Objective To observe the improvement of postoperative pulmonary function and oxygen partial pressure during general anesthesia for open abdominal surgery with lung protective ventilation strategies and alveolar recruitment maneuvers. Methods Seventy patients who underwent selective open abdominal surgery were selected, and they were divided into standard ventilation group (tidal volume 8 ml/kg) and protective ventilation group (tidal volume 6 ml/kg, 5 cmH2O positive end-expiratory pressure, and alveolar recruitment maneuvers, 1 cmH2O=0.098 kPa) according to the random digits table method with 35 cases each. The airway pressure, blood pressure, pulse oxygen saturation (SpO2), end-tidal partial pressure of carbon dioxide (PETCO2) and adverse reactions were observed. The SpO2, partial pressure of O2 (PaO2) and pulmonary function before surgery and 1, 3, 5 d after surgery were measured. Results The respiratory rate, airway pressure and PETCO2 levels in protective ventilation group were significantly higher than those in standard ventilation group: (12.3 ± 2.1) times/min vs. (10.2 ± 1.0) times/min, (15.1 ± 2.8) cmH2O vs. (13.5 ± 2.3) cmH2O, (34.6 ± 2.1) mmHg (1 mmHg=0.133 kPa) vs. (32.1 ± 1.4) mmHg, and there were statistical differences (P<0.05). The SpO2 in 2 groups was maintained at 0.99. There was no statistical difference in the incidence of postoperative complications between 2 groups (P>0.05). The SpO2 and PaO2 levels at 1, 3 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group:0.951 ± 0.018 vs. 0.936 ± 0.016 and 0.964 ± 0.018 vs. 0.949 ± 0.018, (74.8 ± 6.8) mmHg vs. (65.0 ± 6.2) mmHg and (79.6 ± 6.0) mmHg vs. (70.6 ± 5.3) mmHg, and there were statistical differences (P<0.05). The forced expiratory volume in 1 s (FEV1), percentage of the estimated value of FEV1, forced vital capacity (FVC) and percentage of the estimated value of FVC at 1, 3 and 5 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group, the FEV1/FVC at 1 d after surgery was significantly higher than that in standard ventilation group, and there were statistical differences (P<0.05). Conclusions The lung protective ventilation strategy and alveolar recruitment maneuvers can improve the postoperative pulmonary function and oxygen partial pressure during general anesthesia for abdominal surgery. Low vital volume, appropriate positive end-expiratory pressure and recruitment maneuvers can protect the lung in general anesthesia patients.

ObjectiveTo evaluate the value of bispectral index(BIS) monitoring during sedation in the ICU.Methods60 patients in ICU were randomly divided into three groups. By transfusing propofol and midazolam with injecting pump, the BIS of groups Ⅰ,Ⅱ and Ⅲ were controlled within 75～85, 65～75 and 55～65, respectively. ResultsCompared with the pre-sedation, there was no remarkable change in the patients of groups Ⅰ and Ⅱ after sedation(P>0.05)while there was remarkable change in the patients of group Ⅲ(P<0.05).The average score of Ramsay in groups Ⅰ, Ⅱ and Ⅲ were 2.2, 3.4 and 4.6 while the dose of propofol were (9.54±2.43) μg/kg·min, (12.69±3.12) μg/kg·min, (14.18±2.91) μg/kg·min and the dose of midazolam were (0.23±0.09) μg/kg·min, (0.25±0.07) μg/kg·min, (0.28±0.11) μg/kg·min, respectively.ConclusionThe application of BIS can make good judgement in the sedation, which showed different choices to different needs to obtain optimistical sedation effect.

Objective To investigate the role of and relationship between reactivity to autologous serum and dermatophagoides farinae (Df) in the pathogenesis of chronic urticaria (CU). Methods Autologous serum skin test (ASST) and skin prick test (SPT) to Df were carried out in 831 patients with CU. The correlation between reactivity to autologous serum and Df was statistically analyzed. Results The positivity rate of ASST and SPT to Df was 51.74% and 64.62%, respectively in the 831 patients. SPT was positive in 56.52% of patients with positive ASST and in 73.86% of those with negative ASST (P ＜ 0.05). In patients with positive ASST, the degree of autologous serum reactivity was negatively correlated with that of reactivity to Df (P ＜ 0.05). Conclusions The skin reactivity to Df and autologous serum plays an important role in the pathogenesis of CU, and the degree of the reactivity to Df and autologous serum is negatively correlated. To conduct ASST and SPT simultaneously in patients with CU may favor the clinical classification and therapy of CU.

