Cardiovascular nursing discipline construction index system based on the integrated medical model / 中华医学教育探索杂志

Objective:To establish an index system for the construction of cardiovascular nursing discipline based on the internal and external integration model of organ system, and to provide reference for the construction of cardiovascular nursing discipline with patients as the center and circulatory system as the core.Methods:Based on the health science cluster system theory, embodying the integrated nursing concept and the characteristics of cardiovascular discipline, the content of the cardiovascular nursing discipline construction index system and the weight of each index were determined through literature review, semi-structured interview and expert consultation. SPSS 23.0 was used to statistically analyze the obtained consultation data.Results:The positive coefficient of the experts was 92.308%, the authority coefficient was 0.812, and the coordination coefficients of the first-, second- and third-level indicators were 0.412, 0.421 and 0.347, respectively. The final indicator system consisted of 4 first-level indicators, 17 second-level indicators and 66 third-level indicators.Conclusion:The index system of cardiovascular nursing discipline construction is scientific and reliable, which has certain guiding significance to the construction of cardiovascular nursing discipline and the cultivation of talents under the integrated medical model.

Management of corona virus disease-19 (COVID-19): the Zhejiang experience / 浙江大学学报·医学版

The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as and . Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.

Management of COVID-19: the Zhejiang experience / 浙江大学学报·医学版

The current epidemic situation of coronavirus disease 2019 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 in Zhejiang province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance" strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinary personalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in 10%patients' blood samples at acute period and 50%of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifying cytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance" strategy effectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviral effects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favored the balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short period of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbial dysbiosis with decreased probiotics such as and , so nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore,we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.

Qualitative study on working experience of COVID-19 care nurses / 浙江大学学报·医学版

OBJECTIVE@#To study the working experience of COVID-19 care nurses.@*METHODS@#Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software.@*RESULTS@#Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life.@*CONCLUSIONS@#s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.

Effects of needleless connectors on central venous catheter-related thrombotic occlusions: a systematic review / 中国实用护理杂志

Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions , using the Cochrane Library and the databases of Pubmed,EMbase,CINAHL,CBM,CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases,extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review,which contained three randomized controlled trials,three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59,95％CI0.39-0.91,P=0.02). Standard connector and negative- displacement mechanical valve had a higher occlusions rates than positive- displacement mechanical valve ,but the difference did not reach statistical significance after merging the studies( P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation.

The application of Six-Step standardized communication procedure in improving the communication ability of nurses / 中华护理杂志

Objective To explore the effects of Six-Step standardized communication procedure in improving the communication ability of nurses.Methods C-I-CARE communication procedure was converted into Chinese.The Chinese version of Six-Step standardized communication procedure was Yi Kan,Er Yin,San Gaozhi,Si Wen,Wu Da,Liu Zaijian.The procedure was propagandized by making posters,setting up computer desktop,training nurses by lectures,video and role play.The effects were evaluated by pre and post self-control test among 100 nurses.Results The average score of communication behavior of 100 nurses after applying standardized communication procedure increased from 2.55±0.67 to 4.44±0.59 (t=-23.174,P＜0.001).In 2015,the nursing department received 622 silk banners and commendatory letters for appreciating nursing work,increased by 18.9％ compared to 2014.The discharged patient satisfaction increased from 94.2％ to 96.93％.The satisfaction of doctors to nurses' collaboration was 99.86％.There was no nursing complaint or dispute caused by bad communication.Conclusion The application of procedure and standardized communication method can improve the communication ability of nurses,optimize the relationship between nurses and patients and increase patient satisfaction.

