Objective:To compare the effect of two kinds of tube feeding nutrient methods on patients with mechanical ventilation. Methods:Fifty patients with gastrointestinal nutrition and mechanical ventilation were divided randomly into observation group and control group.The observation group was with infusion tube feeding,and the control group with filling tube feeding.Then the incidence of bloating,vomits,food reflu and ventilator-associated pneumonia were recorded in each group.Results:The incidence rate of bloating,vomits,food reflu and ventilator-associated pneumonia were 24%,4%,10.7% and 12% in observation group, while the rates in control group were 80%,20%,34.3% and 32% retrospectively.There were statistically significant difference between the two groups.Conclusion:It was suggested that infusion tube feeding nutrition could obviously reduce the occurrence of bloating,vomits,food reflu and ventilator-associated pneumonia.

Objective:To compare the effect of two kinds of humidification methods on patients with artificial respiratory tract.Methods:42 cases in the experimental group was used in precision infusion set to drip humidity fluid continuously in the airway.The syringe was another 42 cases in the control group used to drip humidify fluid discontinuously.Comparisons of the humidification effects and correlative complications in two groups were made.Results:The complication in experimental group was much less than that in the control group(P

Objective:To observe the effectiveness of extrasomatic vibration sputum discharge machine to patients with COPD.Methods:A total of 65 cases of COPD were randomly divided into experimental group(n=33) and control group(n=32),patients in experimental group accepted extrasomatic vibration sputum discharge machine,while patients in control group accepted aritificial beat sputum elimination.The daily sputum volume within 1 week,heart rate,respiration,SPO2 and artery blood gas index in 1d and 4d with oxygen inhalation 3L/min,SPO2 in 7d without oxygen inhalation were compared for the 2 groups.Result:The daily sputum volume in 1d,2d,3d,4d,5d increased obviously and in 6d,7d decreased notably in experimental group compared with control group and the difference was significant.For the experimental group,the heart rate and respiration decreased notably in 3d compaed with those before hospitalization,and the artery blood gas index had significant difference between 1d and 3d.The heart rate and respiration of control group did not decrease significantly in 3d,and there was no significant difference of the artery blood gas index between 1d and 3d.After 30min without oxygen inhalation,SPO2 of experimental group increased that of control group.Conclusion:The extrasomatic vibration sputum discharge machine is better than aritificial beat sputum elimination,which decrease the labour intensity of medicine and nursing staff as well as improves nursing quality and shortes hospitalization time.Further,it is easy for the patients to accept it.

Purpose:To study the application of DuoDERM dressing treated phaseⅡ and Ⅲ decubital ulcer.Methods:97 patients with phaseⅡand Ⅲ decubital ulcer were randomly divided into experimental group and control group,the patients in experimental group(n=49)were treated with DuoDERMdressing extra-pasting on rawsurface while the patients in control group(n=48)were treated with debridement combined with anti-infective.The clinical observe time confirmed in 30 days,the therapeutic effect,the average healing time and treat cost were be recorded in two groups.Results:The therapeutic effect in experimental group was better than that with control group,and its average healing time shorter and cost little.Conclusion:Therapeutic effect of phase Ⅱ and Ⅲ decubital ulcer with DuoDERMdressing is better,it not only decrease the average healing time,but lessens the cost,and is worth to popularize.

Objective:To study on the best replacement time of breathing humidification pot liquid in mechanical ventilation.Methods:33 mechanical ventilation patients were randomly divided into observation group and control group,in the observation group the humidification pot liquid were replaced 7 days,while in a control group were replaced every day,all liquid samples were cultured for bacteria.Results:119 samples collected in observation group have 3 cases with positive bacterial growth(2.5%),while 112 samples collected in control group have 15 cases with positive bacterial growth(13.4%).Conclusion:Replace humidification pot liquid of breathing machine everyday may cause bacterial pollution more easily than they were replaced in 7 days interval.

The idea of evidence-based medicine(EBM) has brought profound changes to clinical medicine.During clinical medicine teaching,a new method should be used that is based on the nature of evidence-based medicine.All of this is required by the trend of the times and objective reality.

Objective To investigate the correlation of tissue factor (TF) and p53 protein expression in colorectal carcinoma. Methods The expression of TF and p53 protein was studied by immunohistochemistry in 43 cases of primary colorectal carcinoma. Results TF expression was positive in 44.2% (19/43) of cases, and p53 protein expression was positive in 48.8% (21/43) of cases. The lymph node metastatic rate was 78.9% (15/19) in patients with positive expression of TF, and 85.7% (18/21) in patients with positive p53 protein expression. Both TF and p53 protein expressions showed significant correlation with lymph node metastasis (?~2=8.96 and 14.88, P

OBJECTIVE:To study the influencing factors of protocol deviation in drug clinical trial implementation,and pro-vide reference for improving the quality of drug clinical trial. METHODS:Quality verification was conducted for the drug clinical trial projects in the First Affiliated Hospital of Chongqing Medical University during 2010-2016,and protocol deviations in each year were retrospectively studied,classified and analyzed. Category,frequency,international and domestic pilot projects and the differences of protocol deviation after full-time research nurse participating in trail management were explored,and the measures were put forward. RESULTS:27 drug clinical trials were implemented in our hospital during 2010-2016,including 949 cases,176 cases with protocol deviation,accounting for 18.55％. Deviation protocol in drug clinical trial was decreased year by year for 7 years. The categories were mainly incompleteness of observation/records (30.11％),checking omission/broaden the window(28.41％),adverse drug events and improper combined medication (14.20％) and omission in drug management (11.93％). The proportion of protocol deviation with full-time research nurse participated was lower than the projects without full-time research nurse(11.11％ vs. 28.67％,P<0.01),and proportion of deviation protocol in international multi-center project was lower than the domestic projects(6.60％ vs. 28.84％,P<0.01). CONCLUSIONS:It is suggested to pointedly strengthen the weak links of drug clinical trial. For example,clinical trial institutions should establish the clinical trial data retention system,electronic data should be timely backed up in a different places,etc. Besides,clinical trial institutions should equip professional full-time research nurses as much as possible,learn the rigorous scientific experimental design,standard operational procedures and the authenticity of data pro-cessing from the international multi-center clinical trial projects to effectively reduce the incidence of deviation protocol and im-prove the quality of drug clinical trials.

OBJECTIVE To investigate the mechanisms for carbapenem resistance in clinical isolates of Pseudomonas aeruginosa from surgical intensive care unit(SICU).METHODS The minimal inhibitory concentrations(MICs) of various antibiotics were detected with agar dilution method;their ?-lactamases were extracted,types of their enzymes were identified and then their physical and chemical characteristics were studied by three dimentional extract test and isoelectric focusing(IEF) electropheresis;primers specific to IMP and VIM genes were utilized to amplify the metallo-?-lactamase genes.The levels of outer membrane protein OprD2 were measured by Western blot.RESULTS Forty one strains were resistant to imipenem from 49 strains of P.aeruginosa isolated from SICU during 3 years.Among them,34 isolates were found to produce high level of AmpC enzymes.Eight produced extended-spectrum ?-lactamases(ESBLs) at the same time.2 produced ESBLs only.No metallo-?-lactamases were detected.The activity of enzymes in the imipenem resistant group(74.32?53.42) was statistically different from the sensitive one(8.7?16.16,P

Objective To study the presentation,sensitivity of different diagnostic methods,snrgical modalities and pathological findings for patients of substemal goiter. Methods The clinical data of fifty nine cases of substernal goiter surgically treated were retrospectively analyzed. Results The main symptoms of substernal goiter patients were asymptomatic cervical mass(39/59),airway obstruction (13/59),hyperthyroidism(4/59),hoarseness(3/59)and choke(3/59).The sensitivity of chest X-ray,ultrasonography,CT and scintigraphy was 62.8%,15.8%,85.7%,and 50.0%respectively,and the specificity Was 99.4%,99.8%,99.5%and 99.0%,respectively.Standard cervical approach was successful for thyroidectomy operations in 57 cases.One patient underwent thyroidectomy by sternotomic approach,and another one by combined cervici-sternotomic approach.No major complications or perioperative deaths occurred.Pathology revealed nodular goiter in 48 cases.Grave's disease in one,thyroid adenoma in 2,and carcinoma in 8. Conclusions CT and chest X-ray are sensitive diagnostic techniques for substerual goiter.Cervical approach is appropriate for most substernal goiter.