Objective To select the intravenous anesthetic with less effects on the erythrocyte immunity,and observe regulation of ?-endorphin on erythrocyte immunity in vivo Methods Seventy-two mice were randomly allocated to receiving intraperitoneally normal saline 0 04ml/g (group I,n=13), thiopental sodium 60mg/kg (groupⅡ,n=10),etomidate 20mg/kg (groupⅢ,n=10),etomidate -lipuro12mg/kg (groupⅣ n=9), midazolam 20mg/kg (groupⅤ,n=12),fentanyl 100?g/kg (groupⅥ,n=10) or pethidine 20mg/kg (groupⅦ,n=10) at 9 o'clock in the morning ,respectively and were administered at half dosage at 3 o'clock in the afternoon At 9 o'clock of the next day.Results Compared with those in group Ⅰ, the rosette rate of RBC-C3b receptor(RC3bRR) decreased significantly in group Ⅱ, Ⅳ,Ⅴ and Ⅶ(P

Objective To seek a new method to identify viability of myocardium by adenosine stress echocardiography combined with quantitative tissue velocity imaging(QTVI)and tissue tracking(TT).Methods Fifteen healthy canines were selected to establish the models of acute myocardial infarction and reperfusion by ligating anterior descending branch of coronary artery for 90 minutes and then releasing the artery to get reperfusion.After reperfusion.peak velocity in systole(Vs),peak velocity in isovolumic contraction(VIVC)and the displacement in systole(Ds)were measured on anterior wall and anterior septum at baseline.The 2,3,5-triphenyl tetrazolium chloride(TTC)staining was set as a"gold standard"for defining the viable and non-viable groups.The sensitivity and specificity of assessing myocardial viability were determined with QTVI and TT.Comparison of variables between viable and non-viable group was made by using t test.One way analysis of variance and LSD-t test were used to estimate the significance of differences in different states.Results Compared with baseline,Vs,VIVC and Ds decreased significantly(P＜0.01)after reperfusion in both viable and non-viable group.After administration of adenosine,Vs and Ds increased(P＜0.05),but VIVC didn't change significantly compared with that before administration of adenosine in viable group(P＞0.05).Variables in non-viable group didn't change significantly after administration of adenosine(P＞0.05).By receiver operating characteristic(ROC)analysis for predicting myocardial viability,when a cutoff value of △Vs(%)rate was 17.9,the sensitivity and the specificity was 78.6%and 81.1%,respectively,and when the cutoff value of △Ds(%)rate was 18.4,the sensitivity and the specificity was 75.0%,83.6%,respectively.Combined △Vs(%)with △Ds(%),the sensitivity and specificity to prediction of myocardium viability could reach 94.6%and 68.0%,respectively.Conclusions When the viability of myocardium after myocardial infarction is assessed by using the method of adenosine stress echocardiography with QTVI and TT,the sensitivity and the specificity are greatly enhanced.

Myocardial ischemia/reperfusion injury ( MI/RI) is a pathophysiological phenomenon commonly seen during thromboly-sis, percutaneous transluminal coronary angioplasty ( PTCA ) , and coronary artery bypass grafting ( CABG ) . It is defined as restoration of blood flow to a previously ischemic region followed by complex pathological events leading to tissue injury greater than the original ischemic insult. Many experimental interven-tions have been reported to protect the ischemic myocardium in experimental animals; however, with the exception of early reperfusion, none has been translated into clinical practice. The root of Panax notoginseng ( Burk. ) F. H. Chen ( PN) is one of the iconic herbs in traditional Chinese medicine. Traditional pharmacopeia recommended it among the most efficacious herbs for‘promoting blood circulation ’ and hemostasis. Inspired by this, in the last decade, a large number of modern investigators made substantial efforts to search the PN activities against a vari-ety of MIRI. The systematic review was performed according to the protecting drug of the MIRI development guidelines.

The damage of tissue increases dramatically after reperfusion of blood supply to ischemic tissues.Immune response is one of the key reasons of ischemia-reperfusion injury.Th1 /Th2 generally stays balanced in normal states.Under the envi-ronment of ischemia reperfusion,Th1 /Th2 shifting let Th1 domi-nant to mediate cellular immunity.Excessive immune reaction may cause cell apoptosis and tissue damage.Recent studies showed that induction of transferring Th1 dominant to Th2 domi-nant was feasible for the treatment of ischemia-reperfusion inju-ry.With the progress of modern drug development paradigm“multi-composition,multi-target”,Chinese medicine has advan-tages in treating complex diseases.This paper summarizes the research of the relationship between Th1 /Th2 imbalance and is-chemia-reperfusion injury,together with the prospects of tradi-tional Chinese medicine with multi-target effect in ischemia-reperfusion injury.

