ObjectiveTo monitor the real-time changes in ammonia concentration in the laboratory animal facility environment before, during, and after the air conditioning system stops supplying air, so as to provide a basis and reference for developing emergency plans for the shutdown of the air conditioning system. MethodsThe laboratory animal facilities of the Wuhan Institute of Biological Products were used as the research object. Ammonia concentration detectors were used to monitor ammonia concentration continuously in the environment of conventional rabbit production facility, SPF hamster production facility, and SPF guinea pig experimental facility before and after the passive shutdown due to repairs and active maintenance shutdown of the air conditioning system, as well as the time for the ammonia concentration to return to daily levels after resuming air supply. ResultsUnder both shutdown modes of the air conditioning system, the trend of ammonia concentration changes in different laboratory animal facilities was consistent, showing a rapid increase after shutdown and a rapid decrease after resuming air supply. Under active maintenance shutdown, the maximum ammonia concentrations in the conventional rabbit production facilities, SPF hamster production facilities, and SPF guinea pig experimental facilities were 9.81 mg/m³, 14.27 mg/m³, and 6.98 mg/m³, respectively. Within 12 minutes after resuming air supply, ammonia concentration could return to normal daily levels. Under passive long-term shutdown, ammonia concentration value was positively correlated with the duration of air supply suspension. As the shutdown duration increased, ammonia concentration continued to increase. The maximum ammonia concentration values in the three facilities occurred at 88 minutes (38.06 mg/m³), 40 minutes (18.43 mg/m³), and 34 minutes (15.61 mg/m³) after air supply suspension, respectively.Within 11 minutes after resuming air supply, ammonia concentration could return to normal daily levels. ConclusionShutdown of the air conditioning system causes a rapid increase in ammonia concentration in laboratory animal facilities, and the rise in ammonia concentration is positively correlated with the duration of air supply suspension. Therefore, when an emergency shutdown of the air-conditioning system is required due to maintenance or other reasons, backup fans should be provided in accordance with the requirements of GB 50447-2008 "Architectural and Technical Code for Laboratory Animal Facilities". Older facilities should make adequate preparations and develop a scientifically sound emergency plan.

Background: and Purpose To evaluate whether the thrombus enhancement sign (TES) can be used to differentiate embolic large vessel occlusion (LVO) from in situ intracranial atherosclerotic stenosis (ICAS)-related LVO in the anterior circulation of patients with acute ischemic stroke (AIS). Methods: Patients with LVO in the anterior circulation who underwent both non-contrast computed tomography (CT) and CT angiography and mechanical thrombectomy were retrospectively enrolled. Both embolic LVO (embo-LVO) and in situ ICAS-related LVO (ICAS-LVO) were confirmed by two neurointerventional radiologists after reviewing the medical and imaging data. TES was assessed to predict embo-LVO or ICAS-LVO. The associations between occlusion type and TES, along with clinical and interventional parameters, were investigated using logistic regression analysis and a receiver operating characteristic curve. Results: A total of 288 patients with AIS were included and divided into an embo-LVO group (n=235) and an ICAS-LVO group (n=53). TES was identified in 205 (71.2%) patients and was more frequently observed in those with embo-LVO, with a sensitivity of 83.8%, specificity of 84.9%, and area under the curve (AUC) of 0.844. Multivariate analysis showed that TES (odds ratio [OR], 22.2; 95% confidence interval [CI], 9.4–53.8; P<0.001) and atrial fibrillation (OR, 6.6; 95% CI, 2.8–15.8; P<0.001) were independent predictors of embolic occlusion. A predictive model that included both TES and atrial fibrillation yielded a higher diagnostic ability for embo-LVO, with an AUC of 0.899. Conclusion TES is an imaging marker with high predictive value for identifying embo- and ICAS-LVO in AIS and provides guidance for endovascular reperfusion therapy.

Objective:To explore the effect of perioperative nursing based on enhanced recovery after surgery (ERAS) in patients undergoing off-pump coronary artery bypass (OPCAB) .Methods:From January 2018 to February 2020, 200 OPCAB patients admitted to Affiliated Hospital of Jining Medical University were selected as research subjects using convenience sampling method. The 100 patients admitted from January 2018 to January 2019 served as the control group, while the 100 patients admitted from February 2019 to February 2020 served as the observation group. The control group received routine perioperative nursing, while the observation group received perioperative nursing based on the ERAS. The postoperative ventilator assistance time, Intensive Care Unit (ICU) stay time, anal exhaust time, off-bed time after surgery, and postoperative hospital stay time were compared.Results:The observation group had shorter postoperative ventilator assistance time, ICU stay time, anal exhaust time, off-bed time after surgery, and postoperative hospital stay time compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Perioperative nursing based on the ERAS can accelerate the postoperative recovery process of OPCAB patients, which is worthy of clinical promotion and practice.

Objective By reviewing the relevant literature, we explored the current status and problems of the evaluation of the training effectiveness, and put forward the corresponding countermeasures, in order to provide a theoretical basis for the effect evaluation of nurse training in China. Methods By searching Citation online search and integration system (CITE), the Chinese biomedical literature service system (CBM), we included the literatures on the effect evaluation of the nurses training in the core journals from January 2006 to November 2015. Retrieval literatures were imported the bibliographic management software Note express by database. The corresponding field were analyzed in the literature′s age distribution, evaluation object, evaluation model, evaluation method, evaluation index and evaluation tool, et al. Results There were 343 literatures had retrieved, the total number of literatures presented a increasing tendency. The evaluation methods, evaluation tools and evaluation indicators presented a tendency of diversity, and the evaluation model was relatively single. Only 16 (4.7%) literatures tried to construct the training effect evaluation system of nurses, which was not based on some theory or hypothesis, which had not been effectively put into practice. Conclusion The effect evaluation system of nurse training needed to be done in depth, such as reconstruction of the new training evaluation model, the establishment of training evaluation system of different professional, different levels, different positions, to research evaluation methods, evaluation criteria and clinical practice testing, to design, training evaluation management software etc.

Objective To evaluate the influences of laser acupuncture therapy ( LAT ) on asthma control of pediatric asthma patients .Methods Electronic data searched in databases like Cochrane Library , Joanna Briggs Institute Library , Pubmed, MEDLINE, EMbase, AMED, Cancerlit and Cinahl , China Academic Journal Network Publishing Database (CNKI), SinoMed (CBM), etc., from time range of January 1992 to July 2015 , were brought into randomized controlled trial ( RCT ) which were pediatric asthma patients influenced asthma control by LAT .Maastricht-Amsterdam rating scale was adopted to evaluate quality of this research , and Meta analysis was conducted by software of RevMan 5.1.6 afterwards.Results Five RCTs with 254 patients were included .It was revealed in Meta analysis that LAT could effectively improve pediatric asthma patients ′indexes of pulmonary function , like forced vital capacity ( FVC) , forced expiratory volume in one second/forced vital capacity (FEV1/FVC), maximal mid-expiratory flow curve (MMEF) (Z=4.55,2.62,7.02;P<0.01) and life quality (Z=5.40,P<0.000 01);meanwhile, LAT could obviously reduce dose of steroid for pediatric asthma patients (Z=4.21,P<0.000 1).It was revealed by descriptive analysis results that LAT could relieve symptoms in respiratory system of pediatric asthma patients .Conclusions LAT can effectively improve control level of pediatric asthma .FVC, FEV1/FVC, and MMEF can be used as effect indexes of pediatric asthma patients treated by LAT , while FEV1 and PEF have no statistic difference and still to be testified by clinical RCTs with multi centers and large samples .

Objective To analyze the literature related to post competency evaluation index system that based on competency theory and know the deficiencies in the construction of index structure,in order to strengthen its normative and scientification and provide reference for the construction of index structure.Methods By retrieving the database of China national knowledge infrastructure (CNKI),Chinese biomedical literature service system (CBM),Wanfang and VIP database,we included the literature about the post competency evaluation index construction in the core journals from January 2007 to March 2016.Literature acquired by retrieval were imported Note Express 3.1 software,then the title,the first author,year of publication,evaluation object,system framework,system building method,the level of evaluation index and the weights of index were analyzed.Results There were 314 articles,and the overall number of literature was increasing in the past nine years.The evaluation objects were divided into the junior nurses,clinical nurses,the nursing managers,nursing teachers,nursing students,community nurses and new nurses,and the number of articles were:33,157,41,28,29,6 and 20.The main methods were multifarious,there were 20 articles adopted Delphi and analytic hierarchy process (AHP).The contents of index mainly consisted of 3 level such as clinical nursing,nursing management and nursing education.The contents of first-level index were mainly focus on knowledge,skill,social role,self-concept,trait and motivation,while the differences of second-level index were great.Conclusions The constructing methods of nursing post competency evaluation index system in our country are diversified,but relatively loose and lack of systemic.The elements of evaluation index are not full and normative,and the main research contents were knowledge and skill dimension;the weighted empowerment approach is relatively single,and the main methods are experiential judgment and qualitative description.The rigorous scientific design and measurement analysis and qualitative and quantitative method are insufficient.

