OBJECTIVE: To investigate the clinical characteristics of urgent tracheotomy patients. METHOD: Forty-five cases of urgent tracheotomy patients were reviewed retrospectively. The clinical characteristics, pre-operative and post-operative clinical manifestation and complication were studied. Most patients for urgent tracheotomy were head and neck tumor, inflammation and head and neck injury. RESULT: Two patients died in operating and two patients died in post-operation. Finding respiratory depression in six patients of long obstruction in post-operation. Eleven patients had complication in operating or post-operation. Hemorrhage and pneumoderma and local trauma were the main complications. CONCLUSION Emergent tracheotomy and elective tracheotomy were different-in the short operation time and body position. Complication incidence rate were higher than normal tracheotomy. Patients of long obstruction after post-operation shouldn't breathe in pure dephlogisticated air to avoidance respiratory depression.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tracheotomy ; adverse effects ; Young Adult

Objective To analysis the reliability of the examination of Introduction of Nursing by using the methods of generalizability theory and to give advice on how to modify examination paper.Methods Estimation value of variance component from different variations and precision indexes were calculated by applying the principle of generalizability theory.Results The generalizability coefficient and index of dependability were greater than 0.4 in choice question and terminology explanation,the generalizability coefficient of short-answer question was also greater than 0.4.Short-answer question's index of dependability and generalizability coefficient and index of dependability of comprehensive problem were less than 0.4.Conclusions Generalizability theory can be used in analysis the reliability of the examination of Introduction of Nursing.Its result is helpful to improve the framework of examination papers and the reliability of examination.

Objective To investigate the ability level of institutionalized elderly people and its correlation with pension service demand.Methods Ability assessment for older adults and a self-designed questionnaire about pension service demand were used to survey the ability level and service demand of 332elderly people in 7 institutions of Yancheng city in Jiangsu province in July 2014.The influence factors of pension service demand were analyzed by the binary classification Logistic regression.Results 67.8％ (225/332),14.8％(48/332) and 15.7％(52/332) institutionalized elderly's ability level were mild,moderate and severe impairment.The impairment of ability levels of the elderly had positive impact on helping eating,bath,cleaning,medical service and other services agency and negative impact on culture and entertainment.Conclusions The ability of institutionalized elderly were poor in Yancheng city in Jiangsu Province.We should provide service according to their abilities and demand,in order to ensure the rational use of the limited resources.

Objective: To establish the method of determination of the content of Berberine hydrochloride and Palmatine hydrochloride in Wuji Pills. Methods: Ultrasonic extraction, HPLC was used to determine Berberine hydrochloride and Palmatine hydrochloride in Wuji Pills on C 18 Column, using 0.033mol/L KH 2PO 4 CH 3CN(90∶40) as mobile phase, with detection at 265nm. Results: The linearity of this method was well. The average recoveries were 99.07% for Berberine hydrochloride and 98.59% for Palmatine hydrochloride. RSD were 1.3% and 1.7%, respectively. Conclusion: This method shows good separating degree and can be used for quality control of Wuji Pills.

BACKGROUND: D-galactose-induced aging animal model is similar tohuman natural aging. Whether the expression of protein phosphatase-1(PP-1) in the brain of D-galactose-induced aging mice is related to cerebralaging process or not should be researched further. OBJECTIVE: To investigate the effect of the APP17 peptide and theliquid extract ofjiunao yizhi capsule on regulating the expression of PP-1 inhippocampal neurons of the aging mice induced by the D-galactose (D-gal). DESIGN: A random controlled study. SETTING: Department of Pathology, College of Basic Medical Sciences, Capital University of Medical Sciences and Beijing Research Laboratory forBrain Aging, Xuanwu Hospital of Capital University of Medical Sciences. MATERIALS: The study was completed between July 2003 and July2004 in the Experimental Center of Capital University of Medical Sciences. Forty male Kunming mice (SPF grade) with a body mass fron 28 g to 32 gwere purchased from Chinese Academy of Medical Sciences Institute ofMaterial Medical.METHODS: Kunming mice were randomly divided into 5 groups: control group, D-gal group, APP17 peptide treatment group, low dose herb treatment group, and high dose herb treatment group with 8 mice in each group. In Dgal group, APP17 peptide treatment group, low dose herb treatment group and high dose herb treatment group, galactose was injected subcutaneously (50 nmg/kg). Meanwhile, 0.1 mL normal saline containing 0.35 μg of APP17 peptide was injected subcutaneously into the mice in APP17 peptide treatment group, once a day for 3 months; liquid extract of jiunao yizhi capsule (provided by Beijing Chaoyangmen Hospital and Shanxi Quwo Traditional Medical Institute; the main component: dangshen, baizhu, guijia and chuanshanjia, etc.) was perfused by stomach (0.3 g/kg and 1.0 g/kg respectively) in low dose herb treatment group and high dose herb treatment group, once a day. And equivalent normal saline was injected and perfused in the two control groups. After 3 months of survival, the mice were killed and their brains were cut into sections. The immunohistochemical staining of these sections was then performed with PP-1 antibody.MAIN OUTCOME MEASURES: The results of immunohistochemical staining analysis of PP-1.RESULTS: Forty mice entered the final analysis without any loss. PP-1 positive cells in the hippocampus were poorly stained in the D-gal mice. In contrast, PP-1 positive neurons were widely distributed in the hippocampus of those normal mice, the APP17 peptide-treated D-gal mice and the high liquid extract of raw herb-treated D-gal mice. These cells were darkly stained in cytoplasm. The unexpected result was that in the low liquid extract of raw herb-treated D-gal mice the number of PP-1 positive neurons did not increase to normal.CONCLUSION: The results demonstrated that the expression of PP-1 decreased in the hippocampus of D-gal mice. The APP17 and low dose liquid extract of raw herbs can regulate the distribution of PP-1 in the brain of D-gal mice and make them recover to normal situation.

BACKGROUND: In brain insulin does its work through the insulin receptor substrate (IRS). Amyloid beta protein precursor 17 (APP17) peptide has the neurotrophic function, which may improve diabetic encephalopathy resulted from insulin deficiency by affecting insulin receptor substrate.OBJECTIVE: The mouse diabetic model was produced to observe the effect of APP17 peptide on the distribution of IRS-1 in brain tissues.DESIGN: Randomized control animal experiment.SETTING: Staff Room of Pathology, College of Basic Medical Sciences,Capital University of Medical Sciences; Beijing Research Laboratory for Brain Aging of Xuanwu Hospital.MATERIALS: The experiment was performed in Staff Room of Pathology,College of Basic Medical Sciences, Capital University of Medical Sciences and Beijing Research Laboratory for Brain Aging of Xuanwu Hospital from September to October 2003. Totally 18 male kunming mice were employed,and randomly assigned into control group, diabetic group and APP17 peptide treatment group with 6 mice in each group.METHODS: ①The mice were subjected to intraperitoneal injection of streptozotocin (STZ, Sigma) by 200 mg/kg, and 3 days later, the tail blood was sampled to examine non-fasting blood glucose, and the blood glucose over 15 mmol/L was set as the criteria for successful diabetic model establishment. ②In APP17 + diabetes mellitus group, the mice received subcutaneous injection of 0.35 μg APP17 peptide once daily for 2 weeks. The mice in the normal control group were not interfered. ③Then brain was removed and crystat sections were prepared. Immunohistochemical staining was done for IRS-1 at four weeks after giving streptozotocin.MAIN OUTCOME MEASURES: Pattern and distribution of IRS-1 positive cells of mice in each group.RESULTS: Totally 18 mice were involved in the result analysis. ①In the brains of diabetic mice the IRS-1 immunohistochemical positive cells distributed at cortex, hippocampus, thalamus, hypothalamus and so on, while the positive cells distributed only at cortex and hippocampus in the normal control group and APP17 peptide treatment group, lightly stained. ②Numbers of immunohistochemical positive cells of IRS-1 of cerebral hippocampus in the diabetic group, normal control group and APP17 peptide treatment group were (28.7±1.5), (9.2±1.5), (10.1±1.4) piece per 10 power object lens, and that in the diabetic group was higher than that in the other two groups (P ＜ 0. 001 ). CONCLUSION: Neurons in many regions of brains of diabetic mice have plenty of IRS-1 positive cells. APP17 peptide can make part and quantity of IRS-1 positive cells normality so as to ameliorate the degeneration of hippocampal neurons of diabetic mice.

