1.Construction and management of the center for intravenous drug allocation in our hospital
Lirong SHEN ; Xudong HUA ; Hui ZHANG
Chinese Journal of Hospital Administration 1996;0(04):-
Pharmacy intravenous admixture service was built in accordance with the Australian criteria for intravenous drug admixture and managed in light of the ideas contained in the Accreditation Standards for Hospital released by the US Joint Commission International. Cytoxic drugs, total parenter-al nutrition solutions and intravenous infusions were centrally admixted in the service. Aseptic operation was stressed in the admixture of intravenous drugs while the appropriateness of drug use and the rationality of drug formulations were stressed in the review of doctors' orders. In practice, priority was given to environment and equipment management, qualification and certification of personnel and continuous education, the process was standardized, regulations for standard post operation and the rational use of drugs were formulated, and criteria for assessing doctors' orders were established All this has led to satisfactory results.
2.Collection of peripheral blood stem cells from two infants of young age and low body mass:Safety and adverse effects
Hua JING ; Jinyuan ZHANG ; Xujing Lü ; Xudong SHEN
Chinese Journal of Tissue Engineering Research 2010;14(14):2657-2660
BACKGROUND:The rapidly developed transplantation of peripheral blood stem cells have been successfully used to substitute bone marrow transplantation and become the first choice method for transplantation of hemopoietic stem cells.It is relatively difficult to collect peripheral blood stem cells from young age and low body mass infants.OBJECTIVE:To investigate the safety and adverse effects of peripheral blood stem cell collection from young age and low body mass through the use of blood cell separator.METHODS:Two type 1 diabetes mellitus infants,aged younger than 2 years old and with body mass less than 15 kg,were treated using autologous hemopoietic stem cell transplantation.The two infants were adequately comforted to lesion the fear of collection.At 1 week prior to collection,calcium agent was orally taken to reduce the incidences of low calcium.Within 24 hours prior to collection,oily food was forbidden,and on the day of collection,milk was forbidden,to avoid chylemia,which influences blood collection.Prior to collection,200 mL 25 Gy y-ray radiated red blood cells suspension was injected into the tube,which was routinely placed in the subclavian vein,to avoid hypovolaemic syndrome and the effects on hematocrit.Individualized collection parameters were set,During collection,blood circulation volume was 3,4 times of systemic blood circulation to ensure sufficient total circulation volume.During isolation,the ratio of ACD to whole blood was kept between 1:11 and 1:13 to prevent sodium citrate poisoning.RESULTS AND CONCLUSION:Peripheral blood stem cells were successfully collected during first intention in each infant.During collection,stable vital signs but no adverse effects were observed.After collection,mononuclear cells weighted 14.71×108/kg and 18.82×108/kg respectively,and CD34+ cells were about 34.13×108/kg and 32.38×106/kg,respectively in each infant.Therefore,it is feasible to collect peripheral blood stem cells from infants of young age and low body mass under sufficient psychological preparation.
3.Postoperative complication and the risk factors of radical resection for colorectal cancer
Jun MA ; Hua WANG ; Xuesong WU ; Yongqing DUAN ; Xudong MA ; Yanlong YANG
Clinical Medicine of China 2016;32(9):815-819
Objective To investigate the associated risk factors of postoperative complications after rad?ical resecting of colorectal cancer. Methods The clinical data of 237 patients with colorectal cancer performed radical resection in the Second Affiliated Hospital of Kunming Medical University from January 2011 to Decem?ber 2014 were analyzed retrospectively. The incidence of postoperative complications was analyzed,and the relat?ed factors were analyzed by single factor and multi factor correlation analysis. Results The postoperative com?plications occurred in 114 cases of 237 patients( 48. 1%) . Univariate analysis showed that the age more than 70 years old,preoperative comorbidity,intraoperative blood loss,surgeon’ s experience,combined evisceration or en?larged evisceration were related to postoperative complications ( P = 0. 033, 0. 014, 0. 045, 0. 028, 0. 040 ) . Compared with the patients without complications,the postoperative anal exhaust time,length of stay was longer of the patients with complications((3. 7±1. 6) d vs. (3. 2±1. 4) d,P=0. 035;(21. 3±6. 5) d vs. (12. 1 ±2. 4) d,P=0. 001). Logistic regression analysis showed that depth of tumor invasion(P=0. 001),preoperative comorbidity including NRS>3 points (χ2 =8. 903, P=0. 003 ) , anemia and hypoproteinemia (χ2 =3. 494, P=0. 048) ,hypertension complicated with type 2 diabetes mellitus(χ2=5. 418,P=0. 026) ,not complete intesti?nal obstruction(χ2=8. 376,P=0. 003),mild and severe ventilation dysfunction(χ2=6. 331,P=0. 011) and WBC<3. 9×109(χ2=4. 256,P=0. 041) were closely related to the occurrence of complications. The rate of post?operative complication of laparoscopic group and open group had no significant difference( 44. 4%( 64/144) vs. 47. 3%(44/93),P>0. 05) . Conclusion Age>70 years old,preoperative comorbidity,intraoperative blood loss,surgeon`s experience,combined evisceration or enlarged evisceration are main risk factors for patients per?formed colorectal cancer radical resection,but laparoscopy?assisted radical resection is not the risk factor.
