Catheterization ; methods ; Humans ; Needles ; Pneumothorax ; nursing ; surgery ; Silicosis ; nursing ; surgery ; Thoracic Cavity

Adult ; Chronic Disease ; Female ; Humans ; Lead Poisoning ; nursing ; Male ; Mercury Poisoning ; nursing ; Middle Aged ; Young Adult

Objective To establish an influencing factors system for the implementation effect of the vertical integration of services between the hospitals and community health service institutions.Methods Primary data related to influencing indicators were collected by literature review,questionnaire method and in-depth interview,and then the analytic hierarchy process (AHP) and Delphi method were used for the construction of final influencing factors indicator system.Results An influencing factors indicator system which coincides with the status of the vertical integration between hospitals and community health service institutions in Nanjing,Wuhan and Zhenjiang was established,including 4 firstlevel indicators,10 second-level indicators and 36 third-level indicators.Conclusion This study can provide a basis for hospitals and community health centers to improve the integration service system,and fill the gap of research on the influencing factors of the vertical integration of the domestic health care system,which are meaningful for the vertical integration of health care system in other districts and patterns.

Objective: To discuss the treatment of pancreatic encephalopathy(PE).Methods: Recombinant human growth hormone (rhGH)(Saizen)were applied in patients of severe acute pancreatitis(SAP) with suspicious early PE that presented with mental disorders. rhGH was also used in combination with somatostatin as the therapeutic method for SAP and its complication.Dosage and administration: Saizen 4U was injected intramuscularly twice a day for 5～7 days.Results: In 7 patients of this group, all of them showed improvement in the aspect of mental dysfunction and the symptoms disappeared after 48～72 hours. In 13 SAP cases underwent combined application of rhGH and somatostatin, no PE was observed.Conclusion: Application of rhGH showed therapeutic effect on the early manifestations of PE. It also suggested that combined use of rhGH and somatostatin could decrease the occurance of PE.

Objective To analyze the etiology and clinical feature of pi t uitary apoplexy.Methods The clinical data from 18 cases of pitui tary apoplexy were analyzed retrospectively.Results Main symptom s were headache in 12 cases and decreased visual acuity in 12 cases.Positive si ghs were temporal hemianopisia in 6 cases,unequal pupil in 3 cases,oculomotor ne rve(Ⅲ) paralysis in 2 cases and abducent nerve (Ⅵ) paralysis in 2 cases.Imagin g examinations showed CT positive finding in 4 cases and MRI positive finding in 6 cases.Tumor diameter was longer than 2 cm in 13 cases and less than 2 cm in 5 cases.Chromophobe pituitary tumor was found in 11 cases.All cases received surg ical operation.Conclusion Clinical features of pituitary tumor a poplexy are atypical,of which headache and visual acuity decrease are the main s ymptoms.Most cases occur suddenly or primary symptoms are deteriorated suddenly. CT and MRI positive findings are helpful for diagnosis.

OBJECTIVE:To assess the stability of the quality control of FPIA for monitoring of CsA and MEIA for monitoring of FK506.METHODS:The quality control on the blood samples of patients receiving therapeutic drug monitoring of CsA and FK506 from June to August in 2007 were subjected to a continual assessment and analysis to investigate the stability and accuracy of the quality control.RESULTS:The mean recoveries of the low,middle and high concentrations of CsA and FK506 were 93.14%～97.65% and 97.70%～103.09% respectively,with RSD at 4.41%～5.37% and 10.44%～14.23% respectively,which accorded with the requirement for biological sample determination stated in the Chinese Pharmacopoeia.CONCLUSION:The methods of FPIA for monitoring of CsA and MEIA for monitoring of FK506 were accurate,and worth to be applied in clinical to guide individualized medication.

Objective To explore the effect of lysolecithin choline (LPC) on blood-brain barrier(BBB) permeability in rats with acute pancreatitis. Methods Acute pancreatitis rat model was produced and rats were randomly divided into:(1)Test group-AP, rats received LPC by tail vein injection; (2)control group I, AP rats were given normal saline by tail vein injection; (3)control group II, sham operation without AP, but LPC was given by tail vein injection.Horseradish peroxidase(HRP) was used as a tracer to determine BBB permeability 7~10 days later.Results The test group showed local extravascular effusion of HRP, indicating that BBB permeability was markedly increased,while both control groups showed no apparent increase of BBB permeability,which were statistically significant(P

Radical resection is one of the important factors for improving the prognosis of patients with resectable carcinoma of head of the pancreas,carcinoma of the distal bile duct and periampullary carcinoma.In order to proceed with a R0 resection,there are many types of pancreaticoduodenectomy (PD) for pancreatic,biliary and periampullary carcinoma such as PD with lymphadenectomy.In this report,we described a PD with extended retroperitoneal lymphadenectomy (D2 +) for the adenocarcinoma of the distal bile duct.The case presented underscores the feasibility and safety of PD with D2 + lymphadenectomy.

BACKGROUND:Monofocal and multifocal Toric intraocular lens that have been widely used in clinic exhibit xcelent biological and optical characteristics and have good safety and stability after implantation. OBJECTIVE:To compare the outcomes and rotation stability in patients with cataract and astigmatism after implantation of monofocal and multifocal intraocular lens. METHODS:A total of 210 patients with cataract and astigmatism who received phacoemulsification and intraocular lens implantation were included in this study. Of them, 105 patients were assigned to monofocal intraocular lens implantation and the other 105 patients to multifocal intraocular lens implantation. Uncorrected visual acuity, best corrected visual acuity, residual astigmatism were reexamined at 1, 3 weeks and 1 month after surgery. The rotation of Toric intraocular lens was determined. The incidence of complications and spectacles- independent rate were recorded. RESULTS AND CONCLUSION:Visual acuity and residual astigmatism in each group were significantly improved after 1 week of intraocular lens implantation (P < 0.05); furthermore, these two indicators became better over time. Improvement of visual acuity and residual astigmatism in multifocal intraocular lens group was more obvious than that in monofocal intraocular lens group. Postoperative intraocular lens rotation at < 5° occurred in both groups. The intraocular lens rotation degree in multifocal intraocular lens group was higher than that in monofocal intraocular lens group at different time points (P < 0.05). There were no significant differences in incidence of complications and spectacles-independent rates between two groups at 1 month after surgery. These results demonstrate that multifocal Toric intraocular lens provides better visual acuity and residual astigmatism improvement, while monofocal Toric intraocular lens provides better rotation stability.

OBJECTIVE:To study the stability and to predicate the expiration date of betamethasone cream.METHODS:The HPLC method was used to determination the content of betamethasone,the stability test of cream was done by initial mean velocity method and strong light exposure experiment,respectively.RESULTS:The linear concentration range for betametha?sone cream was0.25～8?g/ml(r=0.9991),the average recovery rate was98.56%,RSD=0.78%;The content was highly correlated to temperature,whereas on which the light exposure did little effect.CONCLUSIONS:Betamethasone cream should be stored under room temperature and in a cool place,it is predicted that the expiration date of betamethasone cream is1year.