ObjectiveTo discuss the effect of evidence-based nursing on prevention of pulmonary complications in postoperative elderly lung cancer patients.MethodsTwenty elderly lung cancer patients from January to June 2010 were randomly divided into the observation group and the control group with 10 patients in each group.The control group was given regular care methods.The observation group received evidence-based clinical nursing methods.The preventive effect of pulmonary complications was observed in both groups.ResultsOne case was found to have pulmonary complications in the observation group,while four cases in the control group.The total cure rate of the observation group was higher than that of the control group.ConclusionsEvidence-based nursing methods can satisfy the medical demand of patients and their family members to the utmost degree,reduce the incidence of pulmonary complications and contribute to the early recovery of patients.It is worthy of clinical application.

Teaching in classroom is an essential pattern of clinical theoretic education. Evaluation, which is one of the most available methods to monitor and manage the teaching quality is simultaneously an effective way to build up a teaching group and train the teacher. The evaluating system should include students' opinions, companion's advice and experts' instruction. It is very important for making the evaluating more scientific, more significant and more accurate.

To observe the therapeutic effect of acupuncture and moxibustion on the climacteric syndrome, patients with climacteric syndrome were treated by acupuncture and moxibustion and randomly compared with the patients in control group treated by Chinese herbs. There was a significant difference between two groups (P＜0.05). The results showed that the therapeutic effect in acupuncture and moxibustion group was obviously better than that in Chinese herbs group.

Objective To investigate the characteristics of the cognitive impairment about attentional network among amphetamine-induced psychiatric disorders. Methods Amphetamine-induced psychiatric disorders ( n = 100) and normal controls ( n = 100) were assessed with Attentional Network Test(ANT) in the first week and the fourth week. Results Compared with the control group, the first ANT's response time was significantly increased, and the correct rate, orienting and executive control network were significantly reduced in Amphetamineinduced psychiatric disorders( eg:response time ( 867. 37 ± 272.24 ) ms vs ( 668.56 ± 136. 20 ) ms, correct rate (0.88 ±0.06 ) ms vs (0.88 ±0.06) ms ,orienting( - 217.86 ± 198.00 ) ms vs ( -59.67 ± 85.07 ) ms and executive control network ( 184.74 ± 66.61 ) ms vs ( 74.71 ± 50.77 ) ms, P ＜ 0.01 ), but the alerting network was higher ( ( 151.17 ± 198.27 ) ms vs (50.60 ± 67.47 ) ms). In the second ANT results, there was no significant difference between two groups. Compared with the first ANT results of amphetamine-induced psychiatric disorders, the second ANT had shorten response time ,that the correct rate, orienting and executive control network were significantly increased(P ＜ 0.01 ). Conclusion These results suggest that amphetamine-induced psychiatric disorders have impairment in cognitive function, but these impairment can be recovered within one month.

The change of hemodynamics and hemorrheology induced by hypoxia challenge in the dog were investigated. The results showed that hypoxia caused significant decrease of cardiac output,increased pulmonary artery pressure and pulmonary vascular resistance. Hypoxia also caused increase of blood viscosity. In terms of changes of the reduced viscosity is directly related to the deformation and agglutination properties of red blood cells.

Objective To investigate the effects of early Xuebijing injection on procalcitonin (PCT) with septic shock patients.Methods Sixty-five patients with septic shock were randomly divided into the control group and Xuebijing injection group.The patients in Xuebijing injection group were received Xuebijing injection therapy(50 ml Xuebijing + 100 ml 0.9％ NaCl injection,2 times/d,for 7 d) besides basic treatment,while in the control group were received basic treatment including antibiotic susceptibility + early fluid resuscitation + correct acidosis.At the entering the ICU day and 1,3,5 d after treatment,patients were collected 5 ml venous blood serum C reactive protein(CRP) and PCT,and before treatment and at the 5th,7th day after treatment conducted APACHE Ⅱ evaluation to observation of curative effect of two groups.Results Before treatment,there were no significant difference in terms of heart rate,blood pressure,PCT,CRP,APACHE Ⅱ scores between the two groups (P ＞ 0.05).There was no significant difference in terms of PCT and CRP between the two groups at the 1 d after treatment(P ＞0.05).While at the 3th day after treatment,PCT and CRP of Xuebijing group were lower than of control group and the differences were significant ((7.37 ± 2.58) μg/L vs.(12.25 ± 3.32) μg/L,(64.32 ± 11.12) mg/L vs.(72.37 ± 12.42) mg/L;P ＜0.05).The APACHEⅡ score in control group at before and 5th,7th day after treatment were (20.48 ± 4.41),(16.52 ± 3.45),(12.78 ± 2.91) respectively,in Xuebijing injection group were (20.74 ± 4.73),(12.48 ± 2.76),(9.24 ± 6.67) respectively.And all indices were significant different time points between groups (P ＜ 0.05).At 7th day after treatment,15 cases were improved,10 cases progressed and 8 cases died in the control group and the effect rate was 75.8％ (25/33).Meanwhile,22 cases were improved,5 cases progressed and 5 cases died in the Xuebijing group and effect rate was 84.8％ (27/32).There was significant difference between two group(x2 =7.27,P =0.03).Conclusion Early Xuebijing injection application can inhibit the PCT r~tion of septic shock patients and improve the prognosis.

[ ABSTRACT] AIM:To investigate the role of hydrogen sulfide ( H2 S) on impaired wound healing in ob/ob mice and the underlying mechanism.METHODS:The ob/ob mice were randomly divided into 3 groups, including vehicle, in-sulin and NaHS for treatment.C57BL/6 mice were treated with vehicle as control.Full-thickness punch biopsy wounds were created on the mice.Firstly, H2 S concentrations in the skins and granulation tissues were measured.The mRNA ex-pression of cystathionineγ-lyase ( CSE) was detected by RT-qPCR.The protein expression of CSE and MMP-9 were deter-mined by Western blot.The neutrophil and monocyte/macrophage infiltration was analyzed by immunohistochemistry me-thod.The levels of tumor necrosis factor (TNF)-αand interleukin (IL)-6 were measured by ELISA.Collagen formation was measured by Masson staining.RESULTS:The H2 S levels in the skin and granulation were significantly decreased in ob/ob mice and increased in the NaHS-treated mice ( P<0.05 ) .CSE expression at mRNA and protein levels was significantly decreased in ob/ob mice compared with the control mice (P<0.05).The wound healing period was significantly shorter in NaHS group than that in vehicle-treated ob/ob mice group (P<0.05), in which the insulin group had no difference with vehicle ob/ob mice group.The neutrophil and monocyte/macrophage infiltration, and TNF-αand IL-6 levels were signifi-cantly increased in ob/ob groups, but were decreased in NaHS group ( P<0.01 or P<0.05 ) .Meanwhile, NaHS in-creased collagen formation in the granulation tissues of ob/ob mice.CONCLUSION:H2 S/CSE down-regulation contributes
to impaired wound healing in diabetes, which is alleviated by exogenous H2 S possibly through anti-inflammation.

Objective To investigate the applicability of Cys C-based formulas for prediction of GFR in Chinese patients with CKD.Methods A total of 176 adult patients with CKD including 90 males and 86 females collected from 4 hospitals located in different geographic regions of China (Beijing,Shanghai,Dalian and Changsha) were enrolled in this study from September 2007 to July 2009.The rGFR was measured using 99mTc-DTPA clearance rate two-sample method.Cystantic C was measured by PETIA and PENIA respectively.The results of eGFR in the Larsson formula,Grubb formula,Hoek formula,Filler formula,Stevens formula and Hojs formula were compared with the rGFR to evaluate the calculation coherence,bias,precision,accuracy and the performance of correct phasing of the formulas.Results The mean 99mTc-DTPA clearance was [40.70 ( 19.09 - 86.49)] ml · min-1 · ( 1.73m2 ) -1.Significant difference was witnessed in the evaluation of GFR estimation formulas calculated by PETIA and PENIA (P ＜0.01).ICC and Spearman correlation analysis revealed a significant correlation between eGFR and rGFR.The ICCs of eGFR and rGFR ranged from 0.874 to 0.938.Compared with rGFR,the 30％ accuracy of all the eight evaluation formulas using PETIA and PENIA method were lower than 60％.The percentages of correct phasing in all the 5 stages of CKD were not ideal.With these formulas,percentages of correct phasing from CKD stage 2 to CKD stage 4 were lower than 65％.The eGFRs were underestimated by formulas evaluated by PENIA in CKD stage 1.All the eGFRs were overestimated remarkably by all equations in CKD stage 5.Conclusions None of the eight Cys C based formulas are ideal for estimation of GFR in Chinese CKD patients,and they can not be applied to Chinese patients directly.For this patient population,further studies will be needed to develop a more accurate Cys C-based GFR estimation formula that includes ethnicity,age and other factors.

