Humans ; Occupational Exposure ; Paraquat ; poisoning

Objective To establish the evidence-based nursing educational programme for preventing ventilator-associated pneumonia (VAP) and evaluate the effects in critical care nurses. Methods The evidence-based nursing practice guidelines for preventing VAP from 2008 American Association of Critical Care Nurses was used as training materials,which guided the curriculum design. Seventeen critical care nurses were trained. The difference of the nurses' knowledge and practice was evaluated before and after training by an evaluation scale of nursing quality criteria for preventing VAP. Results After the training,nurses' knowledge and practice of preventing VAP were improved(Z=-3.624,P=0.000). Except the factor score of handwashing,there were significant differences on the factor scores of body position care,endotracheal tube care,enteral nutrition,maintaining the tube cuff pressure,oral care and ventilator equipment management (P<0.01). Conclusion The educational programme of evidence-based nursing for preventing VAP can improve the nurses' knowledge and practice of preventing VAP. Furthermore,it can promote the application of evidence-based nursing for preventing VAP,and thereby to improve the quality of nursing,and provide guidance for the training of critical care nurses and continuing education.

Objective To investigate whether the splenic metastasis of B16 melanoma cells in C57BL/6 mice occur through the blood.Methods Cultured B16 melanoma cells were collected,adjusted into 1?10~7/ml and inoculated into the left armpit of C57BL/6 mice,200 ?l each.After 15 days,the mice were sac- rificed and metastasis was examined in various tissues and organs by HE stain.1.5 % Evan Blue(EB),2 ml/kg, was administered to normal C57BL/6 mice through the tail vein,and the region stained blue was compared with that of metastasis.Results All of 12 mice inoculated were burdened with melanoma.Splenic metastasis occurred in 9 of them,among which 3 were accompanied by lung metastasis,and all of 9 mice showed differ- ent degree of local lymph node metastasis.The dorsal 1/4 part of the positive spleen was stained black by the metastatic tumor cells.Under the microscope,distribution of the metastatic tumor cells in the spleen was scat- tered,their growth inhibited,and maturation accelerated.The region stained blue by EB also located at the dorsal 1/4 part of the spleen,which was almost the same as the positive part of metastasis.Conclusions Metastasis of B16 melanoma cells in C57BL/6 miee occurs earlier in the spleen than in other organs,and this metastasis is achieved most possibly through the blood.

In this experiment, the PAP was used as a specific marker to label the follicular dendritic cells (FDC) and their possible precursors in the spleens of postnatal rats at 21, 27, 34, 41 and 48 days respectively, and the changes of the labeled cells were studied under TEM. In 21-day-old rats the labeled cells were of the histological feature resembling fibroblastic reticulum cells(FRC). As the rats getting elder, the shape and structure of the labeled cells changed. The shape of t he cells and nuclei changed from ellipse to irregular. The heterochromatin decreased and so did the microfilaments in the cytoplasm. The cytoplasmic processes increased in number, length and complexity. The relatively smooth cell surface became folding and invaginating. By the 48 days after birth the labeled cells possessed the features of the FDC. The result implys that the FDC might originate from FRC.

Aclarubicin ; therapeutic use ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Female ; Glutethimide ; administration & dosage ; analogs & derivatives ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To investigate the effect of PBL combined with EBM applied in the teaching of fever of unknown origin. Methods PBL combined with EBM teaching was applied in fever of unknown origin course for 30 clinical medicine specialty(eight years) students of Tongji class of grade 2009(experiment group), while PBL teaching was applied in fever of unknown origin course for 30 clinical medicine specialty (eight years) students of Tongji class of grade 2008 (control group). After teaching, the theory examination for both basic knowledge and case analysis was organized for all students of both groups. At the same time the questionnaire survey was conducted to 30 students of grade 2009 to evaluate the teaching effect. The results were assessed by using SPSS 18.0 statistical software for the T-test of the experimental group and the control group.Inspection level was α=0.05. Results The theory test score of students in the experimental group was (93.5±3.2) point, signifi-cantly higher than that of the students in the control group(84.7±2.8). There was statistically signifi-cant difference between the scores of the two groups of students (P=0.00). Survey results showed 19 students ( 63 . 33%) thought that the development of PBL teaching combined with evidence-based medicine teaching had its necessity, and 16 students(53.33%) thought that the teaching method im-proved their clinical thinking ability of logical reasoning. Conclusion The concept of PBL combined with EBM has achieved significant resultsinthe teaching offever of unknown origin, and it is necessary to carry out this teaching mode in medical colleges with certain teaching strength.

ObjectiveTostudytheprotectiveeffectsofpreconditioningoncryopreservationinjuryofrat liver.MethodsThemodelofisolatednonrecirculatedperfusionratliver (IPRL)wasestablished .Thegrafts werepreconditionedwithischemia (IPC)anddexorubicin (DPC)respectively .ResultsThelevelsofaspartate transaminase (AST)andalaninetransaminase (ALT)inthesolutionsinIPCgroup (40 1? 6 3、17 1? 0 5 )U L andDPCgroup (43 6? 3 7、19 4? 0 8)U Lwerelowerthanthoseofnon preconditioning (NPC)group (6 4 5? 8 2、2 3 8? 3 96 )U L (P 0 0 5 ) .ConclusionsPreconditioninghasobviousprotectiveeffectsoncryopr eservationinjuryofratliver.MedicinepreconditioningmightimitatetheeffectofIPC .Medicinepreconditioning cansupplyclinicaltreatmentasasafeandeffectivepreconditioningmethod .

