Investigation on knowledge, attitude and practice of edema in critically ill patients among ICU nurses / 中国实用护理杂志

Objective:To understand the knowledge, attitude and practice of edema in patients with critically illness of ICU nurses, and to analyze its influencing factors.Methods:After developing the Knowledge-Attitude-Practice Scale of Edema Status in Critically Ill Patients for ICU nurses by Delphi expert consultation method, the level of knowledge, attitude and practice of edema status of ICU nurses in six tertiary hospitals in Shanghai City was investigated by using convenience sampling method.Results:A total of 292 ICU nurses were investigated by questionnaire. The total scores of knowledge dimension, attitude dimension and practice dimension of critical patients with edema in ICU nurses were 38.27 ± 5.52, 58.33 ± 8.34 and 43.04 ± 8.05, respectively. Multiple stepwise regression analysis showed that age ( β=0.28, P<0.05) was the main factor affecting ICU nurses′ knowledge about edema state of critically ill patients; age( β=0.20, P<0.05) and education ( β=0.28, P<0.05) were the factors affecting ICU nurses' attitude towards edema state of critically ill patients; and years of nursing work ( β=0.28, P<0.05) was the factor affecting the practice of critically ill patients of ICU nurses. Conclusions:The level of knowledge and attitude towards edema in critically ill patients of ICU nurses is good, but the level of behavior is general. Nursing managers should strengthen the training related to edema for ICU nurses, further to form a standardized prevent-treatment plan and nursing process in order to actively improve the nursing practice of edema in critically ill patients.

Effects of antibiotic treatment and antibiotics combined with surgery treatment on the prognosis of patients with infective endocarditis / 中华传染病杂志

Objective:To investigate the effects of antibiotic treatment and antibiotics combined with surgery treatment on the prognosis of patients with infective endocarditis (IE).Methods:The clinical data and prognosis of all patients diagnosed as IE discharged from Shanghai Jiao Tong University Affiliated Sixth People′s Hospital from June 2011 to May 2021 were collected. There were 240 IE patients, divided into antibiotic treatment group and the antibiotics combined with surgery group according to the treatment methods. The clinical characteristics and prognosis of the IE patients were compared between the two groups, so as to investigate the timing of surgery for IE patients and to analyze the effects of the two treatment methods on the prognosis of IE patients.Statistical analysis methods including Wilcoxon rank sum test, chi-square test, Kaplan-Meier survival analysis and Cox regression analysis were used when appropriate.Results:Of the 240 patients with IE, 63 cases were only treated with antibiotics and 177 cases were treated with antibiotics combined with surgery. After propensity score matching (PSM), one-year mortality rate of the IE patients in the antibiotics combined with surgery group was 11.1%(4/36), which was significantly lower than that in the antibiotic treatment group (33.3%(12/36), χ2=5.14, P=0.023). The median values of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and left ventricular fractional shortening (LVFS) in the antibiotics combined with surgery group were 59%, 47 mm and 31%, respectively, which were significantly lower than those before surgery (63%, 54 mm and 34%, respectively, Z=6.19, 9.36 and 6.11, respectively, all P<0.001). The most common surgical indication was moderate to severe heart failure, and there was no significant difference between the early operation group and the late operation group (both P>0.050). The one-year cumulative survival rate of antibiotics combined with surgery group was 94.9%, which was significantly higher than that in the antibiotic treatment group (83.2%, χ2=7.38, P=0.007). Heart failure and Pitt bacteremia scores≥4 were the independent risk factors for one-year all-cause death of the IE patients (hazard ratio ( HR)=5.668 and 19.392, respectively, both P<0.050). Hospital days and antibiotics combined with surgery were independent related factors for reducing the risks of one-year all-cause death ( HR=0.931 and 0.299, respectively, both P<0.050). Pitt bacteremia scores≥4 had the greatest impact on one-year prognosis of the IE patients. Conclusions:Surgery could significantly improve cardiac function and one-year prognosis of the IE patients. IE patients with heart failure and Pitt bacteremia score≥4 should be actively treated.

