Objective To summarize the nursing care experience for right ventricular dysfunction after orthotopic heart transplantation.Methods Clinical data of 67 patients underwent heart transplantation were retrospectively analyzed from January 2007 to December 2010.Results 58 patients were discharged after they were cured,9 patients died.67 patients were affected by different degrees of increasing central venous pressure (CVP)early postoperation and right ventricular dysfunction,28 cases received extracorporeal membrane oxygenation(ECMO) assistant,6 cases received continuous renal replacement therapy(CRRT).Among 58 discharged patients,the heart function level showed class two in 54 cases and class three in 4 cases.Conclusions After heart transplantation,followed with intensive care and close observation of right heart failure symptoms,providing effective care and support,active prevention and treatment for right heart failure,maintaining vital organs function were key to successful heart transplantation.

Many trauma victims occur in China every year, with a notably high mortality rate among those who suffered from multiple traumas such as severe traffic trauma. One of the main reasons is the defect of current trauma emergency system, in which the full-time trauma physician often lacks. It has therefore become urgent to establish a well-organized trauma emergency system with full-time physicians.
Accidents, Traffic ; statistics & numerical data ; China ; Emergency Service, Hospital ; manpower ; organization & administration ; standards ; Humans ; Multiple Trauma ; epidemiology ; Physicians ; supply & distribution

Adult ; Catheter Ablation ; methods ; Humans ; Male ; Radial Artery ; surgery ; Tachycardia, Supraventricular ; surgery

OBJECTIVETo observe the curative effect of Qianjin Kouchuang Jiawei Granule (QKJG) on recurrent oral ulceration [yin deficiency fire excess type (YDFET)].

METHODSTotally 120 patients who suffered from recurrent oral ulceration (YDFET) were randomly assigned to two groups, the experiment group and the control group, 60 in each group. Patients in the experiment group took QKJG, 20 g each time, twice per day, while those in the control group took Kouyanqing Granule (KG) , 20 g each time, twice per day. Fourteen days consisted of one therapeutic course, two for all. Scores for patients' symptoms and signs (ulcer area, exudation, hyperaemia, edema, the number of ulceration, burning sensation, and pain degrees) were assessed before treatment, at day 3 and 7 after treatment. Short-term efficacy was assessed by visual analogue scale (VAS). The total paralysis time and the total number of ulceration at month 12 after treatment were taken as judgment for long-term efficacy. Results Compared with before treatment in the same group, symptoms and signs were obviously improved at day 3 and 7 after treatment in the two groups (P < 0.05). Compared with the control group at day 3 after treatment, the improvement of edema, exudation, pain degree, and burning sensation was more obvious in the experiment group (P < 0.05, P < 0.01). The improvement of edema, pain degree, and burning sensation at day 7 after treatment was more obvious in the experiment group than in the control group (P < 0.05). As for short-term efficacy, the total effective rate was 86.67% (52/60 cases) in the experiment group and 83.33% (50/60 cases) in the control group, with no statistical difference between the two groups (P > 0.05). As for long-term efficacy, the total effective rate was 90.00% (54/60 cases) in the experiment group, significantly higher than that of the control group with statistical difference [81.67% (49/60 cases), P < 0.05]. At month 12 after treatment, the total number of ulceration was reduced and the paralysis time of ulcer attack prolonged in the experiment group, with statistical difference when compared with the control group (P < 0.05).

CONCLUSIONQKJG showed better long-term efficacy than that of KG in treating recurrent oral ulceration (YDFET).

Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Pain Measurement ; Phytotherapy ; Treatment Outcome ; Yin Deficiency ; drug therapy

Objective　To assess the efficacy of sandostatin in preventing postoperative adhesions in rats. Methods　Fifty SD rats were randomly divided into five groups: Group 1, Control group; group 2, sandostatin 20μg/kg intraperitoneal injection (IP); group 3, sandostastin 40μg/kg IP; group 4, sandostatin 60μg/kg IP; group 5, hyaluronate sodium(HA) IP. All animal were killed on the 14th postoperative day. After adhesions were graded according to their severity, adhesive ileal segments were resected for hydroxyproline(OHP) determination. Results　The severity of adhesions in group 2.3.4 and 5 were significantly milder than that in group 1.(P<0.05). The OHP levels of adhensive intestine in group 2.3 and 4 were significantly lower than that in group 1 and 5 (P<0.05).The severity of adhesions and OHP levels in group 2.3 and 4 had no significant difference (P>0.05). Conclusions　Intraperitoneal administration of sandostatin intraoperatively might have some efficacy in preventing adhensions of intestine.

Purpose:To report three cases of myelodysplastic syndrome(MDS) transformed to atypical chronic myeloid leukemia(aCML).Methods:Compared the clinical findings,hemograms and bone marrow features in two different courses of the disease,discussed with review of related literatures.Results:The three patients were all old age.They onset with chronic anemia,the results of BM smear were MDS-RAS and MDS-RAEB;Then leukocytosis occurred in 6-65 months.The aCML were diagnosed according to the BM smear and normal chromosome.Conclusions:The MDS/MPD is a new category of the WHO classification that have both dysplastic and proliferative features.Atypical CML lacks the Ph chromosome and BCR/ABL fusion gene that are the hallmarks of classic CML.This kind of case is seldom seen.

BACKGROUND:Lumbar disc herniation is the most common cause of lumbago in clinic, which seriously affect the patient's daily life, study and work. Therefore, studies on biomechanics of lumbar intervertebral disk benefit to prevent and treat the diseases associated with lumbar intervertebral disk. OBJECTIVE: To summarize the biomechanical progress of lumbar intervertebral disk. METHODS: The first author retrieved China National Knowledge Infrastructure and PubMed database for literatures published from 2009 to 2014. The key words were intervertebral disc, nucleus pulposus, biomechanics, fibrosis annulus, cartilage in Chinese and English, respectively. Articles regarding biomechanical characteristics of lumbar intervertebral disk, nucleus pulposus, fibrosis annulus and cartilage were included, and repetitive studies were excluded. Totaly 5 072 articles were retrieved initialy. In accordance with inclusion and exclusion criteria, 41 articles were included in result analysis. RESULTS AND CONCLUSION:We can fuly understand the pathogenesis, development and adverse consequences of diseases related to the lumbar intervertebral disk by summarizing the structural features and internal pressure of lumbar intervertebral disk and the effect of different loads, biomechanical characteristics of lumbar intervertebral disk with degenerative changes and establishment of mechanical model of lumbar intervertebral disk. It is of directive significance for daily health care of the lumbar intervertebral disk and how to better use force, a physical factor, to solve the lumbar intervertebral disk problems.

Objective:To explore diagnostic value of basic head-up tilt table test (HUT)and sublingual nitroglycerin head-up tilt table test (SNHUT)on vasovagal syncope (VVS).Methods:A total of 61 patients,who collapsed be-cause of unknown causes and were highly suspected as VVS,were regarded as VVS group,received HUT,and an-other 22 healthy subjects were regarded as healthy control group.Results:Among the 61 cases of VVS group,57 ca-ses were tilt test positive and the positive rate was 93.44%.Among them,there were 16 cases (26.23%)with posi-tive basic HUT and 41 cases (67.21%)with positive SNHUT.The 22 cases in healthy control group also received basic HUT and SNHUT,one case (4.54%)was basic HUT positive and three cases were SNHUT positive.Positive rates of SNHUT was higher than that of HUT,but there was no significant difference in VVS group (χ2 =0.175,P =0.683).Conclusion:HUT is a noninvasive,repeatable method easily accepted by patients for diagnosing VVS currently.It can elevate positive rate of test when combined with SNHUT.

Objective to investigate the application of the whole course case tracking method in continuous improvement of nursing quality of out-patient operation unit. Methods Administration frames were established for this project,such as monitoring group and executive group. the medi-cal treatment procedure and patients′experience were followed by referees. the results were quantified for statistical analysis. the problems were rec-ognized by priorities and rectification was correspondingly performed. Afterward,another group of patients were traced to evaluate the results of the rectification. We focus on those items of lower scores and undertook rectifications accordingly. Particularly,we optimized signs in outpatient unit, made pamphlets to clarify the procedures,and were cautious to provide more easy-to-understand informs. Results By the second round evaluate, these scores were effectively improved. Especially,the item of“clear informed consent”was statistically significant(P = 0.003). Meanwhile,the team of outpatient operation unit became more cohesion,with enhanced service consciousness,and was initiative to improve the work. Conclusion the whole course case tracking method is feasible for short-range medical service evaluation such as outpatient surgery. the evaluation results clarify the direction for quality improvement,thus set the starting point of quality management aiming at continuously improvement of the patients′ experi-ence and quality of nursing service.

Objective To preliminarily establish the reference interval of serum non‐esterified fatty acids(NEFA)among popula‐tion in Wuhan area by enzymatic assay .Methods NEFA level of serum samples from A total of 1 250 individuals undergoing healthy physical examination in our hospital were selected as the research subjects .The Olympus AU5400 biochemistry analyzer and SEKISUI reagents were adopted to detect serum NEFA level .The regression analysis was adopted to analyze the NEFA influencing factors .The NEFA 95% reference interval was estimated by using the normal distribution method and the reference interval was verified .Results The regression analysis showed that the body mass index (BMI)and age had significant effect on NEFA (P<0 .01) .NEFA was highest in the group aged ≥60 years old ,followed by the group of 18- <45 years old ,and lowest in the group of 45-60 years old ;NEFA was highest in the group of BMI<18 .5 kg/m2 .The 95% reference interval of NEFA for healthy popula‐tion in Wuhan area was estimated as 204 .6 -975 .2 μmol/L .The detected NEFA level for clinical verifiers was 242 .0 -831 .2μmol/L ,which conformed to the above reference interval .Conclusion The serum NEFA reference interval among healthy popula‐tion in Wuhan area is primarily established .