ObjectiveTo investigate the clinical features and nursing care of neuralgic amyotrophy.MethodsThe course of the treatment and nursing in a group of patients with idiopathic neuralgic amyotrophy was analyzed retrospectively.ResultsMyoatrophy was found in all patients, while 42% of patients were involved in both sides. Serious pain, as initial symptom, was found in 92% of patients. After medical and physical treatment, as well as holistic nursing care, the pain disappeared in 1～2 weeks in all patients but one. All patients had been followed up for 2～13 months, muscle power was recovered in 67% of all patients, partially recovered in 33% of patients.ConclusionThe careful nursing and observation is very helpful for recover of neuralgic amyotrophy and can decrease complications.

At present surgical treatment is a main method for gastric cancer,while multidisciplinary comprehensive treatment for gastric cancer has gradually become the mainstream direction of treatment,which is based on regarding patients as the core part of treatment,aiming at specific disease,building multidisciplinary team and making individualized,standardized,scientific and continuous comprehensive treatment plan.Meanwhile,it can provide the best treatment option and efficacy for particular patients,and raise the diagnostic and treatment skills and academic level.There are obvious promotions in the integration between medical education and health management and the progresses of medicine and science.

The present study visualized the knowledge map of research hotspots and changes of keywords by importing literatures from The American Journal of Clinical Nutrition (2000 ～ 2011) into CiteSpace.Analysis of the research hotspots (keywords),evolution of clinical nutrition,and front-line research based on tf-idf algorithm was then performed.

Objective To confirm the performance of rate method for detecting ALT in blood donors to verify that it meets the requirements of ISO15189 .Methods according to the requirements of CNSA‐CL02 :2012 the Medical Laboratory Quality and Abili‐ty Recognized Standards and the Blood Station Technical Operation Regulations(edition 2012) ,the precision ,accuracy ,sensitivity , reportable range ,biology reference interval and measurement uncertainty of the detection system were verified .Results The intra‐batch imprecision for the ALT quality control serum and 2 concentrations of blood donor sample detected for 20 times and 20 d was<5 .0% and the inter‐batch imprecision was <6 .7% ;the correct estimates passed the external quality assessment results of the original Ministry of Public Health in 2014 and calibration results analysis .The relative bias was less than 1/2 of CLIA′88 permissi‐ble error;the regression equation of reportable range obtained by the linear regression was Y =0 .995 1X -5 .618 4 ,r=0 .999 7 (R2 =0 .999 4) ,the results within the detection range were correct ;the biological reference interval was 0 .0 -32 .7 U/L and the measurement uncertainty was (74 .90 ± 3 .32)U/L .Conclusion The performance indexes of ALT detection method conform to the expected requirements of ISO15189 .This method can be used as a blood screening test method in laboratory .

Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Child ; Child, Preschool ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Gastrointestinal Tract ; diagnostic imaging ; Humans ; Infant ; Male ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m

Objective To evaluate the value of magnetic resonance black-blood thrombus imaging (BTI) of the stage of disease in intracranial venous and sinus thrombosis(CVT).Methods From June 2015 to October 2016,37 patients with CVT diagnosed with routine imaging examinations in Beijing Xuanwu Hospital,Capital Medical University were enrolled prospectively,and they also underwent BTI examination.The patients were randomly divided into either a acute group (≤14 d,n=23) or a chronic group (>15 d,n=14) according to the time from the onset of symptoms to BTI.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) difference between acute and chronic CVT groups were compared.The magnetic resonance venography (MRV) examination was used as a reference to calculate the accuracy of BTI on per-segment level.Results (1) The SNR and CNR of thrombosis in the acute group and chronic group were 206±97 and 94±41,201±96 and 86±40,respectively.There was significant difference between two groups (t=4.9 and 5.0 respectively;all P<0.01).(2) In 37 patients with CVT,the thrombi in 159 cerebral veins and venous sinus segments were detected with MRV.BTI identified the thrombi accurately in 152 vascular segments,and the thrombi in 352 vascular segments were eliminated.The diagnostic sensitivity and specificity were 95.6% (152/159) and 98.0% (352/359) respectively.Conclusion Achieving direct angiography of cerebral venous thrombosis,BTI technique can accurately differentiate acute or chronic thrombus.It has higher accuracy.

