ObjectiveTo evaluate the reliability and validity of Chinese version of Postoperative Pain Assessment Nursing Practice Questionnaire (PPA-NPQ).MethodsA forward-backward translation procedure was followed to develop the Chinese version of PPA-NPQ.A total of 258 surgical nurses were investigated by the revised Chinese version dimensions of PPA-NPQ,then the results were tested on reliability and validity by SPSS17.0.ResultsThe cronbach's α of the Chinese version of PPA-NPQ was 0.889.The split- half coefficient and testretest reliability of PPA-NPQ were 0.729,0.875 respectively ; the Cronbach's a,split- half coefficient and test-retest reliability of each sub-scale were ranged from 0.820-0.857,0.797-0.862,0.846-0.902 respectively.The correlation between each sub-scale and total scale were ranged from 0.704-0.818 (P ＜ 0.01 ).ConclusionThe revised Chinese PPA-NPQ is reliable and valid,and can be used to test the level of postoperative pain assessment practice by surgical nurse.

OBJECTIVE:To establish a RP-HPLC method to determinate the plasma concentration of paclitaxel in tumor patients.METHODS:Paclitaxel was extracted from plasma with organic phase(ethyl-acetate)by two-step extraction on Tianhe Kromasil C18 column(250 mm?4.6 mm,5 ?m)with a mobile phase consisted of acetonitrile-methanol-water(40∶25∶40)at a flow rate of 1 mL?min-1.The detective wavelength was set at 227 nm and the column temperature was maintained at 35 ℃.RESULTS:The linear range of paclitaxel was 0.05～5.00 mg?L-1(r=0.999 7)with average recovery rate at 98.75%～100.44%.Both intra-day RSD and inter-day RSD were less than 5%(n=5).The plasma concentration-time profile in 11 patients after iv infusion of paclitaxel was in line with a two-compartment model.CONCLUSION:This established method is simple,accurate,reproducible and applicable for clinical determination of blood drug concentration and pharmacokinetic studies.

OBJECTIVE:To establish an RP-HPLC method for the determination of doxorubicin hydrochloride concentration in human plasma.METHODS:Tianhe Kromasil C18 was used as column,A solution of methenol-0.01 mol?L-1ammonium dihydrogen phosphate-acetic acid(30200.1) was used as the mobile phase at a flow rate of 1.0 mL?min-1.The detection of wavelength was set at 233 nm.The sample size was 20?L and the column temperature was 35℃.The internal standard was daunorubicin.RESULTS:The calibration curve was linear in the range from 0.25～20.16 ?g?mL-1(r=0.999 6);the average methodological recovery was 96.45%(RSD=2.16%).CONCLUSIONS:The method is rapid,accurate,reproducible and easy to use in clinical detection of blood concentration.

Abscess ; therapy ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neck ; Retrospective Studies

Objective To investigate the relationship between end-tidal carbon dioxide with its related indicators and ventilation/perfusion of the acute respiratory distress syndrome (ARDS) lung,and to explore a feasible way to titrate positive end-expiratory pressure (PEEP) in clinical practice.Methods Five mixed-breed dogs with oleic acid lung injury model were mechanically ventilated at a serial PEEP trial including a recruitment maneuver (RM) before each PEEP level changed.The value of blood dynamics,end-tidal carbon dioxide partial pressure ( PetCO2 ) and arterial carbon dioxide pressure under different PEEP levels were recorded.Arterial end-tidal carbon dioxide gradient (Pa-etCO2) and dead space fraction (Vd/Vt％) were calculated.All dogs received CT scan.Lung volume under different pressure levels,and ratio and volume of alveolar closing pressure,collapsed alveoli,sufficiently and insufficiently ventilated alveoli were obtained.Alveolar opening and closing analysis were performed by non-liner regression equation.Results The mean pressure when Vd/Vt％ obtained lowest level were ( 11.2 ± 4.4 ) cm H2O(1 em H2 O =0.098 kPa),which had no significant difference when compared to alveolar closing pressure[ ( 11.5 ± 3.2 ) cm H2O ]( P ＞ 0.05 ).The fraction of insufficiently ventilated and collapsed alveoli showed a significant linear correlation with the Vd/Vt％ when PEEP was lower than Pmin ( r =0.632,P =0.004 ).There was a linear correlation between the Vd/Vt％ and the fraction of over-distended alveoli when PEEP was higher than Pmin ( r =0.770,P =0.001 ).Conclusions Closing pressure is in accordance with PEEP level after RM having reached the best ventilation/circulation ratio.The characteristics of lung collapse can be revealed by Vd/Vt％ changes after RM.To titrate PEEP for the lowest Vd/Vt％ after RM may be a feasible way to match the best ventilation and circulation effects of PEEP.

Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; Medicine, Chinese Traditional ; methods ; Neoplasms

Objective To investigate the effects of parecoxib and morphine on remifentanil-induced postoperative hyperalgesia in patients undergoing orthopedic operation. Methods Sixty ASA Ⅰ or Ⅱ patients,aged 20-62 yr, weighing 45-100 kg, undergoing orthopedic surgery, were randomly divided into 3 groups ( n = 20 each). Anesthesia was induced with midazolam, propofol, remifentanil and rocuronium. The patients were mechanically ventilated after tracheal intubation. Group Ⅰ received iv injection of morphine 0.15 mg/kg, group Ⅱ received iv injection of parecoxib 20 mg and morphine 0.075 mg/kg and group Ⅲ received iv injection of parecoxib 40 mg and morphine 0.075 mg/kg. Anesthesia was maintained with infusion of propofol and remifentanil and intermittent iv boluses of vecuronium. The emergence time, consciousness recovery time, extubation time,incidence of agitation and shivering, and VRS score at 5 min after recovery of consciousness were recorded. Pain at rest and at movement was evaluated using VAS score at 1,2, 4, 8, 12 and 24 h (T1-6) after surgery and MAP andHR were recorded simultaneously. The incidence of nausea and vomiting during 24 h after surgery was also recorded. Blood samples were taken before induction of anesthesia, at the end of operation and 24 h after operation for determination of plasma concentrations of PGE2 and TNF-α. Results There was no significant difference in emergence time, consciousness recovery time, extubation time, VRS scores, MAP, HR, incidence of agitation,shivering, nausea and vomiting among the 3 groups. Compared with group Ⅰ , VAS scores at rest at T1-2 and at movement at T1-6 were significantly increased in group Ⅱ , while VAS scores at rest and at movement decreased at T1-5 in group Ⅲ (P＜0.05). VAS scores at rest at T1-6 and at movement at T1-5 were significantly lower in group Ⅲ than in group Ⅱ (P＜ 0.05). There was no significant difference in the plasma concentrations of PGE2 and TNF-α at different time points between group Ⅰ and Ⅱ (P＞0.05). The plasma concentrations of PGE2 and TNF-α were significantly lower at the end of surgery in group Ⅲ than in group Ⅰ and Ⅱ (P＜0.05). Conclusion Preoperative iv parecoxib 40 mg and morphine 0.075 mg/kg can reduce remifentanil-induced postoperative hyperalgesia in patients undergoing orthopedic operation, and the efficacy is better than that of morphine alone.

Objective:To investigate the knowledge of hand-cleaning in student nurses,cultivate their awareness of washing hands,improve their submitting of washing hands and standardize their washing procedure,so as to reduce the hospital-acquired infection via hands.Methods: A self-designed questionnaire on hand-cleaning-related knowledge was used to survey 100 student nurses in their clinical practice in our hospital.Results:In the 100 questionnaires,some student nurses have poor-mastering of the signs of hand-cleaning,and have indefinite concepts of the time,position and frequency of hand-cleaning.The most frequently forgotten part of hands cleaning is finger(42%),the second is wrist(29%).Lots of student nurses(92%) mistakingly thought that washing hands with warm water was much better.Conclusion:The student nurses had relatively poor knowledge on hand-cleaning,much more attention should be paid on the education of this aspect by nursing department,in order to improve self-protection and control of hospital-acquired infection effectively.

