Objective To discuss the construction of training model for cooperation between doctors and nurses and evaluate its teaching effect.Methods 101 nursing students and 80 clinical medicine students were involved in an overall training for the purpose of cooperation between doctors and nurses by using of Sim-man and then test and questionnaire were conducted to evaluate the effect of the training.Results Statistics showed that training for cooperation between doctors and nurses had improved in such factors as attitude to the cooperation,communication skills,team work,and adaptability (operant skill was note included).In addition,88％ of the subjects supported the views that this kind of training should be offered before their internship.Conclusions Training for cooperation between doctors and nurses by using Sim-man can cultivate awareness of cooperation between doctors and nurses and improve team work,and set a better foundation for good collaboration between doctors and nurses.

Objective To realize medical information collection and digital management in field battle and the fundamental information and cure of medical staff of emergency medical, equipment and the wounded were included in it. Methods The collecting information were transmitted to computer through wireless connection and manage the information with Delphi7 procedure. Results The system was used firstly in large-scale practice and completed the information transcription and management on elementary and cure in hundred of wounded. Conclusion The information is up to the mustard of field and it has established base on cure information in digital management.

Objective To explore the possible correlation of the clinical parameters(such as neck circumference,waist circumference,Hipc,WHR,BMI,ESS scores)with the severity of obstructive sleep apnea/hypopnea syndrome(OSAHS).Methods There were 111 patients with diagnosis of OSAHS.All patients underwent polysomnography and the physical examination.The meatured body parameters and AHI were analyzed.Results A statistically significant correlation between neck circumference,waist circumference,Hipc,WHR,BMI with the AHI was detected.No correlation was found between ESS and AHI.Except for Hips and ESS,the difference of neck circumference,waist circumference,WHR,BMI were significant between the different serious patients(P

Objective To integrative the effect of ulinastatin on postoperative cognitive function in elderly gastric cancer surger-y.Methods Two hundred elderly patients with gastric cancer surgery were randomly divided into observed group (100 cases)and control group (100 cases).Patients in observed group received the intravenous drip of ulinastatin before and after the surgery,while others only received the intravenous drip of physiological saline before and after the surgery.Results The urine output of observed group was (441.7±78.5)mL,which was significantly lower than that in control group as the result was (613.2±81.2)mL(P <0.05).After the treatment,the score of MMSE,visual regeneration and association learning in both observed group and control group were significantly lower than that before the treatment(P <0.05).The scores of MMSE,visual regeneration and association learning in observed group were 24.4±1.5,9.7±1.7 and 12.4±1.8,which were significantly higher than that in control group as the scores were 21.1±1.0,8.7±1.5 and 11.3±1.7 (P <0.05).The level of S100βin serum of observed group at the end of sur-gery,1 day and 3 day after the surgery were (0.099±0.024)μg/L,(0.074±0.026)μg/L and (0.061±0.022)μg/L,which were significantly lower than that in control group as the results were (0.138±0.042)μg/L,(0.110±0.034)μg/L and (0.075±0.031)μg/L (P < 0.05).Conclusion Ulinastatin can not only improve the postoperative cognitive dysfunction in elderly patients with postoperative,but can also reduce the level of S100βin serum.It provides brain protection for patients.

Objective To investigate the clinical application of ultrasound-guided percutaneous puncture aspiration and sclerotherapy of liver hydatid cysts.Methods Thirty-eight patients of hepatic hydatid cysts underwent ultrasound-guided percutaneous puncture aspiration and sclerotherapy;then 20%-25%septic hypertonic saline or 95%absolute alcohol were injected into the cysts (the volume was about 25%-50%of the aspirated fluid) ;and the fluid was reaspirated after 5-15 min.At last,5-10 ml sclerosing agent was injected again.Oral albendazole 30-50 mg/kg was administrated to all patients before and after the above procedures.Ultrasonic follow-up was performed at 3-month interval in the first year and once a year afterwards.Results The successful rate of once puncture was 100%.Aher 6 months,cysts volume reduced 50% in 16 patients,reduced 30% in 22 patients.One year later,34 patients were cured,3 were effectively treated and 1 was improved.All hydatid cysts volume gradually decreased and calcification occurred.The total cure rate was 100%. Conclusion Ultrasound-guided percutaneous puncture aspiration and sclerotherapy is a safe,effective and reliable treatment of liver hydatid cysts.