Comprehensive application of four quality management tools in nursing quality management / 中国实用护理杂志

Objective To analyze the effect and the problems of the comprehensive application of quality management tools in order to improve nursing quality and ensure patient safety.Methods To summarize the implementation of Plan,Do,Check,Action(PDCA),quality control circle(QCC),root cause analysis(RCA),healthcare failure mode and effect analysis(HFMEA) in the nursing quality improvement.Aiming at problems arising in application process,the measures such as systematic training of quality management knowledge,case demonstration,standardized evaluation throughout the whole process,holding competition activities,inviting experts to give immediate guidance were applied.Results Among 1 798 PDCA and QCC programs,the result of 1 795 programs reached the target value,3 substandard programs reached the expected outcome finally after cause analysis,procedure break down and adjust of improvement contents.No nursing error or adverse events occurred.The indicators of nursing quality improved and patient satisfaction was 98.58％,which got the third position among all national hospitals.Conclusions The comprehensive application of four quality management tools was helpful in enhancing the effect of nursing quality improvement.

Analysis on brain targeting of scopolamine following intranasal administration by using solid phase extraction and LC/MS assay / 重庆医学

Objective To investigate the distribution of scopolamine into brain following intranasal .Methods Adult Wistar rats were divided into two groups ,and administrated with scopolamine 0 .3 mg via intraperitoneal or intranasal respectively .Two groups of blood concentration and brain concentration of scopolamine were determined by solid phase extraction (SPE) and LC/MS assay at the time point of 5 ,10 ,20 ,30 ,60 ,120 ,240 ,480 min ,and their kinetic parameters were calculated and compared .Results Scopol-amine bioavailability of intranasal administration was 65% ,and the maximum concentration of scopolamine in brain following in-tranasal administration was much higher than that following intraperitoneal administration .Comparing the ratio of AUC in brain and in plasma ,ratio of intranasal administration is bigger than that of intraperitoneal administration significantly (P<0 .05) .Con-clusion It was concluded that scopolamine′s intranasal administration induced the agent targeting distribution into the brain .

Protective effects of ω-3 PUFA on the second liver injury in rats with traumatic brain injury and hemorrhagic shock / 中华急诊医学杂志

Objective To investigate the effects of preconditioning with ω-3 polyunsaturated fatty acid (ω-3 PUFA) on the second liver injury in rats with traumatic brain injury and hemorrhagic shock (TBIS) and explore the underlying mechanism.Methods Total of 36 male Wistar rats were assigned randomly (random number) into 3 groups (n =12 in each):sham operation group (C),TBIS model group and PUFA pretreatment group.The arterial blood samples were taken for determination of serum levels of ALT,AST and TNF-α.The liver were removed for determination of levels of superoxide dismutase (SOD),malondialdehyde (MDA) and glutathione (GSH),and microscopic examination.Results Compared with group C,the serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly higher (P ＜0.01),but the liver levels of SOD and GSH in group TBIS and group PUFA were significantly lower (P ＜0.01).The serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly lower (P ＜ 0.01 or P ＜ 0.05),but the levels of SOD and GSH in liver tissues were significantly higher (P ＜ 0.01or P ＜ 0.05) in group PUFA than those in group TBIS.Histological examination revealed the injury of liver in TBIS group,and the rats in PUFA treated group showed alleviated severity of liver injury.Conclusions The supplementation of ω-3 PUFA can ameliorate acute liver injury in rats with TBIS,which may contribute to inhibition of oxygen free radicals and inflammatory cytokines expression.

Effects of ω-3 PUFA on inflammatory response of intestine and bacteria translocation in rats with traumatic shock / 中华急诊医学杂志