Objective? To investigate the breast feeding knowledge and self-efficacy among hospitalized multiparae and to explore the influencing factors of breast feeding self-efficacy. Methods? From January to August 2018, we selected hospitalized multiparae at Yuyao People＇s Hospital and Zhejiang Provincial People＇s Hospital as subjects by simple random sampling. All of the multiparae were investigated with the general information questionnaire, breast feeding knowledge questionnaire and breastfeeding self-efficacy scale. A total of 400 questionnaire were sent out and 372 valid questionnaire were collected with 93.0% for the valid recovery rate. Results? Among 372 hospitalized multiparae, the total score of breast feeding knowledge questionnaire was (5.53±1.02); the total score of breastfeeding self-efficacy was (80.36±16.72). Single factor analysis showed that there were statistical differences in the scores of breast feeding self-efficacy among hospitalized multiparae with different ages, education levels, working state, living styles, income levels, delivery modes, number of complications, training for breast feeding, mastery of breast feeding knowledge, breast feeding for the first time (P＜ 0.01). Correlation analysis showed that breast feeding knowledge had a statistically positive correlation with the self-efficacy among hospitalized multiparae (r=0.117, P=0.026). Multiple linear regression analysis proved that the main influencing factors of breast feeding self-efficacy among multiparae included working state, number of complications, training for breast feeding and breast feeding knowledge with a statistical difference. Conclusions? The breast feeding knowledge and self-efficacy of hospitalized multiparae are not good enough. Communities and hospitals need to work hard together to improve styles and strategies of breast feeding education so as to increase the rate of breast feeding.

Objective To explore the risk factors of postoperative pulmonary infection in patients with craniocerebral injury and establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Methods The clinical data of 169 patients with craniocerebral injury,admitted to and underwent craniotomy in our hospital from January 2013 to December 2018,were retrospectively analyzed.The clinical data of patients with postoperative pulmonary infection and without postoperative pulmonary infection were compared.The risk factors of postoperative pulmonary infection were analyzed by multivariate Logistic regression.R language was used to establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Receiver operating characteristic (ROC) curve was used to explore the prediction efficiency of the nomogram model for pulmonary infection after craniocerebral injury.Results Among the 169 patients,74 (43.8％) were complicated with pulmonary infection and 95 (56.2％) were not complicated with pulmonary infection.As compared with non-pulmonary infection group,pulmonary infection group had significantly higher percentages of patients with open craniocerebral injury and Glasgow coma scale (GCS) scores＜7,significantly higher American Society of Anesthesiologists (ASA) grading,lower albumin level one week after surgery,statistically longer operation time,and significantly higher percentages of patients with conscious disorder,patients accepted intraoperative blood transfusion,patients used breathing machine,and patients stayed in bed for 4 weeks or more (P＜0.05).Multivariate Logistic regression analysis showed that GCS scores (OR=0.243,95％CI:0.122-0.497,P=0.000),ASA grading (OR=3.349,95％CI:2.233-5.021,P=0.000),disturbance of consciousness (OR=3.185,95％CI:1.217-8.334,P=0.018),and useofventilator (OR=3.376,95％CI:1.590-7.167,P=0.002) were independent risk factors for postoperative pulmonary infection in patients with craniocerebral injury.The scores of the nomograrn model were 13.7,100.0,38.0 and 27.5 in GCS scores,ASA grading,disturbance of consciousness and use of ventilator,respectively.The consistency index of the nomogram model for predicting postoperative pulmonary infection in patients with craniocerebral injury was 0.835.ROC curve showed that the area under the curve predicted by nomogram model for postoperative pulmonary infection in patients with craniocranial injury was 0.840 (95％CI:0.778-0.901).Conclusion Based on the risk factors for pulmonary infection after craniocerebral injury,a nomogram model for predicting the risk of pulmonary infection is established,which has a good differentiation degree and prediction effect,and can provide a reference for medical staffto identify high-risk patients at an early stage,so as to take more targeted intervention measures.

