Objective To introduce the Patient Mistreatment Scale into the field of nursing research, and to explore the influence of patient mistreatment on job satisfaction. Methods A total of 573 nurses were investigated by using a questionnaire survey. Exploratory factor analysis and multiple linear hierarchical regression analysis were used for data analysis. Results The patient mistreatment scale included 16 items under two dimensions; the internal consistency coefficient of scale was 0.935;experiences of patient mistreatment of nurses had a significantly negative prediction on their job satisfaction (β=-0.482, P<0.01). Conclusions The patient mistreatment scale has a good reliability and validity, meanwhile, nurses suffering a high frequency of patient mistreatment will have more less level of job satisfaction.

Objective: To observe the clinical efficacy of leuprorelin combined with mifepristone in the treatment of endometriosis. Methods: From September 2014 to September 2016, 168 cases of endometriosis were selected in the research.The patients were divided into the control group and the research group according to the random number table method, with 84 patients in each group.All patients underwent laparoscopic endometrial debridement with fertility preservation.The control group was treated with mifepristone, while the study group was treated with combination of leuprorelin and mifepristone.The incidence of adverse drug reactions during treatment was observed, the levels of serum E2, LH, FSH, EmAb and CA125 were detected before and after treatment, the curative effect after treatment was evaluated, and the recurrence and pregnancy of endometriosis within 12 months after treatment were followed. Results: During the treatment, the incidence rate of adverse drug reactions in the study group(17/84, 20.24%) had no statistically significant difference compared with the control group (13/84, 15.48%) (χ²=0.649, P=0.420). The levels of serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), anti-endometrial antibody (EmAb) and carbohydrate antigen 125 (CA125) in the two groups were significantly lower than those before treatment (t=17.694, 13.271, 7.943, 4.315, 10.029, 7.952, 14.231, 10.610, 27.953, 22.436, all P<0.001), and the indicators in the study group were significantly lower than those in the control group (t=5.217, 3.859, 3.526, 4.337, 6.048, all P<0.001). The total effective rate of the study group (96.43%) was significantly higher than that of the control group (83.33%) (χ²=7.919, P=0.005). Within 12 months after treatment, the recurrence rate of endometriosis in the study group (2.38%) was significantly lower than that of the control group (15.48%), while the rate of pregnancy (48.81%) was significantly higher than that of the control group(27.38%), there were statistically significant differences between the two groups (χ²=8.858, 8.178; P=0.003, 0.004). Conclusion Compared with leuprorelin treatment alone, leuprorelin combined with mifepristone can significantly reduce the serum levels of E2, LH, FSH, EmAb and CA125 in patients with endometriosis, and improve the overall treatment of endometriosis, reduce recurrence, promote pregnancy, and has high safety.

OBJECTIVETo observe the short-term clinical efficacy of compound Xiatianwu combined with methotrexate (MTX) in treating rheumatoid arthritis.

METHODOne hundred and four patients with rheumatoid arthritis were randomly divided into two groups: 64 cases in the combined treatment group who was treated with compound Xiatianwu combined with MTX, and the remaining 40 cases in the control group which was only treated with MTX. The changes in ACR20, ACR50, ACR70 and laboratory indexes including anti-cyclic citrulline polypeptide, rheumatoid factor, erythrocyte sedimentation rate, high sensitivity creative protein were compared before and after treatment. Adverse reactions in the two groups were observed as well.

RESULTAfter being treated for 3 months, the ACR20 improvement rate reached 59.4% in the combined treatment group, higher than 35% in the control group, with significant statistical difference (P <0.05); The ACR50 improvement rate reached 32. 8% the treated group, also higher than 17.5% in the control group, with significant statistical difference (P <0.05). After treatment for three months, both groups showed remarkable improvement in anti-cyclic citrulline polypeptide, rheumatoid factor, erythrocyte sedimentation rate and high sensitivity creative protein compared with that before treatment, demonstrating statistical significance (P <0. 05). The combined treatment group displayed more significant improvement in erythrocyte sedimentation rate and high sensitivity creative protein as well as much less adverse reactions than the MTX group.

