Objective:To observe the influence of SBAR communication mode on the condition of patients undergoing thoracolaparoscopic combined with esophageal cancer resection.Methods:A total of 200 patients who were admitted to the Department of Gastroenterology and Oncology from October 2017 to October 2019 in Affiliated Hospital of Southwest Medical University were selected for elective thoracolaparoscopic combined with esophageal cancer resection. According to the random number method, they were divided into 100 cases in the control group and the SBAR group. The control group used conventional preoperative communication visit mode, and the SBAR group used SBAR communication mode and preoperative visit based on the control group. The following items such as the preoperative negative mentality scores, quality of life score, postoperative complications and nursing satisfaction rate of the two groups before and after nursing interventionwere compared.Results:Before the intervention, the difference of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of the two groups was not statistically significant ( P>0.05). After the intervention, the SAS and SDS scores of the two groups were 49.32±4.96, 55.95±5.32, 50.93±4.74, and 56.33±5.89, respectively, which were significantly reduced. The SDS and SAS scores of the SBAR group were lower than those of the control group ( t values were -9.115 and -7.142, P<0.001). The difference of the World Health Organization Brief Table on Quality of Life (WHOQOL-BREF) scores of the two groups before the intervention was not statistically significant ( P>0.05). After the intervention, the WHOQOL-BREF scores of the two groups were 12.27±1.39 vs. 9.18±1.24, 16.13±1.51 vs. 12.48±1.22, 16.13±1.95 vs. 12.71±1.28, 15.09±1.81 vs. 13.08±1.48, 18.11±1.82 vs. 13.51±1.47, 14.09±1.61 vs. 12.98±1.28. The scores of the SBAR group were higher than those of the control group ( t values were 5.397-19.662, P<0.001). The postoperative complications rate of the SBAR group was 3.00% (3/100), which was less than 18.00% (18/100) of the control group ( χ 2 value was 11.971, P<0.001). The overall satisfaction rate of patients in the SBAR group with care was 100.00% (100/100), which was higher than the 84.00% (100/100) in the control group ( χ 2 value was 17.391, P<0.001). Conclusions:In patients with esophageal cancer undergoing thoracic laparoscopy combined with esophageal cancer resection, the use of SBAR communication mode for the patient′s preoperative visit can significantly reduce the patient′s preoperative anxiety and depression negative scores and improve the patient′s quality of life, reduce the occurrence of postoperative complications, improve patient satisfaction with nursing with ideal effect.

Objective To discuss clinical effect of minimally invasive surgery, on herniated lumbar disc.Methods 50 patients of herniated lumbar disc were selected, and 25 patients were treated by micro endoscopy discectomy (MED).Results The treatment effect was better in treatment group, and the surgery time was shorter.1 case in treatment group had erector spinae hematoma, and 9 patients in control group had lumbago, while 2 cases had sciatica behavior.Conclusion The injury of MED was small,the surgery time was shorter,and the recovery was quicker,and it could be popularized in the clinic.

OBJECTIVE To investigate the ?-lactamases in Klebsiella pneumoniae strains isolated from the elderly patients.METHODS We had an observation on 20 strains of Klebsiella pneumoniae about 15 kinds of ?-lactamase gene test(blaTEM,blaSHV,blaLEN,laOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blaGES,blaPER,blaVEB,blaDHA,and blaACT-1).RESULTS Six kinds of ?-lactamase genes had been found out from these 20 strains of K.pneumoniae,namely,blaTEM,blaSHV,blaCTX-M-1 group,blaCTX-M-9 group,blaOXA-1 group,and blaDHA.Their positives were 95%,30%,50%,5%,5% and 15%.Among these 20 strains of K.pneumoniae,there were 19 ones of K.pneumoniae which at least contained 1 kind of ?-lactamase genes.Fifteen strains of K.pneumoniae were found containing more than 2 kinds of ?-lactamase genes,at the same time.Some were even tested out having 4 kinds of ?-lactamase genes.CONCLUSIONS The resistance of ?-lactamase antibiotics of these 20 strains of K.pneumoniae has a close relative to the number of ?-lactamase.

OBJECTIVE To investigate the chloramphenicol-resistant gene in Escherichia coli strains isolated from the old patients.METHODS Twenty strains of E.coli were clinically isolated.The resistance genes were analyzed by polymerase chain reaction(PCR) and verified by DNA sequencing.RESULTS The positive rates of catB and cmlA were 20% and 20%,respectively.Two strains of E.coli were found containing catB gene and cmlA gene.CONCLUSIONS The resistance to chloramphenicol in these 20 strains of E.coli has a close relation to antimicrobial-resistance gene existed,and the genes of catB and cmlA in E.coli are all firstly found and reported in China.