[Objective] To evaluate the efficacy of autologous whole blood injections in patients with chronic spontaneous urticaria and positive autologous serum skin test (ASST).[[Methods]] After assessment of clinical history,patients with chronic spontaneous urticaria underwent skin prick test (SPT) and ASST.Then,100 patients with positive ASST but negative SPT for common allergens were randomly classified into treatment group (n =60) and control group (n =40).Oral loratadine was given to all the patients with a gradual tapering to the least maintenance dose.Patients in the treatment group were also injected with autologous whole blood once a week for 12 times.Patients were evaluated by urticaria activity score (UAS) and dermatology life quality index (DLQI) at the baseline,the end of the 3rd and 6th month after the initial treatment.The total amount of antihistamines required for the control of urticaria every month was calculated.The UAS,DLQI,accumulative amount of administrated antihistamines,and the diameter of wheal/flush induced by autologous serum were compared by t test before and after the treatment,and the efficacy was compared by rank sum test between the two groups.[Results] No significant difference was observed between the control and treatment group in UAS at the baseline (5.73 ± 0.51 vs.5.32 ± 0.79,P＞ 0.05).The UAS reached 1.57 ± 1.42 and 0.69± 0.92 with a decrease rate of 69％ and 81％ in the treatment group,and 3.65 ± 1.53 and 2.65 ± 1.61 with a decrease rate of 35％ and 53％ in the control group,respectively at the end of the 3rd and 6th month,and statistical difference was observed for the decrease in both groups at the two time points (all P ＜ 0.05).The total amount of antihistamines required for the control of urticaria per month averaged 8.63 pills and 3.83 pills respectively in the treatment group after 3 and 6 months of treatment,significantly less than that in the control group (16.85 and 15.27 pills,respectively).[Conclusion]s The combination of oral antihistamine and autologous whole blood injections can not only reduce disease activity and improve patients' quality of life,but also decrease the total amount of antihistamines required for the control of urticaria.

Objective? To explore the knowledge-attitude-practice on patients identification among nurses in hospitals at different levels so as to provide a basis for understanding the knowledge-attitude-practice on patients identification among nurses in hospitals at different levels. Methods? From January 2017 to July 2017, a total of 700 nurses at Class Ⅲ, Ⅱ and Ⅰ hospitals in Shenzhen were investigated with the questionnaire with the methods of group sampling, probability proportionate and cluster sampling. The self-designed Knowledge-attitude-practice on Patients Identification Questionnaire of Nurses was used to investigate the knowledge-attitude-practice on patients identification among nurses. Results? A total of 700 questionnaires were sent out and 658 of them were collected with 94.0% for the valid recovery rate. The total scores of knowledge-attitude-practice on patients identification of nurses at ClassⅢ, Ⅱ and Ⅰ hospitals were (124.82±4.65), (117.75±3.85) and (116.58±3.96) respectively. The score of knowledge-attitude-practice on patients identification of nurses at Class Ⅲ hospitals was the highest followed by that at Class Ⅱ hospitals, and that at Class Ⅱ hospitals was the lowest. There were statistical differences in the scores of knowledge and practice on patients identification of nurses at different levels of hospitals (P＜0.05), and there was no statistical difference in the score of attitude (P＞ 0.05). There were statistical differences in the scores of knowledge-attitude-practice on patients identification among nurses with different educational background and positional titles in hospitals at different levels (P＜0.05), and there were no statistical differences in the scores of knowledge-attitude-practice on patients identification among nurses with different sexes and ages (P＞ 0.05). Conclusions? As a whole, the knowledge-attitude-practice on patients identification among nurses at Class Ⅲ hospitals is excellent. However, we need to improve the knowledge-attitude-practice on patients identification among nurses, especially with nurse in the positional title and with junior college and bellow in the educational background, at Class Ⅰ and Ⅱ hospitals.