Objective To explore the application effect of informational training and management method impacting on clinical nursing training .Methods Based on hospital digital information management system, nurse education information system was build up and applied to optimize the informational management of clinical nurse training including nursing management , service management , intranet assessment , evaluation index extraction, performance analysis and improvement , etc.The assessment of training efficiency and effect before and after the application of informational training system had been evaluated by nurse training efficiency index ( time for examination organization , time for making out questions , time for marking , training coverage , and error rate of statistical analysis ) and nurse satisfaction index .Results After information system constructed, the time for examination organization , time for marking, time questionnaire statistical analysis , training coverage and error rate of statistical analysis were (4.31 ±1.32), (0.21 ±0.11)h, (0.35 ±0.17)h, (99.89 ±0.13)% and (0.05 ±0.02)% respectively (t =47.420, 62.440, 42.495, 24.781, 36.896, respectively;P<0.05 ) , except time for making out questions .Except questionnaire setting , nurses for the satisfaction of training plan , training method, the way of examination and ability improvement were (96.06 ± 3.31), (98.51 ±2.56), (99.62 ±2.91), (94.91 ±2.98),respectively (t=32.387, 24.977, 58.488, 11.660, respectively;P <0.05 ).Conclusions Nurse education information system can optimize the organization and management mode of modern nurse training , improve nurse training effect , and promote the level of nurse management .

Aged ; Humans ; Hyponatremia ; diagnosis ; Inappropriate ADH Syndrome ; diagnosis ; Lung Neoplasms ; diagnosis

Objective To evaluate clinical significance of ischemia grade to predict severe arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 225 patients with STEMI admitting to emergency department were enrolled.All enrolled patients were divided into two groups based on the QRS complex electrocardiogram on admission:grade 1Ⅱ ischemia group(135 cases) and grade Ⅲ ischemia group (90 cases).All patients received thrombolytic therapy.The incidence rate of ST segment resolution (STR) and severe arrhythmia in hospital stay was observed.Results The ST segment elevation (Σ.ST) on admission and 2 h after thrombolysis in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(0.84 ± 0.57) mV vs.(0.44 ± 0.35) mV,(0.50 ± 0.23) mV vs.(0.11 ± 0.06) mV] (P ＜ 0.01).The backing rate of ST segment ≥ 50％ 2 h after thrombolysis in grade Ⅲ ischemia group was significantly lower than that in grade Ⅱ ischemia group [56.7％ (51/90) vs.83.7％ (113/135)] (P ＜0.01).The creatine kinase MB (CK-MB) peak value in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(363 ± 105) U/L vs.(212 ± 97) U/L] (P ＜ 0.01).There was no significant difference in the incidence of severe arrhythmia between two groups (P ＞ 0.05).Multiple Logistic regression analysis demonstrated that the independent predictors of severe arrhythmia were duration from symptom to thrombolysis and initial ΣST,whereas grade Ⅲ ischemia remained a strong predictor of severe arrhythmia.Conclusion Grade m ischemia on admission is associated with lower incidence of STR in patients with STEMI after thrombolysis and a strong predictor of severe arrhythmia.

Objective To evaluate the effect of acupressure on chemotherapy-induced digestive tract reaction of malignant tumor patients.Methods We searched Pubmed,Medline,Embase,AMED,Cochrane Library,Cancerlit and Cinabl,China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),VIP database (VIP)and Wanfang database,the databases were searched from the establishment of the database to March 2014.We identified randomized controlled trials (RCTs) and of acupressure on chemotherapy-induced digestive tract reaction for malignant tumor patients.Results In total,8 RCT,959 patients were included.Meta-analysis showed that compared with the no implementation of acupressure,acupressure could effectively reduce the frequency,duration and severity of chemotherapy-induced nausea,vomiting and retching.Meanwhile,acupressure could decrease anti-emetic medication dosage,but could not increase quality of life.Conclusions Acupressure can improve the digestive tract reaction of malignant tumor patients,alleviate the suffering of patients.Meanwhile acupressure couldn't increase the medical burden and mental burden of patients.More attention should be paid to the effect of acupressure on baseline level of state anxiety,functional state and more items.