4.Effects of virtual reality combined with motor imagery therapy on upper limb function in hemiplegic patients after stroke
Hua WU ; Xudong GU ; Meifang SHI ; Caihong WU ; Meihong ZHU ; Mei JIN ; Wei WANG
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(1):43-46
Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.
5.A structural equation modeling of caregiving experiences of family caregivers caring for people with dementia
Hua YU ; Hongyan JIANG ; Xudong ZHAO ; Li WU ; Lei WU ; Rong LU
Chinese Mental Health Journal 2015;(5):336-342
Objective:To explore and test a caregiving experience model by Structural Equation Modeling (SEM)in the family caregivers caring for people with dementia in China. Method:Totally 349 elder patients with dementia and their family caregivers were selected and interviewed,using a battery of measures including demo-graphic data of the dyads,impairement of care recipient,caregiver's appraisal of role strain,role gain,negative and positive well-being outcomes. By using the Kramer's caregiver adaptation model as theoretical framework,a care-giving experience model were hypothesized tested by structural equation modeling (SEM). Result:A five-factor model for the caregiving experience was supported by SEM. The model demonstrated that the severity of dementia significantly influenced the caregiver's appraisal of role strain (β=0. 5 1 ,P<0. 05 ),which predicted indirectly neg-ative well-being outcomes of the caregiver (β=0. 63,P<0. 05). On the other hand the caregiver's appraisal of rolegain which was negatively influenced by the severity of parent's dementia (β=-0. 33,P<0. 05),predicted posi-tive well-being outcomes of the caregiver (β=0. 75 ,P<0. 05 ). Conclusion:It suggests that both positive and nega-tive aspects of caregiving experiences could independently impact on the well-being outcomes of adult-child care-givers,and therefore both aspects should be targeted in supportive interventions for family caregivers in China.
6.Motor imagery training can improve motor function and gait after stroke
Yan LI ; Xudong GU ; Meifang SHI ; Hui LI ; Jianming FU ; Hua WU
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(7):518-521
Objective To investigate the effect of motor imagery therapy based on mirror neuron theory on the motor function and gait in stroke survivors.Methods Forty-nine stroke survivors were randomly divided into a treatment group (n =24) and a control group (n =25) using a random number table.All the patients in both groups were given similar conventional rehabilitation treatment.In addition,the patients in the treatment group were given motor imagery training based on mirror neuron theory once a day for 20 min each time,5 days a week,lasting 8 weeks.The Fugl-Meyer assessment (FMA),Functional Ambulation Categories (FACs),average step length,the percentage of time spent on the intact foot and the paralyzed foot,and 6 minute walking distance were used to evaluate the subjects' motor function and gait before and after 8 weeks of treatment.Results Before the intervention there was no significant difference between the two groups in terms of any of the measurements.At the end of the 8 weeks of treatment all measurements in both groups had significantly improved compared with before training.The averages of all the measures were significantly better in the treatment group than in the control group.Conclusions Motor imagery training based on mirror neuron theory can improve the motor function and gait of stroke survivors.
7.The effects of robot-assisted walking compared with body weight supported treadmill training for retraining walking ability and improving the gait of hemiplegic patients after stroke
Yan LI ; Hua WU ; Yunhai YAO ; Hu LI ; Jianming FU ; Xudong GU
Chinese Journal of Physical Medicine and Rehabilitation 2012;(11):810-813
Objective To compare the effects of robot-assisted gait training with supported treadmill training (BWSTT) for hemiplegic patients after stroke.Methods A randomized,single-blind,controlled study was performed.Forty-eight hemiplegic patients were divided randomly into a BWSTT group and a robot group with 24 in each Both groups received routine rehabilitation training.The robot group also received robot-assisted gait training,while the BWSTT group received treadmill training in which their body weight was supported.Both groups trained 20-30 minutes daily,5 days a week for 8 weeks in addition to their normal rehabilitation sessions.Their lower extremity functions and walking ability were assessed with the simplified Fugl-Meyer assessment (FMA) and using functional ambulation categories (FACs).Average step length,percentage of loading time on each foot and 3 min walking distance were tested using a Biodex Gait Trainer.All the assessments were administered before and 8 weeks after treatment.Results Both groups showed significant improvements in terms of the FMA,FACs,average step length,loading time on each foot and 3 min walking distance.The robot group,on average,showed significantly better improvements in average step length,percentage of loading time on each foot and 3 min walking distance than the BWSTT group.There was no significant difference in lower extremity function or walking ability in terms of the FMA or FACs.Conclusions Robot-assisted training gives better results than BWSTT in terms of improving average step length,equalizing the loading time on each foot and 3 min walking distance.
8.Robot-assisted lower limb rehabilitation of hemiplegia
Wei WANG ; Yan LI ; Hua WU ; Xudong GU ; Yunhai YAO ; Jianming FU ; Jianhua LI
Chinese Journal of Physical Medicine and Rehabilitation 2013;(6):464-467
Objective To investigate the effects of robot-assisted lower limb rehabilitation on the lower limb motor function of hemiplegic patients in the acute stage.Methods Forty-two hemiplegic patients in the acute stage were randomly divided into a treatment group and a control group with 21 in each.Both groups were treated with routine rehabilitation interventions,but the treatment group also undertook robot-assisted lower limb rehabilitation training.The training lasted for 10 to 20 min/d,6 d/week for 8 weeks.Lower limb motor function,balance,ability in the activities of daily living and walking ability were assessed with a simplified Fugl-Meyer assessment,the Berg balance scale,the Rivermead motility index (RMI) and functional ambulation categories (FACs).Results Before the intervention there was no significant difference between the two groups in any of the assessments.After training,both groups showed significant improvements in terms of their FMA,BBS,RMI and FAC results.The treatment group showed significantly better improvements in lower limb motor function,balance,ability in daily living and walking ability compared with the control group.Conclusions Robot-assisted lower limb rehabilitation can significantly improve the lower limb motor function of hemiplegic patients in the acute stage.
9.The effects of cycling on the lower limb motor function and walking ability of hemiplegic stroke patients
Hua WU ; Yan LI ; Xudong GU ; Caihong WU ; Weiguo WANG ; Yingchun CHEN ; Jianming FU
Chinese Journal of Physical Medicine and Rehabilitation 2011;33(8):599-601
Objective To investigate the effects of exercising on a cycle ergometer on lower limb motor function and the walking ability of hemiplegic stroke patients.MethodsSixty hemiplegic stroke patients were randomly divided into a treatment group and a control group with 30 in each. Both groups were treated with routine rehabilitation, but the treatment group also undertook cycle ergometer training. The training lasted for 10-20 min/d, 6 d/week for 6 weeks. All patients were assessed with the Fugl-Meyer lower limb assessment ( FMA), functional ambulation category (FAC) classification and the modified Barthel index (MBI) pretreatment and 6 weeks post treatment.ResultsBefore intervention there was no significant difference between the two groups in any of the assessments. Six weeks post treatment, the average FMA, FCA classification and MBI results in the treatment group were significantly better than those pretreatment and better than those in the control group.ConclusionsCycling exercise combined with routine rehabilitation training can distinctly improve the motor function of the lower limbs and the walking ability of hemiplegic stroke patients.
10.The effects of a lower-limb rehabilitation robot and body weight supported treadmill training on the walking ability of hemiplegic patients after stroke
Xudong GU ; Hua WU ; Jianhua LI ; Zhisheng XU ; Yunhai YAO ; Yan LI ; Hui LI ; Jianming FU
Chinese Journal of Physical Medicine and Rehabilitation 2011;33(6):447-450
Objective To observe the effects of a rehabilitation robot and body weight supported treadmill training (BWSTT) on the walking ability of hemiplegic patients after stroke.Methods Sixty hemiplegic patients were divided randomly into treatment and control groups (n=30 in each).The treatment group received training assisted by a leg rehabilitation robot for 10-20 min once daily,6 days per week for 8 weeks in addition to conventional treatments and BWSTT.The control group was only given conventional treatments and BWSTT once daily for 8 weeks.Their lower extremity functions,balance and walking ability were assessed with a simplified Fugl-Meyer assessment (FMA) and using the Berg balance scale (BBS) and Functional Ambulation Categories (FACs).Results After training,both groups showed significant improvements in terms of FMA,BBS and FAC results.The treatment group showed significantly better improvements in lower extremity function,balance and walking ability compared with the control group.Conclusions The lower-limb rehabilitation robot and BWSTT could together improve balance and walking ability.