Transitional care is a new mode of nursing practice, fully embodies the people-oriented concept of quality of nursing.Based on the domestic and foreign research, this article elaborates the concept and current application status of transitional care in cancer pain patients,integrates the new progress of transitional care team,information management of discharged patients,contents and quality management of transitional care, systematically puts forward the system framework of transitional care in cancer pain patients, and discusses the design of clinical trial, the dive~ity of transitional care contents et al,to provide theoretical references for further optimizing the transitional care system of the cancer pain patients.

BACKGROUND: After excision of vertebra and cervical intervertebral disc, repairs of bone defect after reducing pressure mainly have used titanium mesh and ilium for a long time, but the effect is not perfect. OBJECTIVE: To prepare nano-hydroxyapatite/polyamide66 (n-HA/PA66) composites, and to test the representation and biomechanical properties. DESIGN, TIME AND SETTING: A repeated and comparative study was performed at Laboratory of Inorganic Material, College of Material Science and Technology, Nanjing University of Aeronautics and Astronautics from January to December 2008. MATERIALS: Nano-hydroxyapatite crystal was prepared using hydrothermal reaction, and the nano-hydroxyapatite/polyamide66 of bone-grafting specimens was prepared by co-precipitation, cold-pressing and sintering. METHODS: Normal C_5 samples were implanted into different materials and then internal-fixed using screw to test the biomechanics. The grouping was as following: normal cervical vertebra group, n-HA/PA66 ilium-grafting internal fixation group, and ilium-grafting internal fixation group. Physiological motion of cervical vertebra was simulate to human body at neutral, flexion, extension and lateral-flexion positions. MAIN OUTCOM MEASURES:① The phase of the composites was characterized by X-ray diffraction. ② The group of thecomposites was analyzed by infrared spectrum. ③ Scanning electron microscopy was used to analyze the scaffold of bone-grafting specimens. ④ The measurements of biomechanical properties were carried out with normal cervical specimens, bone-grafting specimens and the ilium-grafting specimens. RESULTS: ① X-ray diffraction results revealed that the main diffraction curves of nano-hydroxyapatite and polyamide66 remained in the composites, but n-HA would widen and weaken the β crystals in polyamide66. ② Infrared spectrum results showed that nano-hydroxyapatite and polyamide66 were mainly linked by hydrogen-bonding. ③ Scanning electron microscopy examined the scaffold of bone-grafting and revealed that the composites had tight combination and good interface. ④ The measurements of biomechanical properties indicated that the bone-grafting specimens had better performances in load-strain, load-displacement and stress intensity in comparison with ilium-grafting ones, only a little bit lower than the normal cervical vertebrae. CONCLUSION: The bone-grafting specimens have outstanding biomechanical properties and are an ideal kind of material to instead cervical vertebrae.

OBJECTIVE To analyze the high risk factors and etiology character of ventilator-associated pneumonia(VAP) and provide the guidance for preventing VAP. METHODS Eighty three cases given mechanic ventilation over 48 hours in ICU of our hospital from Jan to Oct 2005 were observed.Thirty seven cases met the diagnosis criteria of VAP,while 46 cases without VAP were taken as control. RESULTS Airway secretion was cultivated and Gram-negative germ was the majority(58.0%).The first three pathogens were Pseudomonas aeruginosa(32.0%),Acinetobacter,and Staphylococcus epidermidis,22.0% cases had mixed infection with fungi.Except antiacid treatment,the following factors,such as long time for mechanical ventilation,trachea incision,corticosteroids treatment and coma state had significant relationship with the occurrence of VAP. CONCLUSIONS The occurrence of VAP is related with multiple clinical factors.Clinicians should reduce high risk factors to lower the occurrence of VAP.

