Objective:To determine the pharmacodynamics of ciprofol for adjunctive sedation in elderly patients undergoing neuraxial anesthesia.Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex, aged ≥65 yr, with a body mass index of 18-30 kg/m 2, scheduled for elective knee replacement under neuraxial anesthesia from June to September 2023 in the Second Hospital of Shanxi Medical University, were selected. After completion of neuraxial anesthesia, ciprofol was pumped intravenously at a loading dose of 0.05 mg/kg (administered for approximately 4 min). The maintenance dose was determined by the sequential method. The initial maintenance dose was 0.2 mg·kg -1·h -1, and the dose gradient was 0.02 mg·kg -1·h -1. If the patient was satisfactorily sedated, the dose of ciprofol was decreased by 0.02 mg·kg -1·h -1 in the next patient; if the sedation was unsatisfactory, the dose of ciprofol was increased by 0.02 mg·kg -1·h -1 in the next patient, and the trial was terminated after 8 transitions. The occurrence of adverse reactions was recorded during administration and emergence. The median effective dose (ED 50), 95% effective dose (ED 95) and the corresponding 95% confidence interval ( CI) of ciprofol were calculated using the probit regression analysis. Results:Thirty-five patients were finally included in this study.The ED 50 of ciprofol for adjunctive sedation was 0.246 mg·kg -1·h -1 (95% CI 0.217-0.300 mg·kg -1·h -1), and the ED 95 was 0.325 mg·kg -1·h -1 (95% CI 0.284-0.771 mg·kg -1·h -1) in elderly patients undergoing knee arthroplasty under neuraxial anesthesia. During the administration of ciprofol, bradycardia occurred in 4 cases (11%), hypotension in 2 cases (6%), and hypoxemia in 2 cases (6%), which improved after treatment. No injection pain, abnormal limb movements, agitation during emergence, dizziness, headache, nausea and vomiting and postoperative delirium developed in patients. Conclusions:The ED 50 of ciprofol for adjunctive sedation is 0.246 mg·kg -1·h -1 and the ED 95 is 0.325 mg·kg -1·h -1 in elderly patients undergoing neuraxial anesthesia.

Objective Based on the theory of Service Quality to develop a scale for measuring personal digital assistant satisfaction by nurses and to detect the reliability and validity of this scale. Methods Through the literature research, cross-sectional study and present satisfaction evaluation tool for using personal digital assistant by nurse to build the item pool. The items were selected by 15 experts consultation and the pilot survey of 666 nurses. Results The satisfaction evaluation tool for using personal digital assistant by nurse scale consisted of 41 items;the exploratory factor analysis identified 8 principal factors and explained for 65.22%. Pearson correlation coefficient between each dimension was 0.213-0.684(P<0.01). Pearson correlation coefficient between each dimension and total scale was 0.574-0.798(P<0.01). The Cronbach α coefficient of the scale was 0.928 and test-retest reliability was 0.934. Conclusions The satisfaction evaluation tool for using personal digital assistant by nurse scale has good validity and reliability. It can be used as a tool to measure the satisfaction for using personal digital assistant by nurse.

With the development of technology, the new technologies contact with the medical profession increasingly close. Mobible nursing information system (MNIS) is a new technology product of the combination of the nursing profession, which will digitize the introduction of paperless care industry, providing convenient for clinical work, real-time technical service is an important tool for clinical work. The application of MNIS have played an important role in confined the nursing profession, disease management and pharmaceutical management, more users discover problem from different professional perspective, thus the MNIS should be improved for all-round care. This article is consist of the domestic and care information systems development, application and effect, as well as its application in the clinical factors of its research progress in clinical application were reviewed to provide a basis for the development of leadership and decision-making about MNIS, and thus, enhance the mobile application of the effectiveness of care information systems and promoting their improvement.

Objective Through the analysis of the status quo of the research on neonatal pressure sore in the relevant nursing research, we can understand the strategy and the problems of the prevention of neonatal pressure sore, which provides reference for future research. Methods This article used bibliometric analysis method to construct literature reading and reviewing database,screening articles in the Chinese biological medical disc (CBMdisc), China Journal Full-text Database (CJFD), China Science Periodical Database(CSPD)and China Science and Technology Journal Database(CSTJ), according to the criteria of inclusion and exclusion. Results A total of 74 articles were integrated into the literature, the first published in China in 2006, after the overall trend of growth, especially since 2011 began to significantly increase. Of which 29 (39.2%) of the literature published in 13 kinds of professional nursing journals. The total number of citations was 1.84, the cohort rate was 39.19%, the total number of citations was 54, and the number of citations per article was 0.73. The total number of citations was 447, and the average number of citations was 6.04. Literature research types are subdivided into 10 categories, of which experienced literature was the most (23.0%). Literature research concentrated on the use of chemical or physical methods to prevent neonatal pressure sores. Conclusions Neonatal pressure sore is paid more and more attention by the nurses, and the policy support for it is acceptable, but the related research needs to be further strengthened in the breadth, depth and comprehensive aspects. It is necessary for us to use scientific research methods, combining with the culture of pediatric and the characteristics of pediatric management in our country, to construct the best practice manual for preventing neonatal pressure sore in China.

Objective To evaluate the treatment effect of auricular pressure combined with acupoint sticking for gastrointestinal dysfunction after laparoscopic cholecystectomy ( LC ) , and provide scientific references for the promotion of traditional Chinese medicine ( TCM ) nursing in clinical nursing practice. Methods Totally 100 patients with LC were randomly divided into the observation group and the control group. Patients in the observation group received auricular pressure combined with acupoint sticking based on the routine nursing method, while patients in the control group received the routine nursing method. The time for the first postoperative aerofluxus and defecation, degree of abdominal pain, the usage of auxiliary medicine, the situation of anxiety and depression were observed and compared between two groups. Results The time for the first postoperative aerofluxus and defecation were (22.12±2.57) h and (52.37±4.12) h in the observation group, which were significantly shorter than the time of the control group [(32.61±3.66),(72.67±4.05)h];the degree of abdominal pain in the observation group was significantly lower than that in the control group;the ratio of auxiliary medicine in the control group was more than that in the observation group ( P<0.05) . The score of anxiety and depression in two groups was obvious lower than that before treatment, and the score in the observation group was significantly lower than that in the control group (P<0.05).Conclusions Auricular pressure combined with acupoint sticking can promote postoperative gastrointestinal dysfunction and relieve patients anxiety, so this therapy can be popularized in clinical nursing practice.

Objective To know the status of organizational culture in traditional Chinese medicine (TCM) hospital and provide construction suggestions for nursing managers.Methods A total of 300 registered nurses in TCM hospitals in Tianjin were investigated with the self-designed general information questionnaire and NCAT on nursing organizational culture. Unifactor variance analysis was used to analyze the influencing factors. Results The score of organizational culture of nursing in TCM hospital was (61.72±8.19), and was in the medium level. The team cooperation and communication dimension scored the highest, which was ( 23. 34 ± 3. 21);satisfaction dimension scored lowest, and was (6.42±2.00). Unifactor analysis found that the scores of satisfaction and professional commitment of nursing organizational culture was statistically significant with different age (P<0.05).Conclusions Nursing organizational culture is in the medium level. Nursing managers should strengthen the TCM hospital culture construction from the following three aspects:material, institute and spirit culture.

Objective To study the differentiation and proliferation ability of the spinal neural stem cells (NSCs) at different gestational ages in fetal rats. Methods Sprague-Dawley fetal rats were divided into group A (12 days of pregnancy), group B (14 days of pregnancy) and group C (16 days of pregnancy). NSCs were separated with enzyme-assisted microdissection. The diameter and numbers of NSCs balls were measured at different time. The cell growth curve was drawn with CCK8 colorimeter. NSCs were identified with BrdU/Nestin immunohistochemical staining. They were induced with 10% fetal bovine serum for 10 days, and the expression of β-tubulinⅢ and glial fibrillary acidic protein was detected with immunocytochemistry. Results There were cells expressed BrdU, Nestin, β-tubulinⅢ and GFAP in all the group. The most cells (22.74±0.79%) expressed β-tubulinⅢ in the group B, but no significant difference between group B and group C. The cell vitality on the 5th day of third-generation neural stem cells was the most in group B. Conclusion For enzyme-assisted microdissection, it may obtain more neurons to isolate the neural stem cells from 14 days of pregnancy pregnant rats.

Objective To observe the changes of lung function before and after radiotherapy with the lung perfusion of single-photon emission computed tomography and compare the difference between radiotherapy plans conducted by functional imagines and anatomical imagines in radiotherapy of patients with non-small-cell lung cancer.Methods A total of 36 patients (26 males and 10 females,aged 36-80 years) with lung cancer diagnosed as stage Ⅰ to stage Ⅲ non-small cell lung cancer confirmed by histological proof were selected.The lung perfusion image was delivered to radiotherapy planning system and the two plan (plan1 and plan 2) were made by lung perfusion image fusion.Plan 1 was only based on the anatomical informations and no lung perfusion images of SPECT considering.Plan 2 was optimized based on the lung perfusion image to reduce the irradiation dose of the normal tissues.The differences of protecting lung function between plan 1 and plan 2 were compared.Results 36 patients were stratified for clinical stage.FV10,fV20,fV30,MLD and PTV90/fV20 were decreased significantly after optimized with IMRT (all P =0.000).FV20,fMLD were decreased by (4.89±2.0) ％,(1.74 ±0.9)％.The IMRT plan based on the lung perfusion fusion images of SPECT could reduce the irradiation dose of normal lung tissues and the incidence of radiation pneumonitis.Conclusions Radionuclide pulmonary perfusion imaging can assess effectively the effect of tumor to regional pulmonary artery perfusion function before radiotherapy and reduce the irradiation dose of normal lung tissue in lung cancer patients undergoing IMRT.

Objective Microheterogeneity is an important problem in molecularly biological and proteomic research on malignancies.The goal of this study was to investigate the method to purify targeted cells in lung cancer and its paired normal tissues for proteomic study on lung cancer applying laser capture microdissection(LCM).Methods LCM technique was emploged to obtain the cells of lung cancer tissues and their paired normal tissues from frozen sections.Results LCM can be applied to quickly and precisely obtain pure targeted cells subgroup or single cell without interstitium under the microscope.Conclusion LCM can tackle the problem of tissue heterogeneity in molecular analysis successfully.These results indicate that LCM has a potential as a tool in lung cancer proteomic research.