Objective To investigate the application and effect of aerobic exercise of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD).Methods Ninety-four hospitalized patients with COPD from June 2011 to June 2012 were enrolled.The clinical curative effect and safety of aerobic exercise of pulmonary rehabilitation in patients with COPD were observed and compared.Results After 3 months treatment,first second forced expiratory volume (FEV1) and forced vital capacity (FVC) were increased compared with those before treatment [(3.25 ± 0.49) L vs.(2.59 ± 0.55) L,(1.95 ± 0.41) L vs.(1.44 ± 0.48) L],and there were significant differences (P ＜ 0.05).There was no significant difference in FEV1/FVC before and after treatment (P ＞ 0.05).After 3 months treatment,arterial partial pressure of oxygen and arterial oxygen saturation were increased compared with those before treatment [(87.61 ± 8.56) mm Hg(1 mm Hg =0.133 kPa) vs.(63.88 ± 8.79) mm Hg,0.9648 ±0.0449 vs.0.7632 ± 0.0477],partial pressure of arterial carbon dioxide was decreased compared with that before treatment [(30.57 ± 9.47) mm Hg vs.(49.23 ± 9.54) mm Hg],and there were significant differences (P ＜ 0.05).There was no signifi.cant difference in blood pressure and heart rate before and after treatment (P＞ 0.05).No obvious adverse reactions were observed.Conclusions The aerobic exercise of pulmonary rehabilitation can improve significantly lung function.It is safe and rehable,and has less adverse reaction in patients with COPD.It is worthy of promotion and use.

Objective To investigate the curriculum construction and evaluation of teaching effectiveness of simulation and comprehensive experiment for clinical nursing. Methods Based on the investigation of hospital, taking working progress and working task of nurses as orientation, we constructed the curriculum of simulation and comprehensive experiment for clinical nursing, and unfold in junior class (before clinical practice) for student nurses. The teaching effect was evaluated. Results Unfolding simulation and comprehensive experiment could effectively enhance the nursing students' ability to transform theoretical knowledge into clinical nursing practice, and was favorable to change the role of nurses and improve the satisfaction degree of clinical practice.Conclusions Unfolding simulation and comprehensive experiment for clinical nursing for student nurses before clinical practice is practicable and essential.

Objective:To explore the role of cytokines in the pathogenesis of Graves′disease(GD),by detecting the levels of IFN-γ,IL-6,IL-17 and TGF-β1 in GD patients who were newly diagnosed.Methods:A total of 23 patients with new onset GD and 23 gender-and age-matched healthy controls were examined.The levels of serum IFN-γ, IL-6, IL-17 and TGF-β1 were measured by ELISA,FT3,FT4 and TSH levels were determined by ECL IA;TrAb levels were tested by RRA.Results: There were no significant difference among GD and NC group in sex and age match ( t=0.334 8 ,P>0.05;χ2=0.410 7 ,P>0.05 ).The levels of serum IFN-γ,IL-6,IL-17 and TGF-β1 in the GD group were significantly higher than the control group ( P<0.05 ) .Correlation analysis revealed that IFN-γ,IL-6,IL-17 and TGF-β1 were positively correlated with FT3,FT4(r=0.324 6,0.453 2,0.431 0,0.463 8;0.413 2,0.441 5, 0.436 2,0.467 1;P<0.05 ).Conclusion: IFN-γ, IL-6, IL-17 and TGF-β1 are highly expressed in the newly diagnosed GD patients.They play an important role in the pathogenesis of GD ,and provide helpful evaluation indices of immune dysfunction to Graves disease.

Objective To evaluate the reliability of serum catecholamine concentrations in reflecting the depth of dexmedetomidine-based general anesthesia.Methods Forty patients,aged 30-45 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅱ,undergoing elective laparoscopic hysterectomy under general anesthesia,were divided into 2 groups (n =20 each) using a random number table:dexmedetomidine-based general anesthesia group (group Ⅰ) and general anesthesia group (group Ⅱ).Dexmedetomidine was intravenously infused as a loading bolus of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.5 μg · kg-1 · h-1 until 30 min before the end of operation in group Ⅰ.The equal volume of normal saline was given instead of dexmedetomidine in group Ⅱ.Anesthesia was induced with iv midazolam 0.05 mg/kg,propofol 1 mg/kg,cisatracurium 0.15 mg/kg and sufentanil 0.4 μg/kg.Anesthesia was maintained with iv infusion of remifentanil 0.1-0.3 μg · kg-1 · min 1,1％-2％ sevoflurane inhalation and intermittent iv boluses of cisatracurium.Before administration of dexmedetomidine,at the end of administration of the loading dose,at the end of intubation,at the end of skin incision,after establishment of pneumoperitoneum and at the end of operation (T0-5),venous blood samples were taken from the peripheral vein for determination of concentrations of epinephrine (E) and norepinephrine (NE) in serum (by enzyme-linked immunosorbent assay).Results Compared with group Ⅱ],the serum NE and E concentrations were significantly decreased at T1-4 in group Ⅰ (P＜0.05).Compared with the baseline at T0,the serum NE and E concentrations were significantly decreased at T1 in group Ⅰ,and increased at T2-4 in group Ⅱ (P＜0.05).Conclusion The serum catecholamine concentration produces poor reliability in reflecting the depth of dexmedetomidine-based general anesthesia,and thus it is not a suitable monitoring index.

Objective To develop field medical card based on RFID for storage of casualty information and the sharing in evacuation. Methods Making use of radio frequency identification technology (RFID technology),TEKLOGIX 7527C palm script RFID reader from Canada was adopted with software of Visual Studio 2005 and C# to design and produce the card. Results The basic information of combatants can be entered into the card,and the casualty and cure information could be inquiry,revision and update at any time through the RFID technology. Conclusion After trial in large -scale military exercise,the effect is satisfied.