OBJECTIVE To investigate the respiratory tract infection rate,pathogenic organism and drug resistance for the patients with tracheotomy and endotracheal incubation in ICU,and to provide first-hand information for diseases prevention and clinical treatment.METHODS Fifty eight patients admitted in our hospital ICU from Dec 2006 to May 2007 were analyzed for their pathogenic organisms of lower respiratory tract infection,drug resistance,underlying diseases and age.RESULTS Pathogenic organisms from sputum culture for 58 patients with tracheotomy and endotracheal incubation were all positive.A total of 139 strains of pathogenic organisms have been found.Among them 106 were Gram-negative bacteria,accounted for 76.3%,and 26 were Gram-positive bacteria,accounted for 18.7% and 7 were fungi,accounted for 5%.From sputum culture of 29 patients Burkholderia cepacia was positive,which was the No.1 bacterial infection,accounted for 20.7% of total.Drug sensitive test for most Gram-negative bacteria showed resistance.CONCLUSIONS Bacteria infection of respiratory tract of the patients with mechanic ventilation in ICU is mostly Gram-negative.Clinical doctors should emphasize the inspection of pathogenic infection regularly and its drug resistance evaluation,to administer appropriate antibiotics.

Objective To understand the basic experimental teaching of functional science in order to promote transformative learning. Methods Random sampling questionnaire survey was con-ducted among 274 students (2011 grade, 5-year-program) majored in clinical medicine, medical lab-oratory and medical imaging in Kunming Medical University. Investigation primarily aimed at the stu-dents' learning attitude, learning objectives, and teaching content. Excel 2003 was used for data en-try, percentage of each questionnaire option was calculated and the findings were directly described. Results 94.76%(253/267) students preferred basic experiment; 82.40%(220/267) students hoped to open long term laboratory;97.38%(260/267) students thought that basic experiment could help pro-mote understanding and theoretical knowledge of physiology; 98.50%(262/267) students thought the explain of the basic theories and the operation prior to each experiment were good; 78.27%(209/267) students were willing to strengthen the basic operation while only 59.18%(158/267) students would like to analyze the experiment results. Conclusions Basic experiment of functional science is wel-comed by students. Due to the lack of independent thinking ability of students, experiment course should de designed to promote interest-oriented transformative learning and to culture transformation perspective, finally achieving the transformative learning.

Objective To investigate clinic value of real-time shear wave elastography (SWE) in indentifying benign salivary gland mass through measuring tissue elastic properties of the benign mass in salivary gland.Methods Seventy-four patients with benign salivary gland mass were enrolled.All of them have been obtained the average elasticity modulus of the mass by SWE before surgery,including parotid mixed tumor (22),parotid adenolymphoma (13) and sub maxillary gland mixed tumor (6),adenolymphoma (33).Statistical analysis was done between groups.Results The average elasticity modulus in parotid mixed tumor group and sub maxillary gland mixed tumor group exhibited (133.53 ± 3.35)kPa and (125.57 ± 2.89)kPa respectively.The average elasticity modulus in parotid aden lymphoma group and sub maxillary gland adenolymphoma group exhibited (65.60 ± 2.33)kPa and (64.60 ± 1.93)kPa respectively.There was no significant difference between mixed tumor group and there was no significant difference between adenolymphoma group.There were significant differences between mixed tumor group and adenolymphoma group.ConcLusions The SWE can distinguish salivary gland benign mass from different originates,which can provide more evidence for clinical diagnosis.

Objective To establish a method focusing on regulation of CNN3 gene in the rat hippocampus and help to explore the role of CNN3 gene played in the brain physiology and pathology.Methods One cDNA sequence and three shRNAs targeting CNN3 gene were designed and synthesized.The recombinant lentivirus-mediated expressing and three short hairpin RNA ( shRNA) vectors targeting CNN3 gene in the rats were constructed with engineering technology.All recombinant vectors were intravenously injected into rats hippocampi guided by stereotaxic apparatus.Western blot was performed to explore the best shRNA and to study the changes of CNN3 gene in the rat hippocampus after transfection with the silence and over-expressed vectors.Results The lentivirus-mediated vector expressing CNN3-OE and three shRNA vectors targeting CNN3 gene were successfully constructed.Within eight weeks after transfection, the vectors of CNN3-OE and three CNN3-shRNAs changed the expression of CNN3 gene in the rat hippocampus, in particular, all the protein levels of calponin-3 encoded by CNN3 gene were significantly down-regulated along with the time, with the highest inhibitory rate of 73.6%in the CNN3-shRNA2 group.Significant up-regulation of calponin-3 protein level by 93.88%, was found only on the 14th day after transfection.Conclusions Lentivirus-mediated vectors of CNN3-OE and CNN3-shRNAs may regulate in vivo the CNN3 gene level in the local brain region of rats via stereotactic injection.The study lays a foundation for disease prevention and treatment in the future.

Objective To explore the clinical application effect of a locking type restraint tool that patients and their families cannot take down at will, convenient and practical, safe and reliable, comfortable and ethical.Methods After designing the locking restraint tool, 80 patients in the Neurology Department of Zhejiang Provincial Hospital of TCM from January 2014 to December 2016 were selected by convenient sampling method. The participants were randomly divided into the experimental group and the control group, each with 40 cases. The patients in the experimental group were controlled by locking restraint tools, while patients in the control group were treated with traditional bound gloves and restraint bands. The incidence of accidental extubation (i.e. conventional catheters, common gastric tubes and internal jugular vein catheters) and the skin integrity of the restricted site was compared between the two groups. Moreover, the satisfaction of the family members for the constraint instruments was investigated.Results The experimental group had significantly lower accidental extubation rate for conventional catheter and common gastric tubes compared with the control group (P<0.05). However, there were no significant differences in accidental extubation rate for internal jugular vein catheters between two groups (P>0.05). There were two patients in the control group had skin redness at the protective constraint site but the experimental group did not suffer from skin integrity damage. The satisfaction level of the family members in the experimental group was significantly higher than that in the control group (P<0.05).Conclusions The standard use of locking restraint tools can effectively reduce the accidental extubation rate in patients with restlessness, and improve the satisfaction of the family members. It is ethical and can be further applied in patients who need protective restraint.

Objective:To conduct a bibliometric analysis of domestic journals in the field of transcatheter arterial chemoembolization (TACE) nursing, so as to understand the research hotspots in the field of TACE nursing in China.Methods:The journals related to TACE nursing included in CNKI, Wanfang Database, VIP Chinese Science and Technology Periodical Database and China Biomedical Literature Database were searched from January 1, 2011 to May 31, 2021 by computer and quantitative analysis was performed.Results:A total of 2 050 articles were included, with an average annual publication volume of 186 articles. The journal with the largest number of TACE nursing literatures was Journal of Interventional Radiology, with a total of 64 articles (3.122%) . A core group of authors, mainly Sha Liyan and Liu Fengyong, was formed in China. Research hotspots were quality of life, adverse reactions, influencing factors and evidence-based nursing. Conclusions:Related research in the field of TACE nursing needs to broaden the thinking, strengthen the cooperation between authors and institutions, grasp the research hotspots, improve the research quality and develop towards a more standard, more standardized and more diversified direction.

Objective? To explore the effects of acupoints moxibustion on urination among patients with selective mucosectomy. Methods? From February 2015 to February 2018, we selected 100 hemorrhoids patients in anorectal surgery at Zhejiang Provincial Hospital. All of the patients were randomly divided into experimental group and control group with the randomization scale produced by SPSS 17.0, 50 cases in each group. Control group implemented routine nursing. On the basis of routine nursing, experimental group carried out acupoints moxibustion. We observed the first urination time, volume of the first urination and maximal urinary flow rate of patients between two groups. Results? There was no statistical difference in the volume of the first urination of patients between two groups (P＞ 0.05). There were statistical differences in the first urination time, maximal urinary flow rate of the first urination and the rate of catheterization (P＜ 0.05). Conclusions? Acupoints moxibustion can reduce the first urination time, improve maximal urinary flow rate of the first urination, and decrease the rate of catheterization among patients undergoing selective mucosectomy to improve urination which is worth to be widely generalized in clinic.

OBJECTIVETo explore the clinical effects of acupressure at Neiguan (PC 6) combined with press needles for prevention of gastroscopy-induced nausea and vomiting.

METHODSOne hundred and twenty patients who were scheduled to gastroscopy for the first time were randomly assigned into an acupressure group and a combined treatment group, 60 cases in each one.The patients in the two groups were treated with acupressure at Neiguan (PC 6) 15 min before gastroscopy; moreover, the patients in the combined treatment group were additionally treated with press needles at Neiguan (PC 6) until the end of gastroscopy. The time of gastroscopy-induced nausea and vomiting, VAS-based nausea and vomiting scale and the state-trait anxiety inventory were compared between the two groups.

RESULTSThe time of gastroscopy-induced nausea and vomiting in the combined treatment group was lower than that in the acupressure group (<0.05); the score of VAS-based nausea and vomiting scale in the combined treatment group was lower than that in the acupressure group (<0.05); the state-trait anxiety inventory was not significantly different between the two groups, before and after gastroscopy (all>0.05).

CONCLUSIONSAcupressure at Neiguan (PC 6) combined with press needles can relieve gastroscopy-induced nausea and vomiting without increasing anxiety.

Objective To investigate the clinical effect of air moxibustion combined with pushpin-like needle acupuncture,which is formulated based on the"suppressing wood-supporting earth"theory in the doctrine of the five elements of Traditional Chinese Medicine(TCM),in the treatment of pain,nausea and vomiting after transcatheter arterial chemoembolization(TACE).Methods A total of 160 patients with hepatocellular carcinoma,who were admitted to the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine of China to receive initial TACE between July 2020 and June 2023,were enrolled in this study.The patients were randomly divided into 4 groups with 40 patients in each group.The patients of the control group received TACE with conventional nursing care,the patients of the pushpin-like needle group received pushpin-like needle acupuncture on the basis of the control group,the patients of the air moxibustion group received air moxibustion treatment on the basis of the control group,and the patients of the combination group received air moxibustion combined with pushpin-like needle acupuncture on the basis of the control group.The post-TACE pain degree(VAS scoring)and nausea/vomiting extent(INVR scoring)were compared between each other among the four groups.Results The differences in the VAS score and INVR score(including main effect and interaction effect)between each other among the four groups were statistically significant(all P＜0.05).Statistically significant differences in the VAS score and INVR score existed between the control group and the other three groups(all P＜0.05).The differences in the VAS score and INVR score between combination group and pushpin-like needle group,as well as between combination group and air moxibustion group were statistically significant(both P＜0.05).Conclusion Air moxibustion combined with pushpin-like needle acupuncture can effectively and remarkably relieve post-TACE pain,nausea and vomiting,which is superior to simple use of air moxibustion or pushpin-like needle acupuncture.Therefor,the combination use of air moxibustion and pushpin-like needle acupuncture should be popularized in clinical practice.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.