OBJECTIVE To find out the situation of bacteriological contamination of oxygen humidified fluid in the hyperbaric oxygen chamber in Nanfang Hospital and take appropriate measures accordingly to provide valuable reference for avoiding possibly resulting hospital infection.METHODS Before and after beginning periodically changing oxygen humidified fluid,the humidifying fluid in the oxygen humidifiers of three hyperbaric oxygen chambers in this hospital was sampled once a season.The samples were analyzed with bacteria counting and identification.RESULTS The average amount of bacteria in the samples before and after changing oxygen humidified fluid was(7.9 ? 104) CFU/ml and(2.8 ? 103) CFU/ml,respectively.Identified bacteria were conditioned pathogens,including Chryseobacterium,Acinetobacter baumannii,Escherichia coli,Pseudomonas aeruginosa,Candida albicans,etc.Among them the frequency of Chryseobacterium was the highest.The results had no correlation with the changing of seasons.CONCLUSIONS Hyperbaric oxygen chamber should be disinfected periodically,the humidified fluid should be changed every day,and the amount of bacteria in it should lower than 103 CFU/ml.

Objective To understand the current status of aloneness and analyze the influencing factors,and to provide reference to improve the aloneness among middle?aged and elderly. Methods A total of 994 middle?aged and elderly in Donggang sampled by stratified random sampling method were investigated by UCLA scale. The influencing factors were assessed by t?test and one?way ANOVA. The data were analyzed by SPSS 16.0. Results The average score of UCLA scale among middle?aged and elderly was 41.54 ± 8.91. The results indicated whether living with their children,alcohol drinking,quality of sleep,history of trauma,psychological counseling,monthly income,chronic disease and physical training were the influencing factors of aloneness among middle?aged and elderly,and the differences were statistically significant(P<0.05). Conclusion The aloneness was obvious among middle?aged and elderly in China. Health interventions and effective social support should be provided to improve the physiological,psychological and economic levels that will lead to important influence on the improvement of aloneness among middle?aged and elder?ly in China.

Objective To investigate the effects of normal caloric high-protein diet on metabolic parameters and gastrointestinal hormones in patients with obesity or type 2 diabetes mellitus (T2DM).Methods Totally 30 obese subjects (OB group) and 40 obese patients with type 2 diabetes mellitus (T2DM group) received normal caloric high-protein diet for 24 weeks.Then body weight,fat mass,and metabolic parameters were assessed.The serum ghrelin and glucagon-like peptide-1 (GLP-1) levels were also measured at 0 and 2 h after an oral 100 g of steamed bread meal test.Results After 24 weeks,body weight [(78.23 ± 7.51) kg vs (80.83±8.13) kg,P=0.016; (80.45±7.48) kg vs (83.26±9.35) kg,P=0.011],body mass index [(31.03 ±2.72) kg/m2 vs (32.01 ±2.95) kg/m2,P=0.033; (32.63 ±2.81) kg/m2 vs (33.86±3.03) kg/m2,P =0.043],waist circumference [(93.65 ± 6.23) cm vs (97.30 ± 7.81) cm,P =0.041 ;(97.02±7.43) cm vs (101.87 ±9.87) cm,P =0.034],fat mass [(30.42 ±6.18) kg vs (32.47 ±5.91) kg,P=0.022; (34.23 ±7.03) kg vs (36.64 ±6.83) kg,P =0.032],fasting serum insulin [(10.81±3.69) mmol/Lvs (13.58±4.86) mmol/L,P=0.012; (9.58±3.51) mmol/Lvs (10.82±4.28) mmol/L,P =0.015],HOMA-insulin resistance index [(2.42 ± 0.83) vs (3.16 ± 1.21),P =0.019; (3.15±0.74) vs (4.13±0.67),P=0.024] and triglycerides [(1.24±0.32) mmol/Lvs (1.49±0.52) mmol/L,P=0.046; (1.86±1.05) mmol/L vs (2.46±1.85) mmol/L,P=0.034] were significantly decreased in OB and T2DM groups,respectively,compared with 0 week.Fasting blood glucose (FBG)and glycosylated hemoglobin were also significantly declined in T2DM group [FBG:(6.73 ± 1.25) mmol/Lv s (8.63 ±2.81)) mmol/L,P=0.010; HbA1c (6.44 ±0.47) vs (7.38 ±0.33),P=0.031].The serum ghrelin and GLP-1 both increased at 0h and 2 h after meal test in OB and T2DM groups [fasting serum ghrelin:(4.98 ±0.89) μg/L vs (3.95 ±0.98) μg/L,P=0.021; (4.23 ± 1.67) μg/L vs (3.15 ± 1.01) μgL,P=0.025; 2 h postprandial serum ghrelin:(2.98 ±0.96) μg/L vs (2.56 ±0.83) μg/L,P =0.046; (2.83 ± 1.03) μg/L vs (1.95 ±0.92) μg/L,P =0.033; fasting serum GLP-1:(6.06 ±0.63) μg/L vs (5.13±0.59) μg/L,P=0.041; (5.23±0.71) μg/Lv s (4.49±0.53) μg/L,P=0.039; 2 h postprandialserum GLP-1:(10.01±1.01) μg/L vs (7.68±0.94) μg/L,P=0.007; (8.87±0.94) μg/Lvs (6.59 ± 0.87) μg/L,P =0.013].Conclusions Normal caloric high-protein diet can reduce body weight and serum glucose.Those effects may be due to the increase in secretion of GLP-1.

BACKGROUND: At present, the researches on murine model of acute radiation encephalopathy are still in investigation, and mature model making method is not clear.OBJECTIVE: To establish a murine model of acute radiation encephalopathy in order to provide a good foundation for further researches of radiation encephalopathy(REP) mechanism and therapy.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Animal laboratory in a university hospital. The Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was completed in the Laboratory of the Second Affiliated Hospital of Sun Yat-sen University from June 2001 to August 2002. Totally 30 female and 30 male SD rats, weighted(300 ± 30) g, were selected from the Animal Experiment Center of Sun Yat-sen University, and randomly divided into blank control group with 20 rats and experimental group with 40 rats.METHODS: Fourty rats' brain received 60Co γ-ray irradiation with the dosage of 7 Gy/time per day for 6 consecutive days with the total dosage of 42 Gy. The amount of ingestion and drinking, general activities, central nervous system(CNS) symptoms and signs were recorded every day. The hairs and skin of irradiated field and weight were checked and recorded weekly. On the 3rd, 7th, 14th, 30th days after radiation, the brain tissue was collected and the histopathologic changes were examined.Histopathologic changes after radiation.RESULTS: Since the third day, the ingestion and drinking amount of irradiated rats were decreased. The general activities were increased for the first two days, but decreased without abnormal nervous signs on the 3rd day. The rats in experimental group had a slower weight gain than those of control group, and the difference between them was of no statistical significance. All rats had slight alopecia and neuronal necrosis 2 weeks after irradiation.CONCLUSION: The irradiation method is reliable, practical and good for modeling REP process, which can be used in preventing or reducing the harm effect of radiation therapy on brain tissue.

OBJECTIVE To study the characteristics of pathogens and risk factors of ventilator-associated pneumonia(VAP) in our hospital to determine the prevention and treatment strategies. METHODS Prospective observation was performed in all the ventilator-related patients in 2004. RESULTS Seventy eight events of ventilator-related pneumonia among 56 cases occurred from all the 202 ventilator-related patients,the infection incidence was 98/1000VDs.The revealed important risk factors were oldness,coma,tracheotomy,use of H-2 receptor inhibitors,and prolonged mechanical ventilation.64.8% of the pathogens were G-bacilli,among which Pseudomonas aeruginosa contributed majority accounting for 22.7%,fungi accounting for 20.5%.There was wide resistance to antibiotics in G+ pathogens,including all of the isolated Staphylococcus. CONCLUSIONS VAP is caused predominantly by G-bacteria,fungi,and multiple predisposing factors.The combined treatment is necessary for control of VAP.

