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OBJECTIVE@#The patient monitors were used to explore the alarm fatigue in a cardiac care unit and to investigate the awareness and reaction of nurse to alarms.@*METHODS@#A semi-structured survey was taken to acquire nurses' feeling and knowledge about monitoring alarm. Three full-time researchers were scheduled to track the alarms with annotations, and analyze the alarm data of 12 patient monitors using central monitoring system.@*RESULTS@#A total of 72 310 unique alarms occurred in the 67-day study period. About 75.7% of them were physiological alarms and less than 10% of medium-low alarms were false positives. The average alarm rate was 128 alarms/patient-day.@*CONCLUSIONS@#There remains alarm fatigue in CCU, the alarm accuracy has improved than the past by applying new technologies. In some cases, clinicians will pay more attention to trend alarm and combination alarm.
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Humans , Arrhythmias, Cardiac , Clinical Alarms , Electrocardiography , Monitoring, Physiologic , Surveys and QuestionnairesABSTRACT
Objective: To study the serum interleukin-37 (IL-37) level changes in patients with acute coronary syndrome (ACS) and to explore the relationship between IL-37 and coronary atherosclerotic plaque. Methods: Our research included 3 groups. ACS group, n=60, SAP (stable angina pectoris) group, n=30 and Control group, the subjects with normal coronary artery, n=15. The peripheral serum levels of IL-37 were examined by ELISA and the differences were compared among different groups. Results: ① The serum levels of IL-37 at admission were as ACS group SAP group>Control group, P77ug/L. Conclusion: The serum IL-37 might be involved in the inlfammatory process in ACS patients, it could be expected as an index for ACS monitor and evaluation in clinical practice.
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Objective To investigate the imaging findings of rare tumors or tumor-like lesions in liver grafts after liver transplantation.Methods Imaging data of 4 patients with rare tumors or tumor-like lesions in the liver grafts of patients after liver transplantation from December 2006 to August 2013 in the Third Affiliated Hospital of Sun Yat-sen University were reviewed.Findings of computerized tomography ( CT ) and ( or ) magnetic resonance imaging ( MRI) plain scan and dynamic enhanced MRI of liver lesions in these patients were analyzed specially.Results In the 4 patients, 3 cases were misdiagnosed , including undifferentiated liver sarcoma , secondary lymphoma and eosinophilic granuloma.One case was diagnosed correctly with hepatic metastases of gallbladder carcinoma.The undifferentiated liver sarcomas appeared as cystic and solid space occupying masses with significant and persistent enhancement in the surrounding solid and separating parts .No enhancement was observed in the cystic parts , which increased rapidly in a short term.No edema area around the lesions was observed , but many calcifications were detected.The secondary hepatic lymphoma appeared as intrahepatic multiple nodules , most of which presented uniform signal intensity with moderate enhancement in every phase.No intrahepatic vascular invasion was observed but extrahepatic lymphadenectasis was detected .Bleeding was observed in a few lesions.The liver eosinophilic granuloma appeared as multiple liver lesions with variable signal intensity and enhancement modes , which suggested that the lesions were consisted of variety of elements and in the different disease stages.Most of the lesions were observed with progressive circled enhancement.The recurrence of gallbladder carcinoma and hepatic metastasis after liver transplantation appeared as a intrahepatic hypodensity lesion with slight enhancement in arterial phase and slight hypodensity in portal phase.Retroperitoneal lymph nodes were observed swelled and fused.Conclusions Rare tumors or tumor-like lesions in liver grafts have distinctive imaging features.Imaging examinations are useful for the early detection of these rare tumors or tumor-like lesions in liver grafts.Imaging findings combining with disease history and clinical manifestations can help to make correct diagnosis.
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Objective Using CT perfusion (CTP) technique,to investigate the graft perfusion changes in patients with hepatic artery stenosis (HAS) with or without ischemic-type biliary lesions (ITBL) after orthotopic liver transplantation (OLT).Methods Thirteen recipients with HAS received CTP scan of the liver,including 8 with ITBL and 5 without ITBL.For all patients,the diagnosis of HAS was made by CTA,and the diagnosis of ITBL by percutaneous transhepatic cholangiography.CT perfusion indices were obtained,including hepatic artery perfusion (HAP),portal vein perfusion (PVP),total liver perfusion (TLP) and hepatic perfusion index (HPI).Results Of the 13 patients with HAS,mean HAP in patients with and without ITBL was 59.8 and 35.1 ml·min-1 ·100 ml-1 (P =0.021,two-tailed paired Student t test) ; mean PVP was 125.4 and 166.2 ml·min-1·100 m1-1 (P =0.016) ; mean TLP was 185.2 and 201.3 ml· min-1 · 100 ml-1 (P =0.306) ; and mean HPI was 33.6 and 18.2 (P =0.005),respectively.Conclusion Using CTP technique,liver perfusion changes were reflected by measuring CTP indices noninvasively.Compared to those without ITBL in this study,HAP and HPI in patients with ITBL were higher and PVP was lower,which may be contributed to biliary inflammation.
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Objective To evaluate the effects of two different dosage of rosuvastatin on endothelial dysfunction in diabetic rats. Methods The 24 diabetic rats were randomly divided into three groups (n=8,each): diabetic control group, 20 mg rosuvastatin daily (RV 20 mg group) and 10mg rosuvastatin daily for 8 weeks (RV 10 mg group) and normal control group (SD group). The levels of blood glucose, lipid, nitric oxide(NO) and endothelin-1 (ET-1) were measured before and 8 weeks after treatment. Results The levels of blood glucose were higher in all diabetic rats groups than in SD group before experiment (P＜0. 01). Compared with diabetic rats control group, blood glucose was slightly lower in RV 10 mg group and RV 20 mg group at 8 weeks (P＞0. 05). The plasma NO level was significantly lower in diabetic rats control group than in SD group (P＜0. 05).After 8 weeks, plasma NO levels were significantly higher in RV 20 mg and RV 10 mg groups than in diabetic rats control group (P＜0. 01 or P＜0. 05). The plasma levels of ET-1 was significantly higher in diabetic rats control group than in SD group (P＜0. 01). After 8 weeks, plasma ET-1 levels were significantly lower in RV 20 mg and RV 10 mg group than in diabetic rats control group (P＜0. 01).Meanwhile, the plasma lipids were lower in RV 20 mg and RV 10 mg group than in diabetic control group (P＜0. 05 or P＜0. 01). Conclusions Rosuvastatin can adjust blood lipids and significantly improve endothelial function in diabetic rats by increasing plasma NO level and decreasing plasma ET-1 level.
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Objective To study the effect of percutanous transluminal balloon mitral valvuloplasty(PBMV) on endothelin and endocrine hormones. Methods Plasma concentrations of endothelin(ET), atrial natriuretic factor(ANF), renin activity(PRA), angiotension Ⅱ(AⅡ) and hemodynamic changes were assessed in 14 patients with rheumatic mitral stenosis before and after PBMV. Results After the procedure, ET(80.40?19.13 pg/ml vs 161.94?50.61 pg/ml, P