Objective To investigate COL1A1 gene mutation by PCR-high resolution melting (PCR-HRM) and an-alyze the correlation between genotype and clinical phenotype in a child (proband) with osteogenesis imperfecta (OI). Methods The family history of OI pedigree along with the clinical data was collected. Blood samples from the proband and his family members, as well as 50 normal controls, were collected. The mutation of COL1A1 gene was screened using PCR-HRM and validated by the gene sequence. Results The detection of PCR-HRM showed the abnormal result of COL1A1 17 exon in proband with a lower melting temperature (Tm) value than that of normal controls by 0.4℃. There were signifi-cant differences in the standardization melting curve and the different melting curve between the proband and the normal controls. The sequencing result was c.1138G>A, which meant that cDNA of 1138 base G mutation into A. The mutations transformed the amino acid glycine into a serine at amino acid 380(P. Gly 380 Ser), which resulted in missense mutations. The proband’s father and grandmother had the same mutation of COL1A1 gene. The mutation was not found in the proband’s mother and normal controls. There was no report for such mutation in Chinese population. Pedigree analysis showed the fami-ly genetic characteristics of autosomal dominant inheritance. The proband was clinically diagnosed as OI type Ⅳwith more severe clinical phenotype. Conclusion PCR-HRM analysis is a new effective method for genetic screening of OI. COL1A1 mutation of c.1138G>A is a newly discovered mutation in Chinese population. Gly replaced inαhelical domain may lead to a more severe clinical phenotype.

Objective To evaluate specific clinical and imaging features of osteogenesis imperfecta V and to improve diagnostic accuracy of this disease. Methods Data of 15 patients with osteogenesis imperfecta type V were retrospectively analyzed for their clinical and imaging features. There were 10 males and 5 females, aged from 1 year and 30 years old (median age,12.5 years ). All 15 patients had plain X-ray, and 4 of 15 had CT. All data were analyzed by 3 experienced deputy chief doctors in OI according to OI V standard. Results X-ray:calcification of the interosseous membrane between radius-ulna was detected in all patients and calcification of the interosseous membrane between tibia-fibula was detected in 2 of 15 patients. Dislocation of the radial head was seen in 13 of 15 patients,bilateral in 9 and utilateral in 4.All patients showed restriction in the pronation and supination of the forearm and restricton in the flexion and extention of the elbow joint. Patients with dislocation of raidal head were associated with large coronoid process and olecranon of the ulna. Hyperplastic callus of the extremities were detected in 7 of 15 patients (7 at femur , 3 at humerus, 1 at tibia.In early stage, hyperplastic callus showed thin cortice, and clear boundares with the diaphysis showing and low density, irregular, mesh-like lamellation inside. In the later stage, there were dense calcification inside hyperplastic callus, and no difference in density with the diaphysis. Diaphysis surrounded by hyperplastic callus had clear boundaries with the hyperplastic callus. No cortical destruction was detected. CT:there were sparse needle-dot calcification inside hyperplastic callus, with the patterns of granular, ring-and-arch,irregular streaky mineralization. The cross section of proximal femoral shaft showed irregular shape , flat square shape and tiny medullary cavity, with no calcification on the edge of hyperplastic callus. CT value:-91 HU inside hyperplastic callus; 283 HU in femoral shaft. Conclusions Interosseous membrane between radius-ulna or tibia-fibula, hyperplastic callus ,dislocation of the radial head are specific features in osteogenesis imperfecta V. X-ray can make a definitive diagnosis of osteogenesis imperfecta V. CT scan is helpful in the differential diagnosis of osteogenesis imperfecta V from osteosarcoma.