Objective To investigate the clinical value of simplified Chinese version NU-DESC in assessment of ICU delirium in domestic ICU,and provide easy ICU delirium assessment tool for clinical nurses.Methods We used simplified Chinese version NU-DESC to assess patients in domestic ICU from July to September 2011,and compared with the gold standard DSM-IV diagnosis results.Their validity,reliability and effectiveness were evaluated to analyze the application value of NU-DESC in ICU.Results The area under the ROC curve of simplified Chinese version of Nu-DESC was 0.951,the sensitivity was 82％,the specificity was 90％,the false negative rate was 18％,the false positive rate was 10％,Youden's index was 0.72,the positive likelihood ratio was 7.99,the negative likelihood ratio was 0.20,the agreement rate was 87％,Kappa value was 0.71,the positive predictive value was 77％,the negative predictive value was 92％.Conclusions The simplified Chinese version NU-DESC can easily be understood,used and accepted by nurses.They can be used as an assessment tool for nurses to judge ICU delirium for ICU patients.

Objective To investigate whether nuclear transcription factor κB(NF-κB) through Toll-like receptors 2(TLR2) was activated by lipid-associated membrane proteins(LAMPs) of Mycoplasma genitalium.Methods LAMPs were extractded and THP-1 cells were stimulated.The activation of NF-κBp65 was detected by ELISA and the expression of TLR2 mRNA was detected by RT-PCR.Effects of TLR2 neutralizing antibody on LAMPs induced the activation of NF-κBp65 was analyzed by ELISA.After LAMPs stimulated 293T cells with the co-transfection pFLAG-TLR2,pNF-κB-luc,pRL-TK,the activity of NF-κB firefly luciferase and pRL-TK Renilla luciferase were detected by the dual-luciferase reporter gene,to analyzed the role of TLR2-mediated NF-κB activation by LAMPs in 293T cells.Results The activation of NF-κBp65 was mediated in LAMPs induced THP-1 cells and was significantly increased by LAMPs in a dose dependent manner.when LAMPs was 4.0 μg/ml,the activation of NF-κBp65 was the highest level.TLR2 mRNA expression was up-regulated by LAMPs in THP-1 cells.TLR2 neutralizing antibody could inhibit the activation of NF-κB by 60% in LAMPs stimulated THP-1.NF-κB fluorescence was significantly increased by co-transfection pFLAG-TLR2 in a dose-dependent manner. ConclusionMycoplasma genitalium-derived lipid-associated membrane proteins activate NF-κB via TLR2 and the activation of TLR2-mediated play an important role in pathogenic process of LAMPs.

OBJECTIVE: To provide references for the application of automatic oral drug dispensing system in hospital pharmacy. METHODS: The chief structure of automatic oral drug dispensing system in our hospital (TR-200FDS system) was introduced; the main working process and employment of this system were briefly introduced,and its advantages and disadvantages were discussed. RESULTS: The application of automatic oral drug dispensing system is characterized by convenience,cleanness,quickness and accuracy,but the relative costs are on the high side. CONCLUSION: The application of automatic oral drug dispensing system in hospital pharmacy can enhance hospital pharmaceutical care level,and it may represent the trend of the development in hospital pharmacy.

Objective Through investigation and analysis of nursing services and needs for community home visiting in Yinchuan city in order to improve the quality of nursing service. Methods Using cluster sampling method to collect 300 residents from five community for questionnaire investigation in Yinchuan city.Questionnaire included general situation and evaluation standard of home care patients and service quality satisfaction questionnaire of home care. Results The residents had different degree of nursing needs and differences existed in satisfaction degree with different project of community home visiting. Conclusions Community home visiting need is high,and further improvement of nursing service quality for community home visiting is needed in Yinchuan city.

Objectives To study the status of medical compliance and the reason of non-medical compliance behavior of the Hui diabetics. Methods 121 Hui diabetics were recruited by convenient sampling, investigated by medical compliance questionnaire and interviewed by open questions about the reason of non-medical compliance behavior (e.g. drug therapy, diet therapy, sports therapy, self monitoring and periodic review). Results The mean score of the medical compliance behaviors was (32.69±8.64), and the overall rate of non-medical compliance was 95.9%(116/121) in Hui diabetics. Arranged by the rate of non-medical compliance in descending order, the five dimensions of medical compliance behaviors were sports therapy, self monitoring, periodic review, diet therapy and drug therapy in turn. The reason of non-medical compliance behavior mainly included the cognition of treatment, the economic conditions, job, minority customs and religion. Conclusions Non-medical compliance behaviors existed in five major diabetes therapies in the Hui diabetics. The patients and their families should be educated and conducted individually according to their specific situation to improve the medical compliance behavior.

Objective To investigate the cognitive characteristics and vascular risk factor between early onset de?pression and late onset depression in late life depression and provide a clue to elucidate the cause of cognitive impairment in late life depression. Method Fifty-six late life depression patients were recruited in our hospital, including 29 early on?set depression patients and 27 late onset depression patients. 25 controls were recruited from Guangzhou community. Cog?nitive evaluation were conducted in all the patients and controls, including MMSE, memory, attention, language, visuospa?tial abilities,executive function and Framingham vascular risk assessment, and analyze the cognitive and vascular risk be?tween the patients. Result There were statistically significant differences in overall cognitive assessment MMSE(24.8 ± 2.9,22.8±3.5,P=0.030), symbol digit modalities test(SDMT)(29.8±10.5, 22.9±11.8, P=0.028), clock drawing test(CDT) (3.6 ± 0.8, 2.9 ± 1.3, P=0.006) and trail making test(TMT) (60.4 ± 20.6, 74.7 ± 28.8, P=0.027) between late onset depression and early onset depression. In addition, the score of vascular risk assessment was significant between late onset depression and early onset depression(14.6±2.7,12.3±2.2,P=0.001). Conclusion Compare with early onset depression, late onset de?pression has much severe cognitive impairments and increased vascular risk factors.

Objective To observe the changes of islet cell apoptosis and oxidation-antioxidation before the transplantation, and to explore the pathways of islet protection. Methods Fifteen human pancreases were perfused with the Hanks solution containing collagenase, then digested and isolated. During the procedure, islet cell apoptosis was detected by TUNEL, SOD and MDA in the pancreas were measured by colorimetric method, and the morphologic changes were observed by H-E staining and dithizone staining. Results In the procedure of human islet isolation, especially in the stage of digestion, the apoptosis of human islet cells occurred. In the stages of perfusion and digestion, the MDA contents reached the high levels (6. 18 ± 2. 38 and 9. 21 ± 2. 75 umol/mg protein respectively),and the structures of the islets and tissues around the islets were damaged. Conclusion In the stages of perfusion and digestion, apoptosis of islet cells can be caused by oxidation. It suggests that antioxidation is a pathway for protection of islets before transplantation.

OBJECTIVETo investigate the influence of class III forces in craniofacial morphology and sutural histology in Rhesus monkeys.

METHODSSix male Rhesus monkeys in mixed dentition were employed in this study, two as 90-day experimental group, two as 45-day experimental group and the other two as control respectively. The experimental monkeys were casted magnetic orthopedic appliance-III (MOA-III), the control monkeys received no treatment. Intraoral photographs, casts and cephalometric radiographs of each animal were obtained at the beginning and at the end of the experiment. Fluorescent and haematoxylin-eosin staining were used to observe the histological changes in craniofacial sutures. RESULTS; In experimental groups, the maxillomandibular relationship changed more significantly in 90-day experimental group than 45-day experimental animals. But changes were scarcely noted in the control. The bony depositions of the sutures were distinctly found during the experimental period, especially in zygomaticomaxillary, transverse palatine, pterygopalatine and zygomaticotemporal sutures.

CONCLUSIONThis study indicates that this kind of magnetic appliance could cause skeletal and dental changes of maxilla and mandible, and change the arrangement of connective tissues in craniofacial sutures, and lead to significant new bone deposition in craniofacial sutures.

Animals ; Cephalometry ; Macaca mulatta ; Magnetic Phenomena ; Male ; Mandible ; Maxilla ; Skull

Objective To explore the plasma levels of soluble CD40 (sCD40) and soluble CD40 ligand (sCD40L) in the patients with Alzheimer’s disease (AD) and those with amnestic mild cognitive impairment (aMCI). Methods The levels of plasma sCD40 and sCD40L were measured in 20 patients with AD, 35 patients with aMCI, and 32 cognitively normal controls (NC) using commercially available ELISAs. The cognitive function of AD and aMCI patients was mea?sured by mini-mental state examination (MMSE). Results There were significant differences in plasma sCD40 among AD, aMCI and NC groups (P<0.05) as the medians (the upper and lower quartiles) of plasma levels were 123.3 (97.4, 149.5) pg/mL, 102.9 (63.6, 124.0) pg/mL and 70.66 (51.0, 90.8) pg/mL, respectively. There were significant differences in plasma sCD40L among AD, aMCI and NC groups (P<0.05) as plasma levels were 537.0 (316.0, 1134.0) pg/mL, 316.0 (190.0,546.0) pg/mL and 167.0 (107.5,478.0) pg/mL. A negative correlation between the plasma concentrations of sCD40L and the MMSE scores was found in aMCI patients (r=-0.736, P<0.001). Conclusions There are relevant chang?es of plasma sCD40 and sCD40L levels in patients with AD and aMCI. The present results suggest that plasma levels of sCD40 and sCD40L may be appropriate biomarkers for AD patients and indicate that CD40-CD40L signaling may be in?volved in AD pathophysiology.

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult