To summarize the experience of 5 children with relapsed and refractory acute B lymphocyte leukemia treated with Blinatumomab, during the whole nursing processes, careful nursing was carried out before, during and after infusion. The key points of nursing include: reasonable cooperation with nursing staff and specialized training, design a condition observation form, timely grasp changes in the condition, early identify adverse reactions such as cytokine storms, neurotoxicity, and allergies, and ensure the safety of the children. Through personnel, articles and personalized liquid preparation table, ensure accurate dose, smooth infusion and save hospital expenses ￥3, 846~201, 910 for children. Payattention to the psychological burden of children and their families and attach importance to psychological care. Follow the psychological burden of children and caregivers, and pay attention to psychological nursing. As the results, 3 chidlren successfully completed the first cycle of Blinatumomab. But 2 chidlren interrupted due to the tumor burden. Follow up for 5-12 months showed that 2 cases survived, 1 case died of progressive disease after discharge, and 2 cases died of transplant complications.

Objective::This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).Methods::Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.Results::A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% ( n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% ( n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% ( n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury. Conclusions::These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.

Objective::This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).Methods::Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.Results::A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% ( n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% ( n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% ( n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury. Conclusions::These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.

Objective:To explore the application effect of perioperative pain management based on nurse-based, anesthesiologist and specialist-supervised APS (NBASS-APS) model in patients undergoing radical resection of esophageal cancer under general anesthesia during perioperative period.Methods:A total of 520 patients with esophageal cancer who were admitted to Department of Thoracic Oncology in Affiliated Cancer Hospital of Zhengzhou University from October 2020 to September 2021 were selected as the research objects by the convenient sampling method. A total of 260 patients with esophageal cancer admitted from October 2020 to March 2021 were set as the control group, and 260 patients with esophageal cancer admitted from April to September 2021 were set as the observation group. The control group received conventional perioperative pain management, while the observation group received perioperative pain management based on NBASS-APS model. The operation, postoperative pain, postoperative recovery and adverse events were compared between the two groups.Results:The highest visual analogue scale (VAS) score, average VAS score, duration of the highest VAS level and duration of VAS score in the observation group were (4.59±1.54) , (1.72±1.34) , (2.56±1.62) h and (3.64±2.41) h, respectively. Compared with the control group, the differences were statistically significant ( P<0.01) . The first time to get out of bed and the length of hospital stay in the observation group were respectively (78.33±12.31) h and (8.16±2.53) d, which were shorter than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of excessive sedation, nausea, vomiting and other adverse reactions in the observation group were respectively 3.08%, 3.85%, 4.23%, which were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of NBASS-APS model in perioperative pain management can effectively relieve the pain level of patients undergoing radical esophagectomy under general anesthesia, promote the postoperative recovery of patients and reduce the occurrence of adverse reactions.

Objective:To investigate the effects of forced-air warming blankets combined with conventional warming strategies on the quality of postoperative recovery and cognitive recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods:This was a prospective, randomized, controlled trial.A total of 70 patients aged 65-75 years, who were classified as American Society of Anesthesiologists(ASA)grade-Ⅱ or Ⅲ, undergoing the laparoscopic radical resection of colorectal cancer under general anesthesia, were enrolled.Patients were randomly divided into two groups: the forced-air warming group(group FAW, n=35)and the conventional warming group(group CW, n=35). The inadvertent perioperative hypothermia(IPH), postoperative shivering, postoperative agitation, anesthesia recovery time and other postoperative complications were compared between the two groups.The post-operative quality of recovery scale(PQRS)was used to evaluate the quality of postoperative recovery and the recovery of cognitive function before and 1, 3, and 7 days after operation.Results:As compared with the group CW, the group FAW showed that the incidences of IPH, postoperative shivering and agitation were decreased(5.7% vs.22.8%, 2.8% vs.28.6%, 5.7% vs.31.4%, χ2=4.200, 10.057 and 7.652, P=0.042, 0.003 and 0.006), and the satisfaction degree of patients was increased at 48 hours after operation( P<0.01). The postoperative wake-up time was prolonged in the group CW as compared with the group FAW( P<0.01). Compared with the group CW, the proportion of patients with excellent overall recovery quality was increased in the group FAW 1 day after surgery( P<0.05). There was no significant difference in general recovery quality and cognitive recovery between the two groups at 3 and 7 days after operation. Conclusions:For elderly patients undergoing laparoscopic radical resection of colorectal cancer, the forced-air warming blanket combined with conventional warming strategies is more helpful to decrease the incidence of IPH, reduce postoperative shivering and improve the overall recovery quality at 1 day after operation, but no significant effect on postoperative recovery of cognitive function is found.

