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Objective To study the effects of pressure controlled ventilation(PCV)and volume controlled ventilation(VCV)on diaphragm function and the incidence of postoperative pulmonary complica-tions(PPCs)in patients undergoing laparoscopic surgery.Methods Sixty-six patients underwent laparo-scopic gynecological surgery under general anesthesia,aged 18-64 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ were recruited.The patients were randomly divided into two groups:PCV group(group P)and VCV group(group V),33 cases in each group.All the patients were ventilated in VCV mode after induction.Group P was switched to PCV after pneumoperitoneum and group V maintained VCV until the end of operation after pneumoperitoneum.The diaphragm ultrasonic evaluation indexes including di-aphragmatic excursion(DE),diaphragm contraction velocity(DCV),and diaphragmatic rapid shallow breathing index(D-RSBI)were recorded before anesthesia induction,immediately after extubation,and 30 minutes after extubation.The mechanical ventilation time,artificial pneumoperitoneum time,the time from the end of artificial pneumoperitoneum to extubation,the cumulative dosage of cisatracuriumbesylate,and the patient's observer's assessment alert/sedation(OAA/S)immediately after extubation,the incidence of diaphragm dysfunction immediately after extubation and 30 minutes after extubation,and the cumulative in-cidence of PPCs in 1-3 days after operation.Results Compared with group V,DE in group P was in-creased significantly immediately after extubation(P＜0.05),but there was no significant difference in DE of 30 minutes between the two groups after extubation.Compared with group V,DCV in group P was in-creased significantly immediately after extubation and 30 minutes after extubation(P＜0.05),the inci-dence of PPCs in group P was significantly lower on the 1st day after operation(P＜0.05).There were no significant differences in D-RSBI,time of mechanical ventilation,time of artificial pneumoperitoneum,time from the end of pneumoperitoneum to extubation,cumulative dosage of atracurium besylate,OAA/S score immediately after extubation,and the incidence of diaphragm dysfunction immediately after extubation and 30 minutes after extubation,and the cumulative incidence of PPCs on the 2nd and 3rd day after operation.Conclusion In lower abdominal endoscopic gynecological surgery,compared with volume-controlled venti-lation mode,pressure-controlled ventilation mode dose not reduce the incidence of postoperative diaphragm dysfunction,but dose alleviate the weakening of diaphragm inspiratory force and reduce the incidence of pul-monary complications on the first day after operation.
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Objective:To investigate the level of rumination and its influential factors among Chinese psychiatry nurses who go through work place violence.Methods:In this study, 150 psychiatry nurses were recruited from Affiliated Brain Hospital of Guangzhou Medical University (specialize in psychiatry), via the combination of convenient sampling and snowball sampling. Chinese Event-related Rumination Inventory (C-ERRI) was applied in the survey.Results:The total score of C-ERRI was (22.11±9.62) points, and the scores of intrusive rumination subscale and deliberate rumination subscale were (12.99±5.58) and (9.12±6.01) points, respectively. Multiple Linear Regression Analysis show that assault frequency in recent year ( B=-3.195, P<0.01) and whether got injury in the recent assault ( B=8.591, P<0.01) were predictors of deliberate rumination, which account for 26.8% variance of the equation. Gender (male) ( B=-2.415, P<0.01), Injury frequency in recent year ( B=2.864, P<0.01) and whether got injury in the recent assault ( B=8.949, P<0.01) were predictors of intrusive rumination. They account for 36.0% variance of the equation. Conclusion:In this study, the level of rumination among Chinese psychiatry nurses was low. Their rumination style was deliberate rumination.
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The " Trinity" management model of refined management, PDCA cycle and quality control circle was introduced into operating room ( OR ) management at our hospital since 2017. This practice aims to improve the OR process with refined management, elevate management practice with PDCA cycle, and improve detailed efficiency with quality control circle. 2017 witnessed a significant increase of the hospital in the number of surgical procedures, the punctuality rate of anesthesia, and the punctuality rate of the first surgery, as well as OR turnaround times than 2016. This model plays an important role in improving the efficiency of the OR, thus raising business revenue of the hospital.
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Objective To evaluate the impact of ghrelin on depleted uranium ( DU)-induced damage of the osteoblast MC3T3-E1. Methods MC3T3-E1 cells were treated with different doses of ghrelin for 1 h before DU (500 μM) treatment. After 24 hours,the cell via-bility,intracellular tartrate-resistant acid phosphatase (StrACP),alkaline phosphatase (AKP),osteoprotegerin (OPG),solvable receptor acti-vator of nuclear factor-κB ligand ( sRANKL) ,catalase ( CAT) and reactive oxygen species ( ROS) were measured. Results After DU expo-sure,ghrelin pretreatment increased the cell viability and CAT levels,and reduced intracellular StrACP,AKP,sRANKL/OPG and ROS in a dose-dependent manner. Conclusion Through maintaining the balance of OPG/RANKL and reducing the oxidative stress,ghrelin could pro-tect against DU-induced damage of MC3T3-E1 cells.
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In term of innovating in teaching,the text proposes some rectification and improvement measures according to the weak point existing in the chemical experiment in the past.We have improved the teaching quality of the chemical experiment through improving teacher's innovative quality,adjusting the experiment content rationally,changing the teaching mode of the experiment and examining method,and optimizing the experiment means,etc.