Objective: To integrate the best evidence of venous thromboembolism (VTE) prevention into practice, improve nurses′ compliance, and reduce the incidence of VTE in orthopaedic department. Methods: Guided by the standard procedure in the JBI-Paces program, collected the best evidence from online databases and set the standards. Collected data through field observation, interviews and review of nursing records. A total of 167 patients and 36 nurses we recruited in the study and audited twice. We judged the result by the knowledge level of nurses and patients, nurses′ compliance with the evidence and the incidence rate of VTE. Results: In baseline review, three criteria of poor compliance, "the correct situation of daily inspection of VTE risk assessment", "Wear gradient pressure stockings correctly for VTE high-risk patients", "Intermittent pneumatic compression device (IPCD) used twice a day for 30 minutes each time", were significantly improved after the application of evidence, increased from 47.22% (17/36) ,36.11% (13/36) ,36.11% (13/36) to 86.11% (31/36) , 86.11% (31/36) , 91.67 (33/36) respectively (χ²=12.25, 18.94, 24.08, all P < 0.05); The incidence of VTE decreased from 2.7% to 0 (P=0.195); the correct rate of VTE risk assessment, awareness rate of health education among patients, implementation rate of physical preventive measures and qualified rate of VTE-related knowledge and skills among nurses increased from 82.43% (61/74) ,74.32% (55/74) ,83.78% (62/74) ,77.03% (57/74) to 97.85% (91/93) ,91.40% (85/93) ,97.85% (91/93) ,96.77% (90/93) respectively (χ²= 8.86-15.24, all P < 0.01) . Conclusion The integration of best evidence standardize nurses′ behaviors, reduce the incidence rate of VTE, improve the quality of clinical care and promote the satisfaction of patients continuously.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Low Back Pain ; etiology ; Male ; Spinal Puncture ; adverse effects

0.05).Meanwhile,the cardiac function and the quality of life of the rehabilitation exercise group was improved to a significantly larger extend than those of the control group (P

OBJECTIVETo discuss the clinical characteristics, diagnosis and treatment of the clinical characteristics and prognosis of asbestosis complicated with malignant mesothelioma patients.

METHODSIn 3 cases of asbestosis complicated with malignant mesothelioma were retrospectively analyzed.

RESULTSIn the 3 patients, 2 cases of pleural mesothelioma, with chest tightness, chest and back pain as initial symptom; 1 case of peritoneal mesothelioma, with abdominal distention, abdominal pain, dysuria as initial symptom. One case of the pleural mesothelioma misdiagnosed as tuberculous pleurisy. 3 patients were in CT or B ultrasound guided biopsy pathology confirmed to be malignant mesothelioma. 2 patients received systemic chemotherapy, another received symptomatic and supportive treatment. Up till now, 3 patients have died.

CONCLUSIONThe disease is a high degree of malignant, the early clinical manifestations are not specific, easily missed diagnosis and misdiagnosis. The treatment effect is not ideal, the prognosis is poor. Biopsy is a reliable method for diagnosis of MM.

Abdominal Pain ; Asbestosis ; complications ; diagnosis ; Back Pain ; Biopsy ; Diagnostic Errors ; Humans ; Lung Neoplasms ; complications ; diagnosis ; Mesothelioma ; complications ; diagnosis ; Peritoneal Neoplasms ; Pleural Neoplasms ; Prognosis ; Retrospective Studies ; Tuberculosis, Pleural