Objective To explore the effects of "3S2E" nursing management model in patients with severe pneumonia. Methods Totally 168 patients with severe pneumonia enrolled in the ICU of the First Affiliated Hospital of Zhengzhou University from February 2017 to February 2019 were selected by convenient sampling, and numbered according to the order of admission. Patients with odd numbers were divided into the observation group (n=84), while patients with even numbers were divided into the control group (n=84). Patients in the control group received interventions based on the routine nursing protocol for the ICU, while patients in the observation group received "3S2E" nursing model on the basis of routine nursing. Changes in respiratory function and vital signs, Self-Anxiety Scale (SAS), Self-Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI) scores, mechanical ventilation time, length of hospital stay were compared between the two groups before and after the intervention. Results After the intervention, the ventilatory capacity per minute, respiratory rate, rapid shallow breathing index (RSBI), oxygenation index, mean arterial pressure, central arterial pressure and heart rate of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). The SAS, SDS and PSQI scores of the observation group were lower than those of the control group ,the differences were statistically significant (P<0.05). The mechanical ventilation time and length of hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant (P<0.05). Conclusions The intervention of "3S2E" nursing management model in patients with severe pneumonia can effectively improve the patient's respiratory function, reduce their anxiety and depression, improve their sleep quality.

The modified early warning score (MEWS), as a rapid assessment and early warning scoring tool, has been widely used in patients in China, which can help nurses to identify potentially critical patients early, but not in all clinical fields. Through the retrieval of the relevant literature of the clinical application of the MEWS in Wanfang Medical Database from 2011 to 2018, the SWOT analysis was used in this paper [strength (S), weakness (W), opportunities (O) and threats (T)] methods, to systematically analyze the advantages, problems existence, implementation opportunities and challenges in the clinical application of the MEWS in our country. The purpose of this study was to obtain the best cut-off value of MEWS in different diseases and to formulate standard early-warning intervention measures for MEWS, which may provide reference for clinical workers to carry out relevant research.

OBJECTIVE:To screen antioxidant active components of Schisandra chinensis. METHODS:The orthogonal test was adopted to optimize extraction technology using DPPH free radical scavenging activity(IC50)as index and ethanol volume frac-tion,material-liquid ratio and extraction time as factors,and the verification test were made. The fractions(SC-0,SC-10,SC-30, SC-50,SC-70,SC-95) were made by extracting and purifying S. chinensis with macroporous resin with water and 10%,30%, 50%,70%and 95%ethanol. With IC50 and total antioxidant capacity(determined by ABTS method)as indexes(vitamin C as pos-itive control),the antioxidant active components of S. chinensis were optimized. The contents of 5 kinds of lignan in different posi-tions of S. chinensis were determined by HPLC. RESULTS:The optimal extraction condition of S. chinensis was as follows as 60% ethanol,material-liquid ratio of 1∶14,extracting for 2.0 h. The average IC50 of DPPH free radical scavenging activity was 23.81 mg/ml(RSD=0.52%,n=3)in verification test. SC-0 did not have antioxidant abilities. DPPH free radical scavenging activi-ty of those components (ie. the IC50 value from low to high) were in the following order of positive control>SC-50>SC-30>SC-95>SC-70>SC-10;total antioxidant ability of them were in the following order of SC-50>positive control>SC-30>SC-70>SC-95>SC-10;the contents of 5 types of lignan in different components were in the following order of SC-70>SC-50>SC-95>SC-30. CONCLUSIONS:The antioxidant active component of S. chinensis is 50%ethanol eluate.

