ObjectiveTo observe the effects of Internet plus continuous rehabilitation nursing on older patients after lumbar fusion. MethodsFrom January, 2018 to August, 2021, 157 older patients after transforaminal lumbar interbody fusion (TLIF) in Department of Orthopedics, Chongqing General Hospital were retrospectively studied. A total of 66 patients accepting routine continuous rehabilitation nursing care were as control group, and 91 patients accepting internet plus continuous rehabilitation nursing care were as intervention group. They were assessed with Visual Analog Scale for pain (VAS), Oswestry Disability Index (ODI), Huaxi Emotional-distress Index (HEI) and Adult Health Self-management Skill Rating Scale (AHSMSRS) before, and one and three months after intervention. The compliance and nursing satisfaction were investigated with self-made questionnaire three months after intervention, and the postoperative complications were recorded. ResultsA total of 148 patients finished follow-up of three months, including 61 patients for the control group and 87 patients for the intervention group. The VAS, ODI, HEI and AHSMSRS scores improved in both groups one and three months after intervention (F > 85.4, P < 0.001), and improved more in the intervention group than in the control group (|t| > 3.645, P < 0.001). Both the compliance and nursing satisfaction were better in the intervention group than in the control group (χ² > 5.478, P < 0.05), and no postoperative complication was observed in both groups. ConclusionInternet plus continuous rehabilitation nursing can promote the recovery of function, pain and psychological emotion, ability of self-management, compliance, and nursing satisfaction.

Objective:To investigate the physiological changes of people when advancing rapidly to the plateau, and to evaluate the performance of high-altitude simulation device.Methods:A total of 24 healthy volunteers were randomly divided into 4 groups with 6 individuals in each by the random number table method. The high-altitude simulation device was used to simulate the plateau in two stages. The first stage simulated an altitude of 3 500 m (equivalent to high altitude), and the second stage was performed after an interval of 24 hours from the first stage, which simulated an altitude of 5 000 m (equivalent to ultra-high altitude). During the two stages, for blood routine and blood gas analysis, blood samples were taken before entering the chamber of each stage, and at the simulated altitudes of 3 500 and 5 000 m in the chamber. Furthermore, ECG tests were also conducted before and after entering the chamber. In the case of cardiac abnormality, the cardiac enzyme test would be carried out. Meanwhile, one volunteer in each group was under ECG monitoring.Results:As the simulated altitude increased, the volunteers’ pulse rates increased gradually, while their saturation of periferal oxygen(SpO 2) decreased gradually. Comparing the pulse rate and SpO 2 at 3 500 m with those before entering the chamber, and comparing the pulse rate and SpO 2 at 5 000 m with those before entering the chamber; all the differences were statistically significant ( P<0.05, or P<0.01). The blood routine tests demonstrated a significant increase in the total counts of red blood cells, hemoglobin, platelets and white blood cells and other contents at the first stage, i. e., 3 500 m; and the differences were statistically significant compared with those before entering the chamber ( P<0.05, or P<0.01). Furthermore, the pH values increased gradually, whereas arterial partial pressure of oxygen (PaO 2), oxygen saturation (SaO 2), and arterial partial pressure of carbon dioxide (PaCO 2) decreased gradually. The significant decrease in HCO 3- showed at 5, 000 m, and the differences were statistically significant compared with those before entering the chamber ( P<0.05, or P<0.01). Conclusion:The plateau simulation can reflect physiological changes of the human body after advancing rapidly to the plateau under the premise of ensuring safety. It has laid a foundation for the further implementation of plateau acclimatization on plain area.

Objective:To investigate the physiological changes of people when advancing rapidly to the plateau, and to evaluate the performance of high-altitude simulation device.Methods:A total of 24 healthy volunteers were randomly divided into 4 groups with 6 individuals in each by the random number table method. The high-altitude simulation device was used to simulate the plateau in two stages. The first stage simulated an altitude of 3 500 m (equivalent to high altitude), and the second stage was performed after an interval of 24 hours from the first stage, which simulated an altitude of 5 000 m (equivalent to ultra-high altitude). During the two stages, for blood routine and blood gas analysis, blood samples were taken before entering the chamber of each stage, and at the simulated altitudes of 3 500 and 5 000 m in the chamber. Furthermore, ECG tests were also conducted before and after entering the chamber. In the case of cardiac abnormality, the cardiac enzyme test would be carried out. Meanwhile, one volunteer in each group was under ECG monitoring.Results:As the simulated altitude increased, the volunteers’ pulse rates increased gradually, while their saturation of periferal oxygen(SpO 2) decreased gradually. Comparing the pulse rate and SpO 2 at 3 500 m with those before entering the chamber, and comparing the pulse rate and SpO 2 at 5 000 m with those before entering the chamber; all the differences were statistically significant ( P<0.05, or P<0.01). The blood routine tests demonstrated a significant increase in the total counts of red blood cells, hemoglobin, platelets and white blood cells and other contents at the first stage, i. e., 3 500 m; and the differences were statistically significant compared with those before entering the chamber ( P<0.05, or P<0.01). Furthermore, the pH values increased gradually, whereas arterial partial pressure of oxygen (PaO 2), oxygen saturation (SaO 2), and arterial partial pressure of carbon dioxide (PaCO 2) decreased gradually. The significant decrease in HCO 3- showed at 5, 000 m, and the differences were statistically significant compared with those before entering the chamber ( P<0.05, or P<0.01). Conclusion:The plateau simulation can reflect physiological changes of the human body after advancing rapidly to the plateau under the premise of ensuring safety. It has laid a foundation for the further implementation of plateau acclimatization on plain area.