The clinical outcomes of elderly acute leukemia patients receiving allogenic hematopoietic stem cell transplantation and application of comprehensive nursing care / 中国输血杂志

【Objective】 To investigate the clinical outcomes of allogeneic hematopoietic stem cell transplantation in elderly patients with acute leukemia and the role of comprehensive nursing. 【Methods】 The data of 52 elderly patients with acute leukemia during the treatment of allogeneic hematopoietic stem cell transplantation were collected. According to the characteristics of elderly patients, 52 patients were given comprehensive nursing measures such as psychological, protective isolation, dietary management and specialized nursing. Stem cell engraftment, transplant complications and survival rates were observed in patients with comprehensive nursing support. 【Results】 All patients received comprehensive care. Of the 52 patients, 49 (94.2%) achieved neutrophil engraftment, with a median engraftment time of 12 days (9~19 days), and 45 patients (86.5%) achieved platelet engraftment with a median engraftment time of 13 days (9~35 days). The cumulative incidence of Ⅱ-Ⅳ°acute graft-versus-host disease (GVHD) was 26.9%, and the cumulative incidence of chronic GVHD was 28.5%. Cytomegalovirus (CMV) infection occurred in 15 cases, with a cumulative incidence rate of 37.5%, and Epstein-Barr virus (EBV) infection occurred in 5 cases, with a cumulative incidence rate of 9.9%. Bloodstream bacterial infection occurred in 8 patients with a cumulative incidence of 9.6%. With a median follow-up of 226 days (71~2 365 days), 39 patients survived and 13 died. The 1-year overall survival (OS) was 71.4%, and the OS and disease free survival (DFS) of patients with negative minimal residual disease (MRD) were both 100%. OS and DFS in MRD positive group were 59.2% and 48.1%, respectively. 【Conclusion】 Elderly patients with acute leukemia who receive allogeneic hematopoietic stem cell transplantation can also achieve long-term survival. Taking targeted preventive and nursing measures can ensure the success rate of transplantation.

The mechanism of QDPR on reducing apoptosis induced by fatty acids / 安徽医科大学学报

Objective To investigate the effects of dihydropteridine reductase (QDPR) on regulating apoptosis induced by plamitic acid(PA). Methods The transfection of HEK293T cells experiment was divided into 3 groups. A group was the control vector group. B group was the control vector group induced by PA. C group was the recombinant plasmid QDPR group induced by PA. First, control vector and recombinant plasmid QDPR was respectively transfected into HEK293T cells. After 24 h, PA with concentration of 0. 5 mmol/L was added into the medium of above cells. The cells of control vector group, the cells of control vector group induced by PA and the cells of recombinant plasmid QDPR group induced by PA were cultured for another 24 hours. At last, cells were harvested to detect tetrahydrobiopterin (BH4) and reactive oxygen species(ROS) generation, Beclin 1, Caspase 3 and Beclin 2 expression. Results ① After transfection, the recombinant plasmid QDPR was successfully constructed and expressed in cells.② There was no significant difference between A group and B group in BH4 generation. Compared with B group, BH4 generation increased in C group (P < 0. 05).③ ROS generation was increased in B group compared with A group, and decreased ROS generation in C group compared with B group (P < 0. 05).④ Western blot analysis revealed that Beclin 1 and Caspase 3 increased (P < 0. 05 ) while Beclin 2 decreased in B group compared with A group (P < 0. 05). Compared to B group, Beclin 1 and Caspase 3 decreased while Beclin 2 increased in C group (P < 0. 05 ). Conclusion QDPR may regulate apoptosis induced by fatty acids by decreasing the generation of ROS and increasing the level of BH4 and the expression of Beclin 2 associated with anti-apoptosis.