CONCLUSIONCompound Xiatianwu combined with MTX can effectively improve clinical symptoms of RA patients and laboratory indexes, and shows higher medication safety.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Methotrexate ; therapeutic use ; Middle Aged ; Treatment Outcome

OBJECTIVE: To investigate the correlation between serum vitamin D level and clinical outcomes after repair of rotator cuff tears. METHODS: A total 122 patients who met the inclusion criteria and were followed up for 12 months from March 2018 to March 2020 were analyzed retrospectively, including 50 males and 72 females with an average age of(62.10±8.39) years old (ranged, 34 to 82 years old). All patients were divided into deficiency group(vitamin D<20 μg/L) and control group(vitamin D≥20 μg/L), including 62 cases in the deficiency group, with vitamin D (14.80±3.18) μg/L;60 cases in the control group, with vitamin D(25.17±5.64) μg/L. The two groups were compared in terms of age, gender, body mass index(BMI), tear size, degree of retraction, degree of fatty infiltration, injury factors, postoperative pain VAS score, postoperative shoulder joint function score, and re-tear rate. The age of all patients was divided into two categories:<60 years old and ≥60 years old;BMI was divided into <24 kg/m² and ≥ 24 kg/m²;tear size was divided into ≤3 cm and >3 cm;retraction degree was divided into ≤2 cm and >2 cm;fat infiltration was divided into ≤2 grade and >2 grade;and the course of the disease was ≤3 months and >3 months. The correlation between Sugaya re-tear type and the variables listed above were analyzed and calculated. RESULTS: There were no major complications such as joint infection, anchor withdrawal and revision surgery in any of the 122 patients who were followed up on. There were no statistical differences in age, gender, injury factor, BMI, tear size, degree of retraction, degree of fatty infiltration, and duration of disease between the two groups (P>0.05). The Constant-Murley scores, UCLA scores, and ASES scores of the two groups all improved considerably after surgery(P<0.05);however, there was no statistical differences in the postoperative shoulder function scores between the two groups (P>0.05). There was significant difference in VAS between the two groups 1 month and 3 months after operation, with vitamin D deficiency group scoring higher, and there was no significant differences 6 and 12 months after operation. Tear size(>3 cm), degree of retraction(>2 cm), degree of fatty infiltration(>2 degree) were all shown to be the independent risk factors for retear after surgery by Logistic regression analysis(P<0.05). The comparison between the two groups of patients using a 2×5 row list showed that the Sugaya classification of rotator cuff re-tear(grade Ⅰto Ⅴ) between the vitamin D deficiency group and the control group was statistically different(t=14.228, P=0.007). It was discovered that the Sugaya classification after surgery was statistically different between the two groups. CONCLUSION Vitamin D deficiency is not correlated with clinical function scores and re-tear rate, however it is associated with the early postoperative pain (1 and 3 months) and the quality of rotator cuff healing (Sugaya classification) after surgery.
Adult ; Aged ; Aged, 80 and over ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Rotator Cuff Injuries/surgery* ; Treatment Outcome ; Vitamin D