OBJECTIVE To investigate the prevalence of sulfamethoxazole/trimethoprim(SXT)-resistance genes and drug resistance in Escherichia coli isolates from the old patients.METHODS Drug resistance of 20 E.coli strains were analyzed.The SXT-resistance genes(sul1,dfrA1,dfrA12 and dfrA17)were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS In 20 E.coli strains,95.0% were SXT resistant.The positive rate of genes of sul1,dfrA12 and dfrA17 were 80.0%,20.0% and 65.0%.Gene of dfrA1 was not detected out,17 strains of E.coli were found dfrA gene.The SXT-resistance gene dfrA or sul1 was detected in 18 of the 20 strains.CONCLUSIONS The SXT resistance of E.coli can be caused mainly by gene expression of dfrA and sul1,and the genes of sul1,dfrA12 and dfrA17 are all firstly found and reported in China.

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective To explain the differences between zingiber officinale and its sulfur fumigation products on chromatography fingerprints by HPLC-DAD;To discuss the influence of sulfur-fumigation on the quality of zingiber officinale. Methods HPLC, diode array detector, and ZORBAX SB-C18 column were used with acetonitrile-water as the mobile phase, gradient elute, volume flow rate of 1 mL/min, column temperature of 25 ℃, and detection wavelength of 280 nm. HPLC-DAD technology was applied to establish the fingerprints of zingiber officinale before and after sulfur-fumigating process, in order to analyze the HPLC fingerprints of zingiber officinale before and after sulfur-fumigating process. External standard method was used to do the quantitative determination of 6-gingerol. Results The 17 common peaks were identified through the comparison of 3 batches of fingerprints of zingiber officinale and their sulfur-fumigated samples. The peak areas of NO.3, NO.10, NO.11, and NO.17 were reduced by 50.68%, 64.41%, 67.68%, and 21.23%respectively. The content of 6-gingerol had no significant change. Conclusion The chemical composition of zingiber officinale changed at different degrees after sulfur-fumigated process. The safety and effectiveness of sulfur fumigation products of zingiber officinale require more researches.

A patient developed persistent parkinsonism after intravenously injecting a high dose of methamphetamine. Magnetic resonance imaging revealed bilateral hypoxic/ischemic basal ganglia damage, which could have been caused by the vasoconstrictive effect of methamphetamine. This case adds some circumstantial evidence to the association between methamphetamine and Parkinsonism. Key words: Parkinsonism; methamphetamine; substance use disorders
Parkinsonian Disorders ; Methamphetamine

Objective To investigate the recovery mechanism of brain function in patients with mo-tor aphasia after cerebral infarction by resting-state functional magnetic resonance imaging (fMRI) functional connectivity. Methods 10 patients with aphasia after cerebral infarction (aphasia group),and 10 patients without aphasia (control group)in the same period were enrolled.Both patients underwent resting-state fMRI examination.Patients with aphasia received a second fMRI examination 1 month later.The SPM8 software and DPARSF software were used to process the data.The back of the left middle frontal gyrus ( LFMG) was se-lected as the seed point for functional connectivity analysis.REST was used for pairing and two-sample t-tests. Results Compared with the control group,the brain regions with increased LMFG-ROI functional connectiv-ity were right insula(MNI:x,y,z:45,12,0,t＝7.98),right inferior frontal gyrus (triangular,ankle,island cap) (MNI:x,y,z:42,6,27,t＝6.75),right upper temporal gyrus and right middle temporal gyrus( MNI:x, y,z:48,－45,6,t＝10.57),right superior border gyrus(MNI:x,y,z:15,－66,60,t＝5.59) and right angle gy-rus(MNI:x,y,z:54,－50,12,t＝9.55) in the aphasia group (before rehabilitation),and the brain regions with reduced functional connectivity were left posterior cingulate gyrus( MNI:x,y,z:6,－75,9,t＝－10.05), and left anterior wedge lobe(MNI:x,y,z:－6,－69,33,t＝－9.07).Compared with the control group,the brain regions with enhanced LMFG-ROI functional connectivity in the aphasia group (after rehabilitation 1 month) included head of left caudate nucleus,left middle frontal gyrus and inferior frontal gyrus,left globus pallidus, left central anterior gyrus,central posterior gyrus,left insula; the brain regions with reduced functional con-nectivity were right hippocampus,left cerebellum,right lingual gyrus,posterior left cingulate gyrus,right oc-cipital lobe and right anterior wedge lobe.Compared with aphasia group before rehabilitation,the brain regions with increased LMFG-ROI functional connectivity after rehabilitation 1 month were the left frontal frontal gy-rus(MNI:x,y,z:－51,15,24),t＝15.87),left frontal parietal island cover(MNI:x,y,z:－24,－66,42,t＝5.20),left central anterior gyrus and central posterior gyrus(MNI:x,y,z:－15,－16,55,t＝6.53); and the reduced brain regions were the right superior temporal gyrus and middle temporal gyrus(MNI:x,y,z:57,－18,30,t＝－15.21),right insula (MNI:x,y,z:－24,－66,42,t＝－5.20)and right superior border gyrus (MNI:x,y,z:15,－66,60,t＝－7.69). Conclusion The functional reorganization of the brain regions around the left hemisphere's injury lingual area may be the main mechanism of brain functional plasticity in patients with aphasia after cerebral infarction,and the right hemisphere is also involved in this process.In both the a-cute and chronic phases of motor aphasia,activation of the posterior left cingulate gyrus is reduced.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.