Application of Full-Automatic Tablet Dispensing Machine in the Central Pharmacy of Our Hospital / 中国药房

OBJECTIVE:To provide references for rational application of full-automatic tablet dispensing machine in the inpa-tient pharmacy of the hospital. METHODS:According to the work flow and use of the machine,the errors and problems arising from the use thereof by our hospital were summarized and analyzed,and corresponding improvement measures and solutions were put forward. RESULTS & CONCLUSIONS:Common errors in the use of full-automatic tablet dispensing machine included errors for the machine(including in-box drug shortage warnings accounting for 58.61% and abnormal responses to the quantity of in-box drugs accounting for 36.96%),errors caused by human factors(including errors of inputting doctor’s order and errors of pharma-cist’s adding drugs)and errors of material installation and operation. The solutions put forward are as follows as adjusting the tilt angle of the outlet mouth and controlling the quantity of the drugs added to the box to reduce the errors for the machine;two phar-macists’checking doctor’s order in the hospital information system in advance to reduce the errors caused by human factors;carry-ing out operation training for operators to reduce the errors of material installation;designating special personnel to maintain the ma-chine,etc.

Influence of scorpion alcoholic extraction on mdr1 mRNA and P-gp expression in brain of phenytoin-resistant convulsive rats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the anticonvulsive action of scorpion alcoholic extraction (SAE) on phenytoin-resistant convulsive rats made by direct cortical electrical stimulation in order to investigate the mechanism of antagonizing drug-resistance of SAE.</p><p><b>METHOD</b>Using the method of implanting microelectrodes in the cortical motor area of the brains of rats where the brain tissue was stimulated frequently by electricity through microelectrodes until igniting and then PHT (0.154 g x kg(-1) x d(-1)) ig for 7 days, We established phenytoin-resistant convulsive rat model. Total 6 groups were set up in the experiment: Normal control group, convulsion model control group (CMCG), phenytoin-resistant convulsion control group (PRCG), verapamil positive control group (VPCG, 0.0385 g x kg(-1)), scorpion alcohol extraction (SAE1, 6.5 g x kg(-1)) and scorpion alcohol extraction (SAE2, 13.0 g x kg(-1)). After ig both doses of SAE (6.5, 13.0 g x kg(-1)), the effects of SAE on the changes of convulsion threshold of phenytoin-resistant convulsive rats were observed. The method of RT-polymerase chain reaction (RT-PCR) was used to detect the changes of mdrl gene expression and the method of immunohistochemistry (SABC) was adopted to determine the changes of P-gp expression.</p><p><b>RESULT</b>Both doses of SAE and verapamil (Ver) ig all raised the convulsant threshold of phenytoin-resistant rats (480.38 +/- 18.48) microA, there were statistical differences (P < 0.05) compared to themselves before drugs-treated. PHT was administrated, and mdrl mRNA and P-gp expression in PRCG was much higher than that in CMCG, with significantly statistical difference (P < 0.01); ig both doses of SAE and Ver all decreased mdrl mRNA and P-gp expression compared to PRCG respectively (P < 0.01).</p><p><b>CONCLUSION</b>SAE and Ver ig all produce antagonizing action on phenytoin-resistant convulsive rat model. The machanism is related with inhabiting the mdrl mRNA expression and further decreasing the product P-gp.</p>

Mechanism of achyphylaxis by bradykinin in opening blood-brain barrier / 中国药理学通报

Aim To assess the effect of heat shock factor-1(HSF1)and heat shock protein 70(HSP70)to tachyphylaxis by bradykinin in the opening blood-tumor barrier(BTB).Methods The C6 rat intracerebral glioma model was constructed by stereotactic implantation technique.Using western blotting method to continue monitoring the protein expression of HSF1 and HSP70 in tumor tissue after bradykinin acted on animals.The expression of occludin in tumor tissue were detected by immunohistochemistry method.Using Evans blue and electron microscope,respectively,detected the permeability and pathology of BTB after intracarotid infusion of bradykinin in C6 rats.Results Bradykinin increased the tight junction opening and the permeability of BTB in C6 animals,and the relative increments of EB were 5.19 ?g?g-1(0 min),5.06 ?g?g-1(5 min),11.35 ?g?g-1(10 min,P