Objective To explore the related high risk factors of hyponatremia after transsphenoidal approach for pituitary adenomectomy and to direct postoperative nursing. Methods The clinical data of seventy-seven patients suffering from pituitary adenomas with the way of treatment by transsphenoidal pituitary adenomectomy from June 2014 to May 2015 were summarized retrospectively. According to the value of postoperative serum natremia, the data were divided into hyponatremia group and non-hyponatremia group. The different data between the 2 groups were compared and the high risk factors related to hyponatremia were analyzed. Results Univariate analysis showed that gender(P=0.254) and high blood pressure(P=0.742) were unrelated to postoperative hyponatremia and there was significant difference between two groups in age (P=0.038), max- diameter of tumors(P=0.004), preoperative pituitary dysfunction (P=0.013), visual deficit (P=0.000), operative procedure duration (P=0.008) and diabetes mellitus rate (P=0.023). While Logistic regression analysis showed that preoperative visual deficit (OR=0.152,P=0.004,95%CI 0.043-0.542) and preoperative pituitary dysfunction (OR=0.069, P=0.046,95%CI 0.005-0.950) were independent factors for postoperative hyponatremia. Conclusions Hyponatremia is a common complication after transsphenoidal pituitary adenomectomy. The optimal treatment can benefit the early recovery and more careful nursing should be focused on these patients who are in high risk of postoperative hyponatremia.

BACKGROUND:The repair effects of bone marrow mesenchymal stem celltransplantation on brain injury were not ideal. Combined therapy with medicine and biological engineering materials is needed. OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem celltransplantation and fingolimod immunosuppressants on memory function recovery in rats with brain injury. METHODS:A total of 60 healthy Sprague-Dawley rats were subjected to hydraulic shock with peak value of 253.312 5-303.975 kPa with a hydraulic head injury instrument so as to induce a model of severe hydraulic head injury. They were randomly divided into brain injury group, bone marrow mesenchymal stem celltransplantation group and fingolimod+bone marrow mesenchymal stem celltransplantation group. The Morris water maze test was tested at 21-28 days after PKH-26-labeled bone marrow mesenchymal stem celltransplantation. The PKH-26 immunofluorescence and hematoxylin-eosin staining were conducted in brain tissues at 4 weeks after brain injury. RESULTS AND CONCLUSION:At 4 weeks after transplantation, the average escape latency was gradual y decreased in each group. The average escape latency was shorter in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the bone marrow mesenchymal stem celltransplantation group (P<0.05), and significantly shorter than in the brain injury group (P<0.01). The number of times of crossing the platform and the percentage of swimming distance to total distance were higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). The number of PKH-26-positive cells was significantly higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). Results confirmed that bone marrow mesenchymal stem celltransplantation could apparently improve memory function of rats with severe brain injury. The combined application of fingolimod immunosuppressants has synergistic effects.

Extracellular vesicles (EV) miRNAs are a class of small non-coding RNAs that are encapsulated in membrane-containing vesicles from a variety of cells, and which can mediate intercellular communication and transfer of functional molecules. EV miRNAs in circulation can be served as novel molecular markers for cancer diagnosis, monitoring and prognosis, and also the most promising liquid biomarkers for clinical translation and utility currently, while optimal research strategy is crucial for identifying valuable EV miRNAs in clinical study. Moreover, EV miRNAs have recently also been implicated in cancer progression as direct regulators of metabolic reprogramming, mesenchymal-to-epithelial transition, angiogenesis, anti-cancer immune response and drug resistance in the tumor microenvironment. Study on some key EV miRNAs involving in those processes may highlight their potential utility as liquid biopsies in early diagnosis, companion diagnosis, metastasis, therapeutic control, prognosis analysis as their therapeutic potential for patients with cancer.

