ObjectiveTo investigate the success rate and energy requirements of ibutilide and direct current(DC)cardioversion,summarize the nursing experience.MethodsForty-six patients with persistent atrial fibrillation were enrolled and underwent DC cardioversion were selelct from May 2009 to January 2011.23 patients received pretreatment with ibutilide before DC (the ibutilide group),23 patients received non drugs before DC (the control group).The cardioversion energy started at 100 J and increased if patients could not acquire sinus rhythm.All the patients were given pertinent care before,during and posttreatment.The success rate and energy requirements of the two groups were compared.Results95.7％ of the patients were successfully cardioverted in the ibutilide group,which was significantly higher than 74.0％ of the control group.The energy required for cardioversion was ( 139.1±45.1 ) J in the ibutilide group,significantly lower than (197.8±53.3) J in the control group.Non patients terminated treatment or appeared complication because of improper nursing.ConclusionsPretreatment with ibutilide enhanced the efficacy of DC cardioversion for the patients with persistent AF at lower energy requirements.Proper nursing care can ensure the smooth process of treatment and decrease the complications.

Objective To observe the effect of pulmonary surfactant(PS) on lung function and ventilator parameters of neonatal respiratory distress syndrome(NRDS) in the advanced stage.Methods Twenty-eight infants with NRDS were given PS in one dose by endotracheal intubation on the left side,right side,feet high with head low,and level decub respectively.The dose of PS was 100-150 mg/kg each time,each posture slow note of the drug were required 1/4,out of the straw,hand-controlled ventilation,to reduce fluid loss,with the exception of a clear airway obstruction,within 6 hours after the administration not to shoot back suction,to give mechanical ventilation after the injection.Lung function parameters were also measured:pressure of oxygen in artery[p_a(O_2)],carbon dioxide partial pressure[p_a(CO_2)],the ratio of pressure of oxygen in artery and alveolar oxygen partial pressure[a/Ap(O_2)] and oxygenation index(OI) were determined.Ventilator parameters were determined:oxygen concentration(FiO_2),oxygen peak(PIP),end-expiratory positive pressure(PEEP) and mean airway pressure(MAP) were determined.These numerical data were analyzed and compared before and after treatment with PS.Clinical manifestations,thoracic X-ray changes,survival rate and incidence rate of complications were also analyzed and compared before and after PS therapy.Results p_a(O_2),a/Ap(O_2) showed significant upgrade and OI had a decrease after PS administration in comparison with those before PS therapy.The ventilator parameters(except for PEEP) acquired were also lower after drug administration than those in before drug therapy.There were significant differences in both stages(P_a90%,respiratory sound in 24 cases enhanced,the observation of chest film after 24 h indicated that,lesions in 21 cases improved significantly,5 cases took a favorable turn.The survival rate was 85.7%.The incidence rate of complication was as follows:pneumonia was 25%,patent ductus arteriosus was 10.7%,pneumorrhagia was 7.1% and intraventricular hemorrhage was 3.6%,respectively.Conclusion Respiratory function of NRDS is significantly improved by using PS in the advanced stage,and therapeutic effect is apparent.

OBJECTIVETo study the potential mechanism of the new steroidal drug NSC67657 induced leukemic cells differentiation.

METHODSCell proliferation was assayed by MTT assay. Surface antigen CD14 on THP-1 cells treated by NSC67657 at different time different concentration, was detected by flow cytometry (FCM). The expression of beta-catenin- interacting protein 1 (ICAT) gene and protein were detected by RT-PCR and Western blot. Eukaryotic expressing vector pDsRed-ICAT was constructed and transfected into HL60 cell line. FCM, Wright's staining and electronmicroscope were employed to analyse the differentiation of transfected THP-1 cells after they were treated with NSC67657 for 24 hours.

RESULTSThe proliferation of THP-1 cells was significantly inhibited by NSC67657 treatment. The level of CD14 expression was elevated in line with the increasing drug concentration and treatment time. 10 µmol/L NSC67657 treatment for five days was the optimal condition for the induction of THP-1 cells differentiation, when the CD14(+) THP-1 cells were more than 90%. Morphological study indentified the THP-1 cells of monocytic differentiation. The eukaryotic expressing vector pDSRed-ICAT was successfully constructed, and almost 90% positive clone could be obtained after G418 screening. Electro-transfection was employed for transfecting the vector into THP-1 cells. After the transfection the expression of ICAT gene and protein was increased. On the NSC67657 treatment, there was not significant difference in CD14 expression on transfected THP-1 cells compared to that on the control groups. After 24 h treatment, the transfected THP-1 cells remained in early differentiated stage.

CONCLUSIONNSC67657 can induce THP-1 cell to monocytic differentiation and activate the expression of ICAT gene, but overexpression of ICAT itself is not sufficient to induce such differentiation.

Cell Differentiation ; genetics ; Cell Line, Tumor ; Cell Proliferation ; HL-60 Cells ; Humans ; RNA, Messenger ; genetics ; Transfection ; beta Catenin ; genetics

Objective To determine the analgesic effects of flurbiprofen axetil injection on orthopedic surgery patients.Methods Seventy-eight orthopedic surgery patients were randomly divided into control group ( n=39 ) and test group ( n=39 ).Patients in control group were given intravenous administration of parecoxib 20 mg at 15 min before anaesthe-sia induced by propofol 1-2 mg · kg -1 and maintained by isoflurane in operation; after operation , 60 mg of parecoxib dissolved in 100 mL 0.9%NaCl was intravenously dripped.Patients in test group were given the same treatment beside the 20 mg of parecoxib was changed to 50 mg of flurbiprofen axetil.Average artery pressure ( MAP ) and heart rate (HR), visual analogue score ( VAS), Ramsay sedation score ( RSS), levels of serum C reactive protein ( CRP ) , prostaglandin E 2 ( PGE2 ) and incidence of adverse drug reactions of the two groups were observed.Results The MAP and HR, VAS, RSS of two groups showed no statisti-cal significance expect the VAS at moment post surgery; the content of serum CRP in test group at postoperative 24 h was ( 16.77 ±5.52 ) mg · L-1 , significantly lower than that of control group of ( 20.68 ±7.76 ) mg · L-1 ( P<0.05 ); the PGE2 content in test group had no significant difference with control group ( 135.1 vs 141.6 pg · mL -1 , P >0.05 ).The incidence of adverse drug reaction in test group was significantly lower than that in control group (7.7%vs 20.5%, P<0.05 ).Conclusion Flurbiprofen axetil injection can reduce the stress reaction of orthopedic surgery patients , the incidence of side effect was also lower.

Objective To explore the nutritional status of hemodialysis patients with different ages, and analyze the reasons of differences of nutritional status. Methods 109 hemodialysis patients were divided into the young-age group (n=26), the middle-age group (n=49) and the old-age group (n=34). The body indices, blood biochemical parameters, dietary assessment, handgrip strength and subjective global assessment were measured. The nutritional indices and relationship were compared among patients in the three groups. Results Leg circumstance, prealbumin, creatinine, handgrip strength and SGA scores were different among the three groups (P<0.05 or P<0.01). And those five factors were all statistically associated with age (P<0.05). Conclusions With the increase of age, the hemodialysis patients' nutritional status has a descending trend. It's necessary for nursing staff to timely monitor and intervene the nutrition of elderly patients so as to prevent the incidence of malnutrition.

OBJECTIVETo figure out the function of C/EBPalpha in the monocytic differentiation of HL60 cells induced by a new steroidal drug NSC67657.

METHODSThe differentiation of HL60 cells was induced by NSC67657, and the cell surface antigen CD14 expression was detected by flow cytometry. The gene and protein expressions of CCAAT enhancer binding protein alpha (C/EBPalpha) before and after the induction of cell differentiation were determined by RT-PCR and Western blot. Eukaryotic expressing vector pDsRed-ICAT was constructed and transfected into HL60 cells, and its expression was verified. The effect of C/EBPalpha overexpression in HL60 cells was assessed by MTT assay, Wright's staining and flow cytometry before and after NSC67657 transfection.

