Objective To access evaluate the efficacy and safety of on-line hemodiafiltration for treating a-cute cerebrovascular disease (ACVD) patients complicated with hyperosmolar nonketotie diabetic coma (HNDC).Method Totally 11 patients of ACVD complicated with HNDC were observed for this prospective control study.All of them underwent on-line hemodiafiltrafion for 90 minutes using Fressnius 4008S Hemodialysis Machine withONLILNEplus TM and F60 one hour after final diagnosis was made. The bicarbonate ultrafiltrate rate was set at 500ml/min and blood flow at 150 ～ 180 ml/min; and the substitute fluid were infused with post-dilution at 50 ～ 60ml/min. The symptom of brain edema and cardiac insufficiency during the same course of treatment was observed.Blood were taken from the patients to detect serum kalium, serum glucose, serum natrium, BUN and plasma os-motic pressure at one hour before treatment and six hours after treatment, respectively. The change of in conscious-ness and adverse effects were evaluated at 24 hours after treatment. Results All patients were treated successful-ly. The blood glucose, serum natrium, serum kalium, BUN and plasma osmotic pressure were decreased after on-line hemodiafiltration. Among the 11 patients, consciousness was improved obviously in 8 patients, 3 patientsdied, accounting for 73% of successful effectiveness. Conclusions The on-line hemodiafiltration was effectiveand safe for treating ACVD patients complicated with HNDC.

Objective To observe and analyze the role of different subfields of medial prefrontal cortex (mPFC) in the expression course of startle reflex.Methods 24 healthy male British kind of albino guinea pigs were randomly divided into 4 groups:anterior cingulated cortex lesion ( n =6) and sham-lesion ( n =6) ( Experiment 1 ) ; prelimbic cortex lesion/joint lesion of prelimbic cortex and anterior cingulated cortex(n=6) and sham-lesion ( n =6) ( Experiment 2 ).The animals were injected lidocaine ( lesion ) or physiological saline ( sham-lesion ).Each group received paired training of conditioned stimulus( CS,a tone) and unconditioned stimulus (US,a air puff),to observe the acoustic startle reflex(ASR) change of these groups.Results As the results of experiment 1 suggested,SR rate did not change significantly after anterior cingulated cortex lesion ( time effect:F =15.421,P =0.098 ; group effect:F =14.753,P =0.084).As the results of experiment 2 suggested,SR rate did not change significantly after prelimbic cortex lesion ( time effect:F =14.975,P =0.178 ; group effect:F =18.643,P =0.089).When prelimbic cortex and anterior cingulated cortex were lesioned at the same time,SR rate declined significantly and didn ' t recover with the following training ( group effect:F =67.743,P =0.009 ).ConclusionLesions of the prelimbic cortex and anterior cingulated cortex in mPFC cause the significantly decline of acoustic startle reflex( ASR),which don' t recover with the following training.This study indicates that mPFC involves in the regulation of ASR,but the regulation mechanism needs to be discussed.

BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.

Objective To study the stability of the toxicity,antigenicity and immunogenicity of Neisseria meningitidis serogroup A/C[CMCC(B)29201/29205],and to analyze the quality of the capsular polysaecharide extracted from Neisseria meningitidis.Methods The toxicity of the 3rd,5th,10th,15th,20th,25th and 30th passage of the Neisseria meningitidis was assayed in mice,and the antigenicity of each passage was measured by the tube agglutination test(TAT)and ELISA.The effect of individual 30 passages of Neisseria nveningitidis on the brain tissue and the immunogenicity of each passage were tested in mice,and the capsular polysaccharide was purified and analyzed.Resuits The LD50 of the strains CMCC(B)29201/29205 of each passage was low(≥109/ml),and all the 30 passages of the two strains had no effect on the brain tissue of the mice.The titer of each passage was 1∶320 in TAT and more than 1∶3752 in ELISA.After immunization with individual 30 passages of the Neisseria meningitidis the titers in serum bactericidal assay (SBA)were all more than 1∶32.The capsular polysaccharide purified from Neisseria meningitidis met the quality standard of the requirement.Conclusion The strains of Neisseria meningitidis serogroup A/C used in the manufacture of the meningococcal conjugate vaccine,are stable in the toxicity,antigenicity and immunogenicity.And the capsular polysaccharide has met the quality standard.

