Experience of treating severe cases of 2019 novel coronavirus pneumonia in Changde area / 中华危重病急救医学

Since the cluster of the 2019 novel coronavirus (2019-nCoV) pneumonia, a large number of patients gathered, the mortality of critical patients has remained high and the treatment was unclear. In this outbreak, Hunan Changde region immediately set up a hospital and intensive care unit. The patients relieved through respiratory support, hemodynamics management, nutritional support, the application of antiviral drugs, analgesic and sedation. The treatment experience in severe cases of 2019-nCov pneumonia patients were summarized as follows: in terms of respiratory support, we needed to pay attention to the advantages of high-flow nasal cannula oxygen therapy (HFNC) and the intervention of mechanical ventilation, pay attention to the ventilator parameters, and adopt prone position timely. In the aspects of fluid resuscitation and volume management, we should pay attention to the characteristics of severe patients' volume status, perform early evaluation, and clinicians should focused on hemodynamic management beside the bed. In the aspect of nutritional support and evaluation and maintenance of intestinal function, early enteral nutrition should be adopted in time. However, the trade-off between the risk of intestinal function and nutritional support in patients with mechanical ventilation and the antiviral benefits of Kaletra needed to be reevaluated, the optimized way of analgesia and sedation was adopted, at the same time, the usage and side effects of antiviral drugs should be paid attention to. We should grasp the opportunity of transportation for severe patients. It is suggested that some warning scores should be used to facilitate early recognition of patients with severe infection and then they should be earlier transferred to the designated hospital for intensive care.

Experience of treating severe cases of 2019 novel coronavirus pneumonia in Changde area / 中华危重病急救医学

Since the cluster of the 2019 novel coronavirus (2019-nCoV) pneumonia, a large number of patients gathered, the mortality of critical patients has remained high and the treatment was unclear. In this outbreak, Hunan Changde region immediately set up a hospital and intensive care unit. The patients relieved through respiratory support, hemodynamics management, nutritional support, the application of antiviral drugs, analgesic and sedation. The treatment experience in severe cases of 2019-nCov pneumonia patients were summarized as follows: in terms of respiratory support, we needed to pay attention to the advantages of high-flow nasal cannula oxygen therapy (HFNC) and the intervention of mechanical ventilation, pay attention to the ventilator parameters, and adopt prone position timely. In the aspects of fluid resuscitation and volume management, we should pay attention to the characteristics of severe patients' volume status, perform early evaluation, and clinicians should focused on hemodynamic management beside the bed. In the aspect of nutritional support and evaluation and maintenance of intestinal function, early enteral nutrition should be adopted in time. However, the trade-off between the risk of intestinal function and nutritional support in patients with mechanical ventilation and the antiviral benefits of Kaletra needed to be reevaluated, the optimized way of analgesia and sedation was adopted, at the same time, the usage and side effects of antiviral drugs should be paid attention to. We should grasp the opportunity of transportation for severe patients. It is suggested that some warning scores should be used to facilitate early recognition of patients with severe infection and then they should be earlier transferred to the designated hospital for intensive care.

Establishment effects of nursing work model and clinical application in anuria ward / 中国实用护理杂志

Objective To explore the establishment of nursing work model and clinical application in anuria ward. Methods Established the nursing model of anuria ward in rehabilitation department, including the establishment of neurogenic bladder functional rehabilitation nursing specialist group. Define organizational structure, division of labor and responsibilities, conduct continuous personnel training, education and assessment, formulate standardized procedures for rehabilitation and nursing of neurogenic bladder function, implement bladder function assessment, bladder function training, health education, etc. Stage summary and continuous quality improvement. Results The scores of nurses' theoretical examination, skill assessment, nurses'own satisfaction and doctors'satisfaction were 79.6 ±2.1 and 78.5 ±3.5, 91.3 ±2.3, 93.2±1.8, 92.5 ±2.4, respectively. After the implementation of the model, the scores were 89.2 ±1.8, 87.6 ±2.7, 96.3 ±3.6 and 97.4 ±1.6, 98.6 ±1.3, respectively. Before and after the implementation of the model, the differences were statistically significant (t=-8.755--7.685, P<0.05). The number of days of indwelling urinary catheter, residual urinary volume of bladder, and urinary system infection cases before the implementation of the model were (31.63 ±8.47) days and (263.38 ±18.62) ml, (15.03±3.10) cases, (21.27 ±1.64) days, respectively; and (8.78 ±4.32) days, (79.39 ±17.36)ml, (5.36 ± 1.35) cases, (12.45 ± 1.78) days, respectively after the implementation. There was significant difference between the two groups (t =- 23.643--5.874, P < 0.05). Conclusions The establishment of nursing work model without urinary tube ward it can obviously improve the nurses'theory and skill operation level of bladder function rehabilitation nursing, nurses themselves and doctors, patients'satisfaction to nurses, and significantly reduce the number of days of indwelling catheter, urinary bladder residual urine, urinary tract feeling and hospitalization days. The nursing work mode of no urinary tube ward is normative and operable, and it is worth popularizing in clinic.