Objective: To investigate efficacy of operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism. Methods: A retrospective case control study was conducted to analyze the clinical data of 18 hip fracture patients complicated with pulmonary embolism admitted to Dongyang People's Hospital from May 2017 to January 2019. There were 11 males and seven females, aged 59 to 96 years[(80.0±9.3)years]. There were 10 patients with intertrochanteric fractures, one with femoral subtrochanteric fracture and seven with femoral neck fractures. After diagnosis of pulmonary embolism, the patients were given anticoagulant therapy with low molecular weight heparin for at least one week. The re-examination showed that pulmonary embolism absorption improved and D-dimer did not increase. Eleven patients chose surgical treatment (operation group) with intramedullary nail internal fixation or artificial hip replacement. Seven patients chose non-surgical treatment (non-operation group) with skin traction. The Harris score of hip function was compared between the two groups. Visual analogue scale (VAS) was used to evaluate hip joint pain. At the last follow-up, fracture healing, prognosis of pulmonary embolism and mortality within 3 months were recorded. Results: All the patients were followed up for 3-22 months [(11.2±6.0)months]. At last follow-up, the Harris score was (92.1±2.2)points in the operation group and (28.8±18.8)points in the non-operation group (P<0.01); the VAS was 0 point (0-1 point) in the operation group and 3 points (1-3 points) in the non-operation group (P<0.01). At the last follow-up in the operation group, five patients obtained fracture healing after internal fixation, and among the six patients receiving artificial joint replacement, five patients recovered well except for one deceased patient. At the last follow-up, pulmonary embolism was absorbed and no recurrence of pulmonary embolism was found. None of the patients died within 3 months in operation group, while 14% of the patients (1/7) in the non-operation group died within 3 months. Conclusions For hip fracture patients complicated with pulmonary embolism, compared with non-operation treatment, operation treatment is more beneficial to restore hip function and relieve pain, with lower mortality rate within 3 months. Operation treatment is feasible for patients who showed improved absorption of pulmonary embolism and no secondary increase of D-dimer after one to two weeks of full anticoagulation treatment before operation.

Objective: To investigate the expression and clinicopathological significance of high mobility group box protein B1 (HMGB1) protein in breast cancer. Methods: The expression of HMGB1 protein in 26 normal breast tissues and 417 invasive breast cancer tissues diagnosed at Dongyang People′s Hospital, Zhejiang Province from 2016 to 2018 were detected by immunohistochemical EnVision method. The relationship between nuclear and cytoplasmic HMGB1 protein expression and clinicopathologic features of breast cancer patients were analyzed. Results: The nuclear and cytoplasmic expression of HMGB1 protein was 80.8% (337/417) and 16.8% (70/417) respectively in breast cancer, and was 46.2%(12/26) and 0(0/26) respectively in normal breast tissue. Both nuclear and cytoplasmic expression of HMGB1 protein in breast cancer were significantly higher than normal breast tissue (P<0.001, P=0.046, respectively). The nuclear expression of HMGB1 protein was also higher in high grade, estrogen receptor (ER) negative, progesterone receptor (PR) negative (P=0.006, P=0.004, P<0.001, respectively); whereas the cytoplasmic expression of HMGB1 protein was also higher in high grade, estrogen receptor (ER) negative, progesterone receptor (PR) negative (P<0.001 in all) breast cancers. Multivariate logistic regression model showed that nuclear HMGB1 expression correlated with histologic grade (OR=2.188, 95%CI=1.078-4.443, P=0.030), while cytoplasmic HMGB1 expression correlated with histologic grade (OR=3.031, 95%CI=1.600-5.742, P=0.001), ER (OR=0.129, 95%CI=0.034-0.494, P=0.003) and TNM staging (OR=3.820, 95%CI=1.042-14.001, P=0.043). Multivariate analysis of Cox proportional hazard model showed that nuclear HMGB1 expression was an independent risk factor for the overall survival of breast cancer patients (HR=0.366, 95%CI=0.138-0.972, P=0.044). Conclusion Nuclear and cytoplasmic HMGB1 proteins are related to multiple poor prognostic factors in breast cancer, and may be a potential biomarker for breast cancer treatment.