RESULTSHL60 cells could be induced into monocytes by 10 micromol/L ATRA within 5 days, and the coverage of CD14 positive cells reached 93.9% after 5 days of drug treatment. The eukaryotic expressing vector was successfully constructed, and over 90% positive clones were obtained after screening by G418 and electrotransfection. The results of proliferative analysis, chemical staining, ultrastructural observation, and CD11b detection confirmed that HL60 cells could be induced into granulocytic differentiation by overexpression of C/EBPalpha protein. Moreover, in the drug treatment group, transfected cells could not be induced into monocytic differentiation, and their granulocytic differentiation was also inhibited.

CONCLUSIONThe monocytic differentiation of HL60 cells induced by NSC67657 may not be via the regulation by C/EBPalpha protein-mediated signal transduction. However, the overexpression of CEBPalpha may inhibit the process of NSC67657-induced monocytic differentiation in HL60 cells.

CCAAT-Enhancer-Binding Protein-alpha ; genetics ; metabolism ; CD11b Antigen ; metabolism ; Cell Differentiation ; drug effects ; Genetic Vectors ; Granulocytes ; cytology ; HL-60 Cells ; Humans ; Lipopolysaccharide Receptors ; metabolism ; Mesylates ; pharmacology ; Monocytes ; cytology ; RNA, Messenger ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Signal Transduction ; Steroids ; pharmacology ; Transfection

The practicable and effective methods for residual risk assessment on transfusion-transmitted disease was to establish the mathematic models. Based on the characteristics of the repeat donors which donated their blood on a regular base, a model of sero-conversion during the interval of donations was established to assess the incidence of the repeat donors. Based on the characteristics of the prevalence in the population, a model of ‘prevalence increased with the age of the donor' was established to assess the incidence of those first-time donors. And based on the impact of the windows period through blood screening program, a model of residual risk associated with the incidence and the length of the windows period was established to assess the residual risk of blood transfusion. In this paper, above said 3 kinds of mathematic models were jointly applied to assess the residual risk of hepatitis C virus (HCV) which was transmitted through blood transfusion in Shanghai,based on data from the routine blood collection and screening program. All the anti-HCV unqualified blood donations were confirmed before assessment. Results showed that the residual risk of HCV transmitted through blood transfusion during Jan. 1st,2007 to Dec. 31st,2008 in Shanghai was 1∶101 000. Data showed that the results of residual risk assessment with mathematic models was valuable. The residual risk of transfusion-transmitted HCV in Shanghai was at a safe level, according to the results in this paper.

Objective To explore pefioperative nursing for patients with benign prostatic hyperplasia who received greenlight photoselective vaporization.Methods Totals of 160 cases patients with BPH underwent PVP treatment were recruited.Before operation,the nursing plan and mental nursing were finished.During and after the operation,the condition changes of patients were carefully observed,and complications prevention and nursing were well done.Results The patients' preoperative emotion was stable,and all operations went smoothly and successfully.And no obvious complications was found and all patients were cured.Conclusions The good perioperative nursing care can ensure the success of operation and promote the rehabilitation of patients.

Objective To study the pediatric nurse stressors and coping style so as to provide reference and basic for pediatric nurses seeking effective decompression and implementing effective interventions.Methods A sample of 12 pediatric nurses received half-structured in-depth interviews.Got themes by phenomenology data analysis method,including coding,classification,explain phenomena and significance,refining essence theme and elements materials.Results Communication,workload and job performance were the main pressure source.Compared experience pediatric nurses with the experienced pediatric nurses,experienced pediatric nurses coping styles were more effective,and negative health outcomes were also much less.Conclusions It is should to develop and take intervention measures to improve pediatric nurses coping ways according to the stressors,and it needs work together of individuals and organizations.

Objective To investigate and make the countermeasures of sexual harassment of female nursing students suffered during clinical clerkship.Methods A self -designed questionnaire was adopted to survey 136 students nurses.Results 65 students nurses suffered from various sexual harassment,which mainly from young male patients,there was no significant difference between various academic qualification nurses (P ＞0.05) ; 50.8% victims ignored but were annoyed for it; 92.3% students nurses were harassed when their teachers were not around.69.2% victims' mode was influenced by sexual harassment.Conclusions The universities and the hospitals should take the situation that nursing students suffer sexual harassment during clinical clerkship into account,and take practicable measures for them to accomplish their clinical clerkship.