Objective To study the role of clinical nursing pathway (CNP)in health education for patients undergoing percutaneous nephrolithotomy (PCNL).Methods Ninety patients with PCNL were randomized into the observation group and the control group in equal number: the former received CNP health education and the latter routine health education while hospitalization. The two groups were compared in terms of scores on health education,satisfaction with nursing,incidence of postoperative extubation and hospital stay.Result The scores on health education,satisfaction with nursing and incidence of postoperative extubation in the observation group were all significantly higher than those of the control group (allP<0.05) and the hospital stay in the former was significantly shorter than that of the latter (P<0.05).Conclusions PCNL in use of CNP health education can promote patients’ health education quality,reduce their incidence of extubation,shorten their hospital stays and improve their satisfaction of nursing. It is worthy of clinical promotion and application.

Objective To compare the influence degree of laparoscopic operation and open operation on peripheral blood T lymphocyte subsets and Th1Th2 in patients with severe acute pancreatitis.Methods 54 patients who underwent surgical treatment in our hospital from February 2013 to December 2014 were selected as the subjects, 27 patients with severe acute pancreatitis who were treated with open operation as group A , 27 cases who were treated with laparoscopic operation at the same time were selected as group B , and then the peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of two groups before the operation and at first,third and seventh day after the operation were respectively detected, then the detection results of two groups were compared.Results The peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of group B at first, third and seventh day after the operation were all significantly better than those of group A , the difference was statistically significant ( P<0.05 ) , and the detection results of group A and group B at third day after the operation were worse than those at other time , the difference was statistically significant (P<0.05).Conclusion The influence of laparoscopic operation and open operation on T lymphocyte subsets and Th1Th2 in peripheral blood of patients with severe acute pancreatitis, the adverse effects of laparoscopic operation on the above indicators were relatively small.

Based on the anatomical study of kidney in mammals of 27 families and 163 species, the authors discovered Anoa depressicornis type kidney, and obtained the evidence of morphological transition between Ox-type kidney and Pig-type kidney. After observing the renal papillary structure of Budorcas taxicolor, the evidence of fact and theoretical bases of the biological view was proved that the general papillae are developed from the multi-papillae kidney. The author advanced a new type of leaf-shaped multipapillae kidney. The authors suggest to classify the mammalian kidneys principally into 2 groups, i. e, simple and composite kidney, and subdivide them into 4 types, i. e, multipapillae and concentrated papillae for simple kidney and leaf-shaped multipapillae and ball-shaped mono-papillae for composite kidney. In contrast to the previous classification, the 2-group 4-type classification recommended here with its solid anatomical foundation is conformable with the viewpoint of biology, and is more practical and integrated.

OBJECTIVETo observe the long-term outcome of implantable cardioverter-defibrillator (ICD) implantation in Brugada syndrome patients and to explore how to reduce the frequency of ICD nappropriate schocks.

METHODSThis study included 14 symptomatic patients (mean age (44.3 ± 8.3) years old; all males) with Brugada syndrome implanted with ICD in our hospital between 1998 and 2012, and these patients were followed up routinely every 6 months. The initial ICD parameters were set according o conventional experience. The ventricular tachycardia (VT) zone was programmed to ventricular rate 150-188 bpm/cycle length (CL) 400-320 ms and the ventricular fibrillation (VF) zone was programmed to ventricular rate ≥ 188 bpm/CL ≤ 320 ms. The total events were recorded by ICD. The ICD parameters revision was made by electrophysiological (EP) experts in case of inappropriate shocks.

RESULTSPatients were followed up for mean (43.0 ± 28.3) months. A total of 297 VF/VT events were recorded by ICD. Electrophysiological experts found that 90% (178/198) episodes were true VF ( CL 130-250 ms) among of 198 VF episodes and 147 VF episodes were terminated by one shock and 21 VF events were terminated by two or more shocks, and the rest 10 VF terminated spontaneously. Only 9% (9/99) VT events were true VT (CL 320-360 ms) among of 99 VT episodes. Eight VT episodes were converted by antitachycardia pacing therapy (ATP) and the other one terminated spontaneously. The rest 90 VT episodes (91%) were supraventricular arrhythmias (SVT, CL 340-390 ms). About 90% inappropriate shocks can be reduced by Wavelet discrimination function and optimal programming (VF zone ventricular rate ≥ 222 bpm/CL ≤ 270 ms and/or VT zone ventricular rate 167-222 bpm/CL 270-360 ms ) according to the characteristics of arrhythmia of individual patient.

CONCLUSIONICD can effectively prevent sudden cardiac death and syncope in high-risk patients with Brugada syndrome. The most common complication is inappropriate shock due to SVT. Optimal ICD programming with Wavelet discrimination function can effectively reduce the frequency of inappropriate shock rate.

Adult ; Brugada Syndrome ; Cardiac Conduction System Disease ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Humans ; Male ; Syncope ; Tachycardia, Ventricular ; Treatment Outcome ; Ventricular Fibrillation

Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.

Objective To construct a new replicating adenovirus vector CNHK600-p53 carrying anti-tumor gene p53 and investigate its effect on hepatocarcinoma cell line PLC/PRF5. Methods The methylthiazolyl tetrazolium assay (MTT) was used to observe the killing effect of Fluorouracil, Mitomycin and Epirubicin alone or in combination with adenovirus CNHK600-p53 on PLC/PRF5. Results When 5-Fu at concentration of 400?g/ml, the inhibition rate was (65?4. 2) % ; with MMC at 1?g/ml, the rate was (41?1.9)%; and it was (65?1.8)% when EPI at concentration of 10?g/ml. With PLC/PRF5 infected by adenovirus CNHK600-p53 ( MOI = 0. 625) , the inhibition rate was significantly increased to (89?5. 3)%,(60?2.3)% and (75?1.5)% respectively; When MOI was 0.3125, 0.625, 1.25, the inhibition rate in CNHK600-p53 group and Ad-p53 group was (27?2. 5)% , (30?3. 7)% , (61?4. 3)% and(4?2.7)%, (5?3.5)%, (16?4.5)% respectively. Conclusion For hepatocarcinoma cell line PLC/PRF5 the effect of CNHK600-p53 is stronger than Ad-p53.

Objective To establish a mouse model by transplanting subcutaneously human pancreatic cancer tissue fragments.Methods Surgically resected pancreatic cancer tissue fragments from patients were transplanted into NOD/SCID mice subcutaneously,and then the growth of the tumor and transplanting it into the next generation were observed.The growth rate,HE staining and immunohistochemistry staining of Ki67 and VEGF were compared.Results We have obtained 13 cases ofpancreatic cancer tissues and 6 cases of biopsy specimens.In 5 cases transplantation was successful,in onemouse model passing to fourth generation,in 4 models to second generation.With the increase of generaions,tumor growth accelerated.HE staining showed later passage cells behavior in an identical manner as the primary cells.Immunohistochemistry staining showed that expressions of Ki67 and VEGF are increasing.Conclusions Through transplanting human pancreatic cancer tissue fragments directly,we have constructed mouse model of pancreatic cancer successfully.With the passage of subculture,the malignant degree and invasiveness may increase.

Objective To study the mode and clinical implications of onset of spontaneous tosade de pointes in the congenital long QT syndrome. Methods We reviewed electrocardiograms (ECGs) of 55 patients with congenital QT syndrome for syncope. Documentation of the onset of tosade de pointes was available for 16 patients. All these patients had "definitive long QT syndrome" by accepted clinical and ECG criteria. Results One hundren and forty-nine runs of tosade de pointes were documented in 16 patients,of whom,there were 130 runs of pause-dependent tosade de pointes. Conclusion Our results show that the pause-dependent tosade de pointes,which has been recognized as a hallmark of tosade de pointes in the acquired long QT syndrome,plays a major role in the genesis of tosade de pointes in the congenital long QT syndrome.

Carcinoid Tumor ; diagnosis ; pathology ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; Ear, Middle ; Humans ; Pharynx

OBJECTIVETo explore the linkage relationship between specific genetic markers and arrhythmogenic right ventricular cardiomyopathy (ARVC) in Chinese pedigrees.

METHODSThe microsatellite genetic markers D2S152, D14S252, and D10S1664 were studied for their linkages to ARVC in five Chinese ARVC pedigrees and a normal population of 121 Chinese individuals. Genomic DNA of the pedigrees and normal population was amplified using PCR techniques. Denaturing polyacrylamide sequencing gel (4%) electrophoresis was used to detect microsatellite repeat polymorphisms. Gels were silver-stained. A classical linkage analysis program was used assuming models of autosomal dominance and recession.

RESULTSThe logarithm of the odds (LOD) scores of D2S152 with ARVC in LW, WD, DS, LC and TY pedigrees were 2.174, -0.589, -infinity, - (indicating that linkage is not supported in this mode), and -infinity respectively in autosomal dominant model (recombination fraction = 0.000 respectively)and were -infinity, -infinity, -infinity, -infinity, and 0.182 respectively in the autosomal recessive model. The LOD scores of D14S252 with ARVC in LW, WD, DS, LC and TY pedigrees were -, -, -infinity, -, and 0 respectively in autosomal dominant model, and were -infinity, -0.812, -infinity, -infinity, and 0.087 respectively in autosomal recessive model. The LOD scores of D2S152 with ARVC in LW, WD, DS, LC and TY pedigrees were -, -0.539, -, and 0.602 respectively in autosomal dominant model and were -, -infinity, -infinity, -infinity, and - infinity respectively in autosomal recessive model.

CONCLUSIONSThe LOD score for D2S152 in the LW pedigree was 2.174, indicating that the chance of linkage is about 150:1. This suggests that there is a possible ARVC-related gene near this marker. There were no clear linkage relationships between ARVC and D10S1664 and D14S252 in this family, and no linkages between ARVC and any of the three genetic markers in the other four families. These results also suggest that there is genetic heterogeneity in LW and in the other pedigrees.

Arrhythmogenic Right Ventricular Dysplasia ; genetics ; Asian Continental Ancestry Group ; China ; Female ; Genetic Linkage ; Genetic Markers ; Humans ; Lod Score ; Male ; Microsatellite Repeats