Objective To investigate the immune response of IL-10 to Schistosoma japonicum infection in the early infectioin model and SEA immunization model of the IGTP~(-/-) and IRG-47~(-/-) mice.Methods In the early infection model,the IGTP knock out (IGTP~(-/-)) mice,IRG-47 knock out (IRG-47~(-/-)) mice and wild-type (WT) C57BL/6J mice were exposed to 300 S.japonicum cercariae via the pinna and sacrificed on day 7 post-infection.Each mouse pinna section was stained with hematoxylin-eosin (HE) to detect the pathological lesions,and the culture supernatant of pinna was used to test the levels of Th1/Th2 cytokines by indirect ELISA.In the SEA immunization model,IGTP~(-/-) IRG-47~(-/-) and WT mice were immunized with SEA twice and sacrificed in 3 weeks after the initial immunization.SEA-specific IgG antibody in sera was detected by indirect ELISA;the levels of Th1/Th2 cytokines were tested in culture supernatant of splenocytes by indirect ELISA;the proportions of CD4~+ T cells,CD8~+ T cells,B cells,Th1 and Th2 cells in the spleen were assayed by FACS.Results Although no obvious differences on the pathology of pinna were observed among the three mouse groups,the level of IL-10 in the culture supernatant of pinna of IRG-47~(-/-) mice was lower than that of IGTP~(-/-) mice in 7 days after the exposure.Following SEA immunization,the level of SEA-specific IgG antibody in sera of IGTP~(-/-) mice was lower than that in WT mice,the level of IL-10 in the culture supernatant of splenocytes of IRG-47~(-/-) mice was higher than that of IGTP~(-/-) and WT mice with the stimulation of SEA.However,the proportion of Th2 cells in the spleen of IRG47~(-/-) mice was the lowest among the three mouse groups.Conclusions SEA is the stimulus of IRG-47 deficiency mice to defend Schistosoma japanicum infection and promote the host to produce a protective response,and IL-10 may play an important role in immune regulation in this process.

OBJECTIVETo explore the effect of dexmedetomidine combined electrical stimulation on cognitive function of neurosurgical diseases patients treated by extracerebral intervention.

METHODSTotally 122 patients with neurosurgical diseases who underwent selective intervention were randomly assigned to the observation group and the control group, 61 cases in each group. Patients in the control group recieved anesthesia by dexmedetomidine. Those in the observation group received electrical stimulation at Baihui (DU20), Yintang ( EX-HN3), and Neiguan (PC6) before dexmedetomidine anesthesia. The cognitive function of patients at preoperative day 1 and postoperative day 1 was respectively evaluated by Mini-Mental State Examinations (MMSE). Serum NSE, S-100β, IL-1β, IL-6, and TNF-α levels were detected in the two groups before intervention and immediately after intervention using ELISA.

RESULTSMMSE scores of two groups were significantly reduced at post-intervention day 1, as compared with one day before intervention. MMSE score of the observation group at post-intervention day 1 was (23.15 ± 1.87) points, significantly higher than that of the control group [ (19.34 ± 1.64) points , (P < 0.05)]. The postoperative cognitive dysfunction (POCD) incidence rate of the observation group was 16.4% (10/61), significantly lower than that of the control group [39.3% (24/61); P < 0.05]. Compared with before intervention, NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels of the two groups increased (P < 0.05). Post-intervention NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels were significantly lower in the observation group than in the control group (P < 0.05).

CONCLUSIONDexmedetomidine combied electrical stimulation could effectively prevent the occurrence of postoperative cognition, and reduce levels of NSA, S-100β, IL-1β, IL-6 and TNF-α.

Acupuncture Points ; Anesthesia ; methods ; Cognition ; Cognition Disorders ; prevention & control ; Dexmedetomidine ; therapeutic use ; Electric Stimulation Therapy ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Neuropsychological Tests ; Neurosurgical Procedures ; Phosphopyruvate Hydratase ; blood ; Postoperative Complications ; Postoperative Period ; S100 Calcium Binding Protein beta Subunit ; blood ; Tumor Necrosis Factor-alpha ; blood

Background:Inflammatory bowel disease( IBD)is a group of chronic and non-specific intestinal inflammatory diseases of undetermined origin. Functional impairment of macrophages has been associated with the dysregulation of mucosal immunity in intestinal tract of patients with IBD. Aims:To investigate the correlation of serum levels of macrophage polarization-related cytokines with the development and disease activity of IBD. Methods:A total of 105 IBD patients admitted from May 2013 to May 2014 at Shanghai Ruijin Hospital were recruited,of them 65 were Crohn’s disease (CD)and 40 were ulcerative colitis( UC). Twenty-four patients with colonic polyps were served as controls. Serum samples were obtained and the levels of interleukin-1beta(IL-1β),IL-6,IL-10,IL-13,interferon-gamma(IFN-γ)and inducible nitric oxide synthase(iNOS)were determined by ELISA method. Results:Serum levels of IL-1β,IL-6,IL-10, IL-13 and IFN-γ were significantly higher in CD group than in control group(P < 0. 05),and serum levels of IL-10,IL-13 and IFN-γ were significantly higher in UC group than in control group(P < 0. 05). Logistic regression analysis revealed that serum IL-13(OR = 1. 009,P = 0. 005)and iNOS( OR = 0. 982,P = 0. 013)were correlated with CD,while Spearman correlation coefficient demonstrated a link between serum IL-10 and disease activity of CD(rs = - 0. 432,P =0. 014). No correlations were observed between serum levels of these cytokines and development and disease activity of UC (P > 0. 05). Conclusions:Serum levels of macrophage polarization-related cytokines increase to varying degrees in IBD patients,but these cytokines have no obvious correlations with IBD and its disease activity. Presumably,theses cytokines are only involved in but not the triggers in the development of IBD.