Construction and application of the module of medical first-aid at the door of the space capsule and the air evacuation after the manned spaceflight lands / 中华急诊医学杂志

Objective:To explore the module of the construction and application of medical first-aid at the door of the space capsule and the air evacuation.Methods:According to the purpose, principle, and method set by the module, it was divided into two sub-modules: medical first-aid at the door of the space capsule and the air evacuation. During the comprehensive first-aid training, independent training and combined training were carried out respectively according to different mission stages of launch and recovery and different recovery terrain. Meanwhile, research was performed to ensure that medical carrying equipment was lightweight, modular, and portable, and the efficiency of modularization construction was tested in the comprehensive training.Results:The module of medical first-aid at the door of the space capsule and the air evacuation obviously shortened the rescuing time during the comprehensive training, the saving effect was remarkable, and the overall saving efficiency was significantly improved.Conclusions:The module of medical first-aid at the door of the space capsule and the air evacuation meet the requirements that the emergency support system of aerospace medicine should function on an immediate basis, ensuring accurate treatment and air evacuation without any delay, so that to achieve the aim of aerospace medicare.

Application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight / 中华急诊医学杂志

Objective:To study the application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight.Methods:Twenty nurses from the medical rescue team of Strategic Support Force Characteristic Medical Center were selected as the research objects. The research objects were randomly divided into the scenario simulation combined with practical training group (practical training group, n=10) and traditional teaching group (control group, n=10). Scenario simulation teaching combined with modular training and traditional teaching were used to carry out nursing training. After the training, theoretical assessment, operation assessment and satisfaction survey were organized. Results:The scenario simulation teaching combined with modular training group was significantly better than the traditional training group in theory assessment, operation assessment and satisfaction survey of nursing staff (all P<0.05). Conclusions:Scenario simulation teaching combined with modular training has obvious teaching effect, which can improve the ability and quality of nursing staff, and help to complete the manned space medical rescue mission efficiently.

Comparison of efficacies of levosimendan and recombinant human brain natriuretic peptide in patients with acute decompensated heart failure / 天津医药

Objective To compare the effects of levosimendan (Levo) and recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF). Methods Seventy-five patients were included into this randomized positive-controlled and parallel-group study to receive either Levo (Levo group), rhBNP (rhBNP group) or dobutamine therapy (control group). Heart rate, respiratory rate, 24-hour urine volume,improvement in six-minute walk-test after 72-h treatment were compared between three groups. The blood level of BNP and values of left ventricular end dia?stolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) after one-week treatment were compared between three groups. Results After 72-h treatment, heart rate and respiratory rate were significantly decreased, and 24-hour urine volume, six-minute walk-test were significantly increased in three groups (P0.05), but the LVEDD was improved barely (P>0.05). The improvements were more significant in Levo group and rhBNP group compared to those of control group (P<0.05). There were no significant differenc?es in improvements between Levo group and rhBNP group. The common adverse reactions were hypotension and ventricular premature beats. There were no significant differences in adverse event rates between three groups (P<0.05). Conclusion As compared with dobutamine, Levo and rhBNP have optimized efficacy, fewer side effects and good safety in the treatment of ADHF. They are worth of clinical application.

Relationship Between the Ratio of Neutrophil/Lymphocyte and In-hospital Major Adverse Cardiac Events in Patients With Acute ST-elevation Myocardial Infarction at the Early Admission / 中国循环杂志

Objective: To explore the relationship between the ratio of neutrophil/lymphocyte (NLR) and in-hospital major adverse cardiac events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) at early admission. Methods: A total of 420 acute STEMI patients admitted and received primary PCI in our hospital from 2010-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups:In-hospital MACE group, n=47 and Normal discharged group, n=373. Uni-and multivariate analyses were conducted to assess whether high NLR is the independent predictor for in-hospital MACE occurrence. Results: Univariate regression analysis indicated that the occurrence rate of in-hospital MACE in high NLR patients were higher than those in low NLR patients (OR=3.19, 95%CI 1.55-2.65, P=0.012). Multivariate regression analysis showed that high NLR was the independent risk factor for in-hospital MACE occurrence in STEMI patients (OR=3.05, 95%CI 1.59-10.54, P=0.015). Conclusion: High NLR is the independent risk factor for in-hospital MACE occurrence in STEMI patients at the early admission.

Risk Factor Analysis for Contrast-induced Nephropathy in Patients of Acute Coronary Syndrome With Normal or Slightly Impaired Renal Function After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI). Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min?1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients. Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence. Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.

The risk factors of paroxysmal atrial fibrillation in very olderly hypertensive patients / 天津医药

Objective To analyze the risk factors of paroxysmal atrial fibrillation (PAF) in very olderly hypertensive patients. Methods According to the electrocardiograph (ECG) and history data, two hundred and six older old-hypertensive patients were divided into PAF group (n=66) and sinus rhythm (SR) group (n=140). Data of age, gender, body mass index (BMI), the use of angiotension-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) and statin drug history, 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography, pulse wave velocity (PWV), blood lipid profile and renal function were recorded in two groups. Logistic regression analyses of the relevant factors were compared between groups. Results Data of age, the diameter of the left atrium (LAD), the 1eft ventricular mass index (LVMI) and the PWV were significantly higher in PAF group than those of SR group [(88.92±3.42) years old vs. (86.36±4.67) years old, (39.00±6.66) mm vs. (33.54±7.77) mm, (132.49±14.83) g vs. (119.00±11.35) g, (13.45±4.85) m/s vs. (9.89±2.74) m/s, respectively]. Values of three acyl glycerin (TG), blood pressure smoothing index (SI) were lower in PAF group than those of SR group [(1.33±0.91) mmol/L vs. (1.95±1.29) mmol/L, 0.75±0.06 vs. 0.79±0.04, respectively]. Results of two classification Logistic regression analyses showed that the reduced SI, the enlarged LAD and LVMI and the increased PWV were the risk factors of PAF in very olderly hypertensive patients. Conclusion Unstable blood pressure, left atrial enlargement, left ventricular hypertrophy and arterial stiffness are the risk factors of PAF in very olderly hypertensive patients.

Application research of radial artery angiography in advance on transradial coronary intervention / 中国医师进修杂志

Objective To study the feasibility and necessity of radial artery angiolgraphy in advance on transradial coronary intervention.Methods A total of 682 patients undergoing transradial coronary intervention were divided into two groups by random digits table method.Previous radial artery angiography (pre-RAA) group of 341 cases underwent radial artery angiography;post radial artery angiography (post-RAA) group of 341 cases in the guide wire,catheter in resistance immediately for radial artery angiography.The radial artery imaging characteristics were observed and the radial artery related complications were recorded in two groups.Results The ratio of radial artery spasm in post-RAA group was higher than that in pre-RAA group [11.4％(39/341) vs.6.2％(21/341),P=0.015].The ratio of operation failed in post-RAA group was higher than that in pre-RAA group [3.2％ (11/341) vs.0.6％ (2/341),P =0.014].The radial artery perforation rate and postoperative 1-6 months of radial artery occlusion rate increased significantly in post-RAA group,and there was significant difference between two groups (P ＜ 0.05).Conclusion Transradial coronary intervention in advance for radial artery angiography therapy can effectively observe the radial artery morphology,reduce the radial artery related complications.

Pharmacological intervention of conditioned fear and its extinction / 中南大学学报(医学版)

Conditioned fear and its abnormal extinction are involved in the psychopathology of anxiety disorders, such as posttraumatic stress disorder (PTSD). Cognitive enhancing agents have been demonstrated to alter fear extinction in many animal research literatures. The present review has examined the pharmacological role of gamma-aminobutyric acid (GABA), glutamatergic, cholinergic, adrenergic, dopaminergic, and cannabinoid as well as compounds able to alter the epigenetic and neurotrophic mechanism in fear extinction, highlighting great hope for the future treatment of anxiety disorders with new agents based on the fear extinction.

Drug Resistant Rate and Spectrum of Common Gram-negative Bacilli Isolated from Respiratory Tract of Patients:A Comparison Between ICU Ward and Non-ICU Ward / 中华医院感染学杂志

OBJECTIVE To learn the epidemiology of respiratory infection in ICU and non-ICU wards,and analyze the difference of drug resistance of Gram-negative bacilli between those two wards in order to provide the basis of empirical therapy for the respiratory infection from the different wards.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted by K-B method.Data were analyzed by WHONET 5.3 software.RESULTS Totally 2184 strains of Gram-negative bacilli were isolated all from the respiratory tract,among which 655 strains were isolated from ICU ward and 1529 strains were from non-ICU ward.In ICU ward,the first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Chryseobacterium meningosepticum,and Stenotrophomonas maltophilia.It showed that non-fermentatives were the main pathogenic bacteria in ICU.In non-ICU ward,the first five bacteria were P.aeruginosa,Klebsiella pneumoniae,A.baumannii,B.cepacia,and S.maltophilia.Drug resistant rate of strain from ICU ward was generally higher than that from non-ICU ward,while levofloxacin in ICU ward showed the better activity than in non-ICU ward.CONCLUSIONS The respiratory infection is one of the hazards in nosocomial infection,drug resistant rate of Gram-negative bacilli from respiratory specimen in ICU is generally higher than that in non-ICU,and the main strains are the mlti-resistant non-fermentatives,which should attract the clinician′s more attention.