Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To apply short message service (SMS) for pulmonary rehabilitation in residence. Methods A total of 102 old pa-tients with chronic obstructive pulmonary disease (COPD) in stable situation were equally divided into three groups randomly. They all ac-cepted a two-week lesson of exercise project, and then took in the project for 22 weeks. Meanwhile, group A phoned to their experts once a week, group B was phoned by their experts once a week, and group C accepted SMS once a day and sent back to the experts. They were in-vestigated with Exercise Self Regulatory Efficacy Scale (Ex-SERS), modified British Medical Research Council Scale (mMRC) and COPD Assessment Test (CAT) before and after intervention. Results The score of Ex-SERS was the most in group C (F=179.53, P<0.001), with the interaction of time (F=387.09, P<0.001). While the scores of mMRC (F=8.754, P<0.001) and CAT (F=11.32, P<0.001) were the least in group C. Conclusion Application of SMS in the integrated management for pulmonary rehabilitation in residence may improve the self regu-latory efficacy of exercise, release the dyspnea and the influence on living in patients with COPD.

OBJECTIVEThis study aims to evaluate the bond strength of a self-adhesive resin cement to dentin by ethylene diamine tetraacetic acid (EDTA) and NaClO.

METHODSTwenty-seven freshly extracted non-carious human premolars were prepared to expose the buccal dentin and randomly divided into three groups: control group (A group), EDTA group (B group) and NaClO group (C group). All teeth were bonded to dentin using a self-adhesive resin cement after the teeth in the A group were processed with distilled water. The B and C group were processed with 3%EDTA and 1%NaClO, respectively. After 24 hours at 37 °C water, the shear bond strengths of the twenty-four specimens were measured. All statistical analysis was performed using SPSS 17.0 software package. Each fractured specimen was examined under dental microscope. Three new specimens were cut, and the morphologies of the cement-dentin interface were observed under scanning electron microscope (SEM).

RESULTSThe shear bond strength in the A group, B group and C group was (8.55±0.63), (8.47±0.56) and (12.97± 0.59) MPa, respectively. The difference between A group and B group was no statistically significant (P>0.05), whereas the difference between C group and B group (or A group) was statistically significant (P<0.05). SEM observation of the cement-dentin interface in the C group showed good adaptation, but resin tags were not observed. The other two groups showed poor bonding interface. Most of the fractured adhesive dentin surfaces exhibited cohesive failure in the A group and B group. All the fractured adhesive dentin surfaces exhibited cohesive failure in the C group.

CONCLUSION1% NaClO can increase the bond strength of self-adhesive resin cement to dentin, but 3%EDTA has no effect.

Adhesives ; Dental Bonding ; Dental Stress Analysis ; Dentin ; chemistry ; Dentin-Bonding Agents ; Detergents ; chemistry ; Humans ; Resin Cements

Objective To explore the risk and treatment of laparoscopic cholecystectomy(LC) in patients with liver cirrhosis and cholelithiasis.Methods To summarize the clinical data of 28 patients with liver cirrhosis and cholelithiasis.The patients were repeated right upper quadrant pain,including 4 cases of gallbladder neck stones incarcerated,gallbladder effusion.Among them,there were 20 cases of hepatitis B cirrhosis,5 cases of schistosomiasis cirrhosis,3 cases of alcohol.Results There were 6 patients with hemorrhage during operation.Among them,5 patients were treated with gelatin sponge,hemostatic gauze and bio-glue spray to stop bleeding,1 case was transferred to open surgery because of bleeding.The remaining 27 cases of LC were successful.Complications occurred in 8 patients,3 cases of increased liver function abnormalities,1 case of upper gastrointestinal bleeding,1 case of mild hepatic encephalopathy,2 cases of significant ascites formation,1 patient underwent subtotal resection of the gallbladder with Hartmanns bag,and bile was found in the ascites after surgery,but the bile disappeared after five days.All patients with complications after symptomatic treatment were cured,no death,no major bleeding and liver failure,bile duct injury,severe biliary fistula and other serious complications.Conclusion Although the risk of LC in patients with liver cirrhosis is higher than that in the general population,with the help of current high-tech surgical instruments,we can safely accomplish this with an improved surgical procedure.As these patients require high technical requirements of surgery,surgeons must have a wealth of experience and familiar laparoscopic liver and gallbladder anatomy.

Objective To evaluate the clinical significance of the diameter of the esophageal hiatus on multislice spiral CT(MSCT)and to present the MSCT manifestations of esophageal hiatus hernia (EHH).Methods(1)The distance between diaphragmatic crura(DDC),which indicated the diameter of esophageal hiatus,was measured in 140 normal adult patients on their thoracic and/or abdomenal CT images.(2)The DDC of 56 patients with EHH diagnosed by barium examination was measured on MSCT, and the MSCT findings were analyzed retrospectively.Results(1)The DDC of 140 normal adult cases were(13.44?4.41)mm on average and increased with age.The mean DDCs of patients under the age of 59 year-old(80 cases)and over 60-year-old(60 cases)were 11.03?2.10 mm and 16.67?4.64 mm respective]y,there was a significant difference(t=8.762,P

Humans ; Laryngoscopy ; Larynx ; Magnetic Resonance Imaging ; Tomography Scanners, X-Ray Computed ; Tuberculosis, Laryngeal ; diagnosis

Traditional Chinese medicine (TCM) is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer (NSCLC) are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM. Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC.

AIM:To observe the effects of nobiletin on palmic acid (PA)-induced lipidosis in hepatocytes and to discuss the regulatory mechanism of lncLSTR. METHODS:AML12 cells were cultured in vitro. The control group, PA group (0.2 mmol/L) and protection group (exposure to nobiletin at 1 mg/L, 5 mg/L, 15 mg/L or 50 mg/L for 2 h, fol-lowed by treatment with 0.2 mmol/L PA) were established according to the experimental requirements. The lipid accumula-tion was morphologically observed by Oil red O staining in the cells. The qPCR was applied to detect mRNA expression, and the protein expression was determined by and Western blot. RESULTS:PA treatment (0.2 mmol/L) induced lipidosis, while 50 mg/L nobiletin pretreatment suppressed the lipidosis. Compared with control group, the mRNA expression of Apoc2 in PA group was significantly down-regulated (P<0.05), but increased by nobiletin pretreatment compared with PA group (P<0.05). The protein expression of Apoc2 in PA group was significantly down-regulated (P<0.05), but increased by nobiletin pretreatment (P<0.05). The expression of lncLSTR in PA group was significantly increased (P<0.05) and that was inhibited by nobiletin pretreatment (P<0.05). A negative correlation between Apoc2 protein and lncLSTR expression in PA group (R2=0.717 9, P<0.01) was observed. A negative correlation between Apoc2 protein and lncLSTR expression in protection group (R2=0.525 3, P<0.05) was also found. CONCLUSION:Nobiletin has anti-lipidosis effect on hepa-tocytes. The mechanism is partially related to the inhibition of up-regulation of lncLSTR, thus down-regulating Apoc2 expres-sion.

BACKGROUNDCircumferential pulmonary vein isolation (CPVI), as the basal ablation strategy for treating atrial fibrillation (AF), not only isolates the connection between the left atrium (LA) and the pulmonary veins (PVs), but also induces extensive atrial endocardia damage. This could have an effect on the sinus pulse conduction in the LA and subsequently result in changes of P-wave characteristics of surface electrocardiogram (ECG).

METHODSFifty consecutive patients underwent CPVI for symptomatic drug-refractory paroxysmal AF. The 12-lead ECGs were recorded one day before CPVI and seven days after CPVI at sinus rhythm by a standard resting ECG device. Measured characteristics of the P-wave consisted of P-wave duration (PWD), P-wave amplitude (PWA), P-wave polarity (PWP), P-wave notch, P-wave dispersion and P-wave index.

RESULTSAfter CPVI, a prevalent decrease of PWD, PWA, and P-wave dispersion was observed; a transition of P-wave polarity was observed in the leads of III, aVL and aVF. The rate of P-wave notch decreased significantly in all leads, especially in the leads of II, III, aVF and V3. Patients with sinus rhythm had a shorter P-wave dispersion and P-wave index and had a lower rate of P-wave notch compared with the patients with recurrent atrial tachyarrhythmia.

CONCLUSIONObservations from using the surface ECG showed that CPVI has instant effects on the electrical conduction in the LA, and several changes of P-wave characteristics associated with development of AF are improved by CPVI.

Aged ; Atrial Fibrillation ; physiopathology ; surgery ; Catheter Ablation ; methods ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery

Objective To characterize the resistance mechanisms of a clinical Shigella sonnei strain harboring blaCTX-M-55 .Methods A double-disk synergy test was conducted to detect ESBL.Antibiotic resistance genes were determined by PCR followed by amplicon sequencing.Conjugation experiments were performed to verify the transferability of the plasmids carrying ESBL genes.The minimum inhibitory concentration values were tested using VITEK 2.The transposition unit was confirmed by DNA sequencer,and the transcriptional start site was identified using primer extension assay.Results Strain #1083 produced CTX-M-55,which was encoded by plasmid p1083-CTXM that could be transferred into E.coli through conjugation experiments to confer corresponding antibiotic resistance to the transconjugant #1083-EC600.The transposition unit mediating the transfer of blaCTX-M-55 was ISEcp1-blaCTX-M-55 -Δorf477.ISEcp1 offered strong promoter regions for the resistance genes,facilitating their expressions.Besides,the expressions were constant,not induced by antibiotics.Conclusion BlaCTX-M-55 on plasmids is the major resistance genes for strain #1083.Their expressions and spread are mediated by the insertion sequence ISEcp1.