Objective To explore the anticoagulation effect of low molecular weight heparin (LMWH) combination with warfarin at the early stage at the treatment of intracranial venous sinus thrombosis.Methods 80 cases of intracranial venous sinus thrombosis patients in people's hospital of Xinjiang Uygur autononous region from January 2010 to December 2014 were chosen to be analyzed retrospectively.37 cases in observation group were treated with low molecular heparin (LMWH) in combination with warfarin, and 43 cases in control group were treated with warfarin.The clinical curative effect between two groups was compared post-treatment.Results The effective rate in observation group was 91.89%, which was significantly higher than 67.44% in control group (P<0.05) .The recanalization rate of involved intracerebral venous in observation group was 89.19%, which was significantly higher than 67.29% in control group(P<0.05).After treatment, the prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) were higher and fibrinogen (FBG) in both groups was lower than those pre-treatment(P<0.05).The PT and APTT was higher and FBG was lower in observation group than those in control group(P<0.05).Conclusion Low molecular weight heparin in combination with warfarin worked well than single warfarin in the treatment of intracranial venous sinus thrombosis.

BACKGROUND: With the increase of senile population, it needs to further improve their mental health when improving their physical health. To study the depressive status of retired elderly people in order to provide basis for effective community nursing intervention.OBJECTIVE: To investigate and analyze the depression incidence among retired elderly people and conducted correlative factors analysis in order to improve the nursing service to aged people's mental health.DESIGN: Cross-sectional sampling study towards retired senior people.SETTING: Nursing department of a medical college.PARTICIPANTS: This study was completed in Nursing Department of North China Coal Medical College during September to December 2002. It conducted questionnaire survey to 1 000 retired people in Tangshan city by family visit. There were 574 male and 426 female who aged from 60 to 88years old with mean age of 67 years.METHODS: To adopt geriatric depression scale and general condition questionnaire investigation to individuals.MAIN OUTCOME MEASURES: Depression scale score, depression incidence and frequency of correlative factors RESULTS: Mild depression accounts for 17.2% while moderate and severe depression account for 5% among retired elderly people. There is close relationship between factors such as retired veterans, female, low education,lack of social support, empty life, lack of exercise and poor self-assessed health and depression incidence(x2 = 9.80 - 175.93, P ＜ 0. 05).CONCLUSION: The incidence of senile depression among retired elderly people is pretty high so that it is important to pay attention to mental care towards retried people when doing community nursing, especially to divorced, widowed, female and low educated retired people.

Objective To investigate the influence of pure intercostal nerve block combined with hydromorphone hydrochlo-ride intravenous analgesia on the occurrence of postoperative cognitive function and analgesia in elder patients with thoracic surger-y.Methods Ninety-six ASA I?Ⅱ elder patients with elective thoracic operation were divided into intercostal nerve block group (A),intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia group (B)and hydromorphone hydrochloride intravenous analgesia group(C)according to the random number table method,32 cases in each group.The patient-controlled intravenous analgesia(PCIA)with sufentanyl was postoperatively performed in all cases.When analgesia effect was poor, dezocine 0.1mg/kg was intravenously injected.The mean artery pressure(MAP),heart rate(HR),respiratory rate(RR),visual ana-logue scale (VAS)score and mini mental state examination (MMSE)score were recorded at postoperative 2,6,24,48 h in 3 groups.Results The MMSE score in the group B was higher than that in the group A and C,the VAS score was lower than that in the group A and C,the difference was statistically significant(P <0.05).Postoperative MAP and HR in the group B were more sta-ble than those in the group A and C,the difference was statistically significant(P <0.05).RR in the group C was more fast and had smaller range than those in the group A and B,the difference was statistically significant(P <0.05).Conclusion Intercostal nerve block combined with hydromorphone hydrochloride intravenous analgesia can achieve better postoperative analgesic effect with sta-ble postoperative blood dynamics and low occurrence rate of early postoperative cognitive dysfunction.

Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.

Objective:To investigate and analyze the current status of patient satisfaction and the influencing factors at private hospitals in Guizhou Province,and thus to provide a scientific basis for the management of medical service at private hospitals.Methods:The satisfaction scores were statistically described and analyzed by the factor analysis and multiple linear regression analysis.Results:The overall satisfaction score of patients was (3.87 ± 0.85),of which the satisfaction of medical technology,drug price,inspection fee,and medical facilities was lower.The factor analysis showed that satisfaction of patients at private hospitals could be classified into the environment,the quality of service,medical expense,and service flow.Multivariate linear regression results showed that its standardized partial regression coefficient by the parameter descending order followed as medical expense,the environment,the quality of service,and then service flow.Conclusions:Private hospitals should set up a fair medical expenditure mechanism,improve the environment and quality of medical services,and optimize service flow in order to improve patient satisfaction.

Objective To study a monitoring instrument of multiple physiological parameters being capable of wireless long-distance transmission,low in power dissipation and price and small in size.Methods In combination of embedded technology and mobile communication technology,S3C2410 based on ARM9 core was used as main chip,ARM-Linux as embedded operation system and SIM300 as communication module connected to Internet,to complete wireless long-distance transmission of multiple physiological parameters.Results Tele-monitoring system of embedded multiple physiological parameters based on GPRS was realized.Conclusion The instrument is small,easily-expanded and reliable in the process of transmitting data,facilitating tele-monitoring and data sharing.

