Through the questionnaire survey to three secondary-level health care workers and hospital patients in Northwest of Hubei we find that the doctor-patient relationship at the primary hospitals are,as is shown in the data,more harmonious than that in the bigger city hospitals. Analysis reveals that the geographical location,medical psychology,and the improvement in medical technology and rapid development of hospitals are the main reasons for this phenomenon.

OBJECTIVE: Exploring the clinical features of aviatic nasal diseases to provide references for medical evaluation, prevention and control measures in aircrew. METHOD: To analysis and summary 605 cases with 503 pilots of nasal diseases in aircrew during 1966 to 2013. RESULT: (1) There were 605 cases of aviatic nasal diseases, including 550 cases of general diseases and 55 cases of specific diseases. The general nasal diseases included 140 cases of anatomical abnormalities in nasal cavity type, 290 cases of inflammation in nasal cavity, 73 cases of allergy type, 47 cases of cyst and tumor type, and the specific nasal diseases were 55 cases of sinus barotrauma (SB). (2) The, constituent ratio of SB, which was happened in frontal sinus and /or maxillary sinus, was 95.55%. (3) The constituent ratio of cyst and tumor type in nasal cavity was easier causing to SB than anatomical abnormalities, inflammation, allergy disease in nasal cavity (P < 0.05). (4) The grounded constituent ratio of secondary SB was higher than anatomical abnormalities, inflammation, allergy, cyst and tumor disease in nasal cavity (P < 0.05). (5) The ways of hypobaric chamber tests were different for the kinds of aircrew. The qualified adjustment function of sinuses for barometric pressure was an essential condition for aircrew to continue flying. (6) The key point for the treatment of aviatic nasal diseases was to remove pathological change in nasal cavity and sinus and restore sinus ostium patency. The key point for the medical evaluation was to restore normal sinus pressure balance function. CONCLUSION The key point of medical evaluation about aviatic nasal diseases is to assess the sinus pressure balance function in hypobaric chamber tests. Normative treatment and medical evaluation can effectively avoid flight accidents and improve the attendance rate for aircrew.
Aerospace Medicine ; Barotrauma ; Cysts ; Frontal Sinus ; pathology ; Humans ; Hypersensitivity ; Maxillary Sinus ; pathology ; Nasal Cavity ; pathology ; Nose Diseases ; epidemiology ; prevention & control ; Paranasal Sinuses ; pathology

OBJECTIVE: To explore the expression and significance of vasoactive intestinal peptide and Pituitary adenylate cyclase activiting polypeptide (VIP/PACAP) of nasal mucosa in rats with allergic rhinitis (AR), and the function of botulinum toxin-A(BTX-A) to inhibit the expression of VIP/PACAP in AR. METHOD: Thirty Sprague-Dawley rats were randomly divided into 3 groups, which were the AR group, the intervention group, and the control group. In the AR group, ovalbumin was used to sensitize healthy rats. In the intervention group, BTX-A was dripped into the nasal cavity of AR rats 7 times. In the control group, only physiological saline was used to drip into the nasal cavity of AR rats. Changes of the rats' behavior were observed. ELISA were used to detected the concentration variation of serum IFN-γ and IL-4. Histopathology and immunohistochemistry were employed to observe morphology in the rats' nasal mucosal and the expression of VIP/PACAP. Statistical analysis was also made. RESULT: (1)The typical symptoms marks of nasal scratching, sneezing, nasal blockage and rhinorrhea of AR group (7.5 ± 0.50) were higher than intervention group (1 ± 0.27) and control group (0.8 ± 0.31). (2) Comparing to intervention group and control group, the serm IFN-γ of the AR group obvious reduced (P < 0.05), the serm IL-4 of the AR group obvious rose (P < 0.01), and the serm Th1/Th2 (IFN-γ/IL-4) of the AR group obvious reduced (P < 0.01). (3) Comparing to intervention group and control group, the cilium loss, inflammatory cells infiltration, and inflammatory cells exudation of nasal mucosa in AR group were more obviously (P < 0.01), and the intervention group of the 3 indexes was obviously than control group. (4) The expression of VIP in the rats' nasal mucosa of the AR group (13.27 ± 2.74) were more intense than intervention group (5.21 ± 2.18) and control group (3.56 ± 5.30) (P < 0.01), and the expression of PACAP in the rats' nasal mucosa of the AR group (20.97 ± 2.14) were more intense than intervention group (6.33 ± 3.04) and control group (4.63 ± 1.25) (P < 0.01). (5) In all the 3 groups, there was positive correlation between expression of negative in VIP/PACAP and Thl/Th2 cell infiltration(r were respectively -0.340 and -0.223, P < 0.05). CONCLUSION The VIP/PACAP in the rats' nasal mucosa may play an important role in pathogenesis of AR, and BTX-A could improve the symptoms of AR through inhibition of the expression of VIP/ PACAP.
Animals ; Botulinum Toxins, Type A ; pharmacology ; Disease Models, Animal ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Nasal Mucosa ; drug effects ; metabolism ; Ovalbumin ; Paranasal Sinuses ; Pituitary Adenylate Cyclase-Activating Polypeptide ; antagonists & inhibitors ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; drug therapy ; Vasoactive Intestinal Peptide ; antagonists & inhibitors ; metabolism

