Objective: To evaluate the feasibility of ICU nurse-performed lung ultrasound in screening the reason of dyspnea in ICU patients, and to explore the effect on nursing decisions. Methods: ICU nurses trained on lung ultrasound with 16 hours performed point-of-care lung ultrasound in patient with acute respiratory failure to assess the condition of the patient′s lungs and screen for pleural effusion, atelectasis/lung consolidation. Etc; Repeated examinations by ICU physicians accredited by the International Critical Ultrasound Alliance to evaluate the accuracy of ICU nurse interpretation. Results: A total of 510 lung ultrasonographic examinations were performed in 51 patients. Compared with physicians, ICU nurses correctly interpreted 472 ultrasound signs, accounting for 92.53%. ICU nurses found that the sensitivity of the pleural effusion was 86.7%, the specificity was 95.2%, and the diagnostic accuracy rate was 90.2%, and Youden index was 81.9%. The ultrasonography revealed a sensitivity of 92.1% for atelectic/pulmonary consolidation and a specificity of 92.3.%, the diagnostic accuracy rate was 92.2% and Youden index was 84.4%. Conclusion ICU nurses who have undergone standardized training can correctly interpret lung ultrasound signs and have good diagnostic value for screening of pleural effusions and atelectasis/lung consolidation; they provide the basis for optimization of chest physiotherapy programs.

This article reviews the application of critical ultrasonography in nursing assessment of ICU patients. It summarized the application of critical ultrasonography in hemodynamic assessment, lung assessment, gastric residual monitoring, thrombosis screening, stress injury assessment, bladder scan and education of ICU patients, and prospected its application in nursing assessment of ICU patients. It aims to guide nurses to carry out goal-oriented nursing, help explore a new vision of critical care, improve the quality of nursing.

Objective To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management(P< 0.001) including. Doctors and nurses scored lowest in"family engagement and empowerment"and"sleep management"with (4.620 ± 2.393) and (5.430 ± 2.153) respectively. There was a significant difference between nurses and doctors in the management of analgesia and sedation (P< 0.05). Doctors and nurses from different ICUs had significant discrepancy in the implementation of"delirium assessment"(P<0.05). Conclusions The ICU staff should improve the perceptions and the implementation of delirium management,especially in special ICUs. Delirium management should be included as a routine care in ICU to improve patients' outcome.

Background and purpose: Regional lymph node metastasis was significantly associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study was designed to compare paclitaxel liposome plus cisplatin (LP) with gemcitabine and cisplatin (GP) in patients with regional lymph node metastasis of advanced NSCLC as a ifrst-line treatment. Methods:A total of 55 patients were randomly assigned to receive either liposomal paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) or gemcitabine (1 000 mg/m2) and cisplatin (75 mg/m2) every 3 weeks. Results:Objective response rate (ORR) of lung primary foci was 37.9%in the LP arm and 30.8%in the GP arm (P>0.05) and the disease control rate (DCR) was 91.3%and 80.8%respectively (P>0.05);ORR of regional metastasis lymph node was higher in the LP arm (44.8%vs 15.4%, P<0.05).There was no signiifcant difference in DCR (93.1%vs 73.1%, P=0.101), although slight trends favoring paclitaxel liposome were seen;There was signiifcant difference in median overall survival (17.0 vs 12.0 months, P<0.05). LP was associated with significantly less thrombocytopenia and gastrointestinal side effects (P<0.05), but no signiifcant difference was observed in hyphemia, leucopenia, hepatotoxicity, renal toxicity and allergic reactions (P>0.05). Conclusion: Liposomal paclitaxel plus cisplatin is superior to gemcitabine plus cisplatin with less toxicity and better tolerated, it deserves further research and clinic application for patients with regional lymph node metastasis of advanced NSCLC.

Objective To evaluate efficacy on treatment of acute iliofemoral lower extremity deep venous thrombosis with thrombectomy and pharmacological thrombolysis or pharmacological thrombolysis alone. Methods The clinical data of 175 cases of lower extremity iliofemoral deep venous thrombosis wereanalysed retrospectively. Patients were divided into thrombectomy group and thrombolysis group. There were 85 patients treated by thrombectomy, among these patients there were 46 with common iliac vein occlusion or stenosis. According to state of illness suitable treatment was selected, urokinase and low molecular weight heparin were given after operation. The other 90 patients were treated by pharmacological thrombolysis only,including urokinase and low molecular weight heparin. Results No significant differences were found in age, course of disease, swelling and associated diseases between the two groups before treatment (P ＜0. 05); After 1 month of treatment the circumference difference between bilateral limbs was reduced from (4.6±1.6) cm to (0.8 ±0.5) cm in operation group,and declined from (4.0±1.9) cm to (1.8 ±1.3) cm in thrombolysis group. The cure rate was 71.8% (61/85) in thrombectomy group and 38.9% (35/90) in thrombolysis group. 64.6% patients were followed up for an average of (28 ± 11 ) months.After 12 months of treatment the circumference difference between bilateral limbs was (0.4 ± 0.3 ) cm in thrombectomy group and ( 0.9 ± 0.7 ) cm in thrombolysis group respectively. The cure rate was 86.0% (49/57) in thrombectomy group and 53.6% (30/56) in thrombolysis group. In surgical group the incidence of deep venous thrombosis sequelae was less than in thrombolysis group( P ＜0. 05 ). The incidence of venous valve dysfunction in thrombectomy group was less than in thrombolysis group (P ＜ 0.05 ).Conclusions Thrombectomy and pharmacological thrombolysis was more effective than pharmacological thrombolysis alone in the treatment of acute iliofemoral deep venous thrombosis.

Objective:To investigate and analysis the distribution situations of Rh blood group system from voluntary blood donors in Foshan area.Methods:Anti-D,anti-C,anti-c,anti-E and anti-e reagents were used to identify Rh blood group system and the RhD(-) was confirmed.The phenotypes,haplotypes and corresponding genotypes frequencies were calculated and the datas were analyzed based on Hardy-Weinberg law.Results:The characteristics of phenotype frequencies in the voluntary blood donors in Foshan area was CCDee＞CcDEe＞CcDee＞ccDEE＞ccDEe＞CCDEe＞CcDEE＞ccdee＞ccDee,Ccdee＞CCdee,ccdEe＞CCDEE,CCdEE,CCdEe,CcdEE,CcdEe and ccdEE.The characteristics of haplotypes frequencies was CDe＞cDE＞cDe＞CDE,de＞Cde＞cdE＞CdE.The characteristics of genes frequencies was D＞d,C＞c,e＞E.The frequency of RhD(-)phenotype was 0.379%.The gene frequency of d was 0.061.The observed value and desired value of the haplotypes and corresponding genotypes were not statistically significant(P>0.05).The data were analyzed well based on Hardy-Weinberg law.Conclusion:The result is reliable according to Hardy-Weinberg law.The distribution of Rh blood group system from voluntary blood donors in Foshan area has geographic and general characteristics.The result is important in guiding the recruitment of voluntary blood donors and banking blood reasonably and enhancing the abilitiy of offering blood for the recipients of rare blood group.

In order to characterize the biological activity of fox (Vulpes vulpes) interferon gamma(VuIFN-gamma), We have isolated the cDNA encoding arctic fox (Alopex lagopus) VuIFN-gamma. This cDNA encodes a 23 amino acid signal peptide and a 144 amino acid mature protein, which shares 99.8% or 99.4% for nucleotide identity with silver fox and canine, respectively, and 100% for amino acid identity. Expression of recombinant mature arctic fox interferon gamma (mVuIFN-gamma) in bacterial system was confirmed by SDS-PAGE and Western blotting analysis. Recombinant VuIFN-gamma showed higher antiviral activity against vesicular stomatitis virus in cultured Vero and MDCK by inhibiting virus induced cytopathic effect, In view of the immunomodulatory and antiviral activities of VuIFN-gamma, it may provide a basis for further research on antiviral therapy of recombinant VuIFN-gamma in economic animal practice.
Animals ; Antiviral Agents ; pharmacology ; Base Sequence ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Foxes ; genetics ; Interferon-gamma ; genetics ; pharmacology ; Molecular Sequence Data ; Recombinant Fusion Proteins ; genetics ; pharmacology

Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.ResultsAs compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P＜0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P＜0.05].Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.

Objective:To test a model in which self-esteem mediated the effects of behavior on exposure to violence(victimization) in a sample of rural middle school students.Methods:A cross-section study was conducted in 3620 middle school students randomly selected from rural areas.A questionnaire of violence(WHO) and Achenbach Children Behavior Checklist(CBCL) and Rosenberg self-esteem scale were used to measure the exposure to violence behavior,and self-esteem respectively.Results:Hierarchical regression analyses provided evidence that the addition of self-esteem reduced the links between behavior and exposure to violence(? from 0.232 to 0.226).Sobel Z-test predicted that self-esteem partially mediated the effects of behavior on exposure to violence(victimization) with significant difference(? from 0.232 to 0.226,Sobel-Z value=2.340,P=0.019).Speech violence,physical violence,and sexual violence were tested by the same model respectively,and the results showed that self-esteem partially mediated the effects of behavior on speech violence with significant difference(? from 0.225 to 0.200,Sobel-Z value=1.992,P=0.046),but not on physical or sexual violence.Conclusion:Self-esteem partially mediates the effects of behavior on exposure to violence(emotion violence).