Objective To explore the safety and efficacy of the Wingspan stenting of basilar artery atherosclerosis stenosis though the analysis of single center massive clinical data. Methods Ninety one consecutive patients received Wingspan stenting because of basilar artery stenosis in our center from July 2007 to April 2013. The patients were classified into three groups:early term (n=30), middle term (n=30), and late term (n=31) according to the operation time in our center. The basic clinical data and the factors which may affect the ischemic events were retrospectively analysed, t test and Chi?Square test were used to analyze the factors related to the periprocedural ischemic complications. Results All of patients were stented successfully and the technical success rate was 100%(91/91). The mean stenosis was reduced from (82.2 ± 5.8)% to (15.9 ± 5.7)%; strokes or death happened in 13 cases within 30 days, including perforator stroke in 8 patients(8.8%, 8/91), thrombosis in 4 patients(4.4%, 4/91), subarachnoid hemo rrhage in 1 patient(1.1%, 1/91), 2 patients with disabling or fatal strokes. Lesions involving in the middle segment of basal artery (P=0.049), long?segment disease (P=0.002), severe stenosis (P=0.001) may be a risk factor affecting perioperative ischemic stroke, and the surgeons' surgical technique was not risk factors for ischemic complications (P=1.000). Seventy seven patients (84.6%, 77/91) had the clinical follow?up and the mean follow?up period was (31.3±15.1) months. Four patients suffered from posterior circulation strokes during the clinical follow?up , one of them (1.3%, 1/77) had disabling stroke, another 3 patients (3.9%, 3/77) suffered from TIA. The 2?year accumulate probability of stroke (any stroke or death within 30 days and stroke in the territory of the qualifying artery beyond 30 days)was 16%(95%CI, 8.2%to 23.8%). Forty six patients had the imaging follow?up and the mean follow?up period was(9.5±8.3)months, 6 patients(13.0%,6/46) had in?stent restenosis (ISR) and 2/6 patient had the symptomatic ISR. Conclusions The stroke or death rate of symptomatic basilar atherosclerosis Wingspan stenting within 30 days is high, but the disabling or fatal stroke rate is low. The middle segment of basilar artery involved, the long stenosis, the severe atherosclerosis may be the factors related to the periprocedural ischemic strokes. The incidence of disabling or fatal strokes was low following Wingspan stenting.

Objective To investigate the changes of inositol 1,4,5-triphosphate receptor typeⅠ(IP3RⅠ)expression in the myocardial tissue of rats with endotoxic shock and probe the possible mechanisms of myocardial depression.Methods Thirty-three male Wistar rats were divided into four groups:control group (n=6) were injected normal saline(4ml/kg),and the other 3 groups (n=9) were injected endotoxin via femoral vein with a different dose of 10mg/kg,5mg/kg,and the artificial sacrificed group(10mg/kg,the rats were sacrificed when the mean arterial pressure was first rapidly decreased,then gradually increased to the normal level).IP3RⅠexpression in the myocardial tissue of rats was detected by immunohistochemistry,Western blot and colloidal gold immunoelectron microscopy technique.Results IP3RⅠexpressions were increased significantly in each group of rats with endotoxic shock than in the control group (P<0.01),and most obviously enhanced in the the artificial sacrificed group.The expression of IP3RⅠwas related to the level of mean arterial pressure.Ectopic expression of IP3RⅠwas observed around the cell membrane of the cardiac myocytes.Conclusion (1)The expression of IP3RⅠenhances in the myocardial tissue of rats with endotoxic shock,and exists ectopic expression.(2) The expression of IP3RⅠwas related to the level of mean arterial pressure.(3) IP3RⅠ may be related to the cardiac contractility and involved in the regulation of mean arterial pressure.

OBJECTIVE:To observe the efficacy and safety of paclitaxel combined with cisplatin and fluorouracil for gastric cancer with liver metastases via indwelling hepatic arterial catheter. METHODS:56 gastric cancer patients with liver metastases were randomly divided into control group(28 cases)and observation group(28 cases). Control group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5,pumping administrated via central venous. Ob-servation group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5, administrated via indwelling hepatic arterial catheter. 3-4 weeks were a course,it lasted 8 courses at most. Magnesium isoglycyrrhiz-inate injection 200 mg/d was intravenously infused for liver protection in 2 groups during treatment. Clinical efficacy,serum car-cinoembryonic antigen (CEA),alanine aminotransferase (ALT),aspartate aminotransferase (AST) levels before and after treat-ment,and the incidence of adverse reactions in 2 groups observed. RESULTS:Short-term clinical efficacy in observation group was significantly higher than control group,with statistical significance(P<0.01). Before treatment,there were no significant dif-ferences in CEA,ALT and AST levels(P>0.05). After treatment,CEA,ALT and AST levels in 2 groups were significantly high-er than before,ALT and AST levels in observation group were significantly higher than control group,while CEA level in observa-tion group was lower than control group,with statistical significances(P<0.05). The incidences of bone marrow suppression,nau-sea,vomiting and fever in observation group were significantly lower than control group,with statistical significances (P<0.05). CONCLUSIONS:Paclitaxel combined with cisplatin and fluorouracil has good efficacy for gastric cancer with liver metastases via indwelling hepatic arterial catheter,while it exists liver dysfunction.