OBJECTIVE: To research the serum levels of BDNF, H2S and S-100β as metabolic product of hippocampus and cerebral cortex in moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients before and after surgery, and to analyze their correlations with cognitive impairment. METHOD: Forty-four randomly selected diagnosed OSAHS patients were divided into two groups according to Montreal Cognitive Assessment (MoCA), 19 cases in cognitively normal group and 25 cases in cognitive dysfunction group. Cases in cognitive dysfunction group underwent UPPP oriented surgery, and received 6 months follow-up, 21 cases were remained as treament group, 4 cases lost. 19 cases of healthy subjects were randomly selected as the normal control group. All groups were detected for the serum BDNF, H2S and S-100β levels to analyze the correlations between the biochemical indexes and sleep disorders indexes, hypoxia levels and cognitive function scores. RESULT: (1) In the comparison between the treatment group and the normal control group regarding PSG monitoring results, the AHI, I + II, LA/HT and SLT90% indexes of OSAHS patients increased, and the III + IV phase, REM phase, MSaO2 and LSaO2 decreased. In the comparison between the cognitive dysfunction group and the cognitively normal group, the III + IV, REM and LSaO2 indexes of the cognitive dysfunction group decreased. (2) In the comparison between cognitive dysfunction group and cognitively normal group, and between the treatment group and the normal control group, BDNF and H2S levels increased and S-100β levels decreased, and the MoCA total scores, attention, memory/delayed recall scores decreased. (3) The correlation between biochemical indexes with PSG indexes was as follows. The serum BNDF and H2S levels were negatively correlated with AHI index. The serum BNDF and H2S levels were positively correlated with III + IV stage, REM stage and MSaO2 indexes. The S-100β level was positively correlated with AHI index, and S-100β levels were negatively correlated with III + IV stage, REM stage, MSaO2 and LSaO2 indexes. (4) The correlation between biochemical indexes and MoCA scores was as follows. The serum BNDF and H2S levels were positively correlated with MoCA total scores, attention, and memory/delayed recall scores. The serum S-100β levels were negatively correlated with MoCA total scores, attention and memory/ delayed recall scores. (5) The linear regression equation between MoCA total scores in cognitive dysfunction group of OSAHS patients and the serum BNDF, H2S and S-100β levels was as follows: Y(MoCA) = 40.131 + 0.22 X(BDNF) + 0.012 X(H2S)-0.647X(S-100β) (R2 = 0.461). CONCLUSION OSAHS patients with sleep disorder and nocturnal hypoxemia might suffer from cognitive dysfunction in which attention and memory predominates. Serum BNDF, H2S and S-100β levels, which could indirectly reflect the metabolic abnormalities degree of hippocampus and cerebral cortex, are sensitive indicators of early cognitive dysfunction in OSAHS patients.
Brain-Derived Neurotrophic Factor ; metabolism ; Cerebral Cortex ; physiopathology ; Cognition Disorders ; complications ; Hippocampus ; physiopathology ; Humans ; Hypoxia ; Memory ; Metabolic Diseases ; physiopathology ; S100 Calcium Binding Protein beta Subunit ; metabolism ; Sleep Apnea, Obstructive ; complications

Objective To understand the command and usage of knowledge of pressure ulcer prevention in nursing students of Vocational Colleges, and to strengthen and update the knowledge of pressure ulcer prevention by the pressure ulcer prevention training in the second classroom. Methods A total of 33 nursing students of 2011 in Vocational Colleges from Capital Medical University were recruited twice from Department of Thoracic Surgery, General Surgery Department and Orthopedics Department from 2013 to 2014 by convenience sampling method. Pressure ulcer prevention training was conducted by the second classroom. Grasping and changing knowledge of pressure ulcer prevention were investigated and analyzed by questionnaire survey methods before and after training. Results The score of self testing questionnaire in pressure ulcer prevention was (70. 13 ± 4. 95) before the second classroom and (78. 34 ± 6. 04) after the second classroom with the statistically significant difference (t= -6. 03,P<0. 001). There were 33 nursing students who could accurately identify ulcer stage after the second classroom which was more than that before the second classroom (χ2 =4. 58,P<0. 05). Conclusions Pressure ulcer prevention training in the second classroom during internship can strengthen the command of knowledge on pressure ulcer prevention among nursing students in Vocational Colleges.