Objective To investigate the career decision-making self-efficacy as well as the psychological well-being of medical students and to discuss the correlation between them.Methods A cross-sectional survey with cluster random sampling was performed anonymously among 714 students of different majors and different grades in an medical University.The contents of the survey included the career decision making self-efficacy scale (CDMSE) as well as the self-reporting inventory(SCL-90).All data in the two groups were analyzed with t test; comparison of data between groups were analyzed with One-Way ANOVA; multiple comparison was analyzed with S-N-K; Pearson and Partial correlation analysis were used to analyzed the correlation between the career decision making self-efficacy and wellbeing.Results Totally 659 students completed the inventory,with response rate being92.3％.Average score of the participants' career decision-making self-efficacy was (124.72 ± 26.76)points,situating at the middle and lower level.There were differences in the scores of career decision making selfefficacy among different sexes,sources,grades and being student cadres or not (P =0.019,0.000,0.027,0.026) ; No differences was found among students of different majors and whether being the only child(P =0.243,0.223).Results of the SCL-90 inventory demonstrated that medical students had some psychological problems including obsessive-compulsive,interpersonal sensitivity and anxiety.Correlation analysis showed that psychological well-being and career decision-making self-efficacy was negatively correlated.Conclusions Measures should be taken to improve the medical students' career decision-making self-efficacy according to their psychological characteristics and to improve the medical students' psychological status by the improvement of career decision-making self-efficacy.

Objective To investigate the effect of insulin signaling pathway on neuronal survival and the effect of the peptide App17 on regulating the expression of some apoptosis-related proteins in neurons of the hippocampus through intracerebrorentricular injection of streptozotocin in rats. Methods The rats were injected with App17 peptide subcutaneously three weeks after the model group was established by intracerebrorentricular injection of streptozotocin.After the four-week treament,the expressions of the apoptosis-related proteins,such as Bcl-2,Bax,CytoC in neurons of the hippocampus were tested with immunohistochemical staining and Western blotting.Results Bax,CytoC positive neurons were widely distributed in the hippocampus of the model group,and the cytoplasm was darkly stained.In contrast,the positive neurons for Bax,CytoC in hippocampus were poorly stained in the control group and the treated group,and appeared significant difference in cell counting as compared with model group.Bcl-2 positive neurons were widely distributed in the hippocampus in the control group and the treated group,and the cytoplasm was darkly stained while its positive neurons were poorly stained in the model group,and appeared significant difference in cell counting as compared with the model group.From the Western blotting clear bars could be seen in the three groups and there was a significant difference between them.Conclusions The expression of Bax,CytoC increased in the hippocampus in the rats with intracerebrorentricular injection of streptozotocin while the expression of Bcl-2 decreased.The App17 peptide could promote the rehabilitation of the abnormal expression of the three proteins to some extent.The insulin signaling pathway could affect the survival of the neurons in rats' hippocampus.

Objective: To evaluate the clinical efficacy and safety of domestic faropenem in the treatment of acute bacterial infections. Methods: A multicenter, randomized, double blind and double simulation clinical study was conducted to compare the efficacy and safety of faropenem and cefaclor in the treatment of acute bacterial infection. Patients in trial group(n = 122) were given faropenem 250 mg，and in control group (n = 118) were given cefaclor 200 mg，3 times daily for 7 to 10 days.Results: The clinical cure rates were 33.61% and 27.12% in trail and control groups respectively and the clinical effective rates were 87.70% and 83.05% respectively. There was no significant difference in terms of clinical effectiveness between the two groups（P > 0.05）. The adverse reaction rates were 7.32% in trial group and 3.36% in control group（P > 0.05）. The adverse reaction of the trial group was mainly exaltation of aminotransferase, which did not affect the therapy. No severe adverse reaction was found.Conclusion: Domestic faropenem is effective and safe for the treatment of bacterial respiratory tract and urinary tract infections.

Objective:To observe the effects of moxibustion pretreatment on Glutathione Peroxidase(GSH-Px),Superoxide Dismutase(SOD),and Malondialchehyche(MDA)in gastric mucosa of rats with stress ulcer,and to investigate the mechanism of moxibustion pretreatment preventing the oxidized injury of gastric mucosa.Methods:Forty-eight healthy SD rats were randomly allocated into 4 groups,namely control group,model group,acupoint moxibustion group,and non-acupoint moxibustion group.The ulcer model was developed by restraint and water immersion stress,Ulcer index(UI)was calculated with Guth method,and the contents of GSH-Px,and MDA and SOD activity in the gastric tissues were measured with chromatometry method.Results:Compared those in the model group and nonacupoint moxibustion group,moxibustion at Zusanli(ST 36)could decrease the UI(P<0.01)and MDA(P<0.05)contents,and increase the activity of GSH-Px(P<0.01)and SOD(P<0.05).Conclusion:Pretreatment of moxibustion at Zusanli(ST 36)could promote the recovery of gastric injury in rats induced by restraint and water immersion stress by enhancing the activity of GSH-Px and SOD,and lower MDA content.