Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.

Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

BACKGROUND: The survival rate of patients after cardiac arrest (CA) remains lower since 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) was published. In clinical trials, the methods and techniques for CPR have been overly described. This article gives an overview of the progress in methods and techniques for CPR in the past years. DATA SOURCES: Original articles about cardiac arrest and CPR from MEDLINE (PubMed) and relevant journals were searched, and most of them were clinical randomized controlled trials (RCTs). RESULTS: Forty-two articles on methods and techniques of CPR were reviewed, including chest compression and conventional CPR, chest compression depth and speed, defibrillation strategies and priority, mechanical and manual chest compression, advanced airway management, impedance threshold device (ITD) and active compression-decompression (ACD) CPR, epinephrine use, and therapeutic hypothermia. The results of studies and related issues described in the international guidelines had been testified. CONCLUSIONS: Although large multicenter studies on CPR are still difficult to carry out, progress has been made in the past 4 years in the methods and techniques of CPR. The results of this review provide evidences for updating the 2015 international guidelines.

OBJECTIVE:To observe clinical efficacy and ADR of Houttuynia cordata eye drops combined with Olopatadine eye drops in the treatment of allergic conjunctivitis. METHODS:160 eyes with allergic conjunctivitis were randomly divided into observation group and control group,with 80 eyes in each group. The control group was given olopatadine eye drops,and observa-tion group was additionally given H. cordata eye drops(medication interval>10 min)on the basis of control group. Both groups were treated for 14 days. Symptoms and signs of 2 groups were observed and scored before treatment and 14 d after treatment. Ef-fective rates of 2 groups were calculated,and the occurrance of ADR was observed. RESULTS:Compared with before treatment, symptoms and sings score of 2 groups were decreased,with statistical significance (P<0.01 or P<0.05);the decrease of two score in observation group were more significant than in control group,with statistical significance (P<0.05);effective rates of control group and observation group were 37.50%and 77.50%,with statistical significance(P<0.05). CONCLUSIONS:H. corda-ta eye drops combined with olopatadine eye drops can ameliorate clinical symptoms and signs of allergic conjunctivitis patients sig-nificantly,and improve therapeutic efficacies without obvious ADR.

AIM: To develop a method for determining ginsenoside Rb_1,Rc,Rb_2 and Rd in Shenqi Granules (Radix Rhizoma Ginseng,Radix Astragali,Rhizoma Atractylodis macrocephalae,Poria,etc.) by microbore LC.METHODS: Microbore liquid chromatography was applied.Microsil C_(18) column( 150 mm×1.0 mm) was used with the mobile phase containing acetonitrile-water for gradient elution.The flow rate was 50 μL/min,and the detection wavelength was set at 220 nm.RESULTS : The relationships between the concentrations and the peak areas of these for components were all linear.The recoveries were 98.14% for ginsenoside Rb_1,98.04% for ginsenoside Rc,98.79% for ginsenoside Rb_2,and 97.97% for ginsenoside Rd respectively.The relative standard deviations (RSD) were 0.67%,0.99%,0.75%,and 1.46%,respectively.CONCLUSION: This method is simple,convenient and can be used for quality control.

Objective To detect the expression of Cytokeratin 19 (CK19) mRNA in the peripheral blood of cervical carcinoma patients and evaluate its clinical significance.Methods The expression of CK19 mRNA was evaluated by fluorescent quantitative reverse transcription polymerase chain reaction ( FQRT-PCR ) in the peripheral blood of 138 patients with cervical carcinoma and 36 patients with benign gynecological tumors.In 138 patients,possible correlations between clinical pathological factors were analyzed.Results The positive expression rates of CK19 mRNA was 69.6％ in 138 cervical carcinomas in comparison with 13.9％ in benign gynecological tumors,and 57.9％ in patients with FIGO Stage Ⅰ A to Ⅱ A cervical carcinoma in comparison with 80.6％ in patients with FIGO Stage Ⅱb to Ⅳ cervical carcinoma.The expression of CK19 mRNA in patients with FIGO Stage Ⅰ A to Ⅱ A cervical carcinoma were significantly correlated with stage,differentiation and lymph vascular space involvement,but was not associated with prognostic factors including age,bully tumor size,pathological types,deep stromal invasion and lymph node metastasis.In multivariate survival analysis,lymph vascular space involvement was an independent risk factor of CK19mRNA expression in patients with cervical carcinoma.Conclusions Fluorescent quantitative RTPCR can be used to detect the expression of CK19 in the peripheral blood of cervical carcinoma patients,and it is a sensitive and specific technique.CK19 mRNA in peripheral blood may be a potential biomarker for detecting micrometastasis in cervical carcinoma.The results suggest a possible use of this approach for evaluating prognosis.

