This paper analyzes the absence of humanities in the closed management of psychiatric ward,and proposes relevant countermeasures: strengthening absorbing knowledge in humanities,applying humanistic nursing care,promoting the cultural construction of humanities in psychiatric ward,and strengthening the mental health support for nurses in psychiatric ward.

Objective To explore the correlation between gratitude and turnover intention of nursing staff.Methods A total of 660 clinical nurses from three general hospitals in Hangzhou city were subject to questionnaire survey for the correlation.Results The multidimensional gratitude totaled 128.33±32.67,at a medium or low level; their turnover intention totaled 14.59 ± 2.26,at a medium level.The multiple factor variance analysis showed statistically significant negative correlations between the three dimensions of gratitude(a sense of rich,simple thanks,and thanks to others)and turnover intention.Conclusion Related departments are recommended to pay close attention to nurses' gratitude and carry out gratitude education,so as to decrease their turnover intention,and keep the career stability of nurses.

Objective To provide methodological references for laboratories to carry out newborn screening for disorders of amino acid metabolism,we compared the difference and distribution of ten amino acids including alanine (Ala),arginine (Arg),citrulline (Cit),glycine (Gly),leucine (Leu),methionine (Met),ornithine (Orn),phenylalanine (Phe),tyrosine (Tyr),and valine (Val) from newborn dried blood spots specimen using derivatization or non-derivatization as sample preparation methods.Method It is a comparative research study.A total of 4135 newborn screening dried blood spot samples for inborn errors of metabolism were collected from January to June,2012.All specimens came from neonatal screening center of shanghai children's hospital.Samples were prepared by two different techniques,the corresponding kits and the procedures were used as follows:(1) Simultaneous detection of 100 dried blood spot specimens using two methods respectively to compare the paired difference of each amino acid.(2) 2000 cases of normal newborn specimens were detected respectively to obtain the normal distribution of ten neonatal amino acids.(3) 35 specimens from patients previously diagnosed positively as inborn errors of metabolism were simultaneously detected with 7 amino acids to verify the consistency of two techniques in clinical judgment.Results The amino acid levels of normal newborns analyzed by one-sample.kolmogorovSmirnov test (Z value ranged from 1.997 to 6.229) showed a skewed distribution (P ＜ 0.01).Except for Leu and Tyr,non-derivatization techniqueshowed a lower concentration than derivatization technique,and the CVs of nine amino acids were ＜ 10％ except for Met (the CV of Met was 47.8％),and the average CV is 7.8％.Except for Met,Phe and Tyr,the levels of other 7 amino acids measured by two techniques showed no significant difference (P ＞ 0.05).According to 0.5th to 99.5th percentiles,the normal reference range for derivatization method were greater than on-derivatization method,and the average value was 25.3％.After clinic judgment,the results of the abnormal indicators of children with true metabolism disorders showed no statistically significant between two methods (P ＞ 0.05),the detection rate was 100％.Conclusions There was a slight difference between derivatization and the non-derivatization techniques in detecting multiple amino acids.The results of the abnormal indicators of amino acid metabolism disordersshow no statically significant difference between the two methods,and no difference in clinical judgment.Both methods can be used in detecting amino acid metabolism disorders in newborn screening.

BACKGROUND: During vascular dementia, ischemia, hypoxia, energy expenditure, abnormal metabolism of neurons, decrease of generation of Adenosine Triphosphate and disorder of ionic environment in and out of cells are observed in brain tissue, which can cause abnormal release of monoamine transmitter.OBJECTIVE: To probe into effect of shenma yizhi capsule on content of monoamine transmitter in brain tissue of rat models with vascular dementia induced by multiple cerebral infarction.DESIGN: Randomized controlled study.SETTING: Pathological and Physiological Department o Liaoning Basic Medical Institute.MATERIALS: Totally 96 Wistar rats of either gender,aged 8-12 months, weighing 270-500 g, were selected. METHODS: The experiment was completed in the Pathological and Physiological Department of Vocational-technical College, Liaoning College of Traditional Chinese Medicine from April to July 2001. All rats of either gender were divided into 6 groups with 16 in each group. Wistar rats in 5 groups were injected with cruor embolus in internal carotid artery to make animal model of vascular dementia induced by multiple cerebral infarction.After modeling, rats were randomly divided into 3.2 g/kg, 1.6 g/kg and 0.8 g/kg shenma yizhi capsule groups (shenma yizhi capsule was extracted from ginseng and tall gastrodia tuber with 2.7 g raw materials and provide by Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine),positive control group and dementia control group. Animals without modeling were regarded as normal control group. Rats in each dosage group were perfused with the corresponding dosage of shenma yizhi capsule; rats in positive control group were perfused with 1 mg/kg hydergine dihydroergotoxine; rats in dementia control group and normal control group were perfused with the same volume of saline solution. One week after modeling, rats were medicated once a day for 6 weeks. Content of monoamine transmitter was measured with high performance liquid chromatograpy.MAIN OUTCOME MEASURES: Content of monoamine transmitter such as levarterenol, adnephrin, dopamine, indoleacetic acid, homovanillic acid and 5-serotonin.RESULTS: Nine rats died because of self-body quality and environmental change, and totally 87 animals entered the final analysis. Content of levarterenol of rats in dementia control group was lower than that in normal control group [(0.40±0.23), (0.70±0.14) ng/g, t=2.712, P ＜ 0.01]; content of levarterenol of rats of 3.2 and 1.6 g/kg dosage groups was higher than that of dementia control group [(0.57±0.09), (0.58±0.19), (0.40±0.23) ng/g,t=2.211, P ＜ 0.05], but was lower than that of normal control group. Content of levarterenol of rats of 0.8 g/kg dosage group was lower than that of normal control group [(0.48±0.23) ng/g, t=2.213, P ＜ 0.05], but was higher than that of dementia control group and positive control group [(0.41 ±0.19) ng/g]. Differences of other neurotransmitters were not significant.CONCLUSION: Content of levarterenol in brain tissue of rats of dementia control group is decreased obviously, but shenma yizhi capsule can increase content of levarterenol in brain tissue of rats. The mechanism of shenma yizhi capsule on treating vascular dementia is possibly related with increasing content of levarterenol in brain tissue.

Objective To explore the epidemic characteristics,clinical features and treatment outcome of brucellosis in the Dali area of Yunnan province.Methods The clinical data of 43 cases with brucellosis from Janurany 2012 to September 2015 were retrospectively analyzed.Results Among 43 cases,there were 35 males,8 females, 37 farmers,5 veterinary,and 1 teacher.42 patients had a clear history of contact with cattle and sheep,1 case of no clear history of exposure to cattle and sheep,mainly fever,accompanied by chills,headache,joint pain,low back pain, weight loss,hepatosplenomegaly etc.Laboratory routine examination showed no specificity,SAT was detected in 30 cases,positive rate was 100.0%,blood culture in 28 cases,23 cases were positive,the positive rate was 82.1%. 41 cases of adult patients with rifampicin and tetracycline or doxycycline + levofloxacin and cefotaxime drugs combined therapy,treatment for 6 weeks,2 cases of children took rifampicin and SMZ -TMP treatment for 6 weeks, improvement rate was 100%,there was no recurrence and death cases.Conclusion Dali area is popular in brucellosis, the clinical manifestations and the infection way diversification,need the attention of the clinicians.

Objective To evaluate the feasibility of PerkinElmer Genetic Screening Processor(GSP) in the application of newborn screening for congenital hypothyroidism (CH) and congenital adrenal hyperplasia (CAH) by detecting thyroid-stimulating hormone (TSH) and 17-OH-progesterone(17-OHP).Methods The dried-blood spots specimens from Centers for Disease Control and Prevention(CDC) and the quality control in the reagent kit were detected and the accuracy,precision and linearity were calculated.A total of 1 012 samples of TSH(60 of positive and 952 negative samples) and 991 samples of 17-0HP(34 positive and 957 negative samples)were detected.The initial cut-off value was determined by ROC curve determined.The consistency between the results from GSP and clinical diagnosis was analyzed.Results The average of within-run coefficient of variation(CV) of TSH and 17-OHP were 6.69％ to 12.6％ and 7.52％ to 9.29％,and the average of between-run CV were 6.91％ to 10.96％ and 6.86％ to 12.36％,respectively.The average of bias of TSH and 170HP were-14.28％ to-0.74％ and-0.45％ to 12.54％.The linearity of GSP detection was fine.The initial cut-off values were 23.43 U/mL(TSH) and 21.42 ng/mL(17-OHP).The sensitivity of GSP detection was 100％ and the specificity of TSH and 17-OHP were 98.11％ and 99.58 ％ respectively.The results of GSP detection showed good consistency with clinical diagnosis.Conclusion As the first real automatic fluorescence immunoassay analyzer,GSP could be used in routine clinical diagnosis for CH and CAH.

