OBJECTIVE:To summarize general regularity and characteristics of amiodarone-induced pulmonary toxicity,and to provide reference for rational use of amiodarone and avoiding the occurrence of ADR. METHODS:Retrieved from CNKI,VIP and Wanfang database,individual case report literatures about amiodarone-induced pulmonary toxicity were collected during 1990-2016. The included cases were analyzed statistically. RESULTS:A total of 19 related literatures were collected,involving 20 cases of amiodarone-induced pulmonary toxicity. Among them,the patients older than 60 years old accounted for 75.0% with ratio of male to female 3:1. 75.0% patients had used medicine more than 1 month when pulmonary toxicity occurred. The dose of amiod-arone in 17 patients ranged 200-400 mg/d. Six patients died,accounting for 30.0%. CONCLUSIONS:Pulmonary toxicity induced by amiodarone may be related to patients'gender,age,dose and medication time. The mortality of it is in relative high level. Med-ical staff should pay attention to it,regularly monitor and process it timely.

Objective To develop a new quantitative analytical method for determination of fluoroacetamide,a kind of raticides,in blood and urine samples using solid-phase extraction combined with GC/MS.Methods Using acetamide as the internal standard,extraction column and extraction conditions of fluoroacetamide from blood and urine samples were optimized by comparing the extraction efficiency of different solid-phase extraction columns and the effects of experimental conditions on recovery.By means of the quantitative relation between the ratio of characteristic ion peak areas of fluoroacetamide to acetamide a novel analytical method for determination of fluoroacetamide concentration was established by quantitative GC/GM technique.Results The ratio was proportional to the concentration of fluoroacetamide ranging from 5.0 to 90?g/ml with silica gel column extraction,and the detection limit was estimated to be 1.0?g/ml.The average recovery of fluoroacetamide in blood sample was 91.6%.The standard deviation was less than 7.3%.Conclusion The analytical results were in conformity with those obtained by the classical method,which could satisfy the requirement for quantitative measurement of fluoroacetamide in samples from practical cases.

The changes of pulmonary platelet trapping (PPT) were observed in dogs after they were traumatized with steel-sphere shooting and then the therapeutic effects of nalorphine were studied.It was found that the PPT rate was significantly increased in the 8th hour after injury;when nalorphine was administered before and after gunshot wounding,the PPT rate of the traumatized dogs was signficantly lowered.The fact indicates that the increase of PPT rate in the gunshot dogs results from the activation of opiate ? receptor in the lungs.

Objective: To study the chemical constituents of the flowers of Impatiens balsamina L.. Methods: The compounds were isolated by chromatography and solvant extration and the structures were identified on the basis of spectral analysis. Results: Four compounds were isolated and identified as stigmasterol(1), kaempferol(2), Kaempferol 3 glucoside(3) and Kaempferol 3 glucosyl rhamnoside(4). Conclusions: All the compounds were isolated from the flowers which were cultured for the first time in China.

Objective To explore the related infection factors of the internal jugular vein indwelling central venous catheter , and make prevention countermeasures according to the infection factors of central venous catheter infections .Methods A total of 564 patients admitted in liver and gallbladder surgical ward with external jugular vein indwelling central venous catheter were se‐lected ,extract the relevant hospital infection data in patients by the XingLin hospital infection real‐time monitoring system ,and SPSS15 .0 statistical analysis was conducted .Results The infection rate of 564 cases of patients was 4 .07% .The rate of gram‐neg‐ative bacteria infection was 43 .5% ,the gram positive bacteria infection accounted for 34 .8% ,fungi accounted for 21 .7% ,including multiple drug‐resistant bacteria infection accounted for 52 .1% .Catheter indwelling 14 d or more infection rate was 8 .5% ,14 d fol‐lowing infection rate was 2 .1% ,and infected patients for more advanced cancer and patients with severe acute pancreatitis .Pipe joint respectively with heparin cap and needle positive pressure infusion joint connections ,infection rate was statistically different (P<0 .05) .Conclusion The infection of internal jugular vein indwelling central venous catheter should not be ignored ,and the oc‐currence of catheter‐related infection of patients is closely related to state of an illness ,the time of catheter insertion ,and the joint device and so on .

