This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.

BACKGROUND: Dihydrolycorine (DL) can inhibit the peripheral release of catecholamine from sympathetic nerve ending and block α, β adrenalinergic receptor. It has multiple pharmacological actions, such as vascular dilation, hypotension, anti-hypoglycemia and anti-ischemia.OBJECTIVE: To investigate the selective effect of DL on basilar artery,thoracic aorta and ventricular papillary muscle of rabbit by means of observing the vasoconstriction induced by noradrenaline bitartrate and KCl.DESIGN: Observation of comparative experiment.SETTING: Pharmacological Department of Yunyang Medical College.MATERIALS: This study was carried out at Pharmacological Department of Yunyang Medical College between March and July 2001, and 46 adult healthy New Zealand rabbits were selected.METHODS: New Zealand rabbits were put to death by intravenous injection of 10 mL air from the vein of aural edge, and soon after death, brain,thoracic aorta and heart were obtained. Basilar artery and thoracic aorta was linked into 4.0-5.0 mm vascular rings; meanwhile, ventricular papillary muscle were separated and connected with tension transducer. Obserdose of noradrenaline bitartrate or KCl: Sub-maximal constriction of thoracic aorta was induced by 0.1 mmol/L noradrenaline bitartrate or W60 mmol/L KCl, and when constriction curve became stable, DL or nimodipine of different dosage was added. Basilar artery was exposed to 0.1 mmol/L noradrenaline bitartrate or 60 mol/L KCl, and rinsing fluid was changed once every 20 minutes and thrice in all when vasocontratcion reached the peak level, then different dosage of DL or nimodipine was added 20 minutes later, and the changes of vasoconstriction curve due to administration of single dose of noradrenaline bitartrate or KCl were obconstriction of ventricular papillary muscular induced by electro-stimulation: Electro-stimulation was used to stimulate the ventricle papillary muscular synchronized constriction with the frequency of once per second,wavelength of 3 ms and threshold voltage of 120%; when constriction curve became stable, DL or nimodipine was administered in a accumulative way.ence of DL or nimodipine on the half-effective concentration of noradrenaline bitartrate or KCl that contributed to the vascular ring constriction of rabbit.RESULTS: Basilar artery, thoracic aorta and ventricular papillary muscle Resting tension of basilar artery was increased by DL but decreased by niof basilar artery and thoracic aorta induced by noradrenaline bitartrate and KCl can be relaxed by DL in a dose dependant manner, and the half-effective concentration was (6.69±3.12)×10-4, (3.41±1.52)×10-3mmol/L for basilar artery, and (1.49±0.59)×10-3, (2.91±0.99)×10-3 mmol/L for thoracic aorta, displaying stronger inhibition on the constriction of basilar artery induced by noradrenaline bitartrate than on the contraction induced by KCl.On the contrary, nimodipine showed stronger depression on KCl-induced constriction than on the constriction induced by noradrenaline bitartrate.ventricle papillary muscular induced by electro-stimulation in a dose-dependant manner, and the half-effective concentration of DL on the contraction of ventricle papillary muscle induced by electro-stimulation was significantly higher than that induced by noradrenaline bitartrate.CONCLUSION: DL displays obvious selective effect on basilar artery of rabbit, the possible existence of constrictive α1 receptor subtype and dilating β receptor on basilar artery might be correlated with the selective function of DL, which benefit, for the improvement of blood supply in the ischemic region.

Objective To investigate APP mobile information technology innovation methods in preoperative visits to patients in the clinical application effect. Methods A total of 840 patients undergoing elective surgery were divided into control group and experimental group by random digits table method with 420 cases each and control group by adopting the method of the nurse oral interpretation of the preoperative visit list and health education leaflets oral interpretation information, experimental group using mobile medical technology innovation preoperative visit method, combining with specialized subject characteristic in APP software design way of cartoon animation and video surgery in patients with preoperative visit. The comparison of two groups of patients with the patients know about the operation, cooperate with surgery, perioperative anxiety levels, hospitalized experience satisfaction four dimensions of experience were performed. Results The patients know about the operation was (7.6 ± 2.3) points in control group and(8.5 ± 2.5)points in experimental group, and there was significant difference between two groups (t=5.430,P<0.01). The cooperate with surgery was 92.62%(389/420) in experimental group and 75.71%(318/420) in control group, and there was significant difference between two groups(χ2=45.032, P<0.01). The perioperative anxiety levels was (38.27 ± 2.50) points in experimental group and (47.21 ± 3.84) points in control group, and there was significant difference between two groups (t=8.420, P<0.01). The hospitalized experience satisfaction was (96.41±2.30) points in experimental group and (93.70±1.51)points in control group, and there was significant difference between two groups (t=3.297, P <0.01). Conclusions Using APP for clinical preoperative visit mobile information technology, which can effectively improve the patients know about the operation and the matching degree, reduce the perioperative patients with anxiety, improve surgical patients during hospitalization medical treatment satisfaction.

ObjectiveTo perform pharmacology problem-based learning (PBL) and evaluate its effects.MethodsPBL was performed for the clinical medicine class of grade 2007 and the satisfactory degree of students to teaching effects was observed with questionnaire. Results The students thought that PBL teaching had substantial contents and proper schedule and increased learning interest. Students' participating degree, mutual communication and controlling discussion procedure were fine,which reached the expected learning objective. ConclusionsThe effects of PBL teaching were excellent and most of our students could accept it.

