Objective To discuss the staging and individualized health education on alleviation of anxiety and depression of fracture patients.Methods 60 fracture patients who showed anxiety and depression symptoms were randomly divided into the experimental group and the control group with 30 patients in each group.The experimental group used the special-designed staging and individualized health education plan to intervene the anxiety and depression symptoms of patients.The control group used the routine health education program.The Hamilton Anxiety Scale (HAMA)and Hamilton Depression Scale (HAMD)were used to assess the patients' anxiety and depression degree before and after intervention.Results HAMA and HAMD score at discharge were lower than on admission in both groups.HAMA and HAMD score at discharge in the experimental group were significantly lower than the control group.Conclusions The systematic,staging and individualized health education program has significant effect on the anxiety and depression symptom of fracture patients.It can effectively alleviate the symptoms of anxiety and depression,satisfy the requirement of patients for health education,stimulate the patients' initiative to coordinate with the treatment,establish the confidence to fight with disease and help patients form a good behavior manner,and promote patients' recovery.

Adenine ; analogs & derivatives ; therapeutic use ; Antiretroviral Therapy, Highly Active ; methods ; HIV Infections ; drug therapy ; prevention & control ; Hepatitis B, Chronic ; complications ; Hepatitis C, Chronic ; complications ; Humans ; Lamivudine ; therapeutic use ; Organophosphonates ; therapeutic use

The effect of traditional therapy is limited for liver cancer,gene therapy gets more and more recognition in recent years.Oncolysis virus is a kind of conditionally replicating virus,with special reproductivity in cancer cells,and then kills them.Gene agents are usually introduced into tumor tissue by intra-tumor and intra-arterial injection,and the technique of interventional therapy is able to satisfy the demand excellently.So,some breakthrough is expected in treating liver cancer by skillfully combining oncolysis virus and interventional technique

To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel's di- verticulum disease (MD), we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound (detection rate was about 15. 5%), and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected (detection rates were 24.1%, 24.1% and 15.5%, respectively). Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.
Acute Disease ; Appendicitis ; pathology ; Diagnosis, Differential ; Humans ; Inflammation ; Intestine, Small ; pathology ; surgery ; Meckel Diverticulum ; diagnostic imaging ; surgery ; Retrospective Studies ; Ultrasonography

Purpose:To explore the relationship between the occurence of acute respiratory failure after subototal esophagectomy and three-field lymphadenectomy and the choice of anesthesia and management.Methods:From March 2000 to Janunary 2001,thirty-seven patients scheduled for subtotal esophagectomy and three-field lymphadenectomy with e- sophageal cancer,adopting the combination of epidural,cervical nerve block,and general anesthesia were studied.Re- sults:Seven cases out of thirty-seven had acute respiratory failure,accounting for 19% in whole group.They had complete recovery after antifectious therapy and respiratory support.Conclusions:To combine the epidural,cervical nerve block and general anesthesia can reduce intravenous anesthetics use and shorten the extubation time,decrease the incidence of postop- erative respiratory failure.

Objective To explore the value of neutrophils gelatinases related lipid a carrier protein (NGAL),renal injury molecule-1 (KIM-1) and serum creatinine (SCr) for early diagnosis in adult cardiac surgery after acute renal injury (AKI).Methods Blood and urine samples of 65 cardiac surgery patients before and 24,48,72 h after surgery were collected,SCr,urine NGAL and KIM-1 levels was detected,among whom AKI occurred in 34 cases(AKI group),did not occur in 31 cases (non AKI group),and they were compared with 20 cases of healthy physical examination (control group).Logistic regression model was used to judge the value of early diagnosis of SCr,urine NGAL and KIM-1.Results The incidence of AKI after cardiac surgery was 52.31％ (34/65).The SCr,urine NGAL and KIM-1 levels in AKI group and non AKI group before and 24,48,72 h after surgery were significantly higher than those in control group [SCr:(62.44 ±22.26),(77.38 ±24.38),(98.24 ±25.02),(98.14 ±45.26)μmol/L and (56.67 ±21.68),(59.25 ± 15.58),(55.40 ±22.91),(40.10 ±23.45)μmol/L vs.(16.43 ±5.01)μmol/L;urine NGAL:(4.81 ±0.65),(9.48 ±3.29),(11.87 ±3.93),(7.66 ± 1.52) μg/L and (4.67 ±0.53),(8.89 ± 2.64),(11.46 ± 3.60),(7.47 ± 1.63)μg/L vs.(2.87 ± 0.48) μg/L; KIM-1:(47.93 ± 5.54),(61.89 ± 12.44),(100.21 ± 27.32),(67.69 ± 8.72) μ g/L and (47.12 ± 4.08),(56.38 ± 9.27),(90.14 ± 27.26),(69.40 ±8.90) μ g/L vs.(32.21 ± 12.54)μ g/L] (P ＜ 0.01).Urine NGAL and KIM-1 levels in AKI group and non AKI group 24,48,72 h after surgery were significantly higher than those before surgery (P＜ 0.01).SCr,urine NGAL and KIM-1 levels in AKI group 24 h after surgery were significantly higher than those in non AKI group (P＜ 0.01).Twenty-four hours after surgery,the sensitivity and specificity of urine NGAL,KIM-1 in the diagnosis of AKI,compared with that of SCr had no statistical significance (P ＞ 0.05).Conclusions The adults who accept extracorporeal circulation cardiac surgery appear high incidence of AKI.Twenty-four hours after surgery,early biological markers-urine AKI,KIM-1,has similar sensitivity and specificity with traditional diagnostic gold standard of SCr.

The inter-species differences of thienorphine metabolism were investigated in human, Beagle dog and rat liver microsomes, by comparing enzyme kinetics of the parent drug and the formation of its major metabolites. The incubation systems of thienorphine with liver microsomes of the three species were optimized in terms of thienorphine concentration, microsomal protein content and incubation time. The concentrations of thienorphine and its metabolites in incubates were measured by a LC-MS/MS method. The biotransformation of thienorphine by human liver microsomes was the lowest among the three species. The K(m), V(max), CL(int) and T1/2 of thienorphine obtained from human liver microsomes were (4.00 +/- 0.59) micromol x L(-1), (0.21 +/- 0.06) micromol x L(-1) x min(-1), (117 +/- 3.19) mL x min(-1) x kg(-1) and (223 +/- 6.10) min, respectively. The corresponding kinetic parameters for dog and rat liver microsomes were (3.57 +/- 0.69) and (3.28 +/- 0.50) micromol x L(-1), (0.18 +/- 0.04) and (0.14 +/- 0.04) micromol x L(-1) x min(-1), (213 +/- 1.06) and (527 +/- 7.79) mL x min(-1) x kg(-1), (244 +/- 1.21) and (70.7 +/- 1.05) min, respectively. A total of six phase I metabolites were observed in liver microsomes, including one N-dealkylated metabolite, three oxidative metabolites and two N-dealkylated oxidation metabolites. All these six metabolites were detected in the liver microsomes of the three species. However, the relative amounts of the metabolites generated were different in three species. The results indicated that the major phase I metabolic pathway of thienorphine was similar in the liver microsomes from all three species. However, the inter-species differences observed were relative amounts of the metabolites as well as the metabolic characteristics of thienorphine in liver microsomal incubates.

Acute Disease ; Female ; Humans ; Intubation, Intratracheal ; Male ; Organophosphate Poisoning ; Pesticides ; poisoning ; Respiration, Artificial ; Tracheotomy ; methods

To evaluate the charasteristics and risk factors of hospital infections in patients with contagious diseases, 489 patients with contagious diseases were analyzed. Among 18 patients who contracted hospital infections, 17 were suffering from chronic hepatitis. 77 78% of them were over 40 years old. Infection of ascitic fluid, lower respiratory tract, and blood stream comprised 77 78% of the infections. Most of the doctors used antibiotics empirically. The survey showed that patients over 40 years old in an infectious diseases hospital were vulnerable to hospital infections. Hospital infection often occurred in the abdomen, lower respiratory tract, and blood stream. Abdominal paracentesis liver puncture biopsy, and lumbar puncture were the first three exogenous risk factors.

The inter-species differences of thienorphine metabolism were investigated in human, Beagle dog and rat liver microsomes, by comparing enzyme kinetics of the parent drug and the formation of its major metabolites. The incubation systems of thienorphine with liver microsomes of the three species were optimized in terms of thienorphine concentration, microsomal protein content and incubation time. The concentrations of thienorphine and its metabolites in incubates were measured by a LC-MS/MS method. The biotransformation of thienorphine by human liver microsomes was the lowest among the three species. The Km, Vmax, CLint and T1/2 of thienorphine obtained from human liver microsomes were (4.00 ? 0.59) ?mol?L-1, (0.21 ? 0.06) ?mol?L-1?min-1, (117 ? 3.19) mL?min-1?kg-1 and (223 ? 6.10) min, respectively. The corresponding kinetic parameters for dog and rat liver microsomes were (3.57 ? 0.69) and (3.28 ? 0.50) ?mol?L-1, (0.18 ? 0.04) and (0.14 ? 0.04) ?mol?L-1?min-1, (213 ? 1.06) and (527 ? 7.79) mL?min-1?kg-1, (244 ? 1.21) and (70.7 ? 1.05) min, respectively. A total of six phase I metabolites were observed in liver microsomes, including one N-dealkylated metabolite, three oxidative metabolites and two N-dealkylated oxidation metabolites. All these six metabolites were detected in the liver microsomes of the three species. However, the relative amounts of the metabolites generated were different in three species. The results indicated that the major phase I metabolic pathway of thienorphine was similar in the liver microsomes from all three species. However, the inter-species differencesobserved were relative amounts of the metabolites as well as the metabolic characteristics of thienorphine in liver microsomal incubates.