Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Objective:To construct a set of evaluation index system for the core ability of preventive medicine graduates to respond to sudden biological public health events.Methods:Research methods such as in-depth interviews and group discussions were used to determine the core competence structure, the Delphi method was used to conduct two rounds of expert consultation, and the index system and its weights were finally determined based on the consultation results of 21 experts on the system. Excel and SPSS 21.0 were used for data collation and statistical analysis.Results:The positive coefficient of expert consultation was greater than 80%, the authority coefficient was greater than 0.7, and the average was 0.906. The final index system was composed of 4 first-level indicators, 10 second-level indicators, and 39 third-level indicators.Conclusion:The evaluation index system can provide a reference for exploring effective ways to improve the core competence of graduates.

Objective: To design the self-rating scale on basic ability in graduates of preventive medicine major, and test its reliability and validity, providing a reliable tool for evaluating the basic ability of graduates. Methods: On the basis of constructing the Evaluation Index System on Basic Ability in Graduates of Preventive Medicine Major, the three-level indexes were converted to specific questions. Self-evaluation scale including 58 items, 22 sub-dimensions and 8 main dimensions were finally designed after pre-survey and expert argumentation. A total of 205 graduates of preventive medicine major from a medical college and 9 experts in the field of public health were selected to completed the questionnaire. Scale's reliability was tested by applying internal consistency reliability and composite reliability; it's validity was tested by applying content validity and confirmatory factor analysis. Results: Scale's α coefficient of internal consistency reliability was 0.976; α coefficient and combination reliability of eight main dimensions were both higher than 0.8; the content validity index S-CVI of the scale was 0.94, the content validity index I-CVI of the item level was 0.78 to 1.00; the average variance extraction amount (AVE) of the eight main dimensions was higher than 0.50. Fitting of the structural model with the item used as observation indexes was reasonable (χ²/df=1.749, RMR=0.036, RMSEA=0.061, NFI=0.801, IFI=0.904, TLI=0.904, CFI=0.903), and the sub-dimension as used observation indexes was good(χ²/df=1.876, RMR=0.032, RMSEA=0.066, NFI=0.913, IFI=0.958, TLI=0.945, CFI=0.957). Conclusion This scale is the first self-rating scale on the basic ability in graduates of preventive medicine major on the basis of the National Standards of Teaching Quality on Public Health and Preventive Medicine, with good reliability and validityl. It is able to achieve quantitative evaluation on graduates' basic abilities.

[Objective] To investigate the clinical characteristics and blood transfusion status of patients of liver cirrhosis and analyze its rationality.[Methods] We designed questionnaires to collect the data of patients admitted with liver cirrhosis including clinical features,blood transfusion,smoking,drinking and other living habits.We follow up the patients and analyze the blood transfusion rationality.[Results] Data on 198 patients was collected.34.8％ (69/198) of all patients were transfused at least one blood component.Total blood transfusion was 371 times,of which 52.2％ of the blood transfusion cases (36/69) were transfused with two or more blood during hospitalization.Among the 69 cases of blood transfusion,11 cases were treated with the first blood transfusion for the purpose of treatment and 58 cases for prevention.18 of those cases were infused with red blood cells of 90.5 units.54.55 ％ (60/110) and 60.91％ (67/110) of patients who had a pre-transfusion INR＞1.3 did not receive plasma.2.27％ (2/88) of patients who had a pre-transfusion INR≤1.3 received plasma.29.41％ (5/17)who had a pre-transfusion fib≤1.0 received cryoprecipitate.3.87％(7/181) who had a pre-transfusion fib＞1.0 received cryoprecipitate.[Conclusions] Blood transfusion is common in patients with liver cirrhosis.Empirical and preventive blood transfusion is common also.We should take a more scientific restrictive blood transfusion strategy.