Patients with inflammatory bowel disease(IBD)have an increased risk of thromboembolism.Recent reports on Janus kinases inhibitors and thromboembolic adverse events have revealed that IBD therapeutic drug play an essential role in modifying this risk in a pro or antithrombotic manner,in addition to the increased risk of thrombosis of IBD itself.In this review,we provide an overview of the current understanding on thrombosis risk,mechanism and anticoagulant therapy of IBD drugs.While controlling the activity of the disease with appropriate therapy,thromboembolism prophylaxis and personalized treatment o should be emphasized.

Objective? To explore the clinical application of information technology in the multidisciplinary chain management of surgical patient handover, in order to reduce the safety hazard in the process of surgical patient handover. Methods? In the contemporary controlled study, 300 patients were selected as the control group from February to July 2017 by cluster sampling, and 303 patients were selected as experimental group from February to July 2018. Traditional sectional handover method was adopted in the control group, to managed the patients＇ handover from each section. In the experimental group, based on the information communication platform between the surgery room and relevant clinical departments, by clinical electronic documents chain transfer method, quality inspection and supervision information feedback technology, to achieve shared decision and improvement of patients handover problems, we built the multidisciplinary management pattern. The two groups were compared for statistical difference from six aspects:the rate of acceptance specification, the accuracy of identity verification method, the rate of operation labeling verification, the accuracy of inventory of items, the evaluation of pipeline patency, and the evaluation of skin condition at the compression site. Results? The rate of standard delivery of surgical patient handover increased from 49.33% to 92.08% in the two groups. The experimental group was better than the control group in the rate of correct delivery of handover from the following five aspects: identity recognition, indication of surgical site, inventory of articles carried, unobstructed pipeline and skin state of the pressure site with statistical significance (P＜ 0.01). Conclusions? The multidisciplinary chain management model of surgical patient handover supported by information technology is effective in clinical application, which can significantly reduce the risk of hazard in patient handover and is worthy of clinical promotion.

This study was designed to investigate the effect of silencing microtubule-affinity regulating kinase 4(MARK4)on the apoptosis,inflammatory cytokine release and intestinal barrier protein expression of FHC cells in a lipopolysaccharide(LPS)-induced ulcerative colitis(UC)model,and the underlying molecular mechanisms.Western blot analysis was used to measure the expression levels of MARK4 and apoptosis-related factors including Caspase-1,NLRP3,and GSDMD in colon tissues from both UC patients and healthy individuals,as well as in LPS-induced FHC cell inflammation model.FHC cells was transfected with shRNA to silence MARK4.In control(normal FHC cells),LPS(LPS-stimulated FHC cells),and MARK4-silenced+LPS(shRNA-and LPS-treated FHC cells)groups,the expression levels of Caspase-1,NLRP3,GSDMD,intestinal barrier proteins,and NF-κB pathway-related proteins were assessed by Western blotting.ELISA and RT-qPCR were used to measure the expression levels of inflammatory cytokines IL-1β,IL-6,and TNF-α;flow cytometry was utilized to assess apoptosis.Data showed that both in UC patient colon tissues and the in vitro LPS-induced FHC cell UC inflammation model,there was a significant increase in the expression of MARK4 and apoptosis-related proteins including NLRP3,Caspase-1,and GSDMD.Silencing MARK4 inhibited the expression of these apoptosis-related proteins and downregulated the inflammatory cytokines IL-1β,IL-6,and TNF-α in LPS-induced FHC cells.Silencing MARK4 also reduced apoptosis,increased the expression of intestinal barrier proteins ZO-1,Occludin,and upregulated Claudin2.Gene Set Enrichment Analysis(GSEA)indicated a positive correlation between MARK4 and the NF-κB signaling pathway.Furthermore,silencing of MARK4 inhibited the expression levels of p-P65 and p-IKKα in the NF-κB pathway.In conclusion,MARK4 is significantly upregulated in UC tissues and cells.Silencing MARK4 inhibits the activation of the NF-κB signaling pathway,thereby inhibiting the apoptosis and inflammatory factor expression of UC cells.Thus,MARK4 could be a potential therapeutic target for UC patients.

Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.

Objective To study the effects of perioperative body temperature management on intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor. Methods From June to Decmber 2016, a total of 120 intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor who met the inclusion criteria were recruited and randomly divided into control group and observation group, with 60 cases in each. All the subjects were given routine operation nursing. On the basis of that, the observation group were given perioperative body temperature management. The body temperature, heart rate, pulse pressure and the difference of tumor markers of carcineombryonic antigen (CEA) and carbohydrate antigen19-9(CA199) before and after treatment were compared between the two groups. Results The difference value of temperature, heart rate and pulse pressure between 30 minutes after treatment and before treatment in the observation group were (3.7±0.4)℃, (12.4±2.7)bp/min and (5.6±1.9)mmHg respectively. The fluctuation of vital signs was lower than the control group, and the differences were statistically significant (t=6.062, 14.897, 10.392; P<0.01). The observation group patients' CEA was (52.8±2.4)μg/L, and CA199 was (106.1±5.3)U/ml after treatment, which were both lower than the control group, with statistical differences(t=31.415, 33.803; P< 0.05). Conclusions Perioperative body temperature management could significantly stabilize the body temperature, heart rate and pulse pressure, which could significantly promote intraperitoneal hyperthermic perfusion chemotherapy's curative effect for patient with abdominal malignant tumor.