OBJECTIVETo explore the effects of endoplasmic reticulum stress (ERS) related proteins and their mediated apoptosis in the formation of deep tissue injury of pressure ulcer in rats.

METHODSForty male Sprague-Dawley rats were divided into normal control group and groups A, B, C, D according to the random number table, with 8 rats in each group. Rats in group A were loaded with 22.47 kPa pressure with a special pressure apparatus for 2.0 h in the region over gracilis, and then unloaded for 0.5 h. Rats in group B were treated with the same manoeuvre as that in group A for 3 times in one day. Rats in groups C and D were treated with the same manoeuvre as that in group B for 2 and 3 days. Rats in normal control group were free from pressure loading. Rats in groups A, B, C, and D were sacrificed after pressure loading, and then the central part of pressure loaded muscular tissues were harvested for observation of histomorphological change with HE staining; apoptotic nucleoli per millimeter pressure loaded muscular tissue were counted with Hoechst 33258 staining; the levels of binding protein (BIP), protein disulfide isomerase (PDI), C/EBP homologous protein (CHOP), and caspase-12 were assessed with Western blotting (denoted as gray level ratio of target protein to GAPDH). The same parts of gracilis of rats in normal control group were harvested for determination of all the indexes as above. Data were processed with one-way analysis of variance, LSD-t test was applied for paired comparison.

RESULTS(1) Histomorphological observation. Some pathological changes, including inflammatory cell infiltration, myofibers lysis, and vacuolar degeneration, etc. were observed in pressure loaded muscular tissue of rats in groups A, B, C, and D, but not in the same parts of gracilis muscle of rats in normal control group. Compared with those in normal control group [(2.7 ± 1.4) per millimeter muscular tissue], the number of apoptotic nuclei was significantly increased in pressure loaded muscular tissue of rats in groups A, B, C, and D [(14.5 ± 4.4), (11.0 ± 2.9) , (13.8 ± 5.1), (21.3 ± 6.0) per millimeter pressure loaded muscular tissue, with t values from 4.223 to 6.000, P values all below 0.01). (2) Western blotting. The protein expressions of BIP and PDI in rats of normal control group and groups A, B, C, D were respectively 0.64 ± 0.12, 1.20 ± 0.34, 1.59 ± 0.24, 1.17 ± 0.28, 1.44 ± 0.33; 0.48 ± 0.15, 0.61 ± 0.19, 1.23 ± 0.38, 0.37 ± 0.19, 0.29 ± 0.15, and they showed significant statistical difference (with F values respectively 5.32, 7.95, P < 0.05 or P < 0.01). The protein expressions of CHOP and caspase-12 in rats of normal control group and groups A, B, C, D were respectively 0.58 ± 0.18, 1.48 ± 0.27, 1.03 ± 0.21, 0.95 ± 0.30, 1.69 ± 0.34; 0.55 ± 0.12, 1.08 ± 0.31, 0.69 ± 0.24, 1.79 ± 0.20, 2.06 ± 0.47, with significant statistical difference (with F values respectively 8.17, 15.48, P values all below 0.01).

CONCLUSIONSERS related proteins and their apoptotic pathway may play an important role in the formation of deep tissue injury of pressure ulcer in rats.

Animals ; Apoptosis ; Endoplasmic Reticulum Stress ; Male ; Pressure Ulcer ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley