Objective To explore the effect of the situation-background-assessment-recommendation mode of SBAR communication on the clinic communication competence of nurses.Methods 20 obstetric nurses were selected for the study,the mode of SBAR communication was applied to the communication between doctors and nurses,nurses and nurses,nurses and patients.The clinic communication competence was investigated by the questionnaire of clinic communication competence before and after using the mode of SBAR communication.Results The scores of the clinic communication competence after using the mode of SBAR communication was (56.41±6.32),which was higher than that before the implementation,(48.15±5.26),there were statistically significant differences,P＜0.05.The scores of communication competence between doctors and nurses,between nurses and nurses,between nurses and patients were higher after implementation of SBAR compared with those before,(4.06±1.26)vs.(2.62±1.31),(4.05±1.41)vs.(3.59±1.46),(3.98±1.32) vs.(3.36±1.36),there were statistically significant differences in all of them,P＜ 0.05.Conclusions SBAR communication mode helps improve clinic communication competence of nurses,promote the establishment of harmonious team between doctors and nurses,ensure patients' safety and quality of care.

Objective　To investigate the epidemic situat ion of the dental fluorosis among the people in Tianjin area.Methods　With the method of random sampling we investigated epidemic situation of the dental fluorosis among the people aged 12 to 15 in Tianjin area.Results　The minimum patient's rate for this disease among those aged 12 to 15 is 32.11 percent while the maximum is 78.09 percent.The l owest dental fluorosis index is 0.851 and the highest is 1.923.The patient's rate and the index are both higher than the average rate and index of the whole cou ntry.Conclusions　Tianjin is one of the areas where the dental fluorosise epidemic mostly occurs.

Objective To investigate the relationship between serum cystatin C (Cys C) level and the occurrence of in-stent restenosis after coronary drug-eluting stent implantation.Methods A retrospective analysis of coronary drug-eluting stent implantation was curried out in 592 patients.All patients were from Shengjing Hospital of China Medical University by coronary angiography,and were divided into restenosis group (142 cases) and non restenosis group (450 cases).The Cys C levels before and after surgery and follow-up angiography were analyzed.The biochemical indicators,and transcatheter arterial restenosis were analyzed.Results Either before or after operation and follow-up angiography,serum cystatin C levels were higher in restenosis group patients than that in non restenosis group [before operation:(1.622 ± 1.063) mg/L vs (1.369 ± 0.860) mg/L;after the operation:(1.769 ± 1.062) mg/L vs (1.458 ± 0.883) mg/L;review:(1.924 ± 1.085) mg/L vs (1.440 ± 0.874) mg/L;P ＜ 0.05].Multivariate COX regression analysis showed that serum cystatin C level was an independent risk factor of in-stent restenosis in drugeluting area (P ＜ 0.05).Conclusions The serum cystatin C level is closely related to in-stent restenosis in drug-eluting stents area.High level of serum cystatin C is an independent risk factor of in-stent restenosis after drug-eluting stents implantation.

0.05 ) in baseline study. The atrial pressure in AF group had higher increase than no AF group. (3) there was greater AERP dispersion in patients with PAF than that in those without PAF during baseline study and PSVT (P

Objective:To observe the influence of ginsenoside Rg1 on transcriptional activation of NF-κB induced by hydrogen peroxide (H_2O_2) in 293T cell,and probe into the antioxidant mechanism of ginsenoside Rg1.Methods:In the experiment,cells was exposed to H_2O_2 after pretreatment with Rg1,cell proliferation and cytotoxicity studies were detected by MTT and Trypan blue.The quantities of generation of intracellular reactive oxygen species (iROS) was analyzed by flow cytometric analysis measured with fluorescent probe 2,7-dichlorofluorescin diacetate (DCFH-DA).NF-κB-responsive element-luciferase reporter gene was transfected and dual-luciferase cis-reporting systems were used to assay the transcriptional activity of NF-κB under the stimulated circumstance of oxidative stress induced by H_2O_2.Results:The results of MTT showed that ginsenoside Rg1 apparently protected the proliferation of 293T cell,which were repressed by H_2O_2 (P＜0.05).The results by trypan blue showed that H_2O_2 stimulated substantial cytotoxicity.This effect was markedly attenuated by treatment with ginsenoside Rg1.Oxidant production,measured as the fluorescence of dichlorofluorescein,was significant increased by 40%-50% through H_2O_2 stimulation.The decrease in iROS generation was significant blocked by 35%-40% through Rg1 and antioxidant.The relative luciferase reporter assay of NF-κB was apparently improved by H_2O_2-induced(P＜0.05),but Ginsenoside Rg1 significantly repressed the relative value of luciferase (P＜0.05).Conclusion:Ginsenoside Rg1 has the obvious protective function from the damage of oxidative stress damage,whose possible mechanism is to eliminate excessive free radicals of the cells effectively,to reduce transcriptional activation of nuclear factor kappa B(NF-κB),and subsequently to suppress the NF-κB circuit activation.