Objective To compare the immediate effects of extracorporeal shock wave therapy with that of joint mobilization plus short wave therapy in treating scapulohumeral periarthritis, and to elucidate the mechanism of extracorporeal shock wave therapy and how it should be used. Methods Forty-seven patients diagnosed with scapulohumeral periarthritis were selected and randomized into two groups, a treatment group (n = 26) treated with extracorporeal shock wave therapy, and a control group ( n = 21 ) treated with joint mobilization plus short wave therapy. The short form of the McGill pain questionnaire (SF-MPQ) and range of motion (ROM) measurements were used to evaluate shoulder function. Results Compared with baseline, both groups improved significantly af-ter treatment, but the immediate effect in the treatment group was superior to that in the control group. Concln-sions As a safe, time-saving and effective therapy, extracorpnreal shock waves could be used to treat scapulo-humeral periarthritis.

Background and purpose. Chemotherapy is a standard treatment for patients with advanced stage non-small cell lung cancer (NSCLC) However, platinum based chemotherapeutic regimen haves high toxicity profile to normal tissues. Lobaplatin (LBP) is a new third-generation antitumour platinum drug. Studies abroad have shown that Iobaplatin has an anticancer activity similar to cisplatin with better tolerance and is more effective for those who are resistant to cisplatin. This study was aimed to observe the effectiveness and toxicities of lobaplatin combined with vinorelbine (NVB) for the treatment of advanced NSCLC. Methods: Sixty-four patients pathologically diagnosed as clinical stage Ⅲ_B-Ⅳ NSCLC who did not receive treatment before, were randomly assigned to two groups. NL group (NVB+LBP): LBP at a dose of 30 mg/m~2 intravenous infusion on day 1, and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. NP group (NVB+DDP): Cisplatin (DDP) at a dose of 30 mg/m~2 intravenous infusion on day 1, 2 and 3 and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. Treatments were repeated every 21-28 days for 3 cycles. Results: For 34 patients of NL group, there were CR (1 cases), PR(13 cases), NC(15 cases), and PD(5 cases). The overall response rate (RR) was 41.2%, disease control rate (DCR) was 85.3%. In NP group: RR was 43.3%, DCR was 83.3% (X~2=0.05, P>0.05). Median overall survival time was 8.6 months and 8.9 months for NL group and NP group, respectively. The main toxicities in NL group were myelosuppression. Digestive toxicity such as anorexia, nausea,vomiting were less than those in the NP group (X~2=7.43, P<0.05), Peripheral hour,toxicity, serious liver and renal toxicity were not observed in NL group. Conclusion: Compared with cisplatin plus vinorelbine, domestic lobaplatin with vinorelbine yielded similar efficacies for NSCLC, but had less toxicity and well tolerate.

The impeller profile, which is one of the most important factors, determines the creation of shear stress which leads to blood hemolysis in the internal flow of centrifugal blood pump. The investigation of the internal flow field in centrifugal blood pump and the estimation of the hemolysis within different impeller profiles will provide information to improve the performance of centrifugal blood pump. The SST kappa-omega with low Reynolds correction was used in our laboratory to study the internal flow fields for four kinds of impellers of centrifugal blood pump. The flow fields included distributions of pressure field, velocity field and shear stress field. In addition, a fast numerical hemolysis approximation was adopted to calculate the normalized index of hemolysis (NIH). The results indicated that the pressure field distribution in all kinds of blood pump were reasonable, but for the log spiral impeller pump, the vortex and backflow were much lower than those of the other pumps, and the high shear stress zone was just about 0.004%, and the NIH was 0.0089.
Assisted Circulation ; Heart-Assist Devices ; Hemolysis ; Humans ; Models, Theoretical ; Stress, Mechanical

BACKGROUND: The metal implant internal fixation exhibits good effect for femoral neck fractures of young patients, but few studies report the metal implant treatment for femoral neck fracture in the aged patients. OBJECTIVE: To compare different implant treatments for osteoporotic hip fractures in senile patients. METHODS: A total of 237 aged patients with osteoporotic hip fracture, aged from 60 to 96 years old, were recruited from the hospital between January 1998 and December 2008. There were 32 cases treated by cannulated screw internal fixation, 23 cases by anatomical plate internal fixation, 41 cases by dynamic hip screw internal fixation, 111 cases by bipolar femoral head replacement, and 30 cases by total hip replacement. Comparison of the incidence of complications and the recovery of hip function were performed in each group. RESULTS AND CONCLUSION: Cannulated screws, anatomical plates, dynamic hip screw internal fixation showed a higher complication rate significantly than bipolar femoral head replacement and total hip arthroplasty (P < 0.01); the good and excellent effect rate in cannulated screw, femoral end plate, and dynamic hip screw fixation was significantly lower than that in bipolar femoral head replacement and total hip arthroplasty (P < 0.001, P < 0.01). The results suggested that artificial joint replacement (bipolar femoral head replacement or total hip replacement) is the optimal choice for aged osteoporotic femoral neck fracture, cannulated screw fixation is suitable for Garden I, dynamic hip screw fixation and proximal femoral anatomical plate fixation fit for intertrochanteric fractures of Jensen-Evans I-Ⅱ; Jensen-Evans Ⅱ-Ⅲ osteoporotic intertrochanteric fractures joint replacement is the ideal choice.