OBJECTIVES: This study aimed to explore the changes in the expression of the characteristic transcription factor retinoid related orphan receptor γt (RORγt) and the cytokine interleukin-17 (IL-17) of T helper cell 17 (Th17) in the pressure side of the periodontal tissue of rats under different orthodontic forces. Their effects on the expression of osteoprotegerin (OPG) and the quantity of osteoclast (OC) were also explored. The role of Th17 cell in alveolar bone remodeling under different forces was preliminarily investigated. METHODS: A total of 108 rats were chosen and randomly divided into three groups. Mesial forces of 0, 50, and 100 g were loaded on the maxillary first molar in the three groups. The rats were executed at 0, 1, 3, 5, 7, and 14 days. The expression of RORγt mRNA was quantified by real-time quantitative polymerase chain reaction. The expression of IL-17 protein was quantified by enzyme linked immunosorbent assay. The expression levels of RORγt and OPG proteins were quantified, and the quantity of OC was counted via immunohistochemistry. RESULTS: The expression levels of RORγt and IL-17 and the quantity of OC increased first and then decreased in the 50 and 100 g groups, and the peak values of the two groups were on days 5 and 7, respectively. The expression levels in the 50 g group basically recovered to normal level on day 14, while that in the 100 g group remained at a high level. The expression levels in the 50 g group were higher than those in the 0 g group and lower than those in the 100 g group. The expression of OPG in the 50 g group decreased first, then increased, and finally decreased. It basically recovered to normal level on day 14. The expression of OPG in the 100 g group decreased first and then increased. It remained at a high level on day 14. The expression in the 50 g group was significantly higher than that in the 0 g group on day 7, while the expression in the 100 g group was significantly higher than that in the 0 g group on day 14. CONCLUSIONS RORγt, IL-17, and OPG were expressed regularly over time under different orthodontic forces, indicating that Th17 participated in the process of bone resorption on the pressure side of periodontal tissue by secreting IL-17.
Animals ; Bone Resorption ; Cytokines ; Interleukin-17 ; Molar ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; Osteoclasts ; Osteoprotegerin ; Rats ; Th17 Cells ; Tooth Movement Techniques

OBJECTIVETo investigate the expression and distribution of intrahepatic CD4+ CD25+ regulatory T cells in immuno-tolerant and immuno-clearance phase of patients with chronic hepatitis B.

METHODSThe expression of FoxP3 was detected in 19 cases of immuno-tolerant phase and 12 cases of immuno-clearance phase by immunohistochemistry. The relation between the intrahepatic expression of FoxP3 and the clinicopathological features were analyzed.

RESULTSThe positive signal of FoxP3 is located in nuclear of lymphocyte and mainly aggregated in portal areas as well as occasionally scattered in hepatic sinusoids. The expression of intrahepatic FoxP3 in the group of immuno-tolerant phase was significantly increased than those in normal control (P < 0.01), and greatly decreased than those in immuno-clearance phase (P < 0.01). No correlation was observed among the expression of intrahepatic FoxP3, ALT, levels of HBV DNA, HBeAg positive, in patients of immuno-clearance phase, respectively. There were significant differences between immuno-tolerant phase and immuno-clearance phase age, ALT, TBIL, PTA, HBV-DNA and detection of HBeAg but not in sex and family history of HBV infection.

CONCLUSIONCD4+ CD25+ regulatory T cells may play important roles in the clearance of HBV as well as in liver inflammation and injury during chronic HBV infection.

Adolescent ; Adult ; CD4 Antigens ; immunology ; Female ; Forkhead Transcription Factors ; genetics ; immunology ; Gene Expression ; Hepatitis B virus ; immunology ; Hepatitis B, Chronic ; genetics ; immunology ; virology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology ; Young Adult

OBJECTIVETo investigate the interaction between p38 mitogen-activated protein kinase signal transduction pathway and nuclear factor (NF)-kappaB/IkappaB system on the proinflammatory cytokines release after burn trauma.

METHODSHuman monocyte line THP-1 were incubated with serum from eight healthy controls, burn sera, burn sera pretreatment with SB203580, and burn sera pretreatment with pyrrolidine dithiocarbamate (PDTC). After 24 hours incubation with serum, tumor necrosis factor (TNF)-alpha and interleukin-1beta (IL-1beta) levels in THP-1 culture supernatants were measured by ELISA. The activities of p38 MAPK and expressions of IkappaBalpha in THP-1 were measured by Western blot analysis. The EMSA method was used to characterize the binding activities of NF-kappaB and activating protein (AP)-1 in THP-1.