Objective To investigate the influence of preemptive analgesia with Hydr- omorphone Hy-drochloride on postoperative cognitive function and inflammation cytokines in the elderly patients. Methods Ninety ASA I orⅡ elder patients were randomly divided in control group (C)and Hydromorphone Hydrochloride group(H) with 45 cases each. Hydromorphone Hydrochloride 2 mg was injected iv before induction of anesthesia in group H. Observed plasma concentrations of the CRP、 TNF-α and IL-6 at different time. Cognitive function was assessed by minimental state examination. Results Plasma the CRP、 TNF-a and IL-6 concentrations were lower and MMSE scales were higher in group H than in group C. Conclusion Preemptive analgesia with Hy-dromorphone Hydrochloride 2 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.

Objective To investigate the effects of preemptive analgesia with nalbuphine on inflammatory factors in elderly patients undergoing thoracotomy. Methods Eighty elderly patients with ASA I or Ⅱ undergoing thoracotomy were randomly allocated into control group (group C:n=40) and Nalbuphine group (group N:n=40). Each patient received 20 mg of Nalbuphine intravenously before induction of anesthesia in group N and same volume of normal saline in group C. Plasma levels of IL-10, TNF-α and IL-6 were measured at different time points. The VAS was recorded and the MAP, HR, SpO2 and PaCO2 were monitored. Results Compared with group C, the levels of TNF-α and IL-6 were lower, while IL-10 was higher at T2, T3, T4 in group N(P < 0.05). The VAS, MAP, HR and PaCO2 in group N were lower than those in group C at T2, T3 and T4 (P < 0.05). Conclusion Preemptive analgesia with Nalbuphine can improve the efficacy of postoperative analgesia and effectively reduce inflammatory reaction in the old patients undergoing thoracotomy.

Objective To investigate whether B-cell activating factor (BAFF) involved in the patho-genesis of lupus nephritis (LN) by regulating phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling. Methods Twenty-eight lupus nephritis patients and 20 controls were included in this study. The clinical data were collected. BAFF levels in plasma were measured by ELISA, and the relationship between systemic lupus erythematosus disease activity index (SLEDAI) and BAFF were analyzed. The mRNA and protein levels of BAFF, phosphorylated-PI3K (p-PI3K), phosphorylated-Akt (p-Akt), phosphorylated-mTOR (p-mTOR) and Bcl-2 in kidney tissues were measured using real-time polymerase chain reaction (RT-PCR) and Western blotting. Data were analyzed using Mann-Whitney U test and Spearman correlation analysis. Results ①Plasma BAFF levels were significantly higher in LN patients [(580 ±45) ng/L] compared with controls [(208 ±30) ng/L](Z=-5.856, P<0.01), and significant positive correlation was found between plasma BAFF levels with SLEDAI (r=0.723, P<0.01). ② Plasma BAFF level in LN patients was positively correlated with 24 h UP and anti-dsDNA titers (r=0.381, 0.461, P<0.05). The protein level of BAFF in kidney tissues was positively correlated with 24 h UP and anti-dsDNA titer (r=0.469, 0.489, P<0.05).③The mRNA levels of BAFF, p-PI3K, p-Akt, p-mTOR and Bcl-2 in kidney tissues were increased in patients compared to controls[5.8±1.8 vs 2.1±0.7, Z=-4.915, P<0.01;6.7±0.9 vs 1.71±0.53, Z=-5.857, P<0.01;5.6±0.9 vs 1.8 ±0.5, Z=-5.751, P<0.01; 5.6 ±1.4 vs 1.6 ±0.4, Z=-5.291, P<0.01; 2.11 ±0.36 vs 1.33 ±0.22, Z=-4.844, P<0.01].④The protein levels of BAFF, p-PI3K, p-Akt, p-mTOR and Bcl-2 in kidney tissues were increased in patients compared to controls [0.72±0.19 vs 0.31±0.05, Z=-4.747, P<0.01;0.73±0.11 vs 0.33±0.09, Z=-5.834, P<0.01;0.77±0.06 vs 0.22±0.07, Z=-5.855, P<0.01;1.18±0.27 vs 0.47±0.13, Z=-5.416, P<0.01;2.08±0.37 vs 1.32±0.18, Z=-4.998, P<0.01]. Conclusion The findings of this study indicate that BAFF may participate in the pathogenesis of LN by regulating PI3K/Akt/mTOR signaling.

Objective To explore the association between the genetic polymorphism of hypoxia inducible factor 1 α (HIF-1α) G1790A and the radiosensitivity of nasopharyngeal carcinoma.Methods A total of 189 patients with nasopharyngeal carcinoma treated with radical radiotherapy were followed-up for 3 years.The patients were divided into cured group with 135 cases and recurrence group with 54 cases by clinical follow-up results.PCR-RFLP was used to determine the mononucleotide genotypes of HIF-1α G1790A.Results The observed genotype frequencies of HIF-1α gene 1790 (G→A) for GG, GA and AA were 70.04% , 20.74% , 2.22% in cured group and 59.26% , 38.89% , 1.85% in recurrence group, respectively.The allele frequencies for G and A were 87.4% , 13.9% in cured groups and 78.7% ,21.3% in recurrence group, respectively, without significant difference in distribution of allele frequencies between the two groups(x2 =6.919, P =0.077).Conclusions The genetic polymorphisms of HIF-1α G1790A might be related with the radiosensitivity of nasopharyngeal carcinoma.