Objective To evaluate application of quality care in prevention of general surgery wound infection in elderly patients. Methods 116 cases of elderly patients undertook general surgery from October 2013 to October 2014 were selected in alphabetical order by pinyin of last name as the research objects, who were divided into the observation group (58 cases) and control group (58 cases) by lottery. The control group received routine care, the observation group received quality care. The occurrence of wound infection and the hospitalization time were compared. Results The incidence of wound infection of the observation group was 6.9%(4/58), which was lower than that of the control group [24.1%(14/58),χ2=6.576, P<0.05]. The hospitalization time of the observation group was lower than that of control group [(22.6±3.2) d vs.(28.6±3.8) d, t=5.401, P<0.05]. Conclusions Quality care contributes to reduce the incidence of wound infection on general surgery incisions of elderly patients, and promotes the recovery of patients.

Background Central corneal thickness (CCT)is an important parameter to evaluate corneal healthy status and is crucial for surgical planning.However,clinical study found that the center of cornea does not correspond to the thinnest point of cornea.Thus,it is essential to characterize the minimum corneal thickness(MCT) and its location.Objective Present study was to determine the thickness and location of MCT and its relationship to the fellow eye using Pentacam High Resolution technique.Methods The 564 eyes from 282 Chinese myopic patients were reviewed in this study.The CCT,MCT,pupillary central corneal thickness(PCT) and x-y coordinate of thinnest point were bilaterally measured.Written informed consent was obtained prior to the ocular biomedical measurement.Results CCT was (540.07±31.78) μm in the right eyes and (539.24±31.06) μm in the lefi eyes; PCT was (540.25±30.75)μm in the right eyes and (539.48±31.00)μm in the left eyes.MCT was (537.87± 31.91)μm in the right eyes and (536.35±31.24)μm in the left eyes,showing significant differences in all the parameters between the right eyes and left eyes expect for PCT(CCT:P=0.046;PCT:P=0.065 ;MCT:P=0.000).The C CT,PCT and M CT were significantly correlated between the right eyes and left eyes (r =0.97,0.97,0.98,P＜ 0.01).Bland-Altman plot showed a good consistence between the both eyes.The mean distance from the center was (0.50±0.21) mm in the right eyes and (0.56±0.22)mm in the left eyes,showing a significant difference (P =0.000).The difference between CCT and MCT was approximately (2.20±1.74)μm in the right eyes and (2.88±1.75) μm in the left eyes.The location of MCT in both the right eyes and left eyes tended to symmetry along the vertical midline.The distance between the R (x,y) to transformed L (x,y) was (0.29 ± 0.17)mm and the angular distance was (28.28±28.21)degree.Conclusions This study offers a range of MCT and its location in Chinese myopic patients.The difference exists between the CCT and MCT in bilateral eyes.The location of the thinnest point tends to be symmetrical along the vertical midline between the both eyes.The changes of these parameters may be helpful for the diagnosis of some corneal diseases.