RESULTSIn comparison with normal controls, burn sera resulted in a significant higher level release of TNF-alpha and IL-1beta in THP-1 [(7.30 +/- 0.84) ng/ml vs (2.20 +/- 0.28) ng/ml, P < 0.05; (2.88 +/- 0.38) ng/ml vs (0.81 +/- 0.14) ng/ml, P < 0.05], which were significantly inhibited by pretreatment with SB203580 or PDTC. Burn sera showed increased activities of p38 MAPK and AP-1 in THP-1 (4728 +/- 582 vs 1291 +/- 163, P < 0.05; 946 +/- 137 vs 361 +/- 40, P < 0.05), which were abolished by pretreatment with SB203580 but not PDTC. The expression of IkappaBalpha in THP-1 incubated with burn sera was significantly decreased than those incubated with control sera (1211 +/- 115 vs 2658 +/- 318, P < 0.05), which were abolished by pretreatment with PDTC but not SB203580. Burn sera also leaded to an increased activity of NF-kappaB in THP-1 (1636 +/- 170 vs 317 +/- 32, P < 0.05), which were abolished by pretreatment with PDTC but not SB203580.

CONCLUSIONSThere are no direct interaction between p38 MAPK signal transduction pathway and NF-kappaB/IkappaB pathway. These two pathways, which regulate the production of TNF-alpha and IL-1beta in monocyte following burn trauma, are parallel and independent.

Adolescent ; Adult ; Burns ; immunology ; physiopathology ; Female ; Humans ; I-kappa B Proteins ; physiology ; Immune Sera ; pharmacology ; In Vitro Techniques ; Interleukin-1beta ; metabolism ; Male ; Middle Aged ; Monocytes ; drug effects ; physiology ; NF-KappaB Inhibitor alpha ; NF-kappa B ; metabolism ; physiology ; Signal Transduction ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism ; physiology

Adult ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; diagnosis ; Humans ; Male ; Middle Aged ; Prognosis

OBJECTIVETo investigate the role of p38 mitogen-activated protein kinase (MAPK) signal transduction pathway in the acute lung injury of severely burned rats.

METHODSForty-eight adult healthy rats were randomly divided into three groups: sham group, burn control group, and burn + SB203580 group. A third-degree burns over 30% total body surface area rat model was used and pulmonary capillary permeability, lung water content, pulmonary histology and p38 MAPK activity were measured at 24 hours postburn.

RESULTSBurn trauma resulted in increased pulmonary capillary leakage permeability (42.5 +/- 4.7 vs. 12.1 +/- 1.4, P < 0.01), elevated lung water content (P < 0.05), and worsen histologic condition. There was a significant activation of p38 MAPK at 24 hours postburn compared with control. SB203580 inhibited the activation of p38 MAPK, reduced the pulmonary capillary leakage permeability (24.7 +/- 2.9 vs. 42.5 +/- 4.7, P < 0.01), decreased lung water content, and prevented burn-mediated lung injury.

CONCLUSIONThe activation of p38 MAPK is one important aspect of the signaling event that contributes to burn-induced lung injury.

Animals ; Blotting, Western ; Burns ; enzymology ; physiopathology ; Enzyme Activation ; drug effects ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; Lung ; pathology ; physiopathology ; Male ; Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism ; physiology ; Pyridines ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; enzymology ; physiopathology ; Signal Transduction ; drug effects ; physiology ; p38 Mitogen-Activated Protein Kinases

OBJECTIVETo detect the factors relevant to stenosis of tracheal graft and to find feasible methods to solve this problem.

METHODSSixteen mongrel dogs were divided into groups A and B randomly and equally. Five-ring-length tracheal segments were allotransplanted. All grafts and anastomotic sites were covered with omental pedicles. In group A, no immunosuppressant was given and in group B, the recipients were treated with cyclosporine. The animals were sacrificed 4 weeks after operation, and their postmortem specimens were examined grossly and histologically. All allografts were assessed by percent patency. Epithelial regeneration and morphology of the cartilage were semiquantitatively evaluated.

RESULTSStructural integrity of the allografts were maintained better in group B than in group A. Tracheal stenosis was found to be more serious in group A. The scores of epithelial regeneration and cartilage morphology were higher in group B than in group A, and in each group positive correlation was found between the percent patency and the score of epithelial regeneration or cartilage morphology.

CONCLUSIONSImmunosuppressive drugs are necessary to maintain the structure of allografts. Tracheal stenosis is correlated closely with epithelial regeneration and morphological maintenance of the cartilage.

Animals ; Dogs ; Immunosuppressive Agents ; pharmacology ; Male ; Trachea ; pathology ; transplantation ; Transplantation, Homologous