Objective To find out the nurse's cognitive level of the postoperative pain management and its relevant elements,and influence of intervention measures on their postoperative pain management,so that can provide a theoretic basis for a more effective postoperative pain management.Methods The grounded theory research method taken from qualitative research Was mainly used,and triangulation was applied in collecting the information,such as observational method,interviewing method among nurses and collecting questionnaire among nurses and patients.In addition,the information was analyzed by using the constant tomparative method,generalized the relative elements influencing the postoperative pain managemen,summarized the intervention measure.In the end.analyzed comparatively the change of the nurses'knowledge and behavior of the postoperative pain management before and after intervention.Results Surgical nurses'knowledge and behavior of the postoperative pain management was improved in various degrees.The difference of the data has statistical significance.Satisfaction degree of patients improved and the theoretical model included conceptual structure,contributory factors and results.Conclusions The advance of the surgical nurse's self-awareness can improve the level of the postoperative pain management.

Dental Implantation ; Humans ; Surgery, Computer-Assisted

Objective To study the rehabilitation effects of the cochlear implants on prelingually deaf children with alba abnormality.Methods A retrospective analysis of the effects of CIs was conducted in the prelingually deaf children of 11 cases of the children with abnormal alba(the research group) and 18 cases of the children who had normal alba(the control group) at the First Affiliated Hospital of Fujian medical university.All the operations were completed by the same doctor.There were no obvious complications during and after the operation.The cochlear implants were turned on after one month and the prelingually deaf children with extremely severe bilateral sensorineural deafness were trained for speech at the rehabilitation centre.The assessment criteria of the categories of auditory performance(CAP) and speech intelligibility rate(SIR) were used.After six months and twelve months of the operation, the family members were followed who have direct contacts with the children.The evaluation of data between the research and the control groups was administered.Results In the research group, the average level of CAP after six months'' post-operation was 2.41±0.47.But in the control group, the average level was 3.28±0.45.In the research group, the average level of SIR after six months'' post-operation was 1.27±0.44.There were 3 children in the research group at level 2, but in the control group, the average level was 1.89±0.31.Two children in the control group were level 1 while the others were level 2.In the research group, the average level of CAP after twelve months'' post-operation was 4.00±0.43 while only one child at level 3.There was one child at level 5 in the research group, the rest were level 4.There was a statistically significant difference in the average level of the CAP after six months'' post-operation(t=4.983, P<0.05) and in the average level of the SIR after six months'' post-operation(t=4.371, P<0.05).There was no statistical difference in the average level of the CAP after twelve months'' post-operation(t=1.033, P>0.05) and in the average level of the SIR after twelve months'' post-operation(t=0.434, P>0.05).Conclusion There is no significant difference of the rehabilitation effects of post-operation between the prelingually deaf children with alba abnormality and those with normal alba.

Objective To explore the similarities and differences in amplitude of low frequency fluctuation ( ALLF) between patients with first-episode drug-naive schizophrenia and offspring of schizophrenia patients.Methods ALFF values were estimated by measuring the Blood Oxygen Level-Dependent ( BOLD) signal using resting state function-al magnetic resonance imaging ( rs-fMRI) .The fMRI date were acquired from 23 patients with first-episode drug-naive schizophrenia (SZ), 25 offsprings of schizophrenia patients (OS) and 29 age -and gender -matched health controls ( HC) .The ALFF value of each subject was calculated by MATLAB-based DPARSF software.Results Compared with HC, the ALFF values of SZ and OS were significantly different in the left posterior part of the inferior temporal gyrus, left parahippocampal gyrus, left hippocampus, right postcentral gyrus and bilateral precuneus.The ALFF values were not signif-icantly different between these two groups in the aforementioned regions.Compared with OS and HC, the ALFF values of SZ were significantly different in the left anterior part of the inferior temporal gyrus, left temporal pole and bilateral calcarine cortex.But there was no significant difference between OS and HC.Conclusions The brain function is abnormal in pa-tients with early schizophrenia and offspring of schizophrenia patients.The significant difference of ALFF in the left posterior part of the inferior temporal gyrus, left parahippocampal gyrus, left hippocampus, right postcentral gyrus and bilateral pre-cuneus may suggest the heredodiathesis-related brain functional alterations.Significant difference of ALFF in the left ante-rior part of the inferior temporal gyrus and the left temporal pole bilateral calcarine cortex may suggest the disease-related brain alterations.

OBJECTIVE To identify the clinical risk factors related to the increasing likelihood of surgical drainage and the medical therapy failure in deep space neck abscess. METHODS The clinical data of 111 consecutive patients from January 2009 to June 2016 with deep space neck abscess were reviewed retrospectively. Logistic regression analysis was used to study the clinical risk factors by stepwise forward regression. RESULTS All patients had successful resolution of their infections by medical therapy and(or) surgical drainage. At the level of α=0.05, dyspnea was the risk factor of increasing likelihood of surgical drainage (β=3.001, OR=20.099); the maximum dimension of abscess>2.0 cm was not only the risk factor of increasing likelihood of surgical drainage(β=2.396, OR=10.979), but also that of medical therapy failure(β =4.618, OR=101.313). Age, sex, white blood cell count at presentation, fever, diabetes, neck swelling, and multiple space abscess of neck did not increase the risk of surgical treatment (P>0.05, respectively). CONCLUSION Active preoperative preparation and surgical intervention should be used with those who have dyspnea and the maximum dimension of abscess >2.0 cm as soon as possible. However, those who without dyspnea and abscess size less than or equal to 2.0 cm may be recovered without incision and drainage of operation by only sufficient and effective intravenous antibiotics treatment under close guarded surveillance.

OBJECTIVE: In order to investigate the interaction between the cytokines and keratinocyte and determine the role of cytokines in hyperproliferative of chronic otitis media with cholesteatoma, we observe the expression of matrix metalloproteinase 9 (MMP9), vascular endothelial growth factor (VEGF), keratinocyte growth factor (KGF) and its receptor (KGFR) in middle ear cholesteatoma. METHOD: We examined the expression of MMP9, VEGF, KGF, KGFR and Ki-67 by immunohistochemistry in 50 specimens from chronic otitis media with cholesteatoma and 15 specimens from the normal skin of external auditory meatus. Ki-67 as an evaluation of cholesteatoma proliferation markers were used to detect the keratinocyte proliferative activity. RESULT: (1) The expression of VEGF and MMP9 in cholesteatoma specimens was higher than normal skin, and the difference was statistically significant (t = 4.914, P < 0.01; t = 3.284, P < 0.01). (2) The expression of KGF and KGFR in middle ear tissues was higher than normal skin, and the difference was statistically significant (t = 4.814, P < 0.01; t = 3.104, P < 0.01); The expression of KGF and KGFR increased, and the expression of Ki-67 also correspondly increased in the cholesteatoma. (3) In the tissue MMP9 and VEGF were positive. Mean optical density increased as well. KGF expression also increased accordingly. CONCLUSION MMP9, VEGF, KGF and KGFR proteins played an important role in hyperproliferation of cholesteatoma tissues. VEGF, MMP9 and KGF had a synergistic effect in hyperproliferation of cholesteatoma tissues.
Cholesteatoma, Middle Ear ; pathology ; Cytokines ; metabolism ; Ear Canal ; metabolism ; Ear, Middle ; metabolism ; Fibroblast Growth Factor 7 ; metabolism ; Humans ; Immunohistochemistry ; Keratinocytes ; cytology ; Ki-67 Antigen ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Otitis Media ; pathology ; Receptor, Fibroblast Growth Factor, Type 2 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

Objective To study the effect of calcium gluconate oral solution combined with psychological intervention on preventing the advertise reaction in blood donation by plateletpheresis.Methods From February 2015 to February 2016, 114 cases were collected in Shaoxing downtown blood bank, and were divided into the control group and the experimental group 57 cases in each group.In the blood collection process, the control group were not given any treatment, the experimental group was given calcium gluconate oral liquid combined with psychological intervention.The total incidence adverse reactions and SAS scores in the two groups was compared.Results Before blood donation, Before blood donation, SAS scores in the two groups has no statistically significance.After blood donation, the SAS scores and the total incidence of adverse reactions in the experimental group were significantly lower than those in the control group, the differences in the two groups were statistically significant.(P<0.05).Conclusion Calcium gluconate oral liquid combined with psychological intervention can prevent the adverse reactions in the process of blood donation by plateletpheresis, which is worthy of promotion in the process of plateletpheresis.

AIM:Atherosclerotic calcification is highly linked with plaque instability and cardiovascular events .Adenosine monophosphate-activated protein kinase ( AMPK) has been involved in the pathogenesis of various cardiovascular disease .The contributions of AMPKαsubunits to the development of atherosclerotic calcification in vivo remained unknown .We hypothesized that AMPKαsubunits may play a role in the development of atherosclerotic calcification .METHODS: Atherosclerotic calcification was generated by 24-week fed of western diet in ApoE-/-background mice .Calcification was evaluated in aortic roots and innominate arteries of ApoE-/-mice or in mice with dual deficiencies of ApoE and AMPKαsubunits globally ( AMPKα1 and AMPKα2 ) , or vascular smooth muscle cell ( VSMC)-specific or macrophage-specific knockout of AMPKα1 with atherosclerotic calcification pone diet . The mechanism of AMPKα1 in regulating Runx2 was further explored in human aortic VSMC .RESULTS: Ablation of AMPKα1 but not AMPKα2 in ApoE-/-background promoted atherosclerotic calcification with increased Runt -related transcription factor ( Runx2 ) expression in VSMC compared with ApoE-/-mice.Conversely, chronic administration of metformin, which activated AMPK, markedly reduced ath-erosclerotic calcification and Runx2 expression in ApoE-/-mice but had less effects in ApoE-/-/AMPKα1 -/-mice.Furthermore, VSMC-but not macrophage-specific deficiency of AMPKα1 in ApoE-/-background promoted atherosclerotic calcification in vivo com-pared with the controls .AMPKα1 silencing in human aortic VSMC prevented Runx 2 from proteasome degradation to trigger osteoblastic differentiation of VSMC .Conversely , activation of AMPK led to Runx 2 instability by inducing its small ubiquitin-like modifier modifi-cation (SUMOylation).Protein inhibitor of activated STAT-1 (PIAS1), the SUMO E3-ligase of Runx2, was directly phosphorylated by
AMPKα1 at serine 510, to enhance its SUMO E3-ligase activity.Ablation of PIAS1 serine 510 phosphorylation inhibited metformin-in-duced Runx2 SUMOylation, and subsequently prevented the effect of metformin on reducing oxLDL-triggered Runx2 expression in hu-man aortic VSMC.CONCLUSION:Deficiency of AMPKα1 in VSMC increases Runx2 expression and promotes atherosclerotic calcifi-cation in vivo.AMPKα1 phosphorylates PIAS1 to enhance Runx2 SUMOyalation and subsequent degradation .

OBJECTIVE: To observe the morphology of eroded auditory ossicles obtained in middle ear surgery for cholesteatoma and to investigate the mechanism of bone erosion in cholesteatoma. METHOD: The morphology of eroded auditory ossicles in 8 cholesteatoma cases and 2 normal cases were observed with light microscopy. The ultrastructure of eroded auditory ossicles in 5 cholesteatoma cases and the ultrastructure of control bones in external ear canal of 2 cases were observed and compared with transmission electron microscopy. RESULT: Osteomyelitis and multinucleate osteoclasts with ruffled borders were observed in the eroded auditory ossicles of cholesteatoma. Intramembranous and endochondral ossification were both observed. The obvious bone destruction and remodeling were observed consistently. CONCLUSION Osteoclasts and Osteomyelitis are both responsible for bone destruction in cholesteatoma. Intramembranous and endochondral ossification may co-participate in bone remodeling. Osteogenesis is also a basic pathologic phenomena in cholesteatoma. The obvious bone destruction and remodeling can coexist in cholesteatoma cases.
Case-Control Studies ; Cholesteatoma, Middle Ear ; pathology ; Ear Ossicles ; pathology ; ultrastructure ; Humans ; Microscopy, Electron, Transmission ; Osteoclasts ; pathology ; ultrastructure

OBJECTIVE: To observe the expression of receptor activator nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) in cholesteatoma and to determine their roles in the destruction of bone. To observe the role of osteoclasts in bone destruction. METHOD: Immunohistochemical technique and computer image analysis were used to examine the expression of RANKL and OPG in 27 cholesteatoma and 11 normal tissue respectively. RESULT: RANKL was expressed mainly in promatrix cells, including fibroblasts and foam cells. OPG was expressed both in epithelium and promatrix cells. The results of the computer image quantitative analysis showed that the mean optical density of RANKL and the ratio of RANKL/OPG in cholesteatoma were higher than that in normal skin epithelial tissue (P<0.05). There was no significant difference between the mean optical density of OPG in cholesteatoma and that in normal skin epithelial tissue (P>0.05). CONCLUSION The overexpression of RANKL and the increased ratio of RANKL/OPG in cholesteatoma are associated with the destruction of bone. Osteoclasts is possible mediator of osteolysis.
Adolescent ; Adult ; Aged ; Cholesteatoma ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Osteoclasts ; metabolism ; pathology ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism ; Receptor Activator of Nuclear Factor-kappa B ; metabolism ; Young Adult