Objective To explore Chongqing migrant workers Suiqian children′s mental health status and related factors .Meth-ods In this study 740 children from grade 7 to grade 9 in 3 schools which specify recruit migrant workers′children ,including the 399 migration children of migrant workers and 341 urban household registration students were involved .They were investigated with symptom rating scale(SCL-90) and self-made general questionnaire .Results There were no significant differences in SCL-90 scores between the migrant workers migration children group and urban household registration students group (P>0 .05) .Conclu-sion Generally speaking ,Chongqing migrant workers Suiqian children′s mental health status is good ,but there are still some prob-lems .We need do some further study on the mode of psychological intervention to maintain their physical and mental health .

Objective To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. Methods Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). Results No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P<0.001);the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P<0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P<0.001). Conclusions VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.

Objective To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. Methods Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). Results No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P<0.001);the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P<0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P<0.001). Conclusions VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.

Objective To establish a quality indicator system of interventional nursing.Methods Taking Donabedian quality structure model as the theoretical basis and through literature analysis,expert meeting and summarizing the clinical problems,the first draft about interventional nursing care quality indicators was composed,which included 3 first-level indicators,12 second-level indicators and 55 third-level indicators.A total of 27 experts on interventional nursing and nursing administration were selected from 25 grade-3A level hospitals in 13 provinces and cities of China.The Delphi method was used to conduct two rounds of expert correspondence consultation,and the quality indicator system of interventional nursing was established.Results Finally,a quality indicator system of interventional nursing,which included 3 first-level indicators,7 second-level indicators and 29 third-level indicators,was formulated.In both the two rounds of expert letter inquiry,the positive coefficient and authority coefficient were 100％and 0.95 respectively.The coefficient of variation of each index in the first and the second round of expert letter inquiry was 0-0.25 and 0-0.21 respectively.In the first round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.672,0.271 and 0.341 respectively,while in the second round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.462,0.475 and 0.330 respectively,the differences were statistically significant(all P＜0.01).Conclusion The quality indicator system of interventional nursing established in this study carries a relatively high reliability and scientific nature,and it can provide reference for evaluating and monitoring the safety and quality control in interventional nursing.

Objective To explore the effect of virtual reality(VR)technology on relieving intraoperative pain in patients receiving transcatheter hepatic artery chemoembolization(TACE).Methods A total of 76 patients,who received TACE from June 2023 to January 2024,were enrolled in this study.Using random number table method,the patients were divided into control group(n=38)and study group(n=38).Intraoperative routine nursing was carried out for the patients of the control group,while on the basis of routine nursing additional VR technology was adopted to relieve the intraoperative pain for the patients of the study group.The degree of intraoperative pain,anxiety symptoms,incidence of intraoperative adverse reactions and patient satisfaction with nursing were compared between the two groups.Results The degree of intraoperative pain in the study group was lower than that in the control group,but the difference between the two groups was not statistically significant(P＞0.05).The analgesic effect of VR was much obvious in patients aged≤55 years and in patients with vascular invasion of liver cancer(P＜0.05).The anxiety score in the study group was lower than that in the control group,the patient satisfaction score in the study group was higher than that in the control group,and the differences between the two groups were statistically significant(both P＜0.05).No statistically significant difference in the incidence of adverse reactions existed between the two groups(P＞0.05).Conclusion Immersive VR technology can effectively reduce the degree of intraoperative pain in patients receiving TACE,especially in patients aged ≤55 years.Besides,VR technology can also reduce the anxiety degree of patients,and improve the degree of intraoperative patient satisfaction with nursing.

Polyhexamethyl guanidine (PHMG) is a widely used guanidine disinfectant. Since a lung injury incident induced by humidifier disinfectant (PHMG was identified as a main component) was reported in Korea, its inhalation toxicity has attracted the attention of researchers. At present, there are few domestic studies on inhalation toxicity of PHMG. In this paper, based on the domestic and foreign studies of PHMG, the toxicities of PHMG, including inhalation toxicity and associated toxic mechanism, and other potential toxicities, such as liver toxicities, cardiovascular toxicity, immunotoxicity, and reproductive and developmental toxicity, were systematically introduced, revealing that the effects of use of PHMG in a non-standard manner on the body and its possible mechanisms, which could provide reference for the use of PHMG properly and to lay a theoretical foundation and provide a scientific basis for follow-up study.