Objective To investigate how surgical patients are assessed regarding pressure ulcer risks and the usage of evaluation tools in different stages during perioperative period.Methods Totally 210 nurses from operating rooms and surgical wards in 7 tertiary hospitals of Jiangsu Province were investigated with self-designed questionnaire.Results Operating room nurses of 7 hospitals used different kinds of scales for pressure ulcer risk assessment,the same scale document was used during the different stages of operation,the frequency and time for pressure ulcer risk assessment varied from one to three times,preoperative visit to handover in surgical ward were different;the Braden scale was used by surgical nurses to evaluate pressure ulcer risk after operation,while most surgical nurses believed that the existing scale lacked specificity and intraoperative risk factors that should be considered when assessing postoperative patients.Conclusion The frequency and time of pressure ulcer risk assessment of patients during perioperative period are not standardized,the content of scale is limited and lacks specificity,the assessment of pressure ulcer risk during perioperative period is discontinuous and non-dynamic.There are no specific risk assessment scales targeting preoperative,intraoperative and postoperative pressure ulcer risk assessment.

OBJECTIVE: To determine the expression of palate, lung, and nasal epithelial clone (PLUNC) in na sal polyps (NP) and evaluate its association with clinical severity. METHOD: Twenty-eight NP patients (primary polyp, 15; recurrent polyp, 13) and 16 normal controls (healthy uncinate process) were enrolled, the expression of PLUNC was examined in nasal tissues by immunohistochemistric staining, quantitative PCR and ELISA respectively. The protein level of PLUNC in nasal polyps was correlated with nasal symptom score (nasal congestion and rhinorrhea, respectively). RESULT: PLUNC was mainly distributed in the epithelial layer and submucosal glands in nasal tissues. The staining intensity and mRNA level of PLUNC were significantly decreased in polyp tissues than in normal controls (P < 0.01). The protein levels of PLUNC were 0.33 +/- 0.11 and 0.15 +/- 0.05 in primary and recurrent polyp tissues (P < 0.01), and were 0.32 +/- 0.14 and 0.19 +/- 0.07 in small-size and big-size polyp tissues (P < 0.05). The protein level of PLUNC in polyp tissues significantly correlated with both nasal congestion score and rhinorrhea score (r = -0.51 and r = -0.57, P < 0. 01). CONCLUSION Decreased PLUNC in polyp tissues indicated that impaired innate immunity may account for the pathogenic process of NP. Thus upregulating PLUNC may represent a promising therapeutic target for the management of NP.
Adult ; Case-Control Studies ; Female ; Glycoproteins ; metabolism ; Humans ; Male ; Middle Aged ; Nasal Polyps ; metabolism ; pathology ; surgery ; Phosphoproteins ; metabolism ; Recurrence ; Young Adult

Objective To explore the relationship between obstructive sleep apnea syndrome(OSAS)and the left ventricular diastolic dysfunction.Methods 20 consecutive newly diagnosed middle-aged OSAS patients(OSAS group)with neither controllable factors nor conditions affecting left ventricular diastolic function and 15 healthy control subjects(control group)were examined with echocardiography.Results The OSAS group exhibited left ventricular diastolic dysfunction compared with the control group,including increase of isovolumic relaxation time(P<0.05)and mitral deceleration time(P<0.05),decrease of E/A.There was no difference between tow groups in interventricular systolic thickness,posterior wall thickness,left ventricular systolic diameter,left ventricular diastolic diameter and others.Conclusion OSAS may be related with the left ventricular diastolic dysfunction.

Objective To examine the application value of reticulocyte hemoglobin content (CHr)for diagnosing iron deficiency in premenopausal women.Methods The levels of CHr,hemoglobin (Hb), mean cellular volume(MCV),red cell distribution width (RDW) were measured on the ADVIA 120 (Bayer Diagnostics) automated hematology analyzer.Transferrin saturation (TS) and ferritin (SF) were measured on chemistry analyzer.Results CHr in iron deficiency without anemia group were significantly lower than that in the healthy control group (P＜0.01)and significantly higher than that in iron deficiency anemia group(P＜0.01).CHr in anemia of chronic disease group were significantly higher than that in iron deficiency anemia group(P＜0.01).Receiver operator characteristic curve (ROC) analysis in diagnosis of iron dificiency without anemia demonstrated that the area under the curve for CHr,SF,RDW,MCV,Hb were 0.872,0.798,0.721,0.713,0.677,respectively (P＜0.01).So CHr has a better overall sensitivity than SF,Hb,MCV and RDW in the diagnosis of iron deficiency without anemia.ROC also showed that the area under the curve for Hb,RDW,CHr,SF and MCV was 1.000,0.969,0.958,0.953 and 0.926,respectively (P＜0.01) in iron deficiency anemia.Conclusion CHr is the early and sensitive predictor of iron deficiency in premenopausal women,especially for the diagnosis of iron deficiency without anemia.

Objective To compare the impact of propofol and sevoflurane on thermoregulation in children undergoing orheopaedic surgery.Methods Sixty-eight children scheduled to undergo ortho-paedic surgery were randomly allocated to receive propofol (group P)and sevoflurane(group S)anes-thesia,34 cases in each group.Tympanic temperature was recorded 5 minutes before (T0 )and 5 min (T1 ),1 5 min (T2 ),30 min (T3 ),45 min (T4 ),60 min (T5 ),75 min (T6 ),90 min (T7 ),105 min (T8 )and 120 min (T9 )after anesthesia.Total fluid intake,duration of surgery,duration of anesthe-sia,the incidence of hypothermia,and the incidence of shivering were also recorded.Results Com-pared with T0 ,in both groups body temperature declined at T1-T8 .There was no difference between the two groups in total fluid intake,duration of surgery,duration of anesthesia and the incidence of shivering.Compared with group P,children in group S had a higher incidence of hypothermia(8 vs 1). Children in group S had lower temperature,which had statistical significance at T7 and T8 (P <0.05). Conclusion The core temperature of children undergoing orthopaedic surgery showed a trend of in-crease after the first fall in the surgery.Compared with propofol,sevoflurane anesthesia is more likely to lead to the incidence of hypothermia in children undergoing orthopaedic surgery in 90 min after in-duction of anesthesia.

Objective To sum up the therapeutic experience for pancreatic abscess complicated with severe acute pancretitis (SAP) and to compared the methods of drainage according to its classification , so as to guide the clinical work. Methods Altogether clinical datas of 58 patients with pancreatic abscess were collected in the latest 20 years, pancreatic abscess were divided into 3 groupes according to its size,locationa and figure.Four methods of drainage including open operation drainaging,percutaneous puncture drainaging, small incision drainaging at lower location but not into peritoneal cavity and “F” tube drainaging were adopted.Results 29 cases drainaged by open operation ,among them 10 adopted second look operation and 4 cases third look operation 5 died of the severious complications such as overwelming blooding and intestinal fistula;10 cases through percutaneous puncture drainage ,6 cases cured and the rest converting to open operation and then cured ; 12 cases by small incision through lower location but not into peritoneal cavity ,all cured.Conclusions The results sugggest the effects of drainge related directly to the choose of methods of drainage for pancreatic abscess complicated with SAP,pancreatic classification and to choose an appropriate way according the aforementioned standard will benefit clincial work.

Objective The levels of Thl cytokines(IL-10 and IL-13)and Th2 cytokines(INF-? and TNF-?)were determined in the sera of patients with Schistosomiasis japonica in order to find the relationship between cytokines and severe hepatic fibrosis(HF)in schistosomiasis.Methods A total of 358 patients with advanced Schistosomiasis japonica were examined by ultrasound.68 HBsAg negative patients were chosen randomly as experimental control.Among them,39 patients were found to have mild HF and 29 were severe HF.The sera levels of Thl and Th2 cytokines were determined with ELISA.Results Among these 358 patients,83(23.2%)were HBsAg positive.Neither earlier nor severer hepatic fibrosis was noted in the patients who had been simultaneously infected with HBV than those only infected with schistosomiasis. There was a significant difference between mild[ 1.60(1.30-12.14)ng/L]and severe[ 4.20(1.43- 52.07)ng/L]HF patients in the level of IL-10(Z=-3.907,P0.05)was found in level of IFN-?,between severe[3.12(1.38-66.14)ng/L]and mild[5.87(1.33-216.33)ng/ L]HF subjects.Our observation did not reveal any obvious difference of TNF-? between severe[ 2.48(0.79 -19.86)ng/L]and mild[ 2.28(0.67-15.72)ng/L]HF groups.Conclusions Patients infected with advanced shistosomiasis may become more susceptible to HBV.The results of the present investigation showed that a high level production of IL-13 was associated with severe HF.

Objective To evaluate the risk of plague occurrence via surveying and analyzing indoor rat density and flea index in natural villages having previous plague experience. Methods During August to September 2007, 30 natural villages experiencing previous plague were selected based on the surveillance data, and then all households were coded with numbers and 20 households in each village were randomly selected via computer. Cages and sticky papers were set in 600 selected households to capture rats and fleas. Rat density, flea prevalence, flea index and median were estimated. Results One hundred thirty-three Rattus flavipectus and 33 Suncus murinus were caught and averaged rat density was 2.8 rats per one hundred cage. nights (166/6000), the median was 5 rats each village. One hundred and one mice infected fleas, flea prevalence on rats was 60.8% (101/166), 296 Xenopsylla cheopis and 48 Leptopsylla segnis were collected. Rat flea index was 2.1 fleas per rat (344/166). A total of 315 dissociated flea was caught, average dissociated flea index was 0.026 fleas per sticky paper (315/11888). The median was 5.5 dissociated fleas per village. Of dissociated fleas, Ctenocephalides felis felis (205) and Xenopsylla cheopis (103) accounted for 97.8% (308/315). The proportion for species of the rat flea and the dissociated flea was different(Fisher test: P < 0.01). The rat flea was significantly associated with the rat density(r = 0.68, P < 0.01), but the dissociated flea was significantly associated with neither the rat density(r = -yield than fried wheat batter(χ2 = 5.59, P < 0.05). Conclusions In these villages having previous plague experience of Lianghe County, Rattusflavipectus was dominant species of indoor rats, Xenopsylla cheopis and Ctenocephalides felis felis were dominant species of rat flea and dissociated flea, respectively. Mengsong, Bangdu, and Tangjiatun village had potential risk of plague emergence.

To evaluate the role of murine fibrinogen like protein 2 (mfgl2) /fibroleukin in lung impairment in Severe acute respiratory syndrome (SARS), a murine SARS model induced by Murine hepatitis virus strain 3 (MHV-3) through trachea was established. Impressively, all the animals developed interstitial pneumonia with extensive hyaline membranes formation within alveoli, and presence of micro-vascular thrombosis in the pulmonary vessels. MHV-3 nucleocapsid gene transcripts were identified in multiple organs including lungs, spleen etc. As a representative proinflammatory gene, mfgl2 prothrombinase expression was evident in terminal and respiratory bronchioles, alveolar epithelia and infiltrated cells in the lungs associated with fibrin deposition and micro-vascular thrombosis. In summary, the established murine SARS model could mimic the pathologic characteristics of lungs in patients with SARS. Besides the physical damages due to virus replication in organs, the up-regulation of novel gene mfgl2 in lungs may play a vital role in the development of SARS associated lung damage.