Objective:To study the experience of frontline medical workers in COVID-19 quarantine points.Methods:Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview. Colaizzi′s seven-step analysis method was adopted to analyze and categorize the data.Results:The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined).Conclusions:The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure. Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules.

Chromatography, Gas ; methods ; Dimethoate ; blood ; Humans ; Insecticides ; blood ; Methyl Parathion ; blood

Objective To investigate the electrophysiological characteristics of the ventralis intermedius nucleus (Vim) in order to find an easy and safe way to confirm the target in Vim-thalamotomy. Method In microelectrode-guided selective Vim-thalamotomy for 23 Parkinson's disease patients, the background activity, amplitude and discharge frequencies of Vim were compared with its surrounding structures. The response of kinesthetic neuron and tremor cell to microstimulation was also compared. Result There were differences in backgroud activity and discharge amplitude for Vim, ventralis lateralis nucleus (VL), ventralis caudalis nucleus (VC), and internal capsule. Based on the response to active or passive movement of contralateral limb tremor cells were divided into two subgroups, which were different in localization. Contralateral tremor showed different response when the two subgroups of tremor cells were mircrostimulated. Conclusion The anterior border of Vim was easily found by microrecording. Only by combining microstimulation with microrecording could the posterior border of Vim and its interior and lateral ordination of target were identified exactly and safely. Kinesthetic neurons and tremor cells which responded to the movement of contralateral limbs should be destroyed.

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLES).Methods The data of clinic five cases with RPLES were analyzed retrospectively.Results The primary diseases in this group were hypertension for one case,uraemia for three cases and lupus nephropathy for another.Clinical features of five patients include acute onset of hypertension,headache with vomiting.Neurological symptoms were conscious disturbance,seizures(in 5 cases)and visual disorder(in 3 cases).The movement of limbs were normal.The abnormal laboratery data was renal inadequacy in 5 cases.The findings of imaging of all cases included bilateral white matter of parietal and occipital lobe abnormalities,which appeared as large areas of low density on CT scan,hypo-intense in T1 and hyper-intense in T2 on MRI scan.Four cases presented clinical symptoms improvement in a short time and radiological recovery obviously after anti-hypertensive and anhydration therapy.One patient died caused on brain herniation.Conclusions Clinical features of RPLES is brain damage associated with malignant hypertension or the use of immunosuppressive agents.The most important pathogenesis is considered to be failure of the self regulation of cerebral vascular circulation.The imaging findings are bilateral symmetry cortical and subcortical edema in the posterior areas of the brain.Most patients can be recovery by timely therapy,otherwise the irreversible neuronal injury even death can be also found in very few serious cases.

Objective To investigate the value of combined use of laparoscopic cholecystectomy (LC) and duodenoscopic procedures in the treatment of selective common bile duct stones. Methods We retrospectively analyzed clinical data of 32 cases of selective common bile duct diseases treated with laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography (ERCP) from January 2002 to December 2003. Results Of 24 cases receiving ERCP before LC, 19 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 2 cases normal. These cases underwent ERCP and endoscopic sphincterotomy (EST) following by LC. Of 8 cases receiving ERCP after LC, 4 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 1 case normal. Except for 1 case of conversion to open surgery because of a failed stone removal, all the cases were cured with EST. Conclusions combined use of LC and ERCP is a highly useful approach in the treatment of selective common bile duct stones, which has broadened the utilization of minimally invasive treatment for bile duct diseases.

Objective To find a indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction(CI),with ratio of males to females 19∶11 vs.30∶ 23,and average age was (56 ± 11) vs.(63 ± 11) respectively.Collected urine from 39 heathy volunteers and 33 patients with CI,with ratio of males to females 25∶14 vs.20∶ 13,and average age was (57 ± 10) vs.(64 ± 11) respectively.Ferritin concentration in all samples was detected with the chemical luminescence method,and the urine ferritin/urine cretinin (uFer/uCr) ratio was calculated.Differences of serum ferritin and uFer/uCr between healthy volunteers and CI patients were analyzed with the statistical software under Wilcoxon test.Urinary proteins were extracted with absolute ethanol.The extracted ferritin was displayed with Western blot for light chains and heavy chains to investigate the difference between healthy volunteers and CI patients.Results uFer/uCr was higher than that from healthy volunteers (U =292.00,P ＜0.05),and the median was (14.86 vs.6.22) μg/g.Moreover,after extraction of urinary proteins with alcohol,both light chains and heavy chains of ferritin in urine from CI patients were much more obvious than that from healthy volunteers.Conclusion The uFer/uCr ratio could provide a new proof to assist the diagnosis of cerebral infarction.

Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Objective To eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases.Methods CEA level of peripheral blood and digestive juice(bile,gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA,and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances.Results In malignant diseases,the CEA level of digestive juice was significantly higher than that in the blood,and there was no difference of CEA level in digestive juice and blood in benign diseases.Meanwhile,the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases.A specific band(molecular weight about 210?10~3) was detected in all malignant diseases except four cases whose CEA level was too low(less than 5 ?g/L),whereas no one of benign diseases had this specific band no matter how high or low the CEA level was.Conclusion The specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.

0.05).Conclusions The serum MMP-9 can be tested as an objective index in appraisal the severity of the left to right shunt.The increased level of MMP-9 may be one of important mechanism for developing heart failure process in children with left to right shunt CHD.Monitor the level of MMP-9 will help us find adverse myocardial remodeling earlier and begin treatment immediately to prevent heart failure developing.