Objective To investigate the effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery.Methods Sixty elderly patients with fixed hip fracture by operation were randomly divided into a training group and a control group with 30 cases in each group.The training group received mindfulness behavior training in addition to routine rehabilitation training,while the control group only received routine rehabilitation training.The mindfulness behavior training was administered 90 min for once a week,lasting for 5 weeks.The emotional disorder was assessed with the profile of mood states (POMS),and the immune system function were evaluated by the number of CD3 + 、CD4 + 、CD8 + in T cell subgroup before and after 5 weeks of training.Results Before training,there was no significant difference in scores of POMS and the cells number of CD3 +,CD4 +,CD8 + (P ＞ 0.05) between the two groups.After treatment,scores of POMS including tension-anxiety (13.14 ± 3.36 vs 15.90 ± 4.28),depression-dejection (18.10 ± 6.24 vs 20.06 ± 5.42),fatigue-inertia (16.53 ± 3.50 vs 18.98 ± 4.88),vgor-activity (26.68 ± 5.22 vs 22.43 ± 5.20) (P ＜ 0.05),the level of mindfulness practice(58.00 ± 4.78 vs 54.00 ± 4.89) and the cells number of CD3 +,CD4 +,CD8 + (75.75 ± 5.40vs 69.91 ± 4.42 ;39.54 ± 3.29 vs 34.44 ± 4.21 ; 39.82 ± 3.55 vs 36.82 ± 3.55) in experimental group improved more than those in control group (P ＜ 0.05).Conclusion Mindfulness behavior training can improve the patients' mood state and have positive promotion on immunological function.

Objective To investigate the effects of mindfulness behavior training on mood states and quality of life in old patients post fixation for hip fracture. Methods Patients were randomly divided into experiment group (n=30) and control group (n=30). The control group received routine rehabilitation, while the experiment group received mindfulness practice therapy in addition. They were evaluated with Profile of Mood States (POMS), Short Form of Health Survey (SF-36), and Mindful Attention Awareness Scale (MAAS) before and 5 weeks after treatment. Results There was no difference in the scores of POMS, MAAS and SF-36 before treatment (P>0.05). The scores of MAAS and SF-36, the subscores of tension-anxiety, depression-dejection, fatigue-inertia and vigor-activity of POMS improved more in the experiment group than in the control group (P<0.05). Conclusion Mindfulness behavior training can improve the mood state and quality of life of old patients post fixation for hip fracture.

OBJECTIVE: To investigate the application and the clinical effect of nasal endoscope in styloid process truncating operation. METHOD: Dividing 66 patients into nasal endoscope group and control group randomly, and then observe them. Nasal endoscope group were cured with nasal endoscope during the styloid process truncating operation and the control group were treated with the routine method of intraoral path. All the operations were executed by the same person. Observation index included the following aspects: the length of the truncated styloid process, the operation time, intraoperative bleeding, postoperative pain and pain degree, inflammatory reaction of raw surface and rehaemorrhagia. RESULT: Compared with the control group, the length of the truncated styloid process of nasal endoscope group were longer and the operation time had no significant differences. The intraoperative bleeding of intraoperative bleeding group were (85.0 +/- 35.0)ml and in control group were (95.0 +/- 40.0)ml. There are no significant differences between the result. Nasal endoscope group also had the advantages of fewer aches and less inflammatory reaction of raw surface. Both of the team had no rehaemorrhagia. CONCLUSION nasal endoscope can truncate a longer styloid process in styloid process truncating operation and is effective to relieve pain, and ease inflammatory reaction, it's a safe mini-trauma operation.
Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; methods ; Nose ; surgery ; Ossification, Heterotopic ; surgery ; Temporal Bone ; abnormalities ; surgery ; Treatment Outcome

Objecive:To observe the incidence of early enteral nutrition-related complications in severe brain-injured patients in ICU and its associated factors.Methods:78 nutrition severe brain-injured patients(GCS 4-8) in ICU receiving enteral nutrition were all carried out for GCS scoring.The enteral feeding amount and speed,serum albumin(ALB) and intestinal feeding tolerance were observed.The incidence rate of all kinds of complications related to enteral nutrition was summarized.Results:The patients with lower GCS had lower total feeding amount,prolonged feeding duration and higher incidence rate of complications.The diarrhea was negatively related with serum ALB level and GCS. Conclusion :Enteral nutrition-related complications are related with the severity of disease and Alb level.Some critically ill patients can not sustain total enteral nutririon(TEN),and parenteral nutrition is necessary.

Objectives:To investigate the nutrition support in patients with severe neurosurgical disease. Methods:Enteral nutrition(EN) was used in early phase(48～72 h, postoperatively or after trauma) in 28 cases with severe neurosurgical disease.Parenteral nutrition was adopted when EN was insufficient.Dose of glucose was limited at early period(acute phase,5～7 days after occurrence). Results:23 cases were cured and 5 cases died.During the period of EN,glucose and lipid metabolic abnormality or liver enzyme change were not found.There was no complication such as severe diarrhea,belly bulge.All patients who were on respiration machine were all taken off successfully. Conclusions:Early EN can improve the rate of cure and reduce the complication and mortality.

Radiation therapy is one of the important comprehensive treatment strategies for thoracic neoplasms,but it also can cause radiation-induced heart disease (RIHD) which can affect the quality of life and even endanger the lives of patients while killing tumor.With the development of comprehensive treatment for cancer,the patients achieve better survival outcomes.And the study reported about RIHD increased as well,which made RIHD became an important complication of thoracic neoplasms' treatment.Though modem radiotherapy techniques and new therapeutic principles have significantly made the incidence of RIHD decreased,the harm of RIHD should not be ignored.In this article,we review the research progress of RIHD.

Objective To compared analgesic effect of sufentanil and fentanyl in surgery patients during mechanical ventilation, and to explore the rational dosage of analgesic and sedative drugs. Methods A prospective randomized controlled trial was conducted. 600 postoperative critically ill patients underwent mechanical ventilation for 12-72 hours admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from April 2013 to March 2015 were enrolled. They were randomly divided into two groups, sufentanil and fentanyl was used for analgesia respectively, and 300 patients in each group. The initiate dosage of sufentanil and fentanil was 5 μg/h and 50 μg/h, and the dosage was adjusted. A postoperative pain score (Prince-Henry score) of 0-1, and Richmond agitation-sedation scale (RASS) score -1-0 were targeted. 1 mg/kg of propofol was used if patient could not fall in sleep or felt anxious after loading dose of sufentanil (5 μg) or fentanil (50 μg) for 5 minutes. The use of analgesic drugs, the proportion and dosage of propofol was observed in the two groups, and adverse reactions were recorded. Results The mean dose of sufentanil for analgesia was (0.07±0.02) μg·kg-1·h-1, and the mean dose of fentanyl was (0.67±0.12) μg·kg-1·h-1. The patients in the two groups received propofol 40 to 60 mg/h in night, and the use proportion of propofol in sufentanil group was slightly less than that in fentanyl group (25.7% vs. 28.3%), but the difference was not statistically significant (P > 0.05). It was found by subgroup age analysis that, the mean analgesic dose of sufentanil or fentanyl in patients over 80 years old was lower than that in 70-79 years, 60-69 years and < 60 years groups but without statistical significance. There were 11 cases (3.7%) and 21 cases (7.0%) patients suffered from respiratory depression in sufentanil group and fentanyl group, respectively, without statistical significance (P = 0.069). The hemodynamics of patients in two groups was stable during analgesia, and no accidental extubation due to restlessness was found. Conclusions A smaller dose of sufentanil for postoperative patients underwent mechanical ventilation with satisfactory analgesia was (0.07±0.02) μg·kg-1·h-1, but need to be added with 40-60 mg/h and a small dose of propofol to improve anxiety and sleep. The proportion of patients needing propofol addition was slightly lower than that of fentanyl.

