Objective To analyze the correlation between pressure ulcer during operation and operation time under lateral operation position.Methods 89 operation patients all adopted lateral position.Pressure ulcer during operation was observed and operation time was registered.Results The operations went on smoothly.Operation time lasted 1 to 8 hours.There were 42 operations exceeded 4 hours and pressure ulcer during operation was observed in 15 patients.Positive rate was 35.7％.There were 47 operations lasted less than 4 hours and pressure ulcer during operation was observed in 6 patients.Positive rate was 12.8％.Statistical differences were significant between the two groups.Conclusions For those operation patients with lateral position whose operation time would be longer,especially more than 4 hours,nursing intervention measures should be adopted to prevent pressure ulcer during operation.

Objective To investigate the clinical effect ofFuzheng-Shugan decoction on the treatment of patients with the treatment nodule.Methods A total of 80 patients with thyroid nodule from Jan.2014 to Dec.2015, divided into two groups. The efficacy, thyroid stimulating hormone, high risk factors, the maximum diameter and volume of thyroid nodules were observed.Results The effective rate of observation group was significantly higher than of the control group (90.00%vs.27.50%,χ2=32.237,P=0.000). The shortness of breath (1.62 ± 0.86vs. 4.35 ± 1.13,t=12.159), foreign body sensation (2.53 ± 0.62vs. 4.23 ± 0.56,t=12.289), irritability (1.56 ± 0.53vs. 3.52 ± 1.25,t=9.130), sweating (1.85 ± 0.62vs.4.23 ± 0.56,t=18.017), tongue (1.58 ± 0.93vs. 3.71 ± 1.25,t=8.646) and neck pain (0.82 ± 0.35vs. 3.92 ± 0.65,t=26.558) in the obversation group were significantly lower than those in the control group (P<0.05). The thyroid stimulating hormone levels in the observation group (1.05 ± 0.21 mIU/Lvs. 2.16 ± 0.71 mIU/L,t=9.482), were significantly lower (P<0.05). The maximum diameter (8.52 ± 4.72 mmvs. 12.27 ± 5.69 mm,t=3.208) nodule volume (0.26 ± 0.71 cm3vs. 0.96 ± 1.02 cm3,t=3.562) and high risk factors (2.73 ± 1.45vs. 4.05 ± 1.36,t=4.199) in the observation group were significantly lower than those in the control group (P<0.05).Conclusion TheFuzheng-Shugan decoction can improve TCM syndrome, reduce the risk factors, and effectively reduce the nodule maximum diameter and volume.

Objective To investigate the characteristics of thyroid surgical emergency related disease and prognosis,provide the basis to improve treatment.Methods Retrospective analysis of 24 cases of thyroid surgical emergency patients in Peking Union Medical College Hospital,Chinese Academy of Medical between 2004 and 2014who was performed,and the Fisher analytic method was used.Results According to the condition of diseases,conservative treatment for 1 case,surgical treatment for 23 cases,interventional therapy for 2 cases were performed.The overall preoperative diagnosis rate was 45.8％.The overall perioperative death were 5 cases (20.8％),total death were 7 cases(29.2％).8 cases preoperative diagnosed or highly suspected thyroid lymphoma patients were received oral or intravenous corticosteroid treatment,with the use of corticosteroids perioperative survival rate increased from 50％ to 100％.Conclusions (1) Thyroid surgical emergency with different causes should quickly make a clinical diagnosis based.on the patient's history and examination,select rational treatments.(2) Thyroid lymphoma patients that preoperative highly suspected or diagnosed,immediate received glucocorticoid treatment can reduce airway obstruction and decrease mortality,should be promoted.

ObjectiveTo determine the dose of butorphanol at which 50％ and 95％ effective dose (ED50 and ED95) of patients inhibition uterine contraction pain on analgesic artificial abortion.Methods Twenty-six patients undergoing analgesic artificial abortion were sequentially given different doses butorphanol so that the ED50 and ED95 could be determined by up-and-down sequential test.Anesthetic depth was observed when giving propofol with 200 mg/min speed,uterine contraction pain at awaking immediately,10,20 min after awaleing.Data was analyzed by Probit regression analysis for calculating ED50 and ED95..ResultsButorphanol could restrain uterine contraction pain on analgesic artificial abortion and the ED50 was 246 μg with the 95％ confidence interval of 201 μg to 281 μg,the ED95 was 324 μg with the 95％ confidence interval of 287 μg to 548 μg.ConclusionED50 and ED95 value can be expected as a parameter to optimize analgesic artificial abortion.