Objective:To explore the effects of multifunctional indwelling needle application on the fixation of indwelling peripheral venous needle in children.Methods:Totally 216 children receiving transfusion in the transfusion room of a Class Ⅲ Grade A hospital from June 2018 to March 2019 were selected and divided into the control group ( n=107) and the experimental group ( n=109) according to the random number table. The indwelling needle of children in the experimental group were fixed with the indwelling needle application, while the indwelling needle of children in the control group were fixed with the transparent sticker provided together with the needle. The indwelling time of the indwelling needle, prolapse or displacement of the indwelling needle, curling application, skin damage and residual adhesive tape in the two groups of patients were observed, and the compliance with intravenous infusion and family satisfaction were compared between the two groups. Results:The indwelling time of the indwelling needle of the children in the experimental group was longer than that of the control group; the incidence of indwelling needle prolapse or displacement, curling application, skin damage and residual adhesive tape of the experimental group were lower than that of the control group; the compliance and family satisfaction scores of the experimental group was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The multifunctional indwelling needle application is strongly firm, which can reduce skin damage, prolong the indwelling time of the indwelling needle, and improve the compliance of the children and the satisfaction of family members. It is recommended in the clinical care of children.

Objective:To explore the effects of post level management and secondary performance distribution in the Central Supply Service Department.Methods:From January 2019, the job categories, job labor intensity, technical risk level, division of professional staff, specialist training, job description revision, job capability and other aspects of all staff ( n=67) of Central Supply Service Department of the First People's Hospital of Shangqiu, Henan were set up, and the competitive employment mechanism was applied. Based on the total amount of performance issued by the Nursing Department according to the total number of people in the disinfection supply center, the scientific design and implementation of post performance secondary assessment distribution and post promotion were carried out according to post workload, work quality, technical research, service satisfaction and so on. Results:The difference in the results of comprehensive skills assessment of nurses before and after the performance of secondary assessment and distribution management was statistically significant ( P<0.05) . The difference of job satisfaction of disinfection and supply center among different departments was statistically significant ( P<0.05) . There was statistical significance in the comparison of quality control defects in quality control examination of department ( P<0.05) . In the democratic evaluation of staff, 43 were very satisfied with the performance distribution, 3 were dissatisfied. The content of dissatisfaction was the coefficient in lactation has no difference from other posts. Conclusions:The implementation of the post level management and secondary performance assessment in the Central Supply Service Department has stimulated the potential of nurses at all levels, aroused their enthusiasm for work, and set up goals for everybody. All staff participating in the management improved the work efficiency and quality, guaranteed the nursing safety and the work operation, achieving the satisfactory effect.

OBJECTIVETo observe the impacts of acupoint catgut embedding therapy on postpartum weight retention.

METHODSSeventy-one women of postpartum weight retention were divided into an observation group (35 cases) and a control group (36 cases) according to their own wishes when re-examination in 42 days after delivery. In the control group, the nutrition consultation was provided and the calories intake was controlled continuously for 20 weeks. In the observation group, on the basis of the treatment as the control group, the acupoint embedding therapy was applied to Zhongwan (CV 12), Zhongji (CV 3), Qihai (CV 6), Guanyuan (CV 4), Tianshu (ST 25), Guilai (ST 29), Shuifen (CV 9), Shousanli (LI 10), Zusanli (ST 36), Fenglong (ST 40) and Yinlingquan (SP 9). The sutures, No. 4-0 were cut as 2 to 4 mm in length and put into the embedding needle. Afterarrival, the sutures were pushed into the acupoints with the needle core and the needle was removed quickly. The treatment was given once every two weeks, continuously for 20 weeks. Totally, 10 times of acupoint catgut embedding therapy were required. Before and after treatment, the body mass, weight retention, body mass index (BMI), percentage of body fat (PBF), waist circumference (WC), waist-hip ratio (WHR) and health promoting lifestyle profile (HPLP-Ⅱ) were observed in the participants of the two groups.

RESULTSAfter treatment, body mass, weight retention, BMI, PBF, WC and WHR were all reduced as compared with those before treatment in the participants of the two groups, indicating the significant differences (all<0.05). After treatment, the body mass, weight retention, BMI, PBF, WC and WHR in the participants of the observation group were lower than those in the control group, indicating the significant differences (all<0.05). The score of every dimension of HPLP-Ⅱ after treatment was higher than that before treatment in the participants of the observation group, indicating the significant differences (all<0.05); and the scores of health responsibility, sports and spiritual growth in the observation group were higher than those in the control group, indicating the significant differences (all<0.05).

CONCLUSIONSThe acupoint catgut embedding therapy improves in the postpartum weight retention and achieves the satisfactory clinical therapeutic effects.