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Objective:To analyze the gaps between the allocation of nursing human resources and the workload of emergency department and intensive care unit in Zhongshan Hospital, Fudan University in Shanghai in the past five years, so as to provide basis for the formulation of optimal countermeasures for the allocation of nursing human resources.Methods:Based on the data from January 2016 to December 2020, a retrospective study was used to analyze the trend and correlation between the allocation of nursing human resources (educational background, professional title and years of work experience) and the workload of emergency department and intensive care unit(emergency rescue, 120 vehicle pick-up, triage of level-1 patient, extracorporeal membrane oxygenation, central venous catheter intubation, organ transplantation, blood purification and endotracheal intubation). So as to explore the change trend of human resources and the workload of emergency department and intensive care unit in the past five years.Results:By the end of 2020, the proportion of the nurses with bachelor′s or master′s degree had reached 61.44% and the proportion of nurses with professional titles of nurse in charge and above reached 73.85% in emergency department. The structure of working years was relatively stable, and there was no obvious change trend. At the same time, the proportion of the nurses with bachelor′s or master′s degree has reached 57.62% and the proportion of nurses with professional titles of nurse in charge and above reached 63.42% in intensive care unit. The number of nurses who had worked for more than 5 years had shown an upward trend. However, the proportion of nurses with master′s degree or above was still small both in emergency department and intensive care unit. The workload of acute and critical care for nurses was increasing year by year. The average annual growth rates of nursing workload for triage of level-1 patient, blood purification, organ transplantation, central venous catheter intubation and extracorporeal membrane oxygenation were 8.94%, 9.06%, 11.07%, 18.50% and 28.32% respectively.Conclusions:The allocation of nursing human resources for emergency department and intensive care unit in Zhongshan hospital is changing towards personnel quality improvement and structure optimization, but there is still a shortage of high-level nursing personnel. And the workload of nurses in relevant departments is increasing year by year. Hospitals should actively explore the innovative way for the reform of the allocation of nursing human resource to ensure the balanced development of "quantity" and "quality" of nursing human resources for emergency department and intensive care unit.
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OBJECTIVE To evaluate the clinical value of contrast-enhanced ultrasonography (CEUS) in diagnosing thyroid carcinoma.METHODS The clinical data of 129 patients with thyroid nodules,who were examined by CEUS and were operated in Xinhua Hospital between Jan 2014 and Aug 2015,were analyzed in order to compare the diagnostic results of CEUS to the postoperative pathologic findings,and to summarize its imaging features.RESULTS A total of 132 thyroid nodules in 129 patients were examined by CEUS.Among them,103 nodules were diagnosed as thyroid carcinoma,24 nodules were benign thyroid tumor and 5 nodules were thyroiditis.Compared with pathology results,the diagnostic accuracy,sensitivity and specificity of contrast-enhanced ultrasound is 88.6％,92.2％ and of 75.9％ respectively.The diagnosis of the CEUS in 31 cases was not consistent with the pathological results,in which 8 cases of thyroid carcinoma were misdiagnosed as benign tumor,3 cases of thyroiditis were misdiagnosed as thyroid carcinoma,and 20 cases of benign tumors were misdiagnosed as thyroid carcinoma.The malignant thyroid nodules mainly were papillary carcinoma,which was characterized by'low enhanced'and'slow in fast out'performance in the contrast-enhanced ultrasound examination.CONCLUSION The contrast-enhanced ultrasound examination in diagnosing thyroid carcinoma has much more specificity and sensitivity,the'low-enhanced'and'slow in fast out'signs of the CEUS were the important features of malignant thyroid nodules.
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BACKGROUND: Lidocaine is deemed to can attenuate the inflammatory response, but the mechanisms are poorly understood. Nuclear factor-κB (NF-κB) is a key process of imflammatory response. OBJECTIVE: To determine the effect of lidocaine on activation and apoptosis of NF-κB in human neutrophiis in vitro. DESIGN, TIME AND SETTING: The controlled experiment was conducted at the Jiangsu Provincial Key Laboratory of Anesthesiology from October 2006 to February 2007. MATERIALS: Tumor necrosis factor (TNF)-α (0127:B8) was purchased from Sigma, USA. Peripheral blood samples were obtained from healthy donors after their informed consent. METHODS: Human neutrephilic granulocytes were assigned into five groups: ① saline control, ② TNF-α, ③ TNF-α+ lidocaine 1.0 mmol/L, ④ TNF-α+ lidocaine 2.0 mmol/L, and ⑤ TNF-α+ lidocaine 4.0 mmol/L groups. Incubation wasperformed for 3 hours.MAIN OUTCOME MEASURES: The effects of lidocaine on expression of NF- κB mRNA and I- κB mRNA in the cytosol extracts were analyzed by reverse transcription-polymerase chain reaction (RT-PCR), and content of p65 protein were analyzed by Western blot. Neutrophilic granulocyte apoptosis was detected on flow cytomatry after incubation 12 hours and 24 hours.RESULTS: The expression of NF- κB mRNA in the nuclear extracts was significantly decreased and I- κB mRNA in the cytosoI extracts was markedly increased in the lidocaine group. The expression of NF- κB was significantly better in the 2.0 mmol/L and 4.0 mmol/L lidocaine groups than in the 1.0 mmol/L lidocaine group (P< 0.05). No significant difference was detected between the 2.0 mmol/L lidocaine group and the 4.0 mmol/L lidocaine group (P0.05). Lidocaine could significantly inhibit peripheral blood neutrophilic granulocyte apoptosis induced by TNF-α (p < 0.05). The inhibitory effect was significantly better in the 4.0 mmol/L lidocaine group than in the 1.0 mmol/L lidocaine group (P < 0.05). CONCLUSION: Lidocaine (1.0, 2.0 and 4.0 mmol/L) can down-regulate the expressions of NF- κB subunit p65 mRNA and the content of p65 protein in human polymorphoneclear neutrophils, and can significant reverse the reduction of apoptosis induced by TNF-α.