Objective: To observe the therapeutic efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate in treating chondromalacia patellae and its effect on inflammatory factors in knee joint fluid. Methods: Sixty-eight patients with chondromalacia patellae were randomized into a control group and an observation group, with 34 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate, while the observation group was given additional warm needling moxibustion treatment. Before and after treatment, the two groups were scored using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS), examined by magnetic resonance imaging (MRI) and determined for the levels of nuclear factor-κB (NF-κB), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in knee joint fluid. Clinical efficacy was estimated after treatment. Results: The effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the scores of pain, stiffness and daily activities, as well as the general score of WOMAC declined significantly in both groups (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the time cost for climbing up and down one staircase and VAS score decreased markedly in both groups (all P<0.05), and were shorter or lower in the observation group than in the control group (both P<0.05); the MRI grading showed no significant change in the control group after intervention (P>0.05), while the grading in the observation group showed notable improvement (P<0.05), and was better than that in the control group (P<0.05); the levels of NF-κB and IL-1β in knee joint fluid dropped significantly in the control group after treatment (both P<0.05), while the levels of NF-κB, TNF-α and IL-1β in knee joint fluid all decreased significantly in the observation group (all P<0.05) and were lower than those in the control group (all P<0.05). Conclusion: Warm needling moxibustion plus intra-articular injection of sodium hyaluronate can produce definite efficacy in treating chondromalacia patellae; it can mitigate the clinical symptoms, improve the lesion extent of chondromalacia and down-regulate the levels of NF-κB, TNF-α and IL-1β in knee joint fluid.

Objective To evaluate the effects of limb ischemic preconditioning on myocardial ischemiareperfusion injury in a rat model of severe hemorrhagic shock and resuscitation.Methods Twenty-four male Sprague-Dawley rats,weighing 300-350 g,were randomized into 3 groups (n =8 each) using a random number table:control group (group C); severe hemorrhagic shock and resuscitation group (HSR group); limb ischemic preconditioning group (group LIP).Hemorrhagic shock and resuscitation was induced by withdrawing blood (50％ of the total blood volume) from the left common carotid artery over an interval of 1 h,and 30 min later the animals were then resuscitated by infusion of the shed blood via the jugular vein over 30 min.Limb ischemic preconditioning was induced by 4 cycles of 5 min limb ischemia followed by 5 min reperfusion at 40 min before ischemia in LIP group.Before withdrawing blood (T0),immediately after the end of withdrawing blood (T1),before infusion of the shed blood (T2),and at 0,1 and 2 h after infusion of the shed blood (T3-5),mean artery pressure (MAP) was measured,the cardiac output (CO),left ventricular ejection fraction (LVEF) and myocardial performance index (MPI) were detected using color Vivid flow imaging,and total vessel density (TVD),perfusing vessel density (PVD),proportion of perfused vessels (PPV),microvascular flow index (MFI) of sublingual microcirculation were measured using sidestream dark-field imaging.The survival rates within 72 h after hemorrhagic shock and resuscitation were recorded.Results Compared with C group,MAP,CO,LVEF,TVD,PVD,PPV and MFI were significantly decreased and MPI was increased at T1-5 in HSR group and at T1 and T2 in LIP group (P ＜ 0.01).Compared with HSR group,MAP,CO,LVEF,TVD,PVD,PPV and MFI were significantly increased and MPI was decreased at T3-5,and the survival rate within 72 h was increased in LIP group (P ＜ 0.01).Conclusion Limb ischemic preconditioning can significantly attenuate myocardial ischemiareperfusion injury induced by severe hemorrhagic shock and resuscitation in rats and is helpful for prognosis.