Résumé
Objective To study the correlation between organizational commitment of nurses and their intention to drop out. Methods Toally 304 contract nurses were recruited in this investigation. The questionnaires including demographic data, scale of organizational commitment and intention to drop out scale were used. Results The score of intention to drop out was 16.94 ± 2.16. The score on organizational commitment was 71.19 ± 6.65. There was a positive correlation between intention to drop out and organizational commitment among the contract nurses. Conclusions Improving contract nurses′organizational commitment can be an effective mean to reduce contract nurses′intention to drop out. It is an important means to promote the development of the nurse team and provide a reference for the scientific development of nursing.
Résumé
Objective To investigate the effects of muscle relaxant antagonism on patients with residual paralysis in postanesthesia care unit (PACU).Methods The similar patients who were daily accepted into PACU were chosen to make pairs,and were randomly divided into experimental (J; n =26) and control (F; n =26) groups.On arrival to the PACU,the train-of-four ratio (TO-Fr) was assessed using electromyography.When TOFr reached 4,Grour J was given with neostigmine 40 μg/kg and atropine 20 μg/kg; Group F was given with 5ml saline.Extubation was determined with standard clinical criteria.We recorded TOFr,PaO2,PaCO2at the time point of extubation,SpO2 at the time point of left the PACU,the stay time in PACU,the incidence of respiratory dysfunction,and the side effect.Results The TOFr at the time point of extubation in group J (0.96 ± 0.04) was significantly higher than group F (0.92 ±0.06) (P ＜0.05).The stay time in PACU in group J [(26 ±5)min] was significantly less than group F [(33 ±7) min] (P ＜ 0.01).PaO2,PaCO2,extubation time,and SpO2 were no significant difference between two groups (P ＞ 0.05).Two patients in group F had respiratory dysfunction.There was no incidence of postoperative nausea,vomiting,and other side effects in two groups.Conclusions Regular muscle relaxant antagonism lowered the risk of postoperative residual muscle relaxant effect,shortened the PACU residence time,and had no postoperative nausea and vomiting(PONV) and other side effects.
Résumé
Objective To observe the incidence and the rate of embolism in patients undergoing hysteroscopy procedures by using the transesophageal echocardiography (TEE), as well as the changes of respiratoric and haemodynamic variables. Methods Fourty ASA Ⅰ~Ⅱ patients undergoing hysteroscopy procedures under general anesthesia received intraoperative TEE monitoring. The systolic pulmonary artery pressure, the incidence of the venous gas embolism (VGE) and the eegmental wall motion abnormality (SWMAs) were observed. Results In the 40 patients, 38 patients received intravenous anesthesia hysteroscopic surgery, with the intraoperative TEE to monitor the intracardiac VGE. The degree of gas embolism was related with the perfusion and the usage of monopolar or bipolar diathermia (P<0.05). The systolic pulmonary artery pressure promoted and SWMAs were also observed. Conclusions The continue TEE monitor during hysteroscopy could detect the intracardiac gas embolism in time , contributing to early diagnosis and avoiding the occurrence of malignant arrhythmias or myocardial ischemic events.
Résumé
Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.
Résumé
Objective To investigate the effects of oxytocin on hemodynamies in patients under epidural block.Methods Twenty-six selective myomectomy patients were randomly divided into epidural block group(E) and general anesthesia group(G) with 13 cases each.Epidural anesthesia with 2 % lidocaine was performed with the blocking plane of T_6-T_8.Group G was given general anesthesia with propofol,fentanyl,remifentanyl and vecuroniurn.Oxytocin 5 U was injected in 30 s when hysteromyoma was removed and the hemodynamics was stable.MAP and HR were recorded before and after oxytocin injection.Results Compared to those before,MAP was decreased and HR was increased after oxytocin injection in both groups(P<0.05 or P<0.01).The decrease of MAP was slower but lasted for a longer period in group E than those in group G(P<0.05 or P<0.01).Conclusion Epidural blockade may aggravate the hypotensive effect of oxytocin and inhibit oxytocin-induced HR increasise.
Résumé
Three ASA Ⅱ patients, aged 24-32 yr, weighing 56-74 kg, undergoing caesarean section with nitroglycerine for uterine smooth muscle relaxation, from May 2005 to April 2007 in our hospital, were studied. Among the 3 cases, 2 cases (39 or 40 weeks of gestation) were singleton pregnancy and 1 case (34 weeks of gestation) was twin pregnancy.Combined spinal-epidural block with an injection was used in the 3 patients and the block level was at T4-6-S3-5. The excess contraction of uterine occurred in the patient at 40 week gestation about 140 s after uterus incision and it was difficult in delivery of the fetus, trananasal administration was then performed with nitroglycerine 0.5 nag, but it was inefficient after 60 s observation. Nitroglycerine 0.2 nag was injected intravenously, 32 s later the uterine smooth muscle relaxation was good and the fetus was delivered smoothly. In the patients at 39 and 34 week gestation, nitroglycerine 0.2 mg was injected intravenously when the excess contraction of uterine occurred about 140 s after uterus incision and the 2rid fetus started to be. delivered respectively. The uterine smooth muscle relaxation was good 45 or 35 s after injection and the fetuses were delivered smoothly. Apgar score was 6-8 and 10 at 1 and 5 min after delivery in the 3 patients. The duration from hysterotomy to delivery was 195-240 s. Intravenous drip of oxytocin 20 U was given immediately after delivery, and then uterus contracted. No obvious adverse reactions were found.
Résumé
Objective To study the methods and the effects of posterior peritoneoscope surgery in curing the disease of kindy,ureter and adrenal gland.Methods 92 patients with the disease of adrenal gland,kidney and urethra were conducted with the posterior peritoneoscope surgery,using the posterior auxiliary line puncturation and dilatation and posterior peritoneoscope technique.Results 88 cases(95.7%) were succeeded.4 cases(4.3%) which were changed into the operation on abdominal didn't use blood transfusion,1 case(1.1%) complicating with post-peritoneum abscess had satisfactory therapeutic effect.Conclusion Posterior peritoneoscope used in unroofing of cyst of adrenal gland,ectomy of the adrenal pheochromocytoma,nephrectomy,radical correction of renal carcinoma,unroofing of cyst of kidney,ureterolithotomy,pelvilithotomy,pyeloure-teroplasty shows the fortes such as wound is smaller,hemorrhage is less,recovery is faster,complication is also less.It also has reliable therapeutic effect and strong practicability.Posterior auxiliary line puncturation and dilatation has better close tightly,air leakage is also less,it may not damage peritoneum,it doesn't need dissociation adipose in extro-peritoneum,campus visualis is clear and anatomical layer is also distinct.
Résumé
Objective: To investigate the effects of Shen-Mai injection(SM) on perfusion and oxygenation of intestinaltract during repeffusion in shocked rabbits. Methods:Twenty-one rabbits were divided into control group (Ⅰ,n = 6), shock-repeffusion group ( Ⅱ, n = 9) and SM group ( Ⅲ, n = 6). Intestinal intramucosal pH (pHi) of the sigrnoid colon and portalvein blood gas was observed before shock, at 1 hour after shock, 1 hour and 2 hours of reperfusion. Results: pHi and portal vein pH in group Ⅱ were significantly lower than those in group Ⅰ (P < 0.01), but portal vein increased obviously during reperfusion. There was a good linear positive correlation between pHi and portal vein pH. Portal vein in group Ⅱ was greater than that in group Ⅰ and had anegative correlation with pHi. pHi and portal vein pH of group Ⅲ increased signifi- cantly compared with those of goup Ⅱ ( P < 0.05), while of group Ⅲ returned to the level of group Ⅰ . MAP and CO of group m were higher than those of group Ⅱ after 1 hour or 2 hours reperfusion (P<0.05).CO of group m remained at a high level during reperfusion. But SVR of group Ⅲ was lower than that of group Ⅱ during reperfusion. Conclusion: SM im-proves perfusion and oxygenation of intestinal tract during reperfusion.
Résumé
0 05),increased markedly at R 3 in group C (P
Résumé
AIM: To investigate the immune stimulation capacity of B7-H1 blockade on immature dendritic cells (DCs) in vitro. METHODS: The human monocyte-derived dendritic cells were induced in the presence of cytokine GM-CSF and IL-4. The expression of B7-H1 was detected by FCM. On blockade of B7-H1, the maturation and endocytic activity, T cells stimulatory proliferation capacity, IL-12 production, T cell differentiation effect of DCs were detected by FCM, MTT assay, ELISA and ELISPOT, respectively. RESULTS: The expression of B7-H1 was increased with the induction of DCs. On day 7, the positive expression was 54.12%, and the TNF-? induced mature DCs had the positive expression rate of 83.64%. The blockade of B7-H1 on immature DCs had sharply increased their T cells stimulatory proliferation capacity and IL-12 production, and efficiently induced the development of Th1/Tc1 cells, but had no effect on their maturation and endocytic activity. CONCLUSION: The blockade of B7-H1 on immature DCs increases its immune stimulation activity. It is valuable to investigate the antitumor immune responses of DCs vaccine with B7-H1 blockade.