Purpose Medicine information and features of adverse reactions induced by non-ionic iodinated contrast agent injection for CT examination are analyzed and discussed,offering empirical evidence and reference for medication choice and patient information for clinical CT examination and targeted adverse reactions disposal.Materials and Methods General material,medicine type and name,adverse reactions occurrence time,symptoms and other information of the 20,418 patients receiving CT examination with non-ionic iodinated contrast agent at X-ray Department in Gansu Provincial Hospital from July 2013 to September 2016 were retrospectively analyzed.Results For observation objects in this group,11,679 were male and 8,739 female,aging from 3 to 93 and the average age was (52.1 ± 13.2) years.Various adverse reactions occurrence rate of non-ionic iodinated contrast agent was 0.4％ and adverse reactions occurrence rate of secondary hypertonic contrast and isotonic contrast agent was 0.47％ and 0.27％,respectively.Among the 81 adverse reactions,91.3％ were acute,among which 88.9％ occurred within 15 min after injection.8.7％ were delayed,97.6％ mild and moderate,and 2.4％ severe.Secondary hypertonic contrast and isotonic contrast agent occupied 74.0％ and 26.0％,respectively for the cause of adverse reactions.Delayed adverse reactions were mainly caused by isotonic contrast agent,representing as mild and moderate.Representation frequency of adverse reactions symptoms in turn was skin,digestive tract,central nervous system,respiratory system and circulatory system.Conclusion Adverse reactions caused by iodinated contrast agent were mainly acute and mild and moderate.The patients or their family members shall be fully notified before examinations.Severe adverse reactions caused by iodinated contrast agent developed very quickly and multi-systems would be damaged.Efficient on-site treatment is very important.Delayed reactions caused by isotonic contrast agent shall be paid more attention.

Objective:To investigate the status of anticipatory grief among primary caregivers of families with advanced Alzheimer′s disease (AD) and analyze the influencing factors.Methods:A total of 160 primary caregivers in the families of AD patients in the middle and late stage who were treated in Shaoxing Seventh People′s hospital from August 2018 to September 2019 were selected as research subjects to investigate caregivers′ gender, age, education level, relationship with patients, reasons for taking care of patients, and the patients′ time of illness, combined diseases, and self-care ability. Anticipatory Grief Scale was used to compare the anticipatory grief level (AGL) of caregivers with different characteristics, and Pearson correlation analysis was used to analyze the correlation between the anticipatory grief and burden of caregivers, with a further exploration of the factors affecting caregivers′ anticipatory grief.Results:The anticipatory grief score of primary caregivers of families with AD patients in the middle and late stage was (83.88±17.21). Single factor analysis showed the following facts: the AGL of female caregivers was higher than that of males ( t =12.337, P<0.05); the AGL of spouses was higher than that of children and other family members ( F=10.940); the AGL showed in caretaking based on willingness was lower than that based on responsibility and obligation, and the reason was because other people were available ( F=4.501); the AGL of caregivers of patients with 5-10 years of illness was higher than that of those with 2-4 years of illness ( F=6.014); the AGL of caregivers of patients with more than 3 kinds of other diseases was higher than that of those with less than 1 and 2 kinds of other diseases; the AGL of caregivers of patients with no self-care ability was higher than that of those of patients who lost partial or most self-care ability ( F=5.712). The burden score of primary caregivers of patients in the middle and late stages of AD was (50.19±12.61). Pearson correlation analysis indicated that the anticipatory grief of caregivers was positively correlated with their burden of care ( r=0.581, P<0.001), and multiple regression analysis showed that the caregivers′ gender and relationship with patients, patients′ time of illness, and capacity of self-care, and the caregivers′ burden are the main factors influencing the anticipatory grief of caregivers in families of patients in the middle and late stages of AD (all P<0.05). Conclusion:There exists serious anticipatory grief among primary caregivers in families of patients in the middle and late stages of AD. The main influencing factors include caregivers′ gender, burden of care, relationship with patients, patients′ time of illness, and self-care capacity. Health management should be enhanced to improve the quality of life of the primary caregivers of patients in the middle and late stages of AD.

