Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio-pancreatography (ERCP) under total intravenous anesthesia.Methods Ninety patients,47 males and 43 females,aged 18 years old or more,falling into ASA physical status Ⅰ-Ⅲ,undergoing ERCP under total intravenous anesthesia from July 18,2016 to August 31,2016 in Ruijin Hospital were included in our study.General information and intraoperative situation of patients were collected.The incidence of PONV within 24 h was recorded.A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia.Results In total,90 patients were included in this study,with 33 patients (36.7%) suffering PONV.Logistic analyses showed that female (OR=3.73,95%CI 1.36-10.27),history of PONV/motion sickness(OR=4.39,95%CI 1.40-13.76),and serum-amylase greater than 3 times the normal value (OR=5.22,95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia.Conclusion Female,history of PONV/motion sickness,and serum-amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.

Increasing aged care requisite has become a serious challenge all over the world. Compared with developed countries, aged care in China still has some limitations, i.e., lack of qualified professionals, aged care system needs to be improved, and lack of aged long term care insurance. This article discussed these points and put forward the corresponding countermeasures.

China ; Humans ; Immunization Programs ; Poliomyelitis ; prevention & control ; Poliovirus Vaccines ; administration & dosage

Objective To study the clinical effect of gonadotropin releasing hormone-analogue (GnRH-a) and marvelon in the treatment of ovarian endometriesis after laparoscopy.Method The postoperative women with ovarian endometriosis were divided into three groups:19 treated with GnRH-a and marvelon(greup A),20 treated with GnRH-a(group B),20 without endocrinal therapy(group C).The symptoms scores,the recurrence and side effects were compared.ResultsThree years after laparescopy,the recurrent rate and symptoms scores in group C was the highest (P＜0.05),the recurrent cyst size [(12 + 1)mm] and symptoms scores [(1.2 + 0.9)scores] in group A was the lowest among three groups.Conclusions Marvelon and GnRH-a can be used in the treatment of ovarian endometriesis after laparoseopy.The effect of marvelon combined with GnRH-a is prior to GnRH-a.

Visfatin is a highly conserved protein expressed by visceral fat tissues that previously identified as pre B cell colony-enchancing factor (PBEF). Visfatin is a 52 ku cytokine and has been shown to exert multiple distinct biological activities. By interacting with insulin receptors, visfatin exhibits insulin mimicking or antagonizing effects under different circumstances. In addition, it possesses an nicotinamide phosphoribosyl transferase (Nampt) activity inside the cells, which functions at the rate-limiting step along the pathway of nicotinamide adenine dinucleotide (NAD) biosyntheses. And finally, as an extracellular cytokine, visfatin is able to induce the expression of inflammatory cytokines, such as TNF?, IL-1? and IL-6. Visfatin has drawn increasing attentions to researchers for its close association with a variety of human metabolic and acute/chronic inflammatory diseases or disorders, including diabetes, obesity, acute lung injury, rheumatoid arthritis, sepsis, myocardial infarction and inflammatory bowel disease. Recently, the SNP (single nucleotide polymorphism) analyses of visfatin and its promoter regions have provided more in-depth understandings of its roles in disease pathogenesis. A discussion in the current knowledge of the structure and diversified functions of visfatin, as well as its connections with a variety of common diseases was given.

Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

Objective To isolate and identify the aseites-derived exosomes from patients with ovarian epithelial carcinoma,and explore the relationship between exosomes and the prognosis of ovarian epithelial carcinoma.Methods Ascites-derived egosomes were isolated by ultraeentrifugation on sucrose and D2O gradients from 41 ovarian epithelial carcinoma patients,and identified by transmission electron microscope and western blot analyses.Ascites-derived exosomes were evaluated for effect on prognosis of ovarian epithelial carcinoma.Resulls Exosomes were isolated and purified from the ascites in 85% (35/41)of ovarian epithelial carcinoma patients;major histocompability complex-I(MHC-I)could be detected in 100%(35/35)of the aseites-derived exosomes samples,heat shock protein-70(Hsp70)in 91%(32/35),and CD81 in 86%(30/35).The patients with positive ascites-derived exosomes had no significant difference in age,pathological type and the degree of differentiation of tumor,surgical-pathological staging,the optimal operation and the responsibility to chemotherapy(P>0.05).The patients with positive ascites-derived exosomes,the reduction of CA125 level after cytoreduetive surgery was(66±27)%,which was more than that of the patients without ascites-derived exosomes(37±86)%and all the whole patients not considering the condition of exosomes(61±44)%(P<0.01),and there were also no difference whether or no optimal operation ration(P<0.01).Conclusions There are ascites-derived exosomes in ascites from most patients with ovarian epithelial carcinoma.While the relationship between exosomes and prognosis of ovarian epithelial carcinoma needs further research.

Objective To investigate the effect of continue nursing care post-discharge on the treatment effectiveness of gastric ulcer in active phase, and to facilitate the nursing quality. Methods A total of 163 patients with gastric ulcer were divided into control group including 80 cases and observation group including 83 cases randomly by hospitalization order. Routine nursing care was administrated on the two groups of patient's duration of hospital stay equally, but continue nursing care was administrated on the observation group patients exceptionally. The treatment outcome and intervention effect of the two groups were compared at the end of study. Results The overall cure rates of the control the observation group patients were 63.75%(30/80) and 81.93%(68/83), the eradication rates of helicobacter pylori (Hp) were 86.25%(69/80) and 96.39%(80/83), the medication compliance scores of Morisky were 3.69 ± 1.34 and 6.71 ± 1.57, the quality scores of life instruments for chronic were 67.81 ± 7.10 and 86.34 ± 6.83 respectively at the end of follow-up period. There were significant differences in the above indicators (χ2=6.830,5.330,t=13.199,16.977,P<0.05 or 0.01). Kaplan-Meier analysis showed that the cure period of the observation group was significantly shorter than that of the control group (χ2=20.446,P<0.05). Conclusions The continue nursing care post-discharge has positive effect on the treatment of active gastric ulcer, and it should be recommended in clinical application.

Objective To investigate the exposure level of VOCs in different population and the health effects. Methods In 2005, a questionnaire survey relating to inhalation exposure assessment of VOCs and housing decoration characteristics was carried out in 200 newly decorated apartments (628 residents), 30 house decoration workers and 20 painting workers of an automobile manufacture factory. Indoor concentrations of formaldehyde, BTEX-compounds and TVOC were measured in typical apartments, offices, houses in where the decoration workers were operating, the painting workshops, and public indoor environments. Average daily exposure doses and potential doses for common people at home (non-occupational exposure group) and workers in occupational environments (occupational exposure group) to formaldehyde and BTEX-compounds and TVOC were estimated by combining the survey results with monitoring data. Results The percentages of whom having different discomfortable symptoms in the workers in the painting workshop were higher than that in common people (P

Objective To explore the surgical technique and its promising future of coblation in knee arthroscopic surgery. Methods Twenty cases of different knee problems were treated arthroscopically for partial meniscectomy, cartilage or ligament trimming, synovictomy or lateral retinaculum release with usage of ArthroCare 2000 radiofrequency machine. Arthroscopic diagnosis for these 20 cases were as follows, meniscus tear 6 cases, degenerative cartilage injury on femoral condyle 6 cases, patellar subluxation 5 cases, inflammatory synovitis 2 cases and partial injury of anterior cruciate ligament 1 case. Results The clinic results showed that treatment of injured tissue handled by coblation technique was much precise than that handled by the conventional technique, the former was featured by relative less invasive to the near normal areas and spontaneous coagulation function. No compression wraps were needed to be applied during operation. All patients were comfortable postoperatively with their pain- free and no swelling knees. Conclusion Less pain and easy for early rehabilitation for all ArthroCare 2000 treated cases imply that coblation technique could greatly enhance the clinic results of arthroscopic surgery for knee diseases.