Objective To investigate the drug resistance of pseudomonas aeruginosa changes in the Sixth Hospital of Ningbo, Zhejiang province, in order to provide a basis for clinical rational use of antimicrobial drugs. Methods The clinical distribution and drug resistance to commonly used antimicrobial agents in 1970 strains of pseudomonas aeruginosa from the Sixth Hospital of Ningbo in 2014 －2016 were retrospectively analyzed. The data were statistically analyzed using WHONET 5. 6 software, excel software, SPSS17. 0 software. Results Clinical specimens isolated 15 963 strains of pathogenic bacteria,including 1 970 strains pseudomonas aeruginosa,accounted for 12. 34% . The detection rate of multi－drug resistance pseudomonas aeruginosa( MDRPA) reduced year by year, the detection rate in 2014 was 60. 95% ,which in 2015 was 58. 00% ,which in 2016 was 45. 58% . Pseudomonas aeruginosa was mainly isolated from sputum(67. 16% ),followed by wound secretion(23. 05% ). The detection rate of pseudomonas aeruginosa in ICU and geriatric department was higher,accounted for 20. 25% and 25. 28% respectively. The resistance of pseudomonas aeruginosa to many kinds of antimicrobial agents was increased from 2014 to 2016,the resistance rates to cefoperazone/ sulbactam were＞30% in 3 years,the resistance rate to imipenem was higher than meropenem. The drug resistance of pseudomonas aeruginosa isolated from sputum in ICU was higher than that in geriatric department(all P＜0. 05). Conclusion Pseudomonas aeruginosa nosocomial infection in the Sixth Hospital of Ningbo is severe,the infection rate and drug resistance monitoring should be strengthened,in order to reduce the infection rate and drug resistance.

BACKGROUND:Preliminary data showed that the application of human platelet lysate to human umbilical cord mesenchymal stem cell culture can better maintain the characteristics of stem cells than the application of serum-free medium. However, the serum-free medium can better improve the proliferation of mesenchymal stem cells in vitro than the human platelet lysate.OBJECTIVE:To screen out a better mesenchymal stem cell cultivation system that can greatly maintain the characteristics and proliferation rate of human umbilical cord mesenchymal stem cells.METHODS:Six human umbilical cord specimens were inoculated in six culture systems, and the primary culture of umbilical cord mesenchymal stem cell was performed. These six culture systems were respectively MesenCult serum-free medium with 2% human platelet lysate (group A), StemPro serum-free medium with 2% human platelet lysate (group B), MesenCult serum-free medium (group C), StemPro serum-free medium (group D), low glucose-DMEM with 10% fetal bovine serum (group E), low glucose-DMEM with 10% human platelet lysate (group F). The cells were subcultured at 14 days after inoculation to compare the effects of different culture systems on the morphology, surface markers, differentiation and proliferation of human umbilical cord mesenchymal stem cells.RESULTS AND CONCLUSION:(1) The morphology of passage 3 cells in group D was elongated and uneven in size. The morphology of passage 3 cells was flattened in groups E and F, but the cells in the other groups were spindle-shaped and uniform. There were no significant changes in morphology and size between passage 3 and 5 cells in A and B. In group C, the morphology of passage 5 cells was more flattened and uneven in size compared with passage 3 cells. In group D, the morphology of passage 5 cells was more elongated than that of passage 3 cell. In group E, the morphology of passage 5 cells was more flattened than that of passage 3 cells. There was no significant difference in morphology between passage 3 and 5 cells in group F. (2) The expression rate of cell surface markers had no significant difference at different passages in each group. (3) The adipoinduction and osteoinduction rates were relatively higher in groups A and B compared with groups E and F, and lowest in groups C and D. (4) The cell proliferation rate for each passages in group A was significantly higher than that in group C. The cell proliferation rate for each passage in group B was significantly higher than that in group D. The cell proliferation rate for each passage in groups E and F was significantly lower than that in groups A and B. To conclude, these results suggest that the combination of serum-free medium with human platelet lysate could better maintain the characteristics and the proliferation efficiency of mesenchymal stem cells.

