Objective:To explore the effect of intensified electrocardiogram (ECG) identification by using spectrogram for the monitoring and nursing ability of nurses who worked in department of cardiology.Methods: Monitoring and nursing capacity of 120 nurses of cardiology who had been trained on the intensified ECG identification by using spectrogram were researched by retrospective analysis. The 120 nurses were divided into control group (60 cases) and intervention group (60 cases) as the random number table. The nurses of control group only received routine training of ECG identification, while the nurses of intervention group received the training of using spectrogram for ECG identification on basic routine training of control group. A series of indicators, including the scores of ECG comprehensive application ability, identification ability of abnormal electrocardiogram, and the number of the identified abnormal malignance ECG and successfully treated patients, between the two groups were compared and analyzed.Results: After the training, the scores of basic theory, abilities of description and recording, and analysis ability in field operation of the intervention group were significantly higher than those of the control group, respectively (t=11.896,t=8.596,t=8.283,P<0.05). The identified ability including room speed, atrial flutter, ventricular flutter and other abnormal ECG of intervention group were significantly better than these of control group, respectively (x2=18.836,x2=17.698,x2=16.773,P<0.05). Besides, the discovery rate of abnormal malignance ECG (73.3%) and the successful rate of treatment (100.0%)of intervention group were significantly higher than that (31.7% and 81.7%) of control group, respectively (x2=19.184,x2=10.484,P<0.05). Conclusion:The training of intensified ECG identification by using spectrogram for nurse of cardiology can effectively enhance the capacities of identification for ECG and comprehensive application for nurses, and can faster confirm the situation of patient, and can contribute to achieve precision diagnosis for doctors.

Coronary Disease ; etiology ; psychology ; Humans

Objective: To evaluate the clinical effect and adverse reactions of radioactive seed interstitial brachytherapy com-bined with etoposide (EP) regimen concurrent chemoradiotherapy treatment for locally advanced non-small cell lung cancer. Methods:All 24 cases of locally advanced non-small cell lung cancer received three-dimensional conformal intensity modulated radiation therapy by using 6 MV X-ray to obtain 95%60-66 Gy/30-33 F planning target volume. All cases received radiation therapy five times a week. EP regimen chemotherapy concurrent with radiotherapy was given to 24 patients. The therapy included VP-16, 60 mg/m2 intravenous in-fusion for 1 d to 5 d, and DDP 50 mg/m2 intravenous infusion on the 1st, 8th, and 28th therapy day. Chemotherapy with EP regimen was given for four cycles, in which two cycles were given during radiotherapy and the remaining cycles were completed after radiotherapy. The patients were reexamined three months after concurrent chemoradiotherapy was completed. Patients with residual tumor, con-firmed via positron emission tomography/computed tomography, underwent 125I radioactive seed implantation interstitial brachytherapy to complement the dose of tumor. Results: The response rate was 83.3% (20/24); the local control rates of 3, 6, 9, 12, 18, and 24 months were 87.5% (21/24), 83.3% (20/24), 75.0% (18/24), 70.8% (17/24), 58.3% (14/24), and 50.0% (12/24). The median survival was 20.2 months. The one-year survival rate was 62.5%, and the two-year survival rate was 37.5%. The following main toxicities were observed:the incidence of radiation-induced lung injury was 25%;the incidence of radiation esophagitis was 33.3%;the incidence of grades Ⅰ to Ⅱ gastrointestinal reactions was 82.3%; the incidence of reducing neutropenia was 87.5%, in which the incidence of gradesⅠtoⅡwas 75.0%, gradeⅢwas 12.5%, and gradeⅣwas 0%. Conclusion:EP regimen concurrent radiotherapy and chemo-therapy combined with radioactive seed interstitial brachytherapy for locally advanced non-small cell lung cancer is effective and has few serious adverse reactions, thus making this approach worthy of promotion.

Objective To observe the effects of interleukin-1 ?(IL-1?) on spontaneous electrical activity of neurons in paravenrticular nuclei,and discuss the possible mechanism.MethodsExtracellular recording technique was employed to observe the effects of IL-1? on spontaneous electrical activity of neurons in paravenricular nuclei in rat hypothalamic slices,and the influence of losartan on the electrical activity induced by IL-1? was examined.ResultsAfter exposure to IL-1?(1?10-7 mol/L),the discharge frequency was significantly increased in 46 of the 59 discharge units(78%) of neurons(P

Objective To study the incidence of malignant tumors in renal allografts and explore the mechanism of increased incidence.Methods A retrospective study was performed on 1 120 renal allografts under at least 0.5 year immunosuppression from 1978～2000. Results 47 cases of malignant tumors were found in 1 120 cases undergoing renal transplantation with the incidence being 4.2?%. 40 cases had intact medical history and 34 cases were demonstrated pathologically. Most patients accepted operations, additional therapies including chemical or radiological and immunological therapies. 25 cases survived and the longest survived time was 4.5 years. Conclusions The incidence of malignant tumors in renal allografts was higher than normal persons. Besides the outcome of immunosuppression, the effects of transplantation itself, such as oncogene chimera, transition of carcinogenic virus and so on, can not be neglected.

Objective To explore effects of ginsenosides Rg1 on the expression of poly(ADP-ribose) polymerase-1 (PARP-1) and tumor necrosis factor receptor (TNFR) 1 in cortex cells after focal cerebral ischemia in rats. Methods Ninety healthy rats were randomly divided into sham-operative group, focal cerebral ischemia group, ginsenoside Rg 1groups (low, medium and high concentrations) and drug control group. Rats were intraperitoneally injected saline 45 mg/kg, saline 45 mg/kg+ginsenosides Rg1 10, 20 and 40 mg/kg, nimodipine 1 mg/kg 5 d before surgery, respectively. Focal cerebral isch?emia model was made by middle cerebral artery occluding in rats. The neurological deficit score and TTC staining were used to verify the success of the rat model. The expressions of PARP-1 and TNFR1 were evaluated by immunohistochemical meth?od and Western blot technique. Results There were obvious symptoms of neurological deficit and large pale infarct area in focal cerebral ischemia group compared with those of sham-operative group. There were higher percentages of neurological deficit score and infarct area in ginsenosides Rg1 groups and positive control group than those of sham-operative group, but which were lower than those of ischemia group (P<0.05). There were no significant differences between ginsenosides Rg1 groups and positive control group. The positive cells of PARP-1 and TNFR1 were higher in ginsenosides Rg1 low-dose group than those of sham-operative group and positive control group, while ones of medium and high-dose Rg1 group were higher than those of sham-operative group, and were lower than those of ischemia group (P<0.05). Compared with sham-op?erative group, PARP-1 and TNFR1 expression strips were significantly enhanced in ischemia group. Expression strips were higher in ginsenosides Rg1 low-dose group than those of sham-operative group. Expression strips were higher in ginsen?osides Rg1 medium-dose group than those of sham-operative group, but which were lower than those of ischemia group, and ones of high-dose group were lower than ischemia group (P<0.05). Conclusion Ginsenoside Rg1 shows protective effects on focal ischemia injury, which may be related with down-regulation of the expression of PARP-1 and TNFR1.

Clinic demonstration is the important part of medical education.There are more and more medical students with enlarged university enrolment in recently year.However,the patients for demonstration are relatively fewer.In this condition,we make the best of the available resources to demonstrate clinic pediatrics by teaching at bedside;displaying video products,using human analogue and case record and role playing,thus ensuring the effect of clinic pediatric teaching.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

Source data and its source documents are the foundation of clinical research. Proper source data management plays an essential role for compliance with regulatory and GCP requirements. Both paper and electronic source data co-exist in China. Due to the increasing use of electronic technology in pharmaceutical and health care industry, electronic data source becomes an upcoming trend with clear advantages. To face new opportunities and to ensure data integrity, quality and traceability from source data to regulatory submission, this document demonstrates important concepts, principles and best practices during managing source data. It includes but not limited to: (1) important concepts of source data (e.g., source data originator, source data elements, source data identifier for audit trail, etc.); (2) various modalities of source data collection in paper and electronic methods (e.g., paper CRF, EDC, Patient Report Outcomes/eCOA, etc.); (3) seven main principles recommended in the aspect of data collection, traceability, quality standards, access control, quality control, certified copy and security during source data management; (4) a life cycle from source data creation to obsolete is used as an example to illustrate consideration and implementation of source data management.
China ; Data Collection ; standards ; Documentation ; standards ; Information Storage and Retrieval ; methods ; standards

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.