OBJECTIVETo assess the clinical outcomes of balloon kyphoplasty assisted with calcium phosphate cement (CPC) in treating osteoporotic vertebral fractures (OVF).

METHODSFrom January 2009 to January 2011, 26 patients with osteoporotic vertebral fractures were treated with balloon kyphoplasty assisted with CPC, including 31 vertebrae. There were 15 males and 11 females with an average age of (71.67 +/- 4.36) years old (ranged from 60 to 89 years). Course of disease was from 0.5 to 7 days with an average of 3.2 days. Clinical outcomes were assessed by the visual analogue scale (VAS) and the oswestry disability index (ODI). Vertebral height loss and kyphotic angle were measured by X-rays.

RESULTSAll patients were followed up for 10 to 24 months with an average of 18 months. Before operation, 24 hours after operation and at final follow-up, VAS scores were 7.91 +/- 1.20, 3.22 +/- 1.12, 1.92 +/- 0.83, respectively; ODI scores were 40.00 +/- 1.15, 17.00 +/- 2.12, 13.00 +/- 1.42, respectivesly; vertebral heights were (18.21 +/- 3.21), (23.82 +/- 3.10), (21.85 +/- 3.24) mm, respectivesly; vertebral kyphosis angles were (18.21 +/- 3.21) degrees, (7.42 +/- 3.13) degrees, (10.01 +/- 3.11) degrees, respectivesly. There was significant difference between preoperation and 24 hours after operation, and between final follow-up and preoperation (P < 0.05). There was no significant difference between final follow-up and 24 hours after operation (P > 0.05).

CONCLUSIONBalloon kyphoplasty assisted with calcium phosphate cement (CPC) is effective for the treatment of osteoporotic vertebral fractures (OVF), which can expeditiously relieve pain and effectively rebuild height of vertebral body and kyphotic angle, and also has advantages of minimal trauma and good security.

Aged ; Aged, 80 and over ; Bone Cements ; Calcium Phosphates ; therapeutic use ; Female ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Spinal Fractures ; surgery ; Visual Analog Scale

Objective To construct an scientific quality evaluation system of master academic dis-sertation in post graduates majored in professional clinical medicine, which provides the basis for measuring the level of scientific research and the quality of graduates. Method a preliminary evaluation index system of master academic dissertation in post graduates majored in professional clinical medicine was established by literature review, expert interview and panel discussion, and the given indexes were conducted on the clinical and medical education experts by a two-round Delphi methods. Result According to the character-istics of the graduate training, combined with expert opinion, 6 primary indexes, 18 secondary indexes and 42 third-level indexes were contained. With calculating the weight of all levels of indicators, the final quality evaluation system of master academic dissertation in post graduates majored in professional clinical medicine was built. Conclusion The system is a highly scientific index system and reliable, which can reflect and emphasize the master's requirements and characteristics of the training, so as to be used as a measuring stan-dard for evaluating master academic dissertation in post graduates majored in professional clinical medicine.

Objective To evaluate interleukin-27 ( IL-27 ) as a sepsis diagnostic biomarker in critically ill adults with sepsis. Methods A retrospetive study was conducted. A total of 176 systemic inflammatory response syndrome ( SIRS ) patients in Department of Critical Care Medicine of Xinxiang Medical College First Affiliated Hospital from March to November in 2014 were enrolled. The patients were divided into no sepsis group ( n=66 ), pulmonary originated sepsis group ( n=65 ), and non-pulmonary originated sepsis group ( n=45 ). Plasma IL-27 and procalcitonin ( PCT ) were determined with enzyme linked immunosorbent assay ( ELISA ). Receiver operating characteristic curve ( ROC ) and classification and regression tree methodology was used to evaluate diagnostic biomarker performance. Results The proportion of patients in pulmonary original sepsis group whose body temperature in line with SIRS criteria was significantly higher than no sepsis group ( 66.2%vs. 44.5%, P<0.05 ), and they were easy to suffer from tumor ( 44.6%vs. 22.7%, P<0.05 ). The proportion of patients in non-pulmonary originated sepsis group whose white blood cell count in line with SIRS criteria was significantly higher than no sepsis group ( 68.9%vs. 42.7%, P<0.05 ). It indicated that patients in pulmonary originated sepsis group and non-pulmonary originated sepsis group were more in line with SIRS criteria compared with no sepsis group. It was shown by ROC curve that IL-27 and PCT was not effective in discriminating sepsis among unselected patients showing symptoms and signs of SIRS. The area under the curve ( AUC ) was 0.59 [ 95%confidence interval ( 95%CI )=0.49-0.65 ] and 0.61 ( 95%CI=0.55-0.71 ). According to the further analysis from different infection sources, the highest AUC was 0.71 ( 95%CI=0.59-0.79 ) for IL-27 in patients with a non-pulmonary originated sepsis. A decision tree incorporating IL-27, PCT, and age had an AUC of 0.78 ( 95%CI = 0.71-0.87 ) in patients with a non-pulmonary originated sepsis, which was higher than IL-27 [ 0.71 ( 95%CI = 0.59-0.79 ) ] or PCT [ 0.65 ( 95%CI = 0.57-0.78 ) ]. Compared to that of pediatric cohort with sepsis, lower expression of IL-27 was found in adult patients. Conclusions IL-27 performed overall poorly as a sepsis diagnostic biomarker in adults. IL-27 may be a more reliable diagnostic biomarker for sepsis in children than in adults. The combination of IL-27 and PCT can reasonably estimate the risk of sepsis in subjects with a non-pulmonary originated sepsis.

