICP group(n=10).Ten healthy pregnant women who delivered in the same period were chosen as control group.The location of CAR protein in placenta was studied by immunohistochemical streptavidin-biotin complex(SABC)method.CAR mRNA level was determined by reverse transcription(RT)-PCR technique and CAR protein expression level was determined by western blot.Results(1)CAR was located in the placenta syncytiotrophoblastic cells in control group and mild ICP group,showed light tan when stained,and was mainly in the cytoplasm.In severe ICP group,CAR was also located in placenta syncytiotrophoblastic cells but mainly in the nucleolus,showed dark tan when stained.(2)The mRNA expressions of CAR in control group,mild ICP group,severe ICP group were 0.06 ±0.03,0.07 ±0.03 and 0.56±0.03.respectively.CAR in severe ICP group was significantly higher than those in control group and mild ICP group(P＜0.05).The difference of mRNA between control group and mild ICP group wag not statistically significant(P＞0.05).(3)The CAR protein levels in control group,mild ICP group,severe ICP group were 0.74±0.03,0.79±01 03 and 1.02±0.04,respectively.CAR protein expression in the severe ICP group was significantly higher than the other two groups(P＜0.05).And there was no statistical significance between mild group and control group(P＞0.05).Conclusion In ICP women.especially severe ICP patients,the CAR expression in placenta syncytiotrophoblastic cells increased appreciably,which may be involved in the maintenance of placenta barrier function and protection in ICP pathogenesis.

OBJECTIVE To report a case of AIDS associated with penicilliosis marneffei and discriminate the morphology in bone marrow examination and cultural characteristic of Histoplasma capsulatum and Leishmania donovani.METHODS The three pathogens in bone marrow morphology and cultural characteristic were studied.RESULTS AIDS patient was often infected with P.marneffei,but we could differentiated easily from other pathogens because of its breeding by splitting up and the characteristis structure in bone marrow examination.CONCLUSIONS Isolation of the P.marneffei is the golden diagnosis standard,and the examination of bone marrow is important to diagnose P.marneffei infection.

Objective To evaluate right atrial function in patients with idiopathic dilated cardiomyopathy (IDCM) and ischemic cardiomyopathy (ICM) by using two-dimensional speckle tracking imaging (2D-STI).Methods Study population consisted of 31 patients with IDCM,30 with ICM and 30 healthy subjects.High frame rate two-dimensional images were recorded from the apical four chamber view.Right atrial global longitudinal strain (GLS) was measured using two-dimensional strain soft ware.Results Compared with the controls,left ventricular ejection fraction (LVEF),tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),right ventricular fractional shortening (RVFS) and tricuspid annular peak systolic velocity(S') decreased (P ＜0.05),while right ventricular myocardial performance index (MPI) increased in IDCM and ICM group.There were no significant differences for all above echocardiographic parameters between IDCM and ICM patients.Compared with the controls,right atrial GLS decreased significantly in patients with IDCM and ICM,even much lower in patients with IDCM (P ＜0.001).Conclusions Measurement of right atrial strain using 2DSTI could be used for the assessment of right atrial dysfunction in patients with ICDM and ICM.

Objective: To explore the growth characteristics of rat calvaria by detecting the calvaria of SD rats in different periods. Methods: The calvaria of SD rats at 1 , 4 , 7 , 10 , and 12 weeks from the same littermate were selected (3 rats per week) . Real⁃time PCR and Western blot techniques were used to detect the expression of focal adhesion kinase ( FAK) Ⅳ phosphatidylinositol 3 kinase/protein kinase B ( PI3K/AKT ) signal pathway in the calvaria , and the role of FAK⁃PI3K/AKT in the growth and development of the calvaria was analyzed by correlation. Results: The increase of brain volume and the thickness of calvaria increased synchronously , the expression of FAK was positively correlated with the changes of meridians , and the expression of FAK was positively correlated with the expression of PI3K/AKT. Conclusion The expression of FAK is related to the growth and development of rat skull. FAK plays a role in calvaria by activating PI3K/AKT signal pathway. FAK may be used as a marker of rapid skull growth and development , which provides a basic theoretical basis for the timing of clinical skull defect repair and treatment.

【Objective】 To investigate the application of different ureteral length measurement methods in the indwelling of double-J stent. 【Methods】 Clinical data of 260 patients with double-J stent indwelling after ureteroscopic surgery during Jul.2018 and Dec.2020 were prospectively analyzed. The patients were randomly divided into height calculation group, CT measurement group, KUB group and ureteroscopic measurement group. The length of ureter was calculated accordingly and the appropriate length of double-J stent was selected. KUB was performed on the first day after operation and before extubation to determine the position of double-J stent. The patients completed the ureteral stent-related symptom questionnaire (USSQ), urinary symptom score, lower urinary tract symptom (LUTS) score, pain score, hematuria score, and quality of life score before and after double-J catheter placement. 【Results】 There were no significant differences in age, gender, height, side of stent and urinary symptom score among the four groups (P>0.05). The average lengths of the ureters measured by the four methods were (21.5±1.0) cm, (21.5±1.8) cm, (23.8±1.3) cm and (21.7±1.8) cm, respectively. There were no significant differences among the height calculation group, CT measurement group and ureteroscope group, but there was significant difference between the three groups and the KUB group. The ideal ureteral stent length indwelling ratio in the ureteroscopic group was 76.9%, which was better than that in the other three groups. Postoperative indwelling time was 7-42 d (mean 29.8 d). The USSQ score of the ureteroscopic group before extubation was (14.1±1.5), which was lower than that of the other three groups (P<0.05). The ureteroscopic group was better than the other three groups in the comparison of frequency and urgency of urination, nocturia, hematuria, quality of life score, and pain score (P<0.05). 【Conclusion】 Intraoperative ureteroscopic measurement of the ureteral length is a simple and feasible method in guiding the indwelling of double-J stent to reduce ureteral stent related symptoms.

Objective: To investigate the function of FAK / Twist1 signaling pathway during craniosynostosis closure. Methods: Ten days old rats were divided into a control group (n = 50) and a rotation group (n = 50) . Both of them were made a approximately 0. 5 cm circle bone window at the midpoint of the lambdoid suture of the rat.The bone flaps were left free without damaging the dura mater. The bone flaps in the control group were repositioned in situ , and the bone flaps in the rotation group were rotated 180 ° and repositioned 3 weeks later. Then the experiments were performance as followed :open field test , measurement of body weight , head circumference , bone flap area , and thickness of bone flap in the two groups , observation of cranial suture closure by microscopy and HE staining , FAK / Twist1 expression determined by Western blot , real⁃time PCR , and immunohistochemical staining in the bone flap and dure , respectively. Results: The cranial sutures was completely closed in the rotation groupand that was open in the control group through detecting by microscopic examination and HE staining. The thickness of the bone flap in the derotation group was greater than that in the control group , with statistical significance (P < 0. 01) . There were no significant differences between two groups in head circumference , weight , bone flap area , and operative area. The results of behavioral test showed that after the closure of cranial suture , the acsion of FAK was significantly increased in the calvaria and dura as well as Twsit1 was significantly decreased in the dura in rotating group measuring by Western blot , real⁃time PCR , and immunohistochemical staining (P < 0. 05) . Conclusion FAK/Twist1 may play an important role in craniosynostosis after rotation.