Objective To explore the MRI features of acute optic neuritis with positive aquaporin?4 (AQP4) antibodies and myelin oligodendrocyte glycoprotein (MOG) antibodies during the first attack. Methods Eighty five patients (105 affected nerves) with first?episode AQP4?seropositive optic neuritis (AQP4?ON; n=58; 64 affected nerves) and MOG?seropositive optic neuritis (MOG?ON; n=27; 41 affected nerves) diagnosed by our hospital Neuro?ophthalmology Department between April 2014 and December 2017 were retrospectively analyzed. Double seronegative patients or double seropositive patients were not included. All patients underwent orbital conventional MRI; 29 patients also underwent RESOLVE?DWI and 55 underwent brain T2 fluid?attenuated inversion recovery (T2FLAIR). Theclinical features (age, gender, disease duration) and MRI features (T2WI, bilateral involvement, the degree and extent of enhancement, the extent of involvement, the affected segment and ADC values of nerve; demyelinating lesions of brain) were analyzed by 2 doctors. The qualitative parameters were compared with χ2 test or Fisher exact test and the quantitative parameters were compared with two independent sample t test (normal distribution) or the Mann?Whitney U test (skewed distribution). The Kappa test was used to test the consistency of the qualitative characteristics of the images evaluated by the 2 doctors. The interclass correlation coefficient (ICC) was used to test the consistency of the ADC obtained by the 2 doctors. Results There were no significant differences in the distributions of age and disease duration between 2 groups (t=1.911, Z=-1.054, P>0.05). AQP4?ON had a higher female proportion (χ2=13.911, P<0.05) and showed mainly unilateral involvement. MOG?ON more commonly showed bilateral involvement (χ2=17.640, P<0.05), but there were no significant differences in the demyelinating lesions of brain (χ2=0.000)and the presence/absence of optic tract involvement (both P>0.05). There was a higher probability of optic nerve swelling, long segmental lesions and optic nerve head involvement in MOG?ON(χ2=16.845, 13.525, 13.264, P<0.05). Moreover, the rate of obvious enhancement and the involvement of optic chiasm was higher in AQP4?ON(χ2=7.152, 5.088, P<0.05). RESOLVE?DWI showed the ADC values of the AQP4?ON were significantly lower than those of MOG?ON (t=-3.300, P<0.05). The qualitative features of image evaluated by the 2 doctors were consistent well (Kappa=0.712-0.932, P<0.001).The ADC values obtained by the 2 doctors were consistent well (ICC=0.942, P<0.001).Conclusions For the first?episode acute optic neuritis, AQP4?ON hasobvious female predilection and the trend of unilateral involvement and obvious enhancement, while MOG?ON isoften involved bilaterally with longitudinally extensive lesions. The ADC values of the AQP4?ON are significantly lower than those of MOG?ON and AQP4?ON are more vulnerable to involve the optic chiasm. Conventional MRI and RESOLVE?DWI are helpful for differentiating AQP4?ON from MOG?ON during the early stage of the disease course.

Objective To explore the predictors of reperfusion arrhythmia (RA) after PCI in patients with acute myocardial infarction (AMI) using Meta-analysis, and to provide evidence for clinical diagnosis and treatment of RA.Methods Firstly, the inclusion and exclusion criteria were restricted and the search strategy was planned. The clinical trials that related to emergency PCI treatment in AMI patients and published before 31st December 2016 were included by two researchers in this study by searching PubMed, CINAHL Database, MEDLINE, Web of Science, Cochrane Libraray, CBM, VIP, CNKI and Wanfang Database. After evaluating the quality of the literature, the Review Manager 5.3 software was used for Meta-analysis.Results A total of 10 studies including 13923 participants were enrolled. The Meta-analysis showed that the risk factors for RA after PCI in AMI patients included: smoking (OR=1.73; 95％CI 1.17-2.56;P<0.01), TIMI0 flow grade (OR=2.74; 95％CI 2.15-3.49;P<0.01), inferior MI (OR=4.52; 95％CI 2.47-8.42;P<0.01), right coronary artery infarction (OR=3.19; 95％CI 1.07-9.58;P=0.04), multi-vasculopathy (OR=3.05; 95％CI 1.83-5.09;P<0.01), renal failure (OR=2.81; 95％CI 1.45-5.43;P< 0.01), time from symptom onset to PCI≤6 h (OR=2.41; 95％CI 1.43-4.07;P<0.01), and duration of operation >1 h (OR=4.03; 95％CI 1.60-10.15;P<0.01). The protective factors included hypertension history (OR=0.76; 95％CI 0.63-0.93;P<0.01) and pre-infarction angina (OR=0.20; 95％CI 0.13-0.30;P<0.01). There were no significant differences in age (OR=1.03; 95％CI 0.95-1.11;P=0.48), history of diabetes (OR=1.26; 95％CI 0.29-5.47;P=0.75), and Killip grade>1 (OR=2.22; 95％CI 0.90-5.48;P=0.08).Conclusions The risk factors for RA after PCI in AMI patients include smoking, TIMI0 flow grade, inferior MI, right coronary artery infarction, multi-vasculopathy, renal failure, time from symptom onset to PCI ≤6 h, and duration of operation >1 h. The hypertension history and pre-infarction angina are protective against RA after PCI in AMI patients.