Predictive value of abnormal ECG J wave for short-term prognosis in patients with acute ST-segment el- evation myocardial infarction / 心血管康复医学杂志

Objective:To explore the relationship between abnormal ECG J wave and in‐hospital prognosis in patients with acute ST -segment elevation myocardial infarction (ASTEMI) .Methods :ECG and related clinical data of 204 ASTEMI patients ,who received emergency percutaneous coronary intervention (PCI) in our hospital from Jan 2007 to Dec 2012 ,were retrospectively analyzed .According to the presence of abnormal J wave or not ,patients were di‐vided into abnormal J wave group (n= 82 ,occupied 40.2% ,82/204) and no abnormal J wave group (n= 122 , 59.8% ,122/204) .Single‐and multiple‐factor Logistic regression analysis were used to analyze risk factors of in -hospital death .Results:During hospitalization ,incidence rate of sustained ventricular tachycardia/fibrillation in pa‐tients with abnormal ECG J waves was significantly higher than those without abnormal J waves (9.8% vs .1.6% , P=0.008) , but among the 12 cases (5.9% ) of cardiac deaths ,only six cases had abnormal J waves .Logistic regres‐sion analysis indicated that abnormal ECG J wave cannot predict in‐hospital death of ASTEMI patients (OR=0.99 , 95% CI :0.34~ 2.90 , P= 0.987) ,while age can be regarded as an independent predictor factor for in‐hospital prognosis of these patients (OR = 1.08 ,95% CI :1.01 ~ 1.15 , P= 0.02) .Conclusion:For ASTEMI patients , though the incidence rate of sustained ventricular tachycardia/fibrillation in abnormal J wave group is significantly higher than those of without abnormal J waves group during hospitalization ,but abnormal ECG J waves cannot pre‐dict short-term prognosis of these patients .

Predictive value of abnormal ECG J waves for arrhythmias in patients with acute ST elevation myocar-dial infarction / 心血管康复医学杂志

Objective:To explore the predictive value of abnormal ECG J waves for arrhythmias occurred during short term in patients with acute ST elevation myocardial infarction (ASTEMI ) .Methods :ECG and echocardio‐graphic monitoring recordings of 204 ASTEMI patients who received emergency percutaneous coronary intervention (PCI) in our hospital from Jan 2007 to Dec 2012 were retrospectively analyzed .Univariate and multivariate Logistic regression analyses were performed to analyze the influencing factors of arrhythmias within one week after myocar‐dial infarction .Results:Abnormal J waves detected by ECG were found in 82 cases (40.2% ) among the 204 pa‐tients ,most of which were distributed on inferior leads of ECG .Multivariate Logistic regression analysis indicated that abnormal J waves (OR=14.05 , P=0.01 ,95% CI 1.70~116.40) ,J waves distributed across ≥ two locations (OR=13.38 ,P=0.01 ,95% CI 1.53~38.68) and J wave amplitude≥0.2 mV (OR=4.28 ,P=0.02 ,95% CI 1.82~16.72) were independent predictors for sustained ventricular tachycardia/fibrillation (VT/VF) ,but they cannot be used as predictors for occurrence of all ventricular arrhythmias ,including non‐sustained VT ,sustained VT and VF (P>0.05 all) ,nor the occurrence of atrial arrhythmias , P>0.05 all .Multivariate Logistic regression analysis indicated that diabetes mellitus was an independent predictor for occurrence of ≥30s atrial tachycardia/fibrillation in ASTEMI patients (OR=2.29 ,P=0.047 ,95% CI 1.01~5.18) .Conclusion:Abnormal ECG J wave is an inde‐pendent predictor for occurrence of sustained ventricular tachycardia/fibrillation during short term after ASTEMI .

The correlation of human papillomavirus and EB virus infection in nasopharyngeal carcinoma in Fujian / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the prevalence of human papillomavirus in nasopharyngeal carcinomas of Fujian province in China.@*METHOD@#Samples from 70 patients with NPC and 25 controls. All samples were detected HPV DNA by polymerase chain reaction (PCR) suing GP5+/6+ and MY09/11 primers and genotyped by surface plasmon resonance (SPR) and HPV 16/18 E6 and LMP-1 using immunohistochemistry and EBER using in situ hybridization.@*RESULT@#Only 2 cases of 70 patients were showed evidence of HPV DNA by PCR, the 2 HPV positive cases subtype HPV-70 and HPV-18 were genotyped by SPR, both the 2 HPV positive cases are non-keratinizing carcinomas (the HPV-70 positive one is differentiated and the HPV-18 positive one is undifferentiated), both the 2 HPV positive cases do not show any evidence of EBV. Data showed that 57 of 70 NPC detected EBER positive, but only 25 out of 70 NPC samples were detected LMP-1 positive.@*CONCLUSION@#Our study showed a low prevalence of human papillomavirus in NPC patients of Fujian province in Southern China, there is no evidence about HPV and EBV co-infection.

The Factors Affecting the Effects of Hearing Aids on Presbycusis Patients / 听力学及言语疾病杂志

Objective To analyze the factors affecting the effects of hearing aids in presbycusis patients . Methods One hundred and twenty cases with presbycusis were investigated by using general data and the Satisfac-tion with Amplification in Daily Life questionnaire(SADL) .The individual scores and total scores of all the subjects were collected together with the personal information ,including age ,gender ,degree of education ,pure-tone aver-age ,hearing aid type ,monaural/binaural status ,total hearing aid experience ,daily use time ,the time of perceived hearing difficulty .A single factor analysis and multiple stepwise regression analysis were used to filter out main fac-tors influencing the effect of hearing aids .Results The degree of education ,hearing aid type ,monaural/binaural status ,daily use time ,the time of perceived hearing difficulty were factors influencing the effect of hearing aids . The patients with higher level of education ,the longer daily use ,binaural status obtained more scores than those of the low degree of education ,the shorter daily use ,and monaural status( P< 0 .01) .The older people felt better than the youngers(P<0 .01) .The patients with long -time perceived hearing difficulty got more scores than those with short -time perceived hearing difficulty (P<0 .01) .In general ,the degree of education ,and the daily use time were the main factors influencing the effects of hearing aids .Conclusion There are many factors that influence the effects of hearing aids ,in which the degree of education ,daily use time are the main factors ,and the combination of the two factors obtain the effects of hearing aid maximization ,and the binaural status ,the short time of perceived hearing difficulty and the older obtain better satisfaction .The gender doesn't significantly influence the effects of the hearing aids .

