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Effects of recombinant human erythropoietin on the expression of glutamine synthetase of cultured retinal Müller cells under high glucose condition

Objective To investigate the effect of recombinant human erythropoietin (rhEPO) on the expression of glutamine synthetase (GS) of cultured rat retinal Müller cells in high glucose environment in vitro. Methods Müller cells were isolated from retinas of 10 Sprague-Dawley rats at postnatal day three to five by trypsin digestion, and were randomly divided into six groups, including normal control group, high glucose group, high glucose +5 U/ml rhEPO group, high glucose+10 U/ml rhEPO group, high glucose +20 U/ml rhEPO group, high glucose+40 U/ml rhEPO groups. After 48 hours, the apoptosis of retinal Müller cells were assayed by terminal transferase-mediated DNA end labelling assay, and the expression levels of GS protein were detected with semi-quantitative immunocytochemistry. Results Compared with the normal control group, the cell viability and GS protein were reduced while the cell death increased in Müller cells cultured in high glucose, the difference was statistically significant (t=27.4,P＜0.01). Compared with the high glucose group, rhEPO treatment reduced the apoptotic Müller cells (t=857.2, 2 374.6, 2 473.2, 2 537.7;P＜0.01), induced the expression of GS proteins (t=3.2, 18.0, 22.5, 26.4; P＜0.05). Conclusions rhEPO can protect Müller cells from apoptosis under high glucose condition. The mechanism may be related to its function to up-regulate the GS protein expression, promote glutamic acid cycle, and reduce the excitotoxicity effects of high concentration of glutamate.

Research progress on the correlation between benzodiazepines and postoperative delirium

Postoperative delirium is one of the most common postoperative complications in elderly patients, affecting the outcome of approximately half of surgical patients. The pathogenesis of postoperative delirium is still unclear, but multivariate models of the etiology of postoperative delirium are well-validated and widely accepted, and 40% of postoperative delirium can be effectively prevented by targeting predisposing factors. Benzodiazepines have long been considered as predisposing factors for postoperative delirium. Although benzodiazepines are widely used in clinical practice, most relevant guidelines recommend avoiding the use of benzodiazepines in the perioperative period to reduce the incidence of postoperative delirium. Controversy exists regarding the association of benzodiazepine use with postoperative delirium. This article discusses the results of studies on perioperative benzodiazepines and postoperative delirium.

他克莫司治疗狼疮性肾炎过量致多种并发症一例

PROGRESS OF HIP RESURFACING ARTHROPLASTY

【Abstract】 Objective To review the recent progress of hi p resurfacing arthroplasty. Methods Literatureconcerning hip resurfacing arthroplasty and current achievements was extensively and comprehensively reviewed. Results The new metal-on-metal hip resurfacing arthroplasty made much progress especially in materials and technology, and the results were satisfactory for short-term follow-up. This was increasingly widely used especially in treating young patients. But there were still some problems such as elevation of metal ions which had already aroused publ ic attention. Conclusion The new metal-onmetal hip resurfacing arthroplasty is an efficient method in the treatment of adult hip joint disease and has an encouraging future, but long-term follow-up is still needed.

Clinical Observation of Propofol Combined with Dezocine and Laryngeal Mask Airway for Fiberoptic Bronchoscopy

目的　评价地佐辛配伍丙泊酚联合喉罩用于无痛纤维支气管镜检查的效果。 方法　将2012年10月－12月拟行纤维支气管镜检查，且按美国麻醉医师协会分级Ⅰ或Ⅱ级的60例患者，随机分为芬太尼组（F组）、地佐辛组（D组）、生理盐水组（N组）,每组20例。采用双盲法给药，静脉注射芬太尼（10 μg/mL）或地佐辛（1 mg/mL）或生理盐水0.1 mL/kg，5 min后3组缓慢静脉注射丙泊酚2 mg/kg诱导后置入喉罩，术中保留自主呼吸，持续泵入丙泊酚4～6 mg/（kg·h）维持麻醉，观察3组患者诱导前（T0）、诱导后时（T1）、纤维支气管镜操作时（T2）、术毕时（T3）及拔除喉罩时（T4）的生命体征，记录丙泊酚总用量、苏醒时间、苏醒时的呼吸道疼痛视觉模拟评分（VAS），记录术中及术后有关并发症的发生情况。 结果　与N组相比，D、F两组丙泊酚总用量减少、苏醒时间缩短，头昏及术中体动发生率、VAS评分明显降低（P＜0.05）；呼吸暂停的发生率D组最低（P＜0.05）；恶心、呕吐的发生率F组最高（P＜0.05）。 结论　地佐辛配伍丙泊酚联合喉罩用于无痛纤维支气管镜检查，麻醉效果满意，术后镇痛效果好，值得临床推广。