Objective? To construct a risk assessment scale for patients with acute myocardial infarction (AMI) and reperfusion arrhythmia after percutaneous coronary intervention (PCI) by Delphi expert consultation at home and abroad. Methods? From 1st January 2017 to 31st December 2017, we preliminarily drew up risk factors related to patients with AMI and reperfusion arrhythmia after PCI by retrieving and analyzing the heart surgery related risk assessment scale at home and abroad; and we confirmed the weight of risk factors by two rounds of expert consultation on scientific nature, suitability and operability of risk factors with the method of Delphi method and the expert evaluation method. Results? The recovery rates of questionnaire were 90% and 95% respectively in two rounds of expert consultation, and the authority coefficient was 0.89 and 0.93. The risk assessment scale constructed for patients with AMI and reperfusion arrhythmia after PCI included 3 first-level risk factors, 13 second-level risk factors. Among weight of risk factors by two rounds of expert consultation, the variation coefficients were all less than 0.2, and the coordination coefficient ranged from 0.20 to 0.34. Conclusions? All the experts participating in the investigation are positive with the high consistency of expert opinion, good coordination, professional representativeness and high authority. The constructed risk assessment scale can effectively assess the risk of AMI patients after PCI, reduce the processing time of reperfusion arrhythmia, enhance the ability of nurses to predict the reperfusion arrhythmia of those patients so as to early decrease the incidence of reperfusion risk.

Objective:To investigate the current status of discharged patients at risk of pressure injury and analyze risk factors of pressure injury.Methods:Using the convenient sampling method, 54 medical alliance units of Chongqing Fuling Central Hospital were selected for a cross-sectional survey. Patients at risk of pressure injury when discharged from the hospital and their caregivers were selected as the research objects from August 2019 to June 2020. The general demographic data sheet, clinical test data sheet, Braden Pressure Ulcer Risk Assessment Scale, Barthel index, and Family Caregiver Task Inventory (FCTI) were used for investigation. In this study, a total of 409 questionnaires were issued and 409 were effectively received, with an effective recovery of 100%.Results:There were 224 patients (54.8%) at light risk of pressure injury, 74 patients (18.1%) at moderate risk, 89 patients (21.8%) at high risk and 22 (5.4%) patients at extreme risk. The differences in general demographic data, clinical test data and self-care ability grade of 409 patients were statistically significant ( P<0.05) . The FCTI scores of caregivers for patients with different risk levels were compared, and the difference was statistically significant ( P<0.05) . The results of ordered logistic regression analysis showed that white blood cell count ( OR=1.103, 95% CI: 1.006-1.209, P=0.035) , care ability of caregivers ( OR=1.060, 95% CI: 1.017-1.104, P=0.005) , fecal incontinence ( OR=14.112, 95% CI: 2.505-79.497, P=0.003) , indwelling catheter ( OR=3.111, 95% CI: 1.332-7.269, P=0.009) , severe dependence ( OR=15.705, 95% CI: 2.655-92.918, P=0.002) were risk factors for the risk of pressure injury in discharged patients. Conclusions:Among discharged patients with Braden score less than or equal to 18 points, there are 45.2% (185/409) patients with moderate risk of pressure injury and above. It is necessary to focus on discharged patients with high levels of white blood cells, weak care ability of caregivers, indwelling catheters and self-care ability of heavy dependence grade to prevent pressure injuries.

Based on the theory of "Johari Window", this study introduced how to stimulate information content obtained in doctor-patient communication and how to apply the comprehensive geriatric assessment creatively from the four modules of open area, blind area, hidden area and unknown area in the model. It helped students to gain the trust and cooperation of patients, rapidly narrow down the blind area, hidden area and unknown area, guide patients to actively extend the open area, improve the teaching quality of doctor-patient communication in a scientific way.