Objective To analyze the characteristics of adverse events following immunization ( AEFI) with varicella attenuated live vaccine ( VarV) in Hebei province during 2012—2014, to evaluate the safety of VarV and to provide supportive evidences for planning chicken pox prevention and control strate-gies in Hebei province.Methods The AEFI data associated with VarV in Hebei province during 2012 to 2014 were collected from the national AEFI information management system and were analyzed by using the method of descriptive epidemiology.Results A total of 239 cases reported during 2012 to 2014 were col-lected from the national AEFI information management system, with a male to female ratio of 1.44 ∶1.The estimated incidence rate was 25.51 per 100 000 doses.One case was serious AEFI with an incidence rate of 0.11 per 100 000 doses.Most of the AEFI cases were children under 3 years old and identified in scattered inhibiting children and kindergarten kids.The main symptoms of common vaccine reactions were fever, local swelling and induration .The rare vaccine reactions were presented as anaphylactic rashes .Conclusion The reported incidence rate of VarV associated AEFI in Hebei province was less than expected.However, the estimated incidence rate of common vaccine reactions in Hebei province was higher than that showed on the Analysis on Surveillance Data of Post-marketing Immunization Safety for Varicella Attenuated Live Vac-cine in China, 2010—2012.Attentions to the AEFI after immunization with VarV should also be paid in fu-ture.

Objective To observe the effect of restrictive capacity resuscitation on pelvic type of severe multiple trauma hem-orrhagic shock.Methods In accordance with different methods of resuscitation, 54 enrolled patients were divided into 2 groups:group A (26 cases) and group B (28 cases).The patients in group A were treated with restrictive capacity resuscitation while the patients in group B were treated with conventional full volume resuscitation.Upon completion of resuscitation, clinical data of the 2 groups were an-alyzed accordingly.Results In the patients of group A, resuscitation time was (98.77 ±42.63) min, volume of fluid resuscitation was (983.64 ±326.73) mL, definitive surgical time was (10.28 ±1.23) d, days of hospitalization were (48.37 ±21.36) d.After resus-citation, venous blood routine tests were:HCT (29.64 ±3.26)%, PLT (134.56 ±21.37) 100 ×10/L.Data of blood coagulation function were:PT (16.46 ±6.70) s and APTT (34.65 ±6.23).Statistical significance could be noted in the above data, as compared with those of group B (t=12.274, 14.283, 6.353, 5.639, 8.643, 6.785, 5.318, 4.674)(P <0.05).No statistical significance could be seen in the scores of ISS, mean arterial pressure ( MAP) before resuscitation and HGB, when comparisons were made between the two groups (P>0.05).Conclusion Restrictive capacity resuscitation was a good treatment method for pelvic type of severe multi-ple trauma hemorrhagic shock, and was worth clinical promotion.

Objective To observe the effect of restrictive capacity resuscitation on pelvic type of severe multiple trauma hem-orrhagic shock.Methods In accordance with different methods of resuscitation, 54 enrolled patients were divided into 2 groups:group A (26 cases) and group B (28 cases).The patients in group A were treated with restrictive capacity resuscitation while the patients in group B were treated with conventional full volume resuscitation.Upon completion of resuscitation, clinical data of the 2 groups were an-alyzed accordingly.Results In the patients of group A, resuscitation time was (98.77 ±42.63) min, volume of fluid resuscitation was (983.64 ±326.73) mL, definitive surgical time was (10.28 ±1.23) d, days of hospitalization were (48.37 ±21.36) d.After resus-citation, venous blood routine tests were:HCT (29.64 ±3.26)%, PLT (134.56 ±21.37) 100 ×10/L.Data of blood coagulation function were:PT (16.46 ±6.70) s and APTT (34.65 ±6.23).Statistical significance could be noted in the above data, as compared with those of group B (t=12.274, 14.283, 6.353, 5.639, 8.643, 6.785, 5.318, 4.674)(P <0.05).No statistical significance could be seen in the scores of ISS, mean arterial pressure ( MAP) before resuscitation and HGB, when comparisons were made between the two groups (P>0.05).Conclusion Restrictive capacity resuscitation was a good treatment method for pelvic type of severe multi-ple trauma hemorrhagic shock, and was worth clinical promotion.

Objective:This study aimed to explore the effects of trichosanthin on the proliferative inhibition and apoptosis induc-tion in human lung carcinoma A549 cells. Methods:A549 cells were treated with various concentrations of TCS. The inhibitory effects in proliferation were detected by the MTT method. The microfilament changes were observed by transmission electron microscopy. Apoptosis rate and cell cycle were determined by flow cytometry. Results:A549 cells treated with TCS presented apoptotic changes and decreased cell activity. When the concentration increased and time was prolonged, the inhibition rate increased correspondingly. Conclusion:Pharmacological doses of TCS inhibited the proliferation and differentiation in lung carcinoma A549 cells and affected the function in A549 cells by changes in the cytoskeleton.