A quality improvement program with nutrition therapy: restriction of lipid emulsions in cardiac surgical patients.

BACKGROUND: To evaluate the effect of restriction of soybean-based intravenous fat emulsions (IVFEs) in clinical outcomes in cardiac surgical patients. METHODS: This was a before-and-after interventional study comparing the clinical outcomes regarding the intervention of IVFEs restriction. Before August 2015, parenteral nutrition (PN) using a soy-based lipid emulsion was routinely implemented if patients failed to meet >60% of energy requirements in 48 h post cardiac surgery (Period A). Beginning in August 2015, a lipid restriction strategy was implemented in our cardiac surgery intensive care unit (CSICU) unless enteral route could not be established within 7 days (Period B). The ICU and hospital mortality, nosocomial infections during ICU stay, length of ICU and hospital stay, ICU and hospital cost, mechanical ventilation time and postoperative complications were compared between two periods. RESULTS: A total of 761 patients (370 patients in Period A and 391 patients in Period B) were ultimately enrolled in this study. There were no significant differences in demographic characteristics and intraoperative and postoperative parameters between the two groups. After the implementation of IVFEs restriction, the overall ICU mortality and hospital mortality were similar between two groups. Nosocomial infection rate was significantly reduced (3.84% vs. 7.84%, P=0.021). The mean length of ICU stay (3.15 vs. 3.74 days, P<0.001) and hospital stay (12.14 vs. 13.24 days, P<0.001) were significantly lower. The mean in-hospital cost (133,368 vs. 139,383 Yuan, P=0.037) was found to be reduced after implementation of IVFEs restriction. The duration of mechanical ventilation was shorter in the latter period (35.23±10.43 vs. 47.63±12.54 hours, P=0.011). IVFEs restriction was also associated with reduced cholestasis (2.81% vs. 6.76%, P=0.013). CONCLUSIONS: The implementation of soybean-based IVFEs restriction in cardiac surgical patients was associated with reduced postoperative nosocomial infection rate. It also led to reductions in the length of ICU/hospital stay, hospital costs and mechanical ventilation time and a lower incidence of cholestasis. Further studies are required to validate the conclusions.

Complete genome sequence of astaxanthin-producing bacterium Altererythrobacter ishigakiensis NBRC 107699.

Altererythrobacter ishigakiensis NBRC 107699 was isolated from marine sediment collected from a site on the coast of Ishigaki Island, Japan and deposited to the NITE Biological Resource Center. This strain is able to produce astaxanthin, which can be used as a food supplement. Here we describe the genome sequence and annotation, as well as the features of the organism. The genome of strain NBRC 107699 comprises 2,673,978bp and contains 2618 protein-coding genes (1966 with predicted functions), 42 tRNA genes and 3 rRNA genes. A. ishigakiensis NBRC 107699T encodes fifteen genes related to astaxanthin production, revealing its potential application in biotechnological industry. The genome sequence of A. ishigakiensis NBRC 107699 now provides the fundamental information for future studies.

[Valuation on analgesic, expectorant and antitussive effects of compatible use of Aconiti radix cocta and Fritillaria cirrhosa or Fritillaria thunbergii].

OBJECTIVE: To study the analgesic, expectorant and antitussive effects of the compatible use of Aconiti Radix Cocta and Fritillaria cirrhosa or F. thunbergii with different matching ratio or dose in mice. METHOD: The two-factor, seven-level uniform design method was adopted to observe the analgesic, expectorant and antitussive effects of the oral administration with the two combined decoctions in rats, with frequency of body torsions induced by acetum, secretion of phenol red in tracheas and frequency of coughs as indexes. Significant matching proportions and doses were collected for verification. RESULT: The effect on the frequency of body torsions: The combined decoctions could effectively reduce the frequency of body torsions. According to a regression analysis, Aconiti Radix Cocta and F. cirrhosa had the synergistic effect, which was maximized with a ratio of 1: 1. The 1: 1 combined decoction played the least role in reducing the frequency of body torsions with a total dose of more than 5 g x kg(-1). The effect on the secretion of phenol red in tracheas. The combined decoctions could effectively increase the secretion of phenol red in tracheas. According to a regression analysis, Aconiti Radix Cocta and F. thunbergii had the antagonism, which was maximized at the ratio of 1: 1, and minimized with a total dose of less than 10 g x kg(-1) and a ratio of 5: 1 between F. thunbergii and Aconiti Radix Cocta. The effect on the frequency of coughs. The combined decoctions could effectively reduce the frequency of coughs. According to a regression analysis, Aconiti Radix Cocta and F. cirrhosa had the antagonism, which was maximized at the ratio of more than 1: 5 and less than 10: 1. There was no interaction between Aconiti Radix Cocta and F. thunbergii. F. thunbergii could reduce the frequency of coughs, whereas Aconiti Radix Cocta showed no effect. CONCLUSION: The compatible application of Aconiti Radix Cocta and F. cirrhosa could enhance the analgesic effect of Aconiti Radix Cocta and reduce the expectorant and antitussive effects of F. cirrhosa, which vary according to different matching ratio and dose. The compatible application of Aconiti Radix Cocta and F. thunbergii shows no effect on the antitussive effect of F. thunbergii. This study provides experimental basis for in-depth studies on the combined effect of Aconiti Radix Cocta and Fritillaria--two of eighteen incompatible pairs.

Clinical effects of acupuncture after surgical operation in patients with prolapse of the lumbar intervertebral disc.

OBJECTIVE: To investigate the clinical effects of acupuncture after surgical operation in patients with prolapse of the lumbar intervertebral disc (PLID). METHODS: Sixty-nine patients in this series, who had undergone the removal of nucleus pulposus and the intervertebral fusion as well, were randomly divided into a treatment group of 35 cases and a control group of 34 cases. The former was treated by acupuncture and conventional rehabilitation therapy, and the latter only by the rehabilitation therapy. The therapeutic effects were evaluated according to the scoring system stipulated by Japanese Orthopedics Association (JOA). RESULTS: In the treatment group, the average functional recovery rates in 3-month, 6-month and one-year periods were respectively 49.93%, 90.31% and 95.08%; while the rates were repesctively 26.24%, 63.42% and 71.36% in the control group, showing statistically significant difference between the two groups (P<0.05). CONCLUSIONS: Acupuncture can confirmatively promote the functional recovery for'patients with prolapse of the lumbar intervertebral disc after surgical removal of nucleus pulposus and with intervertebral fusion.

[Luminescence properties and spectral analysis of long phosphorescent phosphors: Ba(1 - x) Ca (x) Al2O4 : Eu2+, RE3+].

New long phosphorescent phosphors Ba(1 -x),Ca(x)Al2O4 : Eu2+, RE3+ (RE3+ = Dy3+, Nd3+) with tunable color emission have been prepared by solid state reaction. The luminescence properties of the samples are discussed and analyzed. The emission spectra show that the tuning range of the color emission of the phosphors is between 498 and 440 nm, which is determined by x, under the excitation of UV. The wavelength of afterglow increases with increasing x until x equals 0.6, and when x equals 0.6, the luminescence property of Ba(1-x) Ca(x)Al2O4: Eu2+, RE3+ (RE3+ = Dy3+, Nd3+) is similar to that of CaAl2O4 : Eu2+, RE3+. The XRD measurements were performed to investigate the single phase states of the samples, and it was found that the single phase limit in the phosphors is below an x value of 0.4. The thermoluminescence curves imply that the traps in the hosts are different with different x value, which well explains the varying delay time of the samples.

Towards a Chinese definition of nursing.

BACKGROUND: A theory of nursing derived from nurses' experience can reflect indigenous practice values, which in turn can act as a fertile source of ideas and inventiveness in developing a relevant knowledge base to inform practice. However, systematic study of how Chinese nurses articulate nursing in their everyday practice is lacking. AIM: The aim of this paper is to describe how Chinese nurses conceptualize the practice of nursing; and to arrive at a definition of nursing based on this common understanding. METHOD: A systematic inquiry using a modified version of Van Kaam's controlled explication was designed. In the prescientific phase, 254 written accounts of nurses' views on nursing as lived in their everyday practice were collected in eight Chinese cities. In the scientific phase, concept analysis based on Aristotle's notion of four causes was adopted to capture the richness of the phrases that explain the multi-dimensionality of Chinese nurses' concepts of nursing. This was followed by a survey of 1782 nurses to verify the findings. The most commonly held views were summarized and a Chinese definition of nursing was drafted. FINDINGS: Nursing in the Chinese sense means to understand the dynamic health status of a person, to verify health concerns dialectically, and to consider interventions with the goal of assisting the person to master the appropriate health knowledge and skills for the attainment of optimal well-being. The survey findings show that nursing has developed into a professional caring practice in China today. The definition has some similarities with those of Western nurses, but the underpinning epistemic concerns are grounded in the philosophy of traditional Chinese medicine and Eastern ideologies. CONCLUSION: The findings provide Chinese nurses with a definition of nursing articulated in their own language. The identification of qing, li, zhi, and xin as its epistemic concerns, and the articulation of the process of nursing as 'dialectical verification', provides a perspective for understanding nursing based on Eastern philosophies. The findings can enhance nurses' engagement in a cross-cultural dialogue to promote better understanding of nursing as it is practised in different parts of the world.