Objective To compare the clinical effect of different materials dentures in repaired of teeth. Methods A retrospective analysis of 570 patients with framework removable partial dentures , which were divided into the Vitallium 2000 group, the pure titanium group and the Co-Cr alloy group randomly from Jan. 2010 to Dec. 2012 in our hospital. Compare the clinical effect of three groups. Results The emplacement rate (χ2=10.283,P<0.05)and the 2-week adjust rate (χ2=16.262,P<0.05)of three groups were statistical different significantly. The incidence rate of denture stomatitis(χ2=12.773,P<0.05),the masticatory efficiency(t=8.194,P<0.05)and the incidence rate of adverse reactions (χ2= 6.028,P < 0.05)of three groups were statistical different significantly. The patients′satisfaction (χ2=2.191,P>0.05)of three groups weren′t statistical different significantly. The degree of comfort(χ2= 6.827,P < 0.05),the speech satisfaction(χ2= 6.002,P < 0.05) and the chewing speech satisfaction (χ2=5.838,P<0.05)three groups were statistical different significantly. Conclusion The clinical effect of the Vitallium 2000 group is better of weight , strength and stability than other groups. The Vitallium 2000 frame removable partial denture is nontoxic , fastness and no peculiar smell , which could be ensure the aesthetics , the degree of comfort and improve the masticatory efficiency , worthy to recommend its clinical use.

Objective To explore the CT appearance of thoracic lymphonodus in AIDS patients with immune reconstitution in-flammatory syndrome(IRIS)after highly active antiretroviral therapy (HAART).Methods The data of thoracic CT in 24 AIDS pa-tients after HAART with enlarged thoracic lymphonodus in IRIS were collected,and the chest CT appearance was analyzed.Results Of the 24 cases of AIDS patients with IRIS after HAART,1 9 cases were complicated with pulmonary tuberculosis,which includ-ed 5 cases with cervical tuberculous lymphadenitis,3 cases were co-infected with bacterium and fungi,1 case was infected by penicil-lium marneffei,1 case by pneumocystis carinii.The enlarged thoracic lymphonodus were primarily located in 4R region(20/24), secondly in 2R region(1 1/24)and 4L region(1 1/24),in which the density was uniform or non-uniform,edge clear or unclear,some parts of lymphonodus were fused together but not calcified.The minor axis of enlarged lymphonodus was 1 1.0-25.0 mm except X region,enhanced uniformly in 2 cases.Obstructive pneumonia and pulmonary consolidation were found in 2 cases with enlarged lym-phonodus,which were located in 10R region.Pleural effusion was found in 13 cases with greatest depth of about 22 mm,pericardial effusion was found in 5 cases with greatest depth of about 24 mm.Conclusion The enlarged thoracic lymphonodus in AIDS patients with IRIS affer HAART are mainly involved in the region of 4R,2R and 4L,with or without pleural effusion and pericardial effusion.

OBJECTIVETo observe analgesic and sedative effect of acupuncture combined with medicine (ACM) on patients undergiong cardiac surgery.

METHODSA total of 50 patients with cardiac surgery from January 2012 to October 2014 were randomly assigned to the conventional analgesia group (group A) and the ACM analgesia group (group B), 25 in each group. Patients in group A were subjected to analgesia and sedation by injecting dexmedetomidine, while patients in group B were subjected to analgesia and sedation by electro-acupuncture [EA, Shenting (GV24); Yintang (EX-HN3)] combined with injection of dexmedetomidine. Morphine hydrochloride injection was performed when analgesia and sedation effect was ineffective in the two groups. The indicators of patients at different time points in the two groups were observed, such as static and dynamic VAS scores, SAS scores, mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2). The injection dosage of dexmedetomidine and morphine hydrochloride, analgesia satisfaction rate, sedation satisfaction rate, the incidences of adverse reactions during treatment such as bradycardia and low blood pressure, mechanical ventilation time, ICU time, and hospitalization expense were observed and recorded in the two groups.

RESULTSThere was no statistical difference in static and dynamic VAS scores, SAS score, MAP, HR and SpO2 between the two groups at different time points (P > 0.05). The injection dosage of dexmedetomidine and morphine hydrochloride was significantly reduced in group B than in group A (P < 0.05). The analgesia satisfaction rate of patients in group B was much higher than that in group A (P < 0.05). The incidence of bradycardia also obviously decreased more in group B than in group A (P < 0.05). There was no statistical difference in patients' sedation satisfaction rate, incidences of low blood pressure, delirium, vomiting; mechanical ventilation time, ICU time, or hospitalization expense between the two groups (P > 0.05).

CONCLUSIONThe analgesia method of ACM could reduce the dosage of traditional analgesic drugs and the occurrence of partial adverse reactions.

Acupuncture Analgesia ; Analgesia ; methods ; Analgesics ; therapeutic use ; Cardiac Surgical Procedures ; Dexmedetomidine ; therapeutic use ; Electroacupuncture ; Heart Rate ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Morphine ; therapeutic use ; Pain ; prevention & control ; Pain Management ; methods ; Respiration, Artificial