BACKGROUND: Dedifferentiation changes in monolayer culture and limited resource are 2 problems in chondrocyte study. There are few reports concerning the phenotype, biological characteristics, and three-dimensional culture SW1353 human chondrosarcoma cells.OBJECTIVE: To observe the kinetics characteristics and ultramicro location of type Ⅱ collagen in three-dimensional cultured SW1353 human chondrosarcoma cells.DESIGN, TIME AND SETTING: The material-cytology in vitro observation was performed at the Xiangya School of Medicine, Central South University, from August 2004 to January 2006.MATERIALS: SW1353 human chondrosarcoma cells were provided by ATCC Company.METHODS: After resuscitation, the cells were cultured in DMEM containing fetal bovine serum and vitamin C. Then the cell aggregate was suspended in alginate solution, with final concentration of 2×10~9/L, gel solution was dropped to obtain alginate beads. At weeks 8 after three-dimensional culture, citrate sodium was added to breakdown gel, and the chondrocyte was harvested. The growth characteristics of SW1353 between in monolayer and in alginate three-dimensional were compared. MAIN OUTCOME MEASURES: Phenotype shift was observed by Toluidine blue staining. Type Ⅱ collagen expression in cell was directed by immunohistochemistry. The location of type Ⅱ collagen in ultrastructure was observed by Immunoelectron microscope. Isotope 14C-proline pulse chase experiment was performed to find out the kinetics of collagen Ⅱ in synthesis and secretion. RESULTS: There were phenotype changes after 8 weeks monolayer cultured in SW1353 as the articular chondrocytes had done. Compare with the monolayer culture, the good phenotype was maintained and the proliferation was slow when the cell was cultured in alginate culture and the type Ⅱ collagen in suspension and alginate matrix was decreased either. Type Ⅱ collagen expression in cell can be directed both in cells and outside of cells; type Ⅱ collagen locate almost in rough endoplasmic reticulum in Immunoelectron microscope; Pulse chase experiment found that the 180 minute was the peak of synthesis and secretion of collagen Ⅱ after intervention by ~(14)C-proline. ELISA confirmed that the expression of type Ⅱ collagen was obvious increased at 8 weeks than 1 week in the suspension of monolayer culture (P < 0.05), which was greater than that in alginate matrix of three-dimensional. CONCLUSION: Long term monolayer culture in SW1353 may lead to cell phenotype change. Alginate three-dimensional can improve the phenotype changes by decrease cells metabolism and maintaining the dormancy situation of SW1353. Expression of type n collagen in SW1353 was abundant. This cell line can be a good research model of chondrocyte function.

Objective To investigate the effects of atorvastutin on the levels of plasm imflammation markers (hs - CRP, MMP - 3, TNF - α) and intima - media thickness(ITM) of the common carotid artery in patient with hyperlipidemic and atherosclerosis. Methods Fifty patient with hyperlipidemic and atherosclerosis were treated with atorvastatin (10mg qd) for 12 weeks. The levels of TC, TG, LDL -C, HDL -C, hs -CRP, TNF -α and MMP -3 were detected with radioimmmuneassay and eolorimetric methods. Color Doppler echo-cardiography was used to measure intima -media thickness(ITM) of the common carotid artery after 6 weeks and 12 weeks. Results TC, TG, LDL -C, hs -CRP, TNF -α and MMP -3 were decreased significantly(P < 0.01)after 12 weeks. IMT was decreased signifi-cantly(P < 0.05) and HDL - C was increased significantly (P < 0.05) after 12 weeks. Conclusion Atorvastatin could be effective in re-ducing blood - fat and anti - inflammatory action , regulating blood vessel endothelium (BVE) function and reversing structural chan-ges in IMT of the common carotid artery.

ObjectiveTo investigate the effect of combined spinal epidural analgesia (CSEA) on immune function by observing the changed level of T lymphocyte subsets in maternity sera in labor.MethodsFifty healthy primipara with single birth,vertex present and ASA I between July 2007 and Dec 2007 at the first Affiliated Hospital of Nangchang University,who were in spontaneous labor,were randomly divided into two subgroups when their rerviral dilations were in 2～3 cm.In interfering subgroup( n =25),the puncture point of CSEA was at L3-4 interspace,the fentanyl (20 μg) was used in lumbar anesthesia,the ropivaraine (0.1％) rombined with fentanyl (2 μg/ml) was used in epidural analgesia.Blood samples were taken from the mother vein at cervical dilation in 2 ～ 3 m (T1),fetal disengagement(T2),24 hrs after childbirth ( T3 ).Flow cytometry was used to measure T lymphocyte subsets,Radioimmunoassay (RIA) was used to measure cortisol.In addition,Data on labor progress,VAS score,and neonatal Apgar score were recorded for each patient.Results(1)The active phase in the first stage of labor after analgesia in the CSEA group [ ( 177.64 ± 67.98 ) min ] was significantly lower than that in control group [ (219.40 ± 67.37) min ].No significant difference was found for the active phase in the second stage and the third stage,and for the neonatal Apgar score between the CSEA group [ (32.92 ± 11.59 ) min,( 7.56 ± 2.47 )min,9.20 ± 0.82,respectively ] and the control group [ ( 31.44 ± 13.93 ) min,( 7.28 ± 2.25 ) min,8.84± 1.31,respectively ].(2)The level of cortisol in A group [ ( 548.11 ± 75.67) ng/ml ] was significantly lower than that in C group[ (789.32±96.07) ng/ml] at T2.(3) In two groups,the levels of the CD3+,CD4+,CD4+/CD8 + degraded in different degree at each point,more significantly decreased at T3,and these in C group[ (48.43 ± 6.46) ％,( 31.35 ± 8.93 ) ％,(0.96 ± 0.21 ) ％,respectively ] were significantly lower than those in A group [ (52.3 ± 5.62 ) ％,( 36.90 ± 7.91 ) ％,( 1.16 ± 0.25 ) ％,respectively ].ConclusionsCSEA could shorten the active delivery phase in the first stage of labor,and did not affect the neonatal Apgar score.It can alleviate the inhibitory effect of pain stress response on the immune function.

Objective To identify the problems of medical record management standardization in clinical case management for the study of medical record quality and give some corresponding measures.Methods 3,000 medical records of patients in our hospital from January 2015 to December 2016 were collected and divided into control group (with 1,500 records from January 2015 to December 2015) and observation group (with 1,500 clinical medical records from January 2016 to December 2016).The control group adopted regular data management while the observation group employed standardized lean management.Medical record defects, rectification rate and the average scores of inpatient medical records between the two groups were compared and analyzed.Results The average score of inpatient medical records in observation group was significantly higher than that of the control group (t=13.672, P<0.05), while the defect degree and the modification rate of the medical records were significantly lower than those of the control group (P<0.05).Conclusion Standardized medical record management contributes to the improvement of the quality of medical records.

BACKGROUND: Previous studies have proved platelet-rich fibrin (PRF) with osteoinduction ability, and the centrifugal speed and time to prepare rabbit advanced PRF (A-PRF) with the most similar structure to that of human PRF have been determined.OBJECTIVE: To observe the histological changes during A-PRF-induced osteogenesis.METHODS: Thirty Japanese white rabbits were randomly divided into A-PRF and blank control groups (n=15 per group).The full-thickness defect models were established on the rabbit parietal bone, followed by implanted with A-PRF or nothing, respectively. The model rabbits were killed immediately, at 2, 4, 8 and 12 weeks after modeling, to grossly observe the bone formation, and the histological changes in the defect region were observed through hematoxylin-eosin staining, Masson staining and immunohistochemistry.RESULTS AND CONCLUSION: Unhealed defects were observed in the blank control group. Gross and histological observations showed that the speed, amount and maturity of bone formation in the A-PRF group were significantly better than those in the blank control group immediately, 4, 8 and 12 weeks after modeling (P < 0.05). Our findings suggest that the rabbit skull bone defect is successfully established. A-PRF can induce osteogenesis, and more mature newly born bones appear with time. Additionally, osteoclasts can act with osteoblasts synergically under the A-PRF induction to promote the bone formation.

OBJECTIVE:To determine the contents of cholalic acid and hyodeoxycholic acid in Qingkailing suppository by HPLC-ELSD(high performance liquid chromatography with evaporative light scattering detection). METHODS: The analytical column was Diamonsil C18(250 mm?4.6 mm, 5 ?m) and the mobile phase consisted of 0.1% formic acid-acetonitrile(gradient elution) with the temperature of the drift tube of the light scattering detector set at 110 ℃ and the flow rate of the nitrogen gas at 2.0 L?min-1. RESULTS: The linear ranges of cholalic acid and hyodeoxycholic acid were 0.59～7.4 ?g(r=0.999 6)and 0.38～4.8 ?g(r=0.999 7),respectively,with their average recoveries at 99.20%(RSD=1.4%,n=6)and 98.57%(RSD=1.8%,n=6), respectively. CONCLUSION: The method is simple, accurate and well-separated, and it is applicable for the quality control of Qingkailing suppository.