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on inflammatory response of intestine and bacteria translocation in rats with traumatic shock (TS) in order to explore the underlying mechanism.Methods A total of 36 male Wistar rats provided by Academy of Military Medical Sciences Animal Center were assigned randomly (random number) into 3 groups (n =12 in each group):sham operation group,TS model group and PUFA pretreatment group.Rat models of IS were established by comminuted fracture of femur and depletion of blood,and 2 mg/kg ω-3 PUFA or normal saline were injected 12 hours and 2 hours before modeling.Blood specimens were collected and intestinal tissue samples were obtained 120 min after modeling.The serum levels of tumor necrosis factor-o (TNF-α),IL-1β,IL-10 and 8-iso-prostaglandin F 2α (8-iso-PGF2α) were measured with ELISA.Light microscopic examination was carried out for histopathological assessment of the intestina tissue and the intestinal mucosa damage index ( IMDI ) was calculated.The number of marked bacilli found in mesenteric lymph nodes,lung,liver,spleen,and kidney tissues were counted under a fluorescent microscope.The percentages for categorical variables and mean ± SD for continuous variables were expressed. Chi-square test and unpaired t-test were used for comparisons among groups,and statistical significance defined as P ＜ 0.05.Results The levels of TNF-α,IL-1β,IL-10 and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation in TS model group were [ (325.14 ±21.17) ng/ml,(26.93 +2.58) μg/L,(7.59 ± 1.26) μg/L,(259.73 +61.32) pg/ml,(4.15 +0.37) and 58.33％,respectively] and those in PUFA group were [ (251.47 + 19.16) ng/ml,(17.81±1.94) μg/L,(9.44±1.85) μg/L,(171.44±39.25) pg/ml,(3.28±0.43) and 36.67％,respectively ].And those biomarkers in both TS group and PUFA group were higher obviously than those in sham group [ (37.02 ±5.54) ng/ml,(2.49 ±0.67) μg/L,(2.93 ±0.74) μg/L,(81.26 ± 15.18) pg/ml,(0.33 ±0.12) and 6.67％,respectively,P＜0.01].Compared with TS model group,the levels of TNF-α,IL-1β and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation were lower,and the levels of IL-10 were higher in PUFA group ( P ＜ 0.01 or P ＜ 0.05 ).Conclusions The supplementation of ω-3 PUFA lessens the injury of intestina mucosa after traumatic shock,and it may be associated with the inhibition of inflammatory response by intestine and bacteria translocation.was carried out for histopathological assessment of the intestina tissue and the intestinal mucosa damage index ( IMDI ) was calculated.The number of marked bacilli found in mesenteric lymph nodes,lung,liver,spleen,and kidney tissues were counted under a fluorescent microscope.The percentages for categorical variables and mean ± SD for continuous variables were expressed. Chi-square test and unpaired t-test were used for comparisons among groups,and statistical significance defined as P ＜ 0.05.Results The levels of TNF-α,IL-1β,IL-10 and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation in TS model group were [ (325.14 ±21.17) ng/ml,(26.93 +2.58) μg/L,(7.59 ± 1.26) μg/L,(259.73 +61.32) pg/ml,(4.15 +0.37) and 58.33％,respectively] and those in PUFA group were [ (251.47 + 19.16) ng/ml,(17.81±1.94) μg/L,(9.44±1.85) μg/L,(171.44±39.25) pg/ml,(3.28±0.43) and 36.67％,respectively ].And those biomarkers in both TS group and PUFA group were higher obviously than those in sham group [ (37.02 ±5.54) ng/ml,(2.49 ±0.67) μg/L,(2.93 ±0.74) μg/L,(81.26 ± 15.18) pg/ml,(0.33 ±0.12) and 6.67％,respectively,P＜0.01].Compared with TS model group,the levels of TNF-α,IL-1β and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation were lower,and the levels of IL-10 were higher in PUFA group ( P ＜ 0.01 or P ＜ 0.05 ).Conclusions The supplementation of ω-3 PUFA lessens the injury of intestina mucosa after traumatic shock,and it may be associated with the inhibition of inflammatory response by intestine and bacteria translocation.

Effects of ω-3 polyunsaturated fatty acids on systemic inflammatory response and gut barrier in rats with traumatic brain injury and hemorrhagic shock / 中华临床营养杂志

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on systemic inflammatory response and intestinal mucosa barrier in rats with traumatic brain injury and hemorrhagic shock (TBIS).Methods A total of 36 male Wistar rats were equally randomized into 3 groups:sham operation group,TBIS model group,and ω-3 PUFA pretreatment group.The serum levels of tumor necrosis factor-α (TNF-α),8-iso-prostaglandin F2 a (8-iso-PGF2 a),interleukin (IL)-1 β,and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).HE staining was performed for morphological assessment of the intestinal tissue and evaluation of the intestinal mucosa damage index (IMDI).The marked bacilli of the mesenteric lymph nodes,lung,liver,spleen,and kidney tissue were counted under a fluorescent microscope.Results Compared with those in the sham group [ (38.15 ± 6.37) ng/ml,(84.91 ± 17.22) pg/ml,(2.52 ± 0.83 ) μg/L,(2.86 ± 0.82) μg/L,0.36 ±0.14,and 8.33％ ],the serum levels of TNF-α [ (328.11 ±20.09) and (244.37 ±21.82) ng/rrl],8-iso-PGF2a [ (263.47±55.19) and (176.35±41.63) pg/ml],IL-1β [ (27.06±2.61) and (18.91 ±1.78) μg/L],IL-10 [ (7.63 ± 1.29) and (9.52 ± 4.66) μg/L],the IMDI (4.18 ±0.39 and 3.31 ±0.40),and the positive rates of bacterial translocation (56.67％ and 35.00％ ) were significantly higher in both the TBIS model group and ω-3 PUFA group ( all P ＜ 0.01 ).Compared with TBIS model group,the levels of TNF-α,8-iso-PGF2 a,and IL-1 β,the IMDI,and the positive rate of bacterial translocation were significantly lower ( all P ＜ 0.05 ) and the levels of IL-10 were significantly higher in the ω-3 PUFA group (P ＜0.01 ).Conclusion The supplementation of ω-3 PUFA can remarkably inhibit the systemic inflammatory response and protect the integrity of intestinal mucosa in rat with TBIS.

Effects of ω-3 polyunsaturated fotty acid preconditioning on liver injury in a rat model of traumatic shock / 中华麻醉学杂志

ObjectiveTo investigate the effects of ω-3 polyunsaturated fatty acid (PUFA) preconditioning on liver injury in a rat model of traumatic shock.MethodsForty-eight male Wistar rats aged 3 months weighing 240-260 g were randomly divided into 4 groups ( n =12 each): sham operation group (group S) ; group S + ω-3 PUFA; traumatic shock group (group TS) and group TS + ω-3 PUFA.In groups S + ω-3 PUFA and group TS + ω-3 PUFA,ω-3 PUFA 2 ml/kg was injected via the caudal vein at 12 and 2 h before induction of traumatic shock.In groups S and TS,normal saline was given instead of ω-3 PUFA.Traumatic shock was induced by fracture of femur and hemorrhage in groups TS and TS + ω-3 PUFA.The arterial blood samples were taken at 2 h after induction of traumatic shock for determination of serum activities of ALT,AST and concentrations of 8-iso-prostagiandin F2,(8-iso-PGF2α) and TNF-α.The liver was removed for determination of levels of SOD and MDA,glutathione (GSH)and microscopic examination.ResultsCompared with group S,the serum ALT,AST,8-iso-PGF2α and TNF-α levels and MDA content in the liver tissues and score of liver injury were significantly increased,but the liver tissues levels of SOD,GSH were decreased in groups TS and TS + ω-3 PUFA( P ＜ 0.01 ).Compared with group TS,the serum ALT,AST,8-iso-PGF2α and TNF-α levels and MDA content in the liver tissues and score of liver injury were significantly decreased,but SOD activity and GSH content in the liver tissues were increased in group TS + ω-3 PUFA( P ＜ 0.05 or 0.01 ).Conclusionω-3 PUFA preconditioning can reduced liver injury in a rat model of traumatic shock through inhibiting lipid peroxidation and inflammatory reaction.

Effects of ω-3 polyunsaturated fatty acid on acute lung injury in a rat model of traumatic shock / 中华麻醉学杂志

Objective To investigate the effects of ω-3 polyunsaturated fatty acid (ω-3 PUFA) on acute lung injury (ALI) in a rat model of traumatic shock. Methods Thirty-six male Wistar rats aged 3 months were randomly assigned into 3 groups ( n = 12 each): control group (group C) ; traumatic shock group (group TS) and ω-3 PUFA + TS group (group to-3 PUFA) . Traumatic shock was induced by fracture of femur and hemorrhage according to the method described by Feeney in groups TS and ω-3 PUFA. In group ω-3 PUFA, ω-3 PUFA 2 ml/kg was injected via the caudal vein at 12 and 2 h before induction of traumatic shock. Arterial blood samples were taken at 120 min after traumatic shock was successfully induced for determination of serum concentrations of TNF-α, IL-1β, IL-10 and 8-iso-PGF2α by ELISA. The animals were then sacrificed and lungs were removed for-determination of W/D lung weight ratio and microscopic examination. Results Traumatic shock significantly increased serum concentrations of TNF-α, IL-1β, IL-10 and 8-iso-PGF2α, W/D ratio and pathologic scores of lung tissues in groups TS and ω-3 PUFA as compared with group C.ω-3 PUFA significantly attenuated traumatic shuck-induced increase in serum concentrations of TNF-α, IL-1β and 8-iso-PGF2α , W/D ratio and pathologic scores of lung tissues but further increased the serum IL-10 concentration in group ω-3 PUFA as compared with group TS. Conclusion ω-3 PUFA can significantly inhibit the svstemic inflammatory response and ameliorate traumatic shock-induced ALI.

The function of Nursing station for blood delivery on the safety of clinical blood transfusion / 中华护理杂志

To effectively implement "Technical manual of clinical blood transfusion ",ensure the safety of clinical blood transfusion,and decrease nursing human resources cost,a nursing station for blood delivery hospital was established. This paper introduces the environment and facility,basic setup of information-based management,organizational structure,operation and management mode of nursing station for blood delivery. With flexible work mode,standard distribution process,safe and timely distribution,and effective quality control of blood transfusion process,the nursing station for blood delivery ensured the safety and effectiveness of clinical blood utilization,strictly implemented "Technical manual of clinical blood transfusion ",made full use of human resources,relieved the stress of laboratory technicians of blood transfusion department,and improved the satisfaction rate of medical staff towards blood transfusion department.

Pathogenic bacteria and drug-resistance in orthopedics patients: a review of the past three years / 中国矫形外科杂志

Objective To investigate the pathogenic bacteria and drug resistance in orthopedics patients, so as to guide the clinical use of antibiotics.Method708 secretions and pus samples from orthopedic outpatients and inpatients were cultured aerobically.The detectable bacteria were subjected to drug sensitivity test in vitro by the K-B assay.Result259 pathogenic strains were detected, and 47.9% of them were Gram-positive (Staphylococcus aureus, 33.0%: coagulase-negative staphylococci, 14.9%),and the remaining 52.1% were Gram-negative (Pseudomonas, 7.3%; Acinetobacter, 6.1%). The drug-resistant rate of Gram-positive cocci to penicillin and oxcillin tended to raise over the three years : however, all the detected Gram-positive cocci were sensitive to vancomycin (100%).Most Gram-negative bacilli were sensitive to imipenem (95.8%) in the past three years and the sensitivity to ceftazidime was also high; however, the sensitivity tended to fall over the past three years. The drug-resistant rates of Gram-negative bacilli to CiprofIoxacin. amikacin and piperacillin were 46.0%. 47.0% and 51.2% respectively.ConclusionGram-negative bacilli dominate the pathogenic bacteria in orthopaedic patients and they tend to increase. The incidence of infections by Gram-positive cocci is lower than that of infections by Gram-negative bacilli. In terms of individual bacteria ,staphylococcus aureus leads among all of these pathogenic bacteria, Vancomycin, Oxacillin and Norfloxacin are preferred drugs against Gram-positive cocci, while imipenem and ceftazidime are preferred for Gram-negative bacilli.The incidence of infections by Gram-negative bacilli tend to raise and drug resistance of Gram-negative bacilli becomes serious:hence, it is crucialOto emphasize the detection of infectious bacteria and drug sensitive test and to use antibiotics rationally.