BACKGROUND:Severely curved root canal preparation is the difficulty during clinical root canal preparation, and improper preparation may induce complications such as stage, root canal offset and apical open, which affect the quality of root canal preparation and apical closure. Therefore, it is important to choose a root canal preparation instrument which has the best cutting and forming ability. OBJECTIVE: To compare the shaping ability of Mtwo nickel-titanium rotary instruments, K3 nickel-titanium rotary instruments and stainless steel K-files for the preparation of curved root canals. METHODS:A total of 30 severely curved root canals of freshly extracted human maxilary molars were randomly divided into three groups, with 10 canals in each group. The canals were prepared by Mtwo instruments, K3 instruments and K-files, respectively. The instrument’s tip location in pre- and post-instrumentation radiographs of the three groups was recorded; the changes of root curvature, working length and working time in the three groups were measured and compared. RESULTS AND CONCLUSION:The root curvature showed no significant difference in the three groups before preparation (P> 0.05). The changes of root curvature after root preparation in Mtwo instrument and K3 instrument groups were significantly less than that in K-files group (P < 0.01), and no significant difference was found between Mtwo instrument group and K3 instrument group (P > 0.05). The root canal preparation time in the three groups showed significant differences (P < 0.01), which was the shortest in Mtwo instrument group and the longest in K-files group. The changes of working length after root preparation in the three groups showed no significant difference (P > 0.05). Mtwo nickel-titanium rotary instruments and K3 nickel-titanium rotary instruments are have high efficacy and strong shaping ability in preparing curved root canals.

Objective To analyze the recurrence rate of intubation and increase of ventilator support rate within 24 hours after using fiberoptic bronchoscopy (FOB) in critically ill patients with hypoxemia complicated with respiratory failure, and to approach the feasibility of FOB in such patients.Methods A prospective study was conducted, including 200 critically ill patients with acute respiratory failure using FOB [oxygenation index (PaO2/FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa)] admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Xinxiang Medical College. The rates of intubation and increased ventilatory support and the reasons for bronchoscopy related complications after using FOB 24 hours were recorded, the main risk factors leading to these changes and complications were analyzed and screened by logistic regression analytic method.Results Within 24 hours after using FOB for 200 patients with respiratory failure, an increase in mechanical ventilatory support was required in 68 patients (34%) of that 28 (14%) led to endotracheal intubation. With the extension of time, the rates of intubation and ventilatory support showed a tendency of elevation, the rise in ventilatory support rate being faster. The reasons for bronchoscopy related complications after FOB consisted of cardiovascular disease (41%), coronary artery disease (17%), chronic obstructive pulmonary disease (COPD, 17%), chronic restrictive pulmonary disease (10%), immunity suppression (54%), malignant neoplastic hematologic disorder (20%), acquired immune deficiency syndrome (AIDS, 12%), solid organ transplantation (3%), solid tumor (10%), corticosteroid therapy (25%), immunosuppressive drug (16%), diabetes (15%), chronic renal failure (14%), swallowing nerve injury (37%), anticoagulant therapy (19%), antiplatelet therapy (13%). In the patients with occurrence of COPD or immunosuppression, the rate of invasive ventilation used was significantly higher than that without using invasive ventilation [COPD: 35% (10/28) vs. 14% (24/172),χ2 = 8.081,P = 0.004; immunosuppression: 75% (21/28) vs. 50% (86/172),χ2 = 6.051,P = 0.014]. The logistic regression analysis showed that the occurrence of COPD or immunosuppression was obviously related to whether the intubation being necessary or not [COPD: odds ratio (OR) = 5.200, 95% confidence interval (95%CI) = 1.500 - 17.700,P = 0.006; immunosuppression:OR = 5.300, 95%CI =1.600 - 17.100,P = 0.004].Conclusions In patients with hypoxemia using FOB, they often require addition of mechanical ventilatory support, but the intubation rate is not high. Under the ventilatory support, FOB has certain feasibility for treatment of critically ill patients with hypoxemia and acute respiratory failure.