麻醉苏醒室患者低氧血症的护理

【摘要】　目的　分析麻醉苏醒室（postanesthesia care unit，PACU）患者发生低氧血症的原因，及纠正处置方法。　方法　对2010年2-10月全身麻醉手术后入PACU的12 485例患者资料进行回顾性分析，了解低氧血症的发生率及处理前后脉搏血氧饱和度（pulse oximetry，SpO2）、呼吸、心率和Ramsay评分的比较。　结果　本研究显示低氧血症的发生率0.94%，处理前后SpO2、心率和Ramsay评分差异有统计学意义。所有入PACU全身麻醉患者中无死亡。　结论　对入PACU的术后全身麻醉患者进行评估及严密观察，及时分析处理低氧血症，减少并发症的发生，保证患者在PACU期间的安全与恢复。

A Survey of Professional Self-concept of Standardized Training Nurses

目的　调查规范化培训护士的职业自我概念现状，以期为其培训方案提供参考依据。 方法　2010年10月－11月采用护理专业自我概念量表对某三甲综合医院2009级、2010级175名规范化培训护士进行面对面问卷调查。 结果　88.37%规范化培训护士职业自我概念积极，5个维度得分从高到低分别是沟通交流、技能、灵活性、领导、满意度。2010级规范化培训护士职业自我概念总得分（t=?2.027，P=0.044）及领导维度得分（t=?3.258，P=0.001）高于2009级者，而技能（t=2.120，P=0.036）、灵活性（t=2.054，P=0.042）维度得分低于2009级；有职业兴趣的规范化培训护士其领导维度得分高于无职业兴趣的规范化培训护士（t=2.063，P=0.043）。 结论　护士规范化培训中除注重技能培训外还应加入情感教育课程，建立领导能力评价体系等。

系统性红斑狼疮伴肾炎、膀胱炎和肠炎一例

Influence of Radiofrequency Ablation on Hepatic Function and Nursing Measures

摘要:目的： 探讨肝癌患者行射频消融术围手术期的肝功能变化情况,以及相应的护理措施。方法:对2006～2009年6月在我院接受射频消融术治疗的91例肝癌患者,监测其围手术期的肝功能指标,如丙氨酸氨基转移酶及总胆红素等变化情况,分析射频消融术对肝功能的影响,总结相应的护理措施。 结果:全组无死亡病例。射频消融术后早期丙氨酸氨基转移酶及总胆红素与术前有显著差异（P＜005）。结论: 肝癌患者行射频消融术后早期肝功能减退,应加强护理措施,促进患者恢复。 Abstract: Objective: To explore the influence of radiofrequency ablation (RFA) on hepatic function of patients suffering hepatocelluler carcinoma and to summarize corresponding nursing measures.Methods: Ninetyone patients suffering hepatocelluler carcinoma received RFA were studied with their hepatic function preoperation and postoperation. Alanine aminotransferase (ALT) and total bilirubin (TB) were selected as the liver functional parameters,and perioperative changes of the two parameters were measured. Influence of RFA on hepatic function was analyzed and corresponding nursing measures were summarized. Results: Significant changes of ALT and TB were observed early after RFA,and there were statistical difference between preoperation and postoperation (P＜005). Conclusion: Proper nursing measures should be applied to improve hypohepatia and promote recovery of patients.

医院环境清洁荧光检测的量化评估研究

目的采用荧光标记法对医院环境卫生清洁效果进行科学评价。 方法2015年1月-2月选择中国石油天然气集团公司中心医院、中国医学科学院血液病医院的内科、呼吸科、普外科、重症医学科等病区的250间病房对病床、卫生间和医疗器械的5 487个清洁接触面作荧光标记定向环境清洁评价，并对保洁员进行培训和现场指导，比较干预前后的清除率。 结果基线调查88 间病房，2 175个接触清洁面的清除率仅为36.28%，经过干预培训教育后，干预后3 115个接触清洁面清除率为64.40%，干预前后清除率差异有统计学意义（χ2=417.198，P＜0.001）。基线调查医疗器械、病床和卫生间接触清洁面的清除率分别为42.02%、40.23%、15.90%，干预后上升为73.17%、68.99%、42.59%，差异均有统计学意义（P＜0.001）。 结论荧光标记法既能直观反映保洁员操作的质量，又能为改善病房环境清洁水平提供可靠的依据。