AIM:To investigate the effects of celecoxib on viability , apoptosis and autophagy in acute myeloid leukemia (AML) cell lines HL-60 and HL-60A.METHODS:The HL-60 cells and HL-60A cells were cultured with vari-ous concentrations (0, 20, 40, 60, 80 and 100μmol/L) of celecoxib.The inhibitory effect of celecoxib on the cell viabil-ity was evaluated by MTT assay .Apoptosis was analyzed by Annexin-V/PI staining.Apoptosis-related and autophagy-relat-ed proteins were determined by Western blot .RESULTS:IC50 of celecoxib were 49.4 μmol/L, 32.0 μmol/L and 25.1μmol/L for HL-60 cells treated with celecoxib for 24 h, 48 h and 72 h, respectively.For HL-60A cells, the corresponding IC50 were 69.1 μmol/L, 42.5 μmol/L and 29.6 μmol/L, respectively.The results of flow cytometry analysis showed the proportions of Annexin-Ⅴ+PI-, Annexin-Ⅴ+PI+and Annexin-Ⅴ-PI+cells were increased in the HL-60 cells, and those of Annexin-Ⅴ+PI-and Annexin-Ⅴ+PI+cells were increased in the HL-60A cells treated with celecoxib for 24 h. After treated with celecoxib , the induction of apoptosis was observed , the apoptosis-related proteins cleaved caspase-3 and cleaved PARP were upregulated , the autophagy-related proteins LC3 II and P62 were both increased , and mTOR, p-mTOR, 4-EBP and p-4-EBP were not changed , indicating that celecoxib inhibited autophagy in the AML cells without the mTOR pathway involvement .CONCLUSION:Celecoxib inhibits the viability of HL-60 cells and HL-60A cells in a time-and dose-dependent manner by its effects of inducing apoptosis and necrosis .Celecoxib inhibits mTOR-independent autoph-agy in AML cells, indicating a possible way of using celecoxib for enhancing the antitumor activity of therapeutic agents to induce cytoprotective autophagy in the AML cells .

Objective To observe the efficacy of hyperbaric oxygen (HBO) in the treatment of acute carbon monoxide poisoning (ACOP),and also to analyze its treatment efficacy by various factors.Methods Four hundred and thirty-seven patients with ACOP who sought medical care in the Fujian Provincial Hospital from January 2005 to June 2014 were chosen for the study.In accordance with different treatment methods,the patients were divided into 2 groups:the control group (n =179) and the HBO group (n =258).The patients in the control group received routine medical care,while the patients in the (HBO) group received HBO treatment in addition to routine care.Medical follow-ups were made one month,6 months,1 year and 2 years after onset,and the scores of therapeutic efficacy,cure rate,efficacy rate,disability rate,death rate,as well as incidence of delayed encephalopathy were analyzed and compared between the 2 groups.Correlation analysis was made of the 21 factors affecting therapeutic efficacy of HBO for the treatment of ACOP,and multiple linear regression analysis of related factors was also made in the study.Results Medical follow-up results indicated that the cure rate and efficacy rate of the patients after 2 years of treatment were significantly better than those patients after just one month of treatment,and the disability rate was also decreased significantly.Statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).One month and 2 years after onset,the scores of therapeutic efficacy,cure rates and efficacy rates of the HBO group were ignificantly higher than those of the control group at the same time points.Disability rates,death rates and incidence of delayed encephalopathy were significantly lower than those of the control group,also with statistical significance (P ＜ 0.05).There was little effect on the scores of therapeutic efficacy and the incidence of delayed encephalopathy for those HBO patients with an age ≤30,1 month and 2 years after onset.However,HBO therapy could decrease the over-all incidence of delayed encephalopathy.There was significant correlation between the interval time of HBO retreatment and the number of HBO sessions in the incidence of delayed encephalopathy.Conclusions Various factors,such as age,pathogenic factors,symptoms after onset,the interval of emergency medical care,coma time,compliance of medical advice about HBO,medical histor.y of diabetes mellitus,duration of stay at the CO environment,the number of HBO sessions,were all important factors affecting the incidence of delayed encephalopathy.HBO therapy could produce good clinical effect on the patients with ACOP,increase cure rate and at the same time decrease the incidence of delayed encephalopathy.For this reason,it was worth further clinical extension.

Objective To observe the efficacy of hyperbaric oxygen (HBO) in the treatment of acute carbon monoxide poisoning (ACOP),and also to analyze its treatment efficacy by various factors.Methods Four hundred and thirty-seven patients with ACOP who sought medical care in the Fujian Provincial Hospital from January 2005 to June 2014 were chosen for the study.In accordance with different treatment methods,the patients were divided into 2 groups:the control group (n =179) and the HBO group (n =258).The patients in the control group received routine medical care,while the patients in the (HBO) group received HBO treatment in addition to routine care.Medical follow-ups were made one month,6 months,1 year and 2 years after onset,and the scores of therapeutic efficacy,cure rate,efficacy rate,disability rate,death rate,as well as incidence of delayed encephalopathy were analyzed and compared between the 2 groups.Correlation analysis was made of the 21 factors affecting therapeutic efficacy of HBO for the treatment of ACOP,and multiple linear regression analysis of related factors was also made in the study.Results Medical follow-up results indicated that the cure rate and efficacy rate of the patients after 2 years of treatment were significantly better than those patients after just one month of treatment,and the disability rate was also decreased significantly.Statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).One month and 2 years after onset,the scores of therapeutic efficacy,cure rates and efficacy rates of the HBO group were ignificantly higher than those of the control group at the same time points.Disability rates,death rates and incidence of delayed encephalopathy were significantly lower than those of the control group,also with statistical significance (P ＜ 0.05).There was little effect on the scores of therapeutic efficacy and the incidence of delayed encephalopathy for those HBO patients with an age ≤30,1 month and 2 years after onset.However,HBO therapy could decrease the over-all incidence of delayed encephalopathy.There was significant correlation between the interval time of HBO retreatment and the number of HBO sessions in the incidence of delayed encephalopathy.Conclusions Various factors,such as age,pathogenic factors,symptoms after onset,the interval of emergency medical care,coma time,compliance of medical advice about HBO,medical histor.y of diabetes mellitus,duration of stay at the CO environment,the number of HBO sessions,were all important factors affecting the incidence of delayed encephalopathy.HBO therapy could produce good clinical effect on the patients with ACOP,increase cure rate and at the same time decrease the incidence of delayed encephalopathy.For this reason,it was worth further clinical extension.

OBJECTIVETo analyze and summarize the characteristics and treatment of acute spinal cord decompression sickness. To explore the factors that influence the treatment effect.

METHODS77 cases of acute spinal cord decompression sickness patients should be divided into 4 groups according to the pressurized treatment and drug treatment options. They were group I, group II, group III and group IV. At the same time they were get hyperbaric oxygen therapy and other treatment. The evaluation index, were Frankel function classification and paraplegia index. There were 17 factors that affected the treatment effect.

RESULTSThe rate of early cure was 57.14% (44/77). The rate of late cure was 74.03% (57/77). Their difference was statistically significant (P<0.05). In 3 months and 1 year the cure rate of group IV and group B were the highest. But there was no difference between them(P>0.05). They were higher than group ii and group I (P<0.05). The Frankel function classification in 3months and 1 year in each group was higher than before treatment (P<0.05). The paraplegia index in 3 months and 1 year in each group was lower than before treatment (P<0.05). In 3 months and 1 year the Frankel function classification was increased gradually and the paraplegia index was decreased gradually in group I , group II, group III (P<0.05). In group IV and group III the Frankel function and the paraplegia index had not significant difference (P>0.05). Among the 17 factors that affect the treatment effect there are 9 factors that affect the proportion of the large.

CONCLUSIONSThe first choice of treatment method for the patients with acute spinal cord decompression sickness would be group III. Drug therapy was also imporpant. At the same time the hyperbaric oxygen therapy and other treatments were taken. Although the cure rate was not high in this article. But most of the cure is within 3 months. Within 1 year.the cure rate still could be improved. 9 factors that affect the efficacy of acute spinal cord decompression sickness was more noteworthy.

Decompression Sickness ; therapy ; Diving ; adverse effects ; Humans ; Hyperbaric Oxygenation ; Paraplegia ; physiopathology ; therapy ; Spinal Cord ; physiopathology

Objective To observe the effects of phlorizin on aorta of diabetes db/db mice and to explore its mechanism.Methods Sixteen diabetes db/db mice were randomized into two groups:untreated diabetic group (DM group) and diabetic group treated by phlorizin(DMT group) with eight db/m mice as normal control group(CC group).Phlorizin (20 mg/kg) was given in normal saline solution intragastrically to the mice of the DMT group for 10 weeks.Mice of the other two groups were given the same amount of saline solution intragastrically for 10 weeks.Animals were weighed weekly.At 10th weekend,all mice were fasted overnight and then sacrificed.Fasting blood was collected,and aortas were dissected.The blood samples were analyzed for fasting blood glucose (FBG),triglycerides (TG),total cholesterol (TC),Serum advanced glycation end products(AGEs)and malondialdehyde (MDA).Aortic tissue were examined microscopically.Results At 10th weekend,the weight (57.53±3.40)g and serum concentration of FBG(31.21±2.16) mmol/L,TG (0.39±0.12) mmol/L,TC(3.15±0.30)mmol/L,AGEs (0.28±0.04) AU/mg and MDA (15.18± 1.60)mol/L in DM group were increased than those in CC group (P＜0.01),and the weight(54.24± 1.28)g,FBG(29.17±1.41) mmol/L,TG(0.26±0.06) mmol/L,TC(2.71±0.26) mmol/L,AGEs (0.24±0.03) AU/mg and MDA(13.46±1.28)mol/L were lowered significantly in DMT group than those in DM group (P＜0.05 or P＜0.01).The severity of aorta damage in DMT group was less than that in DM group.Conclusions Phlorizin can protect the db/db mice from diabetic macrovascular complications,which may be attributed to its decreasing of blood glucose,TG,TC,and AGEs levels,and its antioxidant potential.