Objective To explore related factors affecting bone mineral density (BMD) and osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM). Methods Dual-energy X-ray absorptiometry was used to measure BMD of the femoral neck and the lumbar vertebrae in 220 patients with T2DM. All the patients were divided into three groups:normal bone mass group, decreased bone mass group and OP group according to the value of BMD. The clinical data and biochemical indicators were compared and analyzed between these groups, and the influencing factors of T2DM and OP were explored. Results Compared with normal bone mass group and decreased bone mass group, there were more older patients, longer course of T2DM, lower BMI and high density lipoprotein cholesterol (HDL-C), and higher glycated hemoglobin (HbA1c) level in OP group. There were significantly higher age, longer course of T2DM, higher level of HbA1c, and lower levels of BMI, HDL-C in decreased bone mass group than those of normal bone mass group (P＜0.05). There were no significant differences in waist-to-hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP), postmenopausal women (PMW) ratio, fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), blood phosphorus, calcium, total cholesterol (TC), three acyl glycerin (TG) and low-density lipoprotein cholesterol (LDL-C) between three groups. The risk factors for T2DM combined with OP were older, female, long duration of T2DM, higher levels of FPG, 2hPG and HbA1c. Conclusion Older and female T2DM patients were high-risk group of OP. The treatment plan should be timely adjusted by regularly monitoring indexes of blood glucose and HbA1c.

Objective To observe the changes of the blood pressure after intracerebral hemorrhage (ICH) in spontaneously hypertensive rats (SHRs) as well as the expressions of α2A-adrenergic receptor (AR) in center (brain tissue) and peripheral (renal tissue) α1A-AR and to investigate the correlation between α1A-AR/α2A-AR and blood pressure regulation in acute hypertensive ICH. Methads A total of 30 six-month-old male SHRs were randomly divided into a sham-operation group and ICH (day 1,3, 7 and 14) groups (n =6 in each group). Blood pressure was measured by the tail-cuff method. Collagenase Ⅳ was injected into caudate-puta-men nucleus to induce a model of ICH. The expressions of α1A-AR and α2A-AR were detected by using immunohistochemistry and reverse-transcription polymerase chain reaction. Results One day after ICH, the blood pressure was 195.4 ± 8.39 mm Hg, and it was significantly higher than 177.8 ± 8.69 mm Hg (P = 0. 000) before ICH and 184. 1 ± 3.76 mm Hg in the sham-operation group (P=0. 002). At day 3 it was 185.3 ±9.22 mm Hg, and it was lower than that at day 1. It was 177.7 ±5.62 mm Hg and 176.7 ±6. 06 mm Hg at day7 and 14 respectively, which almost returned to the normal level before ICH. The α1A-AR mRNA and protein in renal tissue at day 1 after ICH were 0. 91 ±0. 013 and 0. 944 ±0. 142%, respectively, They were higher than 0. 89 ±0. 018 and0. 779 ±0. 103% in the sham-operation group, and they reached the peak (0. 93 ±0.015, P =0.008; 1.526 ± 0.296%, P =0.010) at day 3. The α2A-AR mRNA and protein in brain tissue were 0. 93 ±0. 020 and 2.64 ±0. 293% at day 3 after ICH, and they were significantly higher than 0. 86 ±0. 019 (P =0. 001) and 1. 070 ±0. 155% (P = 0. 020), and0.87 ±0. 029 (P =0. 000) at day 1 after ICH and 1. 629 ±0. 488% (P =0. 023) in the sham-operation group. The changes of blood pressure in the ICH day 1 to day 7 grottos in SHRs and correlation coefficient of α2A-AR mRNA absorbance in brain tissue r was - 0. 509 (P = 0.031), and the correlation coefficient of α2A-AR protein-expression volume fraction in brain tissue r was - 0. 473 (P = 0. 047). Conelusions Regulation of blood pressure during acute ICH may have certain correlation with the up-expressions of α2A-AR in brain tissue and α1A-AR in renal tissue.