Accidents, Occupational ; mortality ; Animals ; Cause of Death ; Humans ; Male ; Nitriles ; poisoning ; Rats

Objective To investigate the application effect of quality control management in the prevention of indwelling catheter associated urinary tract infection in intensive care unit (ICU) patients. Methods Cases of patients stayed in the department of ICU undergoing indwelling catheter over 10 d were selected by using time stage sampling method. Totally 136 cases of patients were selected from January 1, 2012 to December 31, 2012, as the control group. A total of 145 cases of patients were selected from January 1, 2013 to December 31, 2013, as the performance group. Cases in performance group were taken standardized training and quantify the performance appraisal on the basis of measures in the control group. The urine routine was tested and bacterial was cultured at indwelling catheter 3 d, 7 d and 10 d, respectively. The indwelling catheter associated urinary tract infections of the two groups were compared. Results After the implementation of the performance appraisal management, the incidences of indwelling catheter associated urinary tract infection at 3 d, 7 d and 10 d were 4.8%(7/145), 19.3% (28/145) and 32.4% (47/145), respectively. Within each quarter, the incidence of indwelling catheter associated urinary tract infection was rising with indwelling catheter time prolonged. And the incidences of the first and second quarter were higher than three and four quarter. The incidences of indwelling catheter associated urinary tract infections at 3 d, 7 d and 10 d in the performance group were lower than the control group, the differences were statistically significant (χ2=4.494, 30.660 and 49.307, P < 0.05). Conclusions Standardized training of nursing staff in ICU and implementation of performance appraisal management could effectively improve the enthusiasm and sense of responsibility of the nurses, and effectively reduce the incidence of indwelling catheter associated urinary tract infection.

To management of syncope in children and adolescents,the primary objectives are etiological diag-nosis and risk stratification.The possible causes for syncope ranging from relatively benign conditions to potentially life -threatening events.The efficient methods of diagnosis and risk stratification are vital important to identify those syncope patients who are at short -term or long -term risk of life -threatening events,avoiding unnecessary hospitali-zation of low -risk patients.In recent years,there came up with a multitude of quantitative methods in diagnosis and risk stratification,according to clinical history and physical exam and 1 2 -lead electrocardiograph.These methods can assit front -line physicians do an optimal decision -making,especially providing valuable guidance to make a well -in-formed choice between hospitalization and outpatient referral.Nevertheless,these existing methods can not replace criti-cal assessment by an experienced physician.

Objective To observe the therapeutic effect of Pinggan Yishen Ditan Decoction (Liver-Calming Kidney-Boosting Phlegm-Flushing Decoction) for hypertensive obesity and its possible mechanism.Methods Sixty cases of hypertensive obesity were randomly divided into Chinese medicine group (Chinese medicine was added on the basis of treatment in control group) and control group.The treatment course lasted for 8 weeks.Blood pressure (BP),body weight,waist circum-ference(WC),waist-to-hip ratio(WHR),metabolism parameters,fasting insulin(FINS) and Leptin were observed and compared before and after treatment.Results There was significant difference in SBP,DBP,BMI,WC,WHR,FPG,TC,TG,HDL-C,LDL-C,FINS,Leptin and ISI after treatment in Chinese medicine group (P

OBJECTIVE:To evaluate the cost-effectiveness of 5 angiotensin converting enzyme inhibitors in the treatment of essential hypertension.METHODS:120 patients with essential hypertension were randomly assigned to receive domestic captopril(Group A),captopril from joint venture(Group B),fosinopril(Group C),benazepril(Group D)or enalapril(Group E)for 4 weeks.The cost-effectiveness of the 5 groups was evaluated.RESULTS:The total effective rates for A,B,C,D and E groups were 75.00%,75.00%,91.67%,91.67% and 87.50%,respectively.As compared with Group A,the incremental cost-effectiveness ratios of C,D and E groups were 1 249.67,1 256.39 and 636.16,respectively.CONCLUSION:The total effective rate in Group E is slightly less than in other groups,yet Group E is superior to other groups because of its lower cost-effectiveness ratio and lower incremental cost-effectiveness ratio.

Physical constraints is a commonly protective medical measure in clinic. if lack of humanistic nurs-ing in the use of the process,then it will give the patient a physical,psychological and ethic issues. This paper sum-marized the research status of humanistic nursing and physical constraints and concluded the humanistic nursing measures before, during, and after physical constraints, and thus to provide a reference for the further implementa-tion of humanistic nursing.

The muscarinic receptor family expressed in smooth muscle throughout the body is thought to be composed of five subtypes coupling to distinct signaling systems,respectively.The population in smooth muscle is composed of mainly M 2 and M 3 subtypes in a 80% to 20% mixture. The muscarinic receptor, mainly M 3 receptor, play an important role in regulating gastrointestinal smooth muscle contraction. Selective muscarinic M 3 antagonist should have therapeutic utility in the treatment of gastrointestinal disease.