Objective To explore the anti-inflammatory effects of ambroxol hydrochloride in chronic obstructive pulmonary disease（COPD）.Methods Thirty Wistar rats were randomly divided into three groups，ie.a control group，a smoking group and an ambroxol group.The rats in the smoking and ambroxol groups were exposed to cigarettes smoking for 12 weeks.Ambroxol hydrochloride was administered via intragastric gavage after 4 weeks smoking in the ambroxol group.After 12 weeks，the expiratory airway resistance(Re) and dynamic lung compliance(CLdyn) were measured.The expression levels of nuclear factor kappa B（NF-κB）and intercellular adhesion molecule-1(ICAM-1) in airway epithelium cell were observed by immunohistochemical method.Results Re was increased and CLdyn was decreased significantly in the smoking and ambroxol groups compared with the control group(all Plt;0.01).Re was lower (Plt;0.01) and CLdyn was higher(Plt;0.05) in the ambroxol group than those in the smoking group.B.The level of NF-κB and ICAM-1 in smoking and ambroxol groups were obviously increased compared with the control group (all Plt;0.05)，which was decreased in the ambroxol group compared with the smoking group(both Plt;0.05).C.The expression of NF-κB was positively correlated with ICAM-1 expression in airway epithelial cells（r=0.924，Plt;0.01）.Conclusions Smoking can increase the airway resistance，reduce the lung compliance and increase the expression of NF-κB and ICAM-1 in airway epithelium.Ambroxol hydrochloride can relieve those effects of smoking，which suggested an anti-inflammatory therapeutic role in COPD.
目的 探讨老年低位直肠癌经肛门局部切除后加放、化疗的临床意义。方法 对18例年龄≥65岁，肿瘤距肛缘≤6 cm且经病理证实但拒绝Miles术的直肠癌患者行经肛门局部切除； 于术后1个月给予放疗（总剂量50 Gy）； 化疗： 亚叶酸钙200 mg、5-FU 400 mg/m2，第1次于术后第1~5 d，每3~4周重复1次，共3~6次。结果 全部病例无手术死亡，术后均有良好的肛门功能。16例获随访，随访5年，其中3例局部复发，拒绝再次手术，给予放、化疗。死亡12例，其中2例死于远处转移，10例死于其他因素。本组患者1年生存率为77.8%（14/18），5年生存率为38.9%（7/18）。结论 对老年低位直肠癌拒绝Miles术的患者行经肛门局部切除加放、化疗，疗效确切，可提高患者生活质量，延长生存期。
ObjectiveTo study the effect of quality control circle activities on reducing the risk of observed patients. MethodBy carrying out the quality control circle, it was done that confirming the subject, grasping the risk of observed patients, setting a goal, analyzing the risk factors of existing problems, finding out the real reasons, drawing up and actualizing the countermeasures. ResultsAfter carrying out the quality control circle, the main risk factor, emergency rescue, of observed patients was ameliorated significantly (P < 0.05). The risk was declined from 0.41% to 0.14% (P < 0.05). The self-evaluation of circle members was improved (P < 0.001). ConclusionBy the quality control circle, it is actualized effectively that reducing the risk of observed patients and improving the overall qualities of nurses. This thing is helpful to improve the quality of nursing.
Objective To develop an evaluation tool for the screening of high risk population for oral complications in critically ill patients, which can be performed accurately and scientifically. Methods Basing on the related foreign oral assessment scale, combined with the method of brainstorming, expert consultation, method of clinical status and so on, the item pool of the assessment scale was determined. Five nursing experts and two oral experts assessed the content validity and 50 ICU nurses were tested. Then, the screening accuracy of the assessment scale was proved by application in 100 critically ill patients selected randomly. Results The Cronbach’s a coefficient of final version of the High Risk Assessment Scale for Oral Complications in Critically Ill Patients (including seven parts contents of oral health assessment and oral pH value test) was 0.815, the content validity index (Sr-CVI/Ave) was 0.932. The results of 50 nurses to the 91.2% assessment items of the assessment scale were very important and important. For screening related indicators of oral complications in high-risk patients, the sensitivity of the assessment scale was 97.53%, the specificity was 94.11%, the positive predictive value was 98.75%, the negative predictive value was 88.89%, and the crude agreement was 95%. Conclusion There are good reliability, validity and a high accuracy of screening test in the High Risk Assessment Scale for Oral Complications in Critically Ill Patients. It can be used for screening patients at high risk for oral complications in critically ill patients, and help clinical nurses to complete the oral health status of the critically ill patients quickly.