Objective To investigate the prevalence of complication and related risk factors in Uygur patients with type 2 diabetes mellitus (T2DM).Methods Total 1 507 Uygur patients aged above 20 with T2DM were recruited in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to October 2015.Clinical characteristics,biochemical parameters and related complications were analyzed in different age groups of patients.Multivariate logistic regression was performed to determine associated factors for diabetic complications.Results Among 1 507 cases,there were 61.3％ male patients (n=924),37.4％ (n=564) with diabetes duration ≥5 years,12.5％ (n=189) with HbA1c＞10％,31.5％ (n=475) with hypertension,28.8％ (n=434) with smoking history and 37.4％ (n=564) patients without antidiabetic drug treatment.The average body mass index (BMI) of patients was (27.4±5.2)kg/m2 with a obesity rate of 43.0％ (648/1 507),and 65.0％ (980/1 507) had physical exercise＜150 min/week.The prevalence of diabetic complication was 70.6％(1 064/1 507),in which 28.7％,19.2％ and 22.7％ cases had 1,2 and 3 or more complications,respectively.The proportion of patients with coronary heart disease,stroke/transient ischemic attack and large artery atherosclerosis was 32.4％,10.4％ and 35.8％,respectively.The proportion of patients with diabetic retinopathy,nephropathy and neuropathy were 23.4％,6.5％ and 35.8％,respectively.Patients aged ≥60 years had highest prevalence of large artery atherosclerosis (38.2％,163/427) and diabetic retinopathy (27.2％,116/427);patients in age group 50-59 years had highest prevalence of diabetic neuropathy (40.3％,207/514).Multivariate logistic regression analysis showed that HbA1c＞10％ (OR=2.74,95％CI:1.40-5.34),obesity (OR=1.54,95％CI:1.07-2.21),systolic pressure≥140 mmHg (1 mmHg=0.133 kPa) (OR=1.42,95％CI:1.01-1.99),diastolic pressure≥90 mmHg (OR=0.37,95％CI:0.21-0.67),smoking (OR=1.53,95％CI:1.09-2.15) and physical aetivity＜150 min/week (OR=1.42,95％CI:1.07-1.89) were the risk factors of diabetic complications.Conclusion Uygur patients with type 2 diabetes in Xinjiang show a relatively high prevalence of complications.Poor glycemic control,obesity,hypertension,smoking and physical inactivity may contribute to development of complications,while well-controlled blood glucose and hypertension and quitting smoking and increasing physical activity may reduce diabetic complications.

OBJECTIVETo explore the applicable value of transanal total mesorectal excision (taTME) in male low rectal cancer patients with narrow pelvis-"difficult pelvis", which remains difficult for both open and laparoscopic sphincter-saving operations.

METHODSClinical data of male low rectal cancer patients diagnosed by pathology undergoing taTME between June 2016 and January 2018 at Peking University Cancer Hospital were collected. A retrospective cohort study was performed. Patients were selected according to the following criteria: (1) low rectal cancer, the distance between inferior margin of tumor and anal verge ≤5 cm; (2) the distance between two sciatic tubercles <5 cm; (3) body mass index (BMI) >25 kg/m; (4) tumor horizontal diameter ≤4 cm. Operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications and anal function were analyzed.

RESULTSA total of 20 patients were included in this study. All the patients received preoperative neoadjuvant chemoradiation and hybrid transabdominal and transanal surgery. The median BMI was 27.7(26.2-36.4) kg/m; the median distance between two sciatic tubercles was 92.5 (78-100) mm; the median distance between the inferior margin of tumor to the anal verge was 4 (2-5) cm; the median operation time was 302 (215-402) min; the median intraoperative blood loss was 100 (50-200) ml; the median postoperative hospital stay was 9 (5-15) d. Postoperative complications occurred in 5 patients (25%), including 3 pelvic infection, 1 intestinal obstruction, 1 anastomotic leakage receiving sigmoid colostomy. There was no perioperative death. Sphincter-preservation rate was 100%. Nineteen patients received anal manometry 1 month after operation with normal resting pressure (41.5±8.6) mmHg and squeeze pressure (121.0±11.6) mmHg. All the patients were followed up to March 2018, and the median follow-up time was 4.5 months. Only 1 patient had supraclavicular lymph node metastasis and no local recurrence was found.

CONCLUSIONSThe safety of transanal total mesorectal excision for male patients with low rectal cancer and difficult pelvis is acceptable. TaTME is helpful to preserve the anal sphincter.

Adult ; Anal Canal ; surgery ; Humans ; Laparoscopy ; Male ; Neoplasm Recurrence, Local ; Pelvis ; surgery ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome ; Universities