Objective: To evaluate the hemodynamics and oxygen consumption following induction of anesthesia with etomidate or midazolam in patients with coronary heart disease(CAD). Method: Thirty patients were divided into E (etomidate,n=15)and M(midazolam,n=15)groups,receiving a infusion of etomidate or midazolam until their eyelash reflex was lost. After pipeuronium(0.15mg/kg) and fentanyl were administered according to the mean blood pressure,the intubetion was achieved. Hemodynsmic and oxygen data were measured before induction, during induction and 1 min after intubation. Result: Induction caused a significant fall in HR,MAP,SVRI,PVRI and VO_2I in both groups (P

1.Conclusion ABR can evaluate the function of brainstem of patients with severe traumatic brain injury in PVS and provide evidence for prognosis.

Objective A rapid and highly sensitive method, based on the high performance thin-layer chromatography, was described for the qualitative and semiquantitative determination of 7-aminon-itramepam, the main metabolites of nitramepam, in human urine. Method 7-aminonitramepam was extracted by diethyl ether under pH9 condition. Fluorecsamine was used as a reagent to produce fluorescent product to show analyte on plate. Results The limit of detection for 7-aminonitramepam in urine was 5ng/ ml and the limit of quantitation was 15ng/ml. Conclusion The method can be successfully used for determining 7-aminonitramepam in urine samples excreted over 48h period after receiving 10mg nitramepam o-rally and could be applied to drug examination for the cases of drug-facilitated rob.

Objective To analyze the distribution of aminoglycoside acetyltransferases (aac) gene in Acinetobacter baumannii, and to establish a molecular biology method to detect the drug-resistance of the bacteria. Methods The aac genes of 42 isolated Acinetobacter baumannii were analyzed by drug susceptibility and multiplex PCR assay. Results The isolated bacteria were more resistant to Gentamicin (57%) and less resistant to Amikacin (29%). As to the bacteria resistant to at least one of the following aminoglycosides, Gentamicin, Tobramycin, Amikacin, aminoglycoside resistant genes were detected in all of pathogens except 2 special. Among them 6 strains with aac(6′)-Ih, 20 strains with aac(3)-Ia, 14 strains with aac(6′)-Ib and 14 strains were found to have both aac(6′)-Ib and aac(3)-Ia. Conclusion Acinetobacter baumannii isolated in this district are easily resistant to Gentamicin, and it is most caused by the enzyme encoded by aac(3)-Ia and aac(6′)-Ib.

Objective To evaluate the effects of acitretin combined with clarithromycin on tumor growth in human oral epidermoid carcinoma xenografts in nude mice,and to investigate their antitumor mechanisms.Methods A cell line of human oral epidermoid carcinoma was subcutaneously inoculated into 31 Balb/c nude mice to establish a xenograft model of human skin tumor.Then,the nude mice were randomly classified into 6 groups according to a double blind protocol:control group (n =6) remaining untreated,placebo group (n =5) treated with wheat flour,acitretin group (n =5) treated with acitretin 7.2 mg/kg per day,clarithromycin group (n =5) treated with clarithromycin 100 mg/kg per day,acitretin + placebo group (n =5) treated with both acitretin (7.2 mg/kg per day) and wheat flour,and acitretin + clarithromycin group (n =5) treated with acitretin (7.2 mg/kg per day) and clarithromycin 100 mg/kg per day.All the drugs were intragastrically administrated once daily.After three weeks of treatment,mice were sacrificed and xenografts were removed.Then,the size and weight of xenografts were measured,and pathological analysis was conducted.Real time-PCR was performed to quantify the mRNA expressions of vascular endothelial growth factor (VEGF) and nuclear factor (NF)-κB,and immunohistochemistry was carried out to observe the expression of VEGF as well as to determine microvessel density (MVD) and Ki-67 proliferation index.By using the software SPSS 19.0,analysis of variance was performed for comparison of measurement data,and least significant difference (LSD) test for paired comparisons.Results Both the size and weight of xenografts in the acitretin + clarithromycin group were significantly lower than those in the other groups (all P ＜ 0.05).Real-time fluorescence-based PCR revealed weaker mRNA expressions of VEGF and NF-κB in the acitretin + clarithromycin group compared with the control group,clarithromycin group and acitretin group (all P ＜ 0.05).As immunohistochemistry showed,the acitretin + clarithromycin group displayed a decrease in the expression rate (all P ＜ 0.01) and staining intensity of VEGF,MVD (all P ＜ 0.01) with a sparse distribution of microvessels,Ki-67 proliferation index (all P ＜ 0.05) and proliferative activity of tumor cells compared with the control group,clarithromycin group and acitretin group.Conclusion Acitretin combined with clarithromycin can synergistically inhibit the growth of human oral epidermoid carcinoma xenografts in nude mice,downregulate VEGF expression,and suppress angiogenesis and tumor proliferation.

OBJECTIVE: To analyze the basic data of adverse drug reactions(ADR) and assess the quality of ADR reports submitted in 2006 in Shenzhen,and to provide bases for ADR monitoring.METHOD: The electronic forms of ADR cases reported in 2006 by different units in Shenzhen that had been subjected to the evaluation of Guangdong provincial center were downloaded,and the related data were subjected to frequency analysis.The three time points(duration of medication,onset time of ADR,turnover time) were used to evaluate the integrity of ADR process recording,and the relevance was evaluated by means of contrast.RESULTS: 19 drug categories and total 465 kinds of medicines were involved in 3 303 ADR cases.The categories of antimicrobials and Chinese herbal preparations and ADR cases induced by these drugs ranked at the first and second among all the drugs.The lesions of ADR involved primarily skin and its accessories,followed by gastrointestinal system.Most ADR cases were caused thorough intravenous route of administration.The majority ADR cases had a favorable turnover.New and severe ADR reports were few.The qualities of most reports were poor.CONCLUSION: The training program for ADR reporters should be strengthened;ADR reporters' reporting awareness and responsibility should be strengthened to enhance ADR reporting quality,and physicians' prescribing behavior should be intervened properly so as to reduce the incidence of ADR.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objeetive To investigate the relationship among social avoidance and acceptance of disability in burn patients.Methods Totally 127 patients were investigated using Social Avoidance and Distress Scale (SADS),Acceptance of Disability Scale (AODS),demographic information questionnaire and disease related information sheet.Results The points of burn patients' SADS was (21.38±6.75),One-way ANOVA showed that gender,marital status,special parts burns,amputation affected social avoidance significantly.The total score and factors scores of acceptance of disability were all negatively related to the score of social avoidance.Regression analysis showed that acceptance of disability,head burns,gender were the independent risk factors of depression.Conclusions Acceptance of disability were negatively related to social avoidance; Nurse can help them accept the reality of disability,develop the confidence to partici-pate in social communication,and improve the social adaptability.