ObjectiveTo discuss the application of clinical pathway in the health education for spinal cord injured patients in rehabilitation department. Methods56 patients with spinal cord injury were divided into 2 groups: treatment group and control group. Both groups were cared with holistic nursing. However, the health education to the treatment group was given by clinical pathway, while to the control group by traditional way. On the day of discharge, the health education standard and the satisfaction of patients were investigated. ResultsBoth the rates of standard in health education and satisfaction were more in treatment group than in control group. ConclusionApplication of clinical pathway can regulate the health educational behavior, improve the communication between nurses and patients, and the quality of nursing.

Adolescent ; Adult ; Chi-Square Distribution ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Occupational Diseases ; prevention & control ; Occupational Health ; Sampling Studies ; Young Adult

Adolescent ; Adult ; Behavior, Addictive ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Smoking ; epidemiology ; Surveys and Questionnaires ; Young Adult

Objective To evaluate the efficacy of pressure-controlled volume-guaranteed (PCVVG) mode for lung protective ventilation in patients requiring one-lung ventilation (OLV) during thoracoscopic surgery.Methods Sixty patients,aged 50-70 yr,with body mass index of 18-26 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of esophageal cancer performed via video-assisted thoracoscope under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:volume-controlled ventilation group (group V) and PCV-VG group (group P).The ventilator settings were adjusted,with a tidal volume 10 ml/kg and respiratory rate 10-12 breaths/min during two-lung ventilation,and with a tidal volume 6 ml/kg and respiratory rate 12-16 breaths/min during OLV.The inspiratory/expiratory ratio was 1 ∶ 2,pressure restriction was 35 cmH2O,and 33％ oxygen was inhaled at 2 L/min.The end-tidal pressure of carbon dioxide was maintained at 35-40 mmHg.Visual analog scale score was maintained ≤ 3 after operation.After admission to the operation room (T0) and at 1,3 and 7 days after operation (T1-3),forced vital capacity (FVC),forced expiratory volume in first second (FEV1),and maximal mid-expiratory flow (MMEF) were measured,arterial blood samples were collected for blood gas analysis,arterial carbon dioxide partial pressure and arterial oxygen partial pressure (PaO2) were recorded,and alveolar-arterial oxygen tension difference (PA-a O2) was calculated.Clinical Pulmonary Infection Score was assessed at T1,T2 and T3.The chest tube removal time and length of postoperative hospital stay were recorded.Results Compared with the baseline at T0,FVC,FEV1,MMEF and PaO2 were significantly decreased,and PA-aO2 was increased at T1-3 in the two groups (P＜0.05).Compared with group V,FVC,FEV1,MMEF and PaO2 were significantly increased,PA-aO2 and Clinical Pulmonary Infection Score were decreased,and the chest tube removal time and length of postoperative hospital stay were shortened at T1-3 in group P (P＜0.05).Conclusion PCV-VG mode can achieve lung protective ventilation,which is helpful in improving outcomes in the patients requiring OLV during thoracoscopic surgery.

Humans ; Occupational Diseases ; diagnosis ; Occupational Health Services ; organization & administration

Objective To investigate the relationship between anti-HCV antibody level and hepatitis C virus genotype in the patients.Methods Total of 603 anti-HCV positive serum samples were collected during 2013 to 2014 by retrospective research method.HCV RNA were detected in anti-HCV positive samples by repeat test and the genotype were detected in HCV RNA positive samples.The distribution of anti-HCV level in different hepatitis C genotype patients was analyzed and the body's response to viral antibodies and viral genotype correlation with anti-HCV concentration interquartile range was explored.Rates among genotype groups were compared using chi-square test.Results Totally 412 of 603 (68.33％) samples were anti-HCV positive by double reagent screening.174(42.3％) samples were detected as HCV RNA positive.The distributions of different anti-HCV level in different genotype patients were 1a(n =8) 1/8,1/8,4/8,2/8;1b(n =112)25.9％ (29/112),17.0％ (19/112),25.9％ (29/112),31.3％ (35/112);2a(n =14)3/14,4/14,5/14,2/14;3a(n =11)3/11,6/11,2/11,0/11;3b(n =16)4/16,11/16,1/16,0/16;6a(n =8)2/8,2/8,1/8,3/8 with anti-HCV concentration interquartile range respectively.The anti-HCV concentration distribution was different in patients with different HCV genotypes.The anti-HCV concentration distribution in patients of 1 b,2a and 6a genotypes were evently,while anti-HCV level was relatively high in 1a (13.65) and relatively low in 3b (8.77).There were differences in different genotypes of antibody concentrations (x2 =35.2,P ＜ 0.05).Conclusions There was correlation between anti-HCV level and HCV genotype.Because there were fewer cases in some genotypes,it was necessary to investigate more samples to corfirm the above results.

Objective: To investigate the effects of Ginkgo biloba extract 50 (GBE50) preconditioning on contents of inflammation-related cytokines in rats with myocardial ischemia-reperfusion. Methods: Fifty-eight SD rats were divided into sham-operated group, untreated group, Salviae miltiorrhizae (SM) injection group and low-, medium- and high-dose GBE50 groups. After intragastric administration for 7 d, the left anterior descending (LAD) coronary artery was occluded for 30 min followed by 60-min reperfusion to induce ischemia-reperfuion injury. Myocardium histopathologic change was observed by HE staining under a light microscope; myeloperoxidase (MPO) activity in myocardium was measured by colorimetric detection; tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8 were detected by radioimmunoassay; IL-4 and IL-10 were tested by enzyme-linked immunosorbent assay (ELISA). Results: Compared with untreated group, rats in medium-dose GBE50 group had lower inflammatory reaction and MPO activity (P<0.01). GBE50 also decreased the content of IL-6 (P<0.05, P<0.01) and increased the content of IL-4 in myocardium (P<0.05, P<0.01) as compared with the untreated group. The content of TNF-alpha in myocardium in the medium-dose GBE50 group was lower and IL-10 was higher than those in the untreated group, but without significant differences. Conclusion: GBE50 can decrease the content of IL-6 and increase the content of IL-4 in myocardium after ischemia-reperfusion injury. It suggests that GBE50 can regulate the inflammatory reaction after ischemia-reperfusion injury via inhibiting inflammatory cytokines and promoting anti-inflammatory cytokines.