Objective:To compare the efficacy and costs of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) and granulocyte colony stimulating factor (G-CSF) for hematopoietic stem cell mobilization and hematopoietic recovery after transplantation in patients with relapsed or refractory malignant lymphoma. Methods:From July 2014 to October 2016, 15 patients with malignant lymphoma using peripheral blood stem cell mobilization (PBSCM) for autologous peripheral stem cell transplantation (APBSCT) were treated in our institution and enrolled in the PEG-rhG-CSF group (experimental group). We analyzed data from other 15 patients with malignant lymphoma mobilized with G-CSF who were treated in our institution from January 2013 to August 2015 (control group). Results:Patients in both groups were successfully mobilized. The median amounts of CD34+cells collected in the experimental and control groups were 16.2×106/kg and 8.9×106/kg, respectively (P=0.414), and the median amount of mononuclear cell (MNC) was 12.4×108/kg and 9.9× 108/kg, respectively (P=0.519). In the experimental and control groups, the mean durations of mobilization were 10.66±1.45 and 9.33±1.83 days (P=0.234), the mean durations of neutropenia during mobilization were 4.20±2.17 and 3.80±2.04 days (P=0.608), the mean durations of absolute neutrophil count recovery after APBSCT were 10.14±1.29 and 10.93±2.69 days (P=0.327), and the mean durations of platelet recovery were 10.36±2.27 and 12.27±3.38 days (P=0.121). Mobilization and hematopoietic recovery after APBSCT were not significantly different between the two groups. The cost was lower in the experimental group than that in the control group (RMB 3,960 yuan versus RMB 11,479.3±2,401.3 yuan). Conclusion:High-dose chemotherapy combined with PEG-rhG-CSF is a promising, effective, and low-cost mobilization regimen for patients with relapsed or refractory malignant lymphoma.

OBJECTIVETo study the effect of island flap from dorsoulnar side of thumb in repairing deep wound on thumb.

METHODSTwenty-two patients with deep wound on thumb were hospitalized from May 2007 to December 2013. The wounds ranged from 2.0 cm x 1.5 cm to 4.0 cm x 2.5 cm in area. Island flap of dorsoulnar thumb was used to repair these defects, with flap area ranging from 2.1 cm x 1.6 cm to 4.1 cm x 2.6 cm. All the donor sites were closed by transplantation of full-thickness skin from upper medial arm.

RESULTSAll flaps survived with good blood supply. All deep wounds of thumb were closed. Skin grafts of donor sites all survived. Patients were followed up for 6 to 12 months. The texture, color, and shape of all flaps were satisfactory, and functions of injured thumbs recovered well.

CONCLUSIONSTransplantation of island flap from dorsoulnar side of thumb can be performed easily with high survival rate and satisfactory configuration, and it is suitable for repairing deep wound of thumb.

Arm ; Burns ; surgery ; Follow-Up Studies ; Graft Survival ; Humans ; Reconstructive Surgical Procedures ; methods ; Recovery of Function ; Skin ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thumb ; injuries ; surgery ; Treatment Outcome ; Wound Healing

Objective To examine the distribution of bacterial species and antimicrobial susceptibility profile of pathogens in febrile neutropenic patients.Methods A total of 355 bacterial strains were isolated from febrile neutropenic patients in Shanghai General Hospital from January 2005 to December 2012. Antimicrobial susceptibility testing was done by Kirby-Bauer method. The susceptibility testing results were analyzed according to CLSI 2014 breakpoints.Results Gram-negative bacteria accounted for 70.4% of the 355 isolates, while gram-positive organisms accounted for 29.6%. The most common bacterial species werePseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Stenotrophomonas maltophiliaand Staphylococcus haemolyticus. Non-fermentative bacteria accounted for 53.2% of all the gram-negative bacterial isolates. All theEnterococcus and
Staphylococcus isolates were susceptible to linezolid, vancomycin and teicoplanin. All theStaphylococcus strains were resistant to methicillin.P. aeruginosa isolates were relatively more susceptible to cefoperazone-sulbactam, piperacillin-tazobactam and cefepime (>70%) than imipenem (40.8%) and meropenem (59.2%). All theK. pneumoniae isolates were susceptible to imipenem and meropenem and more than 70% of the isolates were susceptible to cefoperazone-sulbactam, amikacin. More than 80% of theA. baumannii isolates were susceptible to carbapenems, cefoperazone-sulbactam, amikacin, ciprolfoxacin and aminoglycosides. All the E. coli isolates were susceptible to carbapenems and more than 70% were susceptible to cefoperazone-sulbactam and ceftazidime. More than 90% of theS. maltophilia strains were sensitive to levolfoxacin, minocycline, cefoperazone-sulbactam and trimethoprim-sulfamethoxazole.Conclusions Our data suggest that gram-negative bacteria, especiallyEnterobacteriaceae and non-fermentative bacteria, are still the primary pathogens in febrile neutropenic patients. Antimicrobial resistant strains are prevalent. Such data of bacterial species and antimicrobial susceptibility proifle of pathogens in febrile neutropenic patients are useful for empirical antimicrobial therapy of such infections.