The changes of cytokines in children with hand-foot-mouth disease / 中国小儿急救医学

Objective To study the changes of cytokines in children with hand-foot and mouth disease.Methods Sixty-two cases of hand-foot-mouth disease admitted to our hospital from March 2011 to December 2011 were included in this study.Thirty-seven cases were male and 25 cases were female,the youngest one was four month old,and the oldest one was eleven month and 4 years old,the average age was (1.56 ± 0.98) years old.Sixty-two children with hand-foot-mouth disease were devided into ordinary group (n =20),severe group (n =20),critically ill group (n =22).Twenty healthy children served as control group.The plasma levels of pro-inflammatory cytokines [tumor necrosis factor(TNF)-α,interleukin(IL)-1β、IL-6] and anti-inflammatory cytokines (IL-1 0、IL-13、IL-4) were detected.Results The pro-inflammatory and anti-inflammatory cytokines of patients with hand-foot and mouth disease were increased compared with control group.The levels of TNF-α in severe and critically ill groups were (201.45 ± 133.42) ng/L,(220.37 ± 117.54)ng/L respectively,which significantly increased compared with ordinary group [(118.12 ±11205) ng/L] (P ＜0.05).The levels of IL-1β and IL-6 in critically ill cases were (651.77 ±538.45) ng/L and (88.02 ±50.76) ng/L respectively,which significantly increased compared with severe cases [(551.75 ± 252.75) ng/L,(59.25 ± 28.80) ng/L] and ordinary cases [(270.18 ± 249.79) ng/L,(55.76 ± 28.68) ng/L] (P ＜ 0.05).The level of IL-10 was (137.53 ± 72.07) ng/L in ordinary cases,which increased significantly compared with the severe and critically ill cases[(57.07 ±55.02) ng/L,(73.37 ±56.01) ng/L] (P ＜0.05).The levels of IL-13 were (507.53 ±210.86) ng/L and (489.67 ± 168.99) ng/L in severe and critically ill cases respectively,which significantly increased compared with ordinary cases [(387.16± 157.43) ng/L] (P ＜0.05).The levels of IL-4 showed no significant differences among the ordinary,severe and critically ill groups(P ＞ 0.05).Conclusion The pro-and anti-inflammatory cytokines were involved in inflammatory response simultaneously in patients with hand-foot and mouth disease.The increases of TNF-α,IL-1β and IL-6 are consistent with severity of the disease,while factor IL-10,IL-13 are decreased as the severity of the disease.The increase of the pro-inflammatory cytokines and decrease of the anti-inflammatory cytokines are the important sign of the exacerbation.

Application of health education prescription in the discharge instruction for patients after TURP / 中国实用护理杂志

Objective To discuss the health education modes in order to promote the effect of health education for TURP(transurethral resection of prostate)patients and their family members.Methods A total of 380 cases after TURP were divided into the observation group and the control group at random with 190 cases in each group.The discharge instruction for the patients and their family members in the observation group was in the form of health education prescription,while the discharge instruction for the control group was in the form of oral instruction.The awareness rate of disease-related knowledge and incidence of complication were compared between the two groups. Results The awareness rate of disease-related knowledge in the observation group was higher,and incidence of complications was lower than that of the control group.Conclusions The application of health education prescription in the discharge instruction for the patients after TURP can guarantee the effectiveness of health education,simultaneously decrease the incurrence of complications and improve the life quality of patients.

Etiology of intestinal nutrition related diarrhea and its nursing / 中国实用护理杂志

Objective Aims To analyze the etiology of intestinal nutrition related diarrhea and to study its nursing. Method The rate and etiology of intestinal nutrition related diarrhea of 180 patients receiving intestinal nutrition through traditional nasal way from 2002 to 2003 year 180 patients(A group) was analysed retrospectively and new nursing was studied.From 2004 to 2005 year,202 patients(B group) received intestinal nutrition through nutrition pump and intensive nursing.The intestinal nutrition related diarrhea rate of two groups was compared. Results The diarrhea rate of B group was insignificantly lower than that of A group(P

The stimulating effects of neuropeptide Y on cultured arterial smooth muscle cell proliferation and losartan treatment / 中国病理生理杂志

AIM:To investigate the interplay between the neuropeptide Y(NPY) and renin-angiotensin system, and relationship to the pathogenesis of hypertension. METHODS: The method of cellular culture, MTT colorimetric assay and quantitative immunocytochemistry through ACAS570 were performed for the effect of neuropeptide Y on proliferation of cultured rat vascular smooth muscle cell (VSMC) and losartan treatment. RESULTS:It was observed that exposure of VSMC to neuropeptide Y could stimulate the proliferation of VSMC and caused increase respectively in MTT OD values and expression of proliferating cell nulear antigen(PCNA) but losartan interfered with NPY stimulating effects on VSMC and decreased MTT OD values and expression of PCNA. CONCLUSION:These results demonstrated that the NPY could promote proliferation of VSMC, this effect was partly preformed through angiotensin Ⅱ receptor.

The stimulating effects of neuropeptide Y on cultured arterial smooth muscle cell proliferation and losartan treatment / 中国病理生理杂志

AIM: To observe expression of proliferating cell nuclear antigen (PCNA), platelet derived growth factor (PDGF) and c-myc in cultured vascular smooth muscle cells which is effected by neuropeptide Y (NPY) and losartan (the receptor blocking agent of angiotensin Ⅱ) therefore exploring effects of NPY on the generation of hypertension and its relationship with losartan reverse treatment in molecular biology. METHODS: Applied the method of quantitative immunocytochemistry through ACAS570. RESULTS: 24 hours exposure of vascular smooth muscle cell to NPY caused an increase in expression of PCNA, PDGF and c-myc respectively. But losartan could reverse these expressions by NPY, decreased the expression of PCNA, PDGF and c-myc. CONCLUSION: NPY is closely related to the generation of hypertension. But losartan could reverse these effects of NPY.

Effects of pueraria lobata isoflavones on myocardiac cell hypertrophy induced by neuropeptide-Y in vitro / 中国病理生理杂志

AIM: To investigate the effects of pueraria lobata isoflavones (PLIs) on neuropeptide-Y(NPY)-induced myocardiac cell hypertrophy in vitro. METHODS: Rat cardiomyocytes cultured in vitro were randomized to control, NPY, NPY+PLIs and PLIs group. The protein synthesis in cardiomyocytes was assessed by [~3H-Leu] uptake, C-jun mRNA by RT-PCR and CaN activity by histochemistry. RESULTS: The rate of [~3H-Leu] uptake, the C-jun mRNA expression and the CaN activity of myocardiac cells in 100 nmol/L NPY group were higher than those in control (P

Inhibition of Neuropeptide-Y-induced Vascular Smooth Muscle Cell Proliferation with Pueraria Lobata Isoflavones / 广州中医药大学学报

[Objective] To observe the effect of Pueraria Lobata isoflavones (PLI) on neuropeptide-Y-induced (NPY) vascular smooth muscle cell (VSMC) proliferation. [Methods] Experiment system for VSMC was set up as 4 groups: control group (with DME culture fluid, free of blood serum; group A), model group (with NPY culture fluid; group B), control + PLI group (with PLI culture fluid; group C) and model + PLI group (with NPY and PLI culture fluid; group E). Quantitative fluoroimmunohistochemistry techniques were applied to examine the mean fluorescent values of proliferating cell nuclear antigen (PCNA), platelet derived growth factor (PDGF) and C-myc expression. [Results] The levels of PCNA, PDGF and C-myc expression in model group were higher than control group (P

Effect of neuropeptide Y on bcl-2, bax, fas expressions and proliferation in vascular smooth muscl cells / 中国病理生理杂志

AIM:To explore the effect of neuropeptide Y on expression of apoptosis associated genes and proliferation in vascular smooth muscle cells(VSMC). METHODS: The proliferation activity of VSMC was dterminded by MTT colorimetry. The average fluorescence intensity that represented VSMC nuclear antigen (PCNA) and bcl-2, bax, fas expressions was quantitatively measured by fluorescence immunohistochemistry. RESULTS: Compared with control, the expressions of bcl-2, bax, fas, PCNA and the VSMC proliferation activity in VSMC treated with NPY were significantly increased. CONCLUSION:NPY may increase the expression of apoptosis associated genes in VMSC and promote its proliferation.

The Inhibiting Effects of Losartan on Proliferation of Cultured Arterial Smooth Muscle Cell and Its Relationship with Neuropeptide Y / 中山大学学报(医学科学版)

【Objective】 To explore the mechanism of action of Losa rtan on vascular remodelling in hypertension and its relationship with neuroendo crine factor and renin-angiotensin system.【Methods】 The study consisted of co ntrol group and other three treatment groups: Losartan group、NPY group、and Los artan+NPY group. More than 200 cells were scanned in each group. The methods of c ellular culture, biochemistry and quantitative immunocytochemistry through ACAS5 70 were applied to investigate the proliferation of vascular smooth muscle cell (VSMC) and the expression of proliferating cell nuclear antigen (PCNA) in cultur ed rat VSMC treated with Losartan and Neuropeptide Y (NPY) stimulation. 【Result s】 VSMC proliferation (by absorbauce) in the control group and other three exam ed groups: Losartan group、NPY group and Losartan+NPY group were 0.223 9±0.00 1 0、0.204 5±0.001 3、0.262 6±0.002 5、0.244 0±0.001 3, and PCNA (by fl uorescence intensity) were 1 543±200、1 339±233、1 649±233、1 545±256. It wa s observed that losartan could inhibit the VSMC proliferation in vitro cultu re with and without NPY simulation. Compared with the control groups, the VSMC p roliferation activity and expression of PCNA were obviously descreased in the lo sartan treated gro ups. 【Conclusion】 The results demonstrate that losartan has the inhibitive eff ects on VSMC profiferation and PCNA expression. The results also suggest that lo sartan has anti-NPY effect on VSMC in vascular remodelling of hypertensive vess els.

Effect of neuropeptide Y on bcl- 2, bax, fas expressions and proliferation in vascular smooth muscl cells / 中国病理生理杂志

AIM: To explore the effect of neuropeptide Y on expression of apoptosis associated genes and proliferation in vascular smooth muscle cells(VSMC). METHODS: The proliferation activity of VSMC was dterminded by MTr colorimetry. The average fluorescence intensity that represented VSMC nuclear antigen (PCNA) and bcl -2, bax, fas expressions was quantitatively measured by fluorescence immunohistoehemistry. RESULTS: Compared with control, the expressions of bcl - 2, bax, fas, PCNA and the VSMC proliferation activity in VSMC treated with NPY were significantly increased. CONCLUSION: NPY may increase the expression of apoptosis associated genes in VMSC and promote its proliferation.

Effects of Ca~(2+) /CaM-dependent calcineurin signaling pathway on cardiomyocytes hypertrophy of rats induced by neuropeptide Y / 中国临床药理学与治疗学

AIM : To investigate the effects of Ca 2+ /CaM dependent calcineurin(CaN) signaling pathway on cardiomyocytes hypertrophy of rat induced by neuropeptide Y(NPY). METHODS : Cardiomyocytes of neonatal Wistar rats were cultured with NPY of various concentrations (10,100 nmol?L -1 ). Cyclosporine A (CsA) was used to inhibit the activity of CaN. The methods of 3H Leu incorporation was used to assess protein synthesis rate in cardiomyocytes. Western blot and histochemistry were used to measure CaN protein expression and CaN activity in cardiomyocytes. RESULTS : 3 H Leu incorporation of cardiomyocytes were increased significantly by 100 nmol?L -1 NPY ( P

Inhibitory effects of antisense oligonucleotides targeting connective tissue growth factor mRNA on the proliferation and collagen synthesis of cardiac fibroblasts / 中国病理生理杂志

AIM: To observe the effect of AngⅡ on the ex pression of connective tissue growth factor (CTGF) in cultured cardiac fibroblas t (CFs), the antisense oligonucleotides (ASOND) was used to investigate whether CTGF is necessary for the proliferation and collagen synthesis of CFs. METHODS: CFs of SD rats were isolated and cultured. The proliferation and collagen synthesis of CFs were a ssessed by MTT assay and measuring hydroxyproline, respectively. The expression of CTGF mRNA and protein were detected by reverse-transcription PCR (RT-PCR) and Western blotting, respectively. RESULTS: AngⅡ could significantly increase the expression of CT GF both at mRNA and protein level in a dose and time-dependent manner (P0.05). CONCLUSION: It indicates that CTGF is involved in the process of myocardial fibrosis induced by AngⅡ, which may be a target for the treatment o f cardiac fibrosis.

Construction of human immunoglobulin combinatorial library containing D-Dimer on the surface of phage / 中国病理生理杂志

AIM: To construct a human recombinant immunoglobulin library containing D-Dimer by using phage surface display technology. METHODS: Human immunoglobulin heavy chain and light chain genes were amplified respectively by RT-PCR from different human lymphocytes using family specific primers and signal sequences of immunoglobulin as half-nested PCR primers. The heavy chain and light chain PCR products were cloned into phagemid vector pComb3H and the human immunoglobulin recombination library was generated with helper phage VCSM13. RESULTS: A human combinatorial antibody library consisting of 2.8?10~8 in dependent clones was generated with a titer of 4.1?10~(17)PFU/L. The recombinant frequency of Fab genes was 46%. CONCLUSION: A human combinatorial antibody library was generated. It will be beneficial for selecting Fab antibodies of D dimer from the library.