BACKGROUND:Cytological studies show that bone marrow mesenchymal stem cel s play an important role in postmenopausal osteoporosis mechanism.
OBJECTIVE:To study the osteogenic differentiation in vitro of bone marrow mesenchymal stem cel s from ovariectomied osteoporotic rats.
METHODS:The osteoporotic animal model was established by performing ovariectomy in the 6-month-old female Sprague-Dawley rats. There were four groups:bone marrow mesenchymal stem cel s control group, bone marrow mesenchymal stem cel s osteoporosis group, bone marrow mesenchymal stem cel s osteogenic induction group and oseogenesis induction group. Bone marrow mesenchymal stem cel s were isolated from the rats of control group and oseogenesis induction group by means of the whole bone marrow adherence method and cultured to the 3rd generation. Then the bone marrow mesenchymal stem cel s were used in al the experiments. Cel morphology was observed under the inverted phase contrast microscope, cel cycle and proliferation index of bone marrow mesenchymal stem cel s were detected by flow cytometry. After osteogenic induction, the expression level of alkaline phosphatase was detected, and the fornation of calcium nodes of bone marrow mesenchymal stem cel s were marked by alizarin red staining.
RESULTS AND CONCLUSION:The cel s in the osteogenic induction group and oseogenesis induction group had the morphology of osteobalsts, and the change of morphology of the cel s in the oseogenesis induction group was relatively tardiness. The proliferation index in the control group was higher than that in the osteoporosis group (P<0.05);expression level of alkaline phosphatase in the osteogenic induction group was significantly higher than that in the oseogenesis induction group (P<0. 05), and the control group was significantly higher than the oseogenesis group (P<0.05). The alizarin red staining of the cel s in the osteogenic induction group was positive, while negative in the control group and the oseogenesis group;the staining in the osteogenic induction group was stronger than that in the oseogenesis induction group. These findings indicate that both the proliferative potential and the osteogenic potential of bone marrow mesenchymal stem cel s from the ovariectomized osteoporotic rats are decreased, which may be related with the ostoeporosis pathogensis of ovariectomied rats.

Objective To investigate the screening state and cause of neonatal congenital hypothyroidism(CH) in Henan province.Me-thods Three hundred and thirty-eight thousands no-choice newborns in the 156 hospitals in Henan province from Jan.1998 to Dec.2004 were received screening.The heel peripheral blood samples were taken and the levels of thyroid-stimulating hormone(TSH) were mea-sured by time-resolved fluoroimmunoassay.Positive newborns were recalled and draw out 2 mL venous blood.The levels of TSH,triiodothyronine(T3) and thyroxine(T4) in serum were detected by direct chemiluminescence.The abnormal criterion was that the level of T3,T4 was under the normal range and the level of TSH was above the normal range.Meanwhile their growth and development,intelligence quotient,related medical examination and family histories were investigated in order to find etiological factors and high risk factors.Results The average coverage rate was 5.93% of neonatal screening for CH in Henan province.One hundrend and nine infants were diagnosed CH.The attack rate was about 0.032%.The site and growth of thyroideas of 109 cases with CH were all normal.There were higher morbidity for pregnant women with unhealthy condition or the families with hypertension,diabetes,deformity or dysnoesia.Conclusions Etiology of newborns with CH in Henan province may be not relate with congenital absence and dystopia of thyroidea,but relate with dyssynthesis and receptor deficiency of hormone.And scientific reference is offered for the further study.

Objective To evaluate the clinical efficacy of “Shamrock” ultrasound images?guided lumbar sympathetic ganglion blockade ( LSGB) . Methods Sixty patients of both sexes, aged 18-60 yr, weighing 50-70 kg, of American Society of Anesthesiologists physical statusⅠorⅡ, undergoing unilater?al LSGB, were divided into groupⅠ ( n=30) and group Ⅱ ( n=30) using a random number table. In group Ⅰ, unilateral LSGB was performed at the L2 level under ultrasound guidance with paramedian trans?verse scanning. In groupⅡ, unilateral LSGB was performed at the L2 level under ultrasound guidance with“Shamrock” ultrasound images. After final needle position was confirmed, 2% lidocaine 6?0 ml was ad?ministered in each patient. At 20 min before and after LSGB, the visual analogue scale scores and skin temperature of the big toe of the affected foot were recorded, and the successful blockade and visibility of important paravertebral structures on ultrasound images were recorded during puncture. Results The visu?al analogue scale scores were significantly lower, and the skin temperature on the affected side was signifi?cantly higher after LSGB than before LSGB in both groups ( P<0?05) . The important paravertebral struc?tures such as erector spinae, quadratus lumborum, psoas major, transverse process of L2 vertebrae, and the curved edge of L2 vertebrae were visible in both groups. The visibility rate of the inferior vena cava or ab?dominal aorta on ultrasound images and the success rate of blockade were significantly lower in group Ⅰthan in group Ⅱ (P<0?01). Conclusion Compared with paramedian transverse scanning, LSGB has some advantages such as real?time monitoring, higher success rate of blockade, better efficacy and avoiding damage to great vessels when performed under “Shamrock” ultrasound image guidance.