Objective? To calculate the manpower of nurses in the clinical positions in Interventional Operating Room in a Class Ⅲ Grade A hospital, and to provide reference for appropriate allocation of human resources of nurses in Interventional Operating Room. Methods? From January to December 2017, "Hospital Nurse Management Regulations" and "Interventional Operating Room Nurse Job Description" in Class Ⅲ Grade A hospital in Beijing were interpreted, and combined with on-site investigation and expert meeting, the list of nursing work items and the working hours record table for nurses in clinical positions in Interventional Operating Room were designed; the observation method and the hospital information system extraction method were used to measure the total working hours of the Interventional Operating Room nursing project, and the number of nurses required in the Operating Room was calculated. Results? Totally 9 nurses for clinical positions were required for the Interventional Operating Room, including 8 angiographic nurses and 1 assistant nurse. Conclusions? A total of 9 clinical nurses were needed in 4 operating units of the Interventional Operating Room. The ratio of operating units number to nurses number was close to 1:2.5.

This paper aimed to summarize critical elements in smooth switch between conventional surgery and interventional surgery through nursing cooperation of complex spinal vascular malformation compound surgery.①Before operation,nurses should be familiar with the whole surgical procedure,and anticipate special items which might be used during surgery according to location and size of malformation;②Nurses should understand all medical test results which were important basis for intraoperative medication;③Nurses should complete assessment of physical function for postoperative comparison;④Layout of all medical instruments in operating room should be reasonable,and repeated moving should be avoided.⑤Patient position should satisfy requirements of the surgery as well as functional position simultaneously;⑥Measures to prevent pressure injuries should be taken according to patient's intraoperative position;⑦Thrombogenesis should be prevented via connection of vessel sheath and catheter to the pressure infusion apparatus;⑧Internal length and external length of the vessel sheath should be determined according to patient's body shape and lesion location.

With the changing pattern of disease burden in China and the deepening and acceleration of aging society, healthy aging has become a national strategy. As one of the important roles of the care system, under the opportunity of the action framework for healthy aging, nursing discipline in China has made active exploration in key areas and has achieved research and practice results with Chinese characteristics, including ageism, intrinsic capacity, community development and long-term care system construction. Nursing has demonstrated disciplinary reserves and value in the development of the elderly care industry and the construction of the elderly care service system.

Objective:To explore the current status of intrinsic capacity in elderly patients with hospitalization-associated disability (HAD) and explore its influencing factors.Methods:From November 2023 to January 2024, convenience sampling was used to select 203 elderly patients with HAD at Xuanwu Hospital of Capital Medical University as the study subjects. A survey was conducted on elderly patients using the General Information Questionnaire, Fried Frailty Phenotype, Barthel Index, Social Support Rating Scale, and Intrinsic Capacity Assessment Tool. Binomial Logistic regression was used to analyze the influencing factors of intrinsic capacity in elderly patients with HAD.Results:A total of 203 questionnaires were distributed, and 199 valid questionnaires were collected, with a valid response rate of 98.03% (199/203). The total score of intrinsic capacity in 199 elderly patients with HAD was 5.00 (4.00, 6.00), with scores for cognitive dimension, psychological dimension, motor dimension, vitality dimension, and sensory dimension being 1.00 (1.00, 2.00), 2.00 (1.00, 2.00), 0 (0, 1.00), 1.00 (1.00, 1.00) and 1.00 (1.00, 1.00), respectively. The binomial Logistic regression showed that department of medicine and surgery, self-rating health status, social support, serum albumin, and Barthel Index were the influencing factors of intrinsic capacity in elderly patients with HAD ( P<0.05) . Conclusions:The intrinsic capacity of elderly patients with HAD is at medium to low level, with the most severe impairment in the motor dimension. Medical and nursing staff should develop personalized rehabilitation measures for elderly HAD patients based on the influencing factors of their intrinsic capacity, enhance their intrinsic capacity, and reduce the burden of care on families and society.

Objective:To investigate the status and influencing factors of different types of cognitive frailty in aged inpatients with hypertension.Methods:Totally 300 aged patients with hypertension admitted to the Cardiology, Geriatrics, and Endocrinology Departments of Xuanwu Hospital, Capital Medical University, from April to October 2022 were selected by convenience sampling. Data were collected using a general information questionnaire, the Fried Frailty Phenotype (FP), the Mini-Mental State Examination (MMSE), the 9-item Subjective Cognitive Decline Questionnaire-9 (SCD-Q9), the Morisky Medication Adherence Scale (MMAS), the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS), the Social Support Rating Scale (SSRS), and the Mini Nutritional Assessment (MNA) .Results:A total of 300 questionnaires were distributed and returned, yielding a 100.00% response rate. Among the 300 aged hypertensive patients, 74 were diagnosed with reversible cognitive frailty (RCF) and 98 with potentially reversible cognitive frailty (PRCF). Logistic vegression analysis showed that, factors influencing RCF included daily exercise habits and the use of thiazide diuretics ( P<0.05) ; factors influencing PRCF included age, pre-retirement occupation, daily exercise habits, sleep quality, Barthel Index score, and serum albumin levels ( P<0.05) . Conclusions:The status of both RCF and PRCF is relatively high among aged inpatients with hypertension. The influencing factors for different types of cognitive frailty vary. Targeted interventions based on both common and specific influencing factors should be developed to reverse or slow the progression of cognitive frailty in aged hypertensive patients.