Fourteen compounds were isolated from 95% ethanol extract by silica gel, MCI, and ODS column chromatography. These compounds were respectively identified as quercetin (1), kaempferol (2), (+)-catechin (3), fraxin (4), protocatechuic acid (5), gallic acid (6), methyl gallate (7), ethyl gallate (8), apocynol A (9), baccatin (10), cerevisterol (11), ellagic acid (12), 3, 3',4'-tri-0-methylellagic acid(13) and N-benzoyl-L-phenylalaninyl-N-benzoyl-L-phenylalaninate(14) by analyzing their spectral data and comparing with the previously reported literatures. Except for gallic acid (6), all other compounds were isolated from this plant for the first time. Compounds 1, 2 and 6 showed moderate anti-proliferation activities on tumor cells.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Euphorbiaceae ; chemistry ; Humans ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To investigate the clinical application of acupuncture combined with general anesthe -sia in gynecologic laparoscopic surgery .Methods 60 ASA( the American society of anesthesiologists )Ⅰ-Ⅱpatients undergoing elective gynecologic laparoscopic surgery were randomly divided into the acupuncture group and control group.Patients in the acupuncture group were chosen Hegu (LI 4),Neiguan(PC 6) on both sides.After acupuncture, the two acupoints,electroacupuncture stimulated 20-30min,then administered general anesthesia ,electroacupuncture until surgery finished ,the control group received general anesthesia only .The drug dosages of the two groups was regu-lated,maintained anesthesia depth bispectral index ( BIS) between 40 and 60.The changes of the blood pressure ( BP) ,heart rate and BIS of the two groups at the same time points were observed;the propofol and remifentanil dos-age after the surgery ,the awaken time and extubation time ,OAA/S score and pain score after wake ,the happening of restlessness,chills,nausea and vomiting ,the usage of narcotic analgesics postoperation ,and the intraoperative aware-ness were recorded .The effect of acupuncture combined with general anesthesia was evaluated .Results Anesthetic dosage propofol of the acupuncture group [(7.44 ±1.30)μg· kg-1· h-1] was less than [(8.66 ±1.24)μg· kg-1· h-1] of the control group (t=3.720,P=0.001),remifentanil dosage was also less than the control group [acupunc-ture group (10.59 ±2.58)μg· kg-1· h-1,control group (11.93 ±2.27)μg· kg-1· h-1,t=2.168,P=0.034]. Compared with the basic value ,the BP values were higher at the time of intraoperation ,waking,extubation and 10 min after extubation (all P<0.05),the acupuncture group had more stable BP .Compared with the acupuncture group , heart rates in the control group were faster at extubation and 10min after extubation .Recovery time and extubation time of the acupuncture group were (9.05 ±2.36)min and (1.61 ±2.40)min,which were shorter than (12.50 ± 3.20)min and (15.90 ±3.37)min of the control group (P<0.05).Pain score(VAS) in the acupuncture group was lower than that of the control group .Consciousness score was higher in the acupuncture group ,the incidence rates of restlessness,chills were less.Conclusion The use of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery can reduce the dosage of general anesthetics ,shorten the awaken time and extubation time ,increase the OAA/S score of the patients ,relieve pain ,and the recovery quality is higher .

Objective To investigate the clinical value of contrast-enhanced ultrasonography(CEUS) in evaluating treatment response of hepatocellular carcinoma after interventional therapy. Methods One hundred and three patients with 136 lesions of hepatocellular carcinoma confirmed by pathology were examined by common color ultrasound (US), contrast-enhanced CT, CEUS and DSA pre- and post-interventional treatment respectively. Results The sensitivity,specificity and accuracy of CEUS for focus judgment after interventional therapy were 95.8%, 95.6% and 98. 5% respectively. The sensitivity, specificity and accuracy of US in detecting tumor deactivation and residue were 92.3% ,77.4% and 83.1% respectively. CEUS were highly consistent with the results of enhanced CT/DSA (Kappa = 0.93) and significantly higher than those of US (Kappa = 0.66). Conclusions CEUS is useful to monitor the efficacy and guide treatment after interventional therapy.

Objective To observe on the variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic(T2DM).Methods The diabetic obese group contained 31 cases,the non-diabetic obese group contained 33 cases,healthy normal body weight group contained 23 cases,the blood glucose(FPG),insulin (FPI),blood total cholesterol(TC),triglyceride(TG),IL-18 and the cell population of lymphocyte subpopulations CD3+and CD4+、CD8+ in peripheral blood were determined,the insulin sensitivity index were calcnlated.Results Compared with the healthy normal body weight group,the blood fat,FPG,FPI,IL-18 of T2DM patients significantly increased,there were significant statistical difference(P ＜ 0.05 or P ＜ 0.01).The ISI significantly decreased(P ＜ 0.01).Compared with the non-diabetic obese group,the blood fat and IL-18 of T2DM patients significantly increased (P＜0.05).Compared with the diabetic obese group,the subpopulations cell population of CD3+、CD4+、CD8+ in the non-diabetic obese group significantly decreased,the ratio of CD4+/CD8+ significantly increased,there were significant statistical difference(P＜0.05 or P＜0.01)in the two groups comparison.Compared with the non-diabetic obese CD4+/CD8+ significantly increased(P＜0.05).Conclusion T2DM patients should prevent the hyperinsulinemia,control blood sugar,reduce insulin resistance,sustain normal lipid metabolism,boost immune function.

Objective To investigate the effect of improved bone plate fixation and bone grafting in the treat ment of intra-articular calcaneal fracture.Methods 80 patients with intra-articular calcaneal fractures were randomly divided into the two groups.The non-bone graft group(47 feet in 40 patients)was given improved bone plate fixation.The bone graft group(50 feet in 40 patients)was given improved bone plate fixation and bone grafting.Results The incidence rate of complication in the non-bone graft group was 25.0％ and that in the bone graft group was 19.1％.The difference between the two groups was not significant(x2 =0.21,P ＞ 0.05).Postoperative Bhler's angle and calcaneal height between the two groups had significant differences (t =14.5,16.99,all P ＜ 0.05).The excellent rate of Maryland functionality in non-bone graft group was 66.0％,which was significantly lower than 86.0％ in the bone graft group(x2 =5.38,P ＜ 0.05).The average full weight bearing time between the two groups had significant difference (t =11.17,P ＜ 0.05).Bhler's angle after 1 year and forwa rd Bhler's angle loss of the non-bone graft group had significant differences compared with the bone graft group (t =29.76,9.81,all P ＜ 0.05).Conclusion Improved bone plate fixation and bone grafting in the treatment of intra-articular calcaneal fracture can obtain better results and avoid the long-term loss of reduction.

Objective To explore the applications effect of evidence-based nursing in the health education for patients with mixed vaginal infections.Methods One hundred and sixty-eight patients with mixed vaginal infection were divided into observation group(n=84) and control group(n=84).Based on the evidence-based nursing method,the observation group first raised questions,then sought evidence to determine the conclusion according to the literature search,and finally combined with clinical evidence to formulate a reasonable plan for health education and effectively implemented.The control group was given conventional nursing.The two groups were compared in terms of rate of disease-related awareness in return visit 1 month after discharge,behavior 2 months after discharge and disease relapse 6 months after discharge.Results The rate of disease-related awareness and behavior in the experiment group were better than those of the control group significantly(all P<0.05).The rate of disease relapse of the experiment group was lower than that of the control group(P<0.01).Conclusion Application of evidence-based nursing method for patients with vaginal infections in health education can guide the nurses' health education target,improve the patients' cognitive and behavior and reduce the rate of disease relapse.

Objective Based on the model of exercise induced central fatigue,we attempt to testify that the whole power output in time-counted sporting events was regulated by the central nervous system(CNS).Methods Eighteen national level rowers participated in the experiment.Each participant completed two successive 6 minutes maximal rowing exercise with an interval of 15 minutes.The power output(PO),heart rate(HR),blood lactate(BL),RPE and EMG were measured.Results It was demonstrated that the pacing strategies adopted by the rowers in the 2 successive 6-minute rowing tests were remarkably similar,and the rowers'PO and iEMG activities in the two tests were highly correlated,especially in the last minute of exercise.Conclusion It is concluded that the hypothesis of pacing strategy is controlled by CNS.

Objective To compare the outcomes of total hip replacement and minimally invasive dynamic hip screw in treating osteoporotic femoral intertrochanterie fractures.Methods Retrospectively analyze the clinical data of 56 patients with osteoporotic femoral intertrochanteric fractures who came to our hospital from July,2008-June,2012.Twenty eight cases who accepted minimally invasive dynamic hip screw were divided into the control group while 28 cases who accepted total hip replacement were divided into the experimental group.The blood loss and postoperative drainage,operative time,situation of implant loosening,the occurrence of postoperative complications and the clinical curative effect were compared between two groups.Results The differences in operative time,blood loss,and postoperative drainage flow,limited weight-bearing after operation was statistically significant between two group[(96.37 ± 20.42)min,(529.85±73.82) ml,(7.46±1.23) dvs (66.84±18.63)min,(152.79±37.35) ml,(14.32±2.62)d,t=5.653,24.117,12.542,P＜0.05].The differences in FRS score and Harris score between twogroups was not statistically significant [(27.75±3.59),(89.84±4.17) vs (26.41±3.16),(88.68±3.92),P＞ 0.05].The incidence in internal fixation loosening varied significantly with different degree of osteoporosis in the control group (66.7％vs18.8％,x2 =4.745,P ＜ 0.05) but not in the experimental group (11.1％ vs 10.0％,P＞0.05).Complication rate of the experimental group was significantly lower than the control group (3.6％vs 28.6％,x2 =4.766,P ＜ 0.05).Conclusions For the elder patients with osteoporotic femoral intertrochanteric fractures,the selection of surgical approach should be based on the patient's individual circumstances and the degree of osteoporosis.In the same time,attention should be paid to anti-osteoporosis therapy after operation.