BACKGROUND: Memory loss is the main presentation during the earlier stage of radiative eneephalopathy, and it was reported that ganglioside (GM1) played important role in neural rehabilitation, particular in the improvement of memory.OBJECTIVE: To study the improving effect of GM1 on spatial learning and memory retardation in rats following radiative encepholopathy. DESIGN: Randomized control and comparative observing study based on the experimental animals.SETTING: Department of Neurology and Department of Radiation of Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Laboratory of the Second Hospital Affiliated to Sun Yat-sen University between March 2001 and May 2002. Tctally 80 SD rats were randomly selected and divided into control group, GM1 treatment group, physiological saline group and non-intervention group with 20 rats in each group.INTERVENTIONS: Rats in GM1 group, physiological saline group and non-intervention group subjected to head 60Coγ irradiation of 7Gy each time after anesthesia, once a day for consecutive 6 days, and the total dosage was 42Gy while rats in control group did not receive irradiation after anesthesia. Rats in GM1 and physiological saline(PS) group were given intraperitoneal injection of GM1 and physiological saline of 30 mg/kg respectively at 1 hour after each time of radiation, once a day for consecutive 6 days but not in control group and non-intervention group. Evaluation: ①After irradiation, morris water labyrinth navigation test was used to assess the capability of learning and memory of rats by the time for reaching platform (latency); ② Spatial searching test was used to detect their spatial memory after learning how to reach the platform by recording the way of rats searching the platform in 120 s and calculating the percentage of swimming distance in platform quadrant in the total distance; ③ After labyrinth test, brains were taken out of the rats in GM1 group, PS group and non-intervention group for observing the histological and pathological changes in rat brains.RESULTS: ① The latency become stable form onset of the 4th day in each group. On the 5th day, the searching platform latency in GM1 group was(13.6±1.4) s, shorter than(17.1±2.9) s of PS group and [(15.8±2.2) s, (P＜0.05)] of non-intervention group; ② Rats in GM 1 and control group were found capable of searching platform according to their spatial memory, presented by swimming trail most located in platform quadrant while rats in PS and non-intervention groups were found mostly swimming around the pool with moving trails distributed randomly. The percentage of swimming distance in platform quadrant was found higher in GM 1 treatment group than in the PS group and non-intervention group, but lower than that in the control group; ③ Histological examination revealed slight neuronal degeneration in PS group, part of which was changes of vacuolar degeneration with cell shrank, chromosome concentrated and nuclei gathered aside, and the number of astrocytes also decreased; the pathological changes in non-intervention group and PS group were similar; in GM1 group, part neurons became smaller with peripalsm turning red but the pathological changes, such as the number of cells,neuclei shrank and gathered aside, and vacuolar changes were less than those of the former two groups.ONCLUSION: Radiative encephalopathy would result in obvious learning nd memory impairments in rats but histological and pathological changes due o brain radiation injury can be attenuated with the treatment of GM1, implying that GM1 may play important role in the improvement of radiation-induced spatial learning and memory loss.

Objective To explore the relationship between metabolic syndrome (MS) and prostate volume. Methods One thousand and ninety-eight males aged 36-90 years were divided into two groups according to the definition of MS by CDS in 2004 : MS group and control group. The blood pressure, body weight and height were measured, and the body mass index (BMI) was calculated. Biochemical assays including fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and prostate specific antigen (PSA) were performed. Prostate volume was measured by abdominal ultrasound. Results (1) The BMI, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, serum triglyceride, total cholesterol, prostate volume and PSA level were higher, while HDL-C level was lower in MS group than in control group (all P<0.05). (2)Compared with control group, the prostate volume was enlarged in MS group [(37.8±21.3)ml vs. (31.0±11.1)ml, P<0.01]. (3)The prostate volume was positively correlated with PSA level (r= 0. 350, P< 0. 01), age (r = 0. 429, P<0.01), BMI (r=0.145,P<0.01) and systolic blood pressure (r=0.133, P<0.05), and was negatively correlated with diastolic blood pressure (r= -0. 193,P<0. 01